Mining Clinical Notes for Physical Rehabilitation Exercise Information: Natural Language Processing Algorithm Development and Validation Study.

BACKGROUND: The rehabilitation of a patient who had a stroke requires precise, personalized treatment plans. Natural language processing (NLP) offers the potential to extract valuable exercise information from clinical notes, aiding in the development of more effective rehabilitation strategies. OBJECTIVE: This study aims to develop and evaluate a variety of NLP algorithms to extract and categorize physical rehabilitation exercise information from the clinical notes of patients who had a stroke treated at the University of Pittsburgh Medical Center. METHODS: A cohort of 13,605 patients diagnosed with stroke was identified, and their clinical notes containing rehabilitation therapy notes were retrieved. A comprehensive clinical ontology was created to represent various aspects of physical rehabilitation exercises. State-of-the-art NLP algorithms were then developed and compared, including rule-based, machine learning-based algorithms (support vector machine, logistic regression, gradient boosting, and AdaBoost) and large language model (LLM)-based algorithms (ChatGPT [OpenAI]). The study focused on key performance metrics, particularly F1-scores, to evaluate algorithm effectiveness. RESULTS: The analysis was conducted on a data set comprising 23,724 notes with detailed demographic and clinical characteristics. The rule-based NLP algorithm demonstrated superior performance in most areas, particularly in detecting the "Right Side" location with an F1-score of 0.975, outperforming gradient boosting by 0.063. Gradient boosting excelled in "Lower Extremity" location detection (F1-score: 0.978), surpassing rule-based NLP by 0.023. It also showed notable performance in the "Passive Range of Motion" detection with an F1-score of 0.970, a 0.032 improvement over rule-based NLP. The rule-based algorithm efficiently handled "Duration," "Sets," and "Reps" with F1-scores up to 0.65. LLM-based NLP, particularly ChatGPT with few-shot prompts, achieved high recall but generally lower precision and F1-scores. However, it notably excelled in "Backward Plane" motion detection, achieving an F1-score of 0.846, surpassing the rule-based algorithm's 0.720. CONCLUSIONS: The study successfully developed and evaluated multiple NLP algorithms, revealing the strengths and weaknesses of each in extracting physical rehabilitation exercise information from clinical notes. The detailed ontology and the robust performance of the rule-based and gradient boosting algorithms demonstrate significant potential for enhancing precision rehabilitation. These findings contribute to the ongoing efforts to integrate advanced NLP techniques into health care, moving toward predictive models that can recommend personalized rehabilitation treatments for optimal patient outcomes.

What is the role of physical exercise in the era of cancer prehabilitation? A systematic review.

PURPOSE: Exercise before surgery, as part of prehabilitation, aiming to enhance patients' functional and physiological capacity, has become widespread, necessitating an in-depth understanding. METHODS: A systematic search was conducted on Pubmed, Cochrane, and Scopus to examine the effect of exercise as prehabilitation, alone or in combination with other interventions, in patients with cancer. Interventional studies applying a single-arm, randomized controlled, or nonrandomized design were included. RESULTS: A total of 96 studies were included, and categorized according to cancer types, i.e., gynecological, breast, urological, gastrointestinal and lung cancer. For each cancer site, the effect of exercise, on physical fitness parameters and postoperative outcomes, including length of hospital stay and postoperative complications, was reported. CONCLUSION: Exercise as prehabilitation may have an important role in improving physical fitness, postoperative outcomes, and accelerating recovery, especially in certain types of malignancies.

'Prediabetes' as a practical distinctive window for workable fruitful wonders: Prevention and progression alert as advanced professionalism.

Diabetes is a devastating public health problem. Prediabetes is an intermediate stage in the disease processes leading to diabetes, including types 1 and 2 diabetes. In the article "Prediabetes in children and adolescents: An updated review," the authors presented current evidence. We simplify and systematically clearly present the evidence and rationale for a conceptual framework we term the '3ASs': (1) Awareness Sensible; (2) Algorithm Simple; and (3) Appealing Strategies. Policy makers and the public need to be alerted. The prevalence of prediabetes should send alarm bells ringing for parents, individuals, clinicians, and policy makers. Prediabetes is defined by the following criteria: impaired fasting glucose (100-125 mg/dL); impaired glucose tolerance (2 h postprandial glucose 140-199 mg/dL); or hemoglobin A1c values of 5.7%-6.4%. Any of the above positive test alerts for intervention. Clinical guidelines do not recommend prioritizing one test over the others for evaluation. Decisions should be made on the strengths and shortfalls of each test. Patient preferences and test accessibility should be taken into consideration. An algorithm based on age, physiological stage, health status, and risk factors is provided. Primordial prevention targeting populations aims to eliminate risk factors through public education and encouraging practices through environmental modifications. Access to healthy foods is provided. Primary prevention is for individuals with a prediabetes diagnosis and involves a structured program to reduce body weight and increase physical activity along with a healthy diet. An overall methodical move to a healthy lifestyle for lifelong health is urgently needed. Early energetic prediabetes action is necessary.

Associations between regular physical exercise and physical, emotional, and cognitive health of older adults in China: an 8-year longitudinal study with propensity score matching.

Background: The importance of healthy aging is growing in China as it has the largest number of older adults in the world and is one of the fastest-aging countries. This study aimed to examine the predictive value of regular physical exercise in relation to the physical, emotional, and cognitive health among samples of adults aged ≥60 years in China during an 8-year period. Methods: A total of 10,691 older adults were extracted from two waves of national data from the China Family Panel Studies in 2010 and 2018. To minimize the impact of selection bias on the findings, a longitudinal propensity score matching (LPSM) method was used to examine the relationships between regular physical exercise and emotional health (depression), between regular physical exercise and physical health (instrumental activities of daily living), and between regular physical exercise and cognitive health (cognitive ability) of older adults. After LPSM, 856 older adults were included in the study. In the regular physical exercise group, the average age of participants at baseline year was 65.67 years, with an average age of 65.90 years for 238 men and 65.45 years for 190 women, and in the non-physical exercise group, their average age at baseline year was 65.70 years, with an average age of 65.45 years for 253 men and 65.98 years for 175 women. Results: LPSM indicated that regular physical exercise has been found to be effective in improving physical function and reducing depressive symptoms in old adults, even after controlling for background differences. However, the sensitivity analysis suggests that the positive association between regular physical exercise and cognitive function may not be sufficiently valid. Conclusion: The findings of this study indicate that engaging in long-term structured and repetitive physical exercise can have a significant positive effect on reducing depressive symptoms and improving the physical function of older adults. As a result, incorporating regular physical exercise into the lifestyle of older adults is recognized as an effective strategy for promoting healthy aging and reducing the strain on public health resources.

Understanding physical exercise among individuals with substance use disorders using an integrated theoretical perspective of the health action process approach and theory of planned behavior.

Introduction: Physical exercise is considered a useful non-pharmacological adjunctive treatment for promoting recovery from substance use disorders (SUD). However, adherence to physical exercise treatments is low, and little is known about what factors are associated with the initiation and maintenance of physical exercise behaviors. The aim of this study was to explore the psychosocial factors underlying these behaviors in individuals with SUD using an integrated theoretical model based on the health action process approach (HAPA) and the theory of planned behavior (TPB). Methods: A total of 1,197 individuals with SUDs (aged 37.20 ± 8.62 years) were recruited from 10 compulsory isolation drug rehabilitation centers in Zhejiang Province via convenience sampling according to a set of inclusion criteria. Self-reported data were collected to assess task self-efficacy (TSE), maintenance self-efficacy (MSE), recovery self-efficacy (RSE), outcome expectations (OE), action planning (AP), coping planning (CP), social support (SS), subjective norms (SN), attitude behavior (AB), behavioral intention (BI), perceived behavioral control (PBC), risk perception (RP), exercise stage, and exercise behavior in this integrated model. ANOVA and structural equation modeling (SEM) were used to evaluate this model. Results: One-way ANOVA revealed that the majority of the moderating variables were significantly different in the exercise phase. Further SEM showed that the model fit the data and revealed several important relationships. TSE, RP, SS, AB, and SN were indirectly associated with physical exercise behavior in individuals with SUD through the BI in the SUD initiation stage. In addition, PBC was directly related to physical exercise behavior in individuals with SUD. In the maintenance stage, MSE, AP, CP and exercise behavior were significantly related. Moreover, AP and CP were mediators of BI and MSE. Conclusion: This study is the first attempt to integrate patterns of physical exercise behavior in individuals with SUD. The HAPA-TPB integration model provides a useful framework for identifying determinants of physical exercise behavioral intentions and behaviors in individuals with SUD and for explaining and predicting the initiation and maintenance of physical exercise behaviors in these individuals. Moreover, the model provides scientific guidance for the enhancement of physical exercise adherence in individuals with SUD.

Effects of Physical Activity on Cognition, Behavior, and Motor Skills in Youth with Autism Spectrum Disorder: A Systematic Review of Intervention Studies.

The aim of this paper was to analyze the acute and chronic effects of physical activity (PA) on cognition, behavior, and motor skill in youth with autism spectrum disorder (ASD), taking into account potential confounders. In addition, it was intended to elaborate a guide of educational applications with strategies for PA use. Studies were identified in four databases from January 2010 to June 2023. A total of 19 interventional studies met the inclusion criteria. PA programs ranged from two weeks to one year in duration, with a frequency of one to five sessions per week. More than 58% of the studies showed positive effects of PA on cognition, and 45.5% on behavior and motor skill. Moderate-vigorous PA for 15-30 min has shown acute effects on cognition, general behavior, and stereotypic/repetitive behaviors in youth with ASD. A total of 9 out of 14 studies showed chronic effects on general behavior and stereotypic behaviors, and only 6 on motor skills.

Japan-Multimodal Intervention Trial for the Prevention of Dementia: A randomized controlled trial.

INTRODUCTION: We examined the efficacy of a multidomain intervention in preventing cognitive decline among Japanese older adults with mild cognitive impairment (MCI). METHODS: Participants aged 65-85 years with MCI were randomized into intervention (management of vascular risk factors, exercise, nutritional counseling, and cognitive training) and control groups. The primary outcome was changes in the cognitive composite score over a period of 18 months. RESULTS: Of 531 participants, 406 completed the trial. The between-group difference in composite score changes was 0.047 (95% CI: -0.029 to 0.124). Secondary analyses indicated positive impacts of interventions on several secondary health outcomes. The interventions appeared to be particularly effective for individuals with high attendance during exercise sessions and those with the apolipoprotein E ε4 allele and elevated plasma glial fibrillary acidic protein levels. DISCUSSION: The multidomain intervention showed no efficacy in preventing cognitive decline. Further research on more efficient strategies and suitable target populations is required. HIGHLIGHTS: This trial evaluated the efficacy of multidomain intervention in individuals with MCI. The trial did not show a significant difference in preplanned cognitive outcomes. Interventions had positive effects on a wide range of secondary health outcomes. Those with adequate adherence or high risk of dementia benefited from interventions.

Cardiorespiratory fitness mediates the relationship between depressive symptomatology and cognition in older but not younger adults.

Aging is commonly associated with emotional, physical, and cognitive changes, with the latter, particularly affecting executive functioning. Further, such changes may interact. For instance, depressive symptomatology is a known risk factor for developing cognitive deficits, especially at older ages. In contrast, an active lifestyle, reflected in high cardiorespiratory fitness (CRF) levels, has proven to protect against adverse effects on cognition across the adult lifespan. Hence, this study aimed to investigate the relationships between depressive symptomatology, CRF, and cognition during critical developmental stages, namely in young adults (YA), when cognitive abilities are at their peak, and in older adults (OA), when they may start to decline. Eighty-one OA with ages between 60 and 89 years (M = 70.46; SD = 7.18) and 77 YA with ages between 18 and 34 years (M = 22.54; SD = 3.72) went through (i) a sociodemographic interview, (ii) an emotional assessment, (iii) a battery of cognitive tests, and (iv) a physical evaluation assessing CRF levels, visceral fat and body-mass index. Results showed that OA exhibited lower general cognitive performance, inhibitory control, cognitive flexibility, memory, and CRF. Depressive symptoms and anxiety were not different among groups, with CRF mediating the relationship between depressive symptoms and cognition in the OA group. The present study provides valuable insights into the interplay between emotional, physical, and cognitive well-being. Additionally, it calls attention to how lifestyle factors can play a protective role against the adverse effects that depressive symptoms have on cognition, particularly at older ages.

Bridging the relationship between physical exercise and mental health in adolescents based on network analysis.

Although physical exercise has been recommended as a useful means of enhancing the mental health of adolescents, the exact mechanisms through which physical exercise plays a role are unclear. Both physical exercise and mental health are complex concepts with multiple facets, and traditional methods may constrain the manifestations of their mapping relationships. This research aimed to find the bridging connections between physical exercise and mental health. Mental health and physical exercise behaviors were assessed using the Symptom Checklist 90 (SCL-90) and the Adolescent Physical Activity Questionnaire (PAQ-A) in 9072 Chinese adolescents, respectively. Network analysis was utilized to construct the mental health-physical exercise network and to analyze the relationships between individual physical exercise behaviors and mental health symptoms. Core and bridging nodes were identified based on expected influence (EI) and bridge expected influence (BEI). Gender differences were also examined. The results revealed specific and distinct pathways between physical exercise and mental health (e.g., winter sports-obsessive-compulsive symptoms, winter sports-phobia). For both males and females, anxiety, depression, interpersonal sensitivity, ball sports, and evening activity were the most central symptoms/behaviors, reflecting their relative significance in their respective associations. The nodes with the highest BEI were obsessive-compulsive symptoms and physical education, showing negative associations with nodes in the other community. Furthermore, in the male group, somatization and winter sports stood out as the most positive bridge nodes. Conversely, in the female group, interpersonal sensitivity and sports games were the most positive bridge nodes. These findings illuminate the pathways linking physical exercise and mental health, supporting the implementation of physical exercise in a more elaborate way.

Bright light therapy versus physical exercise to prevent co-occurring depression in adolescents and young adults with attention-deficit/hyperactivity disorder: a multicentre, three-arm, randomised controlled, pilot phase-IIa trial.

Depression is common in attention-deficit/hyperactivity disorder (ADHD), but preventive behavioural interventions are lacking. This randomised controlled, pilot phase-IIa trial aimed to study a physical exercise intervention (EI) and bright light therapy (BLT)-both implemented and monitored in an individual, naturalistic setting via a mobile health (m-health) system-for feasibility of trial design and interventions, and to estimate their effects on depressive symptoms in young people with ADHD. Two hundred seven participants aged 14-45 years were randomised to 10-week add-on intervention of either BLT (10,000 lx; daily 30-min sessions) (n = 70), EI (aerobic and muscle-strengthening activities 3 days/ week) (n = 69), or treatment-as-usual (TAU) (n = 68), of whom 165 (80%) were retained (BLT: n = 54; EI: n = 52; TAU: n = 59). Intervention adherence (i.e. ≥ 80% completed sessions) was very low for both BLT (n = 13, 22%) and EI (n = 4, 7%). Usability of the m-health system to conduct interventions was limited as indicated by objective and subjective data. Safety was high and comparable between groups. Changes in depressive symptoms (assessed via observer-blind ratings, Inventory of Depressive Symptomatology) between baseline and end of intervention were small (BLT: -0.124 [95% CI: -2.219, 1.971], EI: -2.646 [95% CI: -4.777, -0.515], TAU: -1.428 [95% CI: -3.381, 0.526]) with no group differences [F(2,153) = 1.45, p = 0.2384]. These findings suggest that the m-health approach did not achieve feasibility of EI and BLT in young people with ADHD. Prior to designing efficacy studies, strategies how to achieve high intervention adherence should be specifically investigated in this patient group. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03371810, 13 December 2017.

Effects of Exercise Intervention for the Management of Delirium in Hospitalized Older Adults: A Randomized Clinical Trial.

OBJECTIVE: Delirium is a serious neuropsychiatric syndrome frequently occurring in hospitalized older adults, for which pharmacological treatments have shown limited effectiveness. Multicomponent physical exercise programs have demonstrated functional benefits; however, the impact of exercise on the course of delirium remains unexplored. The aim of this study was to investigate the effect of an individualized, multicomponent exercise intervention on the evolution of delirium and patient outcomes. DESIGN: A single-center, single-blind randomized controlled trial. SETTING AND PARTICIPANTS: Medical inpatients with delirium in an acute geriatric unit of a tertiary public hospital. METHODS: Thirty-six patients (mean age 87 years) were recruited and randomized into 2 groups. The control group received usual care and the intervention group received individualized physical exercise (1 daily session) for 3 consecutive days. Primary endpoints were the duration and severity of delirium (4-AT, Memorial Delirium Assessment Scale) and change in functional status [Barthel Index, Short Physical Performance Battery, Hierarchical Assessment of Balance and Mobility (HABAM), and handgrip strength]. Secondary endpoints included length of stay, falls, and health outcomes at 1- and 3-month follow-up. RESULTS: The intervention group showed more functional improvement at discharge (HABAM, P = .015) and follow-up (Barthel, P = .041; Lawton P = .027). Less cognitive decline was observed at 1 and 3 months (Informant Questionnaire on Cognitive Decline in the Elderly, P = .017). Exercise seemed to reduce delirium duration by 1 day and contribute to delirium resolution at discharge, although findings did not reach statistical significance. No exercise-related adverse events occurred. CONCLUSION AND IMPLICATIONS: Findings suggest that individualized exercise in acutely hospitalized older patients with delirium is safe, may improve delirium course and help preserve post-hospitalization function and cognition.

Randomised controlled trial of lifestyle interventions for abdominal obesity in primary health care.

AIM: Assess effects on waist circumference from diet with or without cereal grains and with or without long-term physical exercise. BACKGROUND: Elevated waist circumference is an indicator of increased abdominal fat storage and is accordingly associated with increased cardiovascular mortality. This is likely due to the association between lifestyle-induced changes in waist circumference and cardiovascular risk factors. Reductions in waist circumference may be facilitated by diet without cereal grains combined with long-term physical exercise. METHODS: Two-year randomised controlled trial with factorial trial design in individuals at increased risk of cardiovascular disease with increased waist circumference. Participants were allocated diet based on current Swedish dietary guidelines with or without cereal grains (baseline diet information supported by monthly group sessions) and with or without physical exercise (pedometers and two initial months of weekly structured exercise followed by written prescription of physical activity) or control group. The primary outcome was the change in waist circumference. FINDINGS: The greatest mean intervention group difference in the change in waist circumference among the 73 participants (47 women and 26 men aged 23-79 years) was at one year between participants allocated a diet without cereal grains and no exercise and participants allocated a diet with cereal grains and no exercise [M = -5.3 cm and -0.9 cm, respectively; mean difference = 4.4 cm, 4.0%, 95% CI (0.0%, 8.0%), P = 0.051, Cohen's d = 0.75]. All group comparisons in the change in waist circumference were non-significant despite the greatest group difference being more than double that estimated in the pre-study power calculation. The non-significance was likely caused by too few participants and a greater than expected variability in the change in waist circumference. The greatest mean intervention group difference strengthens the possibility that dietary exclusion of cereal grains could be related to greater reduction in waist circumference.

Evaluation of pregnant women's knowledge and attitude toward physical exercise during pregnancy at maternity hospitals.

BACKGROUND: There are major health benefits to physical exercise during pregnancy for mothers and newborns. However, physical inactivity during pregnancy varies worldwide, but it is more common during the third trimester of pregnancy. A positive attitude toward antenatal exercise can reduce physical inactivity. OBJECTIVES: This study aimed to evaluate pregnant women's knowledge and attitude toward physical exercise during pregnancy and to find out the relationship between pregnant women's knowledge and attitude. METHODS: This is a descriptive study utilizing a non-probability purposive sample of 200 women. The data were collected by distributing a structured, self-administered questionnaire. The questionnaire comprised 37 questions for knowledge and 15 questions for attitude. This study was conducted from October 2021 to November 2022. RESULTS: The higher percentage of women's age was 20-24 years, and 30% graduated from primary school. Nearly two-thirds of them were in the second trimester. More than one-third of them have two to three living children. Nearly two-thirds of women have poor knowledge levels about physical exercise during pregnancy, but most of them have a positive attitude. There is a significant relationship between pregnant women's knowledge and attitude. CONCLUSION: This study indicated that most of the study sample had poor knowledge regarding physical exercise during pregnancy. However, they have a positive attitude toward physical exercise during pregnancy.

Protective role of exercise on breast cancer-related osteoporosis in women undergoing aromatase inhibitors: A narrative review.

Hormone therapy following surgery reduces the risk of breast cancer (BC) recurrence and progression of hormone-sensitive BC, especially in postmenopausal women. Despite the antitumor efficacy of hormone therapy, particularly of aromatase inhibitors, they cause long-term side effects, mainly bone density reduction. Exercise can slow the rate of bone loss, which reduces the risk of fractures from osteoporosis, and could be an integrative treatment able to mitigate the BC treatment side effects positively impacting bone health. This narrative review aims to discuss studies on the effect of exercise on bone health in BC women undergoing aromatase inhibitors, highlighting the possible role of exercise as complementary to conventional therapies. Additionally, according to the literature revision, exercise practical applications to improve bone health in these patients are summarized.

Efficacy of rehabilitation interventions on functioning in patients with hemophilic arthropathy: A systematic review with meta-analysis.

BACKGROUND: Hemophilic arthropathy is a detrimental condition that crucially affects functional outcomes in hemophilic patients. In recent years, due to the advances in systemic therapies, growing attention has been raised in the rehabilitation field in order to improve functional outcomes of hemophilic patients. However, the optimal rehabilitation modalities in these patients are far from being fully characterized. OBJECTIVE: The present study aimed to assess the effects of different rehabilitation interventions on physical functioning and health-related quality of life of hemophilic arthropathic patients. METHODS: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Five databases were systematically searched for randomized controlled trials (RCTs) published until June 22nd, 2023. The selection criteria included adult patients with hemophilia A and B receiving rehabilitation interventions. The outcomes were muscle strength, physical function, pain intensity, physical performance, and health-related quality of life. RESULTS: Out of 1,743 identified records, 17 studies were included in the qualitative synthesis. Rehabilitation interventions were categorized into exercise intervention, fascial therapy, and multimodal intervention. The findings suggested positive outcomes in terms of muscle modifications, range of motion improvements, joint health enhancements, pain intensity reduction, and quality of life improvements. More in detail, meta-analyses showed significant improvements in pain intensity [ES: -1.10 cm (-1.37, -0.82), p< 0.00001], joint health [ES: -1.10 (-1.38, -0.82), p< 0.00001], In accordance, exercise interventions showed significant benefits in terms of joint health [ES: -2.54 (-3.25, -1.83), p< 0.00001)] and quality of life [ES: 1.17 (0.48, 1.86), p< 0.0000)]. CONCLUSION: Rehabilitation interventions have a positive impact on functional outcomes and health-related quality of life of hemophilic arthropathic patients. Further studies are needed to better elucidate the role of a comprehensive intervention combining different rehabilitation approaches to treat hemophilic arthropathy.

FUNCTIONAL STATUS IN PERIPHERAL ARTERIAL DISEASE: REHABILITATED VERSUS NON-REHABILITATED.

OBJECTIVE: to analyze patient perception of functional status related to activity and participation of rehabilitated and non-rehabilitated individuals with PAD. METHODS: Cross-sectional study assessing the activity and participation domain using the Human Activity Profile (HAP) questionnaire and the Participation Scale (P-scale), respectively. Groups were compared using Chi-square test and unpaired t-test. RESULTS: A total of 87 individuals (36 rehabilitated) with 65.28 ± 8.29 years (66.7% male) were included. HAP classified 58.6% of individuals with weak or inactive physical activity level, and approximately half of the sample did not have participation restriction. HAP scores and P-scale (locomotion inside and outside home) were lower in non-rehabilitated than rehabilitated individuals. CONCLUSION: Individuals with PAD presented little participation restriction and a great activity limitation, the last one being more evident among non-rehabilitated.

Physical activity improves the visual-spatial working memory of individuals with mild cognitive impairment or Alzheimer's disease: a systematic review and network meta-analysis.

Objective: Our network meta-analysis aimed to ascertain the effect of physical activity on the visual-spatial working memory of individuals with mild cognitive impairment and Alzheimer's disease as well as to propose tailored exercise interventions for each group. Methods: Employing a frequentist approach, we performed a network meta-analysis to compare the effectiveness of different exercise interventions in improving the visual-spatial working memory of individuals with mild cognitive impairment and Alzheimer's disease. Subsequently, we explored the moderating variables influencing the effectiveness of the exercise interventions through a subgroup analysis. Results: We included 34 articles involving 3,074 participants in the meta-analysis, comprised of 1,537 participants from studies on mild cognitive impairment and 1,537 participants from studies on Alzheimer's disease. The articles included exhibited an average quality score of 6.6 (score studies) and 6.75 (reaction time [RT] studies), all passing the inconsistency test (p > 0.05). In the mild cognitive impairment literature, mind-body exercise emerged as the most effective exercise intervention (SMD = 0.61, 95% CI: 0.07-1.14). In Alzheimer's disease research, aerobic exercise was identified as the optimal exercise intervention (SMD = 0.39, 95% CI: 0.06-0.71). Conclusion: The results of the subgroup analysis suggest that the most effective approach to enhancing the visual-spatial working memory of individuals with mild cognitive impairment entails exercising at a frequency of three or more times per week for over 60 min each time and at a moderate intensity for more than 3 months. Suitable exercise options include mind-body exercise, multicomponent exercise, resistance exercise, and aerobic exercise. For individuals with Alzheimer's disease, we recommend moderately intense exercise twice per week for over 90 min per session and for a duration of 3 months or longer, with exercise options encompassing aerobic exercise and resistance exercise.

Physical exercise and cognition in older adults, a scientific approach scanty reported in Latin America and Caribbean populations.

The advancement of public services, including the increased accessibility of health services, has led to a rise in life expectancy globally. As a result, aging populations are becoming more prevalent, raising concerns about cognitive decline. Fortunately, non-pharmacological methods, such as physical exercise, have been shown to mitigate the effects of aging on the brain. In this perspective article, we examined meta-analyses on the impact of physical exercise on cognition in older adults. The results indicate that combined exercise (i.e., aerobic plus strength training), has a significant positive effect on overall cognition and executive function. However, we found a lack of scientific studies on this topic in Latin American and Caribbean countries. Therefore, there is a pressing need for research to identify the feasibility of physical exercise interventions to improve cognitive skills in older adults from these regions.

Effects of physical exercise on adolescent short video addiction: A moderated mediation model.

Objective: To discuss the effects of physical exercise (PE) on adolescent short video addiction (SVA) and analyze the mediating effects of self-control (SC) and the moderating effects of the cumulative ecological risk (CER), aiming to provide theoretical support for PE relative to adolescent SVA, investigate the underlying mechanisms of the effects of PE. Methods: The Physical Activity Rating Scale-3, Problematic TikTok Use Scale, Self-Control Scale, and Cumulative Ecological Risk Scale were used to survey 756 adolescents in Chongqing and Chengdu, China. SPSS was used to construct a research model by conducting reliability, confirmatory factor, common method bias, and AMOS analyses. Results: PE was significantly and negatively related to adolescent SVA (ß = -0.30, p < 0.01). SC served as a partial mediator between PE and adolescent SVA, the direct and indirect effect values are -0.304 and -0.167 respectively, showing that SC negatively predicted the relationship between the two variables. The CER moderated the effect of PE (t = -11.679, p < 0.001) and SC (t = -15.069, p < 0.001) on adolescent SVA. Conclusion: PE mitigates and moderates adolescent SVA through the mediating effect of SC and the moderating effect of CER.

Characterization of the gut microbiota and fecal and blood metabolomes under various factors in urban children from Northwest China.

Introduction: Children have regional dynamics in the gut microbiota development trajectory. Hitherto, the features and influencing factors of the gut microbiota and fecal and plasma metabolites in children from Northwest China remain unclear. Methods: Shotgun metagenomic sequencing and untargeted metabolomics were performed on 100 healthy volunteers aged 2-12 years. Results: Age, body mass index (BMI), regular physical exercise (RPE), and delivery mode (DM) significantly affect gut microbiota and metabolites. Lactobacillus, Butyricimonas, Prevotella, Alistipes, and predicted pathway propanoate production were significantly increased with age while Bifidobacterium breve, B. animalis, B. pseudocatenulatum, Streptococcus infantis, and carbohydrate degradation were decreased. Fecal metabolome revealed that the metabolism of caffeine, amino acids, and lipid significantly increased with age while galactose metabolism decreased. Noticeably, BMI was positively associated with pathogens including Erysipelatoclostridium ramosum, Parabacteroides distasonis, Ruminococcus gnavus, and amino acid metabolism but negatively associated with beneficial Akkermansia muciniphila, Alistipes finegoldii, Eubacterium ramulus, and caffeine metabolism. RPE has increased probiotic Faecalibacterium prausnitzii and Anaerostipes hadrus, acetate and lactate production, and major nutrient metabolism in gut and plasma, but decreased pathobiont Bilophila wadsworthia, taurine degradation, and pentose phosphate pathway. Interestingly, DM affects the gut microbiota and metabolites throughout the whole childhood. Bifidobacterium animalis, Lactobacillus mucosae, L. ruminis, primary bile acid, and neomycin biosynthesis were enriched in eutocia, while anti-inflammatory Anaerofustis stercorihominis, Agathobaculum butyriciproducens, Collinsella intestinalis, and pathogenic Streptococcus salivarius, Catabacter hongkongensis, and amino acid metabolism were enriched in Cesarean section children. Discussion: Our results provided theoretical and data foundation for the gut microbiota and metabolites in preadolescent children's growth and development in Northwest China.