Comparative Effect of Two Types of Physical Exercise for the Improvement of Exercise Capacity, Diastolic Function, Endothelial Function and Arterial Stiffness in Participants with Heart Failure with Preserved Ejection Fraction (ExIC-FEp Study): Protocol for a Randomized Controlled Trial.

(1) Background: Heart failure (HF) with preserved ejection fraction (HFpEF) accounts for approximately 50% of all patients with HF. In the absence of pharmacological treatments that have been successful in reducing mortality or morbidity in this pathology, physical exercise is recognized as an important adjunct in the treatment of HF. Therefore, the objective of this study is to compare the efficacy of combined training and high intensity interval training (HIIT) on exercise capacity, diastolic function, endothelial function, and arterial stiffness in participants with HFpEF. (2) Methods: The ExIC-FEp study will be a single-blind, 3-arm, randomized clinical trial (RCT) conducted at the Health and Social Research Center of the University of Castilla-La Mancha. Participants with HFpEF will be randomly assigned (1:1:1) to the combined exercise, HIIT or control group to evaluate the efficacy of physical exercise programs on exercise capacity, diastolic function, endothelial function, and arterial stiffness. All participants will be examined at baseline, at three months and at six months. (3) Results: The findings of this study will be published in a peer-reviewed journal. (4) Conclusions: This RCT will represent a significant advance in the available scientific evidence on the efficacy of physical exercise in the treatment of HFpEF.

The effect of sleep quality on academic performance is mediated by Internet use time: DADOS study / O efeito da qualidade do sono no desempenho acadêmico é mediado pelo tempo de uso da internet: estudo DADOS

Abstract Objective: The aims of the present study were to analyze the association of sleep patterns with academic and cognitive performance in adolescents, and to test the potential mediating effect of different activities of screen media usage on this association. Methods: A sample of 269 adolescents (140 boys) aged 14 years from the baseline data of the Deporte, ADOlescencia y Salud study completed questionnaires about sleep quality, cognitive performance, and leisure-time sedentary behaviors. Sleep duration was objectively computed using a wrist-worn GENEActiv accelerometer and academic performance was analyzed through school records. Results: Sleep quality (but not sleep duration) was associated with all the academic performance indicators (all p < 0.05). Analysis of covariance revealed higher grades among adolescents with better sleep quality (PSQI ≤ 5; all p < 0.05). These analyses showed no differences regarding cognitive performance. Internet use time was revealed as a mediator of the association between sleep quality and academic performance, being significant for all academic performance indicators (PM ranging from 15.5% to 16.0%). Conclusions: The association between sleep quality and academic performance in adolescents is mediated by time of Internet use. Overall, reducing Internet use in adolescents could be an achievable intervention for improving sleep quality, with potentially positive effects on academic performance.

Resumo Objetivo: Analisar a associação dos padrões de sono com o desempenho acadêmico e cognitivo em adolescentes e testar o efeito mediador potencial de diferentes atividades com uso de dispositivos (mídias) com tela nessa associação. Métodos: Uma amostra de 269 adolescentes (140 meninos) de 14 anos, da linha de base do estudo DADOS (Deporte, ADOlescencia y Salud) preencheu uma série de questionários sobre qualidade do sono, desempenho cognitivo e comportamentos sedentários no lazer. A duração do sono foi calculada objetivamente com um acelerômetro de pulso GENEActiv e o desempenho acadêmico foi analisado por meio de registros escolares. Resultados: A qualidade do sono (mas não a duração do sono) foi associada a todos os indicadores de desempenho acadêmico (todos os valores de p < 0,05). A análise de covariância revelou notas mais altas nos adolescentes com melhor qualidade de sono (PSQI ≤ 5; todos os valores de p < 0,05). Essas análises não mostraram diferenças em relação ao desempenho cognitivo. O tempo de uso da Internet revelou-se como um mediador da associação entre qualidade do sono e desempenho acadêmico, foi significativo para todos os indicadores de desempenho acadêmico (PM variou de 15,5% a 16,0%). Conclusões: A associação entre qualidade do sono e desempenho acadêmico em adolescentes é mediada pelo tempo de uso da internet. No geral, reduzir o tempo de uso da internet pelos adolescentes pode ser uma intervenção viável para melhorar a qualidade do sono, com efeitos potencialmente positivos no desempenho acadêmico.

The effect of sleep quality on academic performance is mediated by Internet use time: DADOS study.

OBJECTIVE: The aims of the present study were to analyze the association of sleep patterns with academic and cognitive performance in adolescents, and to test the potential mediating effect of different activities of screen media usage on this association. METHODS: A sample of 269 adolescents (140 boys) aged 14 years from the baseline data of the Deporte, ADOlescencia y Salud study completed questionnaires about sleep quality, cognitive performance, and leisure-time sedentary behaviors. Sleep duration was objectively computed using a wrist-worn GENEActiv accelerometer and academic performance was analyzed through school records. RESULTS: Sleep quality (but not sleep duration) was associated with all the academic performance indicators (all p<0.05). Analysis of covariance revealed higher grades among adolescents with better sleep quality (PSQI≤5; all p<0.05). These analyses showed no differences regarding cognitive performance. Internet use time was revealed as a mediator of the association between sleep quality and academic performance, being significant for all academic performance indicators (PM ranging from 15.5% to 16.0%). CONCLUSIONS: The association between sleep quality and academic performance in adolescents is mediated by time of Internet use. Overall, reducing Internet use in adolescents could be an achievable intervention for improving sleep quality, with potentially positive effects on academic performance.

Abdominal obesity as a mediator of the influence of physical activity on insulin resistance in Spanish adults.

OBJECTIVE: The aim of the study was to analyze the relationship between moderate-to-vigorous physical activity (MVPA) and insulin resistance (IR) in Spanish adults and to examine whether this relationship is mediated by abdominal obesity (waist circumference - WC). METHODS: The cross-sectional study included 1162 healthy subjects belonging to the EVIDENT study (mean age 55.0±13.3years; 61.8% women) from six different Spanish provinces. Moderate-to-vigorous physical activity (MVPA) was measured objectively over 7days using Actigraph accelerometers, collecting data in 60-second epochs, and retaining respondents with ≥4 valid days for the analysis. The homeostasis model of assessment (HOMA-IR) was used to determine IR, and its individual components - fasting glucose and insulin - were determined using standard protocols. Linear regression models were fitted according to Baron and Kenny's procedures for mediation analysis. RESULTS: Fasting insulin and HOMA-IR levels were significantly worse in adults who spent fewer minutes in MVPA (first quartile≤30.1 and 22.7min/day in men and women, respectively) after adjusting for age, sex, smoking habits, drinking habits, accelerometer wear time, sedentary time, and Mediterranean diet adherence. However, when WC was added to the ANCOVA models as a covariate, the effects disappeared. Mediation analysis reported that WC acts as a full mediator in the relationship between MVPA and IR (HOMA-IR and fasting insulin). CONCLUSION: These findings show that WC plays a pivotal role in the relationship between MVPA and IR, and therefore highlights that decreasing abdominal obesity might be considered as an intermediate outcome for evaluating interventions aimed at preventing diabetes mellitus.