Search Results (597)

Background/Objectives: The aim of this study was to investigate the acute effect of isometric and plyometric combined activation prior to the endurance performance assessed with the 30-15 Intermittent Fitness Test (30-15 IFT) and cardiovascular parameters. Methods: In this crossover study the data of 14 elite female soccer players aged 22.1 ± 2.9 years were assessed. The conditioning activity (CA) consisted of three sets of five seconds of maximal mid-thigh pull (IMPT), and peak force was measured, and four countermovement jumps were performed. Contact time, jump height, and reactive strength index (RSI) were assessed. Ninety seconds of rest between the sets was performed. Then, 7 min after the CA, the 30-15 IFT was performed. Results: One-way repeated measures (RM) ANOVA showed that performance during the CA did not decrease; what is more, it improved in RSI (p < 0.01). Further, paired samples t-test showed that the performance in the IFT did not change, whereas training impulse (TRIMP) was increased after CA (p = 0.039, ES = 0.61), thus the Bayesian paired test yielded only anecdotal evidence in favor of the alternative hypothesis (BF₁₀ = 1.92; error = 2%). Conclusions: The improvement in CA suggests potentiation rather than fatigue. However, the unchanged performance alongside a modest TRIMP increase should be interpreted with caution, as TRIMP alone provides a limited assessment of physiological cost. Therefore, while the applied protocol did not enhance endurance performance, further research using multiple physiological markers is needed to clarify its impact on internal load and overall efficacy. Full article

Background: Age is considered an independent cardiovascular disease (CVD) risk factor, but limited data exist concerning the impact of age and years in the fire service on firefighter health and physical performance. Objectives: We assessed the impact of age and years in the fire service on structural firefighter health and physical performance. Methods: 142 firefighters completed an annual clinical assessment. General linear model (GLM) multivariate and univariate analyses were performed across age groups, with years of fire service experience as a covariate. Partial Eta squared (η_p²) values for the GLM statics and Cohen’s d for pairwise comparisons were used to assess effect size. Results: GLM analyses revealed statistically significant differences (p < 0.05) for several demographic, body composition, blood biomarker, and physical performance parameters. Pairwise comparisons revealed that younger firefighters displayed more favorable health and fitness profiles than their older counterparts. Interestingly, when accounting for years of fire service experience, differences for only the following variables remained: body mass index, waist circumference, lean mass, visceral adipose tissue, triglycerides, cardiopulmonary exercise test time-to-exhaustion, and VO₂max. Conclusions: These findings suggest differences in CVD risk biomarkers, physical fitness levels, and body composition metrics across age groups. However, years of fire service experience appears to have a greater impact on these variables, suggesting that firefighters’ time in the fire service may accelerate the effects of aging on these outcomes. While age-specific health interventions are recommended to manage and mitigate CVD risk effectively, there also should be consideration for the years of fire service. Full article

Background: Medical clearance for competitive sports is vital to safeguarding athletes’ health, particularly in high-intensity disciplines like football. In Italy, fitness assessments follow stringent protocols set by the Commissione di Vigilanza per il controllo dell’Idoneità Sportiva (COCIS), with a strong focus on cardiovascular screening. The primary goal is to prevent sudden cardiac death (SCD), a rare but catastrophic event in athletes. Methods: This paper provides an in-depth narrative review of the 2023 COCIS guidelines, examining the cardiological screening process, required diagnostic tests, management of identified cardiovascular conditions, and the protocols’ role in reducing SCD risk. Results: Comparisons with international standards underscore the effectiveness of the Italian approach. Conclusions: The COCIS 2023 guidelines provide clear, evidence-based protocols for cardiovascular risk assessment, significantly enhancing athlete safety and reducing the incidence of SCD in high-intensity sports. Full article

Understanding the utilization patterns of nuclear medicine (NM) services is essential for optimizing resource allocation and service provision. This study aimed to address the regional evidence gap by reporting the demand for NM services by sex and age at a public hospital in Jamaica. This was a non-experimental, retrospective study of NM scans that were completed at the University Hospital of the West Indies from 1 June 2022 to 31 May 2024. While all scans were reported in the descriptive totals, for patients with multiple scans during the study period, only the data from the first visit was used in the inferential statistical analysis. This was performed with the IBM SPSS (version 29.0) software and involved the use of chi-square goodness of fit and multinomial logistic regression. A total of 1135 NM scans for 1098 patients were completed (37 patients had more than one scan); 596 (54.3%) were female and 502 (45.7%) were male, with the ages ranging from 3 days to 94 years old. Among the female patients, there was a greater demand in the ≥60 years age group for cardiac amyloid scans (χ² = 6.40, p < 0.05), while females 18–59 years had a greater demand for thyroid scans (χ² = 7.714, p < 0.05) and bone scans (χ² = 3.904, p < 0.05). On the other hand, significantly more males in the ≥60 age group presented for cardiac amyloid (χ² = 4.167; p < 0.05) and bone scans (χ² = 145.79, p < 0.01). Males were significantly less likely to undergo a thyroid scan than females (p < 0.01, OR = 0.072, 95% CI: 0.021, 0.243) while individuals aged 18–59 years were more likely to undergo this scan than patients aged 60 or older (p = 0.02, OR = 3.565, 95% CI: 1.258, 10.104). Males were more likely to do a cardiac amyloid scan (p < 0.05, OR = 2.237, 95% CI: 1.023, 4.891) but less likely to undergo a cardiac rest/stress test than females (p = 0.02, OR = 0.307, 95% CI: 0.114, 0.828). Prolonged life expectancy and an aging population have the potential to impact NM utilization, thus requiring planning for infrastructure, equipment, work force, and supplies. Cancer-related and cardiovascular indications are a top priority at this facility; hence, age- and sex-specific analysis are useful in establishing models for policy makers with regard to the allocation of economic and human resources for the sustainability of this specialized service. Full article

Plaque erosion (PE) is now recognized as a common and clinically significant cause of acute coronary syndromes (ACSs), accounting for up to 40% of cases. Unlike plaque rupture (PR), PE involves superficial endothelial loss over an intact fibrous cap and occurs in a low-inflammatory setting, typically affecting younger patients, women, and smokers with fewer traditional risk factors. The growing recognition of PE has been driven by high-resolution intracoronary imaging, particularly optical coherence tomography (OCT), which enables in vivo differentiation from PR. Identifying PE with OCT has opened the door to personalized treatment strategies, as explored in recent trials evaluating the safety of deferring stent implantation in selected cases in favor of intensive medical therapy. Given its unexpectedly high prevalence, PE is now recognized as a common pathophysiological mechanism in ACS, rather than a rare exception. This growing awareness underscores the importance of its accurate identification through OCT in clinical practice. Early recognition and a deeper understanding of PE are essential steps toward the implementation of precision medicine, allowing clinicians to move beyond “one-size-fits-all” models toward “mechanism-based” therapeutic strategies. This narrative review aims to offer an integrated overview of PE, tracing its epidemiology, elucidating the molecular and pathophysiological mechanisms involved, outlining its clinical presentations, and placing particular emphasis on diagnostic strategies with OCT, while also discussing emerging therapeutic approaches and future directions for personalized cardiovascular care. Full article

Racket sports are very popular not only in professional sports but also among recreational players. As a result, their impact on the field of education has grown significantly in recent years. Table tennis (TT) offers significant advantages in terms of skill acquisition and health improvement. Nevertheless, its application within physical education (PE) curricula remains undetermined. The aim of this systematic review was to analyze the use of TT as educational content in the subject of PE in primary school. The PRISMA 2020 methodology was used to conduct the systematic review. Six databases (ERIC, Pubmed, ScienceDirect, Scopus, Sport Discus, and Web of Science) were used during the search process. The search cutoff date was December 31, 2024. After applying the eligibility criteria, 3595 articles were found. Only seven studies were selected for the final analysis and the data included 1526 students from primary school. The results indicate that TT is rarely used in primary education during PE classes. Research indicates interest among teachers and students in playing it during PE. Furthermore, due to the benefits, motivation, and interest this sport generates, educational experiences have been developed, such as roundtable discussions, table top tennis, balloon TT, and TT triathlon. A lack of materials, facilities, and teacher training for teaching this sport is notable. The teaching experiences analyzed in this review confirm that TT is a highly versatile and interesting sport as a subject matter in school PE. The use of TT allows for innovative, comprehensive, and inclusive PE, thanks to the sport’s multiple possibilities. Given its adaptability and low entry barrier, TT could serve as an effective tool for increasing children’s physical activity levels, improving motor skills, and fostering social–emotional development. However further research is needed to quantify its impact on health outcomes such as cardiovascular fitness or obesity prevention. Full article

Background/Objectives: Cardiorespiratory fitness (CRF) is of great interest in children and adolescents. Due to the limited availability of cardiopulmonary exercise testing, simple and reliable alternatives are needed. A stair climbing test (SCT) for the assessment of CRF developed at the Department of Pediatric Cardiology of the LMU University Hospital in Munich showed a strong correlation with VO₂max. The aim of this study is to prove its feasibility in a non-clinical setting and to analyse its results in a larger study population. Methods: During the “Hand aufs Herz” study, a comprehensive cardiovascular examination was carried out on 922 pupils and siblings (13.2 ± 7.8 years) at a high school in Bavaria. The SCT was performed to evaluate CRF: participants had to run up and down a total of four floors (14.8 m) as quickly as possible without skipping steps or holding on to the banister. Absolute time has been normalized over the standard height of 12 m to allow comparisons with different settings. An SCT Index was calculated to adjust results to the different weights of participants and the exact height of the staircase. Results: The SCT proved to be easily feasible and safe in non-clinical contexts. Out of 922 participants, 13 (1.4%) were not able to perform the test, and 3 (0.3%) had to interrupt it following fatigue or stumbling. A total of 827 participants aged from 9 to 17 years (13.1 ± 2.1 years, 45.8% girls) had a mean absolute SCT time of 53.4 ± 6.2 s and 43.3 ± 5.1 s when normalized over 12 m. Conclusions: The SCT represents a simple, cost- and time-saving test that allows a rapid and solid assessment of cardiorespiratory fitness in children and adolescents. We could demonstrate that it is safe and feasible in non-clinical contexts. Its short duration and universal applicability are valuable advantages that could facilitate the establishment of a repetitive cardiovascular screening in the pediatric population, particularly in outpatient departments or settings with low-resource systems. Full article

Background: Sports performance indicators are mainly based on male athletes, highlighting the importance of portraying the female reality, particularly in rural contexts. This study aims to characterize sports performance indicators (body composition and physical fitness) of young Portuguese female athletes. Methods: A cross-sectional study was conducted with 124 girls (13.66 ± 1.93 years) participating in federated team sports in a rural region of Portugal. Body composition was assessed using bioelectrical impedance, and physical fitness was evaluated through vertical jump tests (countermovement jump and squat jump), sprint (20 m), agility (T-test), handgrip strength, and cardiovascular endurance (Yo-Yo IR1). Results: Volleyball players are taller; football and basketball players are heavier; football and volleyball players have more fat-free mass than handball players (p < 0.05). Body mass index and % body fat did not differ between sports (p > 0.05). Volleyball players performed better in the countermovement jump (F = 4.146, p = 0.008) and squat jump (F = 7.686, p < 0.001) when compared to basketball, football, and handball players. No differences were observed in the speed or cardiorespiratory endurance tests (p > 0.05). Conclusions: The results revealed that, despite some specific differences between sports, most physical fitness indicators did not differ significantly between sports after controlling for age, menarche, and training experience. These findings suggest that shared contextual limitations in rural regions may take precedence over sport-specific adaptations in the early stages of sports participation. Full article

Mild cognitive impairment (MCI) is the transitional stage between normal cognition and dementia and is associated with arterial stiffness, which may lead to cardiovascular disease. A water-based exercise (W) presents a low-impact activity for the joints and increases resistance compared to exercises performed in the air, which benefits older adults. However, little evidence has been found regarding the effect of W on promoting cognitive and physical performance in older individuals with MCI. Therefore, this study aimed to investigate and compare the post-training effects of W alone and in combination with cognitive training on cognitive function, cardiovascular fitness, and arterial stiffness in older adults with MCI. Forty-six adults with MCI, aged 65 years or older, were enrolled. Participants were divided into two groups: a W group and a water-based exercise combined with cognitive training (W-COG) group. Both groups performed an aerobic exercise program in water for 60 min per/day, 3 day/week, for 12 weeks. Participants in the W-COG group simultaneously performed aerobic exercise and cognitive training in water. Cognitive performance, cardiovascular fitness, and arterial stiffness were examined before and after the intervention. The results revealed improvements in cognitive performance and cardiovascular fitness in both the W and W-COG groups after 12 weeks of intervention. However, there were no significant differences in cognitive and cardiovascular fitness changes between the two groups. Neither the W nor the W-COG groups showed a decrease in brachial pulse wave velocity. Therefore, W interventions have the potential to enhance cognitive function, restore cognition, and improve cardiovascular fitness in older adults with MCI. Full article

Background/Objectives: Loneliness is the sensation of feeling alone or emotionally isolated, even when one is surrounded by other people. It is associated with conditions such as depression, anxiety, harmful habits, and cardiovascular problems. The main objective of the present study was to develop and determine the psychometric properties of the Multidimensional Loneliness Scale (MLS), which is a self-report instrument. Methods: The present study is instrumental in nature, as it aims to analyze the psychometric properties of a new assessment instrument. A total of 484 adults, both men and women, aged between 18 and 55 years, participated in this research. Results: Exploratory factor analysis revealed the presence of four dimensions: social disconnection, family estrangement, loss of attachment figure, and intrapersonal emptiness. Confirmatory factor analysis demonstrated that the four-dimensional model exhibited a good fit (CFI = 0.91; RMSEA = 0.07; SRMR = 0.07; AIC = 737.87). The concurrent validity was evidenced by significant correlations with the De Jong Gierveld scale and the Revised UCLA Loneliness Scale. The reliability analysis demonstrated satisfactory internal consistency, with omega coefficients ranging from 0.84 to 0.92 and alpha coefficients from 0.84 to 0.93. Conclusions: The MLS is a self-report instrument designed to assess loneliness, and it has satisfactory psychometric properties. Full article

Background: Well-designed endurance training leads to improved cardiovascular fitness and sports performance in prolonged exercise tasks, with the adaptations depending on multiple factors, including the training modality and the population in question. It is still disputable how the type of training affects myocardial remodeling, and the information on myocardial remodeling by high-intensity interval training (HIIT) is particularly scarce. Methods: The current study investigated changes in cardiac structure after volume-progressive HIIT in running mode. As part of their conditioning program, amateur athletes (mean ± SD age of 18.2 ± 1.0 years) exclusively conducted HIIT in a volume-progressive fashion over 7 weeks (a total of 21 sessions). Peak oxygen uptake as well as 200 m and 2000 m running performance were measured, and transthoracic two-dimensional echocardiography was conducted before and after the intervention. Results: Training improved running performance, increased the peak oxygen uptake and left atrium diameter (from 32.0 ± 2.5 to 33.5 ± 2.3 mm; p = 0.01), and induced ~11% thickening of the left-ventricular posterior wall (7.5 ± 0.7 to 8.2 ± 0.4 mm; p = 0.01) and interventricular septum (7.6 ± 0.7 to 8.6 ± 0.9 mm; p = 0.02), but not the dilation of left-ventricular, right-ventricular, or right atrium chambers. Conclusions: HIIT of just 127 km of running per 8.5 h during 7 weeks was sufficient to improve aerobic capacity and running performance, and induce left-ventricular wall hypertrophy and left atrium dilation, in young healthy athletes. Full article

Background: The early repolarization pattern (ERP) on electrocardiography (ECG) has been associated with an increased risk of ventricular arrhythmias in susceptible individuals. This study aimed to evaluate the impact of exercise on echocardiographic parameters to explore the potential influence of ERP on hemodynamic response. Methods: Twenty-five healthy, young males with ERP (ERP+ group) and 25 age-matched healthy males without ERP (ERP− group) were enrolled. Comprehensive transthoracic echocardiography was performed at rest and during the early recovery phase following a treadmill exercise test. Baseline values and exercise-induced changes in both conventional and strain-derived echocardiographic parameters were analyzed and compared between groups. Results: Anthropometric measures and resting vital signs were similar in both groups. At baseline, the ERP+ group had a shorter QRS duration. Both groups demonstrated excellent cardiovascular fitness, with comparable chronotropic and pressor responses to exercise. Resting and early recovery-phase echocardiographic parameters were largely similar between ERP+ and ERP− individuals, with no overt structural or functional abnormalities observed in either group. However, ERP+ individuals showed significantly greater reductions in left ventricular end-diastolic volume and stroke volume following exercise, suggesting a distinct volumetric response to physical stress. Conclusions: ERP in healthy young males is not associated with structural cardiac abnormalities or overt myocardial dysfunction. The observed exercise-induced volumetric changes may indicate subtle differences in hemodynamic adaptation, warranting further investigation. Full article

Background: Cardiovascular fitness has been proposed as a key factor influencing executive functioning and academic performance during childhood and adolescence. However, the extent and consistency of this relationship remain unclear across diverse populations and educational contexts. This systematic review aimed to evaluate whether cardiovascular fitness, particularly measured through VO₂max, is consistently associated with improvements in executive function and academic performance among students from early childhood to adolescence. Methods: A systematic search of PubMed, Web of Science, SPORTDiscus, and ProQuest Central was conducted up to 15 November 2022. Studies were included if they examined correlations between VO₂max and cognitive or academic outcomes in students from preschool to high school. Methodological quality was assessed using the MINORS checklist. Results: Out of 271 identified studies, 12 met all inclusion criteria. Evidence suggests that higher VO₂max is generally associated with improved executive function domains such as attention, working memory, and inhibitory control, as well as academic performance indicators including mathematics and reading scores. Neurophysiological studies also indicate links between cardiovascular fitness and brain structure/function. However, the strength and specificity of these associations vary across studies due to methodological differences, limited sample diversity, and inconsistent control for confounders. Conclusions: Cardiovascular fitness appears to have a positive, albeit complex, relationship with cognitive function and academic performance in youth. Future research should adopt longitudinal and experimental designs to clarify causal pathways and consider moderating factors such as sex, age, and psychosocial variables. Full article

Sedentary behavior among young women is increasingly associated with adverse metabolic and cardiovascular outcomes. The aim of this randomized controlled trial was to evaluate and compare the effects of three structured group fitness programs on anthropometric parameters, body composition, and lipid profile in overweight young women (N = 111, age 18–25, BMI ≥ 25). Participants were assigned to mix aerobics (E1, n = 27), kickbox aerobics (E2, n = 28), step aerobics (E3, n = 27), or a control group (C, n = 29). Each intervention lasted 12 weeks, with sessions conducted three times per week, each lasting 60 min. The results were analyzed using repeated measures ANOVA. Significant reductions were observed in body weight (−4.8 kg in E1, p < 0.01), waist circumference (−5.3 cm in E1, p < 0.001), and body fat percentage (−3.6% in E1, p < 0.01). High-density lipoprotein (HDL) increased by 7.4 mg/dL (p < 0.01), while low-density lipoprotein (LDL), total cholesterol, and triglycerides decreased by 12.1 mg/dL, 18.6 mg/dL, and 19.4 mg/dL, respectively (all p < 0.01). The most pronounced overall improvements were found in the mix aerobics group. In contrast, the control group showed significant deterioration in most variables, including a 2.1 kg weight gain and a 6.3 mg/dL increase in total cholesterol (p < 0.05). These findings confirm the superior effectiveness of mix aerobics as a non-pharmacological intervention to improve body composition (notably through reductions in body weight, fat percentage, and waist circumference) and cardiovascular biomarkers (such as increased HDL and decreased LDL, total cholesterol, and triglycerides) in young overweight women. Compared to kickboxing and step aerobics, mix aerobics consistently achieved the greatest improvements across all measured parameters, making it the most comprehensive and effective option among the three programs tested. Full article

Transcatheter aortic valve replacement (TAVR) is a high-risk cardiovascular interventional procedure with a high incidence of postoperative complications, urgently requiring more refined risk identification and mitigation strategies. The main challenges in assessing the risk of TAVR complications lie in the scarcity of real-world data and the co-occurrence of multiple complications. This study developed an adjustment evaluation model that adapts randomised clinical trial (RCT) evidence to real-world data (RWD) and adopted multi-label classification methods that incorporate a LocalGLMnet-like regularization term, enabling data-adaptive parameter shrinkage for more accurate estimation. In the empirical analysis, with real surgical data from a hospital in the United States, a combination of multi-label random sampling and representative multi-label classification algorithms was used to fit the data. The model was compared across multiple evaluation metrics, including Hamming loss, ranking loss, and micro-AUC, to ensure robust results. The model used in this paper bridges the gap between medical risk prediction and insurance actuarial science, provides a practical data modelling foundation and algorithmic support for the future development of post-operative complication insurance products that precisely align with clinical risk. Full article