Search Results (3,906)

Background: Robotic liver surgery is emerging as a key advancement in minimally invasive techniques, though it still faces several challenges. Meanwhile, colorectal cancer (CRC) continues to be a leading cause of cancer deaths, with liver metastases affecting 25–30% of patients. These metastases significantly burden healthcare systems by raising costs and resource demands. Methods: A narrative literature review was performed, resulting in the inclusion of 14 studies in our analysis. Fourteen studies met the inclusion criteria and were analyzed with attention to patient characteristics, surgical details, perioperative outcomes, and reporting limitations. For consistency, simultaneous robotic-assisted resection (RAR) refers to cases in which the colorectal primary and liver metastasectomy were performed during the same operative session. Results: The 14 studies included a total of 771 patients (520 males and 251 females), aged between 31 and 88, undergoing simultaneous robotic-assisted resection (RAR). Most were affected by rectal cancer (76%) and unilobar liver metastases (82%). All surgeries using the DaVinci system are represented by 62% wedge resection and 38% anatomical (21.39% major and 16.61% minor). Patients’ BMI ranged from 19.5 to 40.4 kg/m², the average blood loss was 181.5 mL (30–780), the median hospital stay was 7 days (range 2–28), and the mean operative time ranged from 30 to 682 min. Data on POLF (postoperative liver failure) are reported in two studies: Rocca et al., 1/90 patients; Marino et al., 1/40 patients. Biliary leak is reported in one case by Marino et al., while Winckelmans et al. reported a 2.6% incidence of biliary leak in the laparoscopic group and 3.4% in the robotic group. Conclusions: As research advances and new therapies emerge for colorectal liver metastasis (CRLM), surgery remains the mainstay of treatment. However, evidence is limited by small sample sizes, heterogeneous study designs, inconsistent reporting of perioperative chemotherapy, timing of surgery, metastasis localization, and complications. Robotic liver surgery has become a well-established technique and possibly represents the future for managing colorectal liver metastases. Further prospective and comparative studies with standardized outcome reporting are needed to define optimal patient selection and long-term effectiveness. Full article

Football-themed eSports, combining entertainment and learning elements, are booming, offering benefits in terms of cognitive and motor skill development. Despite this, with the increasing use of eSports and their impact on cognitive and motor skills, there is still a paucity of empirical studies that systematically explore how cognitive stimulation from eSports can translate into psychomotor performance on the field, particularly with regard to linear speed. The aim of this study was to investigate the effects of an ecological–dynamic training protocol, integrated with football eSports, on the development of linear sprint speed in young soccer players. Thirty-two male youth football players (age range: 12–16 years) participated in the study. Participants were divided into an experimental group, which followed a combined ecological–dynamic training protocol including football eSports, and a control group, which performed standard training sessions. Pre- and post-intervention assessments of 30 m sprint performance were conducted using electronic timing gates. Statistical analysis using repeated-measures ANOVA indicated a marked improvement in 30 m sprint performance within the experimental group, decreasing from 4.908 s to 4.651 s. A significant time × group interaction was observed (F = 74.076, p < 0.001). Moreover, a robust main effect of time emerged (F = 141.12, p < 0.001), confirming consistent gains in linear sprint speed. Post hoc comparisons revealed significant differences across all assessment points (p < 0.001). The findings suggest that embedding football eSports into an ecologically grounded training framework may enhance the development of linear speed in young soccer players. This integrated approach shows potential as an innovative tool for performance enhancement, although further investigations are needed to confirm long-term efficacy and generalizability to other sporting populations. Full article

The aim of the study was to explore the impact of an intervention based on the manipulation of the margin of error and the provision of ball speed feedback on the ability to spike in introductory volleyball. To this end, an exploratory study without a control group was conducted. The sample consisted of two U-14 volleyball teams, one male team with 14 players (13.2 ± 0.75 years), and one female team with 12 players (14 ± 0 years). The intervention involved reducing the height of the net, providing immediate feedback on the speed of the ball after the spike, and challenging the target zone of the spike. It was applied across 12 sessions, with eight spikes per player per session. The study variables recorded in each spiking were ball speed (which was measured using the Pocket Radar Ball Coach instrument), jump height (which was measured using the VERT Wearable Jump Monitor), and target area for sending the ball (which was filmed using a high-speed video camera). The players’ perception of the intervention was also assessed. The most significant results indicated that the achievement of the impact in the more restricted target area of the spiking, compared to the larger target area, led to a significant increase in jumping, both in men and women. As maintaining spike ball speed was necessary to validate the challenge, speed values did not decrease when hitting toward the restricted zone. In fact, for male players, there was an unexpected significant increase in spike ball speed. The initial speed was the variable that best predicted the maximum speed acquired throughout the treatment. Reducing the net height while restricting the spiking area can have a positive impact on spike kinematics, provided that spike velocity is maintained. Full article

Background: Children in underdeveloped rural areas of China often face socioeconomic disadvantages, which are associated with low confidence and self-esteem. While SEL programs have shown benefits internationally, evidence from Mainland China is limited. This study examined whether a school-based SEL intervention could improve confidence and self-esteem among children in economically disadvantaged rural areas. Methods: The intervention was a quasi-experimental study conducted in a rural, underdeveloped region of central China. It involved 16 weekly sessions, each lasting 90 min. A total of 230 children aged 8–12 years participated in the intervention school, while 325 children from another school served as the control group. The study used a mixed-methods design, including a quantitative survey administered at baseline, post-intervention, and a 5-month follow-up, as well as qualitative interviews with 83 children, nine caregivers, and eight teachers following the intervention. A linear mixed-effects model was employed to evaluate the effectiveness of the intervention, while interview data were analyzed using an inductive thematic approach. Results: The findings suggested (1) children from lower socioeconomic backgrounds consistently reported lower levels of self-esteem and self-efficacy across all three assessment points. (2) There was a short-term intervention effect on self-esteem, with greater improvements among children from poorer families. (3) The increase in children’s confidence meant they were more able to express themselves and mix with others. (4) Children’s improvements were not sustained up to a 5-month follow-up. Conclusions: The program may be effective in improving children’s confidence and self-esteem in underdeveloped rural areas of China. Such a program may contribute not only to educational outcomes but also to broader efforts aimed at social mobility and poverty reduction. Full article

Background/Objectives: Academic burnout is an emerging problem among nursing students, characterized by emotional exhaustion, cynicism, and reduced academic efficacy. Sports interventions have been shown to have a positive effect on nurses as a preventive strategy against burnout. The aim of this study was to evaluate the effect of a nature sports program on the levels of academic burnout in nursing students. Methods: A randomized clinical trial was performed. The intervention was a 12-week nature exercise program with two sessions each week. The main dependent variables were burnout (measured using the Maslach Burnout Inventory—Student Survey), stress (measured using the Perceived Stress Scale), and anxiety and depression (measured using the Hospital Anxiety and Depression Scale). The post-intervention sample size was n = 58 in the control group and n = 48 in the intervention group. Results: After the intervention, significant differences were found in respect of emotional exhaustion (p < 0.001; Cohen’s D: 0.483), stress (p < 0.05; Cohen’s D: 0.456), and mean steps per day (p < 0.001; Cohen’s D: −1.09), with the mean values being reduced in the intervention group by around three points in emotional exhaustion and stress; the intervention group also achieved a higher mean number of daily steps compared to the control group. Conclusions: A nature sports program could help to reduce emotional exhaustion and stress, and increase the number of steps per day. Full article

Background and Objectives: Post-menopausal estrogen decline is considered a contributing factor to sarcopenia, and inspiratory muscle training (IMT) may provide benefits in this demographic. This study examined the impact of a four-week IMT program on diaphragm thickness, abdominal wall muscle thickness (AWMT; transversus abdominis, internal oblique, and external oblique), and liver fat percentage in healthy elderly women. Materials and Methods: Twenty-six women aged 60–80 years were randomly assigned to an IMT group (n = 13) or a control group (n = 13). The IMT group used the PowerBreathe^® Classic device at 40% of maximal inspiratory pressure (MIP), with weekly increments of 10%. Training was performed twice daily, five days per week, with 30 breathing cycles per session (60 per day). The control group maintained their usual routines. AWMT, diaphragm thickness (DT), and fatty liver density (FLD) were measured by a radiologist before and after the intervention. Results: After four weeks, the IMT group showed significant improvements in all parameters compared to controls. Mid-diaphragm thickness (MDT) increased by 11.44% (effect size (ES) = 0.358, p < 0.001) versus 0.76% in controls (p = 0.271). Posterior diaphragm thickness (PDT) improved by 7.48% (ES = 0.282, p < 0.001) versus 0.38% (p = 0.564). Right AWMT increased by 12.7% (ES = 0.492, p < 0.001) compared to 0.10% (p = 0.872), and left AWMT increased by 9.93% (ES = 0.395, p < 0.001) versus 2.64% (p = 0.014). FLD improved by 11.79% (ES = 0.959, p < 0.001) in the IMT group, while the control group showed no meaningful change (−0.13%, p = 0.847). Conclusions: A short-term IMT protocol significantly enhanced diaphragm and AWMT and reduced liver fat in elderly women. These findings support the use of IMT as a simple, non-invasive intervention to preserve musculoskeletal and metabolic health in aging populations. Full article

Introduction: Chronic intestinal failure (CIF) and the resulting dependence on home parenteral nutrition (HPN) often occur abruptly, profoundly disrupting the daily lives of patients and their caregivers. Both groups face persistent psychological and relational challenges, yet evidence on their long-term mental-health trajectories remains scarce. This study aimed to assess the progression of anxiety symptoms over 12 months in CIF patient–caregiver pairs, and to explore whether participation in a systemic–relational psychotherapy program could influence these outcomes. Methods: The Hamilton Anxiety Rating Scale (HAM-A) was administered to all participating patient–caregiver pairs, who were also invited to attend free biweekly psychotherapy sessions for one year. Pairs who accepted (Group Y) were compared with those who declined (Group N). Results: At baseline, both patients and caregivers in both groups exhibited high anxiety levels. Group Y (n = 10) patients had significantly higher total HAM-A scores than Group N (n = 40) patients (p = 0.048); a similar, non-significant trend was observed among caregivers. Emotional and somatic component scores remained largely unchanged at 6 and 12 months, regardless of group allocation. Conclusions: CIF imposes a substantial and persistent anxiety burden on both patients and caregivers. In this cohort, a brief systemic–relational psychotherapy program, offered quarterly, did not significantly modify anxiety levels over 12 months. These findings highlight the need for more intensive, sustained, and possibly earlier psychological interventions tailored to the dyadic experience of living with CIF and HPN. Full article

Background/Objectives: This study aimed to examine the effects of an eight-week wearable resistance (WR) training program on jump performance and jump kinematics in experienced senior female volleyball players. It was hypothesised that using WR would increase training load, thereby enhancing vertical jump performance and influencing kinematic movement patterns. Methods: Sixteen competitive female volleyball players (mean age: 23.5 ± 3.24 years; mean weight: 66.8 ± 6.9 kg; mean height: 174.7 ± 5.8 cm) participated in the study. Participants were randomly assigned to either a control group (n = 8) or an intervention group (n = 8) that trained with calf-mounted WR. The intervention group performed supervised resistance training sessions twice per week for eight weeks, totalling 16 sessions. Jump performance was assessed using an Infrared Optical Contact Grid (MuscleLab, Ergotest Innovation AS, Norway), and jump kinematics were measured with the Xsens Link motion capture system (Movella, The Netherlands). Results: The WR group demonstrated a statistically significant improvement in vertical jump height (p = 0.031), with no significant changes in kinematic variables. The control group, however, showed a significant increase in T8–pelvis flexion during the countermovement jump (CMJ) following the intervention period. Conclusions: Eight weeks of WR training can improve CMJ performance in-season among experienced female volleyball players without affecting movement kinematics. Future research should investigate optimal loading strategies and long-term adaptations. These findings suggest that integrating small wearable loads into regular volleyball practice can help athletes maintain and improve explosive performance without disrupting normal training routines. Full article

Background: The Pharm2Home Initiative’s Community Health Arm adopts a health-equitable approach to chronic disease education and medication therapy management (MTM). We serve senior residents of Solano County, California, who live in affordable housing and have limited financial resources. Aim: This evaluation assesses the uptake of chronic disease management recommendations provided by clinical pharmacists during MTM sessions at community events. Methods: The program engaged clinical pharmacists to provide tailored education and healthcare interventions in senior housing facilities. The goal was to empower seniors to manage their health effectively. The sessions covered various topics, including expired or duplicated medications, incorrect medication use, consultations on medication management, immunizations, and lifestyle adjustments. Results: Over an 18-month period, from January 2022 to August 2023, the program involved 65 participants across ten community health events. These events provided approximately 65 h of direct intervention. Many participants reported significant improvements in understanding their treatment plans and navigating their health needs more confidently. Feedback from 60 seniors after the sessions indicated that 88% felt much better informed about their medications, and 75% expressed that their concerns were addressed extremely well. Conclusions: These outcomes demonstrate the importance of clinical pharmacist-led interventions in improving seniors’ medication use and chronic disease management. The initiative’s approach advocates for integrating clinical pharmacists into community health settings, suggesting a scalable model for enhancing person-centered care. However, further studies are necessary to assess the long-term impacts of these interventions and explore their effectiveness across diverse age groups and more complex conditions. Full article

Background/Objectives: Childhood obesity rates in Jordan have reached alarming levels, with 28% of school-age children classified as overweight or obese. School-based gardening interventions show promise for promoting healthy eating behaviors, yet limited research exists in Middle Eastern contexts. This study evaluated the effectiveness of a five-month school-based vegetable gardening and nutrition education intervention on anthropometric measures, dietary intake, and knowledge, attitudes, and practices (KAP) regarding vegetable consumption among Jordanian primary school children. Methods: A quasi-experimental controlled trial was conducted with 216 students (ages 10–12 years) from two demographically matched schools in Amman, Jordan. The intervention group (n = 121) participated in weekly one-hour gardening sessions combined with nutrition education and vegetable tasting activities over five months, while the control group (n = 95) continued the standard curriculum. Outcomes measured at baseline and post-intervention included anthropometric assessments, dietary intake via 24 h recalls, and vegetable-related KAP using a validated questionnaire. Data were analyzed using paired t-tests and repeated measures ANCOVA. Results: The intervention group demonstrated significant improvements in body composition, including reductions in BMI (−1.57 kg/m²), weight (−1.88 kg), and BMI z-score (−0.37), while controls showed minimal increases. Vegetable intake showed significant time × group interaction (p-value = 0.003), with a non-significant increase in the intervention group (2.7 to 2.9 times/day) and a non-significant decrease in the controls (2.5 to 2.4 times/day). Dietary quality improved, including increased fiber intake (+2.36 g/day) and reduced saturated fat consumption (−9.24 g/day). Nutrition knowledge scores increased substantially in the intervention group (+22.31 points) compared to controls (+1.75 points; p-value ≤ 0.001). However, attitudes and practices toward vegetable consumption showed no significant changes. Conclusions: This intervention effectively improved body composition, dietary quality, and nutrition knowledge among Jordanian primary school children. These findings provide evidence for implementing culturally adapted school gardening programs as childhood obesity prevention interventions in Middle Eastern settings, though future programs should incorporate family engagement strategies to enhance behavioral sustainability. Full article

Health behavior encompasses the attitudes, decisions, and actions that individuals adopt in their daily lives and that directly influence their well-being. The objective of this study was to evaluate the effectiveness of a nursing intervention based on Nola Pender’s Health Promotion Model in promoting healthy behaviors among adults over 20 years of age. A quasi-experimental design was used with a sample of adults from a Colombian community. In 2022, sociodemographic data were collected, and the Health-Promoting Lifestyle Profile II (HPLP-II), developed by Nola Pender to measure healthy lifestyles, was administered. In 2023, the intervention was carried out in 24 group sessions of 40 min each, supported by printed educational material and focused on the dimensions of Pender’s theory. Statistical analysis using nonparametric tests such as the Mann–Whitney U and Kruskal–Wallis tests showed significant improvements: the overall score increased from 22.92 in the pre-test to 27.30 in the post-test. The physical activity dimension received the lowest score, while the spiritual growth dimension showed the highest improvement. The results indicate that nursing interventions based on Pender’s model led to statistically significant improvements in multiple dimensions of healthy behavior, with the greatest impact on spiritual growth and health responsibility. Full article

Objectives: This study aimed to evaluate the effects of a 12-week Active Breaks (ABs) program on physical, cognitive, and academic outcomes in primary school children. Methods: Eighty primary school students (age: 7.52 ± 0.50) (BMI: 18.35 ± 3.07) were recruited and randomly assigned to three experimental groups—involving creativity-based (CRE) (age: 7.97 ± 0.18 years) (BMI: 20.01 ± 3.59), fitness-based (FIT) (age: 7.93 ± 0.26 years) (BMI: 16.74 ± 1.76), and combined (COM) (age: 7.97 ± 0.18 years) (BMI: 19.38 ± 4.24) ABs—and a control group (CON) (age: 7.42 ± 0.49 years) (BMI: 18.31 ± 2.64). The intervention consisted of two daily sessions (10 min each) three times per week over a 12-week period. Numerical skills, calculation abilities, and arithmetic problem-solving performance were evaluated using the “Test for the Assessment of Calculation and Problem-Solving Skills” (AC-MT 6-11). Attention and concentration performance were assessed using the Reynolds Interference Task (RIT). Motor skill performance was assessed using the MOTORFIT tests. Results: The FIT and CRE groups showed higher improvement in physical performances (p < 0.05). Regarding cognitive outcomes, the COM group outperformed the CON group in the Total Correct Index (p = 0.032). Regarding mathematical performance, all EGs achieved higher results than the CON group (p < 0.042), with the COM group achieving the highest scores in operations, problem-solving, and total scores (p < 0.032). Conclusions: Incorporating structured physical activity through ABs during curricular hours is an effective strategy to enhance physical, cognitive, and academic performance in primary school children. A combined approach appears to be especially beneficial, supporting both physical and cognitive development simultaneously. Full article

Background: Obesity remains a major global health challenge, and a significant proportion of bariatric surgery patients continue to experience dysfunctional emotional eating and body image concerns after surgery. Neurofeedback training (NFT) has been investigated as a potential intervention for maladaptive eating behaviours, but evidence in post-bariatric populations is still limited. Methods: Thirty-six patients who underwent sleeve gastrectomy were included, divided into an NFT group (N = 18) and a control group (N = 18). Assessments were performed at baseline and after 10 NFT sessions, using the Eating Disorder Inventory (EDI) and the Body Uneasiness Test (BUT). The intervention aimed to enhance alpha and theta waves with real-time feedback. Results: Compared with the control group, the NFT group showed significant improvements; specifically, reductions were observed in EDI subscales such as Drive for Thinness (p = 0.023, d = 0.51), Bulimia (p = 0.008, d = 0.92), Body Dissatisfaction (p = 0.015, d = 0.52), Ineffectiveness (p = 0.002, d = 0.89), Perfectionism (p = 0.006, d = 0.70), Interpersonal Distrust (p = 0.008, d = 0.82), and Interoceptive Awareness (p = 0.001, d = 0.91). Significant reductions were also found in BUT subscales including Weight Phobia (p = 0.041, d = 0.84), Body Image Concern (p = 0.039, d = 0.90), Avoidance (p = 0.027, d = 0.83), Compulsive Self-Monitoring (p = 0.013, d = 0.83), and Depersonalisation (p = 0.033, d = 0.85). Conclusions: The data indicate that NFT may help reduce emotional eating and related psychological factors in post-bariatric patients in the short term. However, studies with larger samples and longer follow-ups are needed to confirm its effectiveness and assess its clinical applicability. Full article

Background: To reduce work-related illnesses among teachers, various types of programs were implemented. Objectives: The aim of this study was to evaluate the effects of a 12-week multicomponent program on mental disorders, biochemical parameters, and immunological markers in female teachers with overweight. Methods: A total of 33 women who were basic education teachers with a body mass index (BMI) ≥ 25 kg/m² participated in this study. Participants were randomly assigned to either a control group (n = 16), which did not participate in the program, or an intervention group (n = 17), which underwent the multicomponent intervention. The program included physical exercise (three sessions per week), cognitive–behavioral therapy delivered monthly across three modules, and nutritional education consisting of both general and specific guidance. Assessments were conducted at baseline and after 12 weeks and included measurements of symptoms of depression, anxiety, and stress; fasting glucose; total cholesterol; LDL cholesterol; HDL cholesterol; VLDL cholesterol; triglycerides; and concentrations of immunoglobulins IgA, IgG, and IgM. Results: After 12 weeks, the intervention group showed a significant reduction in symptoms of depression, anxiety, and stress (p < 0.05), as well as in fasting glucose, triglycerides, and VLDL cholesterol levels compared to the control group (p < 0.05). No significant changes were observed in the levels of immunoglobulins IgA, IgG, or IgM (p > 0.05). Conclusions: The multicomponent program improved mental health and reduced the risk of developing metabolic and cardiovascular diseases in female teachers with overweight. Full article

Background: Cardiopulmonary resuscitation can generate aerosols, potentially exposing healthcare workers (HCWs) to infection. Bag valve ventilation (BV) is widely used but is prone to aerosol dispersion, whereas chest compression-synchronized ventilation (CCSV) maintains a closed respiratory circuit. In this study, we compared aerosol generation between CCSV and BV during chest compressions following endotracheal intubation in a simulated resuscitation setting. Methods: In a randomized crossover design, 12 sessions each of CCSV and BV were conducted on an intubated manikin undergoing mechanical chest compressions for 10 min. Aerosols with ≤5-μm diameter were generated using a saline nebulizer and measured every minute with a particle counter positioned 50 cm from the chest compression site. Bayesian linear regression of minute-by-minute log-transformed aerosol particle counts was used to estimate group differences, yielding posterior means, 95% credible intervals, and posterior probabilities. Results: The aerosol particle counts increased during the initial 3 min with the use of both methods. Thereafter, the aerosol particle counts with CCSV stabilized, whereas those with BV continued to increase. From 4 to 10 min, the posterior probability that CCSV generated fewer particles exceeded 0.98, peaking at 9 min. Both peak and time-averaged log-transformed aerosol particle counts were significantly lower with CCSV than with BV (p = 0.010 and p = 0.020, respectively). Conclusions: In this simulation, CCSV generated significantly fewer aerosols than BV did during chest compressions, with differences emerging after 4 min and persisting thereafter. Thus, CCSV may reduce aerosol exposure of HCWs, supporting its early implementation during resuscitation in infectious disease settings. Full article