Search Results (2,243)

This study proposes a Personalized Deep Learning-Based Sleep Recommendation System Using Lifelog Data (PDSRS-LD). Traditional sleep research primarily relies on bio signals such as EEG and ECG recorded during sleep but often fails to sufficiently reflect the influence of daily activities on sleep quality. To address this limitation, we collect lifelog data such as stress levels, fatigue, and sleep satisfaction via wearable devices and use them to construct individual user profiles. Subsequently, real sleep data obtained from an AI-powered motion bed are incorporated for secondary training to enhance recommendation performance. PDSRS-LD considers comprehensive user data, including gender, age, and physical activity, to analyze the relationships among sleep quality, stress, and fatigue. Based on this analysis, the system provides personalized sleep improvement strategies. Experimental results demonstrate that the proposed system outperforms existing models in terms of F1 score and Average Precision (mAP). These results suggest that PDSRS-LD is effective for real-time, user-centric sleep management and holds significant potential for integration into future smart healthcare systems. Full article

Background: The definitions and approaches used to diagnose gestational diabetes (GD) are varied. The two-step approach recommended by the American College of Obstetricians and Gynecologists (ACOG) combines the sensitivity of a glucose challenge test (GCT) with the specificity of a 3-hour oral glucose tolerance test (OGTT). We investigated if minor modification of the two-step procedure can provide improved detection of GD by identifying a risk group of pregnant women with high risk of GD. Methods: We conducted a prospective cohort study of pregnant women enrolled early during pregnancy and followed till delivery. All participants underwent the ACOG-recommended two-step procedure for GD diagnosis. Based on GCT and OGTT results, the participants were divided into four risk groups (RGs): GCT-negative (RG0), GCT-positive but OGTT normal (RG1), single abnormal value on OGTT or raised HbA1c (RG2) and diagnosed GD (RG3). Baseline evaluation included dietary history (24 hour recall) and physical activity. A series of multivariable logistic regression analyses were conducted to estimate the odds of maternal and fetal outcomes. Results: A total of 1041 pregnant women were included in the study, of whom 16 (1.6%) were diagnosed as GD. Our two-step approach identified 48 (4.6%) women as GD, while RG2, RG1 and RG0 comprised 75 (7.2%), 218 (20.9%) and 700 (67.2%), respectively. Compared to RG0, RG2 showed a higher likelihood of antepartum complications [odds ratio and 95% confidence interval 2.38 (1.16–4.15)], any adverse outcome without [2.04 (1.17–3.55)] or with cesarean section [2.09 (1.21–3.61)] and primary cesarean section [1.68 (1.01–2.81)] after adjustment for potential confounders. RG2 was also significantly associated with pregnancy-induced hypertension, meconium-stained amniotic fluid and premature rupture of membranes. Conclusions: In the study participants, we identified a subgroup (RG2) at high risk of GD with perinatal outcomes showing profile consistent with that of GD. Full article

The main characteristics of attention deficit hyperactivity disorder (ADHD) are associated with inattention, impulsivity, and/or hyperactivity. Those diagnosed with this neurodevelopmental disorder present with executive function and motor difficulties, which have repercussions in educational, occupational, or social areas. On the other hand, it has been evidenced that the regular practice of physical activity or exercise or sport could produce improvements in areas with difficulties. It is for this reason that the objective of the present review was to describe and analyze the effects of the practice of physical activity, exercise, or sport on executive functions in adults diagnosed with ADHD through the scientific literature (registry: INPLASY202530105). The articles indexed in PubMed (1145), Scopus (43), and WoS (2910) were searched using the following keywords: “Adult” OR “Adults” AND “Attention-Deficit/Hyperactivity Disorder” OR “Attention-Deficit with Hyperactivity Disorder” AND “Physical activity” OR “Exercise” OR “Sports” OR “Sport” AND “Executive Function”. In addition, four articles were identified using other search engines. A total of 10 articles met the selection criteria. TESTEX was used to assess the quality of the articles, and TIDierR was used to report the results. Of the ten included studies, nine mention an improvement in inhibitory control, six in selective attention, three in cognitive flexibility, and one in working memory (all p < 0.05). It was concluded that the practice of physical activity, exercise, or sport has a positive and significant effect on the executive functions of adults with ADHD, specifically on selective attention, inhibitory control, and cognitive flexibility. Furthermore, benefits were observed in depression, brain activation, and stability. Among the limitations is the lack of a meta-analysis, which makes it difficult to quantify and recommend which intervention is most effective for this population. Furthermore, the various types and degrees of ADHD were not considered. Full article

Metabolic dysfunction-associated steatotic liver disease (MASLD) and its progressive form, metabolic dysfunction-associated steatohepatitis (MASH), have become the leading causes of chronic liver disease worldwide, with increasing rates of cirrhosis, hepatocellular carcinoma, and cardiovascular complications. Pathogenesis involves a complex interplay of dietary excess, sedentary lifestyle, insulin resistance, adipose tissue dysfunction, and alterations in the gut microbiome, which collectively lead to hepatocellular stress, inflammation, and fibrogenesis. Despite ongoing advances in pharmacotherapy, lifestyle intervention remains the cornerstone of management. Evidence shows that sustained weight loss of ≥5% reduces hepatic steatosis, ≥7% improves necroinflammation, and ≥10% stabilizes or reverses fibrosis. Dietary strategies, including Mediterranean-style patterns, high-protein approaches, and intermittent fasting, have been shown to be effective in improving insulin sensitivity and reducing intrahepatic triglycerides. Exercise interventions, focusing on both aerobic fitness and resistance training, enhance metabolic flexibility and combat sarcopenia, thereby improving hepatic and systemic outcomes. Equally important are behavioral support, digital health tools, and multidisciplinary approaches that enhance adherence and address barriers such as socioeconomic disparities, limited access, and patient engagement issues. Personalized nutrition plans, integrating physical activity, and ongoing support for behavioral change are essential for long-term disease management. This review synthesizes current evidence on the roles of macronutrients, micronutrients, dietary quality, physical activity, and adjunctive behavioral strategies in managing MASLD. By translating mechanistic insights into practical, evidence-based recommendations, we aim to provide clinicians, dietitians, and exercise professionals with effective frameworks to slow disease progression and improve outcomes across diverse patient populations. Full article

Smartphone addiction has emerged as a significant public health concern, particularly among adolescents and young adults. This narrative review, conducted in line with the ANDJ checklist, synthesizes evidence from 25 systematic reviews and meta-analyses, complemented by randomized controlled trials and clinical studies, to provide a structured overview of the field. The study selection flow and publication trends reveal a rapidly expanding research landscape, with most evidence produced in the last decade, reflecting both the ubiquity of smartphones and increasing awareness of their health impacts. The synthesis highlights converging findings across reviews: excessive smartphone use is consistently associated with psychosocial, behavioral, and academic challenges, alongside sleep disturbances and mental health symptoms. Common messages include the recognition of smartphone addiction as a multidimensional phenomenon, while emerging themes point to heterogeneity in definitions, tools, and methodological approaches. Comparative analysis of reviews underscores both shared risk factors—such as emotional dysregulation and social isolation—and differences in study designs and target populations. Importantly, this review identifies critical gaps, including the lack of standardized definitions, limited longitudinal evidence, and scarce cross-cultural validation. At the same time, promising opportunities are noted, from lifestyle-based interventions (e.g., physical activity) to educational and policy-level strategies fostering digital literacy and self-regulation. The post-pandemic context further emphasizes the need for sustained monitoring and adaptive responses. Overall, this review calls for youth-centered, multi-sector interventions aligned with WHO recommendations, supporting coordinated, evidence-based action across health, education, and policy domains. Full article

Under the accelerating urbanization, the evolution of public spaces in traditional villages increasingly diverges from social needs. The top-down governance model fails to adequately address the actual needs of indigenous residents, highlighting the necessity for structural analysis and optimization from an integrated physical–social perspective. This study, focusing on traditional villages in Beijing’s Fangshan District, constructs a three-tier model (village-street-node) by integrating Social Network Analysis (SNA) and space syntax theory. It analyzes the relationship between the accessibility and traffic potentiality of linear and point-based public spaces across the region and the frequency/scope of villagers’ daily activities. The findings reveal that within the linear belt-like spatial layout of traditional villages in western Beijing, historical spaces situated within the core residential areas demonstrate high stability and integrity, serving as primary venues for villagers’ daily activities. In contrast, historical spaces located at the periphery of settlements suffer from low utilization rates and even exhibit social segregation. Additionally, deficiencies in spatial choice, intermediary nodes, and functionality within settlements are identified as key factors contributing to social segregation in public spaces. Finally, the study proposes targeted policy recommendations for the preservation and sustainable development of traditional villages. Full article

Background: Adherence to Medical Nutrition Therapy (MNT) is a key determinant of therapy success, particularly in chronic diseases like chronic kidney disease (CKD). MNT in CKD requires significant changes in patient’s dietary habits, which can affect long-term adherence. This study aims to evaluate the adherence to MNT in stage 5 CKD patients undergoing conservative kidney management (CKM), identifying potential challenges and strengths of nutritional intervention. Methods: We enrolled in 94 stage 5 CKD patients undergoing CKM at the University Hospital of Modena, Italy. We collect clinical data from medical and nutrition records. The inclusion criteria comprised patients of all genders, ages, and ethnicity with stage 5 chronic kidney disease (CKD), in pre-dialysis, enrolled in the nephrology and dietetics program, who had access to 24-h urine tests, anthropometric measurements, and dietary history records. Exclusion criteria included patients with CKD stages lower than 5, those who had not undergone at least one nutritional assessment, or lacked accessible 24-h urine data. The study utilized medical and dietary records from September 2017 to March 2025. The primary outcome was the assessment of adherence to medical nutrition therapy (MNT), comparing prescribed protein intake with actual intake, estimated from dietary history (DH). Protein intake was compared with normalized protein nitrogen appearance (nPNA) as stated by recent guidelines. Additional factors influencing adherence, such as age, gender, comorbidities, physical activity, and prior dietary interventions, were also evaluated. Anthropometric measurements and biochemical tests were collected, and dietary intake was assessed using a seven-day DH. Results: Data were analyzed using descriptive statistics, linear correlation models, univariate logistic regression, t-tests, paired t-tests, and chi-square tests, with significance set at p < 0.05. Most of the patients follow suggested energy and protein intakes limits; however, substantial individual variability emerged Bland–Altman analysis indicated a moderate bias and wide limits of agreement for energy intake (+116 kcal; limits of agreement –518.8 to +751.3 kcal), revealing frequent overestimation in self-reports. Protein intake showed less systematic error, but discrepancies between dietary recall and biochemical markers persisted. Protein intake decreased significantly over time (p < 0.001), while correlation with nPNA did not reach statistical significance (ρ = 0.224, p = 0.051). No significant associations were identified between adherence and most clinical or lifestyle factors, although diabetes was significantly associated with lower adherence to protein intake (p = 0.042) and a predominantly sedentary lifestyle showed a borderline association with energy intake adherence (p = 0.076), warranting further investigation. Longitudinal analysis found stable BMI and body weight, alongside notable reductions in sodium (p = 0.018), potassium (p = 0.045), and phosphorus intake (p < 0.001) over time. Conclusions: Assessing dietary adherence in CKD remains complex due to inconsistencies between self-reported and biochemical estimates. These findings highlight the need for more objective dietary assessment tools and ongoing, tailored nutritional support. Multifaceted interventions—combining education, personalized planning, regular monitoring, and promotion of physical activity—are recommended to enhance adherence and improve clinical outcomes in this vulnerable population. Full article

Background: Depression affects around 280 million people globally and is one of the main causes of disability. Among people with cancer, depression and anxiety affect 20–25%, significantly reducing quality of life, adherence to treatments, and survival. Despite the availability of pharmacological and psychological treatments, their application can be limited by side effects, accessibility, and costs—especially in low- and middle-income countries. Physical exercise is emerging as a valuable complementary strategy, improving both physical and mental well-being. Nevertheless, structured exercise programs are still rarely implemented in oncology. This review aims to provide evidence-based recommendations for integrating physical activity into mental health support for people with cancer. Methods: This review includes six randomized controlled trials (RCTs) evaluating physical exercise interventions for depression and anxiety in people with cancer aged over 18 years. Included studies compared exercise interventions to control or standard care and reported outcomes related to psychological well-being and adverse effects. Exclusion criteria included non-original studies, non-English articles, and works not focused on exercise. The search was conducted in PubMed, Scopus, Google Scholar, and the Cochrane Library using MeSH terms and Boolean operators. The review protocol was registered in PROSPERO (CRD42025637522). Results: Exercise interventions—such as aerobic, resistance, and mind–body practices—proved effective and feasible across cancer types. Benefits were seen in both psychological and physical outcomes. However, variations in protocols and outcome measures, as well as a lack of long-term data, limit generalizability. Conclusions: Personalized exercise programs can significantly reduce depression and anxiety in people with cancer. Standardized core methods, long-term research, and systemic support are needed to integrate exercise into routine oncology care. Full article

Objective: Mental fatigue (MF) worsens soccer performance. Further knowledge is needed to understand MF’s effects on soccer players and its underlying mechanisms. Our aim was to analyze the subjective, objective, and neural MF-related outcomes induced by different type of tasks. Methods: A randomized crossover experimental design with repeated measures was used. Thirteen amateur soccer players (M_age = 23 ± 5.43) completed three conditions: cognitive (30 min. Stroop.), physical (30 min. cycling), or combined (30 min. Stroop while cycling). Ratings of mental fatigue (measured via the Visual Analogue Scale), electroencephalographical signals (electroencephalography), and psychomotor performance (Brief-Psychomotor Vigilance Test) were measured pre- and post-condition. Soccer-related decision-making (TacticUP^® test) was assessed post-condition. Results: Linear Mixed Models analysis revealed increments in perceived mental fatigue in all conditions, especially cognitive (p = 0.004) and combined (p < 0.0001) conditions. Psychomotor performance worsened, especially for cognitive (p = 0.039) and combined (p = 0.009) conditions. The Individual Alpha Peak Frequency was lower after the cognitive task (p = 0.040) and compared with the physical task (p = 0.021). The Alpha midline power increased after the cognitive task in the central-frontal (p = 0.047) and central-posterior brain regions (p = 0.043). Conclusions: Cognitive and combined conditions were found to be more mentally demanding and fatiguing than single physical tasks. This was also reflected by an impaired reaction time. Based on the neural activity recorded, the performance impairments caused by mental fatigue were caused by reduced brain readiness (i.e., a lower Alpha Peak Frequency). However, non-significant changes were found in soccer-related decision-making. Coaches should consider the type of training tasks they recommend in light of their different effects on mental fatigue and performance. Full article

Straw return is essential for improving soil fertility, recycling organic matter, and sustaining productivity in rice–wheat systems. This study focuses on the conceptual design and systematic analysis of the spatial and temporal variability of straw return methods and their classification. We proposed and analyzed 36 technical models for straw return by integrating spatial distribution (depth and horizontal placement) with temporal variability (decomposition period managed through mulching or decomposers). The models of straw return were categorized into five classes: mixed burial, even spreading, strip mulching, deep burial, and ditch burial. Field experiments were conducted in Babaiqiao Town, Nanjing, China, using clay loam soils typical of intensive rice–wheat rotation. Soil properties (bulk density, porosity, and moisture content) and straw characteristics (length and density) were evaluated to determine their influence on decomposition efficiency and nutrient release. Results showed that shallow incorporation (0–5 cm) accelerated straw breakdown and microbial activity, while deeper incorporation (15–20 cm) enhanced long-term organic matter accumulation. Temporal control using mulching films and decomposer agents further improved moisture retention, aeration, and nutrient availability. For the rice–wheat system study area, four typical straw return modes were selected based on spatial distribution and soil physical parameters: straw even spreading, rotary plowing, conventional tillage with mulching, and straw plowing with burying. This study added to the growing body of literature on straw return by providing a systematic analysis of the parameters influencing straw decomposition and the incorporation. The results have significant implications for sustainable agricultural practices, offering practical recommendations for optimizing straw return strategies to improve soil health. Full article

Objectives: This study examined whether skeletal muscle mass mediates the relationship between sedentary behavior, physical activity, and cardiometabolic health, and if this relationship differs by genders. Methods: Secondary analysis was conducted using data from the 2022–2023 Korean National Health and Nutrition Examination Survey (n = 5956). Cardiometabolic abnormalities were defined as having one or more of the five metabolic syndrome (MS) criteria, while MS was defined as having three or more. Muscle mass relative to body weight was measured by bioelectrical impedance analysis. Sedentary time and recommended moderate-to-vigorous physical activity (MVPA) levels at work, for transportation, and for recreation (≥600 Mets), and strength training (≥2 times/week), were assessed using the Global Physical Activity Questionnaire. Results: Higher MVPA (p < 0.001) and less sedentary time (p < 0.01) were significantly correlated with greater muscle mass in middle-aged and elderly men and women. Mediation analyses, which controlled for MS risk factors, revealed gender differences. In men, the indirect effects of sedentary time, MVPA, and strength training on both cardiometabolic abnormalities (b = 0.007, CI [0.003, 0.013]; b = −0.066, CI [−0.110, −0.033]; b = −0.074, CI [−0.110, −0.033]) and MS (b = 0.007, CI [0.003, 0.011]; b = −0.060, CI [−0.095, −0.032]; b = −0.065, CI [−0.100, −0.035]) were significant, indicating mediation by muscle mass. In women, the indirect effects of these three behaviors on cardiometabolic abnormalities were also mediated by muscle mass (b = 0.003, CI [0.001, 0.006]; b = −0.014, CI [−0.031, −0.002]; b = −0.023, CI [−0.050, −0.003]). However, for MS, sedentary time (b = 0.057, p < 0.001) and MVPA (b = −0.222, p < 0.05) had only direct effects, with no mediation by muscle mass. Furthermore, strength training showed no significant effects. Conclusions: These findings suggest that promoting MVPA and strength training, while reducing sedentary time, can improve cardiometabolic health by increasing muscle mass, though the mediating role of muscle mass for MS differs by gender. Full article

Background: Children today are growing up in a digital environment where screen-based technology is a central part of everyday life. While screens can offer educational and recreational benefits, there is growing concern about their influence on different areas of child development. Objective: This review explored how screen time affects developmental outcomes in children and adolescents aged 0 to 18 years, focusing on physical, cognitive, emotional, and social domains. Methods: A structured search was carried out across databases such as PubMed, Scopus, Web of Science and PsycINFO to identify relevant studies published between 2014 and 2024. Studies were included if they examined the relationship between screen time and at least one area of child development, involved participants within the target age group, and were peer-reviewed and published in English. The review followed PRISMA guidelines, and articles were independently screened and evaluated for quality by two reviewers. Results: A total of 46 studies met the inclusion criteria. Overall, the evidence points to a link between higher levels of screen use and negative outcomes such as reduced physical activity, poorer sleep, attention difficulties, and challenges in emotional and social functioning. However, some studies indicated that limited or educational screen use, especially with parental involvement, may have neutral or even positive effects in certain contexts. Conclusions: Screen time can have both positive and negative effects on child development, depending on factors like duration, type of content, and the context in which screens are used. Managing screen use through age-appropriate guidelines and adult supervision may help reduce risks and promote healthier development. More longitudinal research is needed to establish clearer recommendations for screen use in childhood. Full article

Background: Physical activity is essential in the prevention and management of type 2 diabetes mellitus (T2D), yet adherence to recommended activity levels remains insufficient. Wearable electronic devices have emerged as tools to support physical activity through self-monitoring and enhanced user engagement. This review synthesizes current evidence on the effectiveness of wearable technologies in improving adherence to physical activity and promoting clinical and metabolic health in adults with T2D. Methods: The review was conducted using systematic search strategies in PubMed and Scopus. We included studies that involved the use of wearable devices to monitor physical activity for at least seven consecutive days. The reported outcomes were related to physical activity adherence or clinical–metabolic health. Thirty-two studies met the inclusion criteria and were analyzed in terms of study design, device type, intervention characteristics, and outcomes. Results: Wearable devices were used either for monitoring daily activity in free-living conditions or within structured, often supervised, interventions. Most studies reported increased physical activity, particularly in step count. Several studies showed improvements in blood pressure and lipid profile, while results for HbA1c and BMI were mixed. Structured interventions with behavioural support produced more consistent and clinically relevant outcomes than passive monitoring alone. Conclusions: Wearable technologies can support physical activity in adults with T2D, especially when integrated into structured behavioural programmes. From a clinical standpoint, they may serve as useful tools to enhance lifestyle adherence, particularly when combined with professional support. Their inclusion in care pathways could help personalize interventions and improve long-term self-management. Full article

Background/Objectives: Chronic constipation is a prevalent gastrointestinal (GI) disorder among individuals with diabetes mellitus (DM), occurring more often than in healthy subjects. This review provides a systematic overview of this often-underestimated clinical condition in people with DM. Methods: A narrative review of literature up to 30 May 2025 was conducted, focusing on studies regarding the pathogenesis of constipation in DM, the correlation with GLP-1 RAs treatment, and the diagnostic-therapeutic framework. Results: The mechanisms underlying constipation in DM remain largely unclear; however, a multifactorial etiology has been proposed, involving structural changes in various tissues within the GI tract wall, as well as functional abnormalities, often secondary to hyperglycemia. It is noteworthy that the use of GLP-1 RAs, a class of medications crucial for managing glycemic control and reducing cardiovascular and renal risk in type 2 DM, is another cause of constipation. The diagnosis of constipation is typically based on clinical evaluation, as validated methods for assessing colonic transit are invasive and available only in specialized centers. Treatment objectives include alleviating symptoms and restoring bowel function. The primary strategy for management involves dietary changes and physical activity. If the clinical response is inadequate, the use of laxatives is recommended. Finally, newer agents and mechanical methods may be considered for scenarios that are particularly severe. Conclusions: Given the increasing global prevalence of DM, healthcare professionals must recognize the clinical problem constituted by the occurrence of chronic constipation, especially considering the use of medications such as GLP-1 RAs that may induce this clinical condition. Full article

Background: The worldwide prevalence of obesity in children and adolescents quadrupled in the past decades, becoming a public health priority. Following the recommendation by the Italian Minister of Health, the Emilia-Romagna Region started a community-based program aimed at reducing pediatric overweight through children and family behavioral counseling on nutrition and physical activity. Methods: Children with excess weight, aged 2–17 years, and without severe diseases were visited five times by a multidisciplinary team, who provided dietary advice, exercise plans, and psychosocial support, according to Italian guidelines. The outcomes were the median pre–post change in Δ₃₀BMI (distance between children’s BMI and age- and sex-specific obesity threshold values) and the proportion of children who moved to a lower weight class. Logistic regression was used to identify potential predictors of weight improvement. Results: Up to March 2025, 1331 participants completed the follow-up. In total, 17.5% of the children showed an improvement in weight class, and 32.5% had a reduction of more than one unit of Δ₃₀BMI. The program was significantly and substantially more effective among the children with obesity at baseline (overweight vs. obese children adjusted odds ratio—aOR—of weight class improvement: 0.28; p < 0.001), older than eight years (9–11 years vs. 2–8 years children aOR: 1.41; p < 0.05), who adhered to breakfast recommendations (aOR: 1.60; p < 0.01) and had no obese parents (≥1 vs. 0 obese parents aOR: 0.62; p < 0.05). Conclusions: The multidisciplinary model was associated with an overall positive impact on the weight status of the enrolled children. Given the varying response, however, in order to maximize cost-effectiveness, future programs could be reserved for children with obesity, older than eight years. Further randomized research is needed to investigate the efficacy of this intervention in different settings and on late clinical endpoints. Full article