Objectives To evaluate the effects of hypoxic interventions (HI) on swimming performance and physiological outcomes in competitive swimmers. Design Systematic review and meta-analysis following PRISMA guidelines and registered in PROSPERO (CRD420251170303). Methods Seven databases were searched to identify controlled trials comparing hypoxic and normoxic training under identical conditions. Eleven studies (n = 182 swimmers) were included. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated using a random-effects model. Subgroup analyses were performed by event distance and simulated altitude. Results HI produced a small but significant improvement in swimming performance (SMD = −0.34, 95% CI [−0.62, −0.06], p = 0.02) with low heterogeneity (I 2 = 30%). No significant changes were observed for VO 2 max, HRmax, or VEmax (all p > 0.05). Subgroup analyses indicated greater benefits for 100 m and 200 m freestyle and for interventions conducted at simulated altitudes ≥3500 m. Conclusion Hypoxic interventions yield meaningful yet modest enhancements in competitive swimming performance, likely through non-hematological adaptations such as improved muscle oxygen utilization and fatigue tolerance. Tailoring HI protocols to event-specific demands and sufficient hypoxic stimulus levels may optimize outcomes. Systematic Review Registration Registered on PROSPERO (registration number: CRD420251170303).

Numerous emerging systemic therapies, including monoclonal antibodies and Janus kinase (JAK) inhibitors, are effective for atopic dermatitis (AD). However, their effects on the incidence of airway comorbidities like asthma and allergic rhinitis in AD patients remain unclear. This network meta-analysis evaluates and compares the risks of these adverse events among patients with AD receiving different biologics and systemic JAK inhibitors. PubMed, Cochrane Library, Embase, and Web of Science were searched for randomized controlled trials (RCTs) evaluating asthma and allergic rhinitis in AD patients receiving JAK inhibitors or biologics, from inception to January 4, 2025. Data synthesis employed a Bayesian network meta-analysis with random-effects modeling, using relative risk (RR) and 95% credible intervals (CI) as effect measures. Meta-regression assessed the impact of study design and participant characteristics on intervention effectiveness. The surface under the cumulative ranking curve (SUCRA) ranked intervention safety profiles, and methodological quality was appraised via the Cochrane ROB 2.0 tool. A total of 26 randomized clinical trials (13,069 participants) met inclusion criteria, with 9530 receiving JAK inhibitors/biologics and 3540 assigned to placebo. Compared to nemolizumab 90 mg, dupilumab 300 mg (RR = 0.1, 95% CI: 0.01, 0.93) and tralokinumab 150 mg (RR = 0.03, 95% CI: 0, 0.77) were associated with a significantly lower risk of asthma. SUCRA analysis identified ISB 830 600 mg (SUCRA = 8.0%) as the highest for asthma-related adverse events and tralokinumab 150 mg (SUCRA = 95.1%) as the lowest. For allergic rhinitis, abrocitinib 100 mg had the highest adverse event incidence (SUCRA = 10.3%) and dupilumab 200 mg the lowest (SUCRA = 93.8%). Cluster analysis confirmed dupilumab 200 mg as associated with the lowest combined risk of both conditions, while abrocitinib 100 mg had the highest. Among patients with AD receiving biologics or JAK inhibitors, dupilumab was associated with the lowest risk of asthma and allergic rhinitis in our analysis. Owing to confounding between dose and patient factors (age, disease severity, etc.) in included trials, no specific dose recommendations can be made. These findings warrant confirmation by future large-scale RCTs stratified by age and dose. PROSPERO (CRD42024595904).

Food insecurity remains a persistent public health challenge in the United States, affecting greater than 10% of households for the past 20 years. Although a variety of interventions have been implemented to address food insecurity, no prior review appears to have synthesized evidence exclusively from randomized controlled trials (RCTs). The effectiveness of food insecurity interventions in the United States, focusing exclusively on evidence from RCTs, was examined in this systematic review. The strengths and limitations of the existing evidence were assessed, and recommendations are provided for future research, practice, and policy. A comprehensive search was conducted across the PubMed, Embase, Web of Science, and ProQuest Central databases. Randomized controlled trials conducted in the United States that evaluated food security outcomes were included. Twenty-five studies met inclusion criteria. Two reviewers independently screened abstracts and full texts. Data were extracted by a primary reviewer and verified by a second reviewer. Study quality was assessed using the Cochrane Risk of Bias tool. The reviewed studies used a wide range of interventions across diverse settings. Findings were mixed, with 44% of included studies (n = 11) reporting significant improvements in food security compared with control groups. The evidence does not support any single intervention as consistently effective and reveals significant gaps in geographic and population coverage. Key limitations across studies included short intervention and follow-up periods and limited assessment of intervention utilization. Future RCTs should prioritize long-term follow-up, inclusion of underserved regions and populations, and more rigorous evaluation of intervention uptake. OSF registration no. 49jcs.

The Effect of a Supportive Educational Intervention on Perceived Stress of Family Caregivers of Older Adults with Chronic Diseases

Human blood metabolites have been closely linked to ankylosing spondylitis (AS) in observational studies, yet direct causal evidence remains limited. This study aims to use Mendelian randomization (MR) to pinpoint causal metabolites associated with AS and to predict potential side effects of metabolite interventions. Genetic instruments for exposure were sourced from a genome-wide association study of 1400 blood metabolites, while genome-wide association study data for AS outcomes were derived from the FinnGen cohort. The primary MR analysis was conducted using the inverse variance weighted method. Supplemental analyses were conducted using weighted median, MR-Egger, simple mode, and weighted mode methods, while sensitivity analyses were performed to evaluate heterogeneity and pleiotropy. A replication analysis using an additional the UK Biobank cohort was also performed to determine metabolites associated with AS. The Steiger test and linkage disequilibrium score regression were used to further strengthen causal inference. Lastly, a phenome-wide Mendelian randomization analysis was performed to investigate the potential on-target side effects of metabolite interventions. After comprehensive analyses, 3 metabolites (the 2'-deoxyuridine levels, the hate to mannose ratio, and the Uridine to 2'-deoxyuridine ratio) were identified as being genetically associated with AS. The phenome-wide Mendelian randomization analysis revealed that the hate to mannose ratio might have deleterious effects on 4 other diseases, while no significant associations were found for the 2'-deoxyuridine levels or the uridine to 2'-deoxyuridine ratio with other diseases. This systematic MR analysis unveiled the potential role of the 2'-deoxyuridine levels, hate to mannose ratio and uridine to 2'-deoxyuridine ratio as the causal mediator in the development of AS. Considering the advantages and disadvantages, 2'-deoxyuridine appears as the most promising prospective therapeutic target for the prevention of AS.

Beneficial effects of mindful eating-based interventions during pregnancy have been reported. This study aimed to synthesize the available evidence on the effects of mindfulness-based interventions during pregnancy that incorporate a mindful eating (ME) protocol on the health and well-being of pregnant women, including mental health, body metabolism (weight gain and/or blood glucose levels), eating behavior, and physical activity levels. The search was conducted in the Medline, Web of Science, PsycArticles, Embase, Scopus, Food Science Source, CINAHL, and Google Scholar databases. Studies that describe ME-based interventions in pregnant women were identified. Risk of bias was determined using the Joanna Briggs Institute (JBI) critical appraisal tool, and the level of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Of the 489 articles identified, only 4 non-randomized intervention studies met the inclusion criteria. All selected studies used the "Mindful Motherhood Training" protocol and employed validated methods for measuring outcomes. The studies assessed the impact of the intervention on mental health and revealed significant reductions in stress and depressive symptoms, and significant increases in physical activity, among other outcomes. Although they showed that there are potentially benefits from ME interventions, particularly in contributing to mental health (reduction in depressive symptoms) and increasing physical activity levels, the included studies were assessed as being exploratory in nature, of low methodological quality, having inconsistent results, and having aspects of serious concern regarding the certainty domain. Improvements in the quality of the ME interventions during pregnancy are necessary. PROSPERO registration No. CRD42024496025.

While international evidence suggests seasonal variations may influence outcomes of interventions for pediatric obesity, data for AotearoaNew Zealand are limited. We examined seasonal variations in changes in body mass index standard deviation score (BMI SDS) in young people with obesity enrolled in an intervention programme. We studied 397 children and adolescents (median = 10.1years; range 3.7-16.8years) from Whānau Pakari, a multidisciplinary community-based healthy lifestyle programme (initially a randomised clinical trial that subsequently transitioned into the regional childhood obesity service). Participants were stratified by season at entry and 6-month BMI SDS changes (Δ) were evaluated. Lifestyle factors were also assessed. Data were analysed using traditional linear models and machine learning (random forest). 68% of participants had BMI SDS reductions at 6months (mean = - 0.16 SDS; P < 0.0001). Linear models showed seasonal variations in programme effectiveness, with BMI SDS reductions among summer (- 0.17 SDS), autumn (- 0.19 SDS) and winter (- 0.18 SDS) but not amongspring entrants. Random forest modelling identified higher baseline BMI SDS and younger age as the most influential predictors of greater 6-month reductions in BMI SDS. Season of entry was more important than any single lifestyle factor; spring entrants exhibited attenuated reductions relative to other seasons. The season at programme entry was an important factor associated with intervention effectiveness. Spring entry was associated with attenuated BMI SDS reductions, likely due to the inclusion of thesummer holidayswithin the 6-month intervention. These findings highlight the need for targeted support during such unstructured periods to improve participant outcomes.

Effectiveness of the online video-feedback intervention to promote positive parenting and sensitive discipline (VIPP-Online): a randomized control trial in Chile.

Dysregulated blood glucose levels and insulin resistance are key contributors to various metabolic complications and increased mortality. Among lifestyle interventions, dietary modification is a crucial strategy for improving glucose tolerance. Barley, rich in fiber and β-glucan, may offer a promising dietary approach for glycemic control. To evaluate the impact of barley intake on short- and long-term glycemic and insulin responses through a systematic review and meta-analysis. Through comprehensive searches in major scientific databases, 31 controlled trials with 34 intervention arms were identified, including a total of 660 case patients and 665 control participants. Two reviewers independently extracted data, and a random-effects model was used to calculate pooled estimates of outcomes. Barley supplementation significantly reduced postprandial glucose levels at 30 (-10.48 mg dL-1), 60 (-12.38 mg dL-1), and 120 (-6.95 mg dL-1) minutes; however, no significant effects were observed at 180 minutes. Barley supplementation significantly reduced postprandial insulin levels at 30 (-6.02 pmol L-1), 60 (-12.83 pmol L-1), and 180 (-5.89 mg dL-1) minutes; however, no significant effects were observed at 120 minutes. No significant changes in insulin levels were observed beyond the early postprandial period. In the long term, barley intake did not significantly affect fasting glucose or hemoglobin A1c levels. This meta-analysis supports the short-term benefits of barley consumption in improving early postprandial glucose and insulin responses. No significant impact was found on later or long-term glycemic markers. More high-quality trials are needed to confirm these outcomes. PROSPERO registration No. CRD42022368122.

The effectiveness of mobile app-based interventions to improve parental mental health: a meta-analysis.

While a growing number of studies have highlighted the relevance of core and bridge symptoms as potential intervention targets by following the network approachto psychopathology, their findings have remained primarily descriptive or retrospective. To date, no study has prospectively tested whether interventions tailored to person-specific symptom networks can improve clinical outcomes compared to standard interventions. To address this gap, we conducted an exploratory investigation to examine whether a network-driven, person-specific sequencing of modules yields signals of added benefit compared with a standardized sequence. Accordingly, this proof-of-concept pilot randomized controlled trial recruited participants aged 18-29 years with depressive symptoms, and the Mini International Neuropsychiatric Interview was administered in person to screen for psychiatric conditions. The study compared a digital intervention program, consisting of up to 9 sessions plus one psychoeducation session, sequenced according to core symptoms identified through network analysis using 10-day ecological momentary assessment (EMA) collected beforehand, with astandardizedfixed-sequenceintervention. Depressive symptoms were measured using the, which includesone item assessing thoughts of self-harm or suicide, at post-intervention, and at 1- and 3-months follow-up. In total, 62 participants were randomly assigned to one of two intervention groups in a 1:1 ratio, with 31 participants in each group. An intent-to-treat analysis revealed significant improvements in depressive symptoms over time in both groups (pfdr < 0.01). Both groups showed substantial reductions in depression scores from baseline to post-intervention, with large effect sizes (d = 1.24 for the personalized group and d = 1.15 for the standardized group). These improvements were maintained at the 1-month follow-up (d = 0.86 for the personalized group and d = 1.09 for the standardized group) and the 3-month follow-up (d = 1.05 for the personalized group and d = 0.89 for the standardized group). However, the group × time interaction was near zero and imprecisely estimated (β = -0.01, 95% CI - 0.96-0.94; p = 0.987), indicating that, in this pilot, between-arm differences were small and statistically non-significant. Non-significant results are interpreted as inconclusive rather than evidencing equivalence. These findings underscore the need for further trials to identify the specific conditions under which personalized, network-informed approaches might yield advantages over standard interventions. TRIAL REGISTRATION: The study was pre-registered with the Chinese Clinical Trial Registry (ChiCTR2300078568).

A widespread problem among surgical patients, preoperative anxiety affects recovery, pain perception and general outcomes and calls for efficient remedies including quality control circle (QCC) approaches to enhance perioperative treatment. This study compared, among surgical patients, the efficacy of QCC treatments in lowering preoperative anxiety, boosting postoperative recovery and raising patient satisfaction against conventional treatment. A cross-sectional observational study was conducted on 180 patients in all who were scheduled for elective operations were allocated to either standard treatment (n = 90) or QCC interventions (n = 90). At admission, 1 day before surgery and 3 days following surgery, anxiety levels were measured with the state-trait anxiety inventory. The numeric rating scale and visual analog scale were used at 2, 12, 24, 48, and 72 hours to gauge postoperative pain. Recovery benchmarks, complications, and satisfaction levels were documented. Preoperatively (P = .005) and postoperatively (P = .003) patients in QCC treatments group had notably decreased anxiety scores. Recovering times were notably faster (P = .001: first drinking, 1.2 vs 3.5 days), first bowel movement (2.1 vs 3.2 days), and off-bed activity (3.0 vs 3.8 days). At all-time-points, the QCC group had regularly lower pain scores (P <.01). The QCC group had reduced complications (8.3% vs 15.6% P = .021) and greater satisfaction rates (89.4% vs 75.1%, P = .005). Ultimately, QCC treatments minimized the consequences by efficiently lowering anxiety, raising recovery benchmarks, improving pain management and raising patient satisfaction.

Agricultural land conversion not only threatens the sustainability of the farm sector, but also influences the socioeconomic conditions of farmer. The purpose of this study is to examine the external and internal factors affecting agricultural land conversion on the household economy of rice farmers. Using a quantitative survey approach, this study collected primary data from 30 rice farmers in Kloposepuluh Village, Sidoarjo Regency, selected through purposive sampling. Secondary data were obtained from official sources, including government agencies and regional planning documents. The influence of independent variables on land conversion was examined using multiple linear regression analysis. Results show some variables significantly influence on land conversion, including land area ownership, influences from developers and other farmers, employment opportunities, and economic pressures. These variables encourage farmers to convert their land to non-farm uses. On the other hand, land conversion is not significantly affected by government policy variables, indicating the weak effectiveness of policy interventions in controlling land conversion. The results highlight the need for the government to play an active role in enhancing agricultural land protection policies by adopting more adaptive and participatory strategies. Furthermore, providing economic incentives and safeguarding farmers is expected to reduce the economic pressures that lead to land conversion.

Introduction: During level walking, humans adopt gait patterns that minimize the net energy cost of walking (NCw). Metabolic energy is required by muscles to generate force and perform total positive mechanical work (Wtot). A component of Wtot is the external mechanical work (Wext), which represents the work performed to lift and accelerate the body’s center of mass (CoM). The pendular exchange of potential and kinetic energy (Rstep) during the walk reduces Wext, thereby minimizing NCw (Peyré-Tartaruga et al., 2021). Altered Rstep has been associated with a higher NCw in older and obese adults (Fernández Menéndez et al., 2020; Malatesta et al., 2003). Older adults exhibit lower Rstep (Nùñez-Lisboa &amp; Dewolf, 2025), whereas adults with obesity display higher Rstep and lower Wext (Fernández Menéndez et al., 2020), suggesting an adaptive mechanism that mitigates the increase in NCw in this population (Fernández Menéndez et al., 2020). Therefore, this study aimed to examine the effects of modulating the pendular mechanism via a real-time visual biofeedback on the energetics and mechanics of walking in healthy individuals. Method: 15 healthy adults (7 men and 8 women; height: 1.73±0.10 meters; body mass: 70.9±13.1 kg; age: 26.2±4.3 yr) walked 5 min at 4 km/h on an instrumented treadmill (Gaitway-3D, ®Arsalis, Belgium) in 3 different experimental conditions: 1) normal walking to assess the preferred Rstep values (0%) and at 2) -10% and 3) +10% of preferred Rstep values using a real-time visual biofeedback during the 5 min to obtain these targeted values. Gas exchanges were collected to assess the NCw (J·kg-1·m-1). The ground reaction forces were measured to generate real-time visual biofeedback during -10% and +10% Rstep trials and to assess walking mechanics (Wext and Rstep) during 30 seconds of each walking trial (Fernández Menéndez et al., 2020). Locomotor efficiency was calculated as Wext divided by the NCw (Griffin et al., 2003). Result: NCw increased significantly at +10% (p=0.010) and -10% (p&lt;0.001) Rstep conditions compared with the preferred value (0%). Wext significantly increased at -10% than at 0% (p=0.006) and +10% (p&lt;.001) Rstep conditions, whereas it did not significantly differ between 0% and +10% Rstep conditions (p=0.518). Locomotor efficiency significantly decreased at +10% Rstep (9.2±2.7%) compared with 0% Rstep conditions (12.2±2.0%; p=0.011) but did not significantly differ between 0% and -10% Rstep conditions (11.5±4.2%, p=1.000). Discussion: NCw was minimized at the preferred Rstep value and increased significantly at -10% and +10% Rstep conditions. This confirms that the preferred pattern is the most economical, even when Rstep is increased. At -10% Rstep condition, the current increase in NCw and Wext suggests that targeting Rstep through real-time visual biofeedback may have rehabilitative potential for increasing Rstep and thereby reducing Wext and NCw in populations with naturally lower Rstep during walking, such as older adults (Nùñez-Lisboa &amp; Dewolf, 2025). Conclusion: These results confirm that whole-body energy minimization is a central determinant of human gait behavior. Future longitudinal studies are required to determine the long-term effectiveness of real-time visual biofeedback interventions aimed at enhancing pendular transduction and reducing NCw in older adults.

Abstract Chronic lower back pain (CLBP) is a prevalent occupational problem among hospital workers, primarily caused by prolonged sitting and poor ergonomic posture. This condition contributes to reduced productivity, discomfort, and diminished quality of working life. Ergonomic chair interventions have been introduced as a potential preventive and therapeutic strategy to alleviate pain and improve workplace well-being. A narrative literature review was conducted by searching PubMed, Scopus, and Google Scholar databases from 2015 to 2025 using the keywords low back pain, chair intervention, and hospital workers. Selected studies discussed ergonomic chair modifications, posture correction, and work-related health outcomes. Most reviewed studies demonstrated that ergonomic chair interventions reduced pain intensity and disability scores, while improving posture stability and job satisfaction. Enhanced comfort and reduced fatigue were associated with better concentration and productivity. However, inconsistencies in chair design, user compliance, and study methods remain as limitations. A chair which is pivot adjustable and has adjustable backrest can reduce the muscle activity and also decreases the inter-vertebral disc pressure. Therefore, there is some support that adjustability of the chair can be directly associated with the function of the musculoskeletal system. Ergonomic chair interventions provide a promising approach to reducing CLBP and improving the quality of working life among hospital workers. Further high-quality studies are needed to develop standardized ergonomic recommendations for healthcare workplaces. Keywords: ergonomic chair, hospital worker, low back pain, quality of working life

This narrative review investigates the implications of out-of-pocket (OOP) payments for malaria treatment in developing countries by synthesizing evidence from peer-reviewed articles, reports, and policy documents. A thematic approach was employed to analyze key areas, including economic impacts on households, barriers to accessing care, and the overall effectiveness of malaria control interventions. The review also evaluated alternative financing mechanisms and their potential to mitigate the financial burden on vulnerable populations. The findings reveal that OOP payments significantly hinder timely access to malaria treatment, disproportionately affecting low-income and rural households. Delayed treatment-seeking behavior, underutilization of preventive measures such as insecticide-treated nets, and suboptimal use of diagnostics were identified as major challenges. Furthermore, the financial burden of OOP payments exacerbates health inequities, increasing morbidity and mortality among marginalized groups. Effective alternatives, such as government subsidies, community health insurance, and donor-funded programs, were highlighted as solutions to reduce these barriers. The review concludes that reducing OOP payments is critical to improving malaria control and ensuring equitable healthcare access in developing countries. It recommends scaling up subsidized care, strengthening public health systems, and engaging in public-private partnerships to enhance the availability and affordability of malaria interventions. Policymakers are urged to prioritize financial protection strategies to achieve sustainable progress in malaria eradication efforts.

Brain-derived neurotrophic factor (BDNF) is a neurotrophin important for neuronal survival and synaptic plasticity that also plays a role in metabolic regulation (energy homeostasis and appetite control). Lower circulating BDNF levels have been associated with obesity, metabolic risk factors, and poorer cognitive and mental health outcomes, whereas higher levels are linked to more favorable profiles. In this study we sought to systematically evaluate the effects of dietary weight-loss interventions on circulating BDNF levels in adults with overweight or obesity. A comprehensive literature search of PubMed, Web of Science, Scopus, and Google Scholar was conducted from inception through April 2025 to identify clinical trials investigating dietary weight-loss or calorie-restriction interventions in adults with overweight or obesity that reported data regarding circulating BDNF outcomes. Eligible studies were clinical trials with interventions lasting ≥4 weeks to investigate circulating BDNF concentrations before and after dietary interventions that were conducted in adults (≥18 years old) with baseline overweight or obesity. This systematic review was conducted in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines. Risk of bias was assessed using the Cochrane risk-of-bias tool. Data on study design, participant characteristics, dietary interventions, and BDNF outcomes were extracted and synthesized qualitatively. A summary table of the included studies was generated. Fifteen clinical studies (n = 862 total participants) met inclusion criteria (11 randomized trials and 4 single-arm trials). Diet modalities included continuous calorie restriction (typically 20%-30% caloric deficit), intermittent fasting (eg, alternate-day fasting, time-restricted eating), ketogenic diets (KDs), Mediterranean-type diets, and other weight-loss diets. Duration of interventions ranged from 6 to 26 weeks. Responses to BDNF varied by intervention. In adults with overweight/obesity, weight-loss dietary interventions demonstrated heterogeneous effects on circulating BDNF. We categorized the included studies into 3 groups based on the effects of dietary weight loss on BDNF: increases, no significant change, or decreases. Approximately half of the studies showed no significant effect, while a few interventions showed a decrease. Intermittent fasting regimens and certain dietary patterns (eg, the Mediterranean-DASH [Dietary Approaches to Stop Hypertension] [MIND] diet, and the KD) tend to elevate BDNF levels, whereas continuous calorie restriction often shows no change, and very rapid weight loss may paradoxically reduce BDNF in some cases. These findings suggest that diet-induced weight loss can influence neurotrophic status, potentially modulating brain health. However, results are inconsistent across studies. Overall, interventions involving intermittent calorie restriction, MIND, and/or KD, more frequently reported BDNF increases, whereas continuous calorie restriction produced mixed results.

Overweight and obesity pose an escalating health challenge for the older, yet routine management (RM) often underperform due to fragmented care. The multidisciplinary weight management (MWM) intervention addresses this challenge by integrating family doctor team and sport-health integration. We aim to evaluate the effectiveness of RM versus MWM intervention on body mass index (BMI) and waist circumference (WC) among overweight / obese adults (aged ≥ 65 years). A 24-month retrospective cohort study utilized electronic health records from Xiamen Basic Public Health Cloud Platform, including the MWM group (1177 samples) and the Routine Management (RM) group (1188 samples). McNemar χ² tests were employed to assess within-group changes in BMI and WC from baseline to post-intervention, while χ² tests compared BMI and WC between groups. The Wilcoxon signed-rank test and the Mann-Whitney U test were utilised to compare clinical indicators between the two groups before and after intervention, as well as to compare the two groups. Multivariable linear regression models were fitted to report the effect of MWM versus RM as β coefficients with 95% confidence intervals (CIs). Mediation analysis were conducted on physical activity level, smoking status and alcohol consumption. The MWM group showed more favorable shifts in BMI (normal weight 13.25% vs. 0.00%) and WC (no centrol obesity 42.57% vs. 32.15%) compared with RM (P < 0.001). And MWM is associated with BMI and WC reduction, with a mean reduction in BMI of 0.88kg/m2 (95% CI: 0.77 to 0.99; P < 0.001) and in WC of 1.16cm (95% CI: 0.78 to 1.55; P < 0.001). Physical Activity partially mediated the intervention effect on BMI (mediation proportion 6.78%; P = 0.032). The MWM group produced clinically greater reductions in BMI and WC compared with RM, and its integrated care framework may offer an effective and scalable approach to obesity management in older adults. To promote this management, future research should validate in larger, diverse cohorts.

Purpose This study aims to investigate the synergistic effects of AB-Flu nanodrugs and exercise intervention on enhancing the antitumor effects in melanoma by improving the hypoxic tumor microenvironment (TME). The focus is on evaluating how this combination influences reactive oxygen species (ROS) levels, inhibition of melanoma in vivo . Methods An intact B16F10 melanoma mouse model was established, and mice were divided into four groups: control, AB-Flu treatment, exercise intervention, and combination therapy (AB-Flu + exercise). AB-Flu nanodrug was administered intraperitoneally, while exercise was facilitated by a weighted swimming intervention. Tumor growth, tumor hypoxia, ROS levels, and apoptosis were analyzed through tumor volume measurements, histological staining, and ROS detection assays. The antitumor effects of different treatments were compared. Results The combination therapy group showed the most significant tumor inhibition efficacy with tumor growth inhibition rates of 56%, compared to 30% for the AB-Flu monotherapy group and 41% for the exercise group. Additionally, tumor tissues from the combination group exhibited significantly lower levels of hypoxia and enhanced tumor cell apoptosis. ROS levels were substantially higher in the combination therapy group compared to other groups, indicating that the combination of AB-Flu and exercise synergistically elevated ROS production, which may contribute to increased tumor cell apoptosis. No significant toxicity was observed in major organs. Conclusion The combination of AB-Flu nanodrugs and exercise intervention significantly enhances the antitumor effects in melanoma by improving the hypoxic TME, elevating ROS levels, and promoting apoptosis in tumor cells. This strategy may offer a potential approach for melanoma therapy.

Background Patients with depression have memory impairment. Exercise can improve memory in people with depression. This study employs a three-level meta-analysis to investigate the interventional effects of exercise on verbal and visual memory in patients with depression. Methods A systematic electronic search was conducted in China National Knowledge Infrastructure, Wanfang Data, China Biomedicine, PubMed, EMBASE, the Cochrane Library, and Web of Science to identify randomized controlled trials investigating the effects of exercise interventions on memory in individuals with depression, up to July 18, 2024. A three-level meta-analysis based on a random-effects model was performed using R. The risk of bias of the included studies was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Results A total of 16 studies were included in the analysis. The results indicated a statistically significant but small effect of exercise on verbal memory in patients with depression ( g = 0.17, 95% confidence interval (CI) [0.02–0.32], p = 0.03); however, the 95% prediction interval crossed zero, suggesting that the effect may not be consistent across different settings or future studies; however, the 95% prediction interval crossed zero, suggesting that the effect may not be consistent across different settings or future studies ( g = 0.27, 95% CI [−0.00–0.54], p = 0.05). Exercise intensity significantly moderated the effect of exercise on verbal memory in patients with depression ( F = 3.39, p = 0.04), whereas exercise type, session time, duration, age, and intervention content of the experimental group were not moderating factors ( p &gt; 0.05). Low-to-moderate intensity ( g = 0.43, p &lt; 0.01), duration ≤12 weeks ( g = 0.27, p &lt; 0.01), and session time ≤60 minutes ( g = 0.18, p = 0.03) of mind-body exercise ( g = 0.43, p &lt; 0.01) were most likely to improve verbal memory in patients with depression. The level of evidence was “moderate”. Conclusions Exercise may confer a small improvement in verbal memory among adults with depression, while no clear effect was observed for visual memory. However, further randomized controlled trials are needed to explore the impact of exercise on memory in patients with depression. Research plan was registered in international system evaluation platform PROSPERO ( https://www.crd.york.ac.uk/PROSPERO/ ) (CRD42023473393).