Exercise Recommendations Research Articles

The computational and energy cost of simulation and storage for climate science: lessons from CMIP6

Abstract. The Coupled Model Intercomparison Project (CMIP) is one of the biggest international efforts aimed at better understanding the past, present, and future of climate changes in a multi-model context. A total of 21 model intercomparison projects (MIPs) were endorsed in its sixth phase (CMIP6), which included 190 different experiments that were used to simulate 40 000 years and produced around 40 PB of data in total. This paper presents the main findings obtained from the CPMIP (the Computational Performance Model Intercomparison Project), a collection of a common set of metrics, specifically designed for assessing climate model performance. These metrics were exclusively collected from the production runs of experiments used in CMIP6 and primarily from institutions within the IS-ENES3 consortium. The document presents the full set of CPMIP metrics per institution and experiment, including a detailed analysis and discussion of each of the measurements. During the analysis, we found a positive correlation between the core hours needed, the complexity of the models, and the resolution used. Likewise, we show that between 5 %–15 % of the execution cost is spent in the coupling between independent components, and it only gets worse by increasing the number of resources. From the data, it is clear that queue times have a great impact on the actual speed achieved and have a huge variability across different institutions, ranging from none to up to 78 % execution overhead. Furthermore, our evaluation shows that the estimated carbon footprint of running such big simulations within the IS-ENES3 consortium is 1692 t of CO2 equivalent. As a result of the collection, we contribute to the creation of a comprehensive database for future community reference, establishing a benchmark for evaluation and facilitating the multi-model, multi-platform comparisons crucial for understanding climate modelling performance. Given the diverse range of applications, configurations, and hardware utilised, further work is required for the standardisation and formulation of general rules. The paper concludes with recommendations for future exercises aimed at addressing the encountered challenges which will facilitate more collections of a similar nature.

Exercise recommendations in pregnancy – A literature review

Exercise recommendations in pregnancy – A literature review

Short-duration aerobic high-intensity intervals versus moderate exercise training intensity in patients with peripheral artery disease: study protocol for a randomised controlled trial (the Angiof-HIIT Study)

IntroductionSupervised exercise training is among the first-line therapies for patients with peripheral artery disease (PAD). Current recommendations for exercise include guidance focusing on claudication pain, programme and session duration, and...

Short all-out isokinetic cycling exercises of 90 and 15 s unlock exercise-induced hypoalgesia.

Acute physical activity leads to exercise-induced hypoalgesia (EIH). However, to what degree it can be induced by very short but highly intensive exercise is largely unknown. This study aims to investigate the effects of two different short all-out isokinetic exercise sessions on EIH. Twenty young male participants underwent three different interventions (90, 15 s all-out isokinetic cycling, respectively, and control) after an individualized low-intensity warm-up in a randomized-controlled-crossover design. Before (pre), after warm-up (post 1) as well as immediately post-intervention (post 2) pain sensitivity was measured employing pressure pain thresholds (PPT; in N) at the elbow, knee and ankle joints as well as the sternum and forehead. Performance parameters (e.g. lactate, perceived exertion, heart rate) were documented. A 'time' × 'intervention' × 'body site' interaction effect (p < 0.001, η2 partial = 0.110) was observed for PPT. Both isokinetic interventions resulted in EIH at all body sites, even after ruling out any warm-up effects, while effects were larger for 90 s (maximum increase of 25.7 ± 11.7 N) compared to 15 s (maximum increase of 19.3 ± 18.9 N), and control (maximum increase of 8.0 ± 6.1 N). Compared to control, 15 s also resulted in hypoalgesic effects and differences were not observed at all sites. In this study, 90 s resulted in higher lactate, subjective exhaustion and heart rate levels compared to 15 s and control (p < 0.001), while higher values were also observed for 15 s compared to control. Global EIH assessed immediately after exercise can be induced by short highly intensive exercises. The effects are greater when the subjective and the objective exertion are higher as induced by the 90 s intervention. This study investigates the potential for brief, highly intensive exercise sessions to induce exercise-induced hypoalgesia (EIH). The research demonstrates that EIH can indeed be triggered by such short workouts, with greater effects observed during a 90 s session compared to a 15 s one, most likely due to higher subjective and objective exertion. These findings offer insights into the potential for extremely brief but intense exercises to alleviate pain, impacting exercise recommendations and pain management strategies.

Exercise Prescription for Postprandial Glycemic Management.

The detrimental impacts of postprandial hyperglycemia on health are a critical concern, and exercise is recognized a pivotal tool in enhancing glycemic control after a meal. However, current exercise recommendations for managing postprandial glucose levels remain fairly broad and require deeper clarification. This review examines the existing literature aiming to offer a comprehensive guide for exercise prescription to optimize postprandial glycemic management. Specifically, it considers various exercise parameters (i.e., exercise timing, type, intensity, volume, pattern) for crafting exercise prescriptions. Findings predominantly indicate that moderate-intensity exercise initiated shortly after meals may substantially improve glucose response to a meal in healthy individuals and those with type 2 diabetes. Moreover, incorporating short activity breaks throughout the exercise session may provide additional benefits for reducing glucose response.

A data-driven approach to improve wellness and reduce recurrence in cancer survivors.

For many cancer survivors, toxic side effects of treatment, lingering effects of the aftermath of disease and cancer recurrence adversely affect quality of life (QoL) and reduce healthspan. Data-driven approaches for quantifying and improving wellness in healthy individuals hold great promise for improving the lives of cancer survivors. The data-driven strategy will also guide personalized nutrition and exercise recommendations that may help prevent cancer recurrence and secondary malignancies in survivors.

Guidelines for obesity clinic consultations in primary healthcare clinics

Background: The prevalence of obesity and its public health implications underscore the necessity for prioritizing its prevention and care in primary healthcare clinics.Current Concepts: The establishment of dedicated obesity clinics requires a comprehensive initial assessment of patients, ideally facilitated by a pre-consultation questionnaire. The initial assessment of patients includes a detailed patient interview, thorough physical examination, body composition analysis, and evaluation of visceral adiposity. Identifying potential causes of secondary obesity, particularly drug-induced obesity, is imperative before the initiation of treatment. The primary goal of obesity management transcends weight reduction alone and should encompass the improvement of overall health status, addressing concurrent comorbidities. Individualized treatment goals are established after a thorough assessment. Although the cornerstone of obesity management is the promotion of a healthier lifestyle, personalized approaches tailored to the circumstances of each patient are advocated for long term sustainability. Dietary and exercise recommendations should be personalized and introduced progressively. Pharmacotherapy can significantly potentiate lifestyle modification efforts for weight reduction. However, the selection of pharmacological agents must be reasonable, considering factors as comorbid conditions, severity of obesity, previous weight gain history, and economic constraints related to treatment. Dosing regimens should be meticulously calibrated and adjusted as necessary, with vigilant monitoring of the therapeutic efficacy and potential adverse reactions.Discussion and Conclusion: Effective obesity management in primary healthcare clinics involves thorough assessment, goal setting, recommendation of individualized lifestyle modifications, and careful implementation of suitable pharmacotherapy.

Recommendations for physical activity and exercise in persons living with Systemic Lupus Erythematosus (SLE): consensus by an international task force

ObjectiveThis international task force aimed to provide healthcare professionals and persons living with systemic lupus erythematosus (SLE) with consensus-based recommendations for physical activity and exercise in SLE.MethodsBased on evidence from...

An initiative to implement a triage and referral system to make exercise and rehabilitation referrals standard of care in oncology

BackgroundClinical guidelines suggest that patients should be referred to exercise while undergoing cancer treatment. Oncology clinicians report being supportive of exercise referrals but not having the time to make referrals. Toward the goal of making exercise referrals standard of care, we implemented and evaluated a novel clinical workflow.MethodsFor this QI project, a rehabilitation navigator was inserted in chemotherapy infusion clinics. Patients were offered a validated electronic triage survey. Exercise or rehabilitation recommendations were communicated to patients during a brief counseling visit by the rehabilitation navigator. The implementation approach was guided by the EPIS framework. Acceptability and feasibility were assessed.ResultsInitial meetings with nursing and cancer center leadership ensured buy-in (exploration). The education of medical assistants contributed to the adoption of the triage process (preparation). Audit and feedback ensured leadership was aware of medical assistants’ performance (implementation). 100% of medical assistants participated in implementing the triage tool. A total of 587 patients visited the infusion clinics during the 6-month period when this QI project was conducted. Of these, 501 (85.3%) were offered the triage survey and 391 (78%) completed the survey (acceptability). A total of 176 (45%) of triaged patients accepted a referral to exercise or rehabilitation interventions (feasibility).ConclusionsImplementation of a validated triage tool by medical assistants and brief counseling by a rehabilitation navigator resulted in 45% of infusion patients accepting a referral to exercise or rehabilitation. The triage process showed promise for making exercise referrals standard of care for patients undergoing cancer treatment.

Exercise in Adult Patients with Type 2 Diabetes: Integrated Diabetes and Endocrine Academy Consensus Statement for Indian Patients

Exercise is one of the pillars of diabetes management. Current guidelines provide a general recommendation regarding exercise advice for patients with diabetes, but guidance regarding exercise suited for Indian patients is scarce. We aim to arrive at exercise recommendations for patients with type 2 diabetes incorporating the latest modalities of exercise along with consideration of Indian patients. We conducted an extensive search using the PubMed electronic database and Google Scholar until February 1, 2024. The retrieved literature was then meticulously deliberated upon by the panel members to arrive at appropriate recommendations. The various guidelines and literature recovered have advised exercise regimes for type 2 diabetes, but have not always covered all the aspects of exercise, including timing of exercise, exercising in the presence of associated comorbidities such as diabetic foot, neuropathy, retinopathy, cardiovascular disease, elderly, and pregnancy with diabetes in one complete recommendation. Furthermore, advice regarding soleus exercise has not been incorporated in any recommendation. Moreover, advice specifically for Indian patients with type 2 diabetes was lacking. This recommendation incorporates the latest in exercise modalities for patients with type 2 diabetes, including patients with major macrovascular and microvascular problems, with specific advice for each complication which will serve as a guide for physicians when they advise patients regarding exercise.

Application of Exercise Recommendation Model Based on Deep Reinforcement Learning

In order to consolidate the learning achievements of students at a certain stage, Teachers often provide students with corresponding exercises before or after the beginning of this stage. Therefore, making the exercises appropriately challenging is one of the main goals of adaptive online learning systems. However, because each student's learning status is different, a student's learning situation in the same period of time will also be different. Therefore, it is also very challenging for students to choose appropriate exercises. In this paper, we propose a new method for problem recommendation. Firstly, we use GCKT model to model the user's answer sequence. Obtain the students' mastery of each concept. The learned user and problem representation are integrated into an extended framework to predict the likelihood of user mastery of the problem. Then use this as the basis for recommending exercises. On this basis, the deep reinforcement learning technology is used and the knowledge tracking model is used as a student simulator. The difference in the performance of the student simulator on all the exercises before and after solving the exercises provided by the exercise recommendation model is used as a reward, Make the model learn what kind of exercises can improve students' ability to the greatest extent, and recommend such exercises to students. Finally, the experiment is carried out in the actual use environment. The results show that the model has better performance than the current common recommendation models.

Effects and potential mechanisms of exercise and physical activity on eye health and ocular diseases.

In the field of eye health, the profound impact of exercise and physical activity on various ocular diseases has become a focal point of attention. This review summarizes and elucidates the positive effects of exercise and physical activities on common ocular diseases, including dry eye disease (DED), cataracts, myopia, glaucoma, diabetic retinopathy (DR), and age-related macular degeneration (AMD). It also catalogues and offers exercise recommendations based on the varying impacts that different types and intensities of physical activities may have on specific eye conditions. Beyond correlations, this review also compiles potential mechanisms through which exercise and physical activity beneficially affect eye health. From mitigating ocular oxidative stress and inflammatory responses, reducing intraocular pressure, enhancing mitochondrial function, to promoting ocular blood circulation and the release of protective factors, the complex biological effects triggered by exercise and physical activities reveal their substantial potential in preventing and even assisting in the treatment of ocular diseases. This review aims not only to foster awareness and appreciation for how exercise and physical activity can improve eye health but also to serve as a catalyst for further exploration into the specific mechanisms and key targets through which exercise impacts ocular health. Such inquiries are crucial for advancing innovative strategies for the treatment of eye diseases, thereby holding significant implications for the development of new therapeutic approaches.

Exercise and physical activity after stoma surgery: EXPASS recommendations.

No formal published recommendations exist about exercise and physical activity after stoma surgery and there is no consensus on advice among health professionals. Numerous difficulties after stoma surgery cause physical activity and exercise levels to decrease. Health professionals can feel ill equipped to advise, leaving patients confused and unsupported. Formal recommendations for exercise and physical activity are to be established. An expert panel is working under the auspices of the Association of Stoma Care Nurses (ASCN) UK to review existing literature, explore clinical practice and develop formal Delphi consensus recommendations. The document will be aimed at health professionals but will also be available to individuals undergoing surgery. The formal document will be published by the end of 2024 through ASCN UK. The scope of the EXPASS recommendations will cover adults (aged ≥16 years) with any stoma. It will offer peer-reviewed Delphi guidance on physical activity and exercise before and immediately after surgery as well as for long-term living with a stoma. After peer review, the document will provide clarification, consensus and practical recommendations based on the expert panel's evidence, research and clinical opinion.

Spontaneous coronary artery dissection: a focus on post-dissection care for the vascular medicine clinician.

Spontaneous coronary artery dissection (SCAD) is an uncommon condition which is increasingly recognized as a cause of significant morbidity. SCAD can cause acute coronary syndrome and myocardial infarction (MI), as well as sudden cardiac death. It presents similarly to atherosclerotic MI although typically in patients with few or no atherosclerotic risk factors, and particularly in women. As more patients are recognized to have this condition, there is a great need for clinician familiarity with diagnostic criteria, as well as with contemporary treatment approaches, and with appropriate patient-centered counseling, including genetic testing, exercise recommendations, and psychological care. The standard of care for patients with SCAD is rapidly evolving. This review therefore summarizes the diagnosis of SCAD, epidemiology, modern treatment, cardiac rehabilitation and preconception counseling, and the current approach to genetic testing, exercise recommendations, and psychological care, all of which are crucial to the vascular medicine specialist.

Virtual pulmonary rehabilitation approaches in patients with post COVID syndrome: a pilot study

BackgroundThe characteristics of optimal virtual pulmonary rehabilitation (PR) for individuals with post-COVID syndrome (PCS) have not been identified. This study aimed to assess the feasibility, safety, and satisfaction associated with a virtual PR program with the exercise component delivered through group or self-directed sessions.MethodsAdults with PCS-respiratory symptoms were randomly assigned to the video conference (PRVC) or self-directed (PRSD) group and completed an exercise program (aerobic, strengthening, and breathing exercises) three times/week for eight weeks. PRVC sessions were led by a physiotherapist via Zoom, whereas the PRSD group exercised individually following a pre-recorded video. Both groups received personalized exercise recommendations, education related to the condition, and a weekly follow up call. Satisfaction was assessed through a patient survey. Lung function, dyspnea, fatigue, sit-to-stand capacity, health-related quality of life, and participation were assessed pre- and post-PR.ResultsFourteen PCS individuals (49 ± 9 years, 86% females) completed 83% of the sessions. All participants were satisfied with information provided by the therapist and frequency of data submission, whereas most were satisfied with the frequency and duration of exercise sessions (88% in PRVC and 83% in PRSD). A higher proportion of participants in the PRVC (88%) were satisfied with the level of difficulty of exercises compared with the PRSD (67%), and 84% of the sample reported a positive impact of the program on their health. No adverse events were reported. Significant changes in sit-to-stand capacity (p = 0.012, Cohen’s r = 0.67) and questions related to fatigue (p = 0.027, Cohen’s r = 0.58), neurocognitive (p = 0.045, Cohen’s r = 0.53), and autonomic (p = 0.024, Cohen’s r = 0.60) domains of the DePaul Symptom Questionnaire short-form were also found between groups.ConclusionVirtual PR with exercises delivered via video conference or pre-recorded video were feasible, safe, and well-received by individuals with PCS.Trial registrationNCT05003271 (first posted: 12/08/2021).

Lessons and Untapped Potential of Smartphone-Based Physical Activity Interventions for Mental Health: Narrative Review.

Physical activity has well-known and broad health benefits, including antidepressive and anxiolytic effects. However, only approximately half of Americans meet even the minimum exercise recommendations. Individuals with anxiety, depression, or related conditions are even less likely to do so. With the advent of mobile sensors and phones, experts have quickly noted the utility of technology for the enhanced measurement of and intervention for physical activity. In addition to being more accessible than in-person approaches, technology-driven interventions may uniquely engage key mechanisms of behavior change such as self-awareness. This study aims to provide a narrative overview and specific recommendations for future research on smartphone-based physical activity interventions for psychological disorders or concerns. In this paper, we summarized early efforts to adapt and test smartphone-based or smartphone-supported physical activity interventions for mental health. The included articles described or reported smartphone-delivered or smartphone-supported interventions intended to increase physical activity or reduce sedentary behavior and included an emotional disorder, concern, or symptom as an outcome measure. We attempted to extract details regarding the intervention designs, trial designs, study populations, outcome measures, and inclusion of adaptations specifically for mental health. In taking a narrative lens, we drew attention to the type of work that has been done and used these exemplars to discuss key directions to build on. To date, most studies have examined mental health outcomes as secondary or exploratory variables largely in the context of managing medical concerns (eg, cancer and diabetes). Few trials have recruited psychiatric populations or explicitly aimed to target psychiatric concerns. Consequently, although there are encouraging signals that smartphone-based physical activity interventions could be feasible, acceptable, and efficacious for individuals with mental illnesses, this remains an underexplored area. Promising avenues for tailoring validated smartphone-based interventions include adding psychoeducation (eg, the relationship between depression, physical activity, and inactivity), offering psychosocial treatment in parallel (eg, cognitive restructuring), and adding personalized coaching. To conclude, we offer specific recommendations for future research, treatment development, and implementation in this area, which remains open and promising for flexible, highly scalable support.

Inverted U-shaped relationship between sleep duration and phenotypic age in US adults: a population-based study

Sleep is a modifiable behavior that can be targeted in interventions aimed at promoting healthy aging. This study aims to (i) identify the sleep duration trend in US adults; (ii) investigate the relationship between sleep duration and phenotypic age; and (iii) explore the role of exercise in this relationship. Phenotypic age as a novel index was calculated according to biomarkers collected from US adults based on the National Health and Nutrition Examination Survey (NHANES). Sleep information was self-reported by participants and discerned through individual interviews. The principal analytical method employed was weighted multivariable linear regression modeling, which accommodated for the complex multi-stage sampling design. The potential non-linear relationship was explored using a restricted cubic spline (RCS) model. Furthermore, subgroup analyses evaluated the potential effects of sociodemographic and lifestyle factors on the primary study outcomes. A total of 13,569 participants were finally included in, thereby resulting in a weighted population of 78,880,615. An examination of the temporal trends in sleep duration revealed a declining proportion of individuals with insufficient and markedly deficient sleep time since the 2015–2016 cycle. Taken normal sleep group as a reference, participants with extreme short sleep [β (95% CI) 0.582 (0.018, 1.146), p = 0.044] and long sleep [β (95% CI) 0.694 (0.186, 1.203), p = 0.010] were both positively associated with phenotypic age using the fully adjusted model. According to the dose–response relationship between sleep duration and phenotypic age, long sleep duration can benefit from regular exercise activity, whereas short sleep duration with more exercise tended to have higher phenotypic age. There is an inverted U-shaped relationship between short and long sleep durations and phenotypic age. This study represents an important step forward in our understanding of the complex relationship between sleep and healthy aging. By shedding light on this topic and providing practical exercise recommendations for promoting healthy sleep habits, researchers can help individuals live longer, healthier, and more fulfilling lives.

Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease

BACKGROUND Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease worldwide, affecting about 1/4th of the global population and causing a huge global economic burden. To date, no drugs have been approved for the treatment of NAFLD, making the correction of unhealthy lifestyles the principle method of treatment. Identifying patients with poor adherence to lifestyle correction and attempting to improve their adherence are therefore very important. AIM To develop and validate a scale that can rapidly assess the adherence of patients with NAFLD to lifestyle interventions. METHODS The Exercise and Diet Adherence Scale (EDAS) was designed based on compilation using the Delphi method, and its reliability was subsequently evaluated. Demographic and laboratory indicators were measured, and patients completed the EDAS questionnaire at baseline and after 6 months. The efficacy of the EDAS was evaluated in the initial cohort. Subsequently, the efficacy of the EDAS was internally verified in a validation cohort. RESULTS The EDAS consisted of 33 items in six dimensions, with a total of 165 points. Total EDAS score correlated significantly with daily number of exercise and daily reduction in calorie intake (P &lt; 0.05 each), but not with overall weight loss. A total score of 116 was excellent in predicting adherence to daily reduction in calorie intake (&gt; 500 kacl/d), (sensitivity/specificity was 100.0%/75.8%), while patients score below 97 could nearly rule out the possibility of daily exercise (sensitivity/specificity was 89.5%/44.4%). Total EDAS scores ≥ 116, 97-115, and &lt; 97 points were indicative of good, average, and poor adherence, respectively, to diet and exercise recommendations. CONCLUSION The EDAS can reliably assess the adherence of patients with NAFLD to lifestyle interventions and have clinical application in this population.

Optimizing nutrition in hepatic cirrhosis: A comprehensive assessment and care approach

Cirrhosis is considered a growing cause of morbidity and mortality, which represents a significant public health problem. Currently, there is no effective treatment to reverse cirrhosis. Treatment primarily centers on addressing the underlying liver condition, monitoring, and managing portal hypertension-related complications, and evaluating the potential for liver transplantation in cases of decompensated cirrhosis, marked by rapid progression and the emergence of complications like variceal bleeding, hepatic encephalopathy, ascites, malnutrition, and more. Malnutrition, a prevalent complication across all disease stages, is often underdiagnosed in cirrhosis due to the complexities of nutritional assessment in patients with fluid retention and/or obesity, despite its crucial impact on prognosis. Increasing emphasis has been placed on the collaboration of nutritionists within hepatology and Liver transplant teams to deliver comprehensive care, a practice that has shown to improve outcomes. This review covers appropriate screening and assessment methods for evaluating the nutritional status of this population, diagnostic approaches for malnutrition, and context-specific nutrition treatments. It also discusses evidence-based recommendations for supplementation and physical exercise, both essential elements of the standard care provided to cirrhotic patients.

Bridging the gap: Unveiling the crisis of physical inactivity in inflammatory bowel diseases

In this editorial we comment on the article titled “Inflammatory bowel diseases patients suffer from significant low levels and barriers to physical activity: The BE-FIT-IBD study” published in a recent issue of the World Journal of Gastroenterology 2023; 29 (41): 5668-5682. Inflammatory bowel diseases (IBD) are emerging as a significant global health concern as their incidence continues to rise on a global scale, with detrimental impacts on quality of life. While many advances have been made regarding the management of the disease, physical inactivity in these patients represents an underexplored issue that may hold the key for further and better understanding the ramifications of IBD. Chronic pain, fatigue, and fear of exacerbating symptoms promotes physical inactivity among IBD patients, while the lack of clear guidelines on safe exercise regimens contributes to a norm of physical inactivity. Physical activity (PA) is accepted to have a positive effect on disease outcomes and quality of life, while inactivity exacerbates comorbidities like cardiovascular disease and mental health disorders. The “BE-FIT-IBD” study, focusing on PA levels and barriers in IBD patients of Southern Italy, revealed that a significant proportion (42.9%) were physically inactive. This lack of PA is attributed to barriers such as fear of flare-ups and misconceptions about exercise exacerbating the disease. The study also highlighted the need for better communication between healthcare providers and patients regarding the benefits of PA and safe incorporation into lifestyles. Moreover, physical inactivity may also contribute to disability in IBD patients, having a great impact on employment status. Of note is the fact that IBD also comes with an important psychological burden with relevant evidence suggesting that regular PA can improve mood, reduce anxiety, and enhance mental health. The “BE-FIT-IBD” study advocated for the integration of PA into IBD management, emphasizing the bidirectional link between PA and IBD. Regular exercise can influence the course of IBD, potentially reducing symptom severity and prolonging remission periods. As such, it is mandatory that healthcare providers actively educate patients, dispel misconceptions, and tailor exercise recommendations to improve the quality of life and reduce IBD-related complications.