High-intensity Group Research Articles

Effects of Exercise Intensity Differences in Forest Therapy Programs on Immunoglobulin A and Dehydroepiandrosterone Levels in Older Adults

The purpose of this study was to examine the effects of exercise intensity and the duration of an exercise-based forest therapy program on physiological changes in older adults. The forest therapy program consisted of 20 sessions over 10 weeks. Forty-one older adults aged 65 years and older were divided into no treatment (daily activity group) and experimental (forest therapy) groups. The experimental group was further divided into the medium-intensity forest exercise group and the high-intensity forest exercise group to analyze physiological changes according to exercise intensity and duration. The physiological changes were analyzed by collecting saliva and measuring changes in the levels of immunoglobulin A and dehydroepiandrosterone, a hormone used to predict aging. Changes within the daily activity group and the forest therapy group after their respective exercises were analyzed using paired t-tests. Saliva testing was performed before and in weeks 5 and 10 of the program and analyzed using a repeated measures analysis of variance to assess the effects of the forest therapy on the medium-intensity forest exercise group and the high-intensity forest exercise group based on the duration of exercise. As a result of the study, a significant increase in immunoglobulin A was observed in the medium-intensity forest exercise group. The daily activity group and the high-intensity forest exercise group showed an increase, but there was very little change and no significance. Changes in dehydroepiandrosterone decreased in the daily activity group and significantly increased in the moderate-intensity forest exercise group at 5 and 10 weeks, showing that regular moderate-intensity forest exercise has an effect on dehydroepiandrosterone. The high-intensity forest exercise group improved over time, but no significant level of change was observed. This study shows that forest exercise has a beneficial effect on immunoglobulin A and dehydroepiandrosterone levels in older adults.

The meaningfulness of exploring one's own limits through interactions and enjoyment in outdoor high-intensity physiotherapy for people with multiple sclerosis: a qualitative study.

Physical activity (PA) is often reduced in people with MS (pwMS), even when disability is low. Understanding the perspectives of pwMS on interventions aiming to improve PA is important to inform the development of such services. The aim of this study was to explore the experiences of pwMS participating in an outdoor, high-intensity and balance exercise group intervention. This qualitative study was nested within an RCT exploring a novel intervention integrating sensorimotor exercises with high-intensity intervals of running/walking. Individual, in-depth interviews with the intervention group (n = 15; 12 women, 3 men; age 38-66; EDSS score 0-3.5) were conducted postintervention (mean days = 14), analyzed using a phenomenological-inspired approach with systematic text condensation, and interpreted based on enactive theory. Four categories were generated: (1) Exploration of one's own physical abilities: Challenging one's own limits was perceived by all participants to improve movement performance and/or intensity level. Such bodily changes engendered strong positive feelings. Some negative consequences of high-intensity training were described, increasing a feeling of loss. (2) New insights and beliefs: Participants experienced enhanced beliefs in their own capabilities, which they integrated in activities outside the intervention. (3) An engaging environment: The group setting was perceived as supportive, and the outdoor environment was perceived as stimulating activity. (4) Professional leadership, tailoring and co-creation of enjoyment: Physiotherapist-led, individualized interactions were regarded as necessary to safely revisit prior activities, such as running. Co-creating enjoyment facilitated high-intensity training and intervention adherence. High-intensity training combined with detailed exercises in a physiotherapy outdoor group was perceived to create meaningful bodily changes and enhance PA and prospects for both PA and life. Importantly, however, some negative experiences were also reported from the high-intensity training. Enactive theory allowed for the illumination of new perspectives: the importance of embodiment for self-efficacy and of tailored physiotherapy and an outdoor-group environment for exploring one's own limits to physical capabilities. These aspects should inform future exercise interventions in pwMS with low disability.

Changes in weight status of caregivers of children and adolescents enrolled in a community-based healthy lifestyle programme: Five-year follow-up

Whānau Pakari is a family-centred healthy lifestyle programme for children/adolescents with overweight/obesity in New Zealand. This secondary analysis from our randomised trial within the clinical service assessed 5-year BMI changes in accompanying caregivers (n = 23), mostly mothers. Overall, baseline and 5-year caregivers’ BMI were similar (32.50 vs 31.42 kg/m2, respectively; p = 0.31) but two-thirds (65%) experienced BMI reductions. Five-year BMI change was similar in High-intensity and Low-intensity randomisation groups [–1.37 kg/m2 (–4.95, 2.21); p = 0.44]. Caregiver’s BMI change was not associated with child’s BMI change. Despite no overall BMI reduction, our findings contrast with upward BMI trajectories predicted for NZ adults with overweight/obesity.

Medium-intensity statin with ezetimibe versus high-intensity statin in acute ischemic cerebrovascular disease (MESIA): A randomized clinical trial

BackgroundHigh-risk stroke patients are recommended to receive high-intensity statin therapy to reduce the risk of stroke recurrence. However, doubling the dosage of statin drugs did not increase the achievement rate of LDL-C target or provide additional clinical benefits, but significantly increased the risk of adverse reactions. Statins and ezetimibe work through different mechanisms and the combined use of statins and ezetimibe significantly improves outcomes with comparable safety profiles. We tested the hypothesis that moderate-intensity statin with ezetimibe may offer advantages over the conventional high-intensity statin regimen in terms of efficacy and safety. MethodsWe conducted a randomized controlled trial. Eligible participants were aged 18 years or older with acute ischemic cerebrovascular disease. We randomly assigned (1:1) participants within the acute phase of ischemic stroke, i.e., within 1 week after the onset of mild ischemic stroke (NIHSS score ≤ 5), within 1 month for severe cases (NIHSS score ≥ 16), and within 2 weeks for the rest, as well as patients with TIA within 1 week of symptom onset, to receive either moderate-intensity statin with ezetimibe (either 10–20 mg atorvastatin calcium tablets plus a 10 mg ezetimibe tablet, or 5–10 mg rosuvastatin calcium tablets once per day plus a 10 mg ezetimibe tablet once per day) or high-intensity statin (40 mg atorvastatin calcium tablets or 20 mg rosuvastatin calcium tablets once per day) for 3 months. Randomization was performed using a random number table method. The primary efficacy outcome was the level and achievement rate of LDL-C after 3 months of treatment, specifically LDL-C ≤ 1.8 mmol/L or a reduction in LDL-C ≥ 50 %. The secondary outcome was the incidence of new stroke or transient ischemic attack (TIA) within 3 months. The safety outcome was liver and renal function tests, and the occurrence of statin-related muscle events within 3 months. FindingsThis trial took place between March 15, 2022, and March 7, 2023. Among 382 patients screened, 150 patients were randomly assigned to receive either medium-intensity statins with ezetimibe (n = 75) or high-intensity statins (n = 75). Median age was 60.0 years (IQR 52.75-70.25); 49 (36.6 %) were women and 85 (63.4 %) were men. The target achievement of LDL-C at 3 months occurred in 62 (89.86 %) of 69 patients in the medium-intensity statin with ezetimibe group and 46 (70.77 %) of 65 patients in the high-intensity statin group (P=0.005, OR=0.273, 95 % CI: 0.106, 0.705). The reduction magnitude of LDL-C in moderate-intensity statin with ezetimibe group was significantly higher (-56.540 % vs -47.995 %, P=0.001). Moderate-intensity statin with ezetimibe group showing a trend of a greater reduction in LDL-C absolute value than high-intensity statin group but without statistical significance (-1.77±0.90 vs -1.50±0.89, P=0.077). New AIS or TIA within 3 months, liver and renal function tests, and the occurrence of statin-related muscle events within 3 months were also statistically insignificant. Multivariate logistic regression analysis showed that both gender and lipid-lowering regimen as independent risk factors influencing the rate of LDL-C achievement in individuals diagnosed with acute ischemic cerebrovascular disease, but only lipid-lowering regimen had predictive value. InterpretationCompared to guideline-recommended high-intensity statin therapy, moderate-intensity statin with ezetimibe further improved the achievement rate of LDL-C in patients with acute ischemic cerebrovascular disease, with a higher reduction magnitude in LDL-C. In terms of safety, there was no significant difference between the two regimens, suggesting that moderate-intensity statin with ezetimibe can also be considered as an initial treatment option for patients with acute ischemic cerebrovascular disease.

Profile of the gut microbiota of Pacific white shrimp under industrial indoor farming system

The gut microbial communities interact with the host immunity and physiological functions. In this study, we investigated the bacterial composition in Litopenaeus vannamei shrimp’s gut and rearing water under different host (developmental stage: juvenile and adult; health status: healthy and diseased) and environmental factors (temperature 25 °C and 28 °C; and light intensity: low and high). The PCoA analysis showed that all water samples were clustered together in a quarter, whereas the gut samples spread among three quarters. In terms of functional bacteria, gut samples of adult shrimp, healthy adult shrimp, adult shrimp raised at 28 °C, and juvenile shrimp under high light intensity exhibited a higher abundance of Vibrionaceae compared to each other opposite group. Gut samples of juvenile shrimp, infected adult shrimp, juvenile shrimp with low light intensity, and adult shrimp with a water temperature of 25 °C showed a higher abundance of Pseudoaltromonadaceae bacteria compared to each other opposite group. Gut samples of juvenile shrimp, healthy adult shrimp, adult shrimp raised at a water temperature of 28 °C, and juvenile shrimp with high light intensity showed the higher abundance of Firmicutes/Bacteroidota ratio compared to each other opposite group. Our results showed that L. vannamei juveniles are more sensitive to bacterial infections; besides, water temperature of 28 °C and high light intensity groups were both important conditions improving the shrimp gut bacterial composition under industrial indoor farming systems.Key points• Bacteria diversity was higher among shrimp intestinal microbiota compared to the rearing water.• Shrimp juveniles are more sensitive to bacterial infection compared to adults.• Water temperature of 28 °C and high light intensity are recommended conditions for white shrimp aquaculture.Graphical

Effects of High Intensity Interval Training on Specific Physical Factors in Male College Athletes

The objective of this study was to investigate the effects of high-intensity interval training on specific physical variables among male college athletes. To accomplish this objective, 30 subjects aged between 18 and 24 years were randomly selected from Trichy Districts. These individuals were then randomly assigned to two groups, with each group comprising 15 participants: an experimental group and a control group. The experimental group underwent a high-intensity interval training regimen, while the control group did not participate in any experimental activities. The physical fitness variables focused on in this study were speed and leg explosive power. The research design adhered to a true random group design, incorporating both pre-tests and post-tests. The 30 subjects were evenly distributed between the experimental group (consisting of the high-intensity interval training group) and the control group. Pre-tests were conducted before the six-week experimental period to assess the selected physical variables in all 30 subjects. Following the experimental period, post-tests were administered, and the scores were meticulously recorded. Statistical analysis was performed with a predetermined significance level set at a 0.05 confidence interval. The findings of this study revealed a significant improvement in speed and leg explosive power among participants in the high-intensity interval training group.

Impact of anticoagulation intensity on blood transfusion for venoarterial extracorporeal membrane oxygenation during lung transplantation

Venoarterial ECMO is increasingly used for mechanical circulatory support during lung transplant. Optimal intensity of intraoperative anticoagulation would be expected to mitigate thromboembolism without increasing bleeding and blood product transfusions. Yet, the optimal intensity of intraoperative anticoagulation is unknown. We performed a retrospective cohort study of 163 patients who received a bilateral lung transplant at a single center. We categorized intensity of anticoagulation into four groups (very low to high) based on the bolus dose of unfractionated heparin given during lung transplant and compared the rates of intraoperative blood transfusions and the occurrence of thromboembolism between groups. When compared to the very low intensity group, each higher intensity group was associated with higher red blood cell, fresh frozen plasma, and platelet transfusions. The occurrence of thromboembolism was similar across groups. These preliminary data suggest that lower intensity anticoagulation may reduce the rate of intraoperative blood transfusions although further study is needed.

Efficacy of intradialytic neuromuscular electrical stimulation and oral nutritional supplementation in hemodialysis patients: a multicenter, randomized controlled trial.

Sarcopenia is common in hemodialysis patients. This study aimed to evaluate the effect of simultaneous nutritional support and intradialytic neuromuscular electrical stimulation (NMES) in hemodialysis patients. We performed a 12-week, multicenter, randomized controlled trial. The participants were randomly assigned to the control group, the protein group (25 g of protein at every dialysis session), the NMES group (intradialytic NMES to quadriceps femoris muscles), and the NMES + P group (NMES with protein supplementation). The primary outcome was the difference in hand grip strength (HGS) and leg muscle strength (LMS) among groups. Secondary outcomes included body composition, physical performance (the 10-m walk test and the timed up and go test [TUG]), and questionnaires about quality of life (QoL), physical activity, and depression. In addition, subgroup analysis was performed by dividing NMES and NMES + P groups into high- and low-intensity NMES groups. Fifty-nine patients completed all the study outcomes. There was no difference in muscle strength (HGS and LMS) and muscle mass among groups. Gait speed improved in NMES and NMES + P groups. Subscale scores for QoL (kidney disease effect, role limitations due to physical or emotional problems, and overall health ratings) improved in the NMES + P group. In subgroup analysis, LMS and TUG improved only in the high-intensity NMES group. In this study, NMES and-/or- protein supplementation did not make a significant difference in HGS and LMS. However, NMES or NMES + P improved functional capacity and QoL. Furthermore, higher NMES was superior in improving LMS and functional capacity.

Training intensity of robot-assisted gait training in children with cerebral palsy.

We compared three different intensities of robot-assisted gait training (RAGT) for achieving favourable outcomes in children with cerebral palsy (CP). This study was conducted using a randomized controlled, single-blind design. Thirty children (19 males and 11 females; mean age 6 years 1 month, SD 2 years) with CP classified in Gross Motor Function Classification System levels II and III were assigned to three different RAGT intensity groups: high-intensity (fastest walking speed and lowest body weight support [BWS]), low-intensity (slowest speed and highest BWS), and comfortable intensity (intermediate speed and intermediate BWS). The RAGT intervention was performed three times a week for 6 weeks. Outcome measures included the 88-item Gross Motor Function Measure, stability index, spatiotemporal parameters of gait analysis, paediatric functional independence measure, and the Canadian Occupational Performance Measure. The 88-item Gross Motor Function Measure was significantly improved after training in the high-intensity (D Δ8.3 ± 15.6; E Δ3.8 ± 4.1) and comfortable intensity (D Δ2.9 ± 3.1; E Δ1.2 ± 2.0) groups, whereas gait speed was improved in the comfortable intensity group, without statistically significant group differences. Only the low-intensity group showed improvement on the stability index (Δ -0.6 ± 0.9, p = 0.05). Everyday functional performance significantly improved in all three groups, with the comfortable intensity group showing the greatest improvement. Different training intensities produced improvement in different areas; individualized RAGT intensity adjustment is therefore needed based on the rehabilitation goal.

Exercise-induced changes in plasma S-Klotho levels are associated with the obtained enhancements of heart rate variability in sedentary middle-aged adults: the FIT-AGEING study.

The shed form of the Klotho protein (S-Klotho) is considered a biomarker of longevity, but it is still unknown whether the levels are related to heart rate (HR) and heart rate variability (HRV); both of them greatly influenced by the ageing process, physical fitness, exercise, and health status. This study aimed (i) to investigate the association between S-Klotho plasma levels with HR and HRV parameters and (ii) to examine the association of exercise-induced changes in S-Klotho and those obtained in HR and HRV parameters after a 12-week exercise intervention in sedentary middle-aged adults. Sixty-six sedentary middle-aged adults participated in this study (50% women; 45-65 years old). Participants were randomized into 4 groups: (a) a control group (no exercise), (b) a physical activity recommendation from the World Health Organization group, (c) a high-intensity interval training group, and (d) a high-intensity interval training group adding whole-body electromyostimulation. S-Klotho plasma levels, HR, and HRV parameters (SDNN, RMSSD, high frequency, stress score, and sympathetic/parasympathetic ratio) were measured. At baseline, S-Klotho plasma levels were not related to HR and HRV parameters. After the intervention, exercise-induced changes in S-Klotho plasma levels were positively associated with changes in SDNN (β=0.261; R2=0.102; p=0.014) and negatively related to changes in stress score and sympathetic/parasympathetic ratio (all β=-0.257; R2 ranges between 0.092 and 0.131; all p<0.020). Our study suggests that higher S-Klotho plasma levels are related to increased vagal influence and reduced sympathetic tone in the autonomic nervous system in sedentary middle-aged adults after different training programs. ClinicalTrials.gov identifier: CT03334357.

Clinical Study of 35 Patients with Acute Acoustic Hearing Disorder

AbstractWe conducted a clinical study on 35 patients (42 ears) with acute acoustic hearing disorder who visited the otolaryngology department of Himeji St. Mary's Hospital during 12 years, from January 2012 to December 2023. The patients' ages ranged from 16 to 81 years, with an average of 34.7 years (median age: 27 years); there were 27 male and 8 female patients. The disease was caused by exposure to shooting sounds in 22 patients (shooting sound group) and exposure to other strong and loud sounds in the remaining 13 patients (other high-intensity sound group). The mean age was significantly lower, and the interval from the onset of symptoms to consultation was shorter in the shooting sound group than in the other high-intensity sound group. Regarding hearing type, the C5-dip type was the most common (11 ears), followed in frequency by the gradually down-sloping, sharply down-sloping, and flat type. The overall hearing improvement was as follows: cured: 40.5%; markedly recovered: 11.9%; recovered: 19.0%; and unchanged: 28.6%. The degree of hearing improvement classified by hearing type was good for all of the C5-dip, dip (2K), and V-shaped types. Patients younger than 30 years, with a short interval from the onset to first visit, and with bilateral hearing loss showed satisfactory hearing improvement. There was a tendency for the degree of hearing improvement to be better in the shooting sound group than in the other high-intensity sound group.

Comparison of Exercise Intensity Effects on Irisin Serum Levels and Lipid Profiles in Obese Adolescents

Objective: Irisin is a myokine that has a beneficial effect on obesity by increasing energy expenditure. The aim of this study was to compare the effect of exercise intensity on serum irisin levels and lipid profile in obese adolescents. Materials and Methods: Forty-six male students with an average age of 13.43 ± 0.77 years; height 163.18 ± 23 cm, weight 85.84 ± 8.46 kg, body fat percentage 37.001 ± 4.508 were randomly assigned to three groups: low-intensity activity (experimental 1), high-intensity activity (experimental 2), and control. The training program in experimental group 1 included running at 45-60% heart rate reserve intensity, and in experimental group 2, it was similar to group 1 along with combined exercises at 60-75% heart rate reserve intensity, performed 4 sessions per week for 10 weeks. A paired t-test was used to examine within-group differences, and Mixed ANOVA was used to examine between-group differences. All tests were conducted at a significance level of 0.05 using SPSS22 software. Results: The findings indicated a significant decrease in serum irisin levels in both experimental groups 1 and 2 (p &lt; 0.001). Additionally, weight, body fat percentage, and low-density lipoprotein significantly decreased in both experimental groups. Cholesterol and LDL/HDL ratio only significantly decreased in the high-intensity group. Conclusion: Considering the impact of exercise at both intensities on weight, body fat percentage, and irisin levels, regular physical activity is recommended for adolescents.

Dose-response effects of exercise on mental health in community-dwelling older adults: Exploration of genetic moderators

Background/Objective(1) Examine the role of exercise intensity on mental health symptoms in a community-based sample of older adults. (2) Explore the moderating role of genetic variation in brain-derived neurotrophic factor (BDNF) and apolipoprotein E (APOE) on the effects of exercise on mental health symptoms. MethodThis study is a secondary analysis of a three-arm randomized controlled trial, comparing the effects of 6 months of high-intensity aerobic training vs. moderate-intensity aerobic training vs. a no-contact control group on mental health symptoms assessed using the Depression, Anxiety, and Stress Scale (DASS). The BDNF Val66Met polymorphism and APOE ε4 carrier status were explored as genetic moderators of exercise effects on mental health symptoms. ResultsThe exercise intervention did not influence mental health symptoms. The BDNF Val66Met polymorphism did not moderate intervention effects on mental health symptoms. APOE ε4 carrier status moderated the effect of intervention group on perceived stress over 6 months, such that APOE ε4 carriers, but not non-carriers, in the high-intensity aerobic training group showed a decline in perceived stress over 6 months. ConclusionsAPOE ε4 carrier status may modify the benefits of high-intensity exercise on perceived stress such that APOE ε4 carriers show a greater decline in stress as a result of exercise relative to non-APOE ε4 carriers.

The impact of exercise intensity on depression in fibromyalgia: a randomized controlled trial.

Fibromyalgia (FM) is characterized by widespread chronic pain. Although pain is the main symptom, approximately 90% of patients have depression. This study aimed to analyze the effects of Resistance Training (RT) with low and high intensity on depression in patients with FM. Thirty-eight women with FM and 31 healthy women were allocated to the low-intensity, high-intensity, preferred-intensity, and control groups. The patients underwent 8 weeks of supervised RT, with two sessions per week of approximately 1 h. The low-intensity resistance training group (LIRT) performed two sets of 12 maximum repetitions. The high-intensity resistance training group (HIRT) performed four sets with six maximum repetitions, and the preferred intensity group (PI) performed three sets, with eight to 12 repetitions, according to the patient's tolerance. The healthy control group did not perform any type of exercise. Depression was assessed using the Beck depression inventory before the start of the intervention, after 4 and 8 weeks. FM patients have higher levels of depression than women without the disease. After 4 weeks, there was a difference in depressive symptoms between the HIRT and LIRT (p = 0.048), and the PI and LIRT (p = 0.048). Prescribing RT with low or high intensity did not significantly reduce depression in patients with FM after 8 weeks, however, analyses between groups after 4 weeks indicated that low-intensity training is more effective than high-intensity training. The prescription of RT exercise to FM could vary among low, high, and preferred intensity, following the patient's tolerance for pain. https://ensaiosclinicos.gov.br/rg/RBR-74pcmw, RBR-74pcmw.

Evaluation of the effect of high-intensity light-curing device on micro-leakage of pits and fissure sealants.

Reducing treatment time is one of the most important trends in modern dentistry. This study aimed to compare the micro-leakage around the resin sealants when using both high and conventional intensity light-curing systems. The study sample consisted of 30 extracted human maxillary premolar teeth that were divided into two equal groups according to the light-curing system used: Group 1, High-Intensity Light-Curing System and Group 2, Conventional Light-Curing System. Light-curing by Woodpecker I-LED device with two intensities (high and conventional) has been used. All teeth were subjected to 500 cycles of thermocycling. Then, a methylene blue dye microleakage test was performed, and the teeth were sectioned longitudinally and studied under a stereo microscope. The mean of micro-leakage in the high-intensity group (1.33 ± 1.29) was less than in the conventional intensity group (1.63 ± 1.29) without any statistically significant differences (p = 0.320). The high-intensity light-curing system mode may be a good and acceptable alternative to conventional intensity light-curing system mode in polymerization of pits and fissure sealants.

Effect of Interval Resistance Training with Different Intensities on Some Selected Adipokines in Obese Men

Objective: Adipose tissue-derived adipokines affect cardiometabolic health. This study aimed to evaluate the effect of interval resistance training with different intensities on leptin, adiponectin, and acrosin levels in obese males.&#x0D; Materials and Methods: Fourty-four obese males (27.70± 3.02 years) were randomly allocated into four groups: high intensity (HI), moderate intensity (MI), low intensity (LI), and control (C). Subjects of the HI, MI, and LI groups implemented the training program for 12 weeks, three sessions a week with intensities corresponding 80% 1RM, 60% 1RM, and 40% 1RM,, respectively. Body composition and plasma levels of leptin, adiponectin, and asprosin were evaluated before and after interval resistance training at different intensities.&#x0D; Results: Following exercise, serum levels of leptin and asporin were significantly reduced in all groups (P&lt; 0.01). The greatest reduction of leptin and asporin levels was recorded in the HI group (P= 0.001, P= 0.01) for leptin and asporsin levels, respectively. The level of adiponectin significantly decreased after exercise in all groups (P&lt; 0.001, F= 12.44). The greatest reduction was observed in the HI group compared with the MI and UI group (P= 0.001).&#x0D; Conclusion: Interval resistance training with different intensities can cause significant changes in leptin, asprosin, and adiponectin levels in obese men, and this improvement was better at high intensities.

Comparative Effects of High and Low Intensity Progress Resisted Exercises on Pain, Range of Motion and Functional Disability in Knee Osteoarthritis Patients with Sarcopenia: A Randomized Controlled Trial

Background: Osteoarthritis is the most common kind of arthritis, affecting millions of people. It develops because of the slow loss of the protective cartilage that cushions the ends of the bones over time. Although osteoarthritis may affect any joint, it is most often connected with joints in the hands, knees, hips, and spine. Objective: To compare the effects of high and low intensity progressive resisted exercises on pain, range of motion and functional disability in knee osteoarthritis patients with sarcopenia. Methods: It was a Randomized Controlled Trial. Data was collected from University of Lahore Teaching Hospital, physical therapy department. Group A- High Intensity Program and Group B- Low Intensity Program each had 42 patients in them. They were all male and female, between the ages of 35 and 65, and had osteoarthritis of different grades, according to Kallgren and Lawrence. The SARC-F questionnaire was used to find out if people had sarcopenia. The outcome measures were pain, functional disability, as well as range of motion. Results: Group A had a mean age of 58.47 years (SD = 4.22) and a mean symptom duration of 3.47 (SD = 1.82). In contrast, Group B had a slightly higher mean age of 58.8 years (SD = 3.11) and a mean symptom duration of 3.04 (SD = 1.68). At baseline, no significant differences were seen between Group A and Group B in terms of knee range of motion, KOOS pain, KOOS function, and KOOS quality of life. However, after 8 weeks, all variables showed significant differences (p&gt;0.05) except for knee flexion (p&gt;0.05). Conclusion: Low-intensity exercises showed greater improvements in pain, functional disability, quality of life, and range of motion compared to the high-intensity group among knee osteoarthritis patients with sarcopenia. Notably, knee flexion exhibited superior enhancement within the high-intensity exercise regimen.

Effectiveness of aerobic exercise in the prevention and treatment of postpartum depression: Meta-analysis and network meta-analysis.

Aerobic exercise is widely recognized for improving mental health and reducing negative emotions, including anxiety. However, research on its role in preventing and treating postpartum depression (PPD) has yielded inconsistent results. Some studies show positive effects on PPD symptoms, while others find limited impact, suggesting various factors at play, such as exercise type, intensity, and individual differences. To address this gap, our study aims to comprehensively gather evidence on the preventive and therapeutic effects of aerobic exercise for PPD. We'll focus on differences in exercise program design and implementation, exploring how these factors impact intervention outcomes. By identifying effective exercise approaches, we aim to provide more comprehensive exercise prescription recommendations for this vulnerable population. We conducted a quantitative systematic review of the study in 5 representative databases for the effect of aerobic exercise on PPD. Meta-analysis and network meta-analysis were performed with Review-Manager.5.4 and Stata.16.0 software, respectively. This study has been registered on the official Prospero website, and the registration code is CRD42023398221. Twenty-six studies with 2,867 participants were eventually included and the efficacy of aerobic exercise in preventing and treating postpartum depression is significant compared to standard care. (MD = -1.90; 95%CL: -2.58 to -1.21; I2 = 86%). Subgroup analysis suggests that the intervention objective (prevention vs. treatment) of exercise could potentially be a source of heterogeneity in this study, as the "Test for subgroup difference" revealed the presence of significant distinctions (p = 0.02<0.05). The "Test for subgroup difference" yielded non-significant results for both the supervised vs. unsupervised subgroup comparison (p = 0.55 > 0.05) and the individual vs. team subgroup comparison (p = 0.78 > 0.05). Nonetheless, when assessing their effect sizes [Subtotal (95%CL)], the supervised exercise group [-1.66 (-2.48, -0.85)] exhibited a slightly better performance than the unsupervised exercise group [-1.37 (-1.86, -0.88)], while the team exercise group [-1.43 (-1.94, -0.93)] slightly outperformed the individual exercise group [-1.28 (-2.23, -0.33)]. Network meta-analysis indicated that moderate intensity (35~45 min) group demonstrated a more pronounced intervention effect compared to low intensity (50~60 min) group [-2.63 (-4.05, -1.21)] and high intensity (20~30 min) group [-2.96 (-4.51, -1.41)], while the 3~4 times/week group had a more significant intervention effect compared to 1~2 times/week groups [-2.91 (-3.99, -1.83)] and 5~6 times/week groups [-3.28 (-4.75, -1.81)]. No significant differences were observed in pairwise comparisons of intervention effects among the five common types of aerobic exercises. (95%CL including 0). The Surface Under the Cumulative Ranking curve (SUCRA) results align with the findings mentioned above and will not be reiterated here. The efficacy of aerobic exercise in preventing and treating postpartum depression is significant compared to standard care, with a greater emphasis on prevention. The optimal prescribed exercise volume for intervention comprises a frequency of 3~4 exercise sessions per week, moderate intensity (35~45 minutes). Currently, several uncharted internal factors influence the optimal intervention effect of aerobic exercise, such as the potential enhancement brought by team-based and supervised exercise. Given the absence of significant differences in certain results and the limitations of the study, it is essential to exercise caution when interpreting the outcomes. Further research is needed in the future to provide a more comprehensive understanding.

Multinational Retrospective Analysis of Bridging Therapy Prior to Chimeric Antigen Receptor T Cells for Relapsed/Refractory Acute Lymphoblastic Leukemia in Children and Young Adults

Background: Chimeric antigen receptor (CAR) T cells targeting CD19 are a well-established treatment option for children and young adults suffering from relapsed and/or refractory B-lineage acute lymphoblastic leukemia. Nonetheless, there is still insufficient data about the proper management of bridging therapy between eligibility for therapy and administration of CAR T cells taking into consideration that most of the patients are heavily pretreated. Bridging therapy has been designed to achieve a low leukemia burden prior to CAR T cell infusion. However, systematic data of bridging therapy are still limited and the effect of bridging therapy on outcome, side effects and response to CAR T cell therapy is still poorly understood. With this retrospective, multinational, large-scale study, we strive to understand the impact of low- and high-intensity bridging regimens on a variety of outcome parameters in order to improve the basis for clinical decision making in bridging therapy prior to CAR T cell administration. Methods: Real-world data were collected from 83 patients receiving 88 CAR T cell therapies from twelve different sites in Germany, Austria and Switzerland. Data were collected anonymously via paper case report forms and subsequently analyzed. Performed treatments were classified into the categories 1) no systemic therapy, 2) low-intensity therapy and 3) high-intensity therapy. Bridging therapies were defined as high-intensity if at least one chemotherapeutic agent of the following was given: cyclophosphamide/ifosfamide, etoposide, anthracyclines or other agents with high toxicity potential (intravenous methotrexate, platinum-based antineoplastic drugs, thiotepa, high-dose cytarabine, fludarabine). Low-intensity bridging therapies comprised the administration of steroids, vincristine, low-dose cytarabine, PEG-asparaginase/Erwinia asparaginase and oral maintenance therapy (mercaptopurine, thioguanine, oral methotrexate, hydroxyurea). The administration of specific chemotherapeutic agents as well as immunotherapies and targeted therapies was assessed. CAR therapies comprised CD19 2 nd generation CAR T cell products from commercial and academic providers. We then analyzed the impact of different bridging regimens on several outcome parameters such as overall and disease-free survival, adverse events, tumor burden and performance status at defined time points (eligibility, leukapheresis if performed, lymphodepletion/CAR T cell infusion). Results: 33 of 88 treatments were classified as high-intensity and 34 as low-intensity bridging regimens. Prior to 13 CAR T cell administrations no systemic bridging therapy was given, 8 of 88 bridging regimens could not be stratified due to incomplete data (Figure 1). Between eligibility and apheresis, mostly low-intensity therapy or no systemic therapy was given. Within the period between apheresis and CAR T cell infusion, treatment diversified due to the heterogeneity of the cohort. Patient characteristics are listed in Table 1. Patients receiving a high-intensity bridging therapy had a significantly higher tumor burden at time point of eligibility defined by blasts in bone marrow and by measurement of minimal residual disease (MRD) compared to patients treated with a low-intensity or no systemic bridging therapy. Tumor burden within the two groups converged over the time of bridging therapy. However, at time of lymphodepletion, patients in the high-intensity group showed a significantly lower performance status indicated by Karnofsky/Lansky score than patients in the low-intensity/no systemic therapy group, reflecting the higher toxicity potential. Furthermore, these patients suffered significantly more often from bacterial adverse events and mucositis. Neither overall nor disease-free survival differed significantly between the two bridging regimen groups. Conclusion: In this retrospective cohort data, a high-intensity bridging therapy has not improved the outcome of CAR T cell therapy in terms of overall and disease-free survival. Yet high-intensity bridging therapy has caused more mucositis, bacterial adverse events and worsened the performance status. Our study suggests that a low-intensity bridging regimen may be preferred whenever tumor burden and disease kinetics allow this treatment strategy.

Effects of focused ultrasound on human cervical cancer HeLa cells in vitro.

Cervical cancer is the fourth most common malignant tumor in women. Many studies have confirmed that early childbirth, prolificacy, HPV infection, and smoking are some risk factors. This article explored the effects of exposing human cervical cancer HeLa cells to different focused ultrasound intensities in vitro. The study employed three groups of cells: 1- a high-intensity treated group, 2- a low-intensity treated group, and 3- a control group. Results showed that after 12 hours of focused ultrasound treatment, the growth inhibi-tion rate of the low-intensity group was 55.6% higher than that of the control group, and the growth inhibition rate of the high-intensity group was 41.2% higher than that of the low-intensity group. Therefore, focused ultrasound had a specific inhibitory effect on the growth of HeLa cells, and the higher the intensity of focused ultrasound, the higher the inhibition rate on cancer cells. In addition, the Cycle Threshold (Ct) values of the three groups of cells before treatment were the same, but the Ct values after treatment had changed. The Ct value of the low-intensity group was 18.1% lower than that of the control group, and the Ct value of the high-intensity group was lower than that of the low-intensity group by 27.8%, showing that focused ultrasound can effectively reduce the activity of HeLa cells in vitro.