High-frequency EEG activity during sleep, reflecting cortical hyperarousal, has recently been incorporated into aetiology models of nightmares. However, its precise role remains insufficiently understood because experimental approaches to manipulate hyperarousal during sleep are limited. In the present study, we investigated whether re-presenting a relaxation-associated odour cue during sleep to reactivate a previously practiced deep-breathing relaxation exercise reduces cortical hyperarousal as indexed by beta (16.25-31 Hz) and gamma (31.25-45 Hz) activity and, consequently, nightmare symptoms. Twenty-five participants (21 female, mean age (SD) = 23.12 (3.70) years) experiencing at least one nightmare per week completed a 1-week deep breathing relaxation training paired with an odour cue. In a randomised, blinded, crossover design, either the relaxation-associated odour or a control odour was presented across two laboratory nights. Odour-based reactivation did not influence beta or gamma power but was unexpectedly associated with a significantly reduced spindle count and density. Spindle count during reactivation nights correlated positively with subjective wake-after-sleep-onset. Nightmare symptoms were unaffected. These findings suggest that odour-cued reactivation of a relaxation exercise did not modulate cortical hyperarousal or nightmare symptoms, despite altering spindle activity. The functional significance of this spindle effect remains to be determined. Future studies should employ longer reactivation periods and alternative interventions targeting cortical hyperarousal to further clarify its causal role in nightmare aetiology and the therapeutic potential of sleep-based interventions.

Cardiovascular disease frequently coexists with anxiety and depression, creating a complex bidirectional relationship between mental and cardiovascular health. Anxiety and depression may increase cardiovascular risk, impair treatment adherence and self-management, and contribute to poorer long-term outcomes. Conversely, acute cardiovascular events, persistent physical symptoms, and functional limitations may trigger or exacerbate psychological distress. This narrative review focuses on coronary artery disease, acute coronary syndrome, and heart failure, and summarizes the epidemiological associations, clinical implications, potential mechanisms, and management strategies related to anxiety and depression. The mechanisms discussed include neuroendocrine and autonomic dysregulation, inflammation, mitochondrial dysfunction, gut microbiota alterations, and heart-brain communication. The review also examines integrated approaches involving cardiovascular treatment, psychological interventions, exercise rehabilitation, pharmacotherapy, social support, and digital management. Future research should standardize diagnostic criteria and outcome measures, clarify key mechanistic pathways, develop clinically meaningful phenotypic classifications, identify useful biomarkers, and evaluate comprehensive interventions in multicenter studies. These efforts may strengthen early detection, risk stratification, individualized treatment, and long-term management for patients with coexisting cardiovascular and mental health conditions.

Inadequate sleep contributes to cognitive decline and may accelerate neurodegenerative processes. This article presents a rapid and reproducible workflow for modeling sleep deprivation-induced recognition memory deficits in mice while linking behavioral outcomes to hippocampal molecular alterations. The protocol uses a 5-h gentle-handling sleep deprivation paradigm administered immediately after a standardized 10-min novel object recognition (NOR) familiarization session. Recognition memory is evaluated using a 5-min NOR test after a precisely defined 5-h retention interval, followed by immediate hippocampal collection from the same animals for quantification of pro-inflammatory cytokines, including interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α), and oxidative-stress markers, including superoxide dismutase (SOD), glutathione peroxidase (GPx), and malondialdehyde (MDA). The principal methodological advance is not the individual behavioral or biochemical techniques, which are well established, but their operational standardization as one linked workflow. The protocol requires a structured, quantifiable log of gentle-handling interventions, anchors training and deprivation to a fixed circadian time point, preserves animal-level links between NOR recordings and tissue samples, and prespecifies quality-control and analytical criteria. The procedure is designed to minimize physical restraint and forced exercise, can be completed within a short experimental window, and is proposed as a candidate reference workflow that individual laboratories may use to benchmark their own implementation of gentle-handling sleep deprivation, pending independent replication.

It is widely acknowledged that kinesiophobia is prevalent among patients suffering from acute myocardial infarction (AMI). Although heightened kinesiophobia significantly predicts adverse outcomes, it should be recognized that this fear is dynamic and typically evolves during the recovery process. This study aims to identify distinct trajectories of kinesiophobia and analyze associated influencing factors to accurately detect patients with high levels of kinesiophobia. AMI patients were enrolled from November 2023 to July 2024. Data on kinesiophobia, demographic and clinical characteristics, depression, exercise self-efficacy, and exercise social support were collected. Latent Class Growth Modeling was employed to identify distinct trajectories of kinesiophobia. Subsequently, multivariate logistic regression analysis was performed to identify predictors associated with different kinesiophobia trajectory categories. Initially, 239 patients were recruited, and after 4 follow-up assessments, 207 patients who completed at least 2 assessments were included in the analysis. The total scores of the Tampa Scale for Kinesiophobia-Heart generally demonstrated a decreasing trend (p < .05). Three trajectories of kinesiophobia were identified: persistently high (N = 49, 24.9% of the sample), persistently low (N = 50, 24.5% of the sample), and high-to-critical (N = 108, 50.6% of the sample). Predictive factors distinguishing the persistently high group from the persistently low group included exercise self-efficacy, age, gender, length of hospitalization, and the number of stents implanted. Predictors for the high-to-critical group included exercise self-efficacy, age, and the number of stents implanted. Kinesiophobia in AMI patients exhibited significant heterogeneity, with trajectories demonstrating relative stability over time. Consequently, individuals with high initial kinesiophobia levels often experienced limited alleviation during rehabilitation. Therefore, timely interventions to mitigate fear of movement are critical. Such interventions can reduce kinesiophobia to low levels during rehabilitation and improve patient prognosis.

Endocrine-disrupting chemicals (EDCs) such as bisphenol A (BPA) and triclosan (TCS) are ubiquitous, yet it remains unclear whether acute physiological stressors can transiently modify their urinary profiles. We conducted a randomized, parallel-group pilot laboratory study in overweight postmenopausal women (BMI 25-29.9 kg/m2) assigned to graded aerobic exercise (22-minute Modified Naughton treadmill protocol) or a non-exercise control condition. Fasting morning urine was collected 24 h before and 24 h after the intervention. Urinary free BPA and TCS concentrations were quantified by LC-MS/MS. Within-group changes were assessed using paired t tests, and between-group post-intervention differences were assessed using ANCOVA with baseline values entered as covariates. Twenty participants completed the protocol (n = 10 per group). In the exercise group, urinary BPA increased from 1.27 ± 0.39 to 1.38 ± 0.44 µg/L (p = 0.037) and TCS increased from 1.52 ± 0.98 to 1.89 ± 1.13 µg/L (p = 0.046), whereas no significant pre-post changes were observed in controls. However, baseline-adjusted ANCOVA showed no significant between-group differences for BPA (p = 0.157) or TCS (p = 0.345). These pilot findings should therefore be interpreted cautiously and do not demonstrate a statistically significant intervention effect. Larger studies with repeated sampling and urine dilution assessment are warranted.

Real-world evidence on glucose behavior during competition in highly trained athletes is scarce. We characterized interstitial glucose dynamics in collegiate endurance athletes during sanctioned competitions using continuous glucose monitoring (CGM), with within-subject comparisons to high-intensity training performed at the same prescribed race pace. Twenty male runners and race walkers (Tier 3: Highly Trained/National) wore CGM during 36 races, contributing 20 paired race-versus-training comparisons. Glucose rose from baseline to 8.3 ± 1.5 mM 1 h pre-race, peaked at 11.2 ± 2.2 mM during competition (mean difference + 3.12 mM, 95% CI +2.72 to +3.53; Cohen's dz. = 1.45), and declined to 6.7 ± 1.7 mM post-race (F(2,220) = 225.79, p < 0.001, partial η2 = 0.67). Within-subject maximum glucose was higher during competition than during training (12.91 ± 1.93 vs. 11.02 ± 1.18 mM; mean difference + 1.89 mM, 95% CI 1.06-2.72; Cohen's dz. = 1.07), with a geometric mean ratio of 1.166 (95% CI 1.088-1.249), approximately 17% higher peaks in competition. These findings describe a reproducible pattern of higher peak glucose in competition than in training matched on the recorded external characteristics. Internal exercise load was not measured, so the difference cannot be attributed to the competitive context rather than to differing internal exercise intensity.

Many flashy labels are available to entice athletes, coaches, and parents with promises of preventing injury and improving recovery. To support athletes in continued fitness and competition, it is critical to take a personalized approach to hydration, macro- and micronutrient intake, and supplementation. In this review, the authors aim to provide evidence for various nutrition tools to promote conversations about the safety and efficacy of each with athletes. Consuming a diet of minimally processed, predominantly whole foods offers a solid nutritional base with adequate macro- and micronutrients. Taking a personalized approach to hydration and supplementation for the athlete, environment, and sport optimizes injury prevention and improves recovery.

This video tutorial demonstrates a robotic-assisted left lower lobectomy in a 71-year-old female with critical exercise capacity. Preoperative evaluation revealed a 32 mm cavitated tumour in the left lower lobe. While pulmonary function tests showed a preserved forced expiratory volume in 1 second (84%), the peak oxygen consumption (VO2peak) was critically low at 5.9 mL/kg/min. Multidisciplinary assessment attributed this prohibitive value to severe musculoskeletal impairment rather than cardiopulmonary exhaustion. A robotic approach was selected to minimize chest wall trauma. The procedure involved standard hilar dissection, complete fissure division and systematic lymph node dissection. The patient experienced an uneventful recovery, with chest tube removal on postoperative Day (POD) 2 and hospital discharge on Day 3. Final pathology confirmed a 40 mm papillary adenocarcinoma (Stage IB) with micropapillary and solid components, and negative margins and lymph nodes.

The instep kick is a frequently performed, high-load soccer skill that requires precise intermuscular coordination around ball contact. This study compared time-frequency activation patterns between elite and amateur male soccer players across two kicking phases and identified the key time windows and dominant muscle contributions. Surface electromyography was recorded from seven muscles of the kicking leg in 15 elite and 15 amateur players: rectus femoris, vastus medialis, vastus lateralis, biceps femoris, tibialis anterior, medial gastrocnemius, and lateral gastrocnemius. The instep kick was divided into Phase 1, from maximum hip extension to ball contact, and Phase 2, from post-contact follow-through to maximum hip flexion. Morlet wavelet analysis was used to generate time-frequency intensity maps. Global principal component analysis was then performed to extract PC1 to PC6, and between-group differences in PC score trajectories were assessed using SPM1D independent-samples t tests, with significance evaluated under a Bonferroni adjusted threshold for the 12 PC phase comparisons. In Phase 1, PC3 showed a significant between-group difference at 54-75% of the normalized time (peak t = 7.62, p < 0.001, Hedges' g = 2.96), with higher scores in the elite group. In Phase 2, PC1 differed significantly between groups at 60-70% of the normalized time (peak t = -9.88, p < 0.001, Hedges' g = -2.03), with higher scores in the amateur group. Elite players showed a more temporally focused pre-contact activation pattern centered on mid-frequency components of the biceps femoris, whereas amateur players showed greater reliance on higher-frequency components of the medial gastrocnemius during the post-contact follow-through. These findings suggest that skill-level differences are expressed as phase-specific redistribution of muscle and frequency-band activity within critical time windows, rather than as a simple global difference in activation magnitude.

This study compared acute performance, neuromuscular, and thermal responses to a maximal isometric conditioning activity (ICA) versus a standardized volleyball pre-training activation (VPA) in highly trained male volleyball players, and to explore putative mechanisms underpinning post-activation performance enhancement (PAPE) considering training load. In a randomized crossover, 14 men (27 ± 3 y) completed two sessions: VPA (mobility/plyometric drills; 9 min), and ICA comprising 3×5×3-s maximal isometric back-squat contractions (knee angle 120°; 3-min inter-set rest). Countermovement jump (CMJ) height (primary), relative peak power (PP), RSImod, and contraction time (CT) were recorded pre and 3, 6, 9, and 12 min post. Rectus femoris muscle viscoelastic properties and skin surface temperature (SST) were assessed at matched time points. Analyses used repeated-measures ANOVA, responder analysis, correlations, and regression. Period×Sequence interactions favored ICA for CMJ and PP when delivered in Period 2 (lower training volume): ∆CMJ was higher under ICA versus VPA (p = 0.005, d = 1.20); PP likewise greater (p = 0.026, ηp2 = 0.35). ICA yielded more beneficial responders than VPA (9/14 vs 1/14; McNemar exact p = 0.021). In Period 2, reductions in rectus femoris muscle stiffness independently predicted CMJ gains (β_std = -0.495, p = 0.005), whereas SST changes did not (p = 0.974). RSImod and CT showed no differences. A brief, high-effort isometric squat protocol was associated with superior acute improvements in jump performance compared with a standard volleyball warm-up, but this advantage emerged specifically when the preceding training volume was reduced (Period 2), suggesting that residual fatigue from training may reduce the effects of PAPE. Gains align with neuro-mechanical rather than thermal mechanisms, supporting ICA as a practical, equipment-minimal priming strategy for elite volleyball.

To evaluate the effects of aerobic exercise (AE) versus resistance training (RT) on cardiometabolic health-related outcomes in patients with type 2 diabetes mellitus and concurrent obesity (diabesity). Systematic review and meta-analysis of randomized controlled trials (RCTs). PubMed, Web of Science, Scopus, ScienceDirect, Cochrane Library, and Google Scholar databases were searched from inception up to April 2026. RCTs comparing AE and RT for a minimum duration of two weeks. Participants were adults with diabesity. A total of 23 RCTs qualified, involving 1, 184 patients (58/42 women/men ratio; age range: 30-70 years; body mass index: 32.1 ± 6.6 kg/m2). AE appears to be more efficacious than RT in reducing fasting blood glucose (mean differences (MD) = -0.89 mmol/L, 95% CI: -1.62 to -0.16; I2 = 0%) and increasing cardiorespiratory fitness (MD = 1.78 mL/kg/min, 95% CI: 0.38 to 3.18; I2 = 66%). However, AE led to a greater increase in body fat (MD = 0.34%, 95% CI: 0.10 to 0.57; I2 = 1%) and less fat-free mass retention (MD = -0.86 kg, 95% CI: -1.46 to -0.26; I2 = 37%) compared with RT. For selected cardiometabolic health-related outcomes, including anthropometrics, blood lipids, and hemodynamics, no statistically significant between-group difference was detected. The overall certainty of the evidence across outcomes ranged from high to very low, with most being moderate. In adults with diabesity, AE appears to provide greater benefits for FBG and CRF, whereas RT appears more favorable for preserving FFM and improving BF. For the majority of cardiometabolic outcomes, the two modalities exhibit analogous effects. The present findings support a goal-directed and complementary approach to exercise prescription, as opposed to a one-modality-fits-all model, for the improvement of cardiometabolic health in patients with diabesity.

Although differences between training and competitive contexts in table tennis are widely recognized, empirical evidence quantifying these differences remains limited. This study compared the technical-tactical characteristics of 40 training matches and 40 international competitions among Chinese National Youth Team U15 female players to provide evidence for training optimization. A mixed-method approach combining heat map visualization and Generalized Estimating Equations (GEE) was used to examine contextual differences and identify key factors associated with match-winning probability. Results showed that training and international matches exhibited similar individual technical-tactical indicators but differed substantially in placement-technique combinations and the influence of stroke sequences on winning probability. Training matches emphasized control of short areas, whereas international competitions showed greater use of backhand long-area attacks to initiate offensive play. In addition, early strokes were more influential in training matches, while later strokes played a greater role in international competitions. These findings indicate that current training matches may not fully replicate international competitive demands. Training should therefore enhance rally-transition tactics, offensive initiation, and competitive simulation to improve transferability to international competition.

The aim of this study was to examine the reliability of peak force (PF) and rate of force development (RFD) from the Isometric Mid-Thigh Pull (IMTP) in 59 male basketball players from a Japanese professional club's youth academy classified into three age categories (U12: n = 18, U15: n = 27, and U18: n = 14). Each athlete completed three IMTP sessions, from which PF and mean RFD were calculated over time intervals of 0-50, 0-100, 0-150, 0-200, and 0-250 ms. Within-session and between-day reliabilities were evaluated using the intraclass correlation coefficient (ICC), coefficient of variation (CV), and standard error of measurement (SEM). PF demonstrated consistently high reliability across all age categories for both within-session and between-day analyses (ICC 0.77-0.98, CV 3.4-8.2%), with small SEM values (7.65-91.86 N, 0.60-4.13%) indicating limited measurement error. In contrast, RFD displayed poor reliability in shorter time windows (0-50 and 0-100 ms; ICC < 0.50), particularly in categories U12 and U15. Although longer time windows (0-150 and 0-250 ms) achieved higher reliability (ICC > 0.75) and lower SEM values than those previously reported, the CV values remained high (10.7-34.8%). Such a large variability may obscure true performance changes. Consequently, the PF is recommended as a robust metric for young athletes across all age groups. In contrast, the current protocol limits the ability of RFD to accurately detect individual changes. Therefore, RFD requires careful interpretation and protocol modifications, such as extended familiarization, to improve stability and precision.