Study Protocol: A Hybrid Delivery of Home-Based Cluster Set Resistance Training for Individuals Previously Treated for Lung Cancer

Background: Symptom burden remains a critical concern for individuals with non-small cell lung cancer (NSCLC) following the completion of treatment. The most common symptom clusters, dyspnea (shortness of breath) and fatigue,can contribute to physical decline, reductions in quality of life, and a higher risk of comorbidities and mortality. Dyspnea is a primary limiter of exercise capacity in individuals with lung cancer, resulting in exercise avoidance and an accelerated physical decline. As such, designing resistance training with cluster sets to mitigate symptoms of dyspnea and fatigue may result in improved exercise tolerance. Thus, maintainingthe exercise stimulus via cluster sets, combined with improved tolerance of the exercise, could result in maintenance of physical function and quality of life. The purpose of this study is to investigate the feasibility and preliminary efficacy of a hybrid-delivery home-based cluster-set resistance training program in individuals with NSCLC. Methods: Individuals with NSCLC (n=15), within 12-months of completion of treatment will be recruited to participate in this single arm feasibility trial. Participants will complete 8-weeks of home-based resistance training designed to minimizedyspnea and fatigue. The hybrid-delivery of the program will include supervised sessions in the participants’ home, and virtual supervision via video conferencing. The primary outcome of feasibility will be quantifiedby recruitment rates, retention, acceptability, and intervention fidelity. Exploratory outcomes (dyspnea, fatigue, quality of life, physical function, and body composition) will be assessed pre- and post- intervention. Discussion: This study will provide important data on the feasibility of delivering this intervention and inform procedures for a future randomized controlled trial. Trial Registration: Record not yet public

Davies Bouldin Index Algorithm for Optimizing Clustering Case Studies Mapping School Facilities

The lower Davies Bouldin Index (DBI) is considered the best clustering algorithm based on the criteria that yields a cluster set. The purpose of this research is to optimize the clustering results using DBI. The data sources used are the number of villages that have school facilities and the level of education is obtained from the government website (https://www.bps.go.id). The level of education in question is senior high school and vocational high school. The method used is k-means. The results show that from the number of clusters (k = 2, 3, 4, 5, 6) the optimal DBI for (k = 2) is obtained with a value of 0.168 for Measure Type = Mixed Measures. For the value of k = 2, a mapping of areas with L0 (low) = 31 province and L1 (high) = 3 provinces is obtained. The final centroids obtained for each cluster are L0 (315 and 155) and L1 (1710 and 1259). Based on the results of mapping by optimizing k-means and DBI, more than 90% of the villages still have school facilities, especially at the high school and vocational high school levels.

Creatine Enhances the Effects of Cluster-Set Resistance Training on Lower-Limb Body Composition and Strength in Resistance-Trained Men: A Pilot Study

Creatine monohydrate (CrM) supplementation has been shown to improve body composition and muscle strength when combined with resistance training (RT); however, no study has evaluated the combination of this nutritional strategy with cluster-set resistance training (CS-RT). The purpose of this pilot study was to evaluate the effects of CrM supplementation during a high-protein diet and a CS-RT program on lower-limb fat-free mass (LL-FFM) and muscular strength. Twenty-three resistance-trained men (>2 years of training experience, 26.6 ± 8.1 years, 176.3 ± 6.8 cm, 75.6 ± 8.9 kg) participated in this study. Subjects were randomly allocated to a CS-RT+CrM (n = 8), a CS-RT (n = 8), or a control group (n = 7). The CS-RT+CrM group followed a CrM supplementation protocol with 0.1 g·kg−1·day−1 over eight weeks. Two sessions per week of lower-limb CS-RT were performed. LL-FFM corrected for fat-free adipose tissue (dual-energy X-ray absorptiometry) and muscle strength (back squat 1 repetition maximum (SQ-1RM) and countermovement jump (CMJ)) were measured pre- and post-intervention. Significant improvements were found in whole-body fat mass, fat percentage, LL-fat mass, LL-FFM, and SQ-1RM in the CS-RT+CrM and CS-RT groups; however, larger effect sizes were obtained in the CS-RT+CrM group regarding whole body FFM (0.64 versus 0.16), lower-limb FFM (0.62 versus 0.18), and SQ-1RM (1.23 versus 0.75) when compared to the CS-RT group. CMJ showed a significant improvement in the CS-RT+CrM group with no significant changes in CS-RT or control groups. No significant differences were found between groups. Eight weeks of CrM supplementation plus a high-protein diet during a CS-RT program has a higher clinical meaningfulness on lower-limb body composition and strength-related variables in trained males than CS-RT alone. Further research might study the potential health and therapeutic effects of this nutrition and exercise strategy.

Isolated singularities of mappings with the inverse Poletsky inequality

The manuscript is devoted to the study of mappingswith finite distortion, which have been actively studied recently.We consider mappings satisfying the inverse Poletsky inequality,which can have branch points. Note that mappings with the reversePoletsky inequality include the classes of con\-for\-mal,quasiconformal, and quasiregular mappings. The subject of thisarticle is the question of removability an isolated singularity of amapping. The main result is as follows. Suppose that $f$ is an opendiscrete mapping between domains of a Euclidean $n$-dimensionalspace satisfying the inverse Poletsky inequality with someintegrable majorant $Q.$ If the cluster set of $f$ at some isolatedboundary point $x_0$ is a subset of the boundary of the image of thedomain, and, in addition, the function $Q$ is integrable, then $f$has a continuous extension to $x_0.$ Moreover, if $f$ is finite at$x_0,$ then $f$ is logarithmic H\"{o}lder continuous at $x_0$ withthe exponent $1/n.$

God Class Refactoring Recommendation and Extraction Using Context based Grouping

Code smells are the indicators of the flaws in the design and development phases that decrease the maintainability and reusability of a system. A system with uneven distribution of responsibilities among the classes is generated by one of the most hazardous code smells called God Class. To address this threatening issue, an extract class refactoring technique is proposed that incorporates both cohesion and contextual aspects of a class. In this work, greater emphasis was provided on the code documentation to extract classes with higher contextual similarity. Firstly, the source code is analyzed to generate a set of cluster of extracted methods. Secondly, another set of clusters is generated by analyzing code documentation. Then, merging these two, a final cluster set is formed to extract the God Class. Finally, an automatic refactoring approach is also followed to build newly identified classes. Using two different metrics, a comparative result analysis is provided where it is shown that the cohesion among the classes is increased if the context is added in the refactoring process. Moreover, a manual inspection is conducted to ensure that the methods of the refactored classes are contextually organized. This recommendation of God Class extraction can significantly help the developers in minimizing the burden of refactoring on own their own and maintaining the software systems.

Acute mechanical, physiological and perceptual responses in older men to traditional-set or different cluster-set configuration resistance training protocols

Purpose The aims of this study were to compare mechanical outputs (i.e. power and impulse), physiological (i.e. heart rate) and perceptual (i.e. effort and fatigue) responses in older men to traditional-set or different cluster-set configuration resistance training protocols. Methods In a randomized cross-over design, 20 healthy old men (aged 67.2 ± 2.1 years) completed four resistance training sessions using the back squat exercise loaded with optimal power loads. Training configurations were: traditional (TRA), three sets of six repetitions with 120-s rest between each set; Cluster-set 1 (CLU1), 24 single-repetition clusters with 10 s of rest after every cluster; Cluster-set 2 (CLU2), 12 double-repetition clusters with 20-s rest after every cluster; and Cluster-set 4 (CLU4), 6 quadruple-repetition clusters with 40-s rest after every cluster. Results Cluster-set configurations resulted in greater power outputs compared to traditional-set configuration (range 2.6–9.2%, all p$$\le$$ ≤ 0.07 for main effect and protocol $$\times$$ × set interactions). CLU1 and CLU2 induced higher heart rate (range 7.1–10.5%, all p < 0.001 for main effect and protocol $$\times$$ × set interactions), lower rating of perceived exertion (range − 1.3 to − 3.2 AU, all p$$\le$$ ≤ 0.006 for pairwise comparisons) and lower ratings of fatigue (range − 0.15 to − 4 AU, all p$$\le$$ ≤ 0.012 for pairwise comparisons) compared to TRA and CLU4. Finally, an absolute preference for CLU2 was reported. Conclusions Findings presented here support the prescription of CLU2 as an optimal resistance training configuration for trained older men using the back squat.