Background:Limited nationally representative evidence is available on temporal trends in physical fitness(PF)for children and adolescents during the coronavirus disease 2019(COVID-19)pandemic.The primary aim was to ex...Background:Limited nationally representative evidence is available on temporal trends in physical fitness(PF)for children and adolescents during the coronavirus disease 2019(COVID-19)pandemic.The primary aim was to examine the temporal trends in PF for Japanese children and adolescents before and during the COVID-19 pandemic.The secondary aim was to estimate the concurrent trends in body size(measured as body mass and height)and movement behaviors(exercise,screen,and sleep time).Methods:Census PF data for children in Grade 5(aged 10-11 years)and adolescents in Grade 8(aged 13-14 years)were obtained for the years 2013-2021 from the National Survey of Physical Fitness,Athletic Performance,and Exercise Habits in Japan(n=16,647,699).PF and body size were objectively measured,and movement behaviors were self-reported.Using sample-weighted linear regression,temporal trends in mean PF were calculated before the pandemic(2013-2019)and during the pandemic(2019-2021)with adjustments for age,sex,body size,and exercise time.Results:When adjusted for age,sex,body size,and exercise time,there were significant declines in PF during the pandemic,with the largest declines observed in 20-m shuttle run(standardized(Cohen’s)effect size(ES)=-0.109 per annum(p.a.))and sit-ups performance(ES=-0.133p.a.).The magnitude of the declines in 20-m shuttle run and sit-ups performances were 18-and 15-fold larger,respectively,than the improvements seen before the pandemic(2013-2019),after adjusting for age,sex,body size,and exercise time.During the pandemic,both body mass and screen time significantly increased,and exercise time decreased.Conclusion:Declines in 20-m shuttle run and sit-ups performances suggest corresponding declines in population health during the COVID-19pandemic.展开更多
1.Light intensity physical activity(PA)benefits health PA guidelines worldwide recommend that adults accumulate 150 min of moderate intensity or 75 min of vigorous intensity PA(moderate-to-vigorous PA(MVPA))weekly to ...1.Light intensity physical activity(PA)benefits health PA guidelines worldwide recommend that adults accumulate 150 min of moderate intensity or 75 min of vigorous intensity PA(moderate-to-vigorous PA(MVPA))weekly to achieve health benefits.1-3 Absent from these guidelines are recommendations for light intensity PA(LPA,e.g.,walking at a leisurely pace of 3 km/h or less,equivalent to 1.5-2.9 metabolic equivalents).展开更多
Purpose:The study aimed to examine the reporting completeness of randomized controlled trials(RCTs)of non-pharmacological interventions following concussion.Methods:We searched MEDLINE,Embase,PsycInfo,CINAHL,and Web o...Purpose:The study aimed to examine the reporting completeness of randomized controlled trials(RCTs)of non-pharmacological interventions following concussion.Methods:We searched MEDLINE,Embase,PsycInfo,CINAHL,and Web of Science up to May 2022.Two reviewers independently screened studies and assessed reporting completeness using the Template for Intervention Description and Replication(TIDieR),Consensus on Exercise Reporting Template(CERT),and international Consensus on Therapeutic Exercise aNd Training(i-CONTENT)checklists.Additional information was sought my study authors where reporting was incomplete.Risk of bias(ROB)was assessed with the Cochrane ROB-2 Tool.RCTs examining non-pharmacological interventions following concussion.Results:We included 89 RCTs(n=53 high ROB)examining 11 different interventions for concussion:sub-symptom threshold aerobic exercise,cervicovestibular therapy,physical/cognitive rest,vision therapy,education,psychotherapy,hyperbaric oxygen therapy,transcranial magnetic stimulation,blue light therapy,osteopathic manipulation,and head/neck cooling.Median scores were:TIDieR 9/12(75%;interquartile range(IQR)=5;range:5-12),CERT 17/19(89%;IQR=2;range:10-19),and i-CONTENT 6/7(86%;IQR=1;range:5-7).Percentage of studies completely reporting all items was TIDieR 35%(31/89),CERT 24%(5/21),and i-CONTENT 10%(2/21).Studies were more completely reported after publication of TIDieR(t_(87)=2.08;p=0.04)and CERT(t_(19)=2.72;p=0.01).Reporting completeness was not strongly associated with journal impact factor(TIDieR:rs=0.27;p=0.01;CERT:r_(s)=-0.44;p=0.06;i-CONTENT:r_(s)=-0.17;p=0.48)or ROB(TIDieR:rs=0.11;p=0.31;CERT:rs=0.04;p=0.86;i-CONTENT:rs=0.12;p=0.60).Conclusion:RCTs of non-pharmacological interventions following concussion demonstrate moderate to good reporting completeness,but are often missing key components,particularly modifications,motivational strategies,and qualified supervisor.Reporting completeness improved after TIDieR and CERT publication,but publication in highly cited journals and low ROB do not guarantee reporting completeness.展开更多
Background:Guidelines recommend that adolescents should accumulate an average of 60 min per day of moderate-to-vigorous physical activity(MVPA).However,using only this cut-off could hide important information.For inst...Background:Guidelines recommend that adolescents should accumulate an average of 60 min per day of moderate-to-vigorous physical activity(MVPA).However,using only this cut-off could hide important information.For instance,from a population-level point of view,increasing physical activity for those with no or low physical activity could provide more health benefits than increasing physical activity for those with intermediate levels.Also,including a more sensitive cut-point of≥1 days per week could be an additional strategy for identifying those with low access/opportunities for physical activity practice.Thus,the current study aims to estimate the prevalence of≥60 min of MVPA≥1 days per week among adolescents globally,and to describe any relevant gender inequalities.Methods:We used representative datasets from 146 countries/territories collected between 2003 and 2019.MVPA was self-reported.Participants were grouped into younger(≤14 years old)and older(>14 years old)adolescents.Crude Poisson regression models were used to identify the relative differences in≥60 min of MVPA≥1 days per week between boys and girls,and random-effects meta-analysis models were used to identify the pooled estimates.Analyses were stratified by country and region.Results:Approximately 80%of both younger and older adolescents reported≥60 min of MVPA≥1 days per week.This prevalence was≥94%in Europe and Central Asia and North America,while the estimates for the other regions were<77%.The prevalence of≥60 min of MVPA≥1 days per week was higher among boys than girls,with the largest differences occurring among the oldest adolescents(Prevalence ratio_(≤14y)=1.04(95%confidence interval(95%CI)):1.03-1.04)vs.Prevalence ratio_(>14y)=1.09(95%CI:1.08-1.10)).Conclusion:Approximately 8 out of 10 adolescents reported accumulating≥60 min of MVPA≥1 days per week,with notable differences between regions.Gender differences were observed in several countries,especially among the oldest adolescents.Priorities for physical activity promotion among adolescents should include increasing access/opportunities for physical activity among those who do not achieve≥60 min of MVPA≥1 days per week and reducing gender inequalities.展开更多
Background:Meeting 24-h movement guidelines by children and adolescents has been associated with improved indicators of health,although it has been under-studied in China.Hence,this study aimed to investigate the prev...Background:Meeting 24-h movement guidelines by children and adolescents has been associated with improved indicators of health,although it has been under-studied in China.Hence,this study aimed to investigate the prevalence of meeting the 24-h movement guidelines,its correlates,and its relationships with body mass index in children and adolescents in China.Methods:Cross-sectional data from the 2017 Youth Study in China of 114,072 children and adolescents(mean age=13.75 years,49.18%boys)were used.Meeting 24-h movement guidelines(60 min of daily moderate-to-vigorous physical activity,2 h of daily leisure screen time,911 h and 810 h nightly sleep duration for 613-year-olds and 1417-year-olds,respectively)and height and weight of all participants were assessed.The prevalence of meeting the 24-h movement guidelines and World Health Organization weight status categories were determined.Generalized linear models were used to determine the correlates of meeting the 24-h movement guidelines and the relationships of meeting the 24-h movement guidelines with overweight(OW)and obesity(OB).Results:Only 5.12%of Chinese children and adolescents met the 24-h movement guidelines,and 22.44%were classified as OW/OB.Older children and adolescents were less likely to meet the 24-h movement guidelines.Parental education level and family income were positively related to meeting the 24-h movement guidelines.Children and adolescents meeting the 24-h movement guidelines showed lower odds ratios for OW/OB.Compared with participants meeting the 24-h movement guidelines,boys in 4th6th grades met none of the recommendations(OR=1.22,95%CI:1.061.40),met the screen time recommendation only(OR=1.13,95%CI:1.011.28),met the nightly sleep duration recommendation only(OR=1.14,95%CI:1.031.28),and had significantly higher odds ratios for OW/OB.Similar trends were observed for girls in 4th6th grades:meeting none of the guidelines(OR=1.35,95%CI:1.141.59),meeting sleep duration guidelines only(OR=1.23,95%CI:1.081.39),and meeting moderate-to-vigorous physical activity+nightly sleep duration guidelines(OR=1.24,95%CI:1.011.54).For girls in 7th9th grades,the following trend was observed:meeting none of the guidelines(OR=1.30,95%CI:1.011.67).Conclusion:Very few Chinese children and adolescents met the 24-h movement guidelines.Age(negatively correlated),parental education level,and family income(both positively correlated)were correlates of meeting the 24-h movement guidelines.Children and adolescents meeting the 24-h movement guidelines were more likely to have lower risks for OW/OB,especially in the youngest age group(Grades 46);and girls in the middle age group(Grades 79)were also more likely to have lower risks for OW/OB.Further research studies should explore additional correlates and determinants for meeting the 24-h movement guidelines.Also,future studies should use longitudinal or interventional designs to determine the relationships between meeting the 24-h movement guidelines and OW/OB and other health indicators,while taking sex and age differences into account.展开更多
Purpose:The purpose of this study was to use decision tree modeling to generate profiles of children and youth who were more and less likely to meet the Canadian 24-h movement guidelines during the coronavirus disease...Purpose:The purpose of this study was to use decision tree modeling to generate profiles of children and youth who were more and less likely to meet the Canadian 24-h movement guidelines during the coronavirus disease-2019(COVID-19)outbreak.Methods:Data for this study were from a nationally representative sample of 1472 Canadian parents(Meanage=45.12,SD=7.55)of children(511 years old)or youth(1217 years old).Data were collected in April 2020 via an online survey.Survey items assessed demographic,behavioral,social,micro-environmental,and macro-environmental characteristics.Four decision trees of adherence and non-adherence to all movement recommendations combined and each individual movement recommendation(physical activity(PA),screen time,and sleep)were generated.Results:Results revealed specific combinations of adherence and non-adherence characteristics.Characteristics associated with adherence to the recommendation(s)included high parental perceived capability to restrict screen time,annual household income ofCAD 100,000,increases in children’s and youth’s outdoor PA/sport since the COVID-19 outbreak began,being a boy,having parents younger than 43 years old,and small increases in children’s and youth’s sleep duration since the COVID-19 outbreak began.Characteristics associated with non-adherence to the recommendation(s)included low parental perceived capability to restrict screen time,youth aged 1217 years,decreases in children’s and youth’s outdoor PA/sport since the COVID-19 outbreak began,primary residences located in all provinces except Quebec,low parental perceived capability to support children’s and youth’s sleep and PA,and annual household income ofCAD 99,999.Conclusion:Our results show that specific characteristics interact to contribute to(non)adherence to the movement behavior recommendations.Results highlight the importance of targeting parents’perceived capability for the promotion of children’s and youth’s movement behaviors during challenging times of the COVID-19 pandemic,paying particular attention to enhancing parental perceived capability to restrict screen time.展开更多
Purpose:The objective of this scoping review was to summarize systematically the available literature investigating the relationships between the coronavirus disease 2019(COVID-19)pandemic and movement behaviors(physi...Purpose:The objective of this scoping review was to summarize systematically the available literature investigating the relationships between the coronavirus disease 2019(COVID-19)pandemic and movement behaviors(physical activity,sedentary behavior,and sleep)of school-aged children(aged 511 years)and youth(aged 1217 years)in the first year of the COVID-19 outbreak.Methods:Searches for published literature were conducted across 6 databases on 2 separate search dates(November 25,2020,and January 27,2021).Results were screened and extracted by 2 reviewers(DCP and KR)independently,using Covidence.Basic numeric analysis and content analysis were undertaken to present thematically the findings of included studies according to the associated impact on each movement behavior.Results:A total of 1486 records were extracted from database searches;of those,150 met inclusion criteria and were included for analysis.Of 150 articles,110 were empirical studies examining physical activity(n=77),sedentary behavior/screen time(n=58),and sleep(n=55).Results consistently reported declines in physical-activity time,increases in screen time and total sedentary behavior,shifts to later bed and wake times,and increases in sleep duration.The reported impacts on movement behaviors were greater for youth than for children.Conclusion:The COVID-19 pandemic is related to changes in the quantity and nature of physical activity,sedentary behavior,and sleep among children and youth.There is an urgent need for policy makers,practitioners,and researchers to develop solutions for attenuating adverse changes in physical activity and screen time among children and youth.展开更多
Background:New research suggests that the composition(mix)of movement behaviors within a 24-h period may have important implications for health across the lifespan.Consistent with this integrated movement behavior par...Background:New research suggests that the composition(mix)of movement behaviors within a 24-h period may have important implications for health across the lifespan.Consistent with this integrated movement behavior paradigm,a number of countries across the world have developed and released 24-h movement guidelines for specific age groups.The purpose of this systematic review was to examine the associations between the 24-h time-use composition of movement behaviors,or adherence to 24-h movement guidelines,and multiple health indicators across the lifespan.Methods:Five online databases(PsycINFO,PubMed,SPORTDiscus,Web of Science,and Ovid MEDLINE)were searched for relevant peer-reviewed studies published between January 2015 and January 2020 that met the a priori inclusion criteria,with no study design limits.The methodological quality of research evidence for each individual study and for each health indicator was assessed by using a modified version of the Downs and Black checklist.Results:A total of 51 studies from 20 different countries met the inclusion criteria.A total of 31 studies examined adherence(meeting vs.not meeting)to 24-h movement guidelines,and 20 studies used compositional analyses to explore the 24-h time-use composition of movement behaviors.Findings indicated that meeting the 24-h movement guidelines were(1)not associated with adiposity among toddlers,(2)favorably associated with health-related quality of life,social-cognitive development,and behavioral and emotional problems among preschoolers,(3)favorably associated with global cognition,health-related quality of life,and healthy dietary patterns in children,and(4)favorably associated with adiposity,fitness,and cardiometabolic,mental,social,and emotional health among children and youth.Significant associations were also found between the composition of 24-h movement behaviors and indicators of(1)adiposity and bone and skeletal health among preschoolers,(2)health-related quality of life among children,(3)adiposity,fitness,and cardiometabolic,social,and emotional health among children and youth,(4)cardiometabolic health in adults,(5)adiposity and fitness among adults and older adults,and(6)mental health and risk of mortality among older adults.The quality of the available evidence ranged from poor to good.Conclusion:The current evidence indicates that the composition of movement behaviors within a 24-h period may have important implications for health at all ages and that meeting the current 24-h movement guidelines is associated with a number of desirable health indicators in children and youth.Future studies should employ longitudinal and experimental designs,include valid and reliable measures of 24-h movement behaviors,and examine a wide array of health indicators across all age groups.Such studies would confirm the results from the primarily cross-sectional evidence drawn from studies included in our review and further advance our understanding of the relationships between 24-h movement behaviors and health.展开更多
BACKGROUND Colon cancer is among the most commonly diagnosed cancers in the United States with an estimated 97220 new cases expected by the end of 2018.It affects 1.2 million people around the world and is responsible...BACKGROUND Colon cancer is among the most commonly diagnosed cancers in the United States with an estimated 97220 new cases expected by the end of 2018.It affects 1.2 million people around the world and is responsible for about 0.6 million deaths every year.Despite decline in overall incidence and mortality over the past 30 years,there continues to be an alarming rise in early-onset colon cancer cases(<50 years).Patients are often diagnosed at late stages of the disease and tend to have poor survival.We previously showed that the WNT“gatekeeper”gene,secreted frizzled-related protein 4(SFRP4),is over-expressed in early-onset colon cancer.SFRP4 is speculated to play an essential role in cancer by inhibiting the epithelial mesenchymal transition(EMT).AIM To investigate the correlation between SFRP4 expression and EMT-linked genes in colon cancer and how it affects patient survival.METHODS SFRP4 expression relative to that of EMT-linked genes and survival analysis were performed using the University of California Santa Cruz Cancer Browser interface.RESULTS SFRP4 was found to be co-expressed with the EMT-linked markers CDH2,FN1,VIM,TWIST1,TWIST2,SNAI1,SNAI2,ZEB1,ZEB2,POSTN,MMP2,MMP7,MMP9,and COL1A1.SFRP4 expression negatively correlated with the EMTlinked suppressors CLDN4,CLDN7,TJP3,MUC1,and CDH1.The expression of SFRP4 and the EMT-linked markers was higher in mesenchymal-like samples compared to epithelial-like samples which potentially implicates SFRP4-EMT mechanism in colon cancer.Additionally,patients overexpressing SFRP4 presented with poor overall survival(P=0.0293).CONCLUSION Considering the implication of SFRP4 in early-onset colon cancer,particularly in the context of EMT,tumor metastasis,and invasion,and the effect of increased expression on colon cancer patient survival,SFRP4 might be a potential biomarker for early-onset colon cancer that could be targeted for diagnosis and/or disease therapy.展开更多
Background:Meeting the 24-Hour Movement Guidelines(physical activity,screen time,and sleep duration) has been associated with positive health indicators.However,there are no previous meta-analyses that have examined t...Background:Meeting the 24-Hour Movement Guidelines(physical activity,screen time,and sleep duration) has been associated with positive health indicators.However,there are no previous meta-analyses that have examined the overall adherence to the 24-Hour Movement Guidelines from pre-school to adolescence across the world.Therefore,the main purpose of this systematic review and meta-analysis was to examine the overall(non)adherence to the 24-Hour Movement Guidelines among preschoolers,children,and adolescents worldwide.Methods:Four electronic databases(MEDLINE,Scopus,Web of Science,and Cochrane Database of Systematic Reviews) were searched for quantitative studies published in Spanish and English between January 2016 and May 2021.Studies that were conducted with apparently healthy participants and reported the overall(non)adherence to the 24-Hour Movement Guidelines in preschoolers and/or children and/or adolescents were included.Results:Sixty-three studies comprising 387,437 individuals(51% girls) aged 3-18 years from 23 countries were included.Overall,7.12%(95%confidence interval(95%CI):6.45%-7.78%) of youth met all three 24-Hour Movement Guidelines,and 19.21%(95%CI:16.73%-21.69%)met none of the 3 recommendations.Concerning sex,adherence to all recommendations was significantly lower in girls(3.75%,95%CI:3.23%-4.27%) than in boys(6.89%,95%CI:5.89%-7.89%)(p <0.001).However,there were no sex differences regarding adherence to any of the 3 individual recommendations(girls,15.66%,95%CI:8.40%-22.92%;boys,12.95%,95%CI:6.57%-19.33%).In terms of age group,adherence to the 3 recommendations was 11.26%(95%CI:8.68%-13.84%),10.31%(95%CI:7.49%-13.12%),and 2.68%(95%CI:1.78%-3.58%) in preschoolers,children,and adolescents,respectively.Conversely,8.81%(95%CI:5.97%-11.64%) of preschoolers,15.57%(95%CI:11.60%-19.54%) of children,and 28.59%(95%CI:22.42%-34.75%) of adolescents did not meet any of the recommendations.South America was the region with the lowest adherence(all:2.93%;none:31.72%).Overall adherence to the 24-Hour Movement Guidelines was positively related to country Human Development Index(β=-0.37,95%CI:-0.65 to-0.09;p=0.010).Conclusion:Most young people fail to meet the three 24-Hour Movement Guidelines,particularly adolescents,girls,and those who are from countries with a lower Human Development Index.Moreover,1 in 5 young people did not meet any of these recommendations.Therefore,these results highlight the need to develop age-and sex-specific strategies to promote these movement behaviors from the early stages of life.展开更多
In recent years,pediatric health care has embraced the concept of quality improvement to improve patient outcomes.As quality improvement efforts are implemented,network collaboration(where multiple centers and practic...In recent years,pediatric health care has embraced the concept of quality improvement to improve patient outcomes.As quality improvement efforts are implemented,network collaboration(where multiple centers and practices implement standardized programs)is a popular option.In a collaborative network,improvement in the conduct of structural,process and outcome quality measures can lead to improvements in overall health,and benchmarks can be used to assess and compare progress.In this review article,we provided an overview of the quality improvement movement and the role of quality indicators in this movement.We reviewed current quality improvement efforts in pediatric inflammatory bowel disease (IBD),as well as other pediatric chronic illnesses.We discussed the need to standardize the development of quality indicators used in quality improvement networks to assess medical care,and the validation techniques which can be used to ensure that process indicators result in improved outcomes of clinical significance.We aimed to assess current quality improvement efforts in pediatric IBD and other diseases,such as childhood asthma,childhood arthritis,and neonatal health.By doing so,we hope to learn from their successes and failures and to move the field forward for future improvements in the care provided to children with IBD.展开更多
A new paradigm employing 24-h movement guidelines that combines recommendations for movement behaviors across the whole day(physical activities of all intensities,sedentary behaviors,and sleep)is gaining momentum arou...A new paradigm employing 24-h movement guidelines that combines recommendations for movement behaviors across the whole day(physical activities of all intensities,sedentary behaviors,and sleep)is gaining momentum around the globe,and several jurisdictions are developing and releasing evidence-informed public health guidelines embracing this approach.1,2 The Sedentary Behavior Research Network(SBRN),the world’s largest network of researchers and health professionals focusing specifically on the health impact of sedentary behaviors,embraces this new paradigm and has worked to normalize the integration of sedentary behaviors into the movement-behavior paradigm.展开更多
Background:Physical activity,sleep,and sedentary behaviors compose 24-h movement behaviors and have been independently associated with depressive symptoms.However,it is not clear whether it is the movement behavior it...Background:Physical activity,sleep,and sedentary behaviors compose 24-h movement behaviors and have been independently associated with depressive symptoms.However,it is not clear whether it is the movement behavior itself or other contextual factors that are related to depressive symptoms.The objective of the present study was to examine the associations between self-reported and accelerometer-measured movement behaviors and depressive symptoms in adolescents.Methods:Cross-sectional data from 610 adolescents(14-18 years old)were used.Adolescents answered questions from the Center for Epidemiological Studies Depression scale and reported time spent watching videos,playing videogames,using social media,time spent in various physical activities,and daytime sleepiness.Wrist-worn accelerometers were used to measure sleep duration,sleep efficiency,sedentary time,and physical activity.Mixed-effects logistic regressions were used.Results:Almost half of the adolescents(48%)were classified as being at high risk for depression(score≥20).No significant associations were found between depressive symptoms and accelerometer-measured movement behaviors,self-reported non-sport physical activity,watching videos,and playing videogames.However,higher levels of self-reported total physical activity(odd ratio(OR)=0.92,95%confidence interval(95%CI):0.86-0.98)and volume of sports(OR=0.88,95%CI:0.79-0.97),in minutes,were associated with a lower risk of depression,while using social media for either 2.0-3.9 h/day(OR=1.77,95%CI:1.58-2.70)or>3.9 h/day(OR=1.67,95%CI:1.10-2.54),as well as higher levels of daytime sleepiness(OR=1.17,95%CI:1.12-1.22),were associated with a higher risk of depression.Conclusion:What adolescents do when they are active or sedentary may be more important than the time spent in the movement behaviors because it relates to depressive symptoms.Targeting daytime sleepiness,promoting sports,and limiting social media use may benefit adolescents.展开更多
Background:Pediatric cardiology patients often experience decreased quality of life(QoL)and higher rates of mental illness,particularly with severe disease,but the relationship between them and comparisons across diag...Background:Pediatric cardiology patients often experience decreased quality of life(QoL)and higher rates of mental illness,particularly with severe disease,but the relationship between them and comparisons across diagnostic groups are limited.This mixed-methods cross-sectional study assessed the association between QoL anxiety and behavior problems among children with structural heart disease,arrhythmia,or other cardiac diagnoses.Methods:Children(6–14 years,n=76,50%female)and their parents completed measures of QoL(PedsQL),behavior(BASC-2,subset of 19 children)and anxiety(MASC-2,children 8+years).Pearson correlations/regression models examined associations between QoL,behavior and anxiety,controlling for age,sex,diagnosis and condition severity.Student t-tests compared results to published normative values.Semi-structured interviews(15 children,13 parents)examined self-and parent-reported perceptions of the patient’s emotional health.Results:Child reported social QoL(95%CI difference:−11.0,−2.1),emotional well-being(95%CI difference:−12.5,−3.8)and adjustment skills(95%CI difference:−13.9,−3.0)were significantly below published norms(p<0.05).Neither age,sex,nor diagnosis were significantly related to questionnaire responses.Compared to children with mild conditions,child and parent-reported QoL was significantly lower in children with complex conditions(np2≥0.14,p<0.05).Lower QoL was strongly associated with more internalizing problems based on both child(r=−0.78,p<0.001)and parent(r=−0.67,p<0.001)reports.Interview responses suggested emotional distress was attributed to“normal”child problems rather than the child’s cardiac problem.Conclusion:Children with complex cardiac conditions,regardless of diagnosis,had diminished QoL.Using the PedsQL in clinical settings may help identify pediatric cardiology patients experiencing emotional distress(i.e.,anxiety and depression).展开更多
Background:Psycho social factors predict recurrent inj ury and return to preinjury level of performance following orthopedic injury but are poorly understood following concussion.Current management protocols prioritiz...Background:Psycho social factors predict recurrent inj ury and return to preinjury level of performance following orthopedic injury but are poorly understood following concussion.Current management protocols prioritize physical measures of recovery.Therefore,the objective of this study was to describe the psychosocial factors associated with return to sport(RTS) and how they are measured in athletes who sustained a concussion.Methods:MEDLINE,Embase,APA PsycINFO,CINAHL,and SPORTDiscus were searched through February 2,2021.Eligible studies included original peer-reviewed publications describing psychosocial factors associated with RTS following a diagnosed concussion.The primary outcome was scales or measures employed and/or key thematic concepts.Results:Of the 3615 studies identified,10 quantitative cohort studies(Oxford Centre for Evidence-Based Medicine Level-3) representing 2032 athletes(85% male;high-school and collegiate collision/contact athletes) and 4 qualitative studies representing 66 athletes(74% male;70% American football;aged 9-28 years) were included.We identified 3 overarching themes and 10 outcome measures related to psychosocial factors associated with RTS following concussion:(a) fear(e.g,of recurrent concussion,of RTS,of losing playing status);(b) emotional factors(e.g,depression,anxiety,perceived stress,mental health,disturbance mood);and(c) contextual factors(e.g,social support,pressure,sense of identity).Conclusion:Although current medical clearance decisions prioritize physical measures of recovery,evidence suggests diverse psychosocial factors influence RTS following concussion.It remains unclear which psychosocial factors contribute to a successful RTS,including the influence of sex/gender and age.Future studies should evaluate the association of psychological readiness with physical measures of recovery at medical clearance,preinjury level of performance,and risk of recurrent concussion to support RTS clinical decision-making.展开更多
Autoimmune hepatitis is a chronic liver disease harboring an autoimmune basis and progressive character.Despite still obscurity in etiology and pathogenesis,some evidence supports the importance of sustaining the immu...Autoimmune hepatitis is a chronic liver disease harboring an autoimmune basis and progressive character.Despite still obscurity in etiology and pathogenesis,some evidence supports the importance of sustaining the immune system.Vitamin D is a lipo-soluble vitamin,which has been identified as decreased in our body.It is often due to the daily habit change and decrease of individual sun exposure due to the increase of the ultraviolet-induced potential melanocytic transformation.Here,we emphasize the importance of vitamin D supplementation in patients affected with liver disease.展开更多
Background: The molecular interactions of hepatitis C virus (HCV) with hepatic tissue have yet to be completely elucidated and understood. The purpose of this study was to compare differential gene expression patterns...Background: The molecular interactions of hepatitis C virus (HCV) with hepatic tissue have yet to be completely elucidated and understood. The purpose of this study was to compare differential gene expression patterns in the livers of non-transgenic and transgenic mouse model expressing HCV structural proteins Core, Envelope 1 (E1) and Envelope 2 (E2) using complementary DNA (cDNA) microarrays. Results: Total RNA extracted from the livers of HCV transgenic and non-transgenic mice was analyzed with cDNA microarray and differentially expressed genes confirmed by real-time RT-PCR. Relative expression ratios of individual genes were determined by comparing hybridization of Cy5-labelled cDNA from transgenic mouse livers and Cy3-labelled cDNA from non-transgenic mouse livers. The spot array images were quantified using QuantArray software and the outlier spots was normalized and filtered using five different criteria. 15,297 genes were analyzed using three different analytical methods. Depending on these methods, twenty-one genes were found to be differentially expressed at a statistically significant level. From these, 6 genes had a consistent differential expression. Several genes were directly involved in lipid metabolism and lipid β-oxidation. 5-azacytidine induced gene 2 (AZ2), which is involved in the methylation of genes was down regulated in HCV transgenic mice. Altered transcript levels of these 6 genes were confirmed by real-time RT-PCR analysis. Conclusion: Interactions between HCV and hepatocytes not only involve lipid metabolism and redox balance, but this interaction may also influence DNA methylation, indicating a potential association with the development of hepatocellular carcinoma.展开更多
The frontlin</span><span style="font-family:Verdana;">e</span><span style="font-family:Verdana;"> pharmacists during this pandemic COVID-19 (coronavirus disease 2019) situat...The frontlin</span><span style="font-family:Verdana;">e</span><span style="font-family:Verdana;"> pharmacists during this pandemic COVID-19 (coronavirus disease 2019) situation are potentially contributing to sav</span><span style="font-family:Verdana;">ing</span><span style="font-family:Verdana;"> human lives worldwide. The objective of this study was to demonstrate the current contributions of pharmacists among the frontline healthcare professionals in the management of the COVID-19 crisis across the world. MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Web of Science, and Scopus databases were searched for this study from March 20, 2020 to May 20, 2020. The basic keyword “pharmacist and COVID-19” was used to select studies. Relevant English-language studies, guidelines, articles, relevant published reports in different online news portals and official web pages of different organizations were searched. Pharmacists in the United States and United Kingdom are testing patients for COVID-19 and providing medical advice to patients. Community pharmacists in European countries are focused on the smooth supply of essential medicines, and working to build awareness regarding the community transmission of COVID-19. Hospital and clinical pharmacists are working to facilitate the effective medication therapy management for improving the clinical outcomes of COVID-19 patients. Pharmacists in low-and middle-income countries around the world have focused their efforts mainly on awareness-building activities regarding the community transmission of COVID-19, and the mass production of alcohol-based hand-sanitizer. Several resources are globally available for pharmacists to improve their competency and self-protection from COVID-19. Frontline pharmacists are enthusiastically contributing in the prevention and treatment of COVID-19 from a community-to-clinical level worldwide. Their active participation as a member of the frontline healthcare team is crucial in order to address and overcome the challenges </span><span style="font-family:Verdana;">that </span><span style="font-family:Verdana;">this pandemic has created, and to tackle this global healthcare crisis efficiently.展开更多
Background: Infantile spasm is a type of pediatric seizure often associated with a negative prognosis. The aim of this study was to evaluate the role of Magnetic Resonance Imaging (MRI) in categorization and neurodeve...Background: Infantile spasm is a type of pediatric seizure often associated with a negative prognosis. The aim of this study was to evaluate the role of Magnetic Resonance Imaging (MRI) in categorization and neurodevelopmental outcomes in children with infantile spasm. Materials and Methods: A retrospective study of the clinical charts and MRI findings of infants diagnosed with infantile spasm between December 2007 and February 2014. Results: A total of 26 children (16 males;1.6/1) were included: 8 of unknown etiology and 18 with a genetic/structural-metabolic causes. Unknown etiology cases revealed normal brain MRI in 5/8 (62.5%). In the genetic/ structural-metabolic group, only 2/18 (11.1%) had normal imaging. Abnormal imaging findings significantly correlated with genetic/structural-metabolic infantile spasm which had unfavorable neurodevelopmental outcome. Conclusion: Neuroimaging conveys substantial information to the further categorization of children with infantile spasm, providing not only relevant information of the underlying cause but also the prediction of the neurodevelopmental outcome.展开更多
Anoctamin-5(ANO5)is a multi-pass membrane protein localized to the sarcolemma and the sarcoplasmic reticulum.Mutations were linked to rare autosomal recessive muscle diseases.Here,we summarize the clinical spectrum,im...Anoctamin-5(ANO5)is a multi-pass membrane protein localized to the sarcolemma and the sarcoplasmic reticulum.Mutations were linked to rare autosomal recessive muscle diseases.Here,we summarize the clinical spectrum,imaging data and molecular research findings as well as results of animal modeling,which significantly moved forward the understanding of mechanisms underlying ANO5-related muscle diseases.Given that precise histological information on inflammatory processes taking place in patient-derived muscle are still lacking,an(immuno)histological study on biopsies derived from six ANO5-patients was performed showing focal accumulation of necrotic fibers,mild fiber-size variances and myophagocytosis.In addition,MRI data of four ANO5-patients(including a 10-year follow-up in one patient)are presented and discussed in the context of previously published MRI-findings.Hence,data presented in this article combining a review of the literature with own myopathological findings address scientific trends and open questions on ANO5-related muscle diseases,which would be of significant interest for a wide neuromuscular diseases community.To conclude,a clear genotypeephenotype correlation does not exist,and ANO5-related muscle disorders might represent the next entity of a clinical continuum with varying degree of muscle cell pathologies.In addition,results of pre-clinical studies allowed the definition of suitable cell and animal models characterized by certain histological and functional pathologies resembling the human phenotype.These models might serve as suitable systems for testing of interventional concepts in future.展开更多
基金Supported in part by JSPS KAKENHI Scientific Research(C)(20K11450 to KS)Institute of Health and Sports Science&Medicine,Juntendo University。
文摘Background:Limited nationally representative evidence is available on temporal trends in physical fitness(PF)for children and adolescents during the coronavirus disease 2019(COVID-19)pandemic.The primary aim was to examine the temporal trends in PF for Japanese children and adolescents before and during the COVID-19 pandemic.The secondary aim was to estimate the concurrent trends in body size(measured as body mass and height)and movement behaviors(exercise,screen,and sleep time).Methods:Census PF data for children in Grade 5(aged 10-11 years)and adolescents in Grade 8(aged 13-14 years)were obtained for the years 2013-2021 from the National Survey of Physical Fitness,Athletic Performance,and Exercise Habits in Japan(n=16,647,699).PF and body size were objectively measured,and movement behaviors were self-reported.Using sample-weighted linear regression,temporal trends in mean PF were calculated before the pandemic(2013-2019)and during the pandemic(2019-2021)with adjustments for age,sex,body size,and exercise time.Results:When adjusted for age,sex,body size,and exercise time,there were significant declines in PF during the pandemic,with the largest declines observed in 20-m shuttle run(standardized(Cohen’s)effect size(ES)=-0.109 per annum(p.a.))and sit-ups performance(ES=-0.133p.a.).The magnitude of the declines in 20-m shuttle run and sit-ups performances were 18-and 15-fold larger,respectively,than the improvements seen before the pandemic(2013-2019),after adjusting for age,sex,body size,and exercise time.During the pandemic,both body mass and screen time significantly increased,and exercise time decreased.Conclusion:Declines in 20-m shuttle run and sit-ups performances suggest corresponding declines in population health during the COVID-19pandemic.
文摘1.Light intensity physical activity(PA)benefits health PA guidelines worldwide recommend that adults accumulate 150 min of moderate intensity or 75 min of vigorous intensity PA(moderate-to-vigorous PA(MVPA))weekly to achieve health benefits.1-3 Absent from these guidelines are recommendations for light intensity PA(LPA,e.g.,walking at a leisurely pace of 3 km/h or less,equivalent to 1.5-2.9 metabolic equivalents).
文摘Purpose:The study aimed to examine the reporting completeness of randomized controlled trials(RCTs)of non-pharmacological interventions following concussion.Methods:We searched MEDLINE,Embase,PsycInfo,CINAHL,and Web of Science up to May 2022.Two reviewers independently screened studies and assessed reporting completeness using the Template for Intervention Description and Replication(TIDieR),Consensus on Exercise Reporting Template(CERT),and international Consensus on Therapeutic Exercise aNd Training(i-CONTENT)checklists.Additional information was sought my study authors where reporting was incomplete.Risk of bias(ROB)was assessed with the Cochrane ROB-2 Tool.RCTs examining non-pharmacological interventions following concussion.Results:We included 89 RCTs(n=53 high ROB)examining 11 different interventions for concussion:sub-symptom threshold aerobic exercise,cervicovestibular therapy,physical/cognitive rest,vision therapy,education,psychotherapy,hyperbaric oxygen therapy,transcranial magnetic stimulation,blue light therapy,osteopathic manipulation,and head/neck cooling.Median scores were:TIDieR 9/12(75%;interquartile range(IQR)=5;range:5-12),CERT 17/19(89%;IQR=2;range:10-19),and i-CONTENT 6/7(86%;IQR=1;range:5-7).Percentage of studies completely reporting all items was TIDieR 35%(31/89),CERT 24%(5/21),and i-CONTENT 10%(2/21).Studies were more completely reported after publication of TIDieR(t_(87)=2.08;p=0.04)and CERT(t_(19)=2.72;p=0.01).Reporting completeness was not strongly associated with journal impact factor(TIDieR:rs=0.27;p=0.01;CERT:r_(s)=-0.44;p=0.06;i-CONTENT:r_(s)=-0.17;p=0.48)or ROB(TIDieR:rs=0.11;p=0.31;CERT:rs=0.04;p=0.86;i-CONTENT:rs=0.12;p=0.60).Conclusion:RCTs of non-pharmacological interventions following concussion demonstrate moderate to good reporting completeness,but are often missing key components,particularly modifications,motivational strategies,and qualified supervisor.Reporting completeness improved after TIDieR and CERT publication,but publication in highly cited journals and low ROB do not guarantee reporting completeness.
基金supported by the Brazilian Coordination for the Improvement of Higher Education Personnel(CAPES)with a PhD scholarship(CAPES process:88887.605034/2021-00,88887.605029/2021-00,and 88887.694146/2022-00,respectively)supported by the S?o Paulo Research Foundation(FAPESP)with a PhD scholarship(FAPESP process:2019/24124-7)。
文摘Background:Guidelines recommend that adolescents should accumulate an average of 60 min per day of moderate-to-vigorous physical activity(MVPA).However,using only this cut-off could hide important information.For instance,from a population-level point of view,increasing physical activity for those with no or low physical activity could provide more health benefits than increasing physical activity for those with intermediate levels.Also,including a more sensitive cut-point of≥1 days per week could be an additional strategy for identifying those with low access/opportunities for physical activity practice.Thus,the current study aims to estimate the prevalence of≥60 min of MVPA≥1 days per week among adolescents globally,and to describe any relevant gender inequalities.Methods:We used representative datasets from 146 countries/territories collected between 2003 and 2019.MVPA was self-reported.Participants were grouped into younger(≤14 years old)and older(>14 years old)adolescents.Crude Poisson regression models were used to identify the relative differences in≥60 min of MVPA≥1 days per week between boys and girls,and random-effects meta-analysis models were used to identify the pooled estimates.Analyses were stratified by country and region.Results:Approximately 80%of both younger and older adolescents reported≥60 min of MVPA≥1 days per week.This prevalence was≥94%in Europe and Central Asia and North America,while the estimates for the other regions were<77%.The prevalence of≥60 min of MVPA≥1 days per week was higher among boys than girls,with the largest differences occurring among the oldest adolescents(Prevalence ratio_(≤14y)=1.04(95%confidence interval(95%CI)):1.03-1.04)vs.Prevalence ratio_(>14y)=1.09(95%CI:1.08-1.10)).Conclusion:Approximately 8 out of 10 adolescents reported accumulating≥60 min of MVPA≥1 days per week,with notable differences between regions.Gender differences were observed in several countries,especially among the oldest adolescents.Priorities for physical activity promotion among adolescents should include increasing access/opportunities for physical activity among those who do not achieve≥60 min of MVPA≥1 days per week and reducing gender inequalities.
基金the Key Project of the National Social Science Foundation of China(No.16ZDA227)The first and corresponding authors(STC and YL)are supported by grants from the National Social Science Foundation of China(No.19BTY077)+1 种基金the Philosophy and Social Science Foundation of Shanghai(No.A1904)the Shanghai Key Laboratory of Human Performance(Shanghai University of Sport,No.11DZ2261100)。
文摘Background:Meeting 24-h movement guidelines by children and adolescents has been associated with improved indicators of health,although it has been under-studied in China.Hence,this study aimed to investigate the prevalence of meeting the 24-h movement guidelines,its correlates,and its relationships with body mass index in children and adolescents in China.Methods:Cross-sectional data from the 2017 Youth Study in China of 114,072 children and adolescents(mean age=13.75 years,49.18%boys)were used.Meeting 24-h movement guidelines(60 min of daily moderate-to-vigorous physical activity,2 h of daily leisure screen time,911 h and 810 h nightly sleep duration for 613-year-olds and 1417-year-olds,respectively)and height and weight of all participants were assessed.The prevalence of meeting the 24-h movement guidelines and World Health Organization weight status categories were determined.Generalized linear models were used to determine the correlates of meeting the 24-h movement guidelines and the relationships of meeting the 24-h movement guidelines with overweight(OW)and obesity(OB).Results:Only 5.12%of Chinese children and adolescents met the 24-h movement guidelines,and 22.44%were classified as OW/OB.Older children and adolescents were less likely to meet the 24-h movement guidelines.Parental education level and family income were positively related to meeting the 24-h movement guidelines.Children and adolescents meeting the 24-h movement guidelines showed lower odds ratios for OW/OB.Compared with participants meeting the 24-h movement guidelines,boys in 4th6th grades met none of the recommendations(OR=1.22,95%CI:1.061.40),met the screen time recommendation only(OR=1.13,95%CI:1.011.28),met the nightly sleep duration recommendation only(OR=1.14,95%CI:1.031.28),and had significantly higher odds ratios for OW/OB.Similar trends were observed for girls in 4th6th grades:meeting none of the guidelines(OR=1.35,95%CI:1.141.59),meeting sleep duration guidelines only(OR=1.23,95%CI:1.081.39),and meeting moderate-to-vigorous physical activity+nightly sleep duration guidelines(OR=1.24,95%CI:1.011.54).For girls in 7th9th grades,the following trend was observed:meeting none of the guidelines(OR=1.30,95%CI:1.011.67).Conclusion:Very few Chinese children and adolescents met the 24-h movement guidelines.Age(negatively correlated),parental education level,and family income(both positively correlated)were correlates of meeting the 24-h movement guidelines.Children and adolescents meeting the 24-h movement guidelines were more likely to have lower risks for OW/OB,especially in the youngest age group(Grades 46);and girls in the middle age group(Grades 79)were also more likely to have lower risks for OW/OB.Further research studies should explore additional correlates and determinants for meeting the 24-h movement guidelines.Also,future studies should use longitudinal or interventional designs to determine the relationships between meeting the 24-h movement guidelines and OW/OB and other health indicators,while taking sex and age differences into account.
文摘Purpose:The purpose of this study was to use decision tree modeling to generate profiles of children and youth who were more and less likely to meet the Canadian 24-h movement guidelines during the coronavirus disease-2019(COVID-19)outbreak.Methods:Data for this study were from a nationally representative sample of 1472 Canadian parents(Meanage=45.12,SD=7.55)of children(511 years old)or youth(1217 years old).Data were collected in April 2020 via an online survey.Survey items assessed demographic,behavioral,social,micro-environmental,and macro-environmental characteristics.Four decision trees of adherence and non-adherence to all movement recommendations combined and each individual movement recommendation(physical activity(PA),screen time,and sleep)were generated.Results:Results revealed specific combinations of adherence and non-adherence characteristics.Characteristics associated with adherence to the recommendation(s)included high parental perceived capability to restrict screen time,annual household income ofCAD 100,000,increases in children’s and youth’s outdoor PA/sport since the COVID-19 outbreak began,being a boy,having parents younger than 43 years old,and small increases in children’s and youth’s sleep duration since the COVID-19 outbreak began.Characteristics associated with non-adherence to the recommendation(s)included low parental perceived capability to restrict screen time,youth aged 1217 years,decreases in children’s and youth’s outdoor PA/sport since the COVID-19 outbreak began,primary residences located in all provinces except Quebec,low parental perceived capability to support children’s and youth’s sleep and PA,and annual household income ofCAD 99,999.Conclusion:Our results show that specific characteristics interact to contribute to(non)adherence to the movement behavior recommendations.Results highlight the importance of targeting parents’perceived capability for the promotion of children’s and youth’s movement behaviors during challenging times of the COVID-19 pandemic,paying particular attention to enhancing parental perceived capability to restrict screen time.
文摘Purpose:The objective of this scoping review was to summarize systematically the available literature investigating the relationships between the coronavirus disease 2019(COVID-19)pandemic and movement behaviors(physical activity,sedentary behavior,and sleep)of school-aged children(aged 511 years)and youth(aged 1217 years)in the first year of the COVID-19 outbreak.Methods:Searches for published literature were conducted across 6 databases on 2 separate search dates(November 25,2020,and January 27,2021).Results were screened and extracted by 2 reviewers(DCP and KR)independently,using Covidence.Basic numeric analysis and content analysis were undertaken to present thematically the findings of included studies according to the associated impact on each movement behavior.Results:A total of 1486 records were extracted from database searches;of those,150 met inclusion criteria and were included for analysis.Of 150 articles,110 were empirical studies examining physical activity(n=77),sedentary behavior/screen time(n=58),and sleep(n=55).Results consistently reported declines in physical-activity time,increases in screen time and total sedentary behavior,shifts to later bed and wake times,and increases in sleep duration.The reported impacts on movement behaviors were greater for youth than for children.Conclusion:The COVID-19 pandemic is related to changes in the quantity and nature of physical activity,sedentary behavior,and sleep among children and youth.There is an urgent need for policy makers,practitioners,and researchers to develop solutions for attenuating adverse changes in physical activity and screen time among children and youth.
文摘Background:New research suggests that the composition(mix)of movement behaviors within a 24-h period may have important implications for health across the lifespan.Consistent with this integrated movement behavior paradigm,a number of countries across the world have developed and released 24-h movement guidelines for specific age groups.The purpose of this systematic review was to examine the associations between the 24-h time-use composition of movement behaviors,or adherence to 24-h movement guidelines,and multiple health indicators across the lifespan.Methods:Five online databases(PsycINFO,PubMed,SPORTDiscus,Web of Science,and Ovid MEDLINE)were searched for relevant peer-reviewed studies published between January 2015 and January 2020 that met the a priori inclusion criteria,with no study design limits.The methodological quality of research evidence for each individual study and for each health indicator was assessed by using a modified version of the Downs and Black checklist.Results:A total of 51 studies from 20 different countries met the inclusion criteria.A total of 31 studies examined adherence(meeting vs.not meeting)to 24-h movement guidelines,and 20 studies used compositional analyses to explore the 24-h time-use composition of movement behaviors.Findings indicated that meeting the 24-h movement guidelines were(1)not associated with adiposity among toddlers,(2)favorably associated with health-related quality of life,social-cognitive development,and behavioral and emotional problems among preschoolers,(3)favorably associated with global cognition,health-related quality of life,and healthy dietary patterns in children,and(4)favorably associated with adiposity,fitness,and cardiometabolic,mental,social,and emotional health among children and youth.Significant associations were also found between the composition of 24-h movement behaviors and indicators of(1)adiposity and bone and skeletal health among preschoolers,(2)health-related quality of life among children,(3)adiposity,fitness,and cardiometabolic,social,and emotional health among children and youth,(4)cardiometabolic health in adults,(5)adiposity and fitness among adults and older adults,and(6)mental health and risk of mortality among older adults.The quality of the available evidence ranged from poor to good.Conclusion:The current evidence indicates that the composition of movement behaviors within a 24-h period may have important implications for health at all ages and that meeting the current 24-h movement guidelines is associated with a number of desirable health indicators in children and youth.Future studies should employ longitudinal and experimental designs,include valid and reliable measures of 24-h movement behaviors,and examine a wide array of health indicators across all age groups.Such studies would confirm the results from the primarily cross-sectional evidence drawn from studies included in our review and further advance our understanding of the relationships between 24-h movement behaviors and health.
基金Supported by the SAGES research grant(to Nfonsam VN)
文摘BACKGROUND Colon cancer is among the most commonly diagnosed cancers in the United States with an estimated 97220 new cases expected by the end of 2018.It affects 1.2 million people around the world and is responsible for about 0.6 million deaths every year.Despite decline in overall incidence and mortality over the past 30 years,there continues to be an alarming rise in early-onset colon cancer cases(<50 years).Patients are often diagnosed at late stages of the disease and tend to have poor survival.We previously showed that the WNT“gatekeeper”gene,secreted frizzled-related protein 4(SFRP4),is over-expressed in early-onset colon cancer.SFRP4 is speculated to play an essential role in cancer by inhibiting the epithelial mesenchymal transition(EMT).AIM To investigate the correlation between SFRP4 expression and EMT-linked genes in colon cancer and how it affects patient survival.METHODS SFRP4 expression relative to that of EMT-linked genes and survival analysis were performed using the University of California Santa Cruz Cancer Browser interface.RESULTS SFRP4 was found to be co-expressed with the EMT-linked markers CDH2,FN1,VIM,TWIST1,TWIST2,SNAI1,SNAI2,ZEB1,ZEB2,POSTN,MMP2,MMP7,MMP9,and COL1A1.SFRP4 expression negatively correlated with the EMTlinked suppressors CLDN4,CLDN7,TJP3,MUC1,and CDH1.The expression of SFRP4 and the EMT-linked markers was higher in mesenchymal-like samples compared to epithelial-like samples which potentially implicates SFRP4-EMT mechanism in colon cancer.Additionally,patients overexpressing SFRP4 presented with poor overall survival(P=0.0293).CONCLUSION Considering the implication of SFRP4 in early-onset colon cancer,particularly in the context of EMT,tumor metastasis,and invasion,and the effect of increased expression on colon cancer patient survival,SFRP4 might be a potential biomarker for early-onset colon cancer that could be targeted for diagnosis and/or disease therapy.
基金the financial support of the Ministry of Economy and Infrastructures and European Communitysupported by the Ministry of Economy and Infrastructures of Extremadura (PD 18015)funded by FEDER,FSE and Govern of Extremadura,grant numbers GR18102 and TA18027.
文摘Background:Meeting the 24-Hour Movement Guidelines(physical activity,screen time,and sleep duration) has been associated with positive health indicators.However,there are no previous meta-analyses that have examined the overall adherence to the 24-Hour Movement Guidelines from pre-school to adolescence across the world.Therefore,the main purpose of this systematic review and meta-analysis was to examine the overall(non)adherence to the 24-Hour Movement Guidelines among preschoolers,children,and adolescents worldwide.Methods:Four electronic databases(MEDLINE,Scopus,Web of Science,and Cochrane Database of Systematic Reviews) were searched for quantitative studies published in Spanish and English between January 2016 and May 2021.Studies that were conducted with apparently healthy participants and reported the overall(non)adherence to the 24-Hour Movement Guidelines in preschoolers and/or children and/or adolescents were included.Results:Sixty-three studies comprising 387,437 individuals(51% girls) aged 3-18 years from 23 countries were included.Overall,7.12%(95%confidence interval(95%CI):6.45%-7.78%) of youth met all three 24-Hour Movement Guidelines,and 19.21%(95%CI:16.73%-21.69%)met none of the 3 recommendations.Concerning sex,adherence to all recommendations was significantly lower in girls(3.75%,95%CI:3.23%-4.27%) than in boys(6.89%,95%CI:5.89%-7.89%)(p <0.001).However,there were no sex differences regarding adherence to any of the 3 individual recommendations(girls,15.66%,95%CI:8.40%-22.92%;boys,12.95%,95%CI:6.57%-19.33%).In terms of age group,adherence to the 3 recommendations was 11.26%(95%CI:8.68%-13.84%),10.31%(95%CI:7.49%-13.12%),and 2.68%(95%CI:1.78%-3.58%) in preschoolers,children,and adolescents,respectively.Conversely,8.81%(95%CI:5.97%-11.64%) of preschoolers,15.57%(95%CI:11.60%-19.54%) of children,and 28.59%(95%CI:22.42%-34.75%) of adolescents did not meet any of the recommendations.South America was the region with the lowest adherence(all:2.93%;none:31.72%).Overall adherence to the 24-Hour Movement Guidelines was positively related to country Human Development Index(β=-0.37,95%CI:-0.65 to-0.09;p=0.010).Conclusion:Most young people fail to meet the three 24-Hour Movement Guidelines,particularly adolescents,girls,and those who are from countries with a lower Human Development Index.Moreover,1 in 5 young people did not meet any of these recommendations.Therefore,these results highlight the need to develop age-and sex-specific strategies to promote these movement behaviors from the early stages of life.
文摘In recent years,pediatric health care has embraced the concept of quality improvement to improve patient outcomes.As quality improvement efforts are implemented,network collaboration(where multiple centers and practices implement standardized programs)is a popular option.In a collaborative network,improvement in the conduct of structural,process and outcome quality measures can lead to improvements in overall health,and benchmarks can be used to assess and compare progress.In this review article,we provided an overview of the quality improvement movement and the role of quality indicators in this movement.We reviewed current quality improvement efforts in pediatric inflammatory bowel disease (IBD),as well as other pediatric chronic illnesses.We discussed the need to standardize the development of quality indicators used in quality improvement networks to assess medical care,and the validation techniques which can be used to ensure that process indicators result in improved outcomes of clinical significance.We aimed to assess current quality improvement efforts in pediatric IBD and other diseases,such as childhood asthma,childhood arthritis,and neonatal health.By doing so,we hope to learn from their successes and failures and to move the field forward for future improvements in the care provided to children with IBD.
文摘A new paradigm employing 24-h movement guidelines that combines recommendations for movement behaviors across the whole day(physical activities of all intensities,sedentary behaviors,and sleep)is gaining momentum around the globe,and several jurisdictions are developing and releasing evidence-informed public health guidelines embracing this approach.1,2 The Sedentary Behavior Research Network(SBRN),the world’s largest network of researchers and health professionals focusing specifically on the health impact of sedentary behaviors,embraces this new paradigm and has worked to normalize the integration of sedentary behaviors into the movement-behavior paradigm.
基金the Brazilian National Council for Scientific and Technological Development for providing funding for the ELEVA study(Grant#406258/2018-0)as well as a scholarship(LEAM)。
文摘Background:Physical activity,sleep,and sedentary behaviors compose 24-h movement behaviors and have been independently associated with depressive symptoms.However,it is not clear whether it is the movement behavior itself or other contextual factors that are related to depressive symptoms.The objective of the present study was to examine the associations between self-reported and accelerometer-measured movement behaviors and depressive symptoms in adolescents.Methods:Cross-sectional data from 610 adolescents(14-18 years old)were used.Adolescents answered questions from the Center for Epidemiological Studies Depression scale and reported time spent watching videos,playing videogames,using social media,time spent in various physical activities,and daytime sleepiness.Wrist-worn accelerometers were used to measure sleep duration,sleep efficiency,sedentary time,and physical activity.Mixed-effects logistic regressions were used.Results:Almost half of the adolescents(48%)were classified as being at high risk for depression(score≥20).No significant associations were found between depressive symptoms and accelerometer-measured movement behaviors,self-reported non-sport physical activity,watching videos,and playing videogames.However,higher levels of self-reported total physical activity(odd ratio(OR)=0.92,95%confidence interval(95%CI):0.86-0.98)and volume of sports(OR=0.88,95%CI:0.79-0.97),in minutes,were associated with a lower risk of depression,while using social media for either 2.0-3.9 h/day(OR=1.77,95%CI:1.58-2.70)or>3.9 h/day(OR=1.67,95%CI:1.10-2.54),as well as higher levels of daytime sleepiness(OR=1.17,95%CI:1.12-1.22),were associated with a higher risk of depression.Conclusion:What adolescents do when they are active or sedentary may be more important than the time spent in the movement behaviors because it relates to depressive symptoms.Targeting daytime sleepiness,promoting sports,and limiting social media use may benefit adolescents.
基金Data collection at SickKids was supported by the Cardiovascular Clinical Research UnitData collection by Bhavika Patel was supported by the Mach-Gaensslen Foundation of Canadathrough a summer research studentship+1 种基金Data collection by Julia Jackson was supported by a summer studentship from the CHEO Research InstituteThe analyses and manuscript preparation by Jacqueline Lee was supported by a Queen Elizabeth II Scholarship.
文摘Background:Pediatric cardiology patients often experience decreased quality of life(QoL)and higher rates of mental illness,particularly with severe disease,but the relationship between them and comparisons across diagnostic groups are limited.This mixed-methods cross-sectional study assessed the association between QoL anxiety and behavior problems among children with structural heart disease,arrhythmia,or other cardiac diagnoses.Methods:Children(6–14 years,n=76,50%female)and their parents completed measures of QoL(PedsQL),behavior(BASC-2,subset of 19 children)and anxiety(MASC-2,children 8+years).Pearson correlations/regression models examined associations between QoL,behavior and anxiety,controlling for age,sex,diagnosis and condition severity.Student t-tests compared results to published normative values.Semi-structured interviews(15 children,13 parents)examined self-and parent-reported perceptions of the patient’s emotional health.Results:Child reported social QoL(95%CI difference:−11.0,−2.1),emotional well-being(95%CI difference:−12.5,−3.8)and adjustment skills(95%CI difference:−13.9,−3.0)were significantly below published norms(p<0.05).Neither age,sex,nor diagnosis were significantly related to questionnaire responses.Compared to children with mild conditions,child and parent-reported QoL was significantly lower in children with complex conditions(np2≥0.14,p<0.05).Lower QoL was strongly associated with more internalizing problems based on both child(r=−0.78,p<0.001)and parent(r=−0.67,p<0.001)reports.Interview responses suggested emotional distress was attributed to“normal”child problems rather than the child’s cardiac problem.Conclusion:Children with complex cardiac conditions,regardless of diagnosis,had diminished QoL.Using the PedsQL in clinical settings may help identify pediatric cardiology patients experiencing emotional distress(i.e.,anxiety and depression).
文摘Background:Psycho social factors predict recurrent inj ury and return to preinjury level of performance following orthopedic injury but are poorly understood following concussion.Current management protocols prioritize physical measures of recovery.Therefore,the objective of this study was to describe the psychosocial factors associated with return to sport(RTS) and how they are measured in athletes who sustained a concussion.Methods:MEDLINE,Embase,APA PsycINFO,CINAHL,and SPORTDiscus were searched through February 2,2021.Eligible studies included original peer-reviewed publications describing psychosocial factors associated with RTS following a diagnosed concussion.The primary outcome was scales or measures employed and/or key thematic concepts.Results:Of the 3615 studies identified,10 quantitative cohort studies(Oxford Centre for Evidence-Based Medicine Level-3) representing 2032 athletes(85% male;high-school and collegiate collision/contact athletes) and 4 qualitative studies representing 66 athletes(74% male;70% American football;aged 9-28 years) were included.We identified 3 overarching themes and 10 outcome measures related to psychosocial factors associated with RTS following concussion:(a) fear(e.g,of recurrent concussion,of RTS,of losing playing status);(b) emotional factors(e.g,depression,anxiety,perceived stress,mental health,disturbance mood);and(c) contextual factors(e.g,social support,pressure,sense of identity).Conclusion:Although current medical clearance decisions prioritize physical measures of recovery,evidence suggests diverse psychosocial factors influence RTS following concussion.It remains unclear which psychosocial factors contribute to a successful RTS,including the influence of sex/gender and age.Future studies should evaluate the association of psychological readiness with physical measures of recovery at medical clearance,preinjury level of performance,and risk of recurrent concussion to support RTS clinical decision-making.
基金Corresponding author:Consolato M Sergi,MD,PhD,Chief,Anatomic Pathology Division,Pediatric Pathologist,Children’s Hospital of Eastern Ontario(CHEO),401 Smyth Road,Ottawa K1H 8L1,ON,Canada.csergi@cheo.on.ca。
文摘Autoimmune hepatitis is a chronic liver disease harboring an autoimmune basis and progressive character.Despite still obscurity in etiology and pathogenesis,some evidence supports the importance of sustaining the immune system.Vitamin D is a lipo-soluble vitamin,which has been identified as decreased in our body.It is often due to the daily habit change and decrease of individual sun exposure due to the increase of the ultraviolet-induced potential melanocytic transformation.Here,we emphasize the importance of vitamin D supplementation in patients affected with liver disease.
文摘Background: The molecular interactions of hepatitis C virus (HCV) with hepatic tissue have yet to be completely elucidated and understood. The purpose of this study was to compare differential gene expression patterns in the livers of non-transgenic and transgenic mouse model expressing HCV structural proteins Core, Envelope 1 (E1) and Envelope 2 (E2) using complementary DNA (cDNA) microarrays. Results: Total RNA extracted from the livers of HCV transgenic and non-transgenic mice was analyzed with cDNA microarray and differentially expressed genes confirmed by real-time RT-PCR. Relative expression ratios of individual genes were determined by comparing hybridization of Cy5-labelled cDNA from transgenic mouse livers and Cy3-labelled cDNA from non-transgenic mouse livers. The spot array images were quantified using QuantArray software and the outlier spots was normalized and filtered using five different criteria. 15,297 genes were analyzed using three different analytical methods. Depending on these methods, twenty-one genes were found to be differentially expressed at a statistically significant level. From these, 6 genes had a consistent differential expression. Several genes were directly involved in lipid metabolism and lipid β-oxidation. 5-azacytidine induced gene 2 (AZ2), which is involved in the methylation of genes was down regulated in HCV transgenic mice. Altered transcript levels of these 6 genes were confirmed by real-time RT-PCR analysis. Conclusion: Interactions between HCV and hepatocytes not only involve lipid metabolism and redox balance, but this interaction may also influence DNA methylation, indicating a potential association with the development of hepatocellular carcinoma.
文摘The frontlin</span><span style="font-family:Verdana;">e</span><span style="font-family:Verdana;"> pharmacists during this pandemic COVID-19 (coronavirus disease 2019) situation are potentially contributing to sav</span><span style="font-family:Verdana;">ing</span><span style="font-family:Verdana;"> human lives worldwide. The objective of this study was to demonstrate the current contributions of pharmacists among the frontline healthcare professionals in the management of the COVID-19 crisis across the world. MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Web of Science, and Scopus databases were searched for this study from March 20, 2020 to May 20, 2020. The basic keyword “pharmacist and COVID-19” was used to select studies. Relevant English-language studies, guidelines, articles, relevant published reports in different online news portals and official web pages of different organizations were searched. Pharmacists in the United States and United Kingdom are testing patients for COVID-19 and providing medical advice to patients. Community pharmacists in European countries are focused on the smooth supply of essential medicines, and working to build awareness regarding the community transmission of COVID-19. Hospital and clinical pharmacists are working to facilitate the effective medication therapy management for improving the clinical outcomes of COVID-19 patients. Pharmacists in low-and middle-income countries around the world have focused their efforts mainly on awareness-building activities regarding the community transmission of COVID-19, and the mass production of alcohol-based hand-sanitizer. Several resources are globally available for pharmacists to improve their competency and self-protection from COVID-19. Frontline pharmacists are enthusiastically contributing in the prevention and treatment of COVID-19 from a community-to-clinical level worldwide. Their active participation as a member of the frontline healthcare team is crucial in order to address and overcome the challenges </span><span style="font-family:Verdana;">that </span><span style="font-family:Verdana;">this pandemic has created, and to tackle this global healthcare crisis efficiently.
文摘Background: Infantile spasm is a type of pediatric seizure often associated with a negative prognosis. The aim of this study was to evaluate the role of Magnetic Resonance Imaging (MRI) in categorization and neurodevelopmental outcomes in children with infantile spasm. Materials and Methods: A retrospective study of the clinical charts and MRI findings of infants diagnosed with infantile spasm between December 2007 and February 2014. Results: A total of 26 children (16 males;1.6/1) were included: 8 of unknown etiology and 18 with a genetic/structural-metabolic causes. Unknown etiology cases revealed normal brain MRI in 5/8 (62.5%). In the genetic/ structural-metabolic group, only 2/18 (11.1%) had normal imaging. Abnormal imaging findings significantly correlated with genetic/structural-metabolic infantile spasm which had unfavorable neurodevelopmental outcome. Conclusion: Neuroimaging conveys substantial information to the further categorization of children with infantile spasm, providing not only relevant information of the underlying cause but also the prediction of the neurodevelopmental outcome.
基金Parts of the study were funded by The European Regional Development Fund(ERDFNo.NME-GPS)+2 种基金JC received funding from the University of Duisburg-Essen(ELAN-promotion programme)Germany.AR received funding from the French Muscular Dystrophy Association,France(AFMTe´le´thonNo.21466).
文摘Anoctamin-5(ANO5)is a multi-pass membrane protein localized to the sarcolemma and the sarcoplasmic reticulum.Mutations were linked to rare autosomal recessive muscle diseases.Here,we summarize the clinical spectrum,imaging data and molecular research findings as well as results of animal modeling,which significantly moved forward the understanding of mechanisms underlying ANO5-related muscle diseases.Given that precise histological information on inflammatory processes taking place in patient-derived muscle are still lacking,an(immuno)histological study on biopsies derived from six ANO5-patients was performed showing focal accumulation of necrotic fibers,mild fiber-size variances and myophagocytosis.In addition,MRI data of four ANO5-patients(including a 10-year follow-up in one patient)are presented and discussed in the context of previously published MRI-findings.Hence,data presented in this article combining a review of the literature with own myopathological findings address scientific trends and open questions on ANO5-related muscle diseases,which would be of significant interest for a wide neuromuscular diseases community.To conclude,a clear genotypeephenotype correlation does not exist,and ANO5-related muscle disorders might represent the next entity of a clinical continuum with varying degree of muscle cell pathologies.In addition,results of pre-clinical studies allowed the definition of suitable cell and animal models characterized by certain histological and functional pathologies resembling the human phenotype.These models might serve as suitable systems for testing of interventional concepts in future.
