Teachers' perception on physical activity promotion in kindergarten children in China: a qualitative study connecting social-ecological model.

BACKGROUND: Globally, the majority of kindergarten-aged children face obesity issues and insufficient physical activity (PA) engagement. Regular PA participation can provide various health benefits, including obesity reduction, for kindergarten-aged children. However, limited studies have investigated the factors influencing kindergarten-aged children's PA engagement from the perspective of their teachers. This qualitative study aimed to identify factors that could help promote PA among kindergarten-aged children from teachers' perspectives, including facilitators, barriers, and teachers' recommendations. METHODS: Fifteen kindergarten teachers (age range: 28-50 years; mean age: 38.53 years) with teaching experience ranging from 2 to 31 years (mean: 16.27 years) were recruited from Shanghai municipality, Henan, and Jiangsu provinces in China. One-on-one semi-structured interviews were conducted via face-to-face (n = 7) or telephone (n = 8) to gather insights into factors influencing PA promotion among kindergarten-aged children. The interviews were audio-recorded, transcribed, and analyzed using a constant comparison approach based on grounded theory, which involved open, axial, and selective coding processes. RESULTS: The study revealed mutual theoretical support between themes and the social-ecological model (SEM), as factors identified in the study are distributed at various levels of the SEM. Twelve factors were identified at four levels of the SEM: (1) intrapersonal level (children's personality and skills), (2) interpersonal level (family, peers, and teachers influence), (3) organizational level (school environment and resources, opportunities for kindergarten teachers' training and children's PA, design and organization of PA, and PA that children need), (4) community level (family-school partnerships). CONCLUSION: Various factors at different levels can influence kindergarten-aged children's PA. The study's findings revealed that these factors are distributed across the first four levels of SEM, with the majority being at the organizational level. These multilevel findings are expected to assist in developing and implementing more effective PA interventions for kindergarten-aged children. Future research is warranted to identify strategies for promoting PA among kindergarten-aged children at the policy level of the SEM.

Results from the China 2022 report card on physical activity for children and adolescents.

Background/Objective: Regular physical activity (PA) is beneficial to young people's health and development. In order to provide nationally representative and internationally comparable evidence on youth PA, China has participated in Global Matrix 2.0 and 3.0. The purpose of this study is to report the updated results of China's Report Card on PA for Children and Adolescents. Methods: The grades were assigned by results derived from the PA and Fitness in China--The Youth Study (PAFCTYS), conducted from October to December in 2020. The data from PAFCTYS 2020 included a nationally representative sample of Chinese school-aged children (n = 133,006, boys: 49.6%, aged 9-17 years). Self-report questionnaires were completed by the sampled students, their parents/guardians (n = 133,006), and physical education teachers (n = 1036) from each sampled school respectively. Results: The grades of China 2022 Report Card are Overall PA (C), Organized Sport Participation (F), Active Play (C-), Active Transportation (C), Sedentary behaviors (C), Physical Fitness (INC), Family and Peers (C-), School (D), Community and Environment (D-), and Government (D). Conclusion: Levels of PA among Chinese youth were low and most young people were below the recommended guidelines, although the grade of Overall PA has been improved since the modified benchmark. Prevalence of sedentary behaviors remained high. Interventions and policies at the community and environment level should be encouraged to promote PA and reduce sedentary behaviors. In addition, national policies on young people's PA should be advocated widely to ensure the policies can be transferred into action.

The associations of physical activity and sedentary behavior with self-rated health in Chinese children and adolescents.

OBJECTIVE: The study aimed to analyze the independent and joint associations of physical activity (PA) and sedentary behavior (SB) with self-rated health (SRH) among Chinese children and adolescents. METHODS: Cross-sectional data on moderate-to-vigorous physical activity (MVPA), school-based PA, extracurricular physical activity (EPA), screen time (ST), homework time, and SRH were assessed through a self-report questionnaire in the sample of 4227 Chinese children and adolescents aged 13.04 ± 2.62 years. Binary logistic regression was used to compare gender differences in PA, SB, and SRH among children and adolescents, and analyses were adjusted for age and ethnicity. RESULTS: In independent associations, boys and girls engaging in ≥60 min/day of MVPA and >1 hour/day of EPA reported optimal SRH. Only boys who participated in >1 hour/day of school-based PA were significantly more likely to have optimal SRH (OR = 1.49, 95%CI = 1.19-1.86). Only girls who had ≤2 hours/day of ST were significantly associated with optimal SRH (weekdays: OR = 1.38, 95%CI = 1.10-1.74; weekends: OR = 1.40, 95%CI = 1.14-1.71; whole week: OR = 1.42, 95%CI = 1.16-1.73). In joint associations, regardless of SB recommendation, meeting PA recommendation was significantly associated with optimal SRH in both boys (meet PA and SB recommendations, OR = 1.61, 95%CI = 1.03-2.50; meet PA but not SB recommendations, OR = 2.40, 95%CI = 1.57-3.65) and girls (meet PA and SB recommendations, OR = 3.72, 95%CI = 2.08-6.65; meet PA but not SB recommendation, OR = 4.27, 95%CI = 2.09-8.75). CONCLUSION: Increased PA and reduced SB were positively associated with optimal SRH in Chinese children and adolescents. Notably, lower ST positively influenced only girls' SRH. Meeting PA recommendation is more impactful than meeting SB recommendation for improving SRH in Chinese children and adolescents. Future studies could explore these associations using objective measures of PA and SB in China.

IL-1ß stimulated human umbilical cord mesenchymal stem cells ameliorate rheumatoid arthritis via inducing apoptosis of fibroblast-like synoviocytes.

Rheumatoid arthritis (RA) is characterized by synovial proliferation and lymphocyte accumulation leading to progressive damage of the periarticular bone and the articular cartilage. The hyperplasia of the synovial intima lining mainly consists of fibroblast-like synoviocytes-rheumatoid arthritis (HFLS-RA) which exhibit apoptosis-resistance, hyper-proliferation, and high invasiveness. The therapeutic efficacy of mesenchymal stem cells (MSCs) treatment in RA has been shown to be due to its immuno-regulatory ability. However, the exact factors and mechanisms involved in MSCs treatment in RA remain unclear. In this study, TRAIL receptor-Death receptor 4 (DR4), DR5, and LFA-1 ligand-intercellular adhesion molecule-1 (ICAM-1) were upregulated in IL-1ß-stimulated HFLS-RA. We demonstrated that the total cell number of IL-1ß-stimulated hUCMSCs adhering to IL-1ß-stimulated HFLA-RA increased via LFA-1/ICAM-1 interaction. Direct co-culture of IL-1ß-stimulated hUCMSCs with IL-1ß-stimulated HFLS-RA increased the apoptosis of HFLS-RA. RA symptoms in the CIA mouse model improved after administration of IL-1ß-stimulated hUCMSCs. In conclusion, IL-1ß-stimulated hUCMSCs adhering to HFLS-RA occurred via LFA-1/ICAM-1 interaction, apoptosis of HFLS-RA was induced via TRAIL/DR4, DR5 contact, and RA symptoms and inflammation were significantly improved in a CIA mouse model. The results of this study suggest that IL-1ß-stimulated hUCMSCs have therapeutic potential in RA treatment.

Associations between socioeconomic status and screen time among children and adolescents in China: A cross-sectional study.

BACKGROUND: Socioeconomic status (SES) is an important determinant of screen time (ST) in children and adolescents, however, the association between SES and ST is not fully understood in China. This study aimed to investigate the association between SES and ST (operationalized as meeting the ST guidelines; no more than 2 hours per day) in Chinese children and adolescents. METHODS: Cross-sectional data of 2,955 Chinese children and adolescents aged 8 to 17(53.4% girls) were used. SES was measured using indicators of parental education and perceived family wealth. ST was assessed with detailed items from the Health Behaviour School-aged Children survey questionnaires. Descriptive statistics and a Chi-square test were used to report the sample characteristics and analyse ST differences across different sociodemographic groups. A binary logistic regression was then applied to analyse the association of SES indicators with ST in children and adolescents. RESULTS: Overall, 25.3% of children and adolescents met the ST guidelines. Children and adolescents with higher parental education levels were 1.84 [95% CI 1.31-2.57; father] and 1.42 [95% CI 1.02-1.98; mother] times more likely to meet the ST guidelines than those with lower parental education levels. Associations between SES and ST varied across sex and grade groups. Moreover, the associations of SES with ST on weekdays and weekends were different. CONCLUSIONS: This study demonstrated the association between SES and ST in children and adolescents, highlighting the importance of targeting children and adolescents with low SES levels as an intervention priority. Based on our findings, specific interventions can be tailored to effectively reduce ST. Future studies are encouraged to use longitudinal or interventional designs to further determine the association between SES and ST.

Anti-tumor Effects of IL-1ß Induced TRAIL-Expressing hUCMSCs on Embelin Treated Breast Cancer Cell Lines.

BACKGROUND: Human umbilical cord mesenchymal stem cells (hUCMSCs) have high therapeutic value in cancer treatment. We have found that pre-activating hUCMSCs with IL-1ß promotes tumor necrosis factor-related apoptosis inducing ligand (TRAIL) expression and facilitates anti-tumor effect. Furthermore, embelin has been found to induce apoptosis of different cancer cell lines by upregulating the expression of TRAIL receptor 1 (DR4) and TRAIL receptor 2 (DR5). This study investigated whether IL-1ß induced TRAIL-expressing hUCMSCs, in combination with low-dose embelin, could further induce apoptosis in breast cancer cell lines. MATERIALS AND METHODS: MTT assay was used to examine the cytotoxicity of embelin in MDA-MB-231 and MCF-7. To detect the interested protein expression in cells, Western blot and cell immunofluorescence were used to double-confirm the observed results. Annexin V/PI apoptosis assay was detected by flow cytometry to analyze the apoptosis rate of embelin treated breast cancer cell lines and the effect of co-culturing with breast cancer cells and hUCMSCs. RESULTS: Using Western blot and immunofluorescence, we found that breast cancer cell lines treated with low-dose embelin (2.5-5 µM) increased the expression of apoptosis-related receptor DR4, DR5 and the cleaved caspase 8, 9 and 3. Moreover, TRAIL expression was enhanced in IL-1ß induced hUCMSCs. Combining these observations, we expected that coculturing IL-1ß induced hUCMSCs with low dose embelin treated MDA-MB-231 and MCF-7 cells might enhance the apoptosis of breast cancer cells. We confirmed via flow cytometry that coculture of IL-1ß induced TRAIL-expressing hUCMSCs and embelin treated MDA-MB-231 and MCF-7 cells enhances the apoptosis rate of these breast cancer cells. CONCLUSION: We found that embelin upregulated the expression of DR4 and DR5 to increase the TRAIL-mediated apoptosis in breast cancer cell lines. Low dose embelin treated breast cancer cell lines in combination with IL-1ß induced TRAIL-expressing hUCMSCs may become a potential anti-tumor therapy.

Embelin downregulated cFLIP in breast cancer cell lines facilitate anti-tumor effect of IL-1ß-stimulated human umbilical cord mesenchymal stem cells.

Breast cancer is the leading cause of cancer-related death for women. In breast cancer treatment, targeted therapy would be more effective and less harmful than radiotherapy or systemic chemotherapy. Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) has been shown to induce apoptosis in cancer cells but not in normal cells. Mesenchymal stem cells have shown great therapeutic potential in cancer therapy owing to their ability of homing to tumor sites and secreting many kinds of anti-tumor proteins including TRAIL. In this study, we found that IL-1ß-stimulated human umbilical cord-derived mesenchymal stem cells (hUCMSCs) enhance the expression of membrane-bound and soluble TRAIL. Cellular FADD-like IL-1ß-converting enzyme inhibitory protein (cFLIP) is an important regulator in TRAIL-mediated apoptosis and relates to TRAIL resistance in cancer cells. Previous studies have shown that embelin, which is extracted from Embelia ribes, can increase the TRAIL sensitivity of cancer cells by reducing cFLIP expression. Here we have demonstrated that cFLIPL is correlated with TRAIL-resistance and that embelin effectively downregulates cFLIPL in breast cancer cells. Moreover, co-culture of IL-1ß-stimulated hUCMSCs with embelin-treated breast cancer cells could effectively induce apoptosis in breast cancer cells. The combined effects of embelin and IL-1ß-stimulated hUCMSCs may provide a new therapeutic strategy for breast cancer therapy.

Interleukin-1ß-induced matrix metalloproteinase-3 via ERK1/2 pathway to promote mesenchymal stem cell migration.

Human umbilical cord Wharton's jelly derived mesenchymal stem cells (hUCMSCs), a source of cell therapy, have received a great deal of attention due to their homing or migrating ability in response to signals emanating from damaged sites. It has been found that IL-1ß possesses the ability to induce the expression of matrix metalloproteinase-3 (MMP-3) in bone marrow MSCs. MMP-3 is involved in cell migration in various types of cells, including glioblastoma, vascular smooth muscle, and adult neural progenitor cells. In this study, we proposed that IL-1ß influences hUCMSCs migration involving MMP-3. The expression level of MMP-3 in IL-1ß-induced hUCMSCs was verified using cDNA microarray analysis, quantitative real-time PCR, ELISA and Western blot. Wound-healing and trans-well assay were used to investigate the cell migration and invasion ability of IL-1ß-treated hUCMSCs. In addition, we pre-treated hUCMSCs with interleukin-1 receptor antagonist, MMP-3 inhibitors (ALX-260-165, UK 356618), or transfected with MMP-3 siRNA to confirm the role of MMP3 in IL-1ß-induced cell migration. Our results showed that IL-1ß induced MMP-3 expression is related to the migration of hUCMSCs. Moreover, extracellular signal-regulated protein kinases 1 and 2 (ERK1/2) inhibitor U0126, p38 inhibitor SB205380, JNK inhibitor SP600125 and Akt inhibitor GSK 690693 decreased IL-1ß-induced MMP-3 mRNA and protein expression. The migration and invasion ability analyses showed that these inhibitors attenuated the IL-1ß-induced migration and invasion ability of hUCMSCs. In conclusion, we have found that IL-1ß induces the expression of MMP-3 through ERK1/2, JNK, p38 MAPK and Akt signaling pathways to enhance the migration of hUCMSCs. These results provide further understanding of the mechanisms in IL-1ß-induced hUCMSCs migration to injury sites.

Interleukin-1ß Enhances Umbilical Cord Mesenchymal Stem Cell Adhesion Ability on Human Umbilical Vein Endothelial Cells via LFA-1/ICAM-1 Interaction.

The migration of administered mesenchymal stem cells (MSCs) to sites of injury via the bloodstream has been demonstrated. However, the underlying mechanisms of umbilical cord MSC adhesion to endothelial cells during transendothelial migration are still unclear. In this study, our data showed that IL-1ß induced LFA-1 expression on MSCs and ICAM-1 expression on HUVECs. We then pretreated MSCs with protein synthesis inhibitor cycloheximide. The results showed that IL-1ß induced LFA-1 expression on the surface of MSCs via the protein synthesis pathway. Through the p38 MAPK signaling pathway inhibitor SB 203580, we found that IL-1ß induces the expression of LFA-1 through p38 MAPK signaling and enhances ICAM-1 expression in HUVECs. In addition, IL-1ß-induced MSC adhesion to HUVECs was found to be inhibited by IL-1RA and the LFA-1 inhibitor lovastatin. These results indicate that IL-1ß promotes the cell adhesion of MSCs to HUVECs through LFA-1/ICAM-1 interaction. We address the evidence that the cell adhesion mechanism of IL-1ß promotes MSC adhesion to HUVECs. The implications of these findings could enhance the therapeutic potential of MSCs.