Percutaneous thermal ablation versus open liver resection for recurrent hepatoblastoma: a retrospective study.

BACKGROUND: The survival of children with recurrent hepatoblastoma (RHB) is still unsatisfactory and the treatment for relapsed patients is challenging. PURPOSE: To compare short-term results between open liver resection (OLR) and percutaneous thermal ablation (TA) in the treatment of RHB and provide evidence to support the treatment options for such patients. METHODS: A retrospective data of 21 patients with RHB in two Chinese centers were analyzed from January 2013 to May 2019. The baseline indicators and clinical effect of the two groups of children were compared. RESULTS: There was no statistical difference in baseline indicators between the two groups of children, and complete remission (CR) was achieved after comprehensive treatment. The median follow-up time was 30 months (IQR 38.5 months) in the TA group, and 23 months (IQR 21.7 months) in OLR group (p = .57). The 2-year OS rates were 92.3% in the percutaneous TA group and 87.5% in the OLR group (p = .68, HR = 1.6, 95% confidence interval [CI]: 0.2-12.4). The 2-year EFS rates were 66.7%, in the TA group and 50.0% in the OLR group (p = .51, HR = 0.6, 95% CI: 0.2-2.6). Compared with the OLR group, TA group had shorter operation time (3.5 ± 1.8 vs. 0.5 ± 0.1, p < .001) and postoperative hospitalization time (11.8 ± 3.0 vs. 9.5 ± 6.8 d, p = .045). No major complications occurred in both groups. CONCLUSIONS: Ultrasound-guided percutaneous TA for RHB is a safe and effect treatment option for children. It has comparable effect with surgery within 2 years after treatment. Particularly, due to its minimally invasive advantage, it needs shorter operation and hospitalization time. Percutaneous ablation may be an alternative minimally invasive treatment for RHB children.

Associations of meeting 24-h movement guidelines with stress and self-rated health among adults: is meeting more guidelines associated with greater benefits?

BACKGROUND: Several countries have recently issued 24-h movement guidelines that include quantitative recommendations for moderate-to-vigorous physical activity (MVPA), sedentary behaviour (SB), and sleep. This study explored the associations of meeting the 24-h movement guidelines with stress and self-rated health among adults, and whether the likelihood of favourable outcomes increases with the number of guidelines met. METHODS: A total of 2476 adults aged 18 years and over completed a questionnaire on their time spent in MVPA, SB and sleep, frequency of stress (never, very rarely, occasionally, often, every day), self-rated health (very good, good, fair, bad, very bad), sociodemographic characteristics, and lifestyle variables. RESULTS: In an ordinal logistic regression analysis adjusted for age, sex, body mass index, education, socio-economic status, employment, place of residence, living with or without partner, and smoking, lower odds of higher frequency of stress were found for those meeting the combined 24-h movement guidelines (adjusted odds ratio [OR] = 0.45; 95% confidence interval [CI]: 0.32, 0.63; p <  0.001), any combination of two guidelines (OR range: 0.48-0.63; p <  0.05 for all), and sleep guideline only (OR = 0.51; 95% CI: 0.35, 0.75; p = 0.001). Higher odds of better self-rated health were found for those meeting the combined 24-h movement guidelines (OR = 2.94; 95% CI: 2.07, 4.19; p <  0.001), combination of MVPA and SB guidelines (OR = 2.33; 95% CI: 1.57, 3.44; p <  0.001), combination of MVPA and sleep guidelines (OR = 1.78; 95% CI: 1.23, 2.59; p = 0.002), and MVPA guideline only (OR = 2.24; 95% CI: 1.50, 3.36; p <  0.001). Meeting more guidelines was associated with greater odds of favourable outcomes (p for linear trend < 0.001). CONCLUSION: Adults who meet the sleep guideline, any combination of two guidelines, or all three guidelines experience stress less frequently. Meeting the MVPA guideline alone or in combination with any other movement behaviour guideline was associated with better self-rated health. The likelihood of less frequent stress and better self-rated health increases with the number of guidelines met. Adults should be encouraged to meet as many movement behaviour guidelines as possible.

Optimal movement behaviors: correlates and associations with anxiety symptoms among Chinese university students.

BACKGROUND: The Canadian 24-Hour Movement Guidelines for Adults was released in 2020. There is a dearth of evidence on the association between adherence to the 24 h movement guidelines and health indicators. This study aims to (a) explore the associations between potential correlates and meeting the 24 h movement guidelines using a sample of Chinese university students; and (b) examine if meeting 24 h movement guidelines is associated with the severity of anxiety symptoms. METHODS: Cross-sectional findings are based on 1846 Chinese university students (mean age = 20.7 years, 64.0% female). Movement behaviors (physical activity, sedentary behavior, and sleep duration), possible correlates, and anxiety symptoms were measured through self-reported online questionnaires. Logistic regression models were performed to examine the associations. RESULTS: We found that male students and those who had a mother with a master's degree or above, more close friends and higher perceived family affluence were more likely to meet the overall 24 h guidelines. Meeting all 24 h movement guidelines presented the lower odds for severe anxiety symptoms than those meeting fewer recommendations in the 24 h movement guidelines. CONCLUSIONS: As one of the first to examine the correlates of adherence to the 24 h movement guidelines and the relationship between anxiety symptoms and meeting the guidelines among Chinese university students, our findings contribute to the growing body of evidence linking movement behaviors, psychosocial correlates, and heath indicators. Schools and health providers can encourage movement behaviors that follow the guidelines on campus.

Associations between various kinds of parental support and physical activity among children and adolescents in Shanghai, China: gender and age differences.

BACKGROUND: The associations between various kinds of parental support and children and adolescents' physical activity (PA) are inconclusive. This study aimed 1) to examine the associations between various kinds of parental support and children and adolescents' moderate-to-vigorous physical activity (MVPA), and 2) to examine gender and age differences in the association between each specific kind of parental support and MVPA. METHODS: Using a multi-stage stratified and random cluster sampling method, 711 schools in Shanghai were selected (data were collected from October 2014 to February 2015). In total, 61,429 school-aged children (6-18 years old, 50.7% boys) and their parents were included. Self-reported questionnaires were used to measure sociodemographic characteristics, MVPA and various kinds of parental support, including parental encouragement (PAEN), parental involvement (PAIV), parental financial support (PAFS) and, parental modeling (PAMD). Descriptive statistics and Chi-square were used to report the level of MVPA and its difference across various kinds of parental support by gender groups. The logistic regression analysis was used to examine the associations between parental support and MVPA with odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: Overall, 19.4% of children and adolescents accumulated MVPA at least 60 min/day. Boys were more physically active than girls (21.4% > 17.4%, p <  0.001). According to the observation of OR estimates, girls may be more susceptible to the influences from various kinds of parental support than boys (OR = 1.59, 1.61, 1.27 and 1.63, 95% CI: 1.19-1.73 among girls, and OR = 1.48, 1.60, 1.21, and 1.60, 95% CI: 1.14-1.69 among boys for PAEN, PAIV, PAFS and PAMD respectively). PAMD is the only one supportive kind that was positively associated with MVPA in both genders across all grades (OR = 1.29-2.98, 95% CI: 1.09-4.08 among boys; OR = 1.27-2.64, 95% CI: 1.10-4.10 among girls). CONCLUSIONS: Less than one fifth of children and adolescents accumulated 60 min MVPA per day. Various kinds of parental support have important effects on children and adolescents' MVPA, which varied by gender and grades. PAMD, in particular, should be emphasized more than PAEN, PAIV and PAFS in family-based interventions aiming at increasing PA in the future.

Ultrasound Biomicroscopy and High-Frequency Ultrasound for Evaluating Extramammary Paget Disease With Pathologic Correlation.

OBJECTIVES: The purpose of this study was to investigate the performance of ultrasound biomicroscopy (UBM) and high-frequency ultrasound (HFUS) in the assessment of extramammary Paget disease (EMPD) and to correlate the imaging features with pathologic findings. METHODS: In this retrospective study, we described the imaging features from UBM and HFUS based on 17 pathologically proven EMPD cases. The performance for visualizing layer involvement by UBM and HFUS was compared. Additionally, we checked the consistency between layer involvement of the lesions on UBM images and the pathologic results. Additionally, blood flow and the status of lymph nodes were investigated with HFUS. RESULTS: Ultrasound biomicroscopy revealed that all 17 lesions (100%) were hypoechoic and grew in a creeping form. The feature of layer involvement was shown in 10 lesions (58.8%) limited to the epidermis and 6 lesions (35.3%) involving the dermis, and the remaining lesion (5.9%) involved the full skin layers. Layer involvement was clearly displayed by UBM for all lesions (100%) but for only 5 lesions (29.4%) by HFUS (P < .001). Additionally, the layer involvement of 15 lesions (88.2%) on UBM was consistent with the pathologic results (κ = 0.746). High-frequency ultrasound revealed profuse blood flow in most lesions (64.7% [11 of 17]), and 1 case showed inguinal lymph node metastasis. CONCLUSIONS: Combined use of UBM and HFUS can provide key information on EMPD based on ultrasound features. Comparatively, UBM provides clearer morphologic information, whereas HFUS provides information on lymph node metastasis and blood flow.

Co-existence of physical activity and sedentary behavior among children and adolescents in Shanghai, China: do gender and age matter?

BACKGROUND: There is limited evidence for the prevalence of the co-existence of physical activity (PA) and sedentary behavior (SED), and its correlates among children and adolescents. This study has two aims: 1) to investigate the prevalence of PA and SED, and their co-existence, and 2) to examine the associations between PA or SED, or both with gender and age among children and adolescents in Shanghai, China. METHODS: Using a cross-sectional study design (conducted from September to December 2014), 50,090 children and adolescents (10-18 years old, 50.4% boys) were included in this study. A self-reporting questionnaire was used to measure participants' sociodemographic characteristics, PA, and SED. Descriptive statistics were used to describe sample characteristics, the prevalence of PA and SED, and their co-existence. A Generalized Linear Model was conducted to explore the associations between the prevalence of PA and SED, and their co-existence with gender and age separately. RESULTS: Of the children and adolescents studied, only 18.4% met the guidelines for PA, 25.5% met the guidelines for SED, and 5.7% met the guidelines for both. Boys were more physically active (aOR = 1.43, 95% CI: 1.36-1.50), and girls were less sedentary (aOR = 1.29, 95%CI: 1.24-1.34). The prevalence of PA, SED, or both all declined as age increased (p < 0.001). Stratified analysis by gender revealed greater declining trends of meeting the PA or SED guidelines, or both in girls (all p < 0.005). CONCLUSION: Very few children and adolescents showed active lifestyles, and this was significantly related to age. Effective interventions aiming to promote PA and concurrently to limited SED among children and adolescents should be implemented as early as possible.

Health Benefits of Different Sports: a Systematic Review and Meta-Analysis of Longitudinal and Intervention Studies Including 2.6 Million Adult Participants.

BACKGROUND: Several reviews have examined the health benefits of participation in specific sports, such as baseball, cricket, cross-country skiing, cycling, downhill skiing, football, golf, judo, rugby, running and swimming. However, new primary studies on the topic have recently been published, and the respective meta-analytic evidence needs to be updated. OBJECTIVES: To systematically review, summarise and appraise evidence on physical health benefits of participation in different recreational sports. METHODS: Searches for journal articles were conducted in PubMed/MEDLINE, Scopus, SpoLit, SPORTDiscus, Sports Medicine & Education Index and Web of Science. We included longitudinal and intervention studies investigating physical health outcomes associated with participation in a given sport among generally healthy adults without disability. RESULTS: A total of 136 papers from 76 studies conducted among 2.6 million participants were included in the review. Our meta-analyses of available evidence found that: (1) cycling reduces the risk of coronary heart disease by 16% (pooled hazard ratio [HR] = 0.84; 95% confidence interval [CI]: 0.80, 0.89), all-cause mortality by 21% (HR = 0.79; 95% CI: 0.73, 0.84), cancer mortality by 10% (HR = 0.90; 95% CI: 0.85, 0.96) and cardiovascular mortality by 20% (HR = 0.80; 95% CI: 0.74, 0.86); (2) football has favourable effects on body composition, blood lipids, fasting blood glucose, blood pressure, cardiovascular function at rest, cardiorespiratory fitness and bone strength (p < 0.050); (3) handball has favourable effects on body composition and cardiorespiratory fitness (p < 0.050); (4) running reduces the risk of all-cause mortality by 23% (HR = 0.77; 95% CI: 0.70, 0.85), cancer mortality by 20% (HR = 0.80; 95% CI: 0.72, 0.89) and cardiovascular mortality by 27% (HR = 0.73; 95% CI: 0.57, 0.94) and improves body composition, cardiovascular function at rest and cardiorespiratory fitness (p < 0.010); and (5) swimming reduces the risk of all-cause mortality by 24% (HR = 0.76; 95% CI: 0.63, 0.92) and improves body composition and blood lipids (p < 0.010). CONCLUSIONS: A range of physical health benefits are associated with participation in recreational cycling, football, handball, running and swimming. More studies are needed to enable meta-analyses of health benefits of participation in other sports. PROSPERO registration number CRD42021234839.

Motor Competence and Body Mass Index in the Preschool Years: A Pooled Cross-Sectional Analysis of 5545 Children from Eight Countries.

BACKGROUND AND OBJECTIVE: One in five preschool children are overweight/obese, and increased weight status over time increases the risks of poorer future health. Motor skill competence may be a protective factor, giving children the ability to participate in health-enhancing physical activity. Yet, we do not know when the relationship between motor competence and weight status first emerges or whether it is evident across the body mass index (BMI) spectrum. This study examined the association between motor skill competence and BMI in a multi-country sample of 5545 preschoolers (54.36 ± 9.15 months of age; 50.5% boys) from eight countries. METHODS: Quantile regression analyses were used to explore the associations between motor skill competence (assessed using the Test of Gross Motor Development, Second/Third Edition) and quantiles of BMI (15th; 50th; 85th; and 97th percentiles), adjusted for sex, age in months, and country. RESULTS: Negative associations of locomotor skills, ball skills, and overall motor skill competence with BMI percentiles (p < 0.005) were seen, which became stronger at the higher end of the BMI distribution (97th percentile). Regardless of sex, for each raw score point increase in locomotor skills, ball skills, and overall motor skill competence scores, BMI is reduced by 8.9%, 6.8%, and 5.1%, respectively, for those preschoolers at the 97th BMI percentile onwards. CONCLUSIONS: Public health policies should position motor skill competence as critical for children's obesity prevention from early childhood onwards. Robust longitudinal and experimental designs are encouraged to explore a possible causal pathway between motor skill competence and BMI from early childhood.

Associations Between Gross Motor Coordination and Executive Functions: Considering the Sex Difference in Chinese Middle-Aged School Children.

Considering that motor and cognitive processes are intertwined and inhibit or help each other throughout life and that primary school age is one of the most critical stages of children's cognitive and motor development, this study aimed to investigate the relationship between executive functions and gross motor skills in Chinese children aged 9-10 years, as well as gender differences. The flanker task, the 1-back task, the more-odd shifting task, and the test of gross motor coordination (Körperkoordinationtest für Kinder) were used to collect data on executive functions and gross motor coordination. The results were as follows. First, there was a weak association between gross motor coordination and the inhibition reaction time in the congruent test and the reaction time of working memory (r = -0.181 to -0.233), but no association was found between gross motor coordination and cognitive flexibility. Second, a weak-to-moderate correlation was presented between the move sideways test and the inhibition reaction time in the congruent test and the reaction time in the refreshing test of the working memory (r = -0.211 to -0.330). Finally, gender influenced on the relationship between gross motor coordination and the reaction time of both inhibition (ßGender = -0.153, p < 0.05) and working memory (ßGender = -0.345, p < 0.01). To conclude, our results suggest that children with better motor coordination skills require less reaction time, especially girls, and this association was more substantial than in boys. The finding supports the current assertion that there are commonalities between gross motor coordination and cognitive control by showing the relationship between gross motor coordination and complex cognitive processes (executive function) in preadolescent children.

Is the Health Behavior in School-Aged Survey Questionnaire Reliable and Valid in Assessing Physical Activity and Sedentary Behavior in Young Populations? A Systematic Review.

Backgrounds: Using the self-reported questionnaire to assess the levels of physical activity (PA) and sedentary behavior (SB) has been a widely recognized method in public health and epidemiology research fields. The selected items of the Health Behavior in School-aged (HBSC) Survey Questionnaire have been used globally for measurements and assessments in PA and SB of children and adolescents. However, there are no comprehensive and critical reviews to assess the quality of studies on reliability and validity of selected items for PA and SB measurement and assessment derived from the HBSC. Thus, this review aimed to critically assess the quality of those studies and summary evidence for future recommendations. Methods: A systematic review protocol was used to search potentially eligible studies on assessing reliability and validity of PA and SB measures of the HBSC questionnaire. electronically academic databases were used. The information on the reliability and validity of the PA and SB measures were extracted and evaluated with well-recognized criteria or assessment tools. Results: After a literature search, six studies were included in this review. The reliability of PA measures of the HBSC questionnaire showed a moderate agreement while the reliability of SB measures showed a great variation across the different items in the different subgroups. The validity of the PA measures had acceptable performance, whereas no studies assess the validity of the SB measures. The included studies all had quality weaknesses on reliability or validity analysis. Conclusions: The PA and SB measures of the HBSC questionnaires were reliable in assessing PA and SB among adolescents. However, a little evidence showed that PA measures are partially valid in assessing PA, but no evidence confirmed the validity of SB measures. The included studies all had methodological weaknesses in examining the reliability and validity of the PA and SB measures, which should be addressed in the future. Further studies are encouraged to use a more standardized study design to examine the reliability and validity of the PA and SB measures in more young populations.

Association of Body Weight and Physical Fitness during the Elementary School Years.

Physical fitness and body weight are key correlates of health. Nevertheless, an increasing number of children display poor physical fitness and high body weight. The aim of this study was to examine the prospective association of physical fitness with body weight throughout the elementary school years with a special emphasis on children with high body weight or poor physical fitness at baseline. A total of 303 Austrian children (55.1% male) completed the German motor test up to eight times over a 4-year time span (between the ages 6 and 10 years). Physical fitness did not differ across quartiles of body weight at baseline. A more pronounced weight gain, however, was associated with an impaired development of physical fitness and this association was more pronounced in children with higher baseline body weight. In addition, the detrimental effects of an impaired development of physical fitness on subsequent body weight were more pronounced in children with higher baseline body weight. No differences in the longitudinal association between body weight and physical fitness, on the other hand, were observed across quartiles of baseline fitness. These results emphasize the importance of the promotion of physical fitness, particularly in children with increased body weight, to ensure future health.

Changes in Physical Activity and Sedentary Behavior in Chinese Young Adults during the COVID-19 Pandemic: A Repeated-Measure Study throughout One Year.

Though we know physical activity (PA) decreased while sedentary behavior (SB) increased compared to that before the COVID-19 pandemic, little is known about subsequent changes in PA and SB throughout one year in the post-pandemic era. This study aimed to examine the changes in PA and SB in a sample of Chinese young adults using a four-wave repeated-measure design during the pandemic. A total of 411 participants provided self-reported data of sociodemographic characteristics (e.g., sex, age), PA, and SB. Nonparametric tests and generalized estimating equations were conducted. Results revealed significant changes in moderate to vigorous PA (MVPA), light PA (LPA), and SB. The MVPA of Wave 1, 2, and 3 was significantly less than that of Wave 4 (p < 0.001); the LPA of Wave 1 and 2 was significantly less than that of Wave 4; the SB of Wave 1 was significantly more than that of Wave 4 (p < 0.05). Being female was the only predictor of changes in MVPA (Beta = -0.311, p< 0.001). Being female (Beta = 0.115, p = 0.003) and perceived family affluence (Beta = -0.059, p< 0.001) were predictors of changes in SB. As such, PA was less, while SB was more during the early stages of the pandemic. With the progress of the pandemic stages, health behaviors in young adults have been gradually improved. Sex and perceived family affluence were two important factors in predicting health behaviors. Our results can inform efficient policies or interventions in the COVID-19 era and future similar public health events.

Food Insecurity and Bullying Victimization Among 170,618 Adolescents in 59 Countries.

Background: Bullying victimization can impose long-lasting impacts on adolescent's current and subsequent well-being. Understanding the correlates of bullying victimization and how to prevent its occurrence is an urgent need. Food insecurity, an indicator of low socioeconomic status, may be related to bullying victimization. However, research on the association between food insecurity and bullying victimization is limited. Using a representative global sample, this study aimed to investigate the association between food insecurity and bullying victimization in adolescents and whether the association varied between country income levels, sexes, and age groups. Methods: Using cross-sectional, school-based data by 170,618 adolescents in 59 countries from the Global School-based Student Health Survey, multivariable logistic regression and meta-analysis were conducted to investigate the overall, country-stratified, sex-stratified, and age-stratified associations. Results: The prevalence of bullying victimization was 33.3%. In the total sample, adolescents with food insecurity showed significantly higher odds for bullying victimization than those without no food insecurity with a pooled odds ratio (OR) being 1.37 (1.28, 1.47). Further, the association was stronger in higher-income countries, females, and older adolescents. Conclusions: Bullying victimization is prevalent among global adolescents with food insecurity being a significant correlate. The identification of adolescents with perceptions of food insecurity and remedying this condition may be important to reduce the prevalence of bullying. This highlights the need to design and implement sex- and age-specific interventions focusing on remedying food insecurity and bullying victimization among in-school adolescents by taking country income levels into account.

The Independent, Joint, and Additive Associations of Physical Activity and Self-Compassion on Depression Symptoms Among Chinese College Students.

BACKGROUND: Physical activity and self-compassion are closely related to individuals' mental health (eg, depression). However, most studies only examined their independent roles in mental health without considering the potential interaction between the two variables. The present study aimed to investigate the independent and joint associations between physical activity (PA) and self-compassion (SC) on depression symptoms and examine the additive interaction between PA and SC. METHODS: A cross-sectional design was utilized in the present descriptive study. By recruiting participants via social media platforms, 1846 Chinese college students completed International Physical Activity Questionnaire Short Form, the Self-Compassion Scale-Short Form, the 9-item Patient Health Questionnaire, and items regarding socio-demographic information. Independent and joint roles of low-level PA (LPA) and low-level SC (LSC) on depression symptoms were examined by logistic regression models. Additive interaction between LPA and LSC on depression symptoms was examined by the following indices: relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (S). Socio-demographic variables were included in the models as covariates. RESULTS: Both LPA (OR = 1.47 [1.16, 1.86]) and LSC (OR = 5.74 [3.89, 8.45]) were independently associated with higher probability of depression symptoms. Combining LPA and LSC led to an additive interaction and greatly increased the odds of depression symptoms (OR = 9.62 [5.38, 17.22]; RERI = 2.47 [0.19, 4.75], AP = 0.25 [0.05, 0.44], S = 1.38 [1.02, 1.87]). CONCLUSION: Both LPA and LSC were associated with an increased risk of depression symptoms. Moreover, combining LPA and LSC may develop an additive risk for depression symptoms. Future research and clinical intervention could integrate PA and SC to find a better way to resist depression symptoms.

The Associations of Active Travel to School With Physical Activity and Screen Time Among Adolescents: Do Individual and Parental Characteristics Matter?

Little is known about the relationship of active travel to school (ATS) with physical activity (PA) and screen time (ST) by individual and parental characteristics among adolescents, especially in China. To address the research gap, this study aimed to explore the difference of sex, age, living environment, parental occupation and education level in the relationship of ATS with PA and ST among students of grades 7-12 (aged 10-18 years) using cross-sectional data. In 13 cities of Hubei province, China, students from 39 public schools were recruited to engage in the survey. In total, 5,898 students (response rate = 89.6%) were invited into this study. Participants were required to report their ATS (including its types), PA and ST as well as sociodemographic information using a validated questionnaire. Descriptive analyses were used to report the information of all variables. Regression models were used to analyse the relationships of ATS and its types with PA and ST. In a total of 4,128 participants (boys: 50.9%; younger adolescents: 61.9%) included in the final analysis, the proportion of those with ATS was 47.3%. Regarding the types of ATS, walking accounted for over 30%, while cycling was 13.2%. Participants with ATS were more likely to have sufficient PA (OR = 1.26, 95% CI: 1.14-1.39), especially among boys, younger adolescents and those with lower parental education level. However, ATS was not associated with ST (OR = 0.94, 95% CI: 0.86-1.01). Participants with cycling had a higher odds ratio of being physically active (OR for cycling = 1.47, 95% CI: 1.27-1.70; OR for walking = 1.18, 95% CI: 1.06-1.32). The association of ATS types with PA and ST differed by gender, age, living environment and parental educational level as well as occupations. ATS may be a useful approach to increase PA among adolescents, but this should be explained by individual and parental characteristics.

The relationship between childhood adversities and complex posttraumatic stress symptoms: a multiple mediation model.

Background: There is a growing research literature on complex posttraumatic stress disorder (CPTSD), yet studies that focused on Chinese populations are still limited. Accumulating evidence showed that adverse childhood experiences (ACEs) are associated with a higher likelihood of CPTSD symptoms, but potential mediating roles of self-kindness and self-judgement on the ACEs-CPTSD relationship remain understudied. Objective: The purpose of this study was to first examine the relationship between ACEs and CPTSD among Chinese college students, and then to test the mediating role of self-kindness and self-judgement on the ACEs-CPTSD relationship. Method: The study included 1361 college students for an online survey in May 2020. Demographic variables (e.g. age, gender, having sibling[s] or not, residence, family structure, and subjective socioeconomic status), ACEs, self-compassion (self-kindness and self-judgement subscales), and CPTSD symptoms were assessed. After controlling for demographic variables, a series of structural equation models tested the mediation hypothesis: indirect effects of self-kindness and self-judgement on the relationship between ACEs and CPTSD symptom. Results: ACEs of College students were positively associated with more severe CPTSD symptoms (posttraumatic stress disorder and disturbances in self-organization symptoms). Furthermore, these direct pathways were mediated by decreased self-kindness and increased self-judgement. Conclusions: Findings have substantial theoretical and treatment implications, including the two critical targets (i.e. lowering self-judgement and raising self-kindness) when treating complex PTSD.

Antecedentes: existe una creciente literatura de investigación sobre el trastorno de estrés postraumático complejo (TEPT-C), sin embargo, los estudios centrados en la población China aún son limitados. La evidencia acumulada mostró que las experiencias adversas de la infancia (ACEs en sus siglas en inglés) están asociadas con una mayor probabilidad de síntomas de TEPT-C, pero los posibles roles mediadores de la bondad hacia uno mismo y auto- juicio propio en la relación ACE-TEPT-C siguen siendo poco estudiados.Objetivo: El propósito de este estudio fue examinar primero la relación entre ACE y TEPT-C entre estudiantes universitarios chinos, y luego probar el papel mediador de la bondad y el auto-juicio en la relación ACE-TEPT-C.Método: El estudio incluyó a 1361 estudiantes universitarios para una encuesta en línea en mayo del 2020. Variables demográficas (por ejemplo, edad, sexo, tener hermanos o no, residencia, estructura familiar y estatus socioeconómico subjetivo), ACE, autocompasión (subescalas de auto-bondad y auto-juicio), y se evaluaron los síntomas de TEPT-C. Después de controlar las variables demográficas, una serie de modelos de ecuaciones estructurales probaron la hipótesis de la mediación: los efectos indirectos de la bondad personal y el auto-juicio sobre la relación entre los ACE y los síntomas de TEPT-C.Resultados: Las ACEs de los estudiantes universitarios se asociaron positivamente con síntomas de TEPT-C más graves (trastorno de estrés postraumático y alteraciones en los síntomas de autoorganización). Además, estas vías directas fueron mediadas por una disminución de la bondad hacia uno mismo y un mayor auto-juicio.Conclusiones: Los hallazgos tienen implicaciones teóricas y de tratamiento sustanciales, incluidos los dos objetivos críticos (es decir, reducir el auto-juicio y aumentar la bondad hacia uno mismo) al tratar el TEPT complejo.

Lifestyle Behaviors and Suicide-Related Behaviors in Adolescents: Cross-Sectional Study Using the 2019 YRBS Data.

Objective: The purpose of this research was to investigate the prevalence of lifestyle behaviors and suicide-related behaviors and the association between them using a nationally representative sample of adolescents from the USA. Methods: 13,677 high school students aged 14-18 years were included in this cross-sectional study. The research data were retrieved from the Youth Risk Behavior Surveillance System Survey in 2019. All data on age, sex, grade, race, physical activity, television time, fruit intake, and suicide-related behavior were self-reported by students. Logistic regression models were adopted to examine the association between lifestyle behaviors and the suicide-related behaviors. Results: Students who played video/computer games for ≥2 h had higher risk of suicide attempt (OR = 1.55, 95%CI: 1.30-1.85). Daily sleep duration of ≤8 h was positively associated with considering a suicide attempt (OR = 1.99, 95%CI: 1.62-2.43). In addition, participants who did not engage in any sport team were more likely to report considering a suicide attempt (OR = 1.50, 95%CI: 1.24-1.81). Conclusion: This research suggests that some lifestyle behaviors (e.g., time for video or computer use, sleep duration, sports team participation, regular breakfast intake, and substance use) are associated with increased risk of suicidal behavior and ideation in high school students. To identify the specific effect of multiple lifestyle factors in influencing the risk of suicide-related behaviors in high school students, longitudinal studies are warranted in future.

Association between physical education classes and physical activity among 187,386 adolescents aged 13-17 years from 50 low- and middle-income countries.

OBJECTIVE: This study aimed to examine the association between physical education classes and PA among adolescents from 50 low- and middle-income countries (LMICs). METHODS: A self-reported questionnaire from the Global School-based Student Survey (GSHS) was used to collect information on participation frequency of physical education classes and being physically active over the last week, as well as other control variables (e.g., sex, age, country, sedentary behavior). Multivariable logistic regression and a pooled meta-analysis were performed to explore the association and compared country-wise differences. RESULTS: Included adolescents aged from 13 to 17 years (n=187,386, %boys=51.7; mean age=14.6 years), the prevalence of sufficient PA (meeting the PA guidelines) was 14.9%. The prevalence of 5 days or more to engage in physical education classes was 16.5%. Compared with adolescents who had 0 days for physical education classes, higher participation frequency was more likely related to sufficient PA (OR: 1 day=1.34, 2 days=1.66, 3 days=1.67, 4 days=1.79, 5 days or more=2.46), these findings were also observed in both sexes. A moderate inconsistency on the association across the included countries was found (I2=53%, p<0.01), although the pooled OR was 1.50 (95% CI: 1.36-1.65). CONCLUSIONS: Participating in more physical education classes may be an effective approach to increase physical activity levels among adolescents in LMICs. However, promoting physical activity levels among adolescents in LMICs through physical education classes should consider more country-specific factors.

Effects and Moderators of Exercise on Sarcopenic Components in Sarcopenic Elderly: A Systematic Review and Meta-Analysis.

Background: Sarcopenia is a muscle disease in loss of muscle strength, mass, and function associated with aging. Although protective effects of exercise on muscle mass and function are generally recognized, research findings in sarcopenic adults are inconsistent. It is necessary to conduct a systematic review to determine the effects of exercise on muscle strength, body composition, and physical performance in older adults with sarcopenia, and to examine the potential moderators including sociodemographic characteristics and exercise-related factors. Methods: Six electronical academic databases (Medline, Embase, CINAHL, Scopus, Cochrane Library, and SPORTDiscus) were used to retrieve the eligible studies from inception to May 2020. Two reviewers independently selected and extracted the data from each included study, and effect sizes were calculated by employing random-effect models with 95% confidential interval (CI). The Physiotherapy Evidence Database (PEDro) scale was used to assess study quality. Results: Seventeen studies (985 participants with sarcopenia, aged 67.6-86 years) were included in this review study. The meta-analytic results showed significant improvements in muscle strength [grip strength, SMD = 0.30, 95% CI (0.15, 0.45), I 2 = 6%, p < 0.01; knee extension, SMD = 0.32, 95% CI (0.15, 0.50), I 2 = 0%, p < 0.01; and chair and stand, SMD = 0.56, 95% CI (0.30, 0.81), I 2 = 36%, p < 0.01], in physical performance [timed up and go, SMD = 0.74, 95% CI (0.48, 1.00), I 2 = 0%, p < 0.01; and gait speed, SMD = 0.59, 95% CI (0.35, 0.82), I 2 = 62%, p < 0.01], and in body composition [skeletal muscle mass index, SMD = 0.37, 95% CI (0.15, 0.58), I 2 = 16%, p < 0.01; and appendicular skeletal muscle, SMD = 0.31, 95% CI (0.13, 0.49), I 2 = 20%, p < 0.01]. However, there were no significant differences in other body composition (SMD = 0.20-0.36). Additionally, meta-regression revealed that the higher percent of female participants was significantly associated with improved gait speed (ß = 0.0096, p = 0.03) and decreased skeletal muscle mass index (ß = -0.0092, p = 0.01). Conclusions: The current meta-analysis suggests that exercise is a beneficial therapy, which has protective effects for older adults with sarcopenia. Some beneficial effects may be moderated by gender and exercise intensity.

Active school travel is associated with fewer suicide attempts among adolescents from low-and middle-income countries.

Background/Objective: This study explored the association between active school travel (AST) and suicide attempts among adolescents in low- and middle-income countries (LMICs). Method: We used the data from the Global School-based Health Survey, including 127,097 adolescents aged 13-17 years from 34 LMICs. A self-reported survey was used to collect data on AST and suicide attempts as well as some variables. Multivariable logistic regression was performed to assess the association between AST and suicide attempts. A meta-analysis with random effects was undertaken to identify the difference in the association between AST and suicide attempts. Results: Across all the adolescents, the prevalence of AST was 37% and the prevalence of suicide attempts was 11.60%. Adolescents who engaged in AST were less likely to have suicide attempts irrespective of gender. The country-wise analysis indicated a large inconsistency in the association between AST and suicide attempt across the countries. Conclusions: AST would appear to be a protective factor for reducing suicide attempts among adolescents. However, the association between AST and suicide attempts varied greatly across the countries. Future studies should confirm the association between AST and suicide attempts.

Objetivo: Se exploró la asociación entre desplazamientos escolares activos (AST, por sus siglas en inglés) e intentos de suicidio entre adolescentes en países de ingresos bajos y medios. Método: Se utilizaron datos de la Global School-based Health Survey, que incluyó a 127.097 adolescentes de 13 a 17 años de 34 países de ingresos bajos y medios. Se utilizó una encuesta autoinformada para recopilar datos sobre AST e intentos de suicidio, así como otras variables. Se realizó una regresión logística multivariable para evaluar la asociación entre AST e intentos de suicidio. Se realizó un metanálisis con efectos aleatorios para identificar la diferencia en la asociación entre AST e intentos de suicidio. Resultados: La prevalencia de AST fue del 37% y la prevalencia de intentos de suicidio fue del 11,60%. Los adolescentes que participaron en AST tenían menos probabilidades de tener intentos de suicidio independientemente del sexo. El análisis por países indicó una gran inconsistencia en la asociación entre AST e intento de suicidio. Conclusiones: AST parece ser un factor protector para reducir los intentos de suicidio entre adolescentes. Sin embargo, la asociación entre AST e intentos de suicidio varió mucho entre países. Estudios futuros deberían confirmar la asociación entre AST e intentos de suicidio.