The Effect of Diet Composition on the Post-operative Outcomes of Roux-en-Y Gastric Bypass in Mice.

PURPOSE: Roux-en-Y gastric bypass (RYGB) leads to the improvement of many obesity-associated conditions. The degree to which post-operative macronutrient composition contributes to metabolic improvement after RYGB is understudied. METHODS: A mouse model of RYGB was used to examine the effects of diet on the post-operative outcomes of RYGB. Obese mice underwent either Sham or RYGB surgery and were administered either chow or HFD and then monitored for an additional 8 weeks. RESULTS: After RYGB, reductions to body weight, fat mass, and lean mass were similar regardless of diet. RYGB and HFD were independently detrimental to bone mineral density and plasma vitamin D levels. Independent of surgery, HFD accelerated hematopoietic stem and progenitor cell proliferation and differentiation and exhibited greater myeloid lineage commitment. Independent of diet, systemic iron deficiency was present after RYGB. In both Sham and RYGB groups, HFD increased energy expenditure. RYGB increased fecal energy loss, and HFD after RYGB increased fecal lipid content. RYGB lowered fasting glucose and liver glycogen levels but HFD had an opposing effect. Indices of insulin sensitivity improved independent of diet. HFD impaired improvements to dyslipidemia, NAFLD, and fibrosis. CONCLUSION: Post-operative diet plays a significant role in determining the degree to which RYGB reverses obesity-induced metabolic abnormalities such as hyperglycemia, dyslipidemia, and NAFLD. Diet composition may be targeted in order to assist in the treatment of post-RYGB bone mineral density loss and vitamin D deficiency as well as to reverse myeloid lineage commitment. HFD after RYGB continues to pose a significant multidimensional health risk.

Cross-sectional examination of 24-hour movement behaviours among 3- and 4-year-old children in urban and rural settings in low-income, middle-income and high-income countries: the SUNRISE study protocol.

INTRODUCTION: 24-hour movement behaviours (physical activity, sedentary behaviour and sleep) during the early years are associated with health and developmental outcomes, prompting the WHO to develop Global guidelines for physical activity, sedentary behaviour and sleep for children under 5 years of age. Prevalence data on 24-hour movement behaviours is lacking, particularly in low-income and middle-income countries (LMICs). This paper describes the development of the SUNRISE International Study of Movement Behaviours in the Early Years protocol, designed to address this gap. METHODS AND ANALYSIS: SUNRISE is the first international cross-sectional study that aims to determine the proportion of 3- and 4-year-old children who meet the WHO Global guidelines. The study will assess if proportions differ by gender, urban/rural location and/or socioeconomic status. Executive function, motor skills and adiposity will be assessed and potential correlates of 24-hour movement behaviours examined. Pilot research from 24 countries (14 LMICs) informed the study design and protocol. Data are collected locally by research staff from partnering institutions who are trained throughout the research process. Piloting of all measures to determine protocol acceptability and feasibility was interrupted by COVID-19 but is nearing completion. At the time of publication 41 countries are participating in the SUNRISE study. ETHICS AND DISSEMINATION: The SUNRISE protocol has received ethics approved from the University of Wollongong, Australia, and in each country by the applicable ethics committees. Approval is also sought from any relevant government departments or organisations. The results will inform global efforts to prevent childhood obesity and ensure young children reach their health and developmental potential. Findings on the correlates of movement behaviours can guide future interventions to improve the movement behaviours in culturally specific ways. Study findings will be disseminated via publications, conference presentations and may contribute to the development of local guidelines and public health interventions.

Global effect of COVID-19 pandemic on physical activity, sedentary behaviour and sleep among 3- to 5-year-old children: a longitudinal study of 14 countries.

BACKGROUND: The restrictions associated with the 2020 COVID-19 pandemic has resulted in changes to young children's daily routines and habits. The impact on their participation in movement behaviours (physical activity, sedentary screen time and sleep) is unknown. This international longitudinal study compared young children's movement behaviours before and during the COVID-19 pandemic. METHODS: Parents of children aged 3-5 years, from 14 countries (8 low- and middle-income countries, LMICs) completed surveys to assess changes in movement behaviours and how these changes were associated with the COVID-19 pandemic. Surveys were completed in the 12 months up to March 2020 and again between May and June 2020 (at the height of restrictions). Physical activity (PA), sedentary screen time (SST) and sleep were assessed via parent survey. At Time 2, COVID-19 factors including level of restriction, environmental conditions, and parental stress were measured. Compliance with the World Health Organizations (WHO) Global guidelines for PA (180 min/day [≥60 min moderate- vigorous PA]), SST (≤1 h/day) and sleep (10-13 h/day) for children under 5 years of age, was determined. RESULTS: Nine hundred- forty-eight parents completed the survey at both time points. Children from LMICs were more likely to meet the PA (Adjusted Odds Ratio [AdjOR] = 2.0, 95%Confidence Interval [CI] 1.0,3.8) and SST (AdjOR = 2.2, 95%CI 1.2,3.9) guidelines than their high-income country (HIC) counterparts. Children who could go outside during COVID-19 were more likely to meet all WHO Global guidelines (AdjOR = 3.3, 95%CI 1.1,9.8) than those who were not. Children of parents with higher compared to lower stress were less likely to meet all three guidelines (AdjOR = 0.5, 95%CI 0.3,0.9). CONCLUSION: PA and SST levels of children from LMICs have been less impacted by COVID-19 than in HICs. Ensuring children can access an outdoor space, and supporting parents' mental health are important prerequisites for enabling pre-schoolers to practice healthy movement behaviours and meet the Global guidelines.

Correction to: Comparing and assessing physical activity guidelines for children and adolescents: a systematic literature review and analysis.

An amendment to this paper has been published and can be accessed via the original article.

Comparing and assessing physical activity guidelines for children and adolescents: a systematic literature review and analysis.

BACKGROUND: The impact of declining physical activity and increased sedentary behaviour in children and adolescents globally prompted the development of national and international physical activity guidelines. This research aims to systematically identify and compare national and international physical activity guidelines for children and adolescents and appraise the quality of the guidelines to promote best practice in guideline development. METHODS: This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Only national, or international physical activity and/or sedentary behaviour guidelines were included in the review. Included guidelines targeted children and adolescents aged between 5 and 18 years. A grey literature search was undertaken incorporating electronic databases, custom Google search engines, targeted websites and international expert consultation. Guideline quality was assessed using the Appraisal of Guidelines for Research and Evaluation II Instrument (AGREE II). RESULTS: The search resulted in 50 national or international guidelines being identified. Twenty-five countries had a national guideline and there were three international guidelines (European Union, Nordic countries (used by Iceland, Norway and Sweden), World Health Organization (WHO)). Nineteen countries and the European Union adopted the WHO guidelines. Guidelines varied in relation to date of release (2008 to 2019), targeted age group, and guideline wording regarding: type, amount, duration, intensity, frequency and total amount of physical activity. Twenty-two countries included sedentary behaviour within the guidelines and three included sleep. Total scores for all domains of the AGREE II assessment for each guideline indicated considerable variability in guideline quality ranging from 25.8 to 95.3%, with similar variability in the six individual domains. Rigorous guideline development is essential to ensure appropriate guidance for population level initiatives. CONCLUSIONS: This review revealed considerable variability between national/international physical activity guideline quality, development and recommendations, highlighting the need for rigorous and transparent guideline development methodologies to ensure appropriate guidance for population-based approaches. Where countries do not have the resources to ensure this level of quality, the adoption or adolopment (framework to review and update guidelines) of the WHO guidelines or guidelines of similar quality is recommended. TRIAL REGISTRATION: Review registration: PROSPERO 2017 CRD42017072558.

Investigating Nutritional Deficiencies in a Group of Patients 3 Years Post Laparoscopic Sleeve Gastrectomy.

BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) as a single-stage procedure has shown to be effective in achieving significant weight loss and resolving obesity-related co-morbidities. However, its nutrition consequences have not been extensively explored. This study aims to investigate weight loss and evolution of nutritional deficiencies in a group of patients 3 years post LSG. METHODS: Retrospective data of a group of patients, 3 years following LSG as a stand-alone procedure was collected. Data included anthropometry, nutritional markers (hemoglobin, iron studies, folate, calcium, iPTH, vitamins D, and B12), and compliancy with supplementations. RESULTS: Ninety-one patients (male/female; 28:63), aged 51.9 ± 11.4 years with a BMI of 42.8 ± 6.1 kg/m2 were identified to be 3 years post LSG. Percentage of weight loss at 1 and 3 years post-operatively was 29.8 ± 7.0 and 25.9 ± 8.8 %, respectively. Pre-operatively, the abnormalities included low hemoglobin (4 %), ferritin (6 %), vitamin B12 (1 %), vitamin D (46 %), and elevated iPTH (25 %). At 3 years post-operatively, the abnormal laboratory values included low hemoglobin (14 % females, P = 0.021), ferritin (24 %, P = 0.011), vitamin D (20 %, P = 0.018), and elevated iPTH (17 %, P = 0.010). Compliancy with multivitamin supplementation was noted in 66 % of patients. CONCLUSION: In these patients, LSG resulted in pronounced weight loss at 1 year post-operatively, and most of this was maintained at 3 years. Nutritional deficiencies are prevalent among patients prior to bariatric surgery. These deficiencies may persist or exacerbate post-operatively. Routine nutrition monitoring and supplementations are essential to prevent and treat these deficiencies.

Neutrophils scan for activated platelets to initiate inflammation.

Immune and inflammatory responses require leukocytes to migrate within and through the vasculature, a process that is facilitated by their capacity to switch to a polarized morphology with an asymmetric distribution of receptors. We report that neutrophil polarization within activated venules served to organize a protruding domain that engaged activated platelets present in the bloodstream. The selectin ligand PSGL-1 transduced signals emanating from these interactions, resulting in the redistribution of receptors that drive neutrophil migration. Consequently, neutrophils unable to polarize or to transduce signals through PSGL-1 displayed aberrant crawling, and blockade of this domain protected mice against thromboinflammatory injury. These results reveal that recruited neutrophils scan for activated platelets, and they suggest that the neutrophils' bipolarity allows the integration of signals present at both the endothelium and the circulation before inflammation proceeds.

Fire within the vessels: interactions between blood cells and inflammatory vascular injury.

Inflammation involves multiple molecular, humoral and cellular mechanisms that aim to protect the body from injury or infection by the tight orchestration of immune cell trafficking, interactions and activation. Platelets and neutrophils are major players in the initial thromboinflammatory response by rapidly responding to a variety of danger signals. When the intensity, timing or locations of these responses are uncontrolled, however, they can trigger localized or systemic injury. Studies over the past decades have revealed that during the normal inflammatory response, blood elements frequently interact with each other to form heterotypic aggregates. The formation of these aggregates within blood vessels, in turn, underlies injury in several models of acute inflammation and can in some instances lead to death. These phenomena are likely to have a bigger contribution to the outcome of inflammatory processes than previously expected, not only in acute scenarios but also in those that involve chronic vascular damage, such as atherosclerosis. We will review here the molecular mediators of these interactions and their consequences in the context of cardiovascular injury.

Physiological contribution of CD44 as a ligand for E-Selectin during inflammatory T-cell recruitment.

Endothelial selectins guide the migration of inflammatory T cells to extralymphoid tissues. Whereas P-selectin glycoprotein ligand-1 (PSGL-1) functions as the exclusive ligand for P-selectin, it acts in coordination with additional glycoproteins to mediate E-selectin binding. CD44 can act as one such ligand in neutrophils, but its contribution in inflammatory T lymphocytes remains unexplored. We have used real-time in vivo imaging of the cremasteric and dermal microcirculations to explore the dynamics of leukocyte recruitment, as well as the physiological contribution of CD44 in a model of Th1-driven inflammation. CD4(+) T-cell rolling frequency and kinetics, as well as arrest, were dependent on endothelial selectins and were markedly altered under inflammatory conditions. CD44 extracted from Th1 cells bound to soluble E-selectin in vitro and cooperated with PSGL-1 by controlling rolling velocities and promoting firm arrest. Using several competitive recruitment assays in a delayed-type hypersensitivity model, we show that the combined absence of CD44 and PSGL-1 impairs inflammatory T-cell recruitment beyond that of PSGL-1 alone. Differential expression of leukocyte fucosyltransferases in these cells may account for the differential use of E-selectin ligands relative to neutrophils. Our results identify additional mechanisms by which CD44 modulates the inflammatory response.

Biological consequences of oxygen desaturation and respiratory effort in an acute animal model of obstructive sleep apnea (OSA).

BACKGROUND: An animal model mimicking all the factors involved in obstructive sleep apnea (OSA) is useful for investigating mechanisms because the associated comorbidity usually present in such patients is an important limitation. AIM: To test the hypothesis that hypoxia/normoxia and respiratory effort have different effects on the induction of inflammatory response and endothelial dysfunction in an acute rat model of OSA. METHODS: Four groups of anesthetized rats were studied (n=8): (1) sham; (2) apnea: obstructions (15s each, 60/h, for 3h); (3) apnea+O(2): obstructions and breathing oxygen-enriched air to avoid hypoxia and (4) intermittent hypoxia/normoxia. Inflammatory and endothelial mediators were measured as outcomes along with NF-kappaB in the lung and diaphragm. RESULTS: TNF-alpha and IL-1beta significantly increased in all groups compared with sham. NF-kappaB in the lung was increased in apnea and hypoxia/normoxia groups, but not in apnea+O(2) group. In diaphragm tissue, NF-kappaB was only significant in apnea compared to sham. Significant differences were found in the ratio thromboxane-B2/6-keto-Prostaglandin-F1alpha between apnea and hypoxia/normoxia compared to sham but not in apnea+O(2). CONCLUSIONS: Oxygen desaturations and respiratory efforts play a role in the induction of systemic inflammation but only hypoxia/normoxia induces endothelial dysfunction. These data suggest a potential role for oxygen therapy in patients with OSA.

Rat model of chronic recurrent airway obstructions to study the sleep apnea syndrome.

STUDY OBJECTIVES: To implement a chronic rat model of recurrent airway obstructions to study the obstructive sleep apnea (OSA) syndrome. DESIGN: Prospective controlled animal study. SETTING: University laboratory. PATIENTS OR PARTICIPANTS: 24 male Sprague-Dawley rats (250-300 g). INTERVENTIONS: The rats were placed in a setup consisting of a body chamber and a head chamber separated by a neck collar specially designed to apply recurrent airway obstructions with OSA patterns. Rats in the Obstruction group (n=8) were subjected to 5-s obstructions at a rate of 60 per hour, 6 h/day during 4 weeks. Sham rats (n=8) were placed in the setup but no obstructions were applied. Naive rats (n=8) were subjected to no intervention. MEASUREMENTS AND RESULTS: Breathing flow, pressure, CO2 air concentration, and SpO2 showed that the model mimicked OSA respiratory events (obstructive apneas, increased respiratory efforts, and oxygen saturation dips). Animal stress, assessed by body weight and plasma corticosterone, was not significantly different across Obstruction and Sham groups. This supports the concept that this novel model does not introduce a significant burden of stress in the rat after acclimatization to the chamber. Thromboxane-B2/6-keto-Prostaglandin-Flalpha ratio in plasma, which is an index of vasoconstriction, was significantly increased in the rats subjected to obstructions. CONCLUSIONS: The designed animal model of chronic recurrent airway obstructions is feasible and potentially useful to study the mechanisms involved in the cardiovascular consequences of OSA.

Estilos de crianza en la adolescencia y su relación con el comportamiento prosocial / Rearing styles in adolescence: their realtion with prosocial behavior

The work shows two studies carried out with Spanish adolescents. The objective was to evaluate the relation between rearing styles, prosocial behaviour and empathy, aggressiveness, emotional instability and anger, from a double perspective. In one of these studies (N = 531), the rearing styles were evaluated by the mother and in the other one (N = 782) by the adolescents. The results indicate that prosocial behaviour is not well predicted by the mother's analysis of rearing style. A positive evaluation by the son or daughter, an interest and emotional support and coherence in the application of norms, constitutes the rearing style most related with empathy and with prosocial behaviour.

El trabajo muestra dos estudios realizados con adolescentes españoles cuyo objetivo es estudiar la relación entre los estilos de crianza, el comportamiento prosocial y la empatía, la agresividad, la inestabilidad emocional y la iradesde un doble planteamiento:en uno de los estudios (N = 531) la evaluación de los estilos de crianza la realiza la madre y en el otro (N = 782), los adolescentes. Los resultados indican que cuando es la madre quien evalúa los estilos de crianza, éstos alcanzan menor poder predictor en el comportamiento prosocial. La evaluación positiva del hijo/a, el apoyo emocional junto con la coherencia en la aplicación de las normas es el estilo de crianza más relacionado positivamente con la empatía y con el comportamiento prosocial.

Intratracheal transplantation of alveolar type II cells reverses bleomycin-induced lung fibrosis.

RATIONALE: Transplantation of stem cells has been proposed as a strategy for repair of lung fibrosis. Nevertheless, many studies have yielded controversial results that currently limit the potential use of these cells as an efficient treatment. Alveolar type II cells are the progenitor cells of the pulmonary epithelium and usually proliferate after epithelial cell injury. During lung fibrosis, however, the altered regeneration process leads to uncontrolled fibroblast proliferation. OBJECTIVES: To investigate whether intratracheal transplantation of isolated alveolar type II cells can halt and reverse the fibrotic process in an experimental model of bleomycin-induced lung fibrosis in rats. METHODS: Lung fibrosis was induced in syngeneic female Lewis rats by a single intratracheal instillation of bleomycin (2.5 U/kg). Animals were transplanted with alveolar type II cells from male animals at a dose of 2.5 x 10(6) cells per animal 3, 7, and 15 days after endotracheal bleomycin instillation. Animals were killed 21 days after the induction of lung fibrosis. MEASUREMENTS AND MAIN RESULTS: Lung fibrosis was assessed by histologic study and determination of hydroxyproline content. Engraftment of transplanted cells was measured by real-time polymerase chain reaction for the Y chromosome and by fluorescence in situ hybridization for the Y chromosome. Transplantation of alveolar type II cells into damaged lung 3, 7, or 15 days after bleomycin instillation led to reduced collagen deposition, and reduction in the severity of pulmonary fibrosis. CONCLUSIONS: This study demonstrates the potential role of alveolar type II cell transplantation in designing future therapies for lung fibrosis.

Nuevos aspectos patogénicos en el síndrome de apneas e hipopneas durante el sueño (SAHS) / No disponible

El síndrome de apneas e hipopneas durante el sueño (SAHS) se define como la aparición de episodios de cese total o parcial del flujo aéreo en la boca y la nariz (apnea obstructiva del sueño), con síntomas secundarios. Hasta la fecha los estudios del SAHS se han centrado en aspectos de diagnóstico, tratamiento o epidemiológicos. Sin embargo, en la actualidad es ineludible abordar nuevos retos, como el estudio de la vía aérea superior (VAS), donde se generan la obstrucción y las consecuencias secundarias, especialmente las cardiovasculares. La obstrucción de la VAS se produce por la noche y no durante el día, lo cual indica la ausencia de unos mecanismos que durante la noche no la mantienen abierta. El SAHS hay que considerarlo, en parte, en clave genética. Una serie de genes determinan o favorecen la presencia de varios factores de riesgo (obesidad, control de la ventilación, morfología facial, etc.) que explicarían que un 15-20% de la población tenga un índice de apneas-hipopneas mayor de 10. Habría además otros genes responsables del fenotipo, que serían la causa de que las obstrucciones induzcan síntomas. En esta revisión se analizarán consideraciones generales sobre la inflamación, aspectos de la VAS y las relaciones del SAHS especialmente con las entidades cardiovasculares y, en concreto, con la actividad de los radicales libres (AU)

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Recurrent obstructive apneas trigger early systemic inflammation in a rat model of sleep apnea.

Obstructive sleep apnea (OSA) is associated with vascular disorders possibly due to systemic inflammation. To determine whether repeated episodes of OSA in a rat model lead to endothelial cell activation and systemic leukocyte recruitment in the microcirculation. Three experimental groups (apnea, sham and naive) were studied. The apnea group was instrumented and subjected to repeated obstruction for 3h (rate 60/h, length 5s) using a special device. The sham group was only instrumented and the naive group was used as a control. Leukocyte-endothelial cell interactions (intravital microscopy) and expression of P-selectin (immunohistochemistry) were determined in colonic venules. The apnea group induced a significant increase in the flux of leukocytes rolling, number of rolling leukocytes and number of adherent leukocytes when compared with the sham or naive groups. P-selectin was up-regulated only in the apnea group. This experimental model of recurrent obstruction demonstrates rapid endothelial cell activation, suggesting the onset of an inflammatory response.

Psychological processes and family variables as prosocial behavior predictors in a sample of Spanish adolescents.

A review of personal and family variables that regulate prosocial behavior is based on a sample of 1,433 Spanish adolescents (ages 9 to 13; 743 boys and 690 girls) who were assessed on the Prosocial Reasoning Objective Measure, the Physical and Verbal Aggression Scale, the Emotional Instability Scale, the State-Trait Anger Inventory, the Child's Report of Parental Behavior Inventory, the Prosocial Behavior Scale, and the Index of Empathy for Children and Adolescents. Discriminant analyses showed that empathy, self-control in anger-provoking situations, and affection in family relationships are the best predictors of prosocial behavior.

Adaptación del Child´s Report Parent Behavior Inventory a población española / Adaptation of Child’s Report of Parent Behavior Inventory in spanish population

En este trabajo se presenta una adaptación en población española del Child’s Reports of Parental Behavior Inventory (CRPBI). El CRPBI es un instrumento que permite evaluar la disciplina familiar que perciben los hijos, tanto en su relación con el padre, como en su relación con la madre. Se considera un buen método para investigar las percepciones que los hijos tienen de la conducta paterna. La adaptación española se ha realizado en una muestra de 1.274 adolescentes (varones y mujeres) que pertenecían a diferentes centros educativos de la Comunidad Valenciana (rango de edad entre 13 y 18 años). Los resultados obtenidos muestran que las dimensiones de afecto/apoyo y control en los estilos de crianza que se perciben por parte del padre y de la madre son las dimensiones claras, potentes y fiables en nuestra población

This study presented an adaptation in spanish sample of the Child’s Reports of Parental Behavior Inventory (CRPBI). The CRPBI is an instrument that allows to assess family discipline percibed by children in the relation with their mothers and with their fathers. It’s consider a good instrument to assess the perceptions that children have of parent behavior. The Spanish adaptation has been carried out with a sample of 1.274 spanish adolescents (males and females) from different educational centers of the Valencian Community (13-18 years). The results show that affect, support and control are the main dimensions in the percibed child rearing styles from parents in our population

[Adaptation of Child's Report of Parent Behavior Inventory for a Spanish population]. / Adaptación del Child's Report of Parent Behavior Inventory a población española.

This study presented an adaptation in Spanish of the Child's Reports of Parental Behavior Inventory (CRPBI) . The CRPBI is an instrument that allows us to assess family discipline perceived by children in the relation with their mothers and with their fathers. It's considered a good instrument to assess the perceptions that children have of parent behavior. The Spanish adaptation has been carried out with a sample of 1,274 Spanish adolescents (males and females) from different educational centers of the Valencian Community (13-18 years). The results show that affect, support and control are the main dimensions in the perceived child rearing styles of parents in our population.