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Objectives To evaluate the effect of different exercise interventions on depressive symptoms in children and adolescents. Methods Randomized controlled trials (RCT) published until May 2023 were screened in four databases. The Cochrane collaboration tool was used to assess the risk of bias for quality evaluation. Stata 16.0 software was used for both a pairwise meta-analysis and a series of frequentist network meta-analyses (NMA). Results A total of 35 RCTs and 5393 participants were included. Aerobic exercise had the most significant effect on depressive symptoms (66.2%), followed by group training (62.5%), resistance exercise (59.0%), and aerobic combined with resistance exercise (57.9%). Furthermore, children and adolescents younger than 15 years showed significant improvement in depressive symptoms (SMD=-0.41, 95% CI (-0.63, -0.19), P < 0.01). The study also found a significant improvement in depression among healthy, obesity, and depressed populations (SMD=-0.25, 95% CI (-0.41, -0.08), P < 0.01); SMD=-0.15, 95% CI (-0.31, -0.00), P < 0.01; SMD=-0.75, 95% CI (-1.32, -0.19), P < 0.01). Additionally, 30 min of exercise had a significant effect (SMD=-0.14, 95% CI (-0,81, -0.01), P < 0.01), and 40–50 min of exercise had the best effect (SMD=-0.17, 95% CI (-0,33, -0.02), P < 0.01). Lastly, exercise frequency of three times per week was significant in children and adolescents (SMD=-0.42, 95% CI (-0,66, -0.18), P < 0.01). Conclusion Exercise significantly improves depressive symptoms in children and adolescents, with aerobic exercise having the most significant effect. A 12-week, three-times-a-week, 40-50-minute exercise intervention was found to be more effective in younger children and adolescents.

Background Previous research has suggested that engaging in regular physical activity (PA) can help to reduce symptoms of depression and anxiety in university students. However, there is a lack of evidence regarding the impact of reducing sedentary behavior (SB) and increasing light-intensity PA (LPA) on these symptoms. This study aims to address this gap by using isotemporal substitution (IS) models to explore how substituting SB with LPA or moderate-to-vigorous PA (MVPA) affects depression and anxiety symptoms among university students. Methods The study recruited 318 university students with a mean age of 21.13 years. Accelerometers were used to objectively measure the time spent on SB, LPA, and MVPA, while depression and anxiety symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D) and the Self-rating Anxiety Scale (SAS). IS models using multivariable linear regression were employed to estimate the associations between different behaviors and depression and anxiety symptoms when 30 min of one behavior was substituted with another. Results In the single-activity model, less SB (β = 0.321, 95% CI: 0.089, 1.297) and more MVPA (β = −0.142, 95% CI: −1.496, − 0.071) were found to be significantly and negatively associated with depression scores, while less SB (β = 0.343, 95% CI: 0.057, 1.014), LPA (β = 0.132, 95% CI: 0.049, 1.023), and more MVPA (β = −0.077, 95% CI: −1.446, − 0.052) were significantly and negatively correlated with anxiety scores. The IS analysis revealed that substituting 30 min of SB with LPA (β = −0.202, 95% CI: −1.371, − 0.146) or MVPA (β = −0.308, 95% CI: −0.970, − 0.073) was associated with improvements in depressive symptoms. Substituting 30 min of SB with MVPA (β = −0.147, 95% CI: −1.863, − 0.034) was associated with reduced anxiety symptoms. Conclusion Replacing 30 min of SB with MVPA may alleviate depression and anxiety symptoms in university students. Further research is needed to explore the long-term effects of PA interventions on the mental health disorders of this population.

Background Although prior studies have demonstrated that children with high levels of fundamental movement skill (FMS) are more active throughout the day, little is known about children’s FMS and their physical activity (PA) during different segments of the school day (e.g., recess, lunch break, and physical education). The present study focused on FMS and moderate-to-vigorous PA (MVPA) during school day and identifies the association between children’s FMS and MVPA during different segments of the school day in China. Methods A total of 322 children (boys n  = 163, girls n  = 159; M age = 8.12, SD = 1.22 years) from four elementary schools involved in this study. Children’s FMS and MVPA were measured using the Test of Gross Motor Development-2nd edition (TGMD-2) and hip-mounted accelerometers. Data such as height, weight, and socio-economic status (SES) were also obtained. Multilevel mixed regression models were used to examine the cross-sectional associations between FMS and MVPA. Models were adjusted for gender, age, standardized body mass index, and SES. Results Children engaged in 32.19 min of MVPA during the whole school day. Boys were more active than girls and had higher object-control skills competency. Locomotor skills were positively associated with children’s long recess (B = 1.063) and short recess time (B = 1.502) MVPA. Object-control skills were positively correlated with children’s MVPA time during long recess (B = 1.244) and physical education (PE) lessons (B = 1.171). Conclusion The findings highlight the importance of developing both locomotor and object-control skills in elementary schools to lead more MVPA engagement during different segments of the school day.

Background Anxiety, depression, and stress are the most common mental health problems in childhood. Exercise interventions in childhood help to promote mental health. Objective To investigate the relationship between exercise interventions and improvement of negative emotions such as anxiety, depression, and stress in children (5–12 years). Methods Articles were searched in five electronic databases from their inception to January 2023. The meta-analysis was performed using Stata 16.0. Results Twenty-three intervention studies included 6830 children. 1) The exercise intervention group was significantly better than the control group in improving negative emotions (Standard Mean Difference SMD=-0.25, 95% Confidence Intervals CI: -0.34 to -0.15, P < 0.01). Exercise intervention improved different kinds of negative emotions: anxiety (SMD=-0.19, 95% CI: -0.33 to -0.06, P < 0.01), depression (SMD=-0.22, 95% CI: -0.43 to -0.01, P < 0.01), and stress (SMD=-0.33, 95% CI: -0.53 to -0.14, P < 0.01); it was most effective at relieving problematic stress. Exercise interventions lasting 20–45 min were most effective in improving children’s negative emotions (SMD=-0.38, 95% CI: -0.56 to -0.20, P < 0.01). An exercise intervention period of 10 weeks was more effective in improving children’s negative mood (SMD=-0.26, 95% CI: -0.34 to -0.17, P = 0.274). Conclusion Exercise interventions may improve negative emotions such as anxiety, depression, and stress in children. These findings may have clinical implications for children with negative affect. However, these studies showed a large heterogeneity, and the results should be interpreted with caution. Future studies should report the variability of exercise interventions by gender, age group, and type, intensity, and place of exercise.

Tumour necrosis factor receptor-associated factor 6 (TRAF6) is a ubiquitin E3 ligase that regulates important biological processes. However, the role of TRAF6 in cardiac hypertrophy remains unknown. Here, we show that TRAF6 levels are increased in human and murine hypertrophied hearts, which is regulated by reactive oxygen species (ROS) production. Cardiac-specific Traf6 overexpression exacerbates cardiac hypertrophy in response to pressure overload or angiotensin II (Ang II) challenge, whereas Traf6 deficiency causes an alleviated hypertrophic phenotype in mice. Mechanistically, we show that ROS, generated during hypertrophic progression, triggers TRAF6 auto-ubiquitination that facilitates recruitment of TAB2 and its binding to transforming growth factor beta-activated kinase 1 (TAK1), which, in turn, enables the direct TRAF6–TAK1 interaction and promotes TAK1 ubiquitination. The binding of TRAF6 to TAK1 and the induction of TAK1 ubiquitination and activation are indispensable for TRAF6-regulated cardiac remodelling. Taken together, we define TRAF6 as an essential molecular switch leading to cardiac hypertrophy in a TAK1-dependent manner. TRAF6 is a ubiquitin E3 ligase regulating a number of biological processes. Here the authors show that ROS, generated during pathological cardiac stress, induces TRAF6 auto-ubiquitination and activation, promoting its interaction with and ubiquitination of TAK1 that contributes to development of cardiac hypertrophy.

Background Exercise is widely used for obesity management, but the optimal doses of exercise for improving body mass index (BMI) in children and adolescents with overweight and obesity remain unclear. This study aimed to evaluate the dose‒response effects of various exercises on BMI in children and adolescents with overweight and obesity. Methods A systematic search was conducted in Web of Science (Core Collection), PubMed/MEDLINE, Embase, Scopus, and the Cochrane Library for randomized controlled trials on relevant studies, covering literature up to July 2024. Three independent reviewers assessed bias via the Cochrane risk of bias tool. The quality of evidence was assessed using Confidence in Network Meta-Analysis framework. A dose‒response network meta-analysis was used to evaluate the impact of various exercise interventions and explore dose‒response relationships. All outcomes were analyzed with the mean difference (MD) and 95% credible intervals (CrIs) calculated for combined statistics. Results The study included 39 publications with 1,814 participants, 47.3% female and a median age of 14 years. The intervention involved six exercise modalities. High-intensity interval training demonstrated a significant reduction in BMI (MD = -1.33, 95% CrIs - 2.01 to -0.66), followed by combined exercise (MD = -1.25, 95% CrIs − 1.93 to -0.61), moderate-intensity continuous training (MD = -1.09, 95% CrIs - 1.73 to -0.45), and mixed aerobic exercise (MD = -1.05, 95% CrIs - 1.67 to -0.42). There was an ‘L’-shaped nonlinear dose-response relationship between total exercise dose and BMI, with 200 METs-min/day identified as the minimum exercise dose required to achieve a clinically meaningful reduction in BMI. Conclusion Low-quality evidence indicates that HIIT, CE, MAE, and MICT improve BMI in children and adolescents with overweight and obesity, with clarified exercise doses for clinical benefit. These findings are relevant for exercise prescription and public health policy. Trial registration CRD42024566450.

Sustainable ammonia is one of the leading candidates in the search for alternative clean fuels for marine applications. This paper aims to build a simulation model of a six-cylinder, four-stroke diesel engine to investigate the effects of increasing the ammonia proportion in methanol–ammonia fuel blends on engine performance and emissions. In the present study, the conditions of different speeds and different proportions of ammonia in fuel blends are investigated. The results show that the average effective pressure, brake power, and brake torque increase by about 5% with an increased ammonia substitution ratio. In terms of economic performance, the changes under medium and low speed conditions are not obvious. However, the change in high speed conditions is significant. The brake specific fuel consumption (BSFC) is reduced by 6.6%, and the brake thermal efficiency (BTE) is increased by 4%. It is found that the performance of the engine is best at medium speed. The best performance is achieved with higher efficiency and lower emissions. The present results can provide guidance for the optimization of ammonia–methanol blends and their applications in engines.

Guidelines have recommended endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and endoscopic ultrasound-guided fine-needle aspiration biopsy as initial sampling approaches of mediastinal lymph nodes for lung cancer staging. However, the small sample volume might restrict the diagnostic utility of needle aspiration in certain mediastinal diseases. We have recently shown that transbronchial mediastinal cryobiopsy, which is capable of providing larger amounts of intact tissue, improves diagnostic yield in rare tumors and benign diseases compared to EBUS-TBNA. Here, we present a case of mediastinal nodular lymphocyte predominant Hodgkin lymphoma successfully diagnosed by endoscopic transesophageal cryobiopsy.

Targeting CFLAR in mouse and non-human primates ameliorates non-alcoholic steatohepatitis by decreasing JNK signaling in hepatocytes. Nonalcoholic steatohepatitis (NASH) is a progressive disease that is often accompanied by metabolic syndrome and poses a high risk of severe liver damage. However, no effective pharmacological treatment is currently available for NASH. Here we report that CASP8 and FADD-like apoptosis regulator (CFLAR) is a key suppressor of steatohepatitis and its metabolic disorders. We provide mechanistic evidence that CFLAR directly targets the kinase MAP3K5 (also known as ASK1) and interrupts its N-terminus-mediated dimerization, thereby blocking signaling involving ASK1 and the kinase MAPK8 (also known as JNK1). Furthermore, we identified a small peptide segment in CFLAR that effectively attenuates the progression of steatohepatitis and metabolic disorders in both mice and monkeys by disrupting the N-terminus-mediated dimerization of ASK1 when the peptide is expressed from an injected adenovirus-associated virus 8–based vector. Taken together, these findings establish CFLAR as a key suppressor of steatohepatitis and indicate that the development of CFLAR-peptide-mimicking drugs and the screening of small-molecular inhibitors that specifically block ASK1 dimerization are new and feasible approaches for NASH treatment.

ObjectivesThis study employed compositional data analysis to examine the association between 24-hour activity behaviours and emotional and behavioural problems among left-behind children (LBC).DesignCross-sectional analysis.SettingThe research used a cross-sectional approach to analyse data collected from LBC living in Ningbo, Zhejiang Province, southern China, between February and May 2023.ParticipantsA total of 275 LBC aged 9–15 years old were recruited.Outcome measuresThe measurement of 24-hour activity behaviour, incorporating sleep, sedentary behaviour (SED), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA), was accomplished using accelerometers. Emotional and behavioural problems were assessed through the application of the Strengths and Difficulties Questionnaire. Compositional data analysis was used to evaluate the potential relationship between the composition of 24-hour activity and emotional and behavioural problems.ResultsChanges in allocation, such as transferring time from SED to sleep and LPA, were associated with better internalising (β sleep=−0.53, 95% CI −0.60 to −0.46; β LPA=−0.46, 95% CI −0.55 to −0.38) and externalising problems (β sleep=−0.31, 95% CI −0.39 to −0.22; β LP =−0.23, 95% CI −0.32 to −0.13). Furthermore, reallocating time from LPA to MVPA was associated with reduced internalising problems (β=−0.40, 95% CI −0.84 to −0.12). Positive associations with prosocial behaviour were observed when the time was reallocated to MVPA from sleep (β=0.81, 95% CI 0.57 to 1.05), SED (β=0.75, 95% CI 0.51 to 0.99) and LPA (β=0.82, 95% CI 0.57 to 1.08).ConclusionsThe composition of 24-hour activity behaviours is correlated with emotional and behavioural problems in LBC. The findings indicate that redistributing time from SED to sleep and LPA is linked to improved internalisation and externalisation problem scores. Additionally, the substitution of MVPA for any other behaviours is positively associated with enhanced prosocial behaviours.