Adherence to 24-hour movement guidelines in children with mental,behavioral,and developmental disorders:Data from the 2016-2020 National Survey of Children's Health

Background:Adopting a healthy lifestyle during childhood could improve physical and mental health outcomes in adulthood and reduce relevant disease burdens.However,the lifestyles of children with mental,behavioral,and developmental disorders(MBDDs)remains under-described within the literature of public health field.This study aimed to examine adherence to 24-hour movement guidelines among children with MBDDs compared to population norms and whether these differences are affected by demographic characteristics.Methods:Data were from the 2016-2020 National Survey of Children’s Health—A national,population-based,cross-sectional study.We used the data of 119,406 children aged 6-17 years,which included 38,571 participants with at least 1 MBDD and 80,835 without.Adherence to the 24-hour movement guidelines was measured using parent-reported physical activity,screen time,and sleep duration.Results:Among children with MBDDs,20.3%,37.0%,60.7%,and 77.3%met the physical activity,screen time,sleep,and at least 1 of the 24-hour movement guidelines.These rates were lower than those in children without MBDDs(22.8%,46.2%,66.7%,and 83.4%,respectively;all p<0.001).Children with MBDDs were less likely to meet these guidelines(odds ratio(OR)=1.21,95%confidence interval(95%CI):1.13-1.30;OR=1.37,95%CI:1.29-1.45;OR=1.29,95%CI:1.21-1.37;OR=1.45,95%CI:1.35-1.56)than children without MBDDs.Children with emotional disorders had the highest odds of not meeting these guidelines(OR=1.43,95%CI:1.29-1.57;OR=1.48,95%CI:1.37-1.60;OR=1.49,95%CI:1.39-1.61;OR=1.72,95%CI:1.57-1.88)in comparison to children with other MBDDs.Among children aged12-17 years,the difference in proportion of meeting physical activity and screen time guidelines for children with vs.children without MBDD was larger than that among children aged 6-11 years.Furthermore,the above difference of meeting physical activity guidelines in ethnic minority children was smaller than that in white children.Conclusion:Children with MBDDs were less likely to meet individual or combined 24-hour movement guidelines than children without MBDDs.In educational and clinical settings,the primary focus should be on increasing physical activity and limiting screen time in children aged 12-17 years who have MBDDs;and specifically for white children who have MBDDs,increasing physical activity may help.

Carotid-cavernous fistula following mechanical thrombectomy of the tortuous internal carotid artery:A case report

BACKGROUND A carotid-cavernous fistula(CCF)is an abnormal connection between the internal carotid artery(ICA)and the cavernous sinus.Although direct CCFs typically result from trauma or as an iatrogenic complication of neuroendovascular procedures,they can occur as surgery-related complications after mechanical thrombectomy(MT).With the widespread use of MT in patients with acute ischemic stroke complicated with large vessel occlusion,it is important to document CCF following MT and how to avoid them.In this study,we present a case of a patient who developed a CCF following MT and describe in detail the characteristics of ICA tortuosity in this case.CASE SUMMARY A 60-year-old woman experienced weakness in the left upper and lower limbs as well as difficulty speaking for 4 h.The neurological examination revealed left central facial paralysis and left hemiplegia,with a National Institutes of Health Stroke Scale score of 9.Head magnetic resonance imaging revealed an acute cerebral infarction in the right basal ganglia and radial crown.Magnetic resonance angiography demonstrated an occlusion of the right ICA and middle cerebral artery.Digital subtraction angiography demonstrated distal occlusion of the cervical segment of the right ICA.We performed suction combined with stent thrombectomy.Then,postoperative angiography was performed,which showed a right CCF.One month later,CCF embolization was performed,and the patient’s clinical symptoms have significantly improved 5 mo after the operation.CONCLUSION Although a CCF is a rare complication after MT,it should be considered.Understanding the tortuosity of the internal carotid-cavernous sinus may help predict the complexity of MT and avoid this complication.

Chlorinated Polyfluoroalkyl Ether Sulfonic Acids(Cl-PFESAs)Are Associated with Eye Diseases in Humans and Eye Toxicity in Zebrafish

Evidence from animal experiments has shown that chlorinated polyfluoroalkyl ether sulfonic acids(Cl-PFESAs)can induce vision dysfunction in zebrafish.However,environmental epidemiological evidence supporting this hypothesis remains limited.In our case−control study,samples collected from 270 individuals(135 controls and 135 cases)from the Isomers of C8 Health Project data were analyzed for Cl-PFESAs.We also repeated our analysis on zebrafish to support our findings in humans and to decipher the mechanism underlying Cl-PFESA eye toxicity.The serum levels of per-and polyfluoroalkyl substances(PFASs)and alternatives were significantly higher in the cases than in the controls.Higher serum Cl-PFESA levels were associated with greater odds of eye diseases,and the trend showed a statistically significant dose-dependent relationship.The Shapley additive explanations(SHAP)value indicated that 8:2 Cl-PFESA was the dominant eye disease risk factor among the 13 studied PFASs.In zebrafish experiments,Cl-PFESAs induced eye toxicity in adult zebrafish by oxidative damage and cell apoptosis.Compared to the control group,there was significantly reduced thicknesses of the inner plexiform layer(IPL),outer plexiform layer(OPL),and retinal tissue in the zebrafish exposed to Cl-PFESAs.Our study provides human clinical and animal experimental data,showing that exposure to PFASs increases the odds of the development of eye toxicity.

Pre-conceptional and prenatal exposure to secondhand smoke and autism spectrum disorder:a national multi-center study in China

Background Despite extensive research evaluating the association between prenatal exposure to secondhand smoke(SHS)and the development of autism spectrum disorders(ASD),no study has investigated the association by considering the pre-conceptional period.This study aimed to investigate the associations of pre-conceptional and prenatal SHS exposure and the development of ASD among toddlers.Methods In this cross-sectional study,parents of 6049 toddlers aged 16–30 months were recruited from 7 tertiary hospitals,21 communities,and 7 kindergartens located in seven cities in six provinces from five geographical regions of China.We analyzed the associations of SHS exposure and the odds of ASD among toddlers in different exposure windows(pre-conceptional and/or prenatal periods).Data were analyzed from November 2021 to January 2022.Results Among the 6049 toddlers included in the analysis[22.7(4.1)months;44.8%girls],71 were identified and diagnosed with ASD.Compared with the unexposed toddlers,toddlers with pre-conceptional SHS exposure had higher odds of ASD(OR 2.30,95%CI 1.36–3.84),while we observed a non-significantly positive association regarding prenatal SHS exposure.When considering both pre-conceptional and prenatal periods,toddlers who were continuously exposed to SHS during these two periods had higher odds than those without SHS exposure(OR 2.32,95%CI 1.24–4.14).Conclusion We reported positive SHS–ASD associations when exposed during the pre-conceptional period and continuously exposed during pre-conceptional and prenatal periods,emphasizing the critical window of pre-conception for targeted intervention on smoking.

Global burden and drivers of hyperglycemia:Estimates and predictions from 1990 to 2050

Hyperglycemia is a key risk factor for death and disability worldwide.To better inform prevention strategies,we aimed to delineate and predict the temporal,spatial,and demographic patterns in mean fasting plasma glucose(FPG)levels and their related disease burden globally.Based on the Global Burden of Disease Study 2019,we estimated the distributions of mean FPG levels and high FPG-related disease burden by age,sex,year,socioeconomic status(SES),and geographical region from 1990 to 2050.

Effects on Synaptic Plasticity Markers in Fetal Mice and HT22 Neurons upon F‑53B Exposure:The Role of PKA Cytoplasmic Retention

Chlorinated polyfluorinated ether sulfonate(F-53B),a chromium-fog depressant widely utilized as an alternative to perfluorooctanesulfonate,can transfer from mother to fetus.Recent research has demonstrated that prenatal exposure to F-53B results in synaptic damage in weaning mice.However,the mechanism underpinning F-53B-triggered synaptic damage during fetal development remains unclear.This study aims to investigate the role of the protein kinase A(PKA)/cAMP response element-binding protein(CREB)pathway,a crucial signaling mechanism known as“synaptic switch”,in the early neurotoxicity of F-53B exposure both in vivo and in vitro.Here,C57BL/6 fetal mice were subjected to exposure to F-53B(0,4,and 40μg/L)from gestation days(GD)0 to 14 to evaluate nerve injury prior to delivery.HT22 neurons exposed to F-53B(0,0.016,0.08,0.4,2,and 10μmol/L)for 24 h were utilized to elucidate the underlying mechanism.Our results demonstrated that F-53B significantly increased the fluorescence intensity of Nestin(a neural stem cell marker)in the fetal brain hippocampus(GD14).Subsequently,we found that F-53B downregulated the expression of synaptic plasticity markers(SYP,GAP43,and BDNF)in the fetal brain and HT22 neurons.Further molecular docking analysis revealed that F-53B fits into the ligand-binding pockets of PKA and CREB1.Results showed that F-53B inhibited the translocation of PKA protein from the cytoplasm to the neuronal nuclei and reduced the levels of PKA,CREB1,p-PKA(α/β/γ)-Thr197,and p-CREB1-S133 in the nucleus.Furthermore,the expression of synaptic plasticity markers altered by F-53B could be reversed by a PKA agonist and was intensified by a PKA antagonist.In summary,our findings suggest that intrauterine exposure to F-53B can weaken the expression of synaptic plasticity markers in the fetal brain,with this neurotoxicity being mediated by the cytoplasmic retention of PKA.