Disentangling Physical Activity and Sedentary Behavior Patterns in Children with Low Motor Competence.

Children with low motor competence (MC) are at high-risk for physical inactivity, yet little is known about their physical activity (PA) and sedentary behavior (SB) patterns throughout the day. The purpose of this study is to disentangle PA and SB patterns among children with low MC across segmented day periods taking into account differences in gender and age. Data collection took place between May and July 2017. The Athletic Skills Track was used to measure MC. PA levels were objectively measured using accelerometers (ActiGraph, GT3X+) on school days. Data were segmented for (1) time before school, (2) time during school (based on school schedules), and (3) time after school. In total, data from 117 7-to-11 years-old children with low MC were eligible for analyses (N = 58 girls; N = 59 boys). Differences in moderate-to-vigorous PA (MVPA) and SB between segmented periods, gender, and grade were analyzed by ANOVAs with post hoc tests (Tukey) and Independent Sample T-tests respectively. Time spent at school is the major contributor of time spent in SB in children with low MC. Low MC is equally distributed among gender, but large differences exist among boys and girls in both MVPA and SB, indicating low-MC girls as most inactive group. This pattern is found in all segmented periods of the school day, i.e., before, during, and after school. This study stresses the negative contribution of current school curricula on PA and SB in children with low MC, indicating the most efficient period of the day to intervene. Future school-based PA and SB interventions should particularly focus on specific high-risk populations, i.e., children with low MC, and girls in particular.

Physical Activity and School Absenteeism Due to Illness in Adolescents.

BACKGROUND: Knowledge about the beneficial role of physical activity (PA) for health and school performance is growing. Studies investigating the link between PA and school absenteeism due to illness are lacking. Therefore, we investigated associations between habitual PA and school absenteeism due to illness in adolescents and explored whether mental health and cardiovascular fitness mediated this association. METHODS: We studied 328 students in grades 7 and 9 (mean age 13.8 years; 49% boys). The PA was measured objectively by an ActivPAL3™ accelerometer attached on the thigh during 1 full week (24 hours/day). Depressive symptoms and self-esteem were self-reported by the Center for Epidemiologic Studies Depression Scale (CES-D) and Rosenberg Self-Esteem Scale, respectively, and included as a proxy for mental health in the analyses. Cardiovascular fitness was measured by the 20-m shuttle-run test. School absenteeism due to illness data was provided by the school administration. RESULTS: The PA was not significantly associated with school absenteeism, though there was an indirect association between PA and school absenteeism by cardiovascular fitness. CONCLUSIONS: Cardiovascular fitness mediates the association between PA and school absenteeism due to illness. Thus, cardiovascular fitness of students should be improved to reduce school absenteeism due to illness.

Decline in physical activity during adolescence is not associated with changes in mental health.

BACKGROUND: The majority of studies investigating associations between physical activity and mental health in adolescents have been cross-sectional in design. Potential associations between physical activity and mental health may be better examined longitudinally as physical activity levels tend to decrease in adolescence. Few studies have investigated these associations longitudinally in adolescents and none by measuring physical activity objectively. METHODS: A total of 158 Dutch adolescents (mean age 13.6 years, 38.6% boys, grades 7 and 9 at baseline) participated in this longitudinal study. Physical activity, depressive symptoms and self-esteem were measured at baseline and at the 1-year follow-up. Physical activity was objectively measured with an ActivPAL3™ accelerometer during one full week. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D) and self-esteem was assessed with the Rosenberg Self-Esteem Scale (RSE). Results were analysed using structural equation modelling. RESULTS: Physical activity levels decreased 15.3% over a 1-year period (p < .001), with significantly (p = .001) greater decreases during grade 7 (-20.7%) than during grade 9 (-5.0%). Overall, depressive symptoms decreased (-12.1%, p < .001) over a 1-year period, while self-esteem did not change significantly (+2.9%, p = .066). Higher levels of depressive symptoms at baseline predicted a greater decline in depressive symptoms (ß = -.51, p < .001) and higher levels of self-esteem at baseline predicted a smaller increase in self-esteem (ß = -.48, p < .001). The decline in physical activity did not appear to predict any change in depressive symptoms and self-esteem. CONCLUSION: The decline in physical activity over a 1-year period during adolescence is not associated with a change in mental health. Further studies in adolescents aiming to investigate whether a change in physical activity is associated with a change in mental health should control for baseline levels of mental health and academic year differences.

The association between objectively measured physical activity and academic achievement in Dutch adolescents: findings from the GOALS study.

The main goal of this study was to investigate the association between objectively measured physical activity and academic achievement in adolescents. Students in Grades 7 and 9 (N = 255) were included. Overall, we found no significant dose-response association between physical activity and academic achievement. However, in Grade 7 total physical activity volume (Total PA) was negatively associated with academic achievement, while moderate-to-vigorous intensity physical activity (MVPA) was negatively associated with both academic achievement and mathematics performance. In contrast, in Grade 9 both Total PA and MVPA were positively associated with mathematics performance. In addition, the overall association between MVPA and academic achievement followed an inverted U-shaped curve. Finally, Total PA was positively associated with executive functioning, while executive functioning in turn mediated the associations between Total PA and both academic achievement and mathematics performance. These results indicate that the association between physical activity and academic achievement in adolescents is complex and might be affected by academic year, physical activity volume and intensity, and school grade.

Active commuting to school, cognitive performance, and academic achievement: an observational study in Dutch adolescents using accelerometers.

BACKGROUND: The current study examined the associations between active commuting to school, cognitive performance, and academic achievement in Dutch adolescents. In addition, it was explored whether these associations were moderated by sex and mediated by depressive symptoms. METHODS: Students in grades 7 and 9 (N = 270; mean age 13.4 years; 53% boys) were included. Active commuting to school was measured objectively by an ActivPAL3™ accelerometer. Cognitive performance was measured by the d2 Test of attention (key components of executive functioning) and the Symbol Digit Modalities Test (information-processing speed). Academic achievement was determined by the mean of the school grades obtained in Dutch, mathematics and English. Depressive symptoms were self-reported. RESULTS: Active commuting to school constituted 28% of the total amount of time spent moving per week. Active commuting to school was not significantly associated with cognitive performance and academic achievement, overall. However, active commuting to school was positively associated with performance on the d2 Test of attention in girls (ß = .17, p = .037), but not in boys (ß = -.03, p = .660). The associations were not mediated by depressive symptoms. CONCLUSIONS: The associations between active commuting to school and cognitive performance and academic achievement are weak and might be moderated by sex, while the greatest benefits on cognition due to active commuting to school might be with regard to executive functioning. Future studies might make use of experimental designs, because causal relations between active commuting to school and cognitive performance or academic achievement would provide important implications for both education and public health.

Symptomatic lipid storage in carriers for the PNPLA2 gene.

Neutral lipid storage disease comprises a heterogeneous group of inherited disorders characterized by severe accumulation of cytoplasmic triglyceride droplets in several tissues and neutrophils. A novel type of autosomal recessive lipid myopathy due to PNPLA2 mutations was recently described with associated cardiac disease, myopathy and frequent infections, but without ichthyosis. Here we describe the clinical and biochemical characteristics of a long surviving patient and report on four carrier family members with diverse clinical involvement. Interestingly, heterozygous patients show neutral lipid storage in muscle and in the keratocytes of the skin, Jordans' bodies, mild myopathy and frequent infections. Biochemical analysis of fibroblasts obtained from patients revealed increased triglyceride storage and reduced lipid droplet-associated triglyceride hydrolase activity. Together, our data implicate that the wild-type allele cannot fully compensate for the mutated dysfunctional allele of PNPLA2 leading to triglyceride accumulation in muscle and mild myopathy in PNPLA2 mutation carriers. The presence of neutral lipid droplets in the skin in PNPLA2 mutation carriers strengthens the link between NLSD and other neutral lipid storage diseases with ichthyosis.

Post-menopausal vaginal bleeding caused by carcinoma of the appendix: a case report.

INTRODUCTION: Post-menopausal blood loss is a common complaint of patients seen in gynecological practice. The most frequent malignancy found in cases of post-menopausal bleeding is endometrial cancer. Other causes can be malignancies of the rest of a woman's genital tract or metastases from other tumors. To the best of our knowledge, it appears that this is the first published case of a post-menopausal primary appendiceal carcinoma presenting with vaginal blood loss. CASE PRESENTATION: A 75-year-old Caucasian woman with a history of vaginal hysterectomy presented with a 10-month history of post-menopausal blood loss. After extensive examination and discussion, ovarian carcinoma was suggested. Microscopic examination of the tissue removed at laparotomy revealed an adenocarcinoma of the appendix. She was treated with adjuvant radiotherapy and with palliative chemotherapy after 14 months because of intra-abdominal metastatic disease. CONCLUSION: Post-menopausal blood loss in a patient with a history of hysterectomy is uncommon and always needs further investigation.

Follicular lymphoma with a novel t(14;18) breakpoint involving the immunoglobulin heavy chain switch mu region indicates an origin from germinal center B cells.

With the use of DNA-fiber fluorescent in situ hybridization, a BCL2 protein positive follicular lymphoma with a novel BCL2 breakpoint involving the immunoglobulin heavy chain (IGH) switch mu (S(mu)) region instead of the J(H) or D(H) gene segments was identified. Sequence analysis showed that the genomic breakpoint is localized between the S(mu) region of the IGH complex and the first intron of BCL2. Reverse-transcriptase polymerase chain reaction showed expression of a unique hybrid IGH-BCL2 transcript involving the transcription initiation site I(mu). Sequence analysis of the V(H) region of the functional nontranslocated IGH allele showed multiple shared somatic mutations but also a high intraclonal variation (53 differences in 15 clones), compatible with the lymphoma cells staying in or re-entering the germinal center. This is the first example of a t(14;18) translocation that results from an illegitimate IGH class-switch recombination during the germinal center B-cell stage.