Effects of an exercise program on brain health outcomes for children with overweight or obesity

Importance Pediatric overweight and obesity are highly prevalent across the world, with implications for poorer cognitive and brain health. Exercise might potentially attenuate these adverse consequences. Objectives To investigate the effects of an exercise program on brain health indicators, including intelligence, executive function, academic performance, and brain outcomes, among children with overweight or obesity and to explore potential mediators and moderators of the main effects of exercise. Design, Setting, and Participants All preexercise and postexercise data for this 20-week randomized clinical trial of 109 children aged 8 to 11 years with overweight or obesity were collected from November 21, 2014, to June 30, 2016, with neuroimaging data processing and analyses conducted between June 1, 2017, and December 20, 2021. All 109 children were included in the intention-to-treat analyses; 90 children (82.6%) completed the postexercise evaluation and attended 70% or more of the recommended exercise sessions and were included in per-protocol analyses. Interventions All participants received lifestyle recommendations. The control group continued their usual routines, whereas the exercise group attended a minimum of 3 supervised 90-minute sessions per week in an out-of-school setting. Main Outcomes and Measures Intelligence, executive function (cognitive flexibility, inhibition, and working memory), and academic performance were assessed with standardized tests, and hippocampal volume was measured with magnetic resonance imaging. Results The 109 participants included 45 girls (41.3%); participants had a mean (SD) body mass index of 26.8 (3.6) and a mean (SD) age of 10.0 (1.1) years at baseline. In per-protocol analyses, the exercise intervention improved crystallized intelligence, with the exercise group improving from before exercise to after exercise (mean z score, 0.62 [95% CI, 0.44-0.80]) compared with the control group (mean z score, –0.10 [95% CI, –0.28 to 0.09]; difference between groups, 0.72 SDs [95% CI, 0.46-0.97]; P < .001). Total intelligence also improved significantly more in the exercise group (mean z score, 0.69 [95% CI, 0.48-0.89]) than in the control group (mean z score, 0.07 [95% CI, –0.14 to 0.28]; difference between groups, 0.62 SDs [95% CI, 0.31-0.91]; P < .001). Exercise also positively affected a composite score of cognitive flexibility (mean z score: exercise group, 0.25 [95% CI, 0.05-0.44]; control group, –0.17 [95% CI, –0.39 to 0.04]; difference between groups, 0.42 SDs [95% CI, 0.13-0.71]; P = .005). These main effects were consistent in intention-to-treat analyses and after multiple-testing correction. There was a positive, small-magnitude effect of exercise on total academic performance (mean z score: exercise group, 0.31 [95% CI, 0.18-0.44]; control group, 0.10 [95% CI, –0.04 to 0.24]; difference between groups, 0.21 SDs [95% CI, 0.01-0.40]; P = .03), which was partially mediated by cognitive flexibility. Inhibition, working memory, hippocampal volume, and other brain magnetic resonance imaging outcomes studied were not affected by the exercise program. The intervention increased cardiorespiratory fitness performance as indicated by longer treadmill time to exhaustion (mean z score: exercise group, 0.54 [95% CI, 0.27-0.82]; control group, 0.13 [95% CI, –0.16 to 0.41]; difference between groups, 0.42 SDs [95% CI, 0.01-0.82]; P = .04), and these changes in fitness mediated some of the effects (small percentage of mediation [approximately 10%-20%]). The effects of exercise were overall consistent across the moderators tested, except for larger improvements in intelligence among boys compared with girls. Conclusions and Relevance In this randomized clinical trial, exercise positively affected intelligence and cognitive flexibility during development among children with overweight or obesity. However, the structural and functional brain changes responsible for these improvements were not identified

Probing Primordial Non-Gaussianity with Large-Scale Structure

We consider primordial non-Gaussianity due to quadratic corrections in the gravitational potential parametrized by a non-linear coupling parameter fnl. We study constraints on fnl from measurements of the galaxy bispectrum in redshift surveys. Using estimates for idealized survey geometries of the 2dF and SDSS surveys and realistic ones from SDSS mock catalogs, we show that it is possible to probe |fnl|~100, after marginalization over bias parameters. We apply our methods to the galaxy bispectrum measured from the PSCz survey, and obtain a 2sigma-constraint |fnl|< 1800. We estimate that an all sky redshift survey up to z~1 can probe |fnl|~1. We also consider the use of cluster abundance to constrain fnl and find that in order to be sensitive to |fnl|~100, cluster masses need to be determined with an accuracy of a few percent, assuming perfect knowledge of the mass function and cosmological parameters.Comment: 15 pages, 7 figure

Técnica de recambio de electrodo percutáneo disfuncional para estimulación medular como tratamiento del dolor crónico refractario en paciente con schwannoma de raíz L2 izquierda: reporte de un caso

Introduction: Spinal cord stimulation systems can use percutaneous electrodes or percutaneous (PP) paddles, unlike surgical paddles that require a surgical approach for implantation by laminotomy or laminectomy. To date, there are no reports in the world literature regarding percutaneous withdrawal of dysfunctional (PP). Materials and methods: It is a case report, descriptive and retrospective. Who required implantation of implanted medullary neurostimulator (NEMI) with (PP) for refractory chronic neuropathic pain, who attended with dysfunction and later candidate for replacement of the (PP) with percutaneous technique. Performed in service of Pain Clinic of the National Medical Center "November 20" in September 2016. Results: A 54-year-old female with a diagnosis of Schwannoma of the left L2 root who presented dysfunction of the (PP) of the (NEMI) during an automobile accident. A percutaneous approach is performed in a fluoroscopy room using the Epiducer TM of ST. Jude Medical as a "bridge" for the removal of the dysfunctional (PP) and replacement of the new (PP) without conducting a laminotomy or laminectomy approach. Conclusions: The percutaneous approach to replacement of (PP) is an effective minimally invasive technique, with a lower probability of complications and without the need for laminectomy or laminotomy.Introducción: Los sistemas de estimulación medular espinal pueden utilizar electrodos percutáneos (EP) o paletas percutáneas, a diferencia de los electrodos quirúrgicos que se requiere un abordaje quirúrgico para su implantación mediante laminotomía o laminectomía. Hasta la fecha no existen reportes en la literatura mundial acerca del retiro percutáneo de EP disfuncional. Materiales y métodos: Es un reporte de caso, descriptivo y retrospectivo, que ha requerido de colocación de Neuroestimulador Medular Implantable (NEMI) con EP por dolor neuropático crónico refractario, que cursó con disfunción y posteriormente candidato para recambio del EP con técnica percutánea. Realizado en el servicio de Clínica del Dolor del Centro Médico Nacional "20 de Noviembre" en el mes de septiembre de 2016. Resultados: Paciente de sexo femenino de 54 años con diagnóstico de schwannoma de raíz L2 izquierda, que presentó disfunción del EP del NEMI durante accidente automovilístico. Se realizó abordaje percutáneo en sala de fluoroscopia mediante el uso del EpiducerTM de ST. Jude Medical como "puente" para el retiro del EP disfuncional y recolocación del nuevo EP sin realizar abordaje por laminotomía o laminectomía. Conclusiones: El abordaje percutáneo para recambio de EP es una técnica efectiva mínimamente invasiva, con menor probabilidad de complicaciones y sin necesidad de realizar laminectomía o laminotomía

Aula de innovación educativa

El artículo forma parte de una sección de intercambio de experiencias dedicada a educación para la ciudadanía.Experiencia didáctica centrada en el estudio del comportamiento y opinión del alumnado ante la emigración y el fomento de la tolerancia que ha permitido al alumnado acercarse a la realidad vivida por sus compañeros (marroquíes y españoles), punto de partida para una mejora de la convivencia y de las relaciones personales..CataluñaConsejería de Educación, Ciencia e Investigación. Biblioteca; Av. de la Fama, 15; 30006 Murcia; Tel. +34968279685; Fax +34968279835; [email protected]