Associations of sleep-related outcomes with behavioral and emotional functioning in children with overweight/obesity

Objective To evaluate the associations of parent-reported sleep-disordered breathing (SDB) and deviceassessed sleep behaviors with behavioral and emotional functioning in pediatric patients with overweight/ obesity. Study design A total of 109 children with overweight/obesity (mean age, 10.0 (±) 1.1 years) were included in this cross-sectional study. We used the Spanish version of the Pediatric Sleep Questionnaire (PSQ) to assess SDB and its subscales (ie, snoring, daytime sleepiness, and inattention/hyperactivity). Device-assessed sleep behaviors (ie, wake time, sleep onset time, total time in bed, total sleep time, and waking after sleep onset) were estimated using wrist-worn accelerometers. We used the Behavior Assessment System for Children, second edition to assess behavioral and emotional functioning (ie, clinical scale: aggressiveness, hyperactivity, behavior problems, attention problems, atypicality, depression, anxiety, retreat, and somatization; adaptive scale: adaptability, social skills, and leadership). Results SDB was positively associated with all clinical scale variables (all b > 0.197, P ≤ .041) and with lower adaptability and leadership (all b 0.196, P ≤ .045) and lower adaptability (b = 0.246, P = .011). The inattention/hyperactivity subscale was significantly associated with the entire clinical and adaptive scales (all b > |0.192|, P ≤ .046) except for somatization. The snoring subscale and device-assessed sleep behaviors were not related to any behavioral or emotional functioning variables. Conclusions Our study suggests that SDB symptoms, but not deviceassessed sleep behaviors, are associated with behavioral and emotional functioning in children with overweight/obesity. Specifically, daytime sleepiness, a potential SDB symptom, was related to higher attention problems, depression, anxiety, and retreat and lower adaptability. (J Pediatr 2022;246:170-8).The ActiveBrains project was funded by the Spanish Ministry of Economy and Competitiveness and the Fondo Europeo de Desarrollo Regional (DEP2013-47540, DEP2016-79512-R, DEP2017-91544-EXP, and RYC-2011-09011). L.V.T.-L. is supported by a grant from the Spanish Ministry of Science, Innovation and Universities (FPU17/04802). C.C.-S. is supported by the Spanish Ministry of Science and Innovation (FJC2018-037925-I). J.H.M. is supported by a grant from the Spanish Ministry of Education, Culture, and Sport (FPU15/02645). Additional support was provided by the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence, Scientific Excellence Unit on Exercise and Health, by the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades, and European Regional Development Fund (SOMM17/6107/UGR). Funding was also provided by the SAMID III network, RETICS , funded by the PNI + D + I 2017-2021 (Spain), ISCIII Sub-Directorate General for Research Assessment and Promotion, the European Regional Development Fund (RD16/0022 ), the EXERNET Research Network on Exercise and Health ( DEP2005-00046/ACTI ; 09/UPB/19; 45/UPB/20; 27/UPB/21), the European Union's 2020 Research and Innovation Program under Grant Agreement 667302, and the HL-PIVOT network Healthy Living for Pandemic Event Protection . Additional funding was obtained from the Andalusian Operational Programme supported with European Regional Development Fund (project B-CTS-355-UGR18)

Does sleep‑disordered breathing add to impairments in academic performance and brain structure usually observed in children with overweight/obesity?

Funding for open access charge: Universidad de Granada/CBUA. This work is part of a PhD thesis conducted in the Official Doctoral Programme in Biomedicine of the University of Granada, Spain. Preliminary data from this manuscript has been presented previously in The International Society of Behavioral Nutrition and Physical Activity (ISBNPA) Xchange 2021 Annual Meeting. The ActiveBrains project was funded by the Spanish Ministry of Economy and Competitiveness and the "Fondo Europeo de Desarrollo Regional (FEDER)" (DEP201347540, DEP2016-79512-R, DEP2017-91544-EXP and RYC-201109011). L.V.T.-L. is supported by a Grant from the Spanish Ministry of Science, Innovation and Universities (FPU17/04802). J.H.M. is supported by a Grant from the Spanish Ministry of Education, Culture and Sport (FPU15/02645). C.C.-S. is supported by the Spanish Ministry of Science and Innovation (FJC2018-037925-I). IEC is supported by the Spanish Ministry of Science and Innovation (RYC2019-027287-I). Additional support was obtained from the University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence, Scientific Excellence Unit on Exercise and Health (UCEES), by the Junta de Andalucia, Consejeria de Conocimiento, Investigacion y Universidades, and European Regional Development Funds (ref. SOMM17/6107/UGR). In addition, funding was provided by the SAMID III network, RETICS, funded by the PNI + D + I 2017-2021 (Spain), ISCIII-Sub-Directorate General for Research Assessment and Promotion, the European Regional Development Fund (ERDF) (Ref. RD16/0022), the EXERNET Research Network on Exercise and Health (DEP2005-00046/ACTI; 09/UPB/19; 45/UPB/20; 27/UPB/21), the European Union's 2020 research and innovation program under grant agreement No.667302, and the HL-PIVOT network-Healthy Living for Pandemic Event Protection. Additional funding was obtained from the Andalusian Operational Programme supported with European Regional Development Funds (ERDF in English, FEDER in Spanish, project ref: B-CTS-355-UGR18).Approximately 4–11% of children suffer from sleep-disordered breathing (SDB), and children with obesity are at increased risk. Both obesity and SDB have been separately associated with poorer brain health, yet whether SDB severity affects brain health in children with obesity remains unanswered. This study aimed to examine associations of SDB severity with academic performance and brain structure (i.e., total brain and gray and white matter volumes and gray matter volume in the hippocampus) in children with overweight/obesity. One hundred nine children aged 8–12 years with overweight/obesity were included. SDB severity and its subscales (i.e., snoring, daytime sleepiness, and inattention/hyperactivity) were evaluated via the Pediatric Sleep Questionnaire (PSQ), and academic performance was evaluated with the Woodcock-Muñoz standardized test and school grades. Brain structure was assessed by magnetic resonance imaging. SDB severity was not associated with academic performance measured by the standardized test (all |β|> 0.160, P > 0.076), yet it was associated with the school grade point average (β = -0.226, P = 0.007) and natural and social science grades (β = -0.269, P = 0.024). Intention/hyperactivity seemed to drive these associations. No associations were found between SDB severity and the remaining school grades (all β 0.065) or brain volumes (all P > 0.05). Conclusion: Our study shows that SDB severity was associated with lower school grades, yet it was not associated with the standardized measurement of academic performance or with brain volumes in children with overweight/obesity. SDB severity may add to academic problems in children beyond the effects contributed by overweight/obesity status alone.Universidad de Granada/CBUASpanish Government European CommissionSpanish Government DEP201347540 DEP2016-79512-R DEP2017-91544-EXP RYC-201109011Spanish Government FPU17/04802 FPU15/02645 FJC2018-037925-I RYC2019-027287-IUniversity of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence, Scientific Excellence Unit on Exercise and Health (UCEES)Junta de Andalucia European Commission SOMM17/6107/UGRSAMID III network, RETICS - PNI + D + I 2017-2021 (Spain)ISCIII-Sub-Directorate General for Research Assessment and PromotionEuropean Commission RD16/0022EXERNET Research Network on Exercise and Health DEP2005-00046/ACTI 09/UPB/19 45/UPB/20 27/UPB/21European Commission 667302HL-PIVOT network-Healthy Living for Pandemic Event ProtectionAndalusian Operational ProgrammeEuropean Regional Development Funds (ERDF in English, FEDER in Spanish) B-CTS-355-UGR1

Effects of an exercise program on cardiometabolic and mental health in children with overweight or obesity: a secondary analysis of a randomized clinical trial

Importance: Childhood obesity is a risk factor associated with type 2 diabetes, cardiovascular disease, and mental disorders later in life. Investigation of the parallel effects of a defined exercise program on cardiometabolic and mental health in children with overweight or obesity may provide new insights on the potential benefits of exercise on overall health. Objective: To investigate the effects of a 20-week exercise program on cardiometabolic and mental health in children with overweight or obesity. Design, Setting, and Participants: This secondary analysis of a parallel-group randomized clinical trial was conducted in Granada, Spain, from November 1, 2014, to June 30, 2016. Data analyses were performed between February 1, 2020, and July 14, 2022. Children with overweight or obesity aged 8 to 11 years were eligible, and the study was performed in an out-of-school context. Intervention: The exercise program included 3 to 5 sessions/wk (90 min/session) of aerobic plus resistance training for 20 weeks. The wait-list control group continued with their usual routines. Main Outcomes and Measures: Cardiometabolic outcomes as specified in the trial protocol included body composition (fat mass, fat-free mass, and visceral adipose tissue), physical fitness (cardiorespiratory, speed-agility, and muscular), and traditional risk factors (waist circumference, blood lipid levels, glucose levels, insulin levels, and blood pressure). Cardiometabolic risk score (z score) was calculated based on age and sex reference values for levels of triglycerides, inverted high-density lipoprotein cholesterol, and glucose, the mean of systolic and diastolic blood pressure, and waist circumference. An additional cardiometabolic risk score also included cardiorespiratory fitness. Mental health outcomes included an array of psychological well-being and ill-being indicators. Results: The 92 participants included in the per-protocol analyses (36 girls [39%] and 56 boys [61%]) had a mean (SD) age of 10.0 (1.1) years. The exercise program reduced the cardiometabolic risk score by approximately 0.38 (95% CI, -0.74 to -0.02) SDs; decreased low-density lipoprotein cholesterol level by -7.00 (95% CI, -14.27 to 0.37) mg/dL (to convert to mmol/L, multiply by 0.0259), body mass index (calculated as weight in kilograms divided by height in meters squared) by -0.59 (95% CI, -1.06 to -0.12), fat mass index by -0.67 (95% CI, -1.01 to -0.33), and visceral adipose tissue by -31.44 (95% CI, -58.99 to -3.90) g; and improved cardiorespiratory fitness by 2.75 (95% CI, 0.22-5.28) laps in the exercise group compared with the control group. No effects were observed on mental health outcomes. Conclusions and Relevance: In this secondary analysis of a randomized clinical trial, an aerobic plus resistance exercise program improved cardiometabolic health in children with overweight or obesity but had no effect on mental health. Trial Registration: ClinicalTrials.gov Identifier: NCT02295072.This project was supported with grants DEP2013-47540, DEP2016-79512-R, DEP2017-91544-EXP, and RYC-2011-09011 from the Spanish Ministry of Economy and Competitiveness and the Fondo Europeo de Desarrollo Regional (FEDER) and by grant PID2020-120249RB-I00 from the MCIN/AEI /10.13039/501100011033. Additional funding was obtained from the Andalusian Operational Programme supported with grant B-CTS-355-UGR18 from the European Regional Development Fund (FEDER in Spanish). Dr Cardenas-Sanchez is supported by grant FJC2018-037925-I from the Spanish Ministry of Science and Innovation and by a grant from the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska Curie grant agreement No 101028929. Dr Migueles is supported by grant FPU15/02645 from the Spanish Ministry of Education, Culture and Sport, and grant 2012–00036 from the Swedish Research Council for Health, Working Life and Welfare. Dr Torres-Lopez is supported by grant FPU17/04802 from the Spanish Ministry of Science, Innovation and Universities. Dr Rodriquez-Ayllon was funded by grant DEP2017-91544-EXP from the Ramón Areces Foundation. Additional support was obtained from grant ALICIAK-2018 from the Alicia Koplowitz Foundation, University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence, Unit of Excellence on Exercise, Nutrition and Health, the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades; and grant DEP2005-00046/ACTI from the EXERNET Research Network on Exercise and Health in Special Populations. This research was supported by grant CB22/03/00058 from the Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea–European Regional Development Fund

First observation of the B+→Ds+Ds−K+B^+ \rightarrow D_s^+ D_s^- K^+ decay

The $B^+ \rightarrow D_s^+ D_s^- K^+$ decay is observed for the first time using proton-proton collision data collected by the LHCb detector at centre-of-mass energies of $7$, $8$ and $13\, \text{TeV}$, corresponding to an integrated luminosity of $9\,\text{fb}^{-1}$. Its branching fraction relative to that of the $B^{+} \rightarrow D^{+} D^{-} K^{+}$ decay is measured to be $$\frac{B\left(B^{+} \rightarrow D_s^{+} D_s^{-} K^{+}\right)}{B\left(B^{+} \rightarrow D^{+} D^{-} K^{+}\right)}=0.525 \pm 0.033 \pm 0.027 \pm 0.034,$$ where the first uncertainty is statistical, the second systematic, and the third is due to the uncertainties on the branching fractions of the $D_s^{\pm} \rightarrow K^{\mp} K^{\pm} \pi^{\pm}$ and $D^{\pm} \rightarrow K^{\mp} \pi^{\pm} \pi^{\pm}$ decays. This measurement fills an experimental gap in the knowledge of the family of Cabibbo$-$favoured $\bar{b} \rightarrow \bar{c} c \bar{s}$ transitions and opens the path for unique studies of spectroscopy in future.Comment: All figures and tables, along with machine-readable versions and any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-019.html (LHCb public pages

Study of charmonium decays to KS0KπK^0_S K \pi in the B→(KS0Kπ)KB \to (K^0_S K \pi) K channels

A study of the $B^+\to K^0_SK^+K^-\pi^+$ and $B^+\to K^0_SK^+K^+\pi^-$ decays is performed using proton-proton collisions at center-of-mass energies of 7, 8 and 13 TeV at the LHCb experiment. The $K^0_SK \pi$ invariant mass spectra from both decay modes reveal a rich content of charmonium resonances. New precise measurements of the $\eta_c$ and $\eta_c(2S)$ resonance parameters are performed and branching fraction measurements are obtained for $B^+$ decays to $\eta_c$, $J/\psi$, $\eta_c(2S)$ and $\chi_{c1}$ resonances. In particular, the first observation and branching fraction measurement of $B^+ \to \chi_{c0} K^0 \pi^+$ is reported as well as first measurements of the $B^+\to K^0K^+K^-\pi^+$ and $B^+\to K^0K^+K^+\pi^-$ branching fractions. Dalitz plot analyses of $\eta_c \to K^0_SK\pi$ and $\eta_c(2S) \to K^0_SK\pi$ decays are performed. A new measurement of the amplitude and phase of the $K \pi$ $S$-wave as functions of the $K \pi$ mass is performed, together with measurements of the $K^*_0(1430)$, $K^*_0(1950)$ and $a_0(1700)$ parameters. Finally, the branching fractions of $\chi_{c1}$ decays to $K^*$ resonances are also measured.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-051.html (LHCb public pages

Observation of the Bs0 ⁣→D∗+D∗−B^0_s\!\to D^{*+}D^{*-} decay

The first observation of the $B^0_s\!\to D^{*+}D^{*-}$ decay and the measurement of its branching ratio relative to the $B^0\!\to D^{*+}D^{*-}$ decay are presented. The data sample used corresponds to an integrated luminosity of 9$\,\text{fb}^{-1}$ of proton-proton collisions recorded by the LHCb experiment at centre-of-mass energies of 7, 8 and 13$\,\text{TeV}$ between 2011 and 2018. The decay is observed with a very high significance and the ratio of branching fractions is determined to be \begin{align*} \frac{\mathcal{B}(B^0_s\!\to D^{*+}D^{*-})}{\mathcal{B}(B^0\!\to D^{*+}D^{*-})} = 0.269 \pm 0.032 \pm 0.011 \pm 0.008\, , \end{align*} where the first uncertainty is statistical, the second systematic and the third due to the uncertainty of the fragmentation fraction ratio $f_s/f_d$. The $B^0_s\!\to D^{*+}D^{*-}$ branching fraction is calculated to be \begin{align*} \mathcal{B}(B^0_s\!\to D^{*+}D^{*-}) = (2.15 \pm 0.26 \pm 0.09 \pm 0.06 \pm 0.16)\times 10^{-4} \,, \end{align*} where the fourth uncertainty is due to the $B^0\!\to D^{*+}D^{*-}$ branching fraction.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-023.html (LHCb public pages

Measurement of the CKM angle γ\gamma in the B0→DK∗0B^0 \to DK^{*0} channel using self-conjugate D→KS0h+h−D \to K_S^0 h^+ h^- decays

A model-independent study of CP violation in $B^0 \to DK^{*0}$ decays is presented using data corresponding to an integrated luminosity of 9fb$^{-1}$ collected by the LHCb experiment at centre-of-mass energies of $\sqrt{s}=7, \, 8$ and $13$TeV. The CKM angle $\gamma$ is determined by examining the distributions of signal decays in phase-space bins of the self-conjugate $D \to K_S^0 h^+ h^-$ decays, where $h = \pi, K$. Observables related to CP violation are measured and the angle $\gamma$ is determined to be $\gamma=(49^{+ 23}_{-18})^\circ$. Measurements of the amplitude ratio and strong-phase difference between the favoured and suppressed $B^0$ decays are also presented.Comment: All figures and tables, along with machine-readable versions and any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2023-009.html (LHCb public pages

Search for CPCP violation in the phase space of D0→π−π+π0D^0 \to \pi^-\pi^+\pi^0 decays with the energy test

A search for $CP$ violation in $D^0 \to \pi^-\pi^+\pi^0$ decays is reported, using $pp$ collision data collected by the LHCb experiment from 2015 to 2018 corresponding to an integrated luminosity of 6$fb^{-1}$. An unbinned model-independent approach provides sensitivity to local $CP$ violation within the two-dimensional phase space of the decay. The method is validated using the Cabibbo-favoured channel \D^0 \to \K^-\pi^+\pi^0 and background regions of the signal mode. The results are consistent with $CP$ symmetry in this decay.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2023-005.html (LHCb public pages

Measurement of lepton universality parameters in B+→K+ℓ+ℓ−B^+\to K^+\ell^+\ell^- and B0→K∗0ℓ+ℓ−B^0\to K^{*0}\ell^+\ell^- decays

A simultaneous analysis of the $B^+\to K^+\ell^+\ell^-$ and $B^0\to K^{*0}\ell^+\ell^-$ decays is performed to test muon-electron universality in two ranges of the square of the dilepton invariant mass, $q^2$. The measurement uses a sample of beauty meson decays produced in proton-proton collisions collected with the LHCb detector between 2011 and 2018, corresponding to an integrated luminosity of $9$ $\text{fb}^{-1}$. A sequence of multivariate selections and strict particle identification requirements produce a higher signal purity and a better statistical sensitivity per unit luminosity than previous LHCb lepton universality tests using the same decay modes. Residual backgrounds due to misidentified hadronic decays are studied using data and included in the fit model. Each of the four lepton universality measurements reported is either the first in the given $q^2$ interval or supersedes previous LHCb measurements. The results are compatible with the predictions of the Standard Model.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-045.html (LHCb public pages

First observation and branching fraction measurement of the Λb0→Ds−p\Lambda_b^0\to D_s^- p decay

The first observation of the $\Lambda_b^0\to D_s^- p$ decay is presented using proton-proton collision data collected by the LHCb experiment at a centre-of-mass energy of ${\sqrt{s}=13 \,\textrm{TeV}}$, corresponding to a total integrated luminosity of $6\,\textrm{fb}^{-1}$. Using the $\Lambda_b^0\to\Lambda_c^+\pi^-$ decay as the normalisation mode, the branching fraction of the $\Lambda_b^0\to D_s^- p$ decay is measured to be ${\mathcal{B}(\Lambda_b^0\to D_s^- p)=(12.6 \pm 0.5 \pm 0.3 \pm 1.2 )\times 10^{-6}}$, where the first uncertainty is statistical, the second systematic and the third due to uncertainties in the branching fractions of the $\Lambda_b^0\to\Lambda_c^+\pi^-$, $D_s^- \to K^-K^+\pi^-$ and $\Lambda_c^+\to p K^- \pi^+$ decays.Comment: All figures and tables, along with any supplementary material and additional information, are available at https://cern.ch/lhcbproject/Publications/p/LHCb-PAPER-2022-038.html (LHCb public pages