Strategies for controlling hypertension include reducing excess fat and increasing muscle mass. However, the effects of exercise interventions on hypertension in adolescents have been little investigated. The purpose was to evaluate the effect of 12 weeks of aerobic exercise on systolic blood pressure (SBP) and diastolic blood pressure (DBP) and the cardiometabolic profile of overweight hypertensive and non-hypertensive boys. The sample included 107 boys diagnosed as overweight, aged between 12 and 17, divided into two non-hypertension groups, one control (GCN, n = 14) and one with exercise (GEN, n = 55), as well as two groups of hypertensives, one control (GCH, n = 12) and one with exercise (GEH, n = 26). The boys were assessed at the study baseline and after 12 weeks in terms of anthropometric parameters, biological maturation, SBP, DBP and mean blood pressure (MBP), lipid, and metabolic profile. The aerobic training programs lasted 12 weeks and were carried out in three weekly sessions at different intensities. The high-intensity interval training session lasted around 35 min at an intensity of 80-100% of the reserve heart rate, and the moderate-intensity of continuous training session lasted 60 min at an intensity of 35-75% of the reserve heart rate. Caloric expenditure was equivalent between the exercises (p = 0.388). CGN and CGH participated only in school physical activities. Repeated measures analysis of variance and clinical effect analysis using Cohen\'s effect size were used, with a significance level established at p < 0.05. After 12 weeks, all groups increased their height (p < 0.05), but only the exercise groups showed a reduction in anthropometric variables (p < 0.05), with a possibly beneficial effect in GEN (d =  - 0.203; p = 0.003). No differences were found in the variables for the GCN. The GCH and GEH groups reduced SBP (p < 0.05), but only GEH showed a reduction in DBP (p = 0.005) and MBP (p = 0.001). In relation to the lipid profile, GEH maintained HDL-c close to baseline values, while GCH showed a reduction in HDL-c (p = 0.021). Regarding the clinical effect of exercise on hypertension, GEH showed a large and very beneficial effect size on DBP (d =  - 0.916; p = 0.006) and MBP (d =  - 0.926; p = 0.005).Conclusion: Hypertensive boys who practiced physical exercise showed greater effects in reducing blood pressure, indicating the importance of non-drug therapeutic management in overweight adolescents.Trial registration:Brazilian Registry of Clinical Trials RBR-4v6h7b / RBR-6343y7.

UNASSIGNED: Ferritin has been implicated in body physiology and pathology. Smoking cigarettes (Cg) alters ferritin metabolism. Waterpipe (Wp) smoking has recently reemerged as a global epidemic and is linked to the most devastating diseases. However, the effect of smoking Wp on ferritin is not known. Therefore, the current study compared plasma ferritin in adolescents smoking Cg, Wp, both (CgWp) versus never smoked.
UNASSIGNED: Self-reported smoking status and plasma ferritin levels were obtained from 849 boys (n = 470) and girls (n = 379) in the 7th-10th grade (age range = 13-17 years).
UNASSIGNED: The ANCOVA revealed a main effect for gender (p < 0.000) and smoking status (p < 0.02) without an interaction effect (p > 0.9). Post-hoc analysis showed greater plasma ferritin in the adolescents smoking Wp (p < 0.03) and CgWp (p < 0.004) versus never smoked. Gender-stratified ANCOVA showed a main effect for smoking status in the boys (p < 0.02) and girls (p < 0.03). Additional comparisons among the boys showed greater plasma ferritin in the Wp (p < 0.006) and CgWp (p < 0.008) smoking groups versus never smoking, without differences (p > 0.5) between Wp and CgWp smoking. Another subgroup comparison showed greater plasma ferritin in the girls smoking Cg (p < 0.02) and CgWp (p < 0.02) versus never smoking, without a difference (p > 0.3) between Cg and CgWp smoking.
UNASSIGNED: The results indicate that ferritin is elevated in adolescent smokers, particularly the boys smoking Wp and CgWp and in the girls smoking Cg and CgWp.

Historically, eating disorders (EDs) have been conceptualized from a female-centric lens. However, consistent research demonstrates that EDs afflict individuals across the gender spectrum, including cismales and gender-diverse individuals. Despite this evidence, a consensus regarding gender-sensitive assessment practices, theoretical formulations, and treatment considerations has yet to be established. The present review briefly summarizes research to date on the presentation of EDs in cismales and gender-diverse individuals, suggests appropriate assessment and treatment practices, and offers recommendations for gender-inclusive ED treatment. To effectively serve patients with EDs across the gender spectrum, more research is needed to validate gender-sensitive assessment tools, comprehensively study ED pathology within gender-representative samples, and conduct randomized controlled trials that serve cismales and gender-diverse patients. In doing so, clinicians and researchers may better detect EDs across the gender spectrum and implement gender-appropriate, evidence-based interventions, thereby reducing impairment and mortality related to EDs for all patients.

BACKGROUND: Mental health problems among adolescents is a global challenge. During the transition to adolescence, physiological, psychological, and social changes occur, leading to increased vulnerability. Thus, adolescent boys are less likely to seek help for mental health problems, which makes them an undetected group. The aim of this study was to gain a deeper understanding of adolescent boys\' experiences of mental health and school health service.
METHODS: An inductive, qualitative design was chosen using three focus group interviews and three individual interviews. The study included 18 adolescent boys in 7th grade, in a school located in a medium-sized municipality in Norway. The interviews were analysed with qualitative content analysis. The consolidated criteria for reporting qualitative research (COREQ) were followed in this study.
RESULTS: The overall theme \"barriers towards seeking help\", and three categories- navigating stigma and privacy concerns; perceptions of self-responsibility; and lacking knowledge of mental health problems and help-seeking-described the adolescent boys experiences. The awareness and willingness to seek help were present, but there are barriers preventing the adolescent boys from acting on that willingness.
CONCLUSIONS: Lack of knowledge and a non-permissive culture for mental health problems among adolescents contributes to decreased help-seeking behaviour among adolescent boys. The school health service is the most related health service for adolescents and should focus on being available and strengthening empowerment and mental health literacy through the development and implementation of interventions to promote mental health.

BACKGROUND: Refeeding syndrome is the gravest possible medical complication in malnourished patients undergoing refeeding in the hospital. We previously reported that males with malnutrition secondary to eating disorders required more calories and had longer hospital stays than females; however, sex differences in electrolyte abnormalities indicating refeeding syndrome risk remain unknown. The objective of this study was to assess differences in electrolyte abnormalities indicating refeeding syndrome risk among male and female adolescents and young adults with eating disorders hospitalized for medical instability.
METHODS: We retrospectively reviewed the electronic medical records of 558 patients aged 9-25 years admitted to the University of California, San Francisco Eating Disorders Program for medical instability between May 2012 and August 2020. Serum was drawn per standard of care between 5 and 7 am each morning and electrolyte abnormalities indicating refeeding syndrome risk were defined as: hypophosphatemia (< 3.0 mg/dL), hypokalemia (< 3.5 mEq/L), and hypomagnesemia (< 1.8 mg/dL). Logistic regression was used to assess factors associated with electrolyte abnormalities indicating refeeding syndrome risk.
RESULTS: Participants included 86 (15.4%) males and 472 (84.6%) females, mean (SD) age 15.5 (2.8) years. Rates of refeeding hypophosphatemia (3.5%), hypokalemia (8.1%), and hypomagnesemia (11.6%) in males hospitalized with eating disorders were low, with no statistically significant differences from females. Older age was associated with higher odds of refeeding hypophosphatemia and hypomagnesemia. Lower percent median body mass index and greater weight suppression at admission were associated with higher odds of refeeding hypophosphatemia.
CONCLUSIONS: Rates of electrolyte abnormalities indicating refeeding syndrome risk were low in males hospitalized for eating disorders and rates did not significantly differ from females. Together with our finding that males have higher caloric requirements and longer hospital length of stay, the finding that electrolyte abnormalities indicating refeeding syndrome risk were not greater in males than females supports future research to evaluate the safety and efficacy of higher calorie and/or faster advancing refeeding protocols for males.

The purpose of this study was to investigate the influence of biological sex, independent of differences in aerobic fitness and body fatness, on the change in gastrointestinal temperature (ΔTgi) and whole body sweat rate (WBSR) of children exercising under uncompensable heat stress. Seventeen boys (means ± SD; 13.7 ± 1.3 yr) and 18 girls (13.7 ± 1.4 yr) walked for 45 min at a fixed rate of metabolic heat production per kg body mass (8 W·kg-1) in 40°C and 30% relative humidity. Sex and peak oxygen consumption (V̇o2peak) were entered into a Bayesian hierarchical general additive model (HGAM) for Tgi. Sex, V̇o2peak, and the evaporative requirement for heat balance (Ereq) were entered into a Bayesian hierarchical linear regression for WBSR. For 26 (12 M and 14 F) of the 35 children with measured body composition, body fat percentage was entered in a separate HGAM and hierarchical linear regression for Tgi and WBSR, respectively. Conditional on sex-specific mean V̇o2peak, ΔTgi was 1.00°C [90% credible intervals (Crl): 0.84, 1.16] for boys and 1.17°C [1.01, 1.33] for girls, with a difference of 0.17°C [-0.39, 0.06]. When sex differences in V̇o2peak were accounted for, the difference in ΔTgi between boys and girls was 0.01°C [-0.25, 0.22]. The difference in WBSR between boys and girls was 0.03 L·h-1 [-0.02, 0.07], when isolated from differences in Ereq. The difference in ΔTgi between boys and girls was -0.10°C [-0.38, 0.17] when sex differences in body fat (%) were accounted for. Biological sex did not independently influence the ΔTgi and WBSR of children exercising under uncompensable heat stress.NEW & NOTEWORTHY Limited studies have investigated the thermoregulatory responses of boys and girls exercising under uncompensable heat stress. Boys and girls often differ in physiological characteristics other than biological sex, such as aerobic fitness and body fat percentage, which may confound interpretations. We investigated the influence of biological sex on exercise thermoregulation in children, independent of differences in aerobic fitness and body fatness.

Introduction: Histological data on muscle fiber size and proportion in (very) young typically developing (TD) children is not well documented and data on capillarization and satellite cell content are also lacking. Aims: This study investigated the microscopic properties of the medial gastrocnemius muscle in growing TD children, grouped according to age and gender to provide normal reference values in healthy children. Methods: Microbiopsies of the medial gastrocnemius (MG) muscle were collected in 46 TD boys and girls aged 2-10 years subdivided into 4 age groups (2-4, 4-6, 6-8 and 8-10 years). Sections were immunostained to assess fiber type cross-sectional area (fCSA) and proportion, the number of satellite cells (SC), capillary to fiber ratio (C/F), capillary density for type I and II fiber (CFD), capillary domain, capillary-to-fiber perimeter exchange index (CFPE) and heterogeneity index. fCSA was normalized to fibula length2 and the coefficient of variation (CV) was calculated to reflect fCSA intrasubject variability. Results: Absolute fCSA of all fibers increased with age (r = 0.72, p < 0.001) but more in boys (+112%, p < 0.05) than in girls (+48%, p > 0.05) Normalized fCSA, CV and fiber proportion did not differ between age groups and gender. C/F was strongly correlated with age in boys (r = 0.83, p < 0.001), and to a lesser extent in girls (r = 0.37, p = 0.115), while other capillary parameters as well as the number of SC remained stable with increasing age in boys and girls. Discussion: This study provides reference values of histological measures in MG according to age in normally growing boys and girls. These data may be used as a reference to determine disease impact and efficacy of therapeutic approach on the muscle.

BACKGROUND: Central precocious puberty (CPP) is a prevalent endocrine disorder. Research has indicated that pubertal development is linked to nutritional metabolism. Irisin, a novel myokine/adipokine, has been identified as a potential predictor of CPP in girls. This study aims to examine the relationship between serum irisin levels and CPP in boys.
METHODS: An enzyme-linked immunosorbent assay (ELISA) was used to measure serum irisin levels in 32 boys diagnosed with CPP and 33 prepubertal age-matched boys as normal controls (NC). To assess the impact of body mass index (BMI) on irisin levels, both the CPP and NC groups were divided into overweight/obese and normal-weight subgroups. Spearman correlation analysis was employed to assess the connection between irisin and clinical and biochemical parameters. Additionally, a receiver operating characteristic curve was utilised to determine the optimal threshold value for irisin.
RESULTS: In the normal-weight subgroups, boys with CPP exhibited elevated irisin levels compared to controls, but not in the overweight/obese subgroups. The optimal cut-off value for irisin levels to predict CPP in the normal-weight groups was 93.09 ng/mL, yielding a sensitivity of 47.6% and a specificity of 100%. Furthermore, a positive correlation was noted between irisin levels and bone age (BA), bone age advancement (BA-CA), and BMI.
CONCLUSIONS: Serum irisin levels correlate with BMI and pubertal development. Given its limited sensitivity, irisin level can only be utilised as a supplementary rather than a standalone diagnostic indicator for CPP.

UNASSIGNED: In Iran, ocular injuries sustained at home are a growing public health issue, and few studies have explored their prevalence and the frequencies of different causes of these injuries. We investigated the features of ocular injuries at home among children and adolescents (aged < 18 years), adults (18 - 64 years), and the elderly ( ≥ 65 years) in five metropolitan cities.
UNASSIGNED: In this cross-sectional study, we recruited individuals with ocular injuries sustained at home who presented to 12 public/teaching hospitals in five metropolitan cities during a 5-month period. Using clinical records within the emergency department archives, we collected the following data: age, sex, frequency of injuries requiring hospital admission or surgical intervention, and causes of eye injuries, documented as 1) cleaning products, 2) chemical products, 3) kitchen items, 4) cooking activities, 5) toys, 6) falls from height, 7) sports equipment, 8) penetrating or cutting, 9) abrasions, 10) foreign bodies, and 11) direct blows by other individuals.
UNASSIGNED: Of 5008 participants from the five cities, 74% (n = 3711) were male and 26% (n = 1297) were female. The most frequent causes of injury among children and adolescents, adults, and the elderly were toys, kitchen items, and cooking activities, respectively. In children and adolescents, injuries were caused by kitchen items, toys, foreign bodies, and direct blows by other individuals more frequently than in adults or the elderly, and by cleaning products and abrasions more frequently than in the elderly (all P < 0.05). In adults, injuries were caused by cleaning products, cooking activities, falls from height, sports equipment, penetrating or cutting, and abrasions more frequently than in children and adolescents or the elderly (all P < 0.05), and by kitchen items, toys, and blows by other individuals more frequently than in the elderly (all P < 0.05). In the elderly, injuries were caused by chemical products more frequently than in children and adolescents or adults, and by cooking activities, falls from height, and sports equipment more frequently than in children and adolescents (all P < 0.05). In adults, the frequency of ocular injuries was significantly higher in Tehran and lower in Mashhad when comparing each with that of the other four cities (all P < 0.05). We found a significantly higher frequency of ocular injuries by cleaning and chemical products in Tehran, by toys in Shiraz, by falls from height in Isfahan, and by direct blows by other individuals in Ahvaz when comparing each to that of the other four cities (all P < 0.05). Regarding the prevalence of severe ocular injuries among the children/adolescent and adult age groups, conditions were relatively better in Shiraz and relatively unfavorable in Mashhad.
UNASSIGNED: Ocular trauma was more common in male individuals and the younger age groups. Approximately half of the causes were kitchen items, toys, and foreign bodies, which are avoidable by enhancing public eye health awareness. The prevalence of severe ocular injuries in individuals aged < 18 years was high, highlighting the necessity of nationwide preventive strategies for pediatric ocular injuries.

OBJECTIVE: To investigate the effects of polycyclic aromatic hydrocarbons(PAHs) on puberty in boys.
METHODS: 695 subjects were selected from four primary schools in Chongqing, China. 675 urine samples from these boys were collected four PAH metabolites: 1-hydroxypyrene, 2-hydroxynaphthoic, 2-hydroxyfluorene, and 9-hydroxyphenanthrene. Pubertal development of 695 boys was assessed at follow-up visits starting in December 2015 and occurring every six months thereafter until now, data used in this article ending in June 2021. A total of 12 follow-up visits were performed. Cox proportional hazards regression models were used to analyze the relationship between PAH metabolite concentrations and indicators of pubertal timing.
RESULTS: The mean age at puberty onset of testicular volume, facial hair, pubic hair, first ejaculation, and axillary hair in boys was 11.66, 12.43, 12.51, 12.72 and 13.70 years, respectively. Cox proportional hazards regression models showed that boys with moderate level of 1-OHPyr exposure was associated with earlier testicular development (hazard ratio [HR] = 1.276, 95% confidence interval [CI]: 1.006-1.619), with moderate level of 2-OHNap were at higher risk of early testicular development (HR = 1.273, 95% CI: 1.002-1.617) and early axillary hair development (HR = 1.355, 95% CI: 1.040-1.764), with moderate level of 2-OHFlu was associated with earlier pubic hair development (HR = 1.256, 95% CI: 1.001-1.577), with high level of 9-OHPhe were at higher risk of early fisrt ejaculation (HR = 1.333, 95% CI: 1.005-1.767) and early facial hair development (HR = 1.393, 95% CI: 1.059-1.831).
CONCLUSIONS: Prepubertal exposure to PAHs may be associated with earlier pubertal development in boys.