The primary benign cardiac tumors are the predominant pediatric cardiac tumors, of which rhabdomyoma, fibroma, and myxoma are the most common types. If severe symptoms are nonexistent and the hemodynamics is unaffected, most of the patients can survive in the long term despite the tumors. What is known: • Pediatric cardiac tumors are rare and are predominantly primary and benign. • The symptoms of heart failure, arrhythmia, and outflow obstruction are the most severe complications of cardiac tumors. What is new: • The rhabdomyoma, fibroma, and myxoma are the most common types of primary benign cardiac tumors. • If severe symptoms are not present and the hemodynamics are unaffected, most of the patients can survive in the long term despite the tumors.

Apelin has been reported to be associated with multiple physiological processes in the cardiovascular system. The aim of the present study was to investigate the effects of Apelin-13 administration on cardiac function, hyperglycemia, insulin resistance (IR), dyslipidemia, endothelial function, inflammation and glucose metabolism in type 2 diabetic Goto-Kakizaki (GK) rats, and compare the protective effects of Apelin-13 with metformin or atorvastatin. In the present study, type 2 diabetes was induced in male Goto-Kakizaki (GK) rats fed with high-fat diet (HFD). Simultaneously, the rats were treated with metformin (350 mg/kg/d, by gavage), atorvastatin (50 mg/kg/d, by gavage) or Apelin-13 (200 µg/kg/d, intraperitoneal injection) once daily for 4 consecutive weeks. Hemodynamic parameters were examined by RM6240BD multi-channel physiological signal monitoring. Fasting plasma glucose (FPG), fasting insulin (FINS), homeostasis model assessment for insulin resistance (HOMA-IR), total cholesterol (TC), triglyceride (TG), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), endothelin-1 (ET-1), nitric oxide (NO), constitutive nitric oxide synthase (cNOS) activity, tumor necrosis factor-α (TNF-α), leptin and Apelin-12 levels were measured. Western blotting was performed to determine the levels of Apelin-12, glucose transporter 4 (GLUT4) and phosphorylated (p)-5'adenosine monophosphate-activated protein kinase (AMPK) α2. It was demonstrated that Apelin-13 decreased heart rate, left ventricular end-diastolic pressure, FPG, FINS, HOMA-IR, TC, TG, LDL-C, ET-1, TNF-α and leptin, whereas it increased the rise and fall of maximum rate of left ventricular pressure, HDL-C, NO, cNOS activity and Apelin-12 compared with the GK-HFD group. In addition, GLUT4 and p-AMPKα2 levels in myocardial tissues were elevated by administration of Apelin-13. This protective effect of Apelin-13 was comparable to that of metformin or atorvastatin. Overall, the present study demonstrated that administration ofApelin-13 may be a promising therapeutic agent for the treatment of type 2 diabetes and metabolic syndrome.

Background: The evidence is limited for the dose–response association between breakfast skipping and suicidality. The underlying pathway from breakfast skipping to suicidality has also rarely been explored in previous studies. Methods: The data of Youth Risk Behavior Surveys (YRBSs) of the United States from 2011 to 2019 were used with a sample size of 74,074. The male: female ratio was nearly 1:1. Binary logistic regression models with complex sampling design were adopted to show the effect of breakfast skipping on weight status, depressive symptoms, and suicidality. Serial mediation was used to explore the association between breakfast skipping and suicidality by overweight/obesity and depressive symptoms. Findings: The weighted prevalence rates (95% confidence interval) of suicidal ideation, suicide plan, suicide attempt, and medically serious suicide attempt for skipping breakfast totally (0 times/week) were 25.6% (24.4–26.8%), 21.7% (20.5–22.9%), 14.2% (13.0–15.3%), and 5.3% (4.6–5.9%). Breakfast skipping was significantly associated with increased risk of suicidal ideation, suicide plan, suicide attempt, and medically serious suicide attempt. There was statistical significance for the linear dose–response association between breakfast skipping and overweight/obesity, depressive symptoms, and suicidality regardless of sex and age. A serial mediation with effect sizes between 39.68% and 51.30% for the association between breakfast skipping and suicidality by overweight/obesity and depressive symptoms was found in this study. Conclusions: This study emphasizes the hazards of breakfast skipping, which could increase the risk of suicidality among adolescents. Overweight/obesity and depressive symptoms as the mediating factors for the association between breakfast skipping and suicidality should also be with more attention.

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Abstractasthma as add-on therapy to ICS compared with LTRA and