Joaquin Sanchez-Gomez

Objective To synthesise the evidence on the effects of exercise interventions in children and adolescents during and beyond cancer treatment, and to evaluate the methodological quality and certainty of this evidence. Design Umbrella review of systematic reviews with meta-analyses. Data source PubMed, Web of Science, Scopus, SPORTDiscus and CINAHL were searched from inception to January 2026. Eligibility criteria for selecting studies Systematic reviews with meta-analysis of controlled trials (randomised or non-randomised) evaluating exercise interventions in children and adolescents (≤19 years) during and beyond cancer treatment. Reviews without quantitative synthesis, those including only observational studies, or interventions where the isolated effect of exercise could not be determined were excluded. Results 19 systematic reviews with meta-analyses, including 53 primary studies (n=2361 participants), were identified, yielding 80 effect estimates. Attending to the most comprehensive meta-analyses, exercise induced significant benefits on cardiorespiratory fitness (mean difference (MD) 6.92% (95% CI 1.01% to 12.82%)), cognitive function (standardised mean difference (SMD) 0.26 (95% CI 0.08 to 0.44)) and cognitive performance (SMD 0.41 (95% CI 0.17 to 0.65)), with moderate certainty of evidence. Exercise also induced significant benefits on muscle strength (SMD 0.81 (95% CI 0.05 to 1.57)), functional mobility (MD −1.17 s (95% CI −1.86 to −0.49)) and cancer-related fatigue (SMD −0.62 (95% CI −1.21 to −0.03)), although the certainty was low or very low. These effects were observed across meta-analyses focused exclusively on studies conducted during treatment (n=26), after treatment (n=3) or both (n=51). In contrast, no significant effects of exercise were observed for depression, bone mineral density, health-related quality of life, anthropometry or other clinical outcomes (such as mortality, relapse risk and withdrawal rates). Conclusion Exercise appears to be a beneficial intervention in childhood cancer for improving some physical, cognitive and psychosocial outcomes. However, more high-quality research is warranted to strengthen clinical recommendations and inform personalised exercise prescriptions, given that the certainty of evidence remains variable and overall low across outcomes. PROSPERO registration number CRD420251031412.

Spike timing-dependent plasticity (STDP) is a learning rule important for synaptic refinement and for learning and memory during development. While different forms of presynaptic t-LTD have been deeply investigated, little is known about the mechanisms of somatosensory cortex postsynaptic t-LTD. In the present work, we investigated the requirements and mechanisms for induction of developmental spike timing-dependent long-term depression (t-LTD) at L2/3-L2/3 synapses in the juvenile mouse somatosensory cortex. We found that postnatal day (P) 13–21 mice of either sex show t-LTD at L2/3-L2/3 synapses induced by pairing single presynaptic activity with single postsynaptic action potentials at low stimulation frequency (0.2 Hz) that is expressed postsynaptically and requires the activation of ionotropic postsynaptic NMDA-type glutamate receptors containing GluN2B subunits. In addition, it requires postsynaptic Ca²⁺, Ca²⁺release from internal stores, calcineurin, postsynaptic endocannabinoid synthesis, activation of CB₁receptors, and astrocytic signaling to release the gliotransmitterd-serine to activate postsynaptic NMDARs to induce t-LTD. These results show direct evidence of the mechanism involved in developmental postsynaptic t-LTD at L2/3-L2/3 synapses, revealing a central role of astrocytes and their release ofd-serine in its induction.

Purpose We aimed at exploring whether cardiopulmonary fitness, echocardiographic measures and relative exercise intensity were associated with high-sensitivity cardiac troponin T (hs-TNT) rise and normalization following a marathon. Methods Nighty-eight participants (83 men, 15 women; 38.72 ± 3.63 years) were subjected to echocardiographic assessment and a cardiopulmonary exercise test (CPET) before the race. hs-TNT was measured before, immediately after and at 24, 48, 96, 144 and 192 h post-race. Speed and mean heart rate (HR) during the race were relativized to CPET values: peak speed (%V_VMAX), peak HR (HR_%MAX), speed and HR at the second ventilatory threshold (HR_%VT2 and %V_VT2). Results Hs-TNT increased from pre- to post-race (5.74 ± 5.29 vs. 50.4 ± 57.04 ng/L; p < 0.001), seeing values above the Upper Reference Limit (URL) in 95% of the participants. At 24 h post-race, 39% of the runners still exceeded the URL (High hs-TNT group). hs-TNT rise was correlated with marathon speed %V_VT2 (r = 0.22; p = 0.042), mean HR_%VT2 (r = 0.30; p = 0.007), and mean HR_%MAX (r = 0.32; p = 0.004). Moreover, the High hs-TNT group performed the marathon at a higher Speed %V_VT2 (88.21 ± 6.53 vs. 83.49 ± 6.54%; p = 0.002) and Speed %V_VMAX (72 ± 4.25 vs. 69.40 ± 5.53%; p = 0.009). hs-TNT showed no significant associations with cardiopulmonary fitness and echocardiographic measures, except for a slight correlation with left ventricular end systolic diameter (r = 0.26; p = 0.018). Conclusion Post-race hs-TNT was above the URL in barely all runners. Magnitude of hs-TNT rise was correlated with exercise mean HR; whereas, its normalization kept relationship with marathon relative speed.