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Abstract Background Metabolism is error prone. For instance, the reduced forms of the central metabolic cofactors nicotinamide adenine dinucleotide (NADH) and nicotinamide adenine dinucleotide phosphate (NADPH), can be converted into redox-inactive products, NADHX and NADPHX, through enzymatically catalyzed or spontaneous hydration. The metabolite repair enzymes NAXD and NAXE convert these damaged compounds back to the functional NAD(P)H cofactors. Pathogenic loss-of-function variants in NAXE and NAXD lead to development of the neurometabolic disorders progressive, early-onset encephalopathy with brain edema and/or leukoencephalopathy (PEBEL)1 and PEBEL2, respectively. Methods To gain insights into the molecular disease mechanisms, we investigated the metabolic impact of NAXD deficiency in human cell models. Control and NAXD-deficient cells were cultivated under different conditions, followed by cell viability and mitochondrial function assays as well as metabolomic analyses without or with stable isotope labeling. Enzymatic assays with purified recombinant proteins were performed to confirm molecular mechanisms suggested by the cell culture experiments. Results HAP1 NAXD knockout (NAXDko) cells showed growth impairment specifically in a basal medium containing galactose instead of glucose. Surprisingly, the galactose-grown NAXDko cells displayed only subtle signs of mitochondrial impairment, whereas metabolomic analyses revealed a strong inhibition of the cytosolic, de novo serine synthesis pathway in those cells as well as in NAXD patient-derived fibroblasts. We identified inhibition of 3-phosphoglycerate dehydrogenase as the root cause for this metabolic perturbation. The NAD precursor nicotinamide riboside (NR) and inosine exerted beneficial effects on HAP1 cell viability under galactose stress, with more pronounced effects in NAXDko cells. Metabolomic profiling in supplemented cells indicated that NR and inosine act via different mechanisms that at least partially involve the serine synthesis pathway. Conclusions Taken together, our study identifies a metabolic vulnerability in NAXD-deficient cells that can be targeted by small molecules such as NR or inosine, opening perspectives in the search for mechanism-based therapeutic interventions in PEBEL disorders. Graphical Abstract

Las neurociencias corresponden a un grupo de disciplinas que estudian el sistema nervioso. La falta de conocimiento sobre ellas y su aplicación indiscriminada a la educación han generado una serie de conocimientos erróneos sobre el cerebro y, en consecuencia, han dado origen a los neuromitos. El objetivo de este estudio fue describir y comparar la prevalencia de neuromitos y el conocimiento general sobre neurociencias de integrantes de la comunidad académica de una institución superior de Ecuador. La metodología es cuantitativa, no experimental de corte transversal. La muestra estuvo constituida por 203 integrantes y se utilizó el cuestionario de prevalencia de neuromitos de Dekker. Como resultado se obtuvo que los neuromitos más arraigados en la muestra fueron aquellos asociados a los ejercicios de coordinación y su relación con el lenguaje, a los estilos de aprendizaje VAK y a los entornos enriquecidos en la etapa preescolar. Es necesario propender al intercambio de buenas prácticas para elaborar itinerarios con una formación adecuada al desarrollo de las competencias que requieren los docentes de educación superior en el área de las neurociencias.

Background: Metabolism is error prone. For instance, the reduced forms of the central metabolic cofactors nicotinamide adenine dinucleotide (NADH) and nicotinamide adenine dinucleotide phosphate (NADPH), can be converted into redox-inactive products, NADHX and NADPHX, through enzymatically catalyzed or spontaneous hydration. The metabolite repair enzymes NAXD and NAXE convert these damaged compounds back to the functional NAD(P)H cofactors. Pathogenic loss-of-function variants in NAXE and NAXD lead to development of the neurometabolic disorders progressive, early-onset encephalopathy with brain edema and/or leukoencephalopathy (PEBEL)1 and PEBEL2, respectively. Methods: To gain insights into the molecular disease mechanisms, we investigated the metabolic impact of NAXD deficiency in human cell models. Control and NAXD-deficient cells were cultivated under different conditions, followed by cell viability and mitochondrial function assays as well as metabolomic analyses without or with stable isotope labeling. Enzymatic assays with purified recombinant proteins were performed to confirm molecular mechanisms suggested by the cell culture experiments. Results: HAP1 NAXD knockout (NAXDko) cells showed growth impairment specifically in a basal medium containing galactose instead of glucose. Surprisingly, the galactose-grown NAXDko cells displayed only subtle signs of mitochondrial impairment, whereas metabolomic analyses revealed a strong inhibition of the cytosolic, de novo serine synthesis pathway in those cells as well as in NAXD patient-derived fibroblasts. We identified inhibition of 3-phosphoglycerate dehydrogenase as the root cause for this metabolic perturbation. The NAD precursor nicotinamide riboside (NR) and inosine exerted beneficial effects on HAP1 cell viability under galactose stress, with more pronounced effects in NAXDko cells. Metabolomic profiling in supplemented cells indicated that NR and inosine act via different mechanisms that at least partially involve the serine synthesis pathway. Conclusions: Taken together, our study identifies a metabolic vulnerability in NAXD-deficient cells that can be targeted by small molecules such as NR or inosine, opening perspectives in the search for mechanism-based therapeutic interventions in PEBEL disorders. [ABSTRACT FROM AUTHOR]

El objetivo del estudio fue explorar la percepción del profesorado de educación física sobre el enfoque de enseñanza tecnológico-emergente para atender a la población infantil y juvenil del estado de Sonora, México, durante el periodo de aislamiento social provocado por la COVID-19. El estudio se realizó con la colaboración de 203 docentes de educación física en diversas instituciones de educación básica y media superior. El diseño de la investigación fue transversal con enfoque mixto, desarrollado en dos etapas: en la primera se recuperaron datos de tipo cuantitativo a través de un cuestionario y la segunda etapa fue cualitativa; los datos se obtuvieron por medio de entrevistas semi-estructuradas. El cuestionario se aplicó por medio de Google Forms y los datos se exportaron a Excel, para obtener estadística descriptiva. Los datos cualitativos se obtuvieron a través de una entrevista semi-estructurada a 24 docentes. Se generó una triangulación metodológica entre los datos cuantitativos y cualitativos. Los hallazgos indican que las actividades se encaminaron al desarrollo de patrones motrices básicos con estudiantes de los primeros grados escolares; en primaria intermedia se concentraron en habilidades físicas compuestas. El trabajo remoto ha forzado a las personas participantes a desarrollar nuevas habilidades relacionadas con el manejo de dispositivos electrónicos, aplicaciones digitales y el diseño de clases en múltiples formatos (videos, en tiempo real por Zoom, materiales impresos, etc.), sin embargo, las clases impartidas han impactado a menos del 50 % de la matrícula asignada. Las variables socio-económicas de las familias representan el principal obstáculo para la gestión de las clases, por la carencia de dispositivos electrónicos e internet.

El objetivo del presente trabajo fue identificar el efecto de un programa de activación física matutina (AFM) en el rendimiento escolar de los estudiantes de educación primaria. En el estudio participaron 131 alumnos con una edad 7.8 ±1.06 años (55 niños y 76 niñas). Se desarrolló un programa de 60 sesiones de AFM con una duración de 30 minutos. Se compararon las calificaciones previas al programa (1er bimestre) y las posteriores (3er bimestre) de las materias de español, matemáticas y formación cívica y ética. Los padres entregaron el consentimiento informado por escrito para que sus hijos participaran en el estudio. Se realizaron las pruebas de normalidad y la t de Student para comparar los resultados de ambos bimestres. Se encontró que la materia con mayor incremento significativo del rendimiento fue la de matemáticas p=0.000, el sexo de los participantes no influyó en los resultados y en los grados de segundo y cuarto de primaria se obtuvieron mejores efectos en las calificaciones de los alumnos. Por lo tanto, se concluye que un programa de activación física matutina previo a la jornada escolar puede incidir en mejores resultados académicos sobre todo en la materia de matemáticas en educación primaria. Palabras claves: Activación física, rendimiento escolar, niños, matemáticas. Abstract. The objective of this work was to identify the effect of a morning physical activation program on the school performance of students from elementary school. Participated in the study 131 students with 7.8 ±1.06 years (55 boys y 76 girls). A program of 60 physical activation sessions was developed prior to the school day with a duration of 30 minutes. Qualifications were compared before the program (first bimester) and later (third bimester) of the subjects of Spanish, mathematics and civics and ethics education. Parents provided written informed consent for their children to participate in the study. Normality tests and Student's t tests were performed to compare the results of both bimesters. It was found that the subject with the greatest significant increase in performance was mathematics p = 0.000, the gender of the participants did not influence the results and in the second and fourth grades of primary school, better effects were obtained on the students' grades. Therefore, it is concluded that a physical activation program prior to the school day can influence better academic results in the subject of mathematics in primary education. Key words: Physical activity, school performance, school children, mathematics

Abstract Background Cardiac and neurological involvement in hemolytic uremic syndrome are life-threatening complications. The most frequent complications of cardiac involvement in hemolytic uremic syndrome are myocarditis and cardiac dysfunction due to fluid overload. Pericarditis remains very rare in hemolytic uremic syndrome. To our knowledge, only five cases of cardiac tamponade associated with hemolytic uremic syndrome have been described in literature. Case summary A 27-month-old Caucasian girl presented with symptoms of nonbloody diarrhea and tonic-clonic seizures. The diagnosis of Shiga-like toxin-producing Escherichia coli hemolytic uremic syndrome with central nervous system involvement was made, and stool examination revealed infection with a Shiga-like toxin-producing Escherichia coli. She did not need renal replacement therapy but had severe neurological impairment. The patient’s course was complicated by pericardial effusion. A pericardiocentesis was performed via an apical approach because the pericardial effusion was predominantly surrounding the left ventricle. Effusion analysis showed an exudate and positivity for human herpesvirus-6B on polymerase chain reaction with viremia. This finding was consistent with primary human herpesvirus-6 infection with encephalitis. Conclusion We report this uncommon case of Shiga-like toxin-producing Escherichia coli hemolytic uremic syndrome associated with a severe human herpesvirus-6 infection. Secondary isolated pericardial effusion and atypical neurological involvement are uncommon in Shiga-like toxin-producing Escherichia coli hemolytic uremic syndrome and should lead the physician to perform additional investigations.

ObjectivesThe evidence that risks of morbidity and mortality are higher when very premature newborns are born during the on-call period is inconsistent. This study aimed to assess the impact of this situation among other determinants of outcomes, particularly newborn characteristics and care organization.MethodsObservational study including all infants born < 30 weeks’ gestation in a French tertiary perinatal center between 2007 and 2020. On-call period corresponded to weekdays between 6:30 p.m. and 8:30 a.m., weekends, and public holidays. The primary endpoint was survival without severe morbidity, including grade 3–4 intraventricular hemorrhage (IVH), cystic periventricular leukomalacia, necrotizing enterocolitis, severe bronchopulmonary dysplasia (BPD), and severe retinopathy of prematurity. The relationship between admission and outcome was assessed by an adjusted odds ratio (aOR) on the propensity of being born during on-call period and expressed vs. weekday. Secondary analyses were carried out in extremely preterm newborns (

La satisfacción estudiantil se define como el bienestar que experimentan los alumnos por sentir cubiertas sus expectativas académicas como resultado de las actividades que realiza la institución para atender sus necesidades educativas. El objetivo del presente estudio fue comparar los niveles de satisfacción de estudiantes de educación física de Chile con los alumnos de licenciatura en cultura física y deporte de México. La metodología fue cuantitativa, no experimental de corte transversal y se utilizó una adaptación de la escala de Satisfacción de Recio y Cabero. La muestra estuvo constituida por un total de 491 estudiantes, de los cuales 260 eran de Chile y 231 de México. Los principales resultados muestran una mayor satisfacción de las clases virtuales tanto de las cátedras teóricas como prácticas (deportivas) por parte del estudiantado mexicano. Se concluye que se debe avanzar en investigaciones que indaguen en nuevas metodologías virtuales y también es necesario profundizar por las razones que los estudiantes de México poseen una mayor satisfacción, si es propio a los recursos tecnológicos, culturales o bien mayores niveles de flexibilidad frente a cambios. Abstract. Student satisfaction is defined as the well-being experienced by students by feeling their academic expectations met as a result of the institution’s activities to meet their educational needs. The objective of this study was to compare the satisfaction levels of physical education students in Chile with those with a degree in physical culture and sport in Mexico. The methodology was quantitative, not experimental cross-sectional and an adaptation of the Recio and Cabero satisfaction scale was used. The sample consisted of a total of 491 students, of whom 260 were from Chile and 231 from Mexico. The main results show a greater satisfaction of the virtual classes of both the theoretical chairs and practices (sports) by the Mexican students. It is concluded that it is necessary to advance in investigations that investigate new virtual methodologies and it is also necessary to deepen for the reasons that the students of Mexico have a greater satisfaction, if it is proper to the technological resources, or greater levels of flexibility in the face of change.

Abstract Background In the context of tremendous progress in congenital cardiology, more attention has been given to patient-related outcomes, especially in assessing health-related quality of life (HRQoL) of patients with congenital heart diseases (CHD). However, most studies have mainly focused on teenagers or adults and currently, few HRQoL controlled data is available in young children. This study aimed to evaluate HRQoL of children with CHD aged 5 to 7 y.o., in comparison with contemporary peers recruited in school, as well as the factors associated with HRQoL in this population. Methods This multicentre controlled prospective cross-sectional study included 124 children with a CHD (mean age = 6.0 ± 0.8 y, 45% female) during their outpatient visit and 125 controls (mean age = 6.2 ± 0.8 y, 54% female) recruited at school. A generic paediatric HRQoL instrument was used (PedsQL 4.0). Results Self-reported HRQoL in children with CHD was similar to controls, overall (73.5 ± 1.2 vs. 72.8 ± 1.2, P = 0.7, respectively), and for each dimension. Parents-reported HRQoL was significantly lower in the CHD group than in controls. HRQoL was predicted by the disease severity and by repeated invasive cardiac procedures (surgery or catheterization). Conclusion HRQoL in young children with CHD aged 5 to 7 years old was good and similar to controls. This study contributed to the growing body of knowledge on HRQoL in congenital cardiology and emphasized the need for child and family support in the most complex CHD. Trial registration This study was approved by the institutional review board of Montpellier University Hospital (2019_IRB-MTP_02-19) on 22 February 2019 and was registered on ClinicalTrials.gov (NCT03931096) on 30 April 2019, https://clinicaltrials.gov/ct2/show/NCT03931096 .

Abstract Aims In univentricular hearts, selective lung vasodilators such as phosphodiesterase type 5 (PDE5) inhibitors would decrease pulmonary resistance and improve exercise tolerance. However, the level of evidence for the use of PDE5 inhibitors in patients with a single ventricle (SV) remains limited. We present the SV‐INHIBITION study rationale, design, and methods. Methods and results The SV‐INHIBITION trial is a nationwide multicentre, randomized, double blind, placebo‐controlled, Phase III study, aiming to evaluate the efficacy of sildenafil on the ventilatory efficiency during exercise, in teenagers and adult patients (>15 years old) with an SV. Patients with a mean pulmonary arterial pressure >15 mmHg and a trans‐pulmonary gradient >5 mmHg, measured by cardiac catheterization, will be eligible. The primary outcome is the variation of the VE/VCO2 slope, measured by a cardiopulmonary exercise test, between baseline and 6 months of treatment. A total of 50 patients are required to observe a decrease of 5 ± 5 points in the VE/VCO2 slope, with a power of 90% and an alpha risk of 5%. The secondary outcomes are clinical outcomes, oxygen saturation, 6 min walk test, SV function, NT‐proBNP, peak VO2, stroke volume, mean pulmonary arterial pressure, trans‐pulmonary gradient, SF36 quality of life score, safety, and acceptability. Conclusions The SV‐INHIBITION study aims to answer the question whether PDE5 inhibitors should be prescribed in patients with an SV. This trial has been built focusing on the three levels of research defined by the World Health Organization: disability (exercise tolerance), deficit (SV function), and handicap (quality of life).

Estudios realizados durante las últimas tres décadas han revelado fuertes bases biológicas de la homosexualidad y transexualidad. Los objetivos de la presente investigación fueron validar el cuestionario de Conocimientos Biológicos de la Homosexualidad y Transexualidad (CBHT) en una muestra de estudiantes del área de la actividad física de México y describir estos conocimientos en la muestra evaluada. Para ello se encuestaron a 324 estudiantes de México aplicando una encuesta sociodemográfica y el cuestionario CBHT. Los resultados revelan índices adecuados de validez y confiabilidad del cuestionario CBHT en la muestra, que los niveles de conocimientos biológicos sobre estos temas son bajos y que las variables sociodemográficas que inciden en dichos resultados son el sexo y el tener un amigo/a o conocido/a homosexual o bisexual. Se recomienda continuar con la evaluación de muestras de estudiantes de otras carreras de pedagogía y de diferentes regiones de México. Abstract. Studies conducted over the past three decades have revealed strong biological bases for homosexuality and transsexuality. The objectives of this research were to validate the Biological Knowledge of Homosexuality and Transsexuality (BKHT) questionnaire in a sample of students from the area of physical activity in Mexico and describe this knowledge in the sample evaluated. To this end, 324 students from Mexico were surveyed using a sociodemographic survey and the BKHT questionnaire. The results reveal adequate indices of validity and reliability of the BKHT questionnaire in the sample, that the levels of biological knowledge on these topics are low and that the sociodemographic variables that affect these results are sex and having a friend/a known/a homosexual or bisexual. It is recommended to continue with the evaluation of samples of students from other pedagogy careers and from different regions of Mexico.

Abstract Background Respiratory syncytial virus (RSV) is the most frequently identified pathogen in children with acute lower respiratory tract infection. Fatal cases have mainly been reported during the first 6 months of life or in the presence of comorbidity. Case presentation A 47-month-old girl was admitted to the pediatric intensive care unit following sudden cardiopulmonary arrest occurring at home. The electrocardiogram showed cardiac asystole, which was refractory to prolonged resuscitation efforts. Postmortem analyses detected RSV by polymerase chain reaction in an abundant, exudative pericardial effusion. Histopathological examination was consistent with viral myoepicarditis, including an inflammatory process affecting cardiac nerves and ganglia. Molecular analysis of sudden unexplained death genes identified a heterozygous mutation in myosin light chain 2, which was also found in two other healthy members of the family. Additional expert interpretation of the cardiac histology confirmed the absence of arrhythmogenic right ventricular dysplasia or hypertrophic cardiomyopathy. Conclusions RSV-related sudden death in a normally developing child of this age is exceptional. This case highlights the risk of extrapulmonary manifestations associated with this infection, particularly arrhythmia induced by inflammatory phenomena affecting the cardiac autonomic nervous system. The role of the mutation in this context is uncertain, and it is therefore necessary to continue to assess how this pathogenic variant contributes to unexpected sudden death in childhood.

El presente trabajo pretende evidenciar la correlación entre el nivel de pensamiento táctico de los jugadores de fútbol infantil de nivel iniciación en la mejora de las habilidades técnicas y físicas. Metodología: participaron 26 jugadores de fútbol infantil de ocho y nueve años con dos grupos: un grupo con desigualdad numérica y otro con igualdad, ambos con 13 participantes. A los dos grupos se les aplicó una batería de pruebas físicas y técnicas, así como el test del conocimiento táctico ofensivo en el fútbol (TCTOF). Los grupos estuvieron expuestos a un programa de entrenamiento de 16 sesiones. Resultados: Los jugadores pertenecientes al nivel muy bajo, solo mostraron cambios significativos negativos en la correlación flexibilidad-fuerza en piernas y pase-conducción del grupo con igualdad numérica. Los jugadores de nivel bajo mostraron cambios significativos positivos en las correlaciones de flexibilidad-fuerza en piernas, flexibilidad-cabeceo y cabeceo-fuerza en piernas. En cambio, los participantes de nivel regular (el más elevado en nuestra investigación) produjeron correlaciones significativas positivas entre golpeo de pierna no dominante-flexibilidad y este mismo golpeo con la resistencia aeróbica en el grupo con igualdad numérica. Por su parte, el grupo con igualdad numérica presentó diferencias significativas entre la fuerza-flexibilidad, velocidad-flexibilidad, pase-flexibilidad, pase-fuerza en piernas, pase-velocidad, pase-resistencia, pase-cabeceo, golpeo-regate, golpeo-conducción y golpeo con pierna no dominante-cabeceo. Conclusión: existe una correlación positiva entre el nivel de pensamiento táctico ofensivo en el fútbol con el desarrollo de las habilidades técnicas y físicas, es decir, mientras mayor sea este nivel, mayores cambios significativos se producirán en sus habilidades. Abstract. This work aims to evidence the correlation between the level of tactical thinking of the starting level children's football players in improving technical and physical skills. Methodology: 26 eight- and nine-year-old children's football players participated with two groups: one group with numerical inequality and one with equality, both with 13 participants. The two groups were given a battery of physical and technical tests, as well as the test of tactical offensive knowledge in football (TCTOF). The groups were exposed to a 16-session training program. Results: Players at the very low level only showed changes significant negative in the correlation the flexibility and strength of the legs and pass and running of the ball in the group with numerical equality. Low-level players showed significant positive changes in correlations of flexibility and strength in legs, flexibility and heading, and heading and strength in legs. In contrast, regular-level participants (the highest in our research) produced significant positive correlations between shooting the ball with the non-dominant leg and flexibility and this same shooting the ball with the non-dominant leg with the aerobic resistance in the group with numerical equality. For its part, the group with numerical equality presented significant differences between strength and flexibility, speed and flexibility, pass the ball and flexibility, pass the ball and force in legs, pass the ball and speed, pass the ball and resistance, pass and heading the ball, shoot the ball with dominant leg and dribbling, shoot the ball with dominant leg and running with the ball, and heading the ball with shoot the ball non-dominant leg. Conclusion: there is a positive correlation between the level of tactical offensive thinking in football with the development of technical and physical skills, the higher this level, the greater significant changes in your skills.

Introducción: Las investigaciones de percepción de estudiantes sobre el desempeño del profesorado son fundamentales para estar al tanto de como el estudiantado se está desarrollando en la educación superior y, sobre todo, conocer quiénes o cuales son los factores influyentes en la formación académica. El objetivo del presente estudio fue: comparar la percepción que tienen los estudiantes de educación física sobre los profesores de dos universidades de Chile. Método: la investigación es de tipo cuantitativo, no experimental de corte transversal. La muestra estuvo constituida por 300 estudiantes de primero a cuarto año de la Licenciatura de Pedagogía en Educación Física. Resultados: Se encontraron diferencias significativas por año académico y entre las universidades donde se realizó el estudio, mostrando que es necesario ahondar en la comprensión de dichos resultados para mejorar las experiencias de procesos de aprendizaje del estudiantado. Conclusiones: Se hacen necesarios futuras investigaciones con otras variables, tales como estilos de aprendizaje, estilos de enseñanza, motivación, entre otras. También es relevante realizar este tipo de investigación de manera longitudinal para comprender de alguna manera las percepciones positivas y negativas y cómo este se podría mejorar para favorecer el clima del aula a nivel universitario. Abstract. Introduction: Research on students' perception of teacher performance is essential to be aware of how students are developing in higher education and, above all, to know who or what are the influencing factors in the academic formation. The objective of this study was: to compare the perception that students of physical education have about their teachers of two universities of Chile. Method: the research is quantitative, not experimental cross-sectional. The sample consisted of 300 students from the first to fourth year of the Degree in Pedagogy in Physical Education. Results: Significant differences were found by academic year and between the universities where the study was conducted, showing that it is necessary to deepen the understanding of these results to improve the experiences of the learning processes of the students. Conclusions: Future research with other variables, such as learning styles, teaching styles, motivation, among others, are necessary. It is also important to carry out this type of research in a longitudinal way to understand in some way the positive and negative perceptions and how this could be improved to favor the climate of the classroom at university level.

Background and Aims Cardiopulmonary fitness in congenital heart disease (CHD) decreases faster than in the general population resulting in impaired health-related quality of life (HRQoL). As the standard of care seems insufficient to encourage and maintain fitness, an early hybrid cardiac rehabilitation programme could improve HRQoL in CHD. Methods The QUALIREHAB multicentre, randomized, controlled trial evaluated and implemented a 12-week centre- and home-based hybrid cardiac rehabilitation programme, including multidisciplinary care and physical activity sessions. Adolescent and young adult CHD patients with impaired cardiopulmonary fitness were randomly assigned to either the intervention (i.e. cardiac rehabilitation) or the standard of care. The primary outcome was the change in HRQoL from baseline to 12-month follow-up in an intention-to-treat analysis. The secondary outcomes were the change in cardiovascular parameters, cardiopulmonary fitness, and mental health. Results The expected number of 142 patients was enroled in the study (mean age 17.4 ± 3.4 years, 52% female). Patients assigned to the intervention had a significant positive change in HRQoL total score [mean difference 3.8; 95% confidence interval (CI) 0.2; 7.3; P =.038; effect size 0.34], body mass index [mean difference −0.7 kg/m2 (95% CI −1.3; −0.1); P =.022; effect size 0.41], level of physical activity [mean difference 2.5 (95% CI 0.1; 5); P =.044; effect size 0.39], and disease knowledge [mean difference 2.7 (95% CI 0.8; 4.6); P =.007; effect size 0.51]. The per-protocol analysis confirmed these results with a higher magnitude of differences. Acceptability, safety, and short-time effect of the intervention were good to excellent. Conclusions This early hybrid cardiac rehabilitation programme improved HRQoL, body mass index, physical activity, and disease knowledge, in youth with CHD, opening up the possibility for the QUALIREHAB programme to be rolled out to the adult population of CHD and non-congenital cardiac disease. [ABSTRACT FROM AUTHOR]