bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical activity patterns in a representative sample of adolescents from the largest city in Latin America: a cross-sectional study in Sao Paulo
Authors: Ferrari Gerson , Rezende Leandro F.M. , Wagner Gabriela Arantes , Florindo Alex A , Peres Maria Fernanda Tourinho 
Published: September 2020

ObjectivesWe examined the patterns of total and domain-specific physical activity (PA) by sex, socioeconomic status and maternal education level in adolescents from Sao Paulo city, Brazil.DesignCross-sectional study.ParticipantsWe included a representative sample of 2682 (52.2% boys) adolescents aged 14–15 years from public and private schools in Sao Paulo, 2017. Socioeconomic status was assessed using a wealth index derived from principal component analysis. Descriptive analyses evaluated differences in total and domain-specific PA by sex, socioeconomic status and maternal education level.Outcome measuresWe collected data on the frequency and duration that adolescents spent in each PA domain (active transportation, leisure PA and physical education classes) through a self-report questionnaire.ResultsOn average, adolescents spent 197.7 min/week (95% CI 190.6–204.8) in total PA. The proportion of adolescents achieving at least 60 min/day (≥420 min/week) was 12.7% (95% CI 11.4–14.1), with a higher prevalence in boys (18.3%) and in those with higher socioeconomic status (17.4%). Similar patterns were observed for leisure PA and physical education classes. Active transportation was higher in girls (46.0 min/week; 95% CI 42.6–49.6) than in boys (43.4 min/week, 95% CI 39.9–46.6). Boys and adolescents with higher socioeconomic status and higher maternal education level had higher levels of total PA.ConclusionsWe found a variation in patterns of total and domain-specific PA by sex, socioeconomic status and maternal education level in adolescents from Sao Paulo. Initiatives for promoting PA in adolescents should take these findings into account.
Intensive Care Weaning (iCareWean) protocol on weaning from mechanical ventilation: a single-blinded multicentre randomised control trial comparing an open-loop decision support system and routine care, in the general intensive care unit
Authors: Vizcaychipi M P , Martins Laura , White James R , Karbing Dan Stleper , Gupta Amandeep , Singh Suveer , Osman Leyla , Moreno-Cuesta Jeronimo , Rees Steve 
Published: September 2020

IntroductionAutomated systems for ventilator management to date have been either fully heuristic rule-based systems or based on a combination of simple physiological models and rules. These have been shown to reduce the duration of mechanical ventilation in simple to wean patients. At present, there are no published studies that evaluate the effect of systems that use detailed physiological descriptions of the individual patient.The BEACON Caresystem is a model-based decision support system that uses mathematical models of patients’ physiology in combination with models of clinical preferences to provide advice on appropriate ventilator settings. An individual physiological description may be particularly advantageous in selecting the appropriate therapy for a complex, heterogeneous, intensive care unit (ICU) patient population.Methods and analysisIntenive Care weaning (iCareWean) is a single-blinded, multicentre, prospective randomised control trial evaluating management of mechanical ventilation as directed by the BEACON Caresystem compared with that of current care, in the general intensive care setting. The trial will enrol 274 participants across multiple London National Health Service ICUs. The trial will use a primary outcome of duration of mechanical ventilation until successful extubation.Ethics and disseminationSafety oversight will be under the direction of an independent committee of the study sponsor. Study approval was obtained from the regional ethics committee of the Health Research Authority (HRA), (Research Ethic Committee (REC) reference: 17/LO/0887. Integrated Research Application System (IRAS) reference: 226610. Results will be disseminated through international critical care conference/symposium and publication in peer-reviewed journal.Trial registration numberClinicalTrials.gov under NCT03249623. This research is registered with the National Institute for Health Research under CPMS ID: 34831.
Cascade Screening for Familial Hypercholesterolemia in South Africa
Authors: Raal Frederick J. , Bahassi El Mustapha , Stevens Belinda , Turner Traci A. , Stein Evan A. 
Published: September 2020

Objective:
Due to gene founder effects, familial hypercholesterolemia (FH) has a prevalence of ≈1:80 in populations of Afrikaner ancestry and is a major contributor to premature atherosclerotic cardiovascular disease in South Africans of Jewish and Indian descent. No systematic program exists to identify these families. Furthermore, information regarding FH prevalence in Black Africans is sparse. The Wits FIND-FH program was initiated in late 2016 to address these issues.

Approach and Results:
Based on index subjects with definite or probable FH, first-degree relatives were contacted, informed consent obtained, and targeted medical history, physical examination, and blood samples collected. In patients with likely FH using the Simon Broome criteria, DNA analysis for LDLR (low-density lipoprotein receptor), APOB (apolipoprotein B), PCSK9 (proprotein convertase subtilisin/kexin type 9), and LDLRAP1 (LDLR adaptor protein 1) variants was analyzed by next-generation sequencing.
Of the initial 700 subjects screened of whom 295 (42%) were index cases, 479 (68.4%) were clinically diagnosed with probable or definite FH. Genetic analysis confirmed 285 of 479 (59.5%) as having variants consistent with FH. Three subjects met the clinical diagnosis for homozygous FH, but DNA analysis revealed a further 34 patients, including 4 Black African subjects, with ≥2 FH-causing variants.

Conclusions:
Using phenotype cascade screening, the Wits FIND-FH program has screened an average of 30 subjects monthly of whom 68% had a clinical diagnosis of FH with ≈60% genetically confirmed. The program is identifying a small but growing number of Black South Africans with FH. Interestingly, 37 subjects (7.7%) who underwent DNA testing were found to have ≥2 FH-causing variants.
Aspirin and Growth of Small Unruptured Intracranial Aneurysm
Authors: Weng Jian-Cong , Wang Jie , Li Hao , Jiao Yu-Ming , Fu Wei-Lun , Huo Ran , Yan Zi-Han , Xu Hong-Yuan , Zhan Jiong , Wang Shuo , Du Xin , Cao Yong , Zhao Ji-Zong ,   on behalf of the Small Unruptured Aneurysms Study Group
Published: September 2020

Background and Purpose:
The role of aspirin in unruptured intracranial aneurysm (UIA) growth remains largely unknown. We aim to identify whether aspirin is associated with a lower rate of UIA growth in patients with UIA <7 mm.

Methods:
This prospective cohort study consecutively enrolled patients with UIAs <7 mm with ischemic cerebrovascular disease between January 2016 and December 2019. Baseline and follow-up patient information, including the use of aspirin and blood pressure level, were recorded. Patients were considered aspirin users if they took aspirin, including standard- and low-dose aspirin, ≥3× per week. The primary end point was aneurysm growth in any direction or an indisputable change in aneurysm shape.

Results:

Among the 315 enrolled patients, 272 patients (86.3%) underwent imaging examinations during follow-up (mean follow-up time, 19.6±12.7 months). A total of 113 patients were continuously treated with aspirin. UIA growth occurred in 31 (11.4%) patients. In the multivariate Cox analysis, specific aneurysm locations (anterior communicating artery, posterior communicating artery, or middle cerebral artery; hazard ratio, 2.89 [95% CI, 1.22–6.88];
P
=0.016) and a UIA size of 5 to <7 mm (hazard ratio, 7.61 [95% CI, 3.02–19.22];
P
<0.001) were associated with a high risk of UIA growth, whereas aspirin and well-controlled blood pressure were associated with a low risk of UIA growth (hazard ratio, 0.29 [95% CI, 0.11–0.77];
P
=0.013 and hazard ratio, 0.25 [95% CI, 0.10–0.66];
P
=0.005, respectively). The cumulative annual growth rates were as high as 40.0 and 53.3 per 100 person-years in the high-risk patients (>1 risk factor) with and without aspirin, respectively.

Conclusions:
Aspirin therapy and well-controlled blood pressure are associated with a low risk of UIA growth; the incidence of UIA growth in high-risk patients in the first year is high, warranting intensive surveillance in this patient group.

Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02846259.
New Zealand Case Studies to Test the Meaning and Use of Article 5 of the 1989 United Nations Convention on the Rights of the Child
Authors: Henaghan Mark 
Published: September 2020

Abstract
Article 5 of the UN Convention on the Rights of the Child recognises the importance of parents and wider family members in ensuring that children are given appropriate directions on their rights in the UN Convention on the Rights of the Child. This paper analyses the wording of Article 5 and four New Zealand case studies to test the possible interpretations of Article 5. The paper builds on the work of Landsdown and Kamchedzera (Landsdown, 2005; Kamchedzera, 2012) who have done previous comprehensive analyses of the ambit and significance of the wording in Article 5. Article 5, like all international instruments, is not designed to provide prescriptive answers to challenging problems where there is a clash of which rights should prevail for children in particular situations. The central theme of this paper is that where there is a clash of a child’s rights, the tiebreaker should be which right in the particular situation will best enhance the unique identity of a particular child. The paper draws on the work of Ronen (Ronen, 2004) which argues that the purpose of a child’s rights framework is so the child can construct their individualised identity which is authentic and real for that particular child. The New Zealand case studies have been chosen to exemplify particular aspects of Article 5 and see how they are played out in particular court settings and whether the outcome enhances or inhibits the child’s opportunity to develop their unique identity.
“Evolving Capacities” and “Parental Guidance” in The context of Youth Justice
Authors: Kilkelly Ursula 
Published: September 2020

Abstract
Article 5 of the United Nations Convention on the Rights of the Child (uncrc) is a pivotal children’s rights provision, which recognises the ‘responsibilities, rights and duties of parents’ to provide ‘appropriate direction and guidance’ to the child in the exercise of his/her rights, in a manner consistent with ‘the evolving capacities of the child’. Underpinning children as holders of rights, Article 5 bridges the gap between children who require parental support to exercise their rights and those who are capable of exercising them on their own behalf. There has been limited consideration of Article 5 to date and even less in specific contexts like juvenile justice. The uncrc has particular relevance to children in conflict with the law where issues of criminal responsibility, capacity and the role of parents are central. This article explores the application of Article 5 by querying the relevance of the principle of “evolving capacities” to children in conflict with the law and to the exercise of children’s rights in the criminal justice system. It considers what role, if any, ‘the responsibilities, rights and duties’ of parents have in such proceedings while addressing, more generally, whether Article 5 adds value to the child’s rights approach to youth justice.
Assessing Children’s Capacity
Authors: Daly Aoife 
Published: September 2020

Abstract
This article seeks to reconceptualise approaches to assessing children’s capacity, particularly in light of Article 5 of the crc, which enshrines the principle of the evolving capacities of the child. Professionals regularly assess children’s capacity, for example when doctors treat children, or when lawyers represent child clients. They usually do this assessment intuitively however, as there is little guidance on how assessment should work in practice. Medical law in England and Wales serves as a case study to examine law and practice as well as challenges in the area. It is concluded that it may not necessarily be possible objectively to measure children’s capacity, and it may need to be done intuitively. Yet it should be done via a process which is rights-based. An approach to children’s capacity is proposed through four concepts based on the UN Convention on the Rights of the Child: Autonomy, Evidence, Support and Protection.
Trichoptera and Plecoptera of the Seybouse River, northeast Algeria: Distribution, phenology and new records
Authors: SAMRAOUI BOUDJÉMA , BOUHALA ZINEB , GARCIA ANTONIO RUIZ , MÁRQUEZ-RODRÍGUEZ JOAQUÍN , FERRERAS-ROMERO MANUEL , EL-SEREHY HAMED A. , SAMRAOUI FARRAH 
Published: September 2020

The stoneflies and caddisflies of North Africa are still poorly known as vast areas of Algeria have yet to be investigated. A survey of the macroinvertebrates of the Seybouse River, northeast Algeria, was carried out from July 2014 to December 2016. Three species of stoneflies (Capnopsis schilleri, Capnioneura petitpierreae, and Tyrrhenoleuctra tangerina) and five taxa of caddisflies (Mesophylax aspersus, Hydropsyche maroccana, H. resmineda, H. artax/lobata, and H. gr. pellucidula) were identified. All taxa are new records to the Seybouse River and seven of them are new to northeastern Algeria. A multivariate analysis indicated that the Hydropsychidae exhibited a clear longitudinal gradient along the Seybouse River while Mesophylax aspersus seemed adapted to species-poor, intermittent streams. Further investigations of the stoneflies and caddisflies may inform conservation efforts and will prove useful to monitor the Seybouse River and similarly threatened North African rivers and streams.
Antitumor activity of the dual BET and CBP/EP300 inhibitor NEO2734
Authors: Spriano Filippo , Gaudio Eugenio , Cascione Luciano , Tarantelli Chiara , Melle Federica , Motta Giovanna , Priebe Valdemar , Rinaldi Andrea , Golino Gaetanina , Mensah Afua Adjeiwaa , Aresu Luca , Zucca Emanuele , Pileri Stefano , Witcher Michael , Brown Bill , Wahlestedt Claes , Giles Francis , Stathis Anastasios , Bertoni Francesco 
Published: September 2020

AbstractBromodomain and extra-terminal domain (BET) proteins, cyclic adenosine monophosphate response element-binding protein (CBP), and the E1A-binding protein of p300 (EP300) are important players in histone acetylation. Preclinical evidence supports the notion that small molecules targeting these proteins individually or in combination can elicit antitumor activity. Here, we characterize the antitumor activity of the pan BET/CBP/EP300 inhibitor NEO2734 and provide insights into its mechanism of action through bromodomain-binding assays, in vitro and in vivo treatments of cancer cell lines, immunoblotting, and transcriptome analyses. In a panel of 60 models derived from different tumor types, NEO2734 exhibited antiproliferative activity in multiple cell lines, with the most potent activity observed in hematologic and prostate cancers. Focusing on lymphoma cell lines, NEO2374 exhibited a pattern of response and transcriptional changes similar to lymphoma cells exposed to either BET or CBP/EP300 inhibitors alone. However, NEO2734 was more potent than single-agent BET or CBP/EP300 inhibitors alone. In conclusion, NEO2734 is a novel antitumor compound that shows preferential activity in lymphomas, leukemias, and prostate cancers.
Allogeneic hematopoietic cell transplantation after prior targeted therapy for high-risk chronic lymphocytic leukemia
Authors: Kim Haesook T. , Shaughnessy Conner J. , Rai Sharmila C. , Reynolds Carol , Ho Vincent T. , Cutler Corey , Koreth John , Gooptu Mahasweta , Romee Rizwan , Nikiforow Sarah , Armand Philippe , Alyea Edwin P. , Antin Joseph H. , Wu Catherine J. , Soiffer Robert J. , Ritz Jerome , Brown Jennifer R. 
Published: September 2020

Abstract
Allogeneic hematopoietic cell transplantation (alloHCT) can cure previously treated high-risk chronic lymphocytic leukemia (CLL) patients if they are suitable for transplant through the graft-versus-leukemia effect. However, since the emergence of targeted therapies, the role of alloHCT for high-risk CLL is less clear. To address this question, we evaluated 108 high-risk CLL patients who underwent alloHCT from 2010 to 2018. Thirty patients from the period of 2013 to 2018 received targeted therapy prior to alloHCT. The median age for the targeted therapy cohort was 60 years (range, 30-71 years), and 20% and 73% had complete and partial remission, respectively: 76% had del(17p), 46.2% had 5 or more cytogenetic abnormalities, and 78.9% were IGHV unmutated. The median number of prior therapies was 4 (range, 1-9). With a median follow-up time of 36 months (range, 10-72 months), the 3-year overall (OS) and progression-free survival (PFS) were 87% and 69%, respectively. The 3-year cumulative incidence of nonrelapse mortality and relapse was 7% and 24%, respectively. For the control cohort of 78 patients who underwent alloHCT from 2010 to 2014 and received only chemoimmunotherapy prior to transplant, the 3-year OS and PFS were 69% and 58%, respectively. Patients treated with targeted therapy prior to alloHCT had a significantly higher number of circulating T and B cells and a lower ratio of CD4 regulatory T cells to CD4 conventional T cells early after transplant. In summary, despite multiple high-risk features, the clinical outcome of CLL patients who receive targeted therapy prior to transplant is excellent and alloHCT should be offered while the disease is under control.
COVID-19 and ocular implications: an update
Authors: Nuzzi Raffaele , Carucci Luigi Ludovico , Tripoli Flavia 
Published: September 2020

Abstract
Background
COronaVIrus Disease 19 (COVID-19) was first reported in Wuhan, China in December 2019 and is now pandemic all over the world. The purpose of this review is to highlight the possible ocular presentation of COVID-19 infection and the consequence of the pandemic in the daily ophthalmology routine. A total of 9 articles was included by searching PubMed database for articles published between December 2019 and April 2020.

Main body
Conjunctivitis (and keratoconjunctivitis) can be the first symptom in infected patients. The virus can be present in tear and conjunctival secretions, requiring maximum attention. It’s important to understand if COVID-19 could spread through the ocular route or present as the primary infected site.
Ocular implications should also be considered for therapy. In fact, one potential treatment is chloroquine and its derivatives, including hydroxychloroquine. Hydroxychloroquine, in fact, can induced retinal toxicity.
The exponential increase in lthe number of Covid-19 cases was like a tsunami for health care companies, which were not ready to face this emergency. Ophthalmology departments were also affected by the reorganization of healthcare services.

Conclusion
The studies analaysed have some limitations. First, the sample size and the covered population consisted mainly of patients with mild disease. Moreover, the studies are often descriptive study, without a correlation analysis.
Finally, no normal population was observed in the studies, so a normal control group should be included for comparison in future studies.
With the evolving COVID-19 pandemic and with its high infectivity, it is necessary to rearrange ophthalmologist routine clinical practice in order to control viral spread and try to maximize patient and health-care provider’s safety.
Interprofessional education and collaboration between general practitioner trainees and practice nurses in providing chronic care; a qualitative study
Authors: van der Gulden R. , Haan N. D. Scherpbier-de , Greijn C. M. , Looman N. , Tromp F. , Dielissen P. W. 
Published: September 2020

Abstract
Background
Effective interprofessional collaboration (IPC) is essential for the delivery of chronic care. Interprofessional education (IPE) can help support IPC skills. This makes IPE interesting for GP practices where chronic care is delivered by GPs together with practice nurses, especially for GP trainees who have to learn to collaborate with practice nurses during their training. The aim of this study is to gain insights in how IPE and IPC occur between GP trainees and practice nurses during the delivery of chronic care in GP training practices.

Methods
We conducted a qualitative research using semi structured focus groups and interviews with GP trainees, practice nurses and GP supervisors. All respondents were primed to the subject of IPE as they had followed an interprofessional training on patient-centred communication. The verbatim transcripts of the focus groups and interviews were analysed using thematic analysis.

Results
Despite the overall positive attitude displayed by respondents towards IPE and IPC, the occurrence of IPE and IPC in GP training practices was limited. Possible explanations for this are impeding factors such as limited knowledge, prejudice, lack of role models and a hierarchical organisational structure. Contributing to IPE and IPC use was the integration of IPE in daily practice, e.g. via recurring scheduled meetings.

Conclusion
We found a limited occurrence of IPE and IPC in GP training practices. Our results show a discrepancy between respondents enthusiasm for IPE and IPC and their actual behaviour. IPE activities have to be initiated in GP training practices, otherwise, despite good intentions, IPE and IPC will be ineffective.
The effects and safety of omega-3 fatty for acute lung injury: a systematic review and meta-analysis
Authors: Huang Zhongjie , Zheng Jianming , Huang Wencheng , Yan Meihao , Hong Liyue , Hong Yuancheng , Jin Runnv , Huang Xincheng , Fan Hongtao , Chen Huiling , Yang Heping , Su Weiping , Huang Xiaoping 
Published: September 2020

Abstract
Background
Several randomized controlled trials (RCTs) have compared the treatment of acute lung injury (ALI) with omega-3 fatty, yet the results remained inconsistent. Therefore, we attempted this meta-analysis to analyze the role of omega-3 fatty in the treatment of ALI patients.

Methods
We searched PubMed databases from inception date to October 31, 2019, for RCTs that compared the treatment of ALI with or without omega-3 fatty. Two authors independently screened the studies and extracted data from the published articles. Summary mean differences (MD) with 95% confidence intervals (CI) were calculated for each outcome by fixed- or random-effects model.

Results
Six RCTs with a total of 277 patients were identified, of whom 142 patients with omega-3 fatty acid treatment and 135 patients without omega-3 fatty treatment. Omega-3 fatty treatments significantly improve the PaO2 (MD = 13.82, 95% CI 8.55–19.09), PaO2/FiO2 (MD = 33.47, 95% CI 24.22–42.72), total protein (MD = 2.02, 95% CI 0.43–3.62) in ALI patients, and omega-3 fatty acid treatments reduced the duration of mechanical ventilation (MD = − 1.72, 95% CI − 2.84 to − 0.60) and intensive care unit stay (MD = − 1.29, 95% CI − 2.14 to − 0.43) in ALI patients.

Conclusions
Omega-3 fatty can effectively improve the respiratory function and promote the recovery of ALI patients. Future studies focused on the long-term efficacy and safety of omega-3 fatty use for ALI are needed.