Correlates of sedentary time in young children: A systematic review.

Background: Young children appear to spend large portions of their waking time being sedentary. Understanding the correlates of sedentary time would assist in developing effective interventions among young children. The purpose of this systematic review was to summarize the current literature on the correlates of objectively measured sedentary time in young children aged 1-5.99y. Methods: This review was registered with PROSPERO (registration no. CRD42017081374) and aligned with the PRISMA Statement for systematic reviews. Five electronic databases (MEDline, CINAHL Complete, PsycINFO, SportDiscus, Scopus) were searched up to October 26, 2017 for studies investigating correlates of sedentary time measured using objective devices. A semiquantitative approach was used to synthesize data. Results: Forty-five studies were retrieved comprising 13,430 participants, and 84 correlates of sedentary time in young children were evaluated. The associations between sex, sleep habits, daily patterns (childcare vs. non-childcare hours), childcare type and sedentary time were indeterminate. Thirty-nine correlates were consistently unrelated. Forty-one potential correlates were examined in too few studies (<4) to make confident conclusions. Parental sedentary behaviour was reported 3 times and maternal sedentary behaviour was reported once. Out of these four studies, three were positively associated with child sedentary time. Conclusions: Despite reviewing 45 studies that evaluated associations for 84 correlates, this review was unable to identify any consistent correlates of sedentary time in young children. Additional research is needed in this area to provide robust evidence of the correlates of sedentary time in young children, particularly for those examined in only a small number of studies.

Remote monitoring using donor-derived, cell-free DNA after kidney transplantation during the coronavirus disease 2019 pandemic.

BACKGROUND: Donor-derived, cell-free DNA (dd-cfDNA) level correlates with allograft injury with clinical validity and utility for quiescence and active acute rejection (AR) in kidney transplant recipients. We analyzed trends in dd-cfDNA level immediately preceding and during the coronavirus disease 2019 (COVID-19) pandemic with implemented "shelter in place" and a tele-health strategy with remote home phlebotomy to limit COVID-19 exposure. METHODS: During COVID-19 in the United States (US), we surveyed weekly (January 6, 2020-May 25, 2020) metrics for dd-cfDNA corresponding to both a low risk for active rejection (dd-cfDNA < 0.5%) and cohorts with indeterminate levels of 0.5% to 1.0% and > 1.0%. During the study timeframe, over 11,000 patient samples (67%) from 150 kidney transplantation centers were transitioned from standard facility-based to remote phlebotomy. RESULTS: The proportion of dd-cfDNA samples, analyzed in 21 weekly aggregated cohorts by risk-stratification category, was unchanged during the COVID-19 escalation in the US. Linearized slopes for numbers of samples corresponding to indeterminate risk for AR cohorts of > 1.0% and 0.5% to 1.0% were -0.31 and -0.12, respectively; indicating that prevalence of these "at risk for AR cohorts" decreased during remote surveillance. Approximately 73% of samples corresponded to low risk of AR (dd-cfDNA < 0.5%), while an additional 15% of samples had dd-cfDNA level ≤ 1.0%. CONCLUSION: The combination of remote home phlebotomy including dd-cfDNA analysis and a tele-health program offer a new paradigm that may substantially improve patient compliance and assuage anxiety regarding the state of kidney allograft health during the COVID-19 pandemic. Further prospective multi-center studies with robust outcomes data are warranted.

Remote monitoring using donor-derived, cell-free DNA after kidney transplantation during the coronavirus disease 2019 pandemic

Background@#Donor-derived, cell-free DNA (dd-cfDNA) level correlates with allograft injury with clinical validity and utility for quiescence and active acute rejection (AR) in kidney transplant recipients. We analyzed trends in dd-cfDNA level immediately preceding and during the coronavirus disease 2019 (COVID-19) pandemic with implemented “shelter in place” and a tele-health strategy with remote home phlebotomy to limit COVID-19 exposure. @*Methods@#During COVID-19 in the United States (US), we surveyed weekly (January 6, 2020-May 25, 2020) metrics for dd-cfDNA corresponding to both a low risk for active rejection (dd-cfDNA 1.0%. During the study timeframe, over 11,000 patient samples (67%) from 150 kidney transplantation centers were transitioned from standard facility-based to remote phlebotomy. @*Results@#The proportion of dd-cfDNA samples, analyzed in 21 weekly aggregated cohorts by risk-stratification category, was unchanged during the COVID-19 escalation in the US. Linearized slopes for numbers of samples corresponding to indeterminate risk for AR cohorts of > 1.0% and 0.5% to 1.0% were -0.31 and -0.12, respectively; indicating that prevalence of these “at risk for AR cohorts” decreased during remote surveillance. Approximately 73% of samples corresponded to low risk of AR (dd-cfDNA < 0.5%), while an additional 15% of samples had dd-cfDNAlevel ≤ 1.0%. @*Conclusion@#The combination of remote home phlebotomy including dd-cfDNA analysis and a tele-health program offer a new paradigm that may substantially improve patient compliance and assuage anxiety regarding the state of kidney allograft health during the COVID-19 pandemic. Further prospective multi-center studies with robust outcomes data are warranted.

Remote monitoring using donor-derived, cell-free DNA after kidney transplantation during the coronavirus disease 2019 pandemic

Background@#Donor-derived, cell-free DNA (dd-cfDNA) level correlates with allograft injury with clinical validity and utility for quiescence and active acute rejection (AR) in kidney transplant recipients. We analyzed trends in dd-cfDNA level immediately preceding and during the coronavirus disease 2019 (COVID-19) pandemic with implemented “shelter in place” and a tele-health strategy with remote home phlebotomy to limit COVID-19 exposure. @*Methods@#During COVID-19 in the United States (US), we surveyed weekly (January 6, 2020-May 25, 2020) metrics for dd-cfDNA corresponding to both a low risk for active rejection (dd-cfDNA 1.0%. During the study timeframe, over 11,000 patient samples (67%) from 150 kidney transplantation centers were transitioned from standard facility-based to remote phlebotomy. @*Results@#The proportion of dd-cfDNA samples, analyzed in 21 weekly aggregated cohorts by risk-stratification category, was unchanged during the COVID-19 escalation in the US. Linearized slopes for numbers of samples corresponding to indeterminate risk for AR cohorts of > 1.0% and 0.5% to 1.0% were -0.31 and -0.12, respectively; indicating that prevalence of these “at risk for AR cohorts” decreased during remote surveillance. Approximately 73% of samples corresponded to low risk of AR (dd-cfDNA < 0.5%), while an additional 15% of samples had dd-cfDNAlevel ≤ 1.0%. @*Conclusion@#The combination of remote home phlebotomy including dd-cfDNA analysis and a tele-health program offer a new paradigm that may substantially improve patient compliance and assuage anxiety regarding the state of kidney allograft health during the COVID-19 pandemic. Further prospective multi-center studies with robust outcomes data are warranted.

Flexibility is associated with motor competence in schoolchildren.

Available data on the associations between motor competence (MC) and flexibility are limited and result inconclusive. This study aims to examine the relationship between flexibility and MC in children. The sample comprised 596 Portuguese children (47.1% girls) aged 9.7 ± 0.6 years. Motor competence was evaluated with the body coordination test, Körperkoordination Test für Kinder. Cardiorespiratory fitness (20-m shuttle run), muscular strength (curl-up and push-up tests), and flexibility (back-saver sit and reach and trunk-lift tests) were evaluated using the Fitnessgram Test Battery. Z-scores by age and gender for the physical fitness tests were constructed. Analysis of variance and regression analysis were performed. Participants in the healthy zone groups of both flexibility tests exhibited significantly better scores of MC than the participants under the healthy zone (P < 0.001). Back-saver sit and reach and trunk-lift Z-scores, either individually or as a sum, were significant predictors of MC (P < 0.05 for all) after adjustments for the other physical fitness components, age, body mass index, and socioeconomic status, in both genders. Our findings highlight the importance of promoting and developing flexibility, as well as the other health-related physical fitness components in schoolchildren to reach adequate levels of MC.

Objectively measured sedentary behaviour and health and development in children and adolescents: systematic review and meta-analysis.

Sedentary behaviour has emerged as a unique determinant of health in adults. Studies in children and adolescents have been less consistent. We reviewed the evidence to determine if the total volume and patterns (i.e. breaks and bouts) of objectively measured sedentary behaviour were associated with adverse health outcomes in young people, independent of moderate-intensity to vigorous-intensity physical activity. Four electronic databases (EMBASE MEDLINE, Ovid EMBASE, PubMed and Scopus) were searched (up to 12 November 2015) to retrieve studies among 2- to 18-year-olds, which used cross-sectional, longitudinal or experimental designs, and examined associations with health outcomes (adiposity, cardio-metabolic, fitness, respiratory, bone/musculoskeletal, psychosocial, cognition/academic achievement, gross motor development and other outcomes). Based on 88 eligible observational studies, level of evidence grading and quantitative meta-analyses indicated that there is limited available evidence that the total volume or patterns of sedentary behaviour are associated with health in children and adolescents when accounting for moderate-intensity to vigorous-intensity physical activity or focusing on studies with low risk of bias. Quality evidence from studies with robust designs and methods, objective measures of sitting, examining associations for various health outcomes, is needed to better understand if the overall volume or patterns of sedentary behaviour are independent determinants of health in children and adolescents.

A systematic review of the validity and reliability of sedentary behaviour measures used with children and adolescents.

The aim of this review was to evaluate the reliability and validity of methods used to assess the multiple components of sedentary behaviour (i.e. screen time, sitting, not moving and existing at low energy expenditure) in children and adolescents. Twenty-six studies met our inclusion criteria and were reviewed. Thirteen studies reported the reliability of self- and proxy-report measures of sedentary behaviour and seven of these were found to have acceptable test-retest reliability. Evidence for the criterion validity of self- and proxy-report measures was examined in three studies with mixed results. Seven studies examined the reliability and/or validity of direct observation and the findings were generally positive. Five studies demonstrated the utility of accelerometers to accurately classify sedentary behaviour. Self-report measures provide reliable estimates of screen time, yet their validity remains largely untested. While accelerometers can accurately classify participants' behaviour as sedentary, they do not provide information about type of sedentary behaviour or context. Studies utilizing measures of sedentary behaviour need to more adequately report on the validity and reliability of the measures used. We recommend the use of objective measures of sedentary behaviour such as accelerometers, in conjunction with subjective measures (e.g. self-report), to assess type and context of behaviour.

The impact of child and adolescent obesity treatment interventions on physical activity: a systematic review.

Efforts to treat obesity in childhood and adolescence would benefit from a greater understanding of evidence-based strategies to modify physical activity behaviour. A systematic review was conducted to examine the impact of child and adolescent obesity treatment interventions on physical activity. Studies included were randomized controlled trials or controlled trials, with overweight and obese youth (aged < 18 years), which reported statistical analysis of free-living physical activity at pretreatment and post-treatment. Two independent reviewers assessed each study for methodological quality. Seventeen child and three adolescent studies were retrieved, half of which were conducted in the USA. Studies were characterized by small samples of limited cultural and economic diversity. Fifteen studies reported an increase in at least one physical activity outcome at post-test or follow-up. Overall, study quality was rated as low (child median score = 3/10, range = 0-9; adolescent median score = 3/10, range = 2-5) with three child studies classified as high quality (>or=6/10). Research evaluating the effect of child and adolescent obesity treatment trials on physical activity is limited in both quantity and quality. Studies testing innovative, theoretically driven treatment approaches that use robust methodologies are required to better understand generalizable approaches for promoting physical activity participation among obese youth.

Novel thienopyrimidine and thiazolopyrimidine kinase inhibitors with activity against Tie-2 in vitro and in vivo.

The SAR and improvement in potency against Tie2 of novel thienopyrimidine and thiazolopyrimidine kinase inhibitors are reported. The crystal structure of one of these compounds bound to the Tie-2 kinase domain is consistent with the SAR. These compounds have moderate potency in cellular assays of Tie-2 inhibition, good physical properties, DMPK, and show evidence of in vivo inhibition of Tie-2.

The Creatures global digital ecosystem.

An artificial life entertainment software product called Creatures was released in Europe in late 1996 and in the United States and Japan in mid-1997. When installed on a domestic computer (PC or Macintosh), each Creatures CD-ROM creates a virtual world in which autonomous software agents exist. The agents, known as "norn," interact with the human user, with each other, and with objects in their virtual world. Each norn coordinates perception and action via its own modular recurrent neural network. Each network has Hebbian learning, plus diffuse modulation of activity via a "hormonal" system that is part of that norns "biochemistry." Details of each norns neural network and biochemistry are genetically specified, and norns can breed via sexual reproduction. In the reproduction process, genetic material may be mutated and may also be subjected to "gene duplications" that enable potentially unlimited increases in complexity of the norns' design. Over 500,000 Creatures CD-ROMS have now been sold. As each installed copy of Creatures can support 5 to 10 simultaneously existing individual norns, it seems reasonable to estimate that there are up to 5 million norns existing in the "cyberspace" provided by the global Creatures user community. Continued growth of the global norn population, to figures measured in tens of millions, is quite likely. Although a commercial product, the Creatures digital ecosystem should be of interest to artificial life scientists. There are obvious parallels with Yaeger's PolyWorld and Ray's NetTierra systems. This article provides a detailed discussion of the links between the artificial life literature and the technology used in Creatures and includes anecdotal discussion of the "digital naturalism" witnessed on the many independent websites maintained by Creatures enthusiasts.

Comparison of frequency of complications of implantable cardioverter-defibrillators in children versus adults.

Compared with adults patients (n = 309) receiving implantable cardioverter-defibrillators at the same institution, pediatric patients (n = 11) exhibited a trend toward lower defibrillation thresholds. At follow-up of 29 +/- 17 months, the incidence of recurrent arrhythmias was similar, but lead revisions and device infections were more common in the pediatric patients.

Too much like school: social class, age, marital status and attendance/non-attendance at antenatal classes.

OBJECTIVE: To investigate patterns of attendance and non-attendance at National Health Service antenatal classes of first-time mothers in the indigenous white population of a large northern city of the UK. DESIGN: Survey using questionnaires, and selected participants were then given an in-depth interview. SETTING: Five maternity wards in two large northern hospitals in the UK. In-depth interviews took place in the respondents' homes. PARTICIPANTS: Fifty newly delivered women were surveyed of whom 18 took part in the follow-up interviews. FINDINGS: There was a clear hierarchy in attendance and non-attendance based on social class, with middle class women being the most regular attenders, closely followed by older, married, working class women. However, overall social class differences were found to be accounted for by the overwhelming non attendance of young, unmarried, working class women. Older, married, working class women were found to have attendance patterns which were close to their middle class counterparts, and what differences there were seemed to be based on material factors. KEY CONCLUSIONS: The majority of women felt that antenatal classes were too technical and did not address emotional and psychological issues. However, young, single unmarried women perceived the classes most negatively. If midwives are to attract such young women, their fears and their need for peer support will have to be recognised.

Knowledge-based vision and simple visual machines.

The vast majority of work in machine vision emphasizes the representation of perceived objects and events: it is these internal representations that incorporate the 'knowledge' in knowledge-based vision or form the 'models' in model-based vision. In this paper, we discuss simple machine vision systems developed by artificial evolution rather than traditional engineering design techniques, and note that the task of identifying internal representations within such systems is made difficult by the lack of an operational definition of representation at the causal mechanistic level. Consequently, we question the nature and indeed the existence of representations posited to be used within natural vision systems (i.e. animals). We conclude that representations argued for on a priori grounds by external observers of a particular vision system may well be illusory, and are at best place-holders for yet-to-be-identified causal mechanistic interactions. That is, applying the knowledge-based vision approach in the understanding of evolved systems (machines or animals) may well lead to theories and models that are internally consistent, computationally plausible, and entirely wrong.

Artificial evolution: a new path for artificial intelligence?

Recently there have been a number of proposals for the use of artificial evolution as a radically new approach to the development of control systems for autonomous robots. This paper explains the artificial evolution approach, using work at Sussex to illustrate it. The paper revolves around a case study on the concurrent evolution of control networks and visual sensor morphologies for a mobile robot. Wider intellectual issues surrounding the work are discussed, as is the use of more abstract evolutionary simulations as a new potentially useful tool in theoretical biology.

Radiofrequency catheter ablation--Part 1: Pre- and post-procedure nursing responsibilities.

Radiofrequency ablation as a treatment for supraventricular and ventricular tachycardias has increased in popularity as a safe and effective mode of therapy. The critical care nurse's role includes pre-procedure, peri-procedure, and post-procedure observations and interventions that contribute to positive patient outcomes.