Viscosities and Densities of Binary and Ternary Mixtures of Aliphatic and Polyaromatic Hydrocarbons: Pyrene +1-Methylnaphthalene + Dodecane at T = (293.15 to 343.15) K. Experiment and Modeling.

This work presents new experimental viscosity and density data for aromatic and polyaromatic compounds in binary and ternary pyrene, 1-methylnaphthalene, and dodecane mixtures. The lack of experimental viscosity data for these mixtures requires the development of a new database, which is vital for understanding the behavior of mixtures in more complex systems, such as asphaltenes and fuels. The mixtures proposed in this work have been measured over a temperature range of (293.15 to 343.15) K at atmospheric pressure. Several mixture compositions have been studied at these conditions: 1.0, 2.5, 5.0, 7.5, 10.0, 12.5, and 15.0% pyrene mass fraction. The concentration of pyrene correlates with an increase in the viscosity and density values. At the lowest temperature in binary mixtures, the corresponding values reach 4.4217 mPa·s for viscosity and 1.0447 × 103 kg·m-3 for density, respectively. In ternary mixtures, the introduction of dodecane leads to the lowest maximum values of 3.5555 mPa·s for viscosity and 1.0112 × 103 kg·m-3 for density at the same temperature. The experimental data have been employed for the specific modification of viscosity models. These modifications could facilitate the prediction of the viscosity of mixtures that are more complex than those presented in this work. Various viscosity models have been employed, such as Linear, Ratcliff and Khan, modified UNIFAC-Visco, and Krieger-Dougherty. The settings in the models used reliably reproduce the experiment reliably. However, the Ratcliff model agrees excellently with the experiment, having a low standard deviation (2.0%) compared to other models. Furthermore, a model based on the equation of state of Guo is proposed to predict the viscosity values by modifying the specific parameters and adjusting them to the mixtures proposed in this work. The results from this study are compared to previous work, where pyrene, toluene, and heptane mixtures were analyzed. In this case, we find that the decrease of aggregation grade in the present systems is predicted by the model fixed in this work.

Molecular Bridge Engineering for Tuning Quantum Electronic Transport and Anisotropy in Nanoporous Graphene.

Recent advances on surface-assisted synthesis have demonstrated that arrays of nanometer wide graphene nanoribbons can be laterally coupled with atomic precision to give rise to a highly anisotropic nanoporous graphene structure. Electronically, this graphene nanoarchitecture can be conceived as a set of weakly coupled semiconducting 1D nanochannels with electron propagation characterized by substantial interchannel quantum interferences. Here, we report the synthesis of a new nanoporous graphene structure where the interribbon electronic coupling can be controlled by the different degrees of freedom provided by phenylene bridges that couple the conducting channels. This versatility arises from the multiplicity of phenylene cross-coupling configurations, which provides a robust chemical knob, and from the interphenyl twist angle that acts as a fine-tunable knob. The twist angle is significantly altered by the interaction with the substrate, as confirmed by a combined bond-resolved scanning tunneling microscopy (STM) and ab initio analysis, and should accordingly be addressable by other external stimuli. Electron propagation simulations demonstrate the capability of either switching on/off or modulating the interribbon coupling by the corresponding use of the chemical or the conformational knob. Molecular bridges therefore emerge as efficient tools to engineer quantum transport and anisotropy in carbon-based 2D nanoarchitectures.

Mapping recommended strategies to promote active and healthy lifestyles through physical education classes: a scoping review.

BACKGROUND: Understanding which strategies have been recommended for the promotion of active and healthy lifestyles through physical education (PE) classes can guide PE policies and practice. Therefore, we summarized worldwide recommendations regarding strategies for PE classes that have aimed to promote active and healthy lifestyles among school-aged children and adolescents. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines were utilized. A literature search was carried out in June 2020 in eight peer-reviewed literature databases, in addition to searches in institutional and personal libraries. The eligibility criteria included any online document that included recommendations targeting any dimension of PE classes (e.g., policy and environment, curriculum, appropriate instruction, student assessment, and strategies that interact with PE) published since 2000. RESULTS: In total, 2,408 potentially eligible documents were screened. Of these, 63 were included in the final analysis. The recommended strategies were as follows: six referred to policy and environment (valuing PE, higher frequency and duration of classes, inclusive PE classes, mandatory daily classes, evaluation of PE classes, and qualified teachers), five to curriculum (structure, type of content, cross-cutting themes, and components that improve PE classes), four to appropriate instruction (promotion of physical activities, inclusion of social issues, employment of the use of innovative technologies, and organization of the teaching-learning process), and three to student assessment (understanding human movement concepts, evaluation of contents, and assessment methods to develop an active and healthy lifestyle). CONCLUSION: Twenty-one strategies recommended for PE classes linked to five dimensions aimed at different target populations were identified. Over half were linked to the dimensions of policy and environment and appropriate instruction. PE is recommended to be mandatory and valued at all educational levels, with weekly frequency that contributes to an active and healthy lifestyle. This review shows that guaranteeing different experiences beyond sports, improving social inclusion, using innovative technologies, and providing adequate materials and spaces to be important challenges and ways to guide policies, programs, and new research in this field of knowledge. Open Science Framework Registration: https://osf.io/harwq/.

Health behaviors of the Sierra de Cádiz. Myths and beliefs?

INTRODUCTION: Throughout history, the practice and persistence of health behaviours and attitudes based on traditional medicine have been observed. OBJECTIVES: To determine whether there are health myths and beliefs in the study population, to describe these myths and beliefs, to determine whether they have persisted over time and to compile the most common myths and beliefs in Sierra de Cádiz. METHODOLOGY: This is a descriptive, observational, cross-sectional study. Our data collection tool was a questionnaire completed by 45 health care professionals in the study area. RESULTS: A total of 73.3% of the population had health-related myths or beliefs, of which 70% resorted to healers and the use of a herpes remedy. CONCLUSIONS: This study opens and motivates new research lines and highlights the need to develop educational campaigns and implement health-education programmes in which traditional medicine is involved.

Transfusion support in COVID-19 patients: Impact on hospital blood component supply during the outbreak.

BACKGROUND: During the COVID-19 outbreak, most hospitals deferred elective surgical procedures to allow space for the overwhelming number of COVID-19 patient admissions, expecting a decrease in routine blood component requirements. However, because transfusion support needs of COVID-19 patients are not well known, its impact on hospital blood supply is uncertain. The objective of this study was to assess the effect of the COVID-19 pandemic on transfusion demand. STUDY DESIGN AND METHODS: Transfusion records during the peak of the COVID-19 pandemic (March 1-April 30, 2020) were reviewed in our center to assess changes in blood requirements. RESULTS: During this period 636 patients received a total of 2934 blood components, which reflects a 17.6% reduction in transfusion requirements with regard to the same period of 2019, and blood donations in Madrid dropped by 45%. The surgical blood demand decreased significantly during the outbreak (50.2%). Blood usage in the hematology and oncology departments remained unchanged, while the day ward demand halved, and intensive care unit transfusion needs increased by 116%. A total of 6.2% of all COVID inpatients required transfusion support. COVID-19 inpatients consumed 19% of all blood components, which counterbalanced the savings owed to the reduction in elective procedures. CONCLUSION: Although only a minority of COVID-19 inpatients required transfusion, the expected reduction in transfusion needs caused by the lack of elective surgical procedures is partially offset by the large number of admitted patients during the peak of the pandemic. This fact must be taken into account when planning hospital blood supply.

Children's moderate-to-vigorous physical activity on weekdays versus weekend days: a multi-country analysis.

PURPOSE: The Structured Days Hypothesis (SDH) posits that children's behaviors associated with obesity - such as physical activity - are more favorable on days that contain more 'structure' (i.e., a pre-planned, segmented, and adult-supervised environment) such as school weekdays, compared to days with less structure, such as weekend days. The purpose of this study was to compare children's moderate-to-vigorous physical activity (MVPA) levels on weekdays versus weekend days using a large, multi-country, accelerometer-measured physical activity dataset. METHODS: Data were received from the International Children's Accelerometer Database (ICAD) July 2019. The ICAD inclusion criteria for a valid day of wear, only non-intervention data (e.g., baseline intervention data), children with at least 1 weekday and 1 weekend day, and ICAD studies with data collected exclusively during school months, were included for analyses. Mixed effects models accounting for the nested nature of the data (i.e., days within children) assessed MVPA minutes per day (min/day MVPA) differences between weekdays and weekend days by region/country, adjusted for age, sex, and total wear time. Separate meta-analytical models explored differences by age and country/region for sex and child weight-status. RESULTS/FINDINGS: Valid data from 15 studies representing 5794 children (61% female, 10.7 ± 2.1 yrs., 24% with overweight/obesity) and 35,263 days of valid accelerometer data from 5 distinct countries/regions were used. Boys and girls accumulated 12.6 min/day (95% CI: 9.0, 16.2) and 9.4 min/day (95% CI: 7.2, 11.6) more MVPA on weekdays versus weekend days, respectively. Children from mainland Europe had the largest differences (17.1 min/day more MVPA on weekdays versus weekend days, 95% CI: 15.3, 19.0) compared to the other countries/regions. Children who were classified as overweight/obese or normal weight/underweight accumulated 9.5 min/day (95% CI: 6.9, 12.2) and 10.9 min/day (95% CI: 8.3, 13.5) of additional MVPA on weekdays versus weekend days, respectively. CONCLUSIONS: Children from multiple countries/regions accumulated significantly more MVPA on weekdays versus weekend days during school months. This finding aligns with the SDH and warrants future intervention studies to prioritize less-structured days, such as weekend days, and to consider providing opportunities for all children to access additional opportunities to be active.

Aortitis in the setting of catastrophic antiphospholipid syndrome in a patient with systemic lupus erythematosus.

Catastrophic antiphospholipid syndrome (CAPS) is a rare condition characterized by multiple thromboses affecting mainly small vessels in a short period of time in patients with antiphospholipid antibodies. A high suspicion index is mandatory in order to initiate rapidly aggressive immunomodulatory therapy to avoid a very poor prognosis. Systemic lupus erythematosus (SLE) is often associated with antiphospholipid syndrome, with a worse outcome when the catastrophic features occur. We report the case of a 64-year-old woman with a clinical debut of SLE who presented concomitantly with CAPS with several thrombosis affecting the kidney, spleen and bilateral limbs with blue toe syndrome in both legs. Furthermore, she presented with aortitis, with a malaise and myalgias and general syndrome (asthenia, hyporexia and mild weight loss). Fortunately, she had a good response to multi-target combination therapy (anticoagulants, corticosteroids, hydroxychloroquine, intravenous immunoglobulins, plasma exchange and rituximab). Here, we discuss the association between aortitis and CAPS secondary to SLE, and review the literature regarding similar conditions.

Physical activity and sedentary time of youth in structured settings: a systematic review and meta-analysis.

BACKGROUND: Structured settings, such as school, childcare, afterschool programs, summer camps, and physical activity/sport programs are crucial to promoting physical activity (PA) opportunities and reducing sedentary (ST) for children and adolescents. However, little is known about how much PA and ST children and adolescents accumulate in structured settings. The aim of this study is to conduct a systematic review and meta-analysis of the absolute amount of time youth spend physically active and sedentary in different structured settings (Prospero number: 42018111804). METHODS: Observational and experimental/quasi-experimental studies (baseline data only) with full-text available, written in English and published in a peer-reviewed journal, reporting the total amount of objectively measured PA (light, moderate, vigorous, and/or total physical activity) and/or time spent ST during structured settings among youth (3 to 18 years) were eligible. Adjusted meta-analysis was conducted to estimate the pooled mean of time spent in PA and ST, by settings and sex. RESULTS: A total of 187 studies (childcare n=60; school n=91; afterschool programs n=14; summer camp n=4; and Physical activity/ sport programs n=18) from 30 countries (47.9% United States), representing 74,870 youth (mean age 8.6 years old) were included. Overall, there was a high variation between studies in outcomes and settings. The meta-analyses revealed, on average, youth spend 221.8 minutes (36.7 min/hour) in ST and 32.1 minutes (5.1 min/hour) in MVPA during childcare hours, and 223.9 minutes (36.7min/hour) in ST and 27.8 min (4.4 min/hour) in MVPA at school. Relatively, youth are engaged in more MVPA in afterschool programs (11.7 min/hour), PA/ sport programs (20.9 min/hour), and summer camps (6.4 min/hour), when compared to childcare and school. CONCLUSION: Total PA accumulated during childcare and MVPA accumulated during schools hours were close to recommendations, despite high proportion of ST. Afterschool programs, summer camp and PA/ sport programs are important settings that can contribute to daily PA and reduced ST. Ensuring all youth have access to these structured settings may be an important step forward for public health.

Use of eltrombopag for secondary immune thrombocytopenia in clinical practice.

Eltrombopag is a second-line treatment in primary immune thrombocytopenia (ITP). However, its role in secondary ITP is unknown. We evaluated the efficacy and safety of eltrombopag in secondary ITP in daily clinical practice. Eighty-seven secondary ITP patients (46 with ITP secondary to autoimmune syndromes, 23 with ITP secondary to a neoplastic disease subtype: lymphoproliferative disorders [LPDs] and 18 with ITP secondary to viral infections) who had been treated with eltrombopag were retrospectively evaluated. Forty-four patients (38%) had a platelet response, including 40 (35%) with complete responses. Median time to platelet response was 15 days (95% confidence interval, 7-28 days), and was longer in the LPD-ITP group. Platelet response rate was significantly lower in the LPD-ITP than in other groups. However, having achieved response, there were no significant differences between the durable response of the groups. Forty-three patients (49·4%) experienced adverse events (mainly grade 1-2), the commonest being hepatobiliary laboratory abnormalities. There were 10 deaths in this case series, all of which were related to pre-existing medical conditions. In routine clinical practice, eltrombopag is effective and well-tolerated in unselected patients with ITP secondary to both immune and infectious disorders. However, the response rate in LPD-ITP is low.

Two novel mutations (HBG1: c.-250C > T and HBG2: c.-250C > T) associated with hereditary persistence of fetal hemoglobin.

Mutations within the promoters of either of the γ-globin genes [(G)γ (HBG1) and (A)γ (HBG2)] lead to variably increased levels of fetal hemoglobin (Hb) (Hb F, α2γ2) in the syndrome of hereditary persistence of fetal Hb (HPFH). Carriers of such mutations are clinically asymptomatic and the mutations are usually detected as part of routine screening or family studies. We describe two new nondeletional HPFH mutations, both C > T substitutions at position c.-250, one in the HBG1 and the other in the HBG2 globin gene promoters.

Introducing Design Strategies to Preserve N-Heterocycles Throughout the On-Surface Synthesis of Graphene Nanostructures.

Despite the impressive advances in the synthesis of atomically precise graphene nanostructures witnessed during the last decade, advancing in compositional complexity faces major challenges. The concept of introducing the desired functional groups or dopants in the molecular precursor often fails due to their lack of stability during the reaction path. Here, a study on the stability of different pyridine and pyrimidine moieties during the on-surface synthesis of graphene nanoribbons on Au(111) is presented. Combining bond-resolved scanning tunneling microscopy with X-ray photoelectron spectroscopy, the thermal evolution of the nitrogen dopants throughout the whole reaction sequence is tracked. A comparative experimental and ab initio electronic characterization confirms the presence of dopants in the final structures, revealing also that the pyridinic nitrogen leads to a significant band downshift. The results demonstrate that, by using synthetic strategies to lower the reaction temperatures, one can preserve specific N-heterocycles throughout all the reaction steps of the synthesis of graphene nanoribbons and beyond the interibbon coupling reaction that leads to nanoporous graphene.

On-Surface Synthesis of Organolanthanide Sandwich Complexes.

The synthesis of lanthanide-based organometallic sandwich compounds is very appealing regarding their potential for single-molecule magnetism. Here, it is exploited by on-surface synthesis to design unprecedented lanthanide-directed organometallic sandwich complexes on Au(111). The reported compounds consist of Dy or Er atoms sandwiched between partially deprotonated hexahydroxybenzene molecules, thus introducing a distinct family of homoleptic organometallic sandwiches based on six-membered ring ligands. Their structural, electronic, and magnetic properties are investigated by scanning tunneling microscopy and spectroscopy, X-ray absorption spectroscopy, X-ray linear and circular magnetic dichroism, and X-ray photoelectron spectroscopy, complemented by density functional theory-based calculations. Both lanthanide complexes self-assemble in close-packed islands featuring a hexagonal lattice. It is unveiled that, despite exhibiting analogous self-assembly, the erbium-based species is magnetically isotropic, whereas the dysprosium-based compound features an in-plane magnetization.

Dermoscopy of very small basal cell carcinoma (≤3mm).

BACKGROUND: Basal cell carcinoma (BCC) dermoscopy is key to lower the biopsy threshold of suspicious lesions. There is a scarcity of published data on the dermoscopy of very small BCC (≤3mm) and its differences from larger BCCs. OBJECTIVE: To describe and compare dermoscopic features of BCCs measuring ≤3mm, with those from 3 to 10mm. METHODS: An analytical cross-sectional study, included biopsy-proven BCCs that had dermoscopic photographic images, between January 2017 and December 2022 in a Skin Cancer Center in Medellín, Colombia. Demographic, clinic-pathological and dermoscopic features were compared between very small BCCs (vsBCCs) and a reference group. RESULTS: A total of 326 BCCs in 196 patients were included, of whom 60% were male. The most common Fitzpatrick phototype was III. vsBCCs accounted for 25% of the lesions (81/326). Face and neck were the most frequent locations (53%), especially in very small tumors. The nodular type was more common in very small tumors than in larger lesions, the superficial type was less frequent, and aggressive types were equally prevalent in both groups. On dermoscopy, very small tumors were statistically more likely to present pigmented structures than reference lesions, especially blue-gray dots (67% vs. 54%), vessels were less frequent, particularly short-fine telangiectasias (SFT) (52% vs. 66%), as were other structures such as shiny white structures (SWS), ulceration, micro-erosions, and scales. STUDY LIMITATIONS: Latin-American sample, lacks information on dark phototypes CONCLUSIONS: Pigmented structures, especially blue-gray dots, were most common in vsBCCs when compared to larger lesions; SFT, SWS and other findings were less prevalent.

Lanthanide metal-organic network featuring strong perpendicular magnetic anisotropy.

The coordination of lanthanides atoms in two-dimensional surface-confined metal-organic networks is a promising path to achieve an ordered array of single atom magnets. These networks are highly versatile with plenty of combinations of molecular linkers and metallic atoms. Notably, with an appropriate choice of molecules and lanthanide atoms it should be feasible to tailor the orientation and intensity of the magnetic anisotropy. However, up to now only tilted and almost in-plane easy axis of magnetizations were reported in lanthanide-based architectures. Here we introduce an Er-directed two-dimensional metallosupramolecular network on Cu(111) featuring strong out-of-plane magnetic anisotropy. Our results will contribute to pave avenues for the use of lanthanides in potential applications in nanomagnetism and spintronics.

Physical Education for Health Among School-Aged Children and Adolescents: A Scoping Review of Reviews.

BACKGROUND: Physical education (PE) classes in schools are considered relevant to implement interventions, especially focused on physical activity. However, evidence overviews on how PE classes contribute to general health (physical, social, affective, and cognitive domains) are still needed. Thus, we summarized evidence synthesis (eg, systematic reviews) that addressed the contribution of PE classes to the health of school-aged children and adolescents. METHODS: We performed a scoping review with searches in 8 databases and institutional websites to find systematic reviews or meta-analyses that answered this review's research question. Data charting form included the identification of the study, health outcomes, and PE classes' strategies (policies and environment, curriculum, appropriate instructions, and evaluation). An interactive process was performed to build the evidence summary. RESULTS: An initial search yielded 2264 titles, and 49 systematic reviews (including 11 with meta-analysis) were included in this review. Most documents reported the main benefits of PE classes on physical domain outcomes (eg, physical activity, cardiorespiratory fitness, body mass index, and fundamental motor skills). However, evidence on the benefits of PE classes in affective (eg, enjoyment, motivation, and autonomy); social (eg, cooperation, problem-solving, and making friends); and cognitive (eg, memory, attention, concentration, and decision making) domains were found. Strategies on PE classes for health benefits were highlighted. CONCLUSIONS: These elements were detailed in the evidence summary, which may be considered to guide researchers, teachers, and practitioners to define research and practice priorities on PE class interventions for health in the school context.

Atomically Sharp Lateral Superlattice Heterojunctions Built-In Nitrogen-Doped Nanoporous Graphene.

Nanometer scale lateral heterostructures with atomically sharp band discontinuities can be conceived as the 2D analogues of vertical Van der Waals heterostructures, where pristine properties of each component coexist with interfacial phenomena that result in a variety of exotic quantum phenomena. However, despite considerable advances in the fabrication of lateral heterostructures, controlling their covalent interfaces and band discontinuities with atomic precision, scaling down components and producing periodic, lattice-coherent superlattices still represent major challenges. Here, a synthetic strategy to fabricate nanometer scale, coherent lateral superlattice heterojunctions with atomically sharp band discontinuity is reported. By merging interdigitated arrays of different types of graphene nanoribbons by means of a novel on-surface reaction, superlattices of 1D, and chemically heterogeneous nanoporous junctions are obtained. The latter host subnanometer quantum dipoles and tunneling in-gap states, altogether expected to promote interfacial phenomena such as interribbon excitons or selective photocatalysis.

Physical Activity Guidelines for the Brazilian Population: Recommendations Report.

BACKGROUND: This article presents the recommendations from the Physical Activity Guidelines for the Brazilian Population. METHODS: A steering committee composed of a chair, 6 experts in physical activity, and representatives from the Ministry of Health/Brazil, Pan American Health Organization, Brazilian Society of Physical Activity and Health designed the guidelines, which was implemented by 8 working groups, as follows: (1) understanding physical activity, (2) children up to 5 years old, (3) children and youth from 6 to 17 years old, (4) adults, (5) older adults (60 years and above), (6) physical education at school, (7) pregnant and postpartum women, and (8) people with disabilities. The methodological steps included evidence syntheses, hearings with key stakeholders, and public consultation. RESULTS: Across 8 chapters, the guidelines provide definitions of physical activity and sedentary behavior, informing target groups on types of physical activity, dosage (frequency, intensity, and duration), benefits, and supporting network for physical activity adoption. The guidelines are openly available in Portuguese, Spanish, English, and Braille and in audio versions, with a supplementary guide for health professionals and decision makers, and a report about the preparation and references. CONCLUSIONS: The Physical Activity Guidelines for the Brazilian Population provide evidence-based recommendations, being a public-directed resource to contribute to the physical activity promotion in Brazil.

Physical Activity Guidelines for the Brazilian Population: Development and Methods.

BACKGROUND: This article describes the process and methods used in the development of the first ever Physical Activity Guidelines for the Brazilian Population. METHODS: The steering committee established 8 working groups based on other guidelines and the Brazilian agenda for public health and physical activity (PA) promotion: (1) understanding PA; (2) children up to 5 years; (3) children and youth (6-17 y); (4) adults; (5) older adults (60 years and above); (6) physical education at school; (7) pregnant and postpartum women; and (8) people with disabilities. Working groups were formed to (1) synthesize the literature on each topic; (2) conduct workshops with stakeholders, health professionals, researchers, and the public; and (3) prepare a draft chapter for open online consultation. RESULTS: The document provides guidance for the population on the benefits of being active and recommendations regarding the amount (frequency, intensity, and duration) of PA recommended across all chapters. It also includes information on supporting networks for PA. CONCLUSIONS: The PA guidelines are widely accessible in Portuguese, including versions in English, Spanish, audiobook, and Braille, and will assist policy makers and professionals from several sectors to promote PA. The ultimate goal is to increase population levels of PA in Brazil.

Temporal Trends in Children's School Day Moderate to Vigorous Physical Activity: A Systematic Review and Meta-Regression Analysis.

BACKGROUND: Evidence from a limited sample of countries indicates that time for physical education and recess during school have declined. Schools are called to provide children with 30 minutes of moderate to vigorous physical activity (MVPA). This systematic review and meta-analysis estimated temporal trends in children's school day MVPA. METHODS: Three online databases were searched to identify studies with objectively measured MVPA, during school hours, in school aged children (5-18 y). Multilevel random-effects meta-analyses estimated MVPA by year, and meta-regression analyses estimated temporal trends in school day MVPA. RESULTS: Studies (N = 65) providing 171 MVPA estimates, representing 60,779 unique children, from 32 countries, and spanning 2003-2019 were identified. Most studies were conducted in North America (n = 33) or Europe (n = 21). School day MVPA ranged from 18.1 (95% confidence interval, 15.1-21.1) to 47.1 (95% confidence interval, 39.4-54.8) minutes per day in any given year. Meta-regression analyses indicated that MVPA declined from 2003 to 2010 (approximately 15 min decline), plateaued from 2010 to 2015 (approximately 1 min decrease), and increased from 2015 to 2019 (approximately 5 min increase). CONCLUSIONS: School day MVPA decreased from 2003 to 2010 and has recently begun to increase. However, the majority of the evidence is from North America and Europe with some evidence from Oceania and very little evidence from Asia to South America.