Cannabidiol (CBD) is being investigated as a treatment for several medical disorders but there is uncertainty about its safety. We conducted the first systematic review and meta-analysis of the adverse effects of CBD across all medical indications. Double-blind randomized placebo-controlled clinical trials lasting ≥7 days were included. Twelve trials contributed data from 803 participants to the meta-analysis. Compared with placebo, CBD was associated with an increased likelihood of withdrawal for any reason (OR 2.61, 95% CI: 1.38–4.96) or due to adverse events (OR 2.65, 95% CI: 1.04–6.80), any serious adverse event (OR 2.30, 95% CI: 1.18–4.48), serious adverse events related to abnormal liver function tests (OR 11.19, 95% CI: 2.09–60.02) or pneumonia (OR 5.37, 95% CI: 1.17–24.65), any adverse event (OR 1.55, 95% CI: 1.03–2.33), adverse events due to decreased appetite (OR 3.56, 95% CI: 1.94–6.53), diarrhoea (OR 2.61, 95% CI: 1.46–4.67), somnolence (OR 2.23, 95% CI: 1.07–4.64) and sedation (OR 4.21, 95% CI: 1.18–15.01). Associations with abnormal liver function tests, somnolence, sedation and pneumonia were limited to childhood epilepsy studies, where CBD may have interacted with other medications such as clobazam and/or sodium valproate. After excluding studies in childhood epilepsy, the only adverse outcome associated with CBD treatment was diarrhoea (OR 5.03, 95% CI: 1.44–17.61). In summary, the available data from clinical trials suggest that CBD is well tolerated and has relatively few serious adverse effects, however interactions with other medications should be monitored carefully. Additional safety data from clinical trials outside of childhood epilepsy syndromes and from studies of over-the-counter CBD products are needed to assess whether the conclusions drawn from clinical trials can be applied more broadly.

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The Cypher property graph query language is an evolving language, originally designed and implemented as part of the Neo4j graph database, and it is currently used by several commercial database products and researchers. We describe Cypher 9, which is the first version of the language governed by the openCypher Implementers Group. We first introduce the language by example, and describe its uses in industry. We then provide a formal semantic definition of the core read-query features of Cypher, including its variant of the property graph data model, and its "ASCII Art" graph pattern matching mechanism for expressing subgraphs of interest to an application. We compare the features of Cypher to other property graph query languages, and describe extensions, at an advanced stage of development, which will form part of Cypher 10, turning the language into a compositional language which supports graph projections and multiple named graphs.

Despite the maturity of commercial graph databases, little consensus has been reached so far on the standardization of data definition languages (DDLs) for property graphs (PG). The discussion on the characteristics of PG schemas is ongoing in many standardization and community groups. Although some basic aspects of a schema are already present in Neo4j 3.5, like in most commercial graph databases, full support is missing allowing to constraint property graphs with more or less flexibility.In this paper, we focus on two different perspectives from which a PG schema should be considered, as being descriptive or prescriptive, and we show how it would be possible to switch from one to another as the application under development gains more stability. Apart from proposing concise schema DDL inspired by Cypher syntax, we show how schema validation can be enforced through homomorphisms between PG schemas and PG instances; and how schema evolution can be described through the use of graph rewriting operations. Our prototypical implementation demonstrates feasibility and shows the need of offering high-level query primitives to accommodate flexible graph schema requirements as showcased in our work. * Currently on leave at the University of Waterloo, Canada.

Objectives: We conducted a cluster-randomized feasibility trial of 90-minute Chlamydia trachomatis tests and same day on-site treatment ('Test n Treat/TnT') in six technical colleges in London, England, to assess TnT uptake rates; follow-up rates; prevalence of C. trachomatis at baseline and 7 months; time to treatment; acceptability of TnT. Methods: Participants completed questionnaires and provided genitourinary samples at baseline and 7 months. Participants were informed that baseline samples would not be tested for 7 months and were advised to get screened independently. Colleges were randomly allocated 1:1 to intervention (TnT) or control (no TnT). One month and 4 months post recruitment, participants at intervention colleges were texted invitations for on-site free C. trachomatis tests. A purposive sample of students who did/did not attend for screening were interviewed (n ¼ 26). Results: Five hundred and nine sexually active students were recruited: median age 17.9 years, 47% male, 50% black ethnicity, 55% reporting two or more sexual partners in the previous year. TnT uptake was 13% (33/259; 95% CI 8.9e17.4%) at 1 month and 10% (26/259; 6.7e14.4%) at 4 months with overall C. trachomatis positivity 5.1% (3/59; 1.1e14.2%). Follow-up at 7 months was 62% (317/509) for questionnaires and 52% (264/509) for samples. C. trachomatis prevalence was 6.2% (31/503) at baseline and 6.1% (16/264) at 7 months. Median time from test to treatment was 15 h. Interviews suggested low test uptake was associated with not feeling at risk, perceptions of stigma, and little knowledge of sexually transmitted infections (STIs). Conclusions: Despite high C. trachomatis rates at baseline and follow-up, uptake of testing was low. Like many countries, England urgently needs better sex education, including making STI testing routine/ normal.

The paper describes the present and the future of graph updates in Cypher, the language of the Neo4j property graph database and several other products. Update features include those with clear analogs in relational databases, as well as those that do not correspond to any relational operators. Moreover, unlike SQL, Cypher updates can be arbitrarily intertwined with querying clauses. After presenting the current state of update features, we point out their shortcomings, most notably violations of atomicity and nondeterministic behavior of updates. These have not been previously known in the Cypher community. We then describe the industry-academia collaboration on designing a revised set of Cypher update operations. Based on discovered shortcomings of update features, a number of possible solutions were devised. They were presented to key Cypher users, who were given the opportunity to comment on how update features are used in real life, and on their preferences for proposed fixes. As the result of the consultation, a new set of update operations for Cypher were designed. Those led to a streamlined syntax, and eliminated the unexpected and problematic behavior that original Cypher updates exhibited.