bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regulation of lipoprotein lipase-mediated lipolysis of triglycerides
Authors: Basu Debapriya , Goldberg Ira J. 
Published: April 2020

Purpose of review
To discuss the recent developments in structure, function and physiology of lipoprotein lipase (LpL) and the regulators of LpL, which are being targeted for therapy.

Recent findings
Recent studies have revealed the long elusive crystal structure of LpL and its interaction with glycosylphosphatidylinositol anchored high-density lipoprotein binding protein 1 (GPIHBP1). New light has been shed on LpL being active as a monomer, which brings into questions previous thinking that LpL inhibitors like angiopoietin-like 4 (ANGPTL4) and stabilizers like LMF1 work on disrupting or maintaining LpL in dimer form. There is increasing pharmaceutical interest in developing targets to block LpL inhibitors like ANGPTL3. Other approaches to reducing circulating triglyceride levels have been using an apoC2 mimetic and reducing apoC3.

Summary
Lipolysis of triglyceride-rich lipoproteins by LpL is a central event in lipid metabolism, releasing fatty acids for uptake by tissues and generating low-density lipoprotein and expanding high-density lipoprotein. Recent mechanistic insights into the structure and function of LpL have added to our understanding of triglyceride metabolism. This has also led to heightened interest in targeting its posttranslational regulators, which can be the next generation of lipid-lowering agents used to prevent hypertriglyceridemic pancreatitis and, hopefully, cardiovascular disease.
The next generation of triglyceride-lowering drugs: will reducing apolipoprotein C-III or angiopoietin like protein 3 reduce cardiovascular disease?
Authors: Reeskamp Laurens F. , Tromp Tycho R. , Stroes Erik S.G. 
Published: April 2020

Purpose of review
Apolipoprotein C-III (ApoC-III) and angiopoietin like protein 3 (angptl3) have emerged as key regulators of triglyceride metabolism. Based on Mendelian randomisation studies, novel therapeutic strategies inhibiting these proteins using monoclonal antibodies or gene silencing techniques might reduce residual cardiovascular disease (CVD) risk in dyslipidemic patients. This article aims to review the role of apoC-III and angptl3 in triglyceride metabolism and combine early clinical evidence of CVD reducing potential of these new therapeutic targets.

Recent findings
Angptl3 inhibition by mAb or antisense therapy has recently completed phase I and II studies, respectively and demonstrate robust apolipoprotein B (apoB) lowering up to 46%. Volanesorsen is an antisense therapy approved for patients with extremely elevated plasma triglyceride levels in which it showed no consistent apoB reduction. However, the GalNAc-conjugated oligonucleotide showed moderate (up to ∼30%) apoB reduction in a phase 1/2a dose-finding study.

Summary
Angptl3 and apoC-III are novel targets in lipoprotein metabolism that reduce triglycerides when inhibited. The expected CVD risk reduction may be mediated through reduced triglyceride-rich lipoprotein particle number, reflected by apoB, rather than triglyceride reduction per se. Limited human evidence shows that apoC-III and angptl3 inhibition both potently lower triglycerides, but since angptl3 inhibition reduces apoB more robustly it may be expected to confer more favorable CVD risk reduction.
The Effect of Adalimumab Treatment on Linear Growth in Children With Crohn Disease
Authors: Matar Manar , Shamir Raanan , Lev‐Zion Raffi , Broide Efrat , Weiss Batia , Ledder Oren , Guz‐Mark Anat , Rinawi Firas , Cohen Shlomi , Topf‐Olivestone Chani , Shaoul Ron , Yerushalmi Baruch , Assa Amit 
Published: April 2020

ABSTRACTObjectives:Growth impairment is common in children with Crohn disease (CD). We aimed to assess the effect of adalimumab (ADL) treatment on linear growth in children with CD in a post‐hoc analysis of the Pediatric Crohn's Disease AdalImumab Level–based Optimization Treatment randomized controlled trial.Methods:Children 6 to 17 years who responded to ADL induction were assessed consecutively for anthropometric parameters. Associations of these parameters with disease characteristics and disease activity were analyzed.Results:Overall, 66 patients completed 72 weeks of follow‐up (25% girls, mean age of 15.6 ± 2.5 years). Median (interquartile range [IQR]) height z score improved from −0.6 (−1.6–0.15) at baseline to −0.33 (−1.3–0.5) at week 72 (P = 0.005) with lesser improvement in patients with perianal disease. Similar effect was noted in children with growth potential (boys younger than 16 years, girls younger than 14 years). Median (IQR) height velocity standard deviation was −0.32 (−1.5–0.8) at week 26, and +0.11 (−1.1–1.3) at week 72. Median weight z score increased from −0.54 (−1.2–0.15) to −0.1 (−0.9–0.6), P < 0.001 and body mass index from −0.4 (−1.0–0.5) to 0.0 (−0.8–0.9), P = 0.005. Pediatric CD activity index and erythrocyte sedimentation rate at week 4 correlated negatively with height z score changes (P = 0.043 and P = 0.048, respectively), whereas sustained clinical and biologic remission (week 4–72) were positively associated with changes in height z scores. Significant improvement in linear growth was predicted by lower pediatric CD activity index and erythrocyte sedimentation rate at the end of induction and sustained clinical remission (P = 0.05) and sustained normal C‐reactive protein (P = 0.001) at all visits.Conclusion:In children with moderate‐to‐severe CD, ADL treatment had a significant effect on linear growth, with normalization of weight and body mass index (clinicaltrials.gov no: NCT02256462).
Development and Pilot Testing of a Multidimensional Learning Environment Survey
Authors: Jessee Mary Ann , Russell Regina G. , Kennedy Betsy B. , Dietrich Mary S. , Schorn Mavis N. 
Published: April 2020

Background
Multiple, complex factors comprise the learning environment and influence student learning outcomes, yet comprehensive evaluation of the learning environment in nursing schools is limited.

Purpose
The Learning Environment Survey (LES) was developed to facilitate nursing students' report of perceptions of the complex learning environment in nursing education.

Methods
Systematic exploration of the literature, conceptual operationalization of the learning environment, and development of an item pool were completed. Content validity was established with expert assessment, student testing for clarity, and calculation of scale-content validity index/average (S-CVI/Ave). Pilot testing was completed at 1 school of nursing with baccalaureate-equivalent prelicensure and advanced practice master's level students, and doctor of nursing practice students.

Results
The CVI (S-CVI/Ave) was 0.92. Domain scores demonstrated Cronbach's α reliabilities of 0.67 or higher with most being > 0.85.

Conclusion
The LES establishes a mechanism for eliciting comprehensive learning environment data for systematic assessment and national comparison of multiple nursing learning environments.
Nursing Student Medication Administration Performance
Authors: Jarvill Melissa 
Published: April 2020

Background
Nurses must be adequately prepared for safe medication administration.

Purpose
The specific aims of the study were to compare first- and final-semester nursing students' medication administration performance, describe graduating nursing student performance, assess the long-term effect of an Individual Simulation-Based Experience (ISBE), and determine if nursing assistant experience impacted performance.

Methods
The study was a longitudinal, descriptive, experimental, 2-group pretest-posttest design. The Medication Administration Safety Assessment Tool was used to assess nursing student (n = 68) medication administration performance at 3 points in time: after learning the skill, after participation in an ISBE or traditional practice session, and prior to graduation.

Results
Only one-third of senior nursing students accurately demonstrated medication administration. There was no significant difference between first- and last-semester performance.

Conclusion
Findings suggest nursing students are not prepared for safe medication administration upon graduation. The reality of practice opportunities to perform this skill throughout a nursing program should be examined.
Trends of Human Immunodeficiency Virus, Syphilis, and Hepatitis C Infections Among Men Who Have Sex With Men in Chongqing, China: A Serial Cross-sectional Survey From 2011 to 2018
Authors: Lu Rongrong , Zhang Xiangjun , Zhou Chao , Zhang Wei , Ouyang Lin , Xing Hui , Shao Yiming , Ruan Yuhua , Wu Guohui 
Published: April 2020

Background
Human immunodeficiency virus (HIV) prevalence and incidence rates have expeditiously increased among Chongqing men who have sex with men (MSM) over the past decade. This study investigated the trends of HIV, syphilis, and hepatitis C virus (HCV) infections and behavioral attributes of Chongqing MSM.

Methods
Chongqing MSM who were 18 years or older were recruited annually from 2011 to 2018. Interviewer-administered paper-pencil interviews were used to collect demographics, behavioral information, and sexually transmitted diseases history. Blood samples were collected for the tests of HIV, syphilis, and HCV. A stepwise regression model was conducted to assess the associations of demographics, behaviors, and syphilis and HCV infections with HIV infection.

Results
A total of 4900 MSM participated in the study. The average HIV, syphilis, and HCV prevalence over 8 years were 15.4%, 4.0%, and 0.3%, respectively. The HIV prevalence ranged from 13.5% to 16.4%. Syphilis and HCV were generally low and stable across years. An increased proportion of participants received HIV counseling, testing, and condoms. Multivariable regression indicated that HIV-positive MSM were more likely to be older, married, and less educated, and they were more likely to perform unprotected anal intercourse with male partners in the past 6 months, have syphilis, and less likely to receive HIV counseling, testing, condoms, and peer education in the past year.

Conclusions
The HIV counseling, testing, and peer education programs showed a negative association with HIV-positive status among Chongqing MSM. The HIV prevalence is still high. More programs must be implemented to effectively curb the HIV epidemic.
Sexual Mixing Patterns and Anal Human Papillomavirus Among Young Gay, Bisexual, and Other Men Who Have Sex With Men and Transgender Women in 2 Cities in the United States, 2012–2014
Authors: Assaf Ryan D. , Javanbakht Marjan , Meites Elissa , Gratzer Beau , Steinau Martin , Crosby Richard A. , Markowitz Lauri E. , Unger Elizabeth R. , Gorbach Pamina M. 
Published: April 2020

Background
Human papillomavirus (HPV) is a common sexually transmitted infection. Men who have sex with men (MSM) and transgender women (TGW) are at high risk for anal HPV infection and subsequent anal cancer. This study assessed the association of partner discordances with prevalent high-risk anal HPV (HRAHPV) among MSM and TGW.

Methods
Participants were enrolled in the cross-sectional young men's HPV study of gay, bisexual, and other MSM, and TGW, aged 18 to 26 years, from 2 cities. Participants completed a confidential standardized computer-assisted interview and provided self-collected anal swabs for type-specific HPV DNA testing. Multivariate analyses were conducted for 3 discordances of interest (i.e., partner age, race/ethnicity, and concurrent partner) to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI).

Results
Eight hundred sixty-two participants were included for partner race/ethnicity discordance, 601 for partner age discordance, and 581 for concurrent partner analysis. Most reported being older than 21 years, cisgender male, and gay. Adjusted odds of HRAHPV were not significantly increased among participants reporting partner age discrepancy >10 years (aOR, 0.89; 95% CI, 0.51–1.56), partner race/ethnicity discordance (aOR, 0.88; CI, 0.62–1.24), or partner with concurrent partners (aOR, 0.85; 95% CI, 0.50–1.42), compared with those who did not.

Conclusions
This analysis did not identify any partner discordances associated with HRAHPV. Because HPV infection can persist for years, sexual mixing patterns with early partners might be more relevant than the most recent sex partner. Prevalence of HRAHPV was high and could be preventable by preexposure vaccination, as recommended for everyone through age 26 years including MSM and TGW.
Racial/Ethnic Minority Children With Cancer Experience Higher Mortality on Admission to the ICU in the United States*
Authors: Leimanis Laurens Mara , Snyder Kristen , Davis Alan T. , Fitzgerald Robert K. , Hackbarth Richard , Rajasekaran Surender 
Published: April 2020

Objective:
We investigated whether differences in survival exist between children of various racial/ethnic groups with cancer admitted to the PICU.

Design:
A retrospective multicenter analysis was conducted using Virtual Pediatric Systems data from reporting centers. Demographic information, Pediatric Risk for Mortality III score, and outcome variables were analyzed using mixed-effects logistic regression modeling to assess for differences in mortality.

Setting:
One hundred thirty-five PICUs in the United States.

Patients:
Pediatric patients with cancer admitted to PICUs in the United States.

Interventions:
None.

Measurements and Main Results:
This study details the analysis of 23,128 PICU admissions of 12,232 unique oncology patients representing 3% of all PICU admissions with 1,610 deaths (7.0% case fatality). African American (8.5%) and Hispanic children (8.1%) had significantly higher mortality (p < 0.05) compared with Caucasian children (6.3%). Regional analysis showed Hispanic patients to have higher mortality in the West in the United States, whereas African American patients in the South in the United States had higher mortality. A pulmonary disease diagnosis in Hispanics increased odds of mortality (odds ratio, 1.39; 95% CI, 1.13–1.70), whereas a diagnosis of shock/sepsis increased risk for mortality in African Americans (odds ratio, 1.56; 95% CI, 1.11–2.20) compared with Caucasians. There were no differences between races/ethnic groups in the rates of limitations of care. After controlling for Pediatric Risk of Mortality III, PICU length of stay, stem cell transplant status, readmissions, cancer type (solid, brain, hematologic), mechanical ventilation days, and sex, Hispanic (odds ratio, 1.24; 95% CI, 1.05–1.47) and African Americans (odds ratio, 1.37; 95% CI, 1.14–1.66) had significantly higher odds of mortality compared with Caucasians.

Conclusions:
The results show that after controlling for severity and cancer type, a child’s race, ethnicity, and region of presentation influence mortality in the PICU. This suggests that additional investigation is warranted along with a need to rethink our approach to the evaluation and treatment of critically ill African American and Hispanic children with cancer.
Applying RE-AIM to Evaluate the External Validity of Weight Gain Prevention Interventions in Young Adults: A Systematic Review
Authors: Haire-Joshu Debra , Morshed Alexandra B. , Phad Allison , Johnston Shelly , Tabak Rachel G. 
Published: April 2020

Objectives:
The purpose of this review was to use RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) to assess the extent to which weight gain prevention studies targeting young adults reported on elements of external validity.

Design:
Systematic review.

Eligibility Criteria:
Articles of interest included a lifestyle/behavioral intervention targeting weight gain prevention. Eligibility criteria included the following: study design of randomized controlled trials, quasi-randomized control trials, or natural experiments; average participant age between 18 and 35 years; study duration of at least 12 months; and published in English between January 2008 and May 2018. Studies had to report weight or body mass index as a measured outcome and were excluded if they were paired with smoking cessation programs, were conducted in specific groups (ie, pregnant women, breast cancer survivors), or were follow-ups to weight loss studies.

Study Selection:
After removing duplicates, the search yielded 11426 articles. Titles and abstracts were screened by 1 reviewer; 144 articles were assessed in a full-text review by 2 reviewers. Discrepancies were resolved by consensus. Nine studies (13 articles) were included in the review.

Main Outcomes Measure(s):
Reported elements of the RE-AIM framework.

Results:
A total of 9 studies met the selection criteria. All studies lacked full reporting on external validity elements. Of the total of 60 RE-AIM reporting criteria, 8 were reported by all 9 studies, 26 criteria were reported by fewer than 4 studies, and 22 criteria were not reported by any of the studies.

Discussion:
There remains inadequate reporting of elements of external validity and generalizability in weight gain prevention studies. This is a significant scientific constraint that limits the information required to disseminate and implement prevention of weight gain interventions for population impact. Standardized reporting may be needed to ensure results that demonstrate not only internal validity but also external validity and generalizability are needed to promote public health impact.
Concentric and Eccentric Resistance Training Comparison on Physical Function and Functional Pain Outcomes in Knee Osteoarthritis
Authors: Vincent Kevin R. , Vincent Heather K. 
Published: April 2020

Objective
The aim of the study was to compare the effectiveness of concentrically focused resistance training to eccentrically focused resistance training on physical function and functional pain in knee osteoarthritis.

Design
This is a randomized, single-blinded controlled 4-mo trial. Older adults with knee osteoarthritis (N = 88; 68.3 ± 6.4 yrs, 30.4 ± 6.9 kg/m2, and 67.4% women) were randomized to eccentrically focused resistance training, concentrically focused resistance training, or no-exercise control. Main outcomes included chair rise time, stair climb time, 6-min walk test distance, temporal-spatial parameters of gait, community ambulation, and functional pain.

Results
Leg muscle strength improved in both training groups compared with no-exercise control. There were no significant group × time interactions for any functional performance score (chair rise time, stair climb time, 6-min walk test distance, gait parameters, community ambulation). Compared with no-exercise control, functional pain scores were reduced for chair rise (−38.6% concentrically focused resistance training, −50.3% eccentrically focused resistance training vs. +10.0%) and stair climb (−51.6% concentrically focused resistance training, −41.3% eccentrically focused resistance training vs. +80.7%; all P < 0.05). Pain scores were reduced during the 6-min walk and in early recovery with concentrically focused resistance training compared with the remaining two groups (P < 0.05).

Conclusions
Either resistance exercise type improves activity-related knee osteoarthritis pain, but concentrically focused resistance training more effectively reduced severity of ambulatory pain and pain upon walking cessation.
Retrospective Review of the Safety and Efficacy of Virtual Reality in a Pediatric Hospital
Authors: Caruso Thomas J. , O’Connell Chloe , Qian Jimmy J. , Kung Tiffany , Wang Ellen , Kinnebrew Susan , Pearson Molly , Kist Madison , Menendez Maria , Rodriguez Samuel T. 
Published: April 2020

Introduction:
Virtual reality (VR) is an emerging tool for anxiety and fear reduction in pediatric patients. VR use is facilitated by Certified Child Life Specialists (CCLS) at pediatric hospitals. The primary aim of this study was to retrospectively review the safety of VR by analyzing adverse events after the utilization of VR under CCLS supervision. Secondary objectives were to characterize the efficacy of VR in enhancing patient cooperation, describe the integration of VR into Child Life services, and identify interventions that accompanied VR.

Methods:
The Stanford Chariot Program developed VR applications, customized VR interfaces, and patient head straps, and distributed these to CCLS. Chart review analyzed VR utilization through CCLS patient notes. Inclusion criteria were all patients ages 6 to 18-years-old who received a Child Life intervention.

Results:
From June 2017 to July 2018, 31 CCLS saw 8,098 patients, 3,696 of which met age criteria with pre- and post-intervention cooperation data. Two hundred thirteen patients received VR with an accompanying intervention, while 34 patients received only VR. Adverse events were rare, and included increased anxiety (3.8%, n=8), dizziness (0.5%, n=1), and nausea (0.5%, n=1). Patients were more likely to be cooperative after receiving VR (99.5%, n=212) compared to pre-intervention (96.7%, n=206, p=0.041). VR use was most common in the perioperative setting (60%, n=128), followed by outpatient clinics (15%, n=32).

Conclusion:
VR is safe in pediatric patients with appropriate hardware, software, and patient selection. Side effects were rare and self-limited. VR appears to be associated with improvements in cooperation.
Feasibility of Surgeon-Delivered Audit and Feedback Incorporating Peer Surgical Coaching to Reduce Fistula Incidence following Cleft Palate Repair: A Pilot Trial
Authors: Sitzman Thomas J. , Tse Raymond W. , Allori Alexander C. , Fisher David M. , Samson Thomas D. , Beals Stephen P. , Matic Damir B. , Marcus Jeffrey R. , Grossoehme Daniel H. , Britto Maria T. 
Published: April 2020

Background:
Improving surgeons’ technical performance may reduce their frequency of postoperative complications. The authors conducted a pilot trial to evaluate the feasibility of a surgeon-delivered audit and feedback intervention incorporating peer surgical coaching on technical performance among surgeons performing cleft palate repair, in advance of a future effectiveness trial.

Methods:
A nonrandomized, two-arm, unblinded pilot trial enrolled surgeons performing cleft palate repair. Participants completed a baseline audit of fistula incidence. Participants with a fistula incidence above the median were allocated to an intensive feedback intervention that included selecting a peer surgical coach, observing the coach perform palate repair, reviewing operative video of their own surgical technique with the coach, and proposing and implementing changes in their technique. All others were allocated to simple feedback (receiving audit results). Outcomes assessed were proportion of surgeons completing the baseline audit, disclosing their fistula incidence to peers, and completing the feedback intervention.

Results:
Seven surgeons enrolled in the trial. All seven completed the baseline audit and disclosed their fistula incidence to other participants. The median baseline fistula incidence was 0.4 percent (range, 0 to 10.5 percent). Two surgeons were unable to receive the feedback intervention. Of the five remaining surgeons, two were allocated to intensive feedback and three to simple feedback. All surgeons completed their assigned feedback intervention. Among surgeons receiving intensive feedback, fistula incidence was 5.9 percent at baseline and 0.0 percent following feedback (adjusted OR, 0.98; 95 percent CI, 0.44 to 2.17).

Conclusion:
Surgeon-delivered audit and feedback incorporating peer coaching on technical performance was feasible for surgeons.