bluuebunny/crossref_metadata_2025_split huggingface dataset:
Climate Change Policymaking in the States: A View at 2020
Authors: Bromley-Trujillo Rebecca , Holman Mirya R 
Published: May 2020

Abstract
Climate change policymaking has stalled at the federal level in the United States, especially since Donald Trump’s election as president. Concurrently, extreme weather, rising sea levels, and other climatic effects have increased the salience of climate change in the mass public and among elected officials. In response, legislators in state governments increasingly introduce and adopt policies associated with climate change. In this article, we evaluate the state of climate change policymaking in state legislatures, with a focus on overall trends in climate mitigation and adaptation innovation and cases of policy retrenchment. We document an increased level of climate legislation introduced in U.S. states since President Trump’s election, particularly in states under Democratic Party control. We evaluate patterns of introduced legislation across the states between 2011 and 2019 and consider the factors associated with bill sponsorship. Our results demonstrate the increased partisan nature of climate change policymaking in U.S. states.
A study of Interleukin 6 as a predictive biomarker for development of nonalcholic steatohepatitis in patients with Nonalcholic fatty liver disease
Authors: Mohamed K A , Mohamed E E , Ahmed D M , Sayed M A , Hussien A R 
Published: May 2020

Abstract

Background
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease worldwide, with a prevalence of 15%-30% in Western populations. Non-alcoholic fatty liver disease (NAFLD) has emerged as the most important cause of chronic liver disease related to the increase in incidence of obesity and diabetes mellitus type II in the population.

Aim of the Work
To predict nonalcholic steatohepatitis in patient with NAFLD through measurement of interleukin 6 to prevent progression of the disease into liver cirrhosis through early diagnosis.

Patients and Methods
This study was designed to be case control study; it was conducted on 70 patients selected from Internal Medicine and Hepatology outpatient clinics and inpatient wards at Ain Shams University Hospitals from (Jun/2017 to Jul 9/2018) and 20 healthy subjects as control group.

Results
NASH patients had more obesity (BMI 30) (83.3%) than both simple steatosis patients (57.5%) and control (55.0%). NASH patients had higher BMI as compared to simple steatosis patients and control (p value =0.01). The present study revealed that there is a statistically significant difference between groups according to IL6 (P &gt; 0.001) as IL6 was positive in 70% of patients with NASH while in patients with simple steatosis and control was positive in 25%, 20% respectively.

Conclusion
NAFLD is a highly prevalent condition, shares many features of the metabolic syndrome (MetS), a highly atherogenic condition.

Recommendations
Large scale multi-centre studies are recommended to study the prevalence of NAFLD in Egypt. Further studies on the effect of presence of steatosis and increased risk of hepatocellular carcinoma.
Implementation intentions for weight loss in college students with overweight and obesity: a proof-of-concept randomized controlled trial
Authors: Hayes Jacqueline F , Balantekin Katherine N , Graham Andrea K , Strube Michael J , Bickel Warren K , Wilfley Denise E 
Published: May 2020

AbstractOne in three college students have overweight or obesity and are in need of brief, simple weight loss interventions. Implementation intentions, a strategy that connects a goal-aligned behavior to a cue, facilitate goal attainment of health behaviors but have not been applied as a standalone treatment for weight loss. The purpose of this study was to examine the efficacy of an implementation intention weight loss intervention in college students. In this three-arm, proof-of-concept, randomized controlled trial, college students with overweight/obesity (N = 95) were randomized to one of three conditions: an implementation intention group (IMP), an enhanced implementation intention group (IMP+) that included text message reminders and fluency training (i.e., training for speed and accuracy), and a control goal intention group (GOL) for 4 weeks. Participants completed anthropometric and self-report assessments pretreatment and posttreatment and experience-sampling assessments during the study to assess how implementation intentions contribute to behavior change. Across the sample, IMP and IMP+ groups reported significantly more goal-congruent behaviors than the GOL group. However, no between-condition differences emerged for weight and diet outcomes. Across conditions, students lost a statistically significant amount of weight, improved diet quality, and reduced caloric intake (ps &lt; .05). Setting implementation intentions was associated with increased behaviors consistent with weight loss goals. Moreover, participants in all groups lost a statistically significant amount of weight. Incorporating implementation intentions into weight loss interventions, and testing the efficacy of this approach on weight loss over a longer duration, may be beneficial for college students with overweight/obesity.
Macromolecular substances as a dangerous factor in traditional Chinese medicine injections were determined by size-exclusive chromatography
Authors: Li Yue , Duan Jinlian , Xia Heng , Shu Bin , Duan Weigang 
Published: May 2020

Abstract
Macromolecular substances in traditional Chinese medicine injections (TCMIs) are expected to be a main dangerous factor causing anaphylactic or anaphylactoid reaction. The main aim of the study was to verify the macromolecular substances’ anaphylactic or anaphylactoid reaction in guinea pigs and establish a size-exclusive chromatographic method to detect them. The macromolecular substances from six TCMIs (Danshen injection, Dengzhanxixin injection, Honghua injection, Qingkailing injection, Shuanghuanglian injection and Shuxuening injection) were prepared by removing substances with molecular weight less than 10 kDa with an ultra-filter. The anaphylactic and anaphylactoid reactions caused by original TCMIs, injections rich in or free of macromolecules were assayed in guinea pigs. The relationship between the amount of the macromolecular substances and peak area of chromatogram was established by size-exclusive chromatography. Injections free of macromolecules were not likely to cause anaphylactic and anaphylactoid reactions, but injections rich in macromolecular substances were more likely to do so. If the macromolecular substances with molecular weight bigger than 10 kDa were removed, the signal of macromolecular substances in TCMIs was quantitatively reduced. All the results suggested that macromolecular substances in TCMIs are a dangerous factor causing safety problems, and the macromolecular substances can be quantitatively detected with size-exclusive chromatography.
Postnatal Effects of Gestational and Lactational Gavage Exposure to Boric Acid in the Developing Sprague Dawley Rat
Authors: Watson AtLee T D , Sutherland Vicki L , Cunny Helen , Miller-Pinsler Lutfiya , Furr Johnathan , Hebert Charles , Collins Brad , Waidyanatha Suramya , Smith Lori , Vinke Trey , Aillon Kristin , Xie Guanhua , Shockley Keith R , McIntyre Barry S 
Published: May 2020

AbstractHuman exposure to boron occurs primarily through diet and drinking water sources. Animal studies have found that reduced fetal weight following gestational exposure to boron (as boric acid) is the most sensitive toxicological effect. However, recent studies suggest that newborns in areas with elevated boron in drinking water may receive levels of exposure that exceed the U.S. EPA oral reference dose for B. Currently, there are no data to inform a boron risk assessment accounting for this developmental window. To address this knowledge gap, the National Toxicology Program evaluated developmental toxicity following pre- and postnatal boron exposure. Time-mated female Sprague Dawley (Hsd: Sprague Dawley SD) rats were administered 0–20 mg B/kg/day (as boric acid) via gavage from gestation day 6 to 21; offspring were dosed via gavage at the same respective dose level from postnatal day (PND) 1 to 28. There were no dose-related effects on dam bodyweight, bodyweight gain, or feed consumption. Clinical findings were limited to low incidences of umbilical hernia in the 20 mg B/kg pups which resolved by study completion. Pup plasma boron concentrations increased in dose-proportional manner and were similar between PND 4 and PND 28. Postnatal weight gain was significantly reduced at 20 mg B/kg, with male and female pups weighing 23% less than the controls on PND 28. These findings demonstrate that postnatal growth in the Sprague Dawley rat is sensitive to boron exposure and highlights the importance of evaluating the potential toxicity of agents with known human exposures during early life stages.
The combination of platelet count and lymphocyte to monocyte ratio is a prognostic factor in patients with resected breast cancer
Authors: Deng Yunfu , Li Wen , Liu Xuejuan , Ma Guangzhi , Wu Qiang , Chen Fang , Wang Zhu , Zhou Qinghua 
Published: May 2020

Abstract
Many inflammation indicators have been reported to be related with patient outcomes in various cancers. Previous studies have evaluated the combination of platelet (PLT) and lymphocyte to monocyte ratio (COP-LMR) as a systemic inflammatory marker for prognostication in lung cancer, yet its prognostic role among breast cancer patients remains unclear.
In the present study, a total of 409 breast cancer patients with surgical resection were retrospectively investigated. The receiver operating characteristic (ROC) curve was used to choose the optimal cut-off value of PLT and lymphocyte to monocyte ratio (LMR). Patients were classified into 3 groups according to the score of COP-LMR, and its relationship with various clinicopathological factors and breast cancer prognosis were further evaluated.
The ROC curve analysis showed that COP-LMR had a higher area under the ROC curve for the prediction of 5-year disease-free survival and overall survival than PLT or LMR alone. Multivariable analysis showed that an elevated COP-LMR was an independent predictor of poor disease-free survival (P = .032) and overall survival (P = .005). Subgroup analysis revealed that COP-LMR was still significantly associated with prognosis in both luminal A and luminal B subtypes.
Preoperative COP-LMR is a potential prognostic factor in breast cancer patients who underwent surgery.
Chronic malnutrition and oral health status in children aged 1 to 5 years
Authors: Vieira Karlla A. , Rosa-Júnior Laerto S. , Souza Maria A. V. , Santos Natanael B. , Florêncio Telma M. M. T. , Bussadori Sandra K. 
Published: May 2020

Abstract
To evaluate the effect of chronic malnutrition on the oral health of children aged 1 to 5 years.
An observational, analytical, cross-sectional study was conducted and involved 82 children (12–71 months of age). Nutritional status was evaluated using anthropometric indicators and oral health status/caries prevalence was measured. Non-stimulated saliva was collected and flow rate and buffering capacity was measured.
The mean dmft index was 1.38 for the adequately nourished children, 3.04 for those with mild malnutrition, 2.5 for those with moderate malnutrition and 2.4 for those with severe malnutrition. 69 of the 82 children had low to very low buffering capacity. No significant differences among the groups were found between malnutrition and age, buffering capacity or the dmft index (P > .05). However, significant differences in salivary flow were found among the different malnutrition categories (P < .05). Spearman correlation coefficient revealed a weak negative correlation between nutrition and salivary flow (r = −0.267).
Malnutrition exerts a negative impact on the oral cavity of children and a reduction in salivary flow rate was observed with the increase in malnutrition. Diagnosing the effects of malnutrition in oral environment of children is important because it could improve the quality of life and give them an adequate treatment.
Consolidation period of 18 months no better at promoting off-treatment durability in HBeAg-positive chronic hepatitis B patients with tenofovir disoproxil fumarate treatment than a 12-month period
Authors: Wang Chun-Hsiang , Chang Kuo-Kuan , Lin Ruey-Chang , Kuo Ming-Jeng , Yang Chi-Chieh , Tseng Yuan-Tsung 
Published: May 2020

Abstract
There has been no clear consensus on the optimal consolidation periods following HBeAg seroconversion (SC) in HBeAg-positive chronic hepatitis B (CHB) patients. Our study aimed to prospectively compare relapse rates between 12 months’ and 18 months’ consolidation periods to see whether or not there is beneficial durability of tenofovir disoproxil fumarate (TDF) therapy with longer consolidation periods.
We enrolled a total of 137 HBeAg-positive Asian CHB patients treated with TDF monotherapy. Forty-six patients achieved HBeAg SC. Then, they were randomly assigned to consolidation period of either 12 months (group A) or 18 months (group B). After stopping TDF therapy, all patients were followed up for 12 months.
Thirteen patients (56.5%) relapsed in group A and 12 patients (52.2%) relapsed in group B after 12 months’ follow-up (P = .958). Pretreatment HBsAg level is the only significant predictor for off-therapy recurrence by univariate analysis (P = .024). Baseline HBeAg >1000 S/CO in group B patients were significantly less likely to relapse than those of group A (P = .046). Baseline alanine aminotransferase (ALT) >133 U/L could significantly predict occurrence of HBeAg SC (P = .008; 95% CI: 0.545–0.763; AUC: 0.654).
Overall, a prolonged consolidation period has no positive effect on TDF therapy on sustained viral suppression in HBeAg-positive Asian CHB patients. However, a prolonged consolidation period was beneficial to patients with high baseline semi-quantitative HBeAg levels in terms of off-treatment durability. Baseline ALT > 133 U/L could significantly predict the occurrence of HBeAg SC.
Acupoint injection of Bacillus Calmette–Guerin polysaccharide nucleic acid for patients with chronic urticaria
Authors: Cao Wei , Xiao Xianjun , Zhang Leixiao , Wang Lu , Zheng Qianhua , Zhou Siyuan , Liu Ying , Cao Yue , Chen Mingling , Li Chunxiao , Li Ying 
Published: May 2020

AbstractBackground:To investigate the efficacy and safety of acupoint injection of Bacillus Calmette–Guerin polysaccharide nucleic acid (BCG-PSN) in the treatment of chronic urticaria (CU).Methods:The following databases will be searched from their inception: Medline, Embase, Pubmed, Web of Science, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure Database, China Biomedical Literature Database, China Science Journal Database, and Wanfang Database. All databases will be searched from the date of creation until October 2019. In addition, we will manually search the list of medical journals as a supplement. The scope of the search included randomized controlled clinical studies related to acupoint injection of BCG-PSN for CU. The primary outcome is the disease activity control. Secondary outcomes include response rate, adverse events, and recurrence rates. The Cochrane RevMan V5.3 Deviation Assessment Tool will be used to assess bias assessment risk, data integration risk, meta-analysis risk, and subgroup analysis risk (if conditions are met). The average difference, standard mean difference and binary data will be used to represent continuous results.Results:This study will comprehensively review the existing evidence on the treatment of CU by acupoint injection of BCG-PSN.Conclusion:This systematic review will provide a judgment basis for the effectiveness and safety of acupoint injection of BCG-PSN in the treatment of CU.Systematic review registration:PROSPERO, CRD42019139885.
Subacute combined degeneration induced by nitrous oxide inhalation
Authors: Zhao Bing , Zhao Lixian , Li Zhixing , Zhao Renliang 
Published: May 2020

Abstract

Rationale:
Nitrous oxide (N2O), commonly known as “laughing gas,” is being increasingly abused by young people as a recreational drug; this can subsequently result in myelopathy and peripheral neuropathy, however, in China, few cases of neurologic deterioration by N2O abuse have been reported.

Patient concerns:
Herein, we present 2 patients who developed progressive limb weakness, numbness, and ataxia. Both of them had recreationally inhaled N2O intermittently for a long time.

Diagnosis:
Subacute combined degeneration (SCD) based on myelopathy and polyneuropathy after N2O abuse.

Interventions:
The 2 patients were treated with cessation of N2O inhalation, methylcobalamin capsule 500 μg tid (ter in die, which means 3 times a day), and compound vitamin B 1 tablet tid p.o.(per os, which means taken orally) for 1 month.

Outcomes:
The symptoms of altered sensation and the patients’ gait improved significantly.

Lessons:
The 2 cases raise awareness of the important mechanisms of N2O neurotoxicity, and clinicians should be made fully aware of such substance-related diseases. The incidence of N2O -induced neurotoxicity is insufficiently recognized and should be considered as an important cause of SCD, especially in adolescents with undifferentiated weakness and abnormal sensation; this is essential because serious complications such as irreversible paralysis can result from the absence of early diagnosis and treatment.
The cardiovascular risk of celecoxib for knee osteoarthritis
Authors: Cheng Shirui , Xin Ming , Zhou Jun , Cheng Ying , Xu Guixing , Zhou Yuanfang , Li Zhengjie , Liang Fanrong 
Published: May 2020

Abstract

Objective:
The aim of this systematic review and meta-analysis is to assess the cardiovascular (CV) risk of celecoxib on knee osteoarthritis (KOA) patients compared with the risk in those prescribed other non-selective non-steroidal anti-inflammatory drugs (NSAIDs), no intervention or placebo-controlled patients.

Methods:
The following databases will be searched: MEDLINE, EMBASE, the Cochrane Library, Web of Science, Chinese Biomedical Literature Database, Chinese Nation Knowledge Infrastructure, Wanfang Database, and the Chongqing VIP from inception to April 1, 2020. All randomized controlled trials (RCTs) of celecoxib that presented data on serious cardiovascular events among KOA patients will be included. Study selection, data extraction, quality assessment, and assessment of risk bias will be performed by 2 reviewers independently. Odds ratios and correlative 95% confidence intervals will be calculated to present the association between the celecoxib and CV risk using Review Manager version 5.3 when there is sufficient available data.

Ethics and dissemination:
This review does not require ethical approval. The results of this review may be published in a peer-reviewed journal or disseminated at relevant conferences.

PROSPERO registration number:
CRD42020166721.
Recent trends in tablet subdivision and factors affecting subdivision in South Korea
Authors: Son Kyung-Bok 
Published: May 2020

Abstract
Tablet subdivision by physicians or patients frequently occurs in various clinical settings for multiple reasons, including dose adjustment, alleviation of swallowing difficulties, or cost savings. However, not all tablets are suitable for subdivision, and it might cause side effects. It is informative to know which medicines are regularly subdivided, which healthcare institutions prescribe subdivided medicines, and to whom the medicines are prescribed from the perspectives of quality of care and patient safety. In this study, we aimed to examine recent trends in tablet subdivision and to address factors associated with subdivision of tablets both at the patient and healthcare institution levels.
The yearly claims data in 2016 retrieved from the National Patients Sample provided by the Health Insurance Review and Assessment (HIRA-NPS). This study used descriptive statistics to examine characteristics of medicines that were frequently prescribed in subdivided forms, and retrieved information regarding the medicines to assess the appropriateness for tablet splitting. Then, we selected five medicines, and performed a multivariate logistic regression analysis to estimate the effect of the variables of interest on tablet subdivision.
We presented the top 25 medicines prescribed in subdivided forms in 2016, and confirmed these medicines could be relevantly halved according to their Summary of Product Characteristics. Of the 25 medicines, 14 (56%), 5 (20%), and 3 (12%) medicines belonged to the respiratory system (R), nervous system (N), and systemic hormonal preparations (H), according to the first category of Anatomical Therapeutic Chemical (ATC) classification system, respectively. Being female at the patient level and tertiary healthcare institutions and private owned institutions at the institution level were positively associated with subdivision of medicines.
Subdivision of tablets frequently occurred for vulnerable populations with various reasons. Female and geriatric patients are prescribed split medicines for clinical reasons, while low-income patients are prescribed nonsplit medicines for cost savings. It would be better if medicines were not so small, and if they had dividing lines on their surfaces to enable successful splitting of the tablet and to protect the health of vulnerable patients. Furthermore, avoid splitting those pharmacotherapies with a narrow therapeutic range, and provide a pharmacist assistance and a splitting device for unavoidable splitting.
Traditional Chinese medicine may reduce the dosage of systemic glucocorticoids in required patients with acute exacerbation of chronic obstructive pulmonary disease
Authors: Zhao Keni , Chen Keling , Huang Qingsong , Gao Peiyang , Zhang Chuantao , Yang Hongjing , Gan Wenfan , Xiao Wei , Sun Zengtao , Xie Xiaohong , Long Kunlan , Zhang Song , Chen Jun 
Published: May 2020

Abstract

Introduction:
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) involves a severe inflammatory response. Systemic glucocorticoids are very important for the treatment of the acute exacerbation period; however, their use causes serious adverse effects. There is still no evidence on whether traditional Chinese medicine (TCM) can be used to reduce the dosage of systemic glucocorticoids in the treatment of patients with AECOPD.

Methods:
In this trial, we plan to enroll 204 eligible patients with AECOPD who will be randomly assigned to receive TCM or a placebo. The effect of TCM in the treatment of patients with AECOPD will be measured by the dosage of systemic glucocorticoids (at which COPD assessment test [CAT] scores improve by 50%). Safety will also be assessed.

Trial registration:
ChiCTR2000029568.