bluuebunny/crossref_metadata_2025_split huggingface dataset:
Judicial Enforcement of Environmental Democracy: a Critical Analysis of Case Law on Access to Environmental Information in the European Union
Authors: Peeters Marjan 
Published: June 2020

Abstract
Since the 1970s, the concept of environmental democracy, including the right to gain access to environmental information, has emerged as an important concept to promote and ensure public engagement in governmental environmental decision-making. While it is, generally, understood that environmental procedural rights deserve protection across the globe, it remains to be identified to what extent, in practice, the application of such rights differs across jurisdictions. Such differences may be caused by specific understandings of democracy and institutional characteristics. In light of this, this article analyses the case law of the Court of Justice of the European Union (CJEU) regarding the right of access to environmental information. It observes that the EU legislature has implemented the right of access to environmental information more ambitiously than required under the Aarhus Convention, particularly with regard to legislative information. Moreover, the CJEU has steered EU institutions, including the European Commission, towards even greater transparency. The judicial reasoning by the CJEU is principled and refers to general values regarding openness and transparency codified in primary EU law and in the EU Charter of Fundamental Rights. These judicial developments also highlight the importance of promoting discourse on the implications of a rigorous approach to the right of access to environmental information, including the question of whether enabling wider public engagement necessarily leads to better decision-making. Finally, the article promotes the need for comparative research on how the right to gain access to environmental information is developing across the world.
Astragalus polysaccharides protect renal function and affect the TGF-β/Smad signaling pathway in streptozotocin-induced diabetic rats
Authors: Meng Xue , Wei Mingmin , Wang Dong , Qu Xiaohan , Zhang Kun , Zhang Nan , Li Xinjian 
Published: May 2020

Objectives The objective was to observe the effects of Astragalus polysaccharides on diabetes and on regulation of the TGF-β/Smad signaling pathway. Methods A type 2 diabetic rat model was established with a high-fat diet in combination with low-dose streptozotocin (35 mg/kg). Astragalus polysaccharides were applied as treatment intervention and changes in blood glucose and kidney morphology and function were assessed. Results Eight weeks after model establishment, kidney weight as a proportion of total weight (KW/TW) in the high-, medium-, and low-dose Astragalus polysaccharide groups was significantly lower than that in the model group, and the KW/TW value gradually decreased with increasing dose of polysaccharides in each treatment group. Fasting blood glucose in the low- and medium-dose Astragalus polysaccharide groups was numerically lower than that in the model group and fasting blood glucose in rats in the high-dose group was significantly lower than that in the model group. Levels of 24-hour urinary microalbumin, creatinine, blood urea nitrogen, collagens I, III, and IV, α-smooth muscle actin, transforming growth factor-β1, and Smad3 in Astragalus polysaccharide groups (all doses) were significantly lower than those in the model group. Conclusions Astragalus polysaccharide significantly improved blood glucose and protected kidney function in a rat diabetes model.
Clinical evaluation of the T-SPOT.TB test for detection of tuberculosis infection in northeastern Guangdong Province, China
Authors: Zhong Hua , Wu Heming , Yu Zhikang , Zhang Qunji , Huang Qingyan 
Published: May 2020

Objective We evaluated clinical performance of the T-SPOT.TB test for detecting tuberculosis (TB) infection in Meizhou, China. Methods We enrolled 2,868 patients who underwent T-SPOT.TB, smear, and TB-DNA at the same time. The tests’ sensitivity and specificity were evaluated and compared in different groups, and in pulmonary TB (PTB) and extrapulmonary TB (EPTB) subgroups. Receiver operator characteristic (ROC) curve analysis was used to evaluate T-SPOT.TB’s diagnostic value and determine its cutoff value. Results T-SPOT.TB, TB-DNA, and sputum smear sensitivity was 61.44%, 37.12%, and 14.02%; and specificity was 76.49%, 99.20% and 99.60%, respectively. The T-SPOT.TB positive rate was higher in the PTB and EPTB subgroups than in patients with other pulmonary diseases (61.38% and 61.76% vs. 23.34%). The T-SPOT.TB test had better diagnostic accuracy and sensitivity when the positive cutoff value of marker ESAT-6 was 2.5 [area under ROC curve = 0.701, 95%CI 0.687–0.715] and marker CFP-10 was 6.5 [area under ROC curve = 0.669, 95%CI 0.655–0.683]. Conclusion T-SPOT.TB sensitivity was higher than that of TB-DNA or sputum smear, but the specificity was lower. T-SPOT.TB had moderate sensitivity and specificity for diagnosing TB. T-SPOT.TB’s new positive cutoff value may be clinically valuable according to ROC analysis.
The Global Impact of COVID-19 on Craniomaxillofacial Surgeons
Authors: van der Tas Justin , Dodson Thomas , Buchbinder Daniel , Fusetti Stefano , Grant Michael , Leung Yiu Yan , Roethlisberger Erich , Aniceto Gregorio Sánchez , Schramm Alexander , Bradley Strong Edward , Wolvius Eppo 
Published: May 2020

Study Design: The COrona VIrus Disease-19 (COVID-19) pandemic has disrupted craniomaxillofacial (CMF) surgeons practice worldwide. We implemented a cross-sectional study and enrolled a sample of CMF surgeons who completed a survey. Objective: To measure the impact that COVID-19 has had on CMF surgeons by (1) identifying variations that may exist by geographic region and specialty and (2) measuring access to adequate personal protective equipment (PPE) and identify factors associated with limited access to adequate PPE. Methods: Primary outcome variable was availability of adequate PPE for health-care workers (HCWs) in the front line and surgeons. Descriptive and analytic statistics were computed. Level of statistical significance was set at P < .05. Binary logistic regression models were created to identify variables associated with PPE status (adequate or inadequate). Results: Most of the respondents felt that hospitals did not provide adequate PPE to the HCWs (57.3%) with significant regional differences ( P = .04). Most adequate PPE was available to surgeons in North America with the least offered in Africa. Differences in PPE adequacy per region ( P < .001) and per country ( P < .001) were significant. In Africa and South America, regions reporting previous virus outbreaks, the differences in access to adequate PPE evaporated compared to Europe ( P = .18 and P = .15, respectively). Conclusion: The impact of COVID-19 among CMF surgeons is global and adversely affects both clinical practice and personal lives of CMF surgeons. Future surveys should capture what the mid- and long-term impact of the COVID-19 crisis will look like.
Using generalizability theory to evaluate the comparative reliability of developmental measures in neurogenetic syndrome and low-risk populations
Authors: Hamrick Lisa R. , Haney Alison M. , Kelleher Bridgette L. , Lane Sean P. 
Published: June 2020

Abstract
Background
The lack of available measures that can reliably characterize early developmental skills in children with neurogenetic syndromes (NGS) poses a significant challenge for research on early development in these populations. Although syndrome-specific measures may sometimes be necessary, a more cost- and time-efficient solution would be to identify existing measures that are appropriate for use in special populations or optimize existing measures to be used in these groups. Reliability is an important metric of psychometric rigor to consider when auditing and optimizing assessment tools for NGS. In this study, we use Generalizability Theory, an extension of classical test theory, as a novel approach for more comprehensively characterizing the reliability of existing measures and making decisions about their use in the field of NGS research.

Methods
We conducted generalizability analyses on a popular early social communication screener, the Communication and Symbolic Behavior Scales—Infant-Toddler Checklist (CSBS-ITC), collected on 172 children (41 Angelman syndrome, 30 Prader-Willi syndrome, 42 Williams syndrome, 59 low-risk controls).

Results
Overall, the CSBS-ITC demonstrated at least adequate reliability in the NGS groups included in this study, particularly for the Prader-Willi and Williams syndrome groups. However, the sources of systematic error variance in the CSBS-ITC varied greatly between the low-risk control and NGS groups. Moreover, as unassessed in previous research, the CSBS-ITC demonstrated substantial differences in variance sources among the NGS groups. Reliability of CSBS-ITC scores was highest when averaging across all measurement points for a given child and was generally similar or better in the NGS groups compared to the low-risk control group.

Conclusions
Our findings suggest that the CSBS-ITC communicates different information about the reliability of stability versus change, in low-risk control and NGS samples, respectively, and that psychometric approaches like Generalizability Theory can provide more complete information about the reliability of existing measures and inform decisions about how measures are used in research on early development in NGS.
Population segments as a tool for health care performance reporting: an exploratory study in the Canadian province of British Columbia
Authors: Langton Julia M. , Wong Sabrina T. , Burge Fred , Choi Alexandra , Ghaseminejad-Tafreshi Niloufar , Johnston Sharon , Katz Alan , Lavergne Ruth , Mooney Dawn , Peterson Sandra , McGrail Kimberlyn 
Published: May 2020

AbstractBackgroundPrimary care serves all age groups and individuals with health states ranging from those with no chronic conditions to those who are medically complex, or frail and approaching the end of life. For information to be actionable and guide planning, there must be some population disaggregation based on differences in expected needs for care. Promising approaches to segmentation in primary care reflect both the breadth and severity of health states, the types and amounts of health care utilization that are expected, and the roles of the primary care provider. The purpose of this study was to assess population segmentation as a tool to create distinct patient groups for use in primary care performance reporting.MethodsThis cross-sectional study used administrative data (patient characteristics, physician and hospital billings, prescription medicines data, emergency department visits) to classify the population of British Columbia (BC), Canada into one of four population segments: low need, multiple morbidities, medically complex, and frail. Each segment was further classified using socioeconomic status (SES) as a proxy for patient vulnerability. Regression analyses were used to examine predictors of health care use, costs and selected measures of primary care attributes (access, continuity, coordination) by segment.ResultsAverage annual health care costs increased from the low need ($ 1460) to frail segment ($10,798). Differences in primary care cost by segment only emerged when attributes of primary care were included in regression models: accessing primary care outside business hours and discontinuous primary care (≥5 different GP’s in a given year) were associated with higher health care costs across all segments and higher continuity of care was associated with lower costs in the frail segment (cost ratio = 0.61). Additionally, low SES was associated with higher costs across all segments, but the difference was largest in the medically complex group (cost ratio = 1.11).ConclusionsPopulation segments based on expected need for care can support primary care measurement and reporting by identifying nuances which may be lost when all patients are grouped together. Our findings demonstrate that variables such as SES and use of regression analyses can further enhance the usefulness of segments for performance measurement and reporting.
Anti-inflammatory effect of Salsola komarovii extract with dissociated glucocorticoid activity
Authors: Seo Ji Hyun , Jin Mu Hyun , Chang Yun Hee 
Published: June 2020

Abstract
Background
Glucocorticoids (GCs) are anti-inflammatory drugs widely used to treat acute and chronic inflammatory diseases. However, despite their excellent efficacy, the long-term use of GCs is relatively limited owing to their adverse effects. Recent studies have sought to reduce these adverse effects by developing dissociated GCs that bind to GC receptors (GRs) to induce potent anti-inflammatory effects without the transcription of GC response element (GRE)-promoted genes. Some species of the genus Salsola are used in traditional Chinese medicine to treat cancer, hypertension, and inflammation. In this study, we investigated the potential dissociated GC activities and underlying mechanisms of Salsola komarovii (SK), which is native to Korea.

Methods
To determine whether SK ethanol extract (SEE) directly interacts with the GR, an in vitro fluorescence polarization based-GR competitor assay was performed. The effect of SEE on the transcriptional activity of nuclear factor (NF)-κB and GRE was confirmed in HepG2 cells using the Cignal reporter assay. The anti-inflammatory effect of SK was determined by assessing lipopolysaccharide (LPS)-induced interleukin (IL)-6 production. To confirm whether SEE induces GRE-driven gene expression, preadipocyte differentiation followed by lipid deposition was performed in the presence of SEE.

Results
SEE exhibited GR binding activity in the fluorescence polarization competitive binding assay and induced GR nuclear translocation. It also interfered with the nuclear translocation of NF-κB and the NF-κB-dependent transcriptional activity based on the immunofluorescence analysis and reporter assay, respectively. SEE exerted anti-inflammatory effects by reducing LPS-induced IL-6 production as effectively as hydrocortisone (positive control). SK did not induce GRE-driven gene expression and preadipocyte differentiation, which is one of the major adverse effects of GCs.

Conclusions
Collectively, these results suggest that SK could be a novel and safe anti-inflammatory agent with dissociated GC properties and, therefore, it has great potential for use in treating inflammatory disorders.
Serum metabolite profiles are associated with the presence of advanced liver fibrosis in Chinese patients with chronic hepatitis B viral infection
Authors: Xie Guoxiang , Wang Xiaoning , Wei Runmin , Wang Jingye , Zhao Aihua , Chen Tianlu , Wang Yixing , Zhang Hua , Xiao Zhun , Liu Xinzhu , Deng Youping , Wong Linda , Rajani Cynthia , Kwee Sandi , Bian Hua , Gao Xin , Liu Ping , Jia Wei 
Published: June 2020

AbstractBackgroundAccurate and noninvasive diagnosis and staging of liver fibrosis are essential for effective clinical management of chronic liver disease (CLD). We aimed to identify serum metabolite markers that reliably predict the stage of fibrosis in CLD patients.MethodsWe quantitatively profiled serum metabolites of participants in 2 independent cohorts. Based on the metabolomics data from cohort 1 (504 HBV associated liver fibrosis patients and 502 normal controls, NC), we selected a panel of 4 predictive metabolite markers. Consequently, we constructed 3 machine learning models with the 4 metabolite markers using random forest (RF), to differentiate CLD patients from normal controls (NC), to differentiate cirrhosis patients from fibrosis patients, and to differentiate advanced fibrosis from early fibrosis, respectively.ResultsThe panel of 4 metabolite markers consisted of taurocholate, tyrosine, valine, and linoelaidic acid. The RF models of the metabolite panel demonstrated the strongest stratification ability in cohort 1 to diagnose CLD patients from NC (area under the receiver operating characteristic curve (AUROC) = 0.997 and the precision-recall curve (AUPR) = 0.994), to differentiate fibrosis from cirrhosis (0.941, 0.870), and to stage liver fibrosis (0.918, 0.892). The diagnostic accuracy of the models was further validated in an independent cohort 2 consisting of 300 CLD patients with chronic HBV infection and 90 NC. The AUCs of the models were consistently higher than APRI, FIB-4, and AST/ALT ratio, with both greater sensitivity and specificity.ConclusionsOur study showed that this 4-metabolite panel has potential usefulness in clinical assessments of CLD progression in patients with chronic hepatitis B virus infection.
Perception of farmers about endometritis prevention and control measures for zero-grazed dairy cows on smallholder farms in Rwanda
Authors: Nyabinwa Pascal , Kashongwe Olivier Basole , Hirwa Claire d’Andre , Bebe Bockline Omedo 
Published: June 2020

Abstract
Background
Endometritis is a prevalent uterine disease in postpartum cows. The disease reduces fertility performance and milk yield, and subsequently, productivity and profitability of dairy farms. The reduction in performance is associated with considerable economic losses on dairy farms. Smallholder farmers are likely to incur considerable economic losses from the disease where they lack knowledge of effective prevention and control measures for the disease. This study used farmer’s perspectives to determine the effectiveness of different management interventions (MIs) for endometritis prevention and control on smallholder farms in Rwanda practicing dairy zero-grazing. The best-worst scaling (BWS) choice method was applied that relied on past 1 year recall data obtained from 154 farmers. These farmers were identified through snowball sampling in a cross-sectional study.

Results
Of the 20 MIs evaluated, 12 scored highly for effectiveness. The top four most effective are: avoiding sharing equipment with neighbouring farms (45.5%), consulting animal health service provider about disease treatment (31.8%), keeping cows in a clean and dry shed (26.7%), and selecting sires based on calving ease (26.6%). The MIs considered least effective were: maintaining clean transition cow housing (35.1%), removal of fetal membrane immediately after passing (33.1%), disinfecting the equipment used in calving assistance before and after use (32.5%), and selecting sires with low percent stillbirths (29.2%).

Conclusion
This study has demonstrated the application of BWS object case method in understanding the MIs that farmers consider are most effective in the prevention and control of endometritis disease in the dairy herds. The MIs are on-farm biosecurity and hygiene, seeking veterinary services for disease treatment and selecting sires for ease of calving. These MIs should be considered for prioritization in extension services and research to continuously improve and enhance their practical application on smallholder dairy farms.
LncRNA FLVCR1-AS1 promotes proliferation, migration and activates Wnt/β-catenin pathway through miR-381-3p/CTNNB1 axis in breast cancer
Authors: Pan Zhiyu , Ding Junbin , Yang Zhen , Li Huaqing , Ding Hongjian , Chen Qian 
Published: June 2020

Abstract
Background
Understanding the molecular mechanism of long non-coding RNAs (lncRNAs) in carcinogenesis is conducive for providing potential target for cancers. The role of FLVCR1-AS1 in breast cancer (BC) has not been probed yet.

Materials and methods
qRT-PCR and western blot assays were used to estimate relevant expressions of mRNAs and proteins. CCK8, MTT and EdU were implemented to assess cell proliferation ability. TUNEL was performed to investigate cell apoptosis, whereas transwell assay was performed to test cell migration and invasion capacities. TOP/FOP Flash assay was conducted to determine the activity of Wnt/β-catenin pathway. Luciferase reporter, RNA pull down and RIP assays were performed to verify interaction between genes.

Results
FLVCR1-AS1 was abnormally up-regulated in BC cells. Silencing FLVCR1-AS1 inhibited cell proliferation, migration, invasion, yet accelerating apoptosis. Inhibition of miR-381-3p reversed the tumor restraining impacts of FLVCR1-AS1 depletion on BC progression. Additionally, CTNNB1 was recognized to be targeted by miR-381-3p. FLVCR1-AS1 aggravated BC malignant progression via up-regulation CTNNB1 through sponging miR-381-3p.

Conclusion
FLVCR1-AS1 regulates BC malignant behavior via sequestering miR-381-3p and then freeing CTNNB1, implying a promising target for BC therapy.
Assessing health outcomes in the aftermath of the great recession: a comparison of Spain and the Netherlands
Authors: Thompson Kristina , Wagemakers Annemarie , van Ophem Johan 
Published: June 2020

Abstract
Background
Across time and space, financial security has been shown to impact health outcomes, with the acute loss of financial security being particularly detrimental. We compare financial security’s association with health in Spain and the Netherlands. These countries respectively exemplify low and high levels of financial security, general trends that have been exacerbated by the Great Recession of the 2010s.

Methods
We exploit the Spanish (n = 1001) and Dutch (n = 1010) editions of the European Social Survey 7, conducted in 2014, and condense relevant financial security- and health-related survey questions into latent variables using factor analyses. Using the component loadings as quasi-weightings, we generate one financial security variable and three health variables (mental, physical and social). Then, we run ordinary least squares regressions interacting financial security and nationality, for each of the three health outcomes.

Results
In unadjusted models, we find that financial security (p < 0.01) is positively associated with the three health outcomes, while being Spanish relative to being Dutch (p < 0.01) is associated with worse health outcomes. However, the results of the interaction term show that being Spanish relative to being Dutch weakens the relationship between physical health and social health, although not mental health.

Conclusions
We find evidence that financial security’s influence on health outcomes may vary in different contexts. This may be an important aspect of determining the Great Recession’s influence on health outcomes. Our study is a first step in understanding how the relationships between financial security and health may differ in countries with different experiences of the Great Recession.