bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contact with Nature: A Construction Study of the GREEN Model
Authors: Li Shih-Ming , Huang I-Feng , Yang Ya-Hui 
Published: December 2024

Abstract

Objective:
Contact with nature (CWN) is a key mental health promoting lifestyle. We developed the GREEN model, which comprises five factors – group, reflection, empowerment, emotion, and nature, to assess the mental health benefits from CWN. In this study, we intended to investigate whether the GREEN model can serve as a framework for CWN.

Methods:
In this study, we included 112 study participants of students aged 19–28 years taking classes between March and May 2023 at one of two Taiwanese universities. Assessments were done using the Analytic Hierarchy Process (AHP) questionnaire and the Inclusion of Nature in Self (INS) scale.

Results:
On the basis of the AHP survey results, we found that the following weights were assigned to the GREEN model factors: group, 0.13; reflection, 0.21; empowerment, 0.22; emotion, 0.31; and nature, 0.14. We also found that in a subset of study participants with a consistency ratio of < 0.1 in the AHP, the weights to the model factors were as follows: group, 0.12; reflection, 0.22; empowerment, 0.20; emotion, 0.34; and nature, 0.12. All five factors had a weight of > 0.1, indicating that they had good CWN. The weights for the GREEN model factors differed between the low- and high-INS groups. Emotional calmness was emerged as the most crucial factor for effective CWN programs.

Conclusion:
The results of this study suggest that the GREEN model is useful for CWN-related interventions.
Renal effects and safety of tirzepatide in subjects with and without diabetes: A systematic review and meta-analysis
Authors: Kamrul-Hasan A B M , Patra Shinjan , Dutta Deep , Nagendra Lakshmi , Muntahi-Reza AFM , Borozan Sanja , Pappachan Joseph M 
Published: December 2024

BACKGROUND
Type 2 diabetes (T2D), as well as obesity, are risk factors for chronic kidney disease (CKD) and end-stage renal disease. The renal impacts of glucose-lowering and weight-lowering drugs and their potential benefits in preventing CKD often guide clinicians in choosing them appropriately. Only limited data based on randomized controlled trials (RCTs) is currently available on the renal effects and safety profile of tirzepatide.
AIM
To explore the renal benefits and safety of tirzepatide vs controls.
METHODS
RCTs involving patients receiving tirzepatide for any indication in the intervention arm and placebo or active comparator in the control arm were searched through multiple electronic databases. The co-primary outcomes were percent change from baseline (CFB) in urine albumin-to-creatinine ratio (UACR) and absolute CFB in estimated glomerular filtration rate (eGFR; in mL/min/1.73 m2); the secondary outcome was tirzepatide’s renal safety profile. RevMan web was used to conduct meta-analysis using random-effects models. Outcomes were presented as mean differences (MD) or risk ratios with 95% confidence intervals.
RESULTS
Fifteen RCTs (n = 14471) with mostly low risk of bias (RoB) were included. Over 26-72 weeks, tirzepatide 10 mg [MD -26.95% (-40.13, -13.76), P < 0.0001] and 15 mg [MD -18.03% (-28.58, -7.47), P = 0.0008] were superior to placebo in percent reductions of UACR. Tirzepatide, at all doses, outperformed insulin in percent reductions of UACR. Compared to the placebo, the percent UACR reduction was greater in subjects with T2D than those with obesity but without T2D (MD -33.25% vs -7.93%; P = 0.001). The CFB in eGFR with all doses of tirzepatide was comparable [5 mg: MD- 0.36 (-1.41, 2.14); 10 mg: MD- 1.17 (-0.22, 2.56); 15 mg: MD- 1.42 (-0.04, 2.88)]; P < 0.05 for all] vs insulin. Tirzepatide (pooled and separate doses) did not increase the risks of adverse renal events, urinary tract infection, nephrolithiasis, acute kidney injury, and renal cancer compared to the placebo, insulin, and glucagon-like peptide-1 receptor agonists.
CONCLUSION
Short-term data from RCTs with low RoB suggests that tirzepatide positively impacts UACR without detrimental effects on eGFR in subjects with T2D and obesity without T2D, with a reassuring renal safety profile. Larger RCTs are warranted to prove the longer-term renal benefits of tirzepatide, which might also prevent eGFR decline and worsening of CKD.
Insulin autoantibodies, D-dimer and microalbuminuria: A cross-sectional, case-control study of type 2 diabetes
Authors: Zhang Lin-Shan , Yu Peng , Yao Fei , Lu Zhi-Qiang , Li Xiao-Mu , Chen Hong 
Published: December 2024

BACKGROUND
Type 2 diabetes mellitus (T2DM) often leads to vascular complications, such as albuminuria. The role of insulin autoantibodies (IAA) and their interaction with D-dimer in this context remains unclear.
AIM
To investigate the characteristics of IAA and its effect on albuminuria in T2DM patients.
METHODS
We retrospectively analyzed clinical data from 115 T2DM patients with positive IAA induced by exogenous insulin, and 115 age- and sex-matched IAA-negative T2DM patients as controls. Propensity scores were calculated using multivariate logistic regression. Key variables were selected using the least absolute shrinkage and selection operator (LASSO) algorithm. We constructed a prediction model and analyzed the association between IAA and albuminuria based on demographic and laboratory parameters.
RESULTS
The IAA-positive group had significantly higher D-dimer levels [0.30 (0.19-0.55) mg/L vs 0.21 (0.19-0.33) mg/L, P = 0.008] and plasma insulin levels [39.1 (12.0-102.7) μU/mL vs 9.8 (5.5-17.6) μU/mL, P < 0.001] compared to the IAA-negative group. Increases in the insulin dose per weight ratio, diabetes duration, and urinary albumin-to-creatinine ratio (UACR) were observed but did not reach statistical significance. The LASSO model identified plasma insulin and D-dimer as key factors with larger coefficients. D-dimer was significantly associated with UACR in the total and IAA-positive groups but not in the IAA-negative group. The odds ratio for D-dimer elevation (> 0.5 g/L) was 2.88 (95% confidence interval: 1.17-7.07) in the IAA-positive group (P interaction < 0.05).
CONCLUSION
D-dimer elevation is an independent risk factor for abnormal albuminuria and interacts with IAA in the development of abnormal albuminuria in T2DM patients.
Distinguishing exocrine pancreas disease-associated diabetes from type 2 diabetes based on anthropometric and metabolic parameters
Authors: Juza Anna , Kołodziej-Spirodek Lilianna , Gutkowski Krzysztof , Partyka Mariusz , Dąbrowski Mariusz 
Published: December 2024

BACKGROUND
Adult-onset diabetes is most often considered to be type 2 diabetes. However, other types of diabetes can develop in adults, including exocrine pancreas disease-associated diabetes, also called type 3c diabetes. Differential diagnosis between these types of diabetes still remains a diagnostic challenge.
AIM
To define anthropometric and laboratory markers that will allow for early diagnosis of pancreatic disease-associated diabetes.
METHODS
The study group included 44 patients with pancreatogenic diabetes (26 with pancreatic cancer and 18 with chronic pancreatitis), while the control group consisted of 35 patients with type 2 diabetes. We analyzed several parameters, including sex, age, body mass index (BMI), fasting plasma glucose, fasting C-peptide and insulin with homeostasis model assessment of insulin resistance (HOMA-IR) index calculation, adrenomedullin, adiponectin and creatinine levels with epidermal growth factor receptor (eGFR) calculation. We also developed an equation, termed type 3c diabetes index, which utilized BMI, fasting insulin and adrenomedullin levels, and eGFR to better identify patients with type 3c diabetes.
RESULTS
Compared to patients with type 2 diabetes, patients with pancreatogenic diabetes had significantly lower BMI (25.11 ± 4.87 kg/m2 vs 30.83 ± 5.21 kg/m2), fasting C-peptide (0.81 ± 0.42 nmol/L vs 1.71 ± 0.80 nmol/L), insulin (76.81 ± 63.34 pmol/L vs 233.19 ± 164.51 pmol/L) and HOMA-IR index, despite similar fasting plasma glucose levels. Patients with pancreatogenic diabetes also had lower adrenomedullin levels (0.41 ± 0.25 ng/mL vs 0.63 ± 0.38 ng/mL) but higher adiponectin levels (13.08 ± 7.20 μg/mL vs 8.28 ± 4.01 μg/mL) and eGFR levels (100.53 ± 21.60 mL/min/1.73 m2 vs 85.14 ± 19.24 mL/min/1.73 m2). Finally, patients with pancreatogenic diabetes had significantly lower Type 3c diabetes index values.
CONCLUSION
Patients with pancreatogenic diabetes differ from patients with type 2 diabetes in anthropometric and laboratory parameters. The type 3c diabetes index had the highest discriminating value, above any single parameter.
Interdisciplinary perspectives on diabetes and microcirculatory dysfunction: A global bibliometric analysis
Authors: Li Yuan , Wang Bing , Xu Meng-Ting , Wang Ying-Yu , Liu Wei-Qi , Fu Sun-Jing , Li Bing-Wei , Ling Hao , Liu Xue-Ting , Zhang Xiao-Yan , Li Ai-Ling , Zhang Xu , Liu Ming-Ming 
Published: December 2024

BACKGROUND
The prevalence of diabetes and its association with microcirculatory dysfunction presents a significant challenge in contemporary global health. Addressing this nexus is crucial for developing targeted therapeutic interventions.
AIM
To trace the progression and delineate the current state of interdisciplinary research concerning diabetes and microcirculation.
METHODS
Employing a bibliometric approach, this study scrutinizes 12886 peer-reviewed publications retrieved from the PubMed and Web of Science databases. The focus is on elucidating the research trajectory and thematic concentrations at the confluence of diabetes and microcirculation.
RESULTS
Research outputs have surged since 2011, with the United States, China, and the United Kingdom leading in the quantity and quality of publications. This analysis revealed that journals such as Diabetes Care and The New England Journal of Medicine, along with top research institutions, have significantly contributed to advancing the understanding of microvascular processes affected by diabetes. The central themes identified include inflammation, oxidative stress, and endothelial dysfunction, which are critical in mediating the microvascular complications of diabetes.
CONCLUSION
This bibliometric evaluation reveals an evolving landscape focusing on diabetes and microcirculatory dysfunction. The complexity of diabetic microvascular issues encouraged multidisciplinary research strategies that are imperative for global health outcomes.
Tacrolimus induces insulin receptor substrate 1 hyperphosphorylation and inhibits mTORc1/S6K1 cascade in HL7702 cells
Authors: Li Hao-Yan , Wang Yi , Ran Min , Gao Fei , Zhu Bo-Yu , Xiao Hai-Ying , Xu Chun 
Published: December 2024

BACKGROUND
Tacrolimus (FK506) is a key calcineurin inhibitor used to prevent organ transplant rejection and is effective in improving graft survival. However, it is linked to hyperglycemia and insulin resistance, contributing to new-onset diabetes after transplantation and negatively affecting islet function.
AIM
To study the effects of tacrolimus on the insulin signaling pathway of hepatocytes.
METHODS
HL7702 cells were treated with different concentrations of tacrolimus (0.1 mg/L, 1 mg/L, 5 mg/L) for 24 hours. The proteins involved in insulin signaling were detected by Western blotting.
RESULTS
Compared with the control group, phosphorylation of insulin receptor substrate (IRS) 1 at Ser 307 and Ser 323 were increased significantly when the tacrolimus concentration reached 1 and 5 mg/L. Phosphorylation of IRS1 at Ser 1101 was also increased, although not significantly. However, phosphorylation of Ribosomal protein S6 kinase beta-1 at Thr 389 was decreased significantly. The levels of phosphorylated glycogen synthase kinase 3α Ser 21 and Ser 9 were increased. Surprisingly, phosphorylation of glycogen synthase at Ser 641 was increased. There was no significant change in the activity of glycogen phosphorylase.
CONCLUSION
Tacrolimus has no direct effect on hepatic glucose metabolism, but inhibits IRS1-mediated insulin signaling. This may be one of the underlying mechanisms by which tacrolimus induces insulin resistance.
Efficacy of sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists on proteinuria and weight in a diabetes cohort
Authors: Lu Di-Fei , Zheng Rui , Li Ang , Zhang Jun-Qing 
Published: December 2024

BACKGROUND
With accumulating evidence showing a benefit in the renal and cardiovascular systems, diabetes guidelines recommend that patients with diabetes and chronic kidney disease (CKD) be treated with sodium-glucose cotransporter-2 inhibitor (SGLT2i) and/or glucagon like peptide-1 receptor agonists (GLP-1RAs) for renal protection. The real-world efficacy of the two medications on the urinary albumin-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) remains to be explored.
AIM
To evaluate the SGLT2i and GLP-1RA application rates and UACR alterations after intervention in a real-world cohort of patients with diabetes.
METHODS
A cohort of 5482 patients with type 2 diabetes were enrolled and followed up at the Integrated Care Clinic for Diabetes of Peking University First Hospital for at least 6 months. Propensity score matching was performed, and patients who were not recommended for GLP-1RA or SGLT2i with comparable sex categories and ages were assigned to the control group at a 1:2 ratio. Blood glucose, body weight, UACR and eGFR were evaluated after 6 months of treatment in real-world clinical practice.
RESULTS
A total of 139 (2.54%) patients started GLP-1RA, and 387 (7.06%) received SGLT2i. After 6 months, the variations in fasting blood glucose, prandial blood glucose, and glycosylated hemoglobin between the GLP-1RA group and the SGLT2i and control groups were not significantly different. UACR showed a tendency toward a greater reduction compared with the control group, although this difference was not statistically significant (GLP-1RA vs control, -2.20 vs 30.16 mg/g, P = 0.812; SGLT2i vs control, -20.61 vs 12.01 mg/g, P = 0.327); eGFR alteration also showed no significant differences. Significant weight loss was observed in the GLP-1RA group compared with the control group (GLP-1RA vs control, -0.90 vs 0.27 kg, P < 0.001), as well as in the SGLT2i group (SGLT2i vs control, -0.59 vs -0.03 kg, P = 0.010).
CONCLUSION
Compared with patients who received other glucose-lowering drugs, patients receiving SGLT2i or GLP-1RAs presented significant weight loss, a decreasing trend in UACR and comparable glucose-lowering effects in real-world settings.
Correlation between diabetic peripheral neuropathy and thyroid hormone sensitivity in elderly patients with type 2 diabetes mellitus
Authors: Fei Si-Jia , Luo Jing-Yi , Wang Wei-Hao , Guo Li-Xin , Pan Qi 
Published: December 2024

BACKGROUND
Diabetic peripheral neuropathy (DPN) is a common complication of type 2 diabetes mellitus (T2DM), significantly affecting patients’ quality of life and imposing a substantial economic burden. Recent studies have highlighted the role of thyroid hormones in diabetes complications, particularly in elderly patients with T2DM. However, the relationship between thyroid hormone sensitivity and DPN remains unclear.
AIM
To investigate the correlation between thyroid hormone sensitivity and DPN in elderly patients with T2DM.
METHODS
In a cohort of 256 elderly patients with T2DM, propensity score matching was used to balance age, sex, and diabetes duration. Clinical data were collected to calculate thyroid hormone sensitivity and analyze its correlation with DPN. A random forest model was used to evaluate the diagnostic value of free triiodothyronine/free thyroxine (FT3/FT4) for DPN.
RESULTS
Patients with DPN had a lower FT3/FT4 ratio [ (0.302 ± 0.053) vs (0.316 ± 0.049), P = 0.040]. Quartile stratification showed decreasing DPN prevalence with higher FT3/FT4 ratios. Spearman’s correlation analysis showed that a lower FT3/FT4 ratio was associated with higher glycated hemoglobin, fasting blood glucose, reduced nerve conduction velocity, and electrical skin conductance. Logistic regression indicated a positive relationship between the median FT3/FT4 ratio and bilateral foot electrochemical skin conductance [odds ratio (OR): 1.019; 95%CI: 1.005-1.034; P = 0.007] and sural nerve sensory amplitude (OR: 1.310; 95%CI: 1.008-1.703; P = 0.043). Receiver operating characteristic analysis using a random forest model showed that incorporating FT3/FT4 improved predictive performance for DPN, with an area under the curve of 0.74, sensitivity of 0.79, specificity of 0.64, and accuracy of 0.77.
CONCLUSION
In elderly patients with T2DM with euthyroidism, a lower FT3/FT4 ratio is correlated with increased DPN incidence, affecting both large and small nerve fibers. FT3/FT4 is an effective predictor of DPN.
Environmental degradation of Nike lake: a study on water quality parameters and heavy metal accumulation in fish
Authors: Ujah Innocent Izuchukwu , Ujah I I , Ani O. N. , Nsude C. A. , Okolo K. O. , Okeke Okechukwu David , Ekekezie C. U. , Okpashi V. E. , Okwesili L. C. , Okpako I. O. , Nneji E. O. , Anieke C. A. 
Published: December 2024

Environmental pollution is a pressing global issue, with heavy metal pollution posing a significant threat. This study examined the concentrations of heavy metals (cadmium, nickel, lead, chromium, manganese, iron, zinc, copper, mercury, selenium, and arsenic) in various organs and tissues (blood, gills, intestines, liver) of African Catfish (Clarias gariepinus) and Redbelly Tilapia (Tilapia zillii) from Nike Lake in Enugu State, Nigeria. Water samples from the lake were also analyzed for heavy metal concentrations, as well as nitrogen and phosphorous content, nitrate, phosphate, and dissolved oxygen levels. The results showed that the fish samples contained varying concentrations of heavy metals, with the highest levels found in the gills. The ranges of metal concentrations were: Cd (0.00-0.033), Ni (0.00-0.002), Pb (0.00-0.072), Cr (0.00-0.039), Mn (0.00-0.041), Fe (0.010-1.363), Zn (0.268-0.604), Cu (0.008-0.084), Hg (0.00-0.147), Se (0.293-0.474), Mo (0.020-0.095), and As (0.00-0.034). The water samples contained similar concentrations of heavy metals, were Cd:0.02, Ni:0.001, Pb:0.034, Cr:0.00, Mn:0.012, Fe:0.037, Zn:0.173, Cu:0.008, Hg:0.147, Se:0.309, Mo:0.027, As:0.004, with the addition of nitrate (4.373), phosphate (4.383), and dissolved oxygen (45.33) levels. The nitrogen and phosphorous content in the fish organs ranged from 2.938-4.987 and 3.089-7.484, respectively. The study highlights the presence of toxic heavy metals in the organs of the fish, emphasizing the need for regulation and monitoring to mitigate the risks associated with heavy metal pollution in aquatic ecosystems.
Analisis Penyebab Pending Klaim Pasien BPJS Rawat Inap dalam Rangka Mengoptimalkan Pendapatan di RSUD Banten
Authors: Handayani Handayani , Wahyudi Bayu , Mulyani Kahar 
Published: December 2024

Cara penagihan piutang terhadap biaya pelayanan yaitu dengan menggunakan sistem klaim. Berkas persyaratan klaim dikirim ke verifikator BPJS Kesehatan. Berdasarkan pengamatan yang mendalam terdapat permasalahan yaitu pengembalian berkas klaim oleh pihak verifikator BPJS. Penelitian ini adalah penelitian kualitatif dengan menggunakan analisis 5M (men, money, materials, methods and machines), untuk mengetahui penyebab klaim pending. Pengumpulan data diperoleh dari wawancara yang mendalam, pengamatan dan penelusuran dokumen. Hasil penelitian menyatakan bahwa penyebab berkas klaim mengalami pending dan tidak bisa diajukan klaimnya adalah kurangnya SDM, kurangnya pelatihan, berkas tidak lengkap, salah coding, salah input, hasil pemeriksaan penunjang tidak dilampirkan, tidak ada back up jaringan internet serta pelaksanaan manajemen operasi di RSUD Banten belum optimal.
Pelatihan Pembuatan Ayam Bumbu Suwir Vegetarian di Vihara Wisata Maitreya Rupat Utara, Bengkalis
Authors: Rohit Rohit , Wijaya Kurnia , Rozana Sridiana , Jelita Rida 
Published: December 2024

Proteina adalah daging imitasi yang terbuat dari tepung kedelai. Walaupun imitasi, bukan berarti konotasinya negatif. Proteina tetap sangat layak dikonsumsi. Bahkan menurut informasi nilai gizinya, per takaran saji (100 gram) Proteina mengandung lemak total 1 gram, protein 54 gram, karbohidrat total 32 gram, natrium 0 mg, dan energi totalnya 350 kkal. Kandungan protein tersebut diklaim memenuhi 91% AKG. Tujuan kegiatan pengabdian kepada masyarakat ini adalah untuk meningkatkan keterampilan para umat Buddha Maitreya Di Vihara Wisata Maitreya (VWM) , Rupat Utara, Bengkalis dalam membuat Pembuatan Ayam Bumbu Suwir Vegetarian dengan bahan dasar Proteina. Kegiatan dilakukan dengan metode pelatihan, yang meliputi diskusi, sosialisasi, praktek, dan pendampingan dan evaluasi. Ayam Bumbu Suwir vegetarian yang dihasilkan berbahan baku proteina dengan bumbu masakan tradisional khas Rupat. Produk ayam bumbu suwir vegetarian yang dihasilkan memiliki aroma, tekstur, dan rasa yang sangat sesuai dengan selera masyarakat Rupat, Bengkalis. serta bebas kolesterol dan bibit penyakit yang biasa terbawa dalam daging hewan. Kegiatan Program kreativitas mahasiswa kategori pengabdian kepada masyarakat (PKM M) ini sangat bermanfaat bagi khalayak sasaran karena dapat membuka peluang bisnis kuliner vegatarian khas Rupat, Begkalis. Hasil dari program pengabdian masyarakat ini adalah pengetahuan, kemampuan untuk mengolah ayam bumbu suwir meningkat. Bagi Mahasiswa Perancangan PKM M ini diharapkan mampu menjadi suatu sarana pembelajaran dan pengembangan pengetahuan dan juga keilmuan tentang vegetarian.