bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation and Analysis of the Satisfaction Degree of the Intelligent Outpatient Clinic of Tianjin 3A Grade Hospitals Based on the KANO Model
Authors: Zhao Fanyu , Xiao Yawen , Feng Xue , Liu Chang , Jiang He 
Published: August 2021

Objective — Based on the Kano model, we investigated the outpatients' satisfactions with the functions of the intelligent outpatient clinic of 3A Grade hospital in Tianjin, to improve the function of the intelligent outpatient clinic. Methods — Based on the Kano model, a questionnaire was designed to investigate the satisfaction and expectation of Tianjin outpatients with the use of intelligent outpatient clinic. A survey was conducted on 384 outpatients to determine the functions of the intelligent outpatient clinic. Results — Among the 14 intelligent outpatient service, 11 (79%) are attractive quality, 3 (21%) are one-dimensional quality, and there are no must-be quality. In the quadrant diagram, there are 3 requirements in the dominant area and 11 requirements in the retention area. There are three high satisfying attributes: convenience of multifunctional payment method, convenience of reservation registration and security of multiple payment methods. There is an unsatisfying function: the information pushed by WeChat platform. Conclusion — The intelligent outpatient clinic function has been satisfied by most patients, but it hasn’t been fully popularized. It is necessary to improve the payment security, the order waiting and other attractive quality, to optimize the medical experience of the intelligent clinic and improve patients' satisfaction.
Research on the Coordination of Green Finance and Green Economy with the Goal of Sustainable Development
Authors: Yang Bing 
Published: August 2021

In order to give full play to the integration between green finance and green economy, the selection of appropriate evaluation indicators is worth further exploration. Therefore, this paper is conducted with exploration on the combination of comprehensive index system and comprehensive method, which give evaluations on the coupling coordination degree between green finance and green economy by combining the coupling coordination degree model with ESG, so as to achieve the goal of sustainable development.
PENGGUNAAN TEPUNG DAUN INDIGOFERA SP DALAM PAKAN TERHADAP PENAMPILAN PRODUKSI, KUALITAS TELUR DAN LEMAK DARAH AYAM PETELUR
Authors: Atma Alfian Adi , Kurnia Dyanovita Al 
Published: August 2021

Indigofera sp adalah jenis tanaman leguminosa dengan genus Indigofera. Penelitian ini bertujuan untuk mengevaluasi pengaruh penggunaan tepung daun indigofera sp terhadap penampilan produksi dan lemak darah ayam petelur. Medote yang digunakan adalah percobaan dengan model RAL (rancangan acak lengkap) 4 perlakuan dan 5 ulangan dengan proporsi P1 kontrol, P2 pemberian tepung daun Indigofera sp 2,5 %, P3 pemberian tepung daun Indigofera sp 5 %, dan P4 pemberian tepung daun Indigofera sp 7,5 %. Bahan yang digunakan pada penelitian adalah tepung daun Indigofera sp. Hasil penelitian berdasarkan analisis Ragam menunjukkan bahwa pengaruh perlakuan terhadap konsumsi pakan ayam petelur berbeda nyata (P<0,05), konsumsi pakan tertinggi ( 86,65 ± 0,30b g/ekor ) pada P4 dengan penambahan tepung daun Indigofera sp 7,5 % memberikan hasil terbaik karena peningkatan konsumsi pakan memberikan pengaruh terhadap produksi telur. HDP ( Hen Day Production ), Egg Mass, konversi pakan, IOFC, kualitas telur terhadap tebal kerabang, skor kuning telur, dan kolesterol kuning telur serta lemak darah meliputi kolesterol total darah, HDL, LDL, dan trigliserida menunjukkan pengaruh tidak berbeda nyata ( P>0,05).
Association Between Changes in Physical Activity and New-Onset Atrial Fibrillation After ICD/CRT-D Implantation
Authors: Sun Xuerong , Zhao Shuang , Chen Keping , Hua Wei , Su Yangang , Xu Wei , Wang Fang , Fan Xiaohan , Dai Yan , Liu Zhimin , Zhang Shu 
Published: August 2021

Background: Changes in physical activity (PA) after implantable cardioverter defibrillator (ICD) or cardiac resynchronization therapy defibrillators (CRT-D) implantation were unknown. The association of PA changes with new-onset atrial fibrillation (AF), cardiac death and all-cause mortality was unclear in patients at high risk of sudden cardiac death.Methods: Patients receiving ICD/CRT-D implantation from SUMMIT registry were retrospectively analyzed. Changes in PA were considered from baseline status to 1 year after implantation. New-onset AF was defined as the first atrial high-rate episode ≥1% of the daily AF burden detected after implantation.Results: Over a mean follow-up of 50.3 months, 124 new-onset AF events (36.2%), 61 cardiac deaths (17.8%), and 87 all-cause deaths (25.4%) were observed in 343 patients with ICD/CRT-D implantation. PA at 1 year after implantation was increased compared with PA at baseline (11.97 ± 5.83% vs. 10.82 ± 5.43%, P = 0.008), and PA at 1 year was improved in 210 patients (61.2%). Per 1% decrease in PA was associated with 12.4, 18.3, and 14.3% higher risks of new-onset AF, cardiac death and all-cause mortality, regardless of different baseline characteristics. Patients with decreased PA had 2-fold risks of new-onset AF (hazard ratio [HR] = 1.972, 95% confidence interval [CI]: 1.352–2.877, P &lt; 0.001) as high as those with unchanged/increased PA. Decreased PA was an independent risk factor for cardiac death (HR = 3.358, 95% CI: 1.880–5.996, P &lt; 0.001) and all-cause mortality (HR = 2.803, 95% CI:1.732–4.535, P &lt; 0.001).Conclusion: PA decrease after ICD/CRT-D implantation is associated with a higher incidence of new-onset AF, resulting in worsened outcomes in cardiac death and all-cause mortality.
Shale Gas Exploration Potential in Southwestern Shandong Province of Eastern China
Authors: Cuifang Li , Xinglong Huang , Yubao Shao , Fengke Dou 
Published: August 2021

The shale layers of the Permian Shanxi Formation and Taiyuan Formation in the southwestern part of Shandong Province are marine-continental transitional sedimentary facies. When compared with the Ordos Basin, which was a typical breakthrough in marine-continental transitional shale gas exploration, the geological characteristics, exploration, and development prospects of marine-continental transitional shale gas in the southwestern section of Shandong Province are more defined. The shale gas deposits of the Shanxi and Taiyuan Formations in southwestern Shandong Province have the following geological characteristics. The sedimentary environments of Shanxi and Taiyuan Formations are considered to be stable and characterized with widely distributed organic-rich shale, which can be used as composite evaluation layers. The total thickness of the shale range is between 140 and 350 m, with an average of 230 m. The main types of organic matter in the Shanxi Formation are Type Ⅲ and Type Ⅱ2 kerogen, while the main types of organic matter in the Taiyuan Formation are rock types. The abundance and maturity of the organic matter are high, and the gas generating capacity is strong. The reservoir rock mineral composition is complex in the region. The clay mineral content is relatively high and the brittle mineral content is rich. Also, the shale fracturing ability is good. The region has the characteristics of a low porosity and low permeability reservoir, with relatively good reservoir capacity. Three primary points of interest have stably been developed within the region, which are located in the upper high water level system, near the initial flood surface, and the majority of flood surface, including a transgressive system tract and high level system tract. The total gas content is estimated to range between 0.03 and 4.47 m3/t, with an average of 0.30 m3/t. The shale gas resources are rich, including one favorable Class I location with an area of 819.06 km2 and a resource amount of 985.84 × 108 m3; four favorable Class Ⅱ locations with an area of 1,979.68 km2 and a resource amount of 2,278.14 × 108 m3; and five prospective locations with an area of 8,385.52 km2 and a resource amount of 7,299.48 × 108 m3. Therefore, the region was considered to have major exploration potential.
Systematic Influence of Circulating Bilirubin Levels on Osteoporosis
Authors: Zhao Jinqiu , Zhang Muzi , Quan Zhengxue , Deng Liang , Li Yongguo , He Bin 
Published: August 2021

Observational studies report some association between circulating bilirubin levels and osteoporosis, but it is unknown if this association is causal or confounded. In this two-sample Mendelian randomization (MR) study, we included a large genome-wide association study (GWAS) associated with total bilirubin levels among 317,639 people, a large meta-analysis to identify genetic variants associated with bone mineral density (BMD) estimated by heel quantitative ultrasound (eBMD) among 426,824 individuals and fracture among 1.2 million individuals. The results revealed that circulating bilirubin levels had no causal influence on eBMD (beta-estimate: 0.004, 95% confidence interval [CI]: -0.019 to 0.028, SE:0.012, P-value=0.705) or the risk of fracture (beta-estimate: -0.009, 95% CI: -0.035 to 0.017, SE:0.013, P-value=0.488), which were both confirmed by multiple sensitivity analyses. Our results confirm that circulating bilirubin levels have no causal role in eBMD or the incidence of fracture, indicating that circulating bilirubin levels is unlikely to be a causal risk factor for osteoporosis or fracture.
Antibiotic Intervention Affects Maternal Immunity During Gestation in Mice
Authors: Benner Marilen , Lopez-Rincon Alejandro , Thijssen Suzan , Garssen Johan , Ferwerda Gerben , Joosten Irma , van der Molen Renate G. , Hogenkamp Astrid 
Published: August 2021

BackgroundPregnancy is a portentous stage in life, during which countless events are precisely orchestrated to ensure a healthy offspring. Maternal microbial communities are thought to have a profound impact on development. Although antibiotic drugs may interfere in these processes, they constitute the most frequently prescribed medication during pregnancy to prohibit detrimental consequences of infections. Gestational antibiotic intervention is linked to preeclampsia and negative effects on neonatal immunity. Even though perturbations in the immune system of the mother can affect reproductive health, the impact of microbial manipulation on maternal immunity is still unknown.AimTo assess whether antibiotic treatment influences maternal immunity during pregnancy.MethodsPregnant mice were treated with broad-spectrum antibiotics. The maternal gut microbiome was assessed. Numerous immune parameters throughout the maternal body, including placenta and amniotic fluid were investigated and a novel machine-learning ensemble strategy was used to identify immunological parameters that allow distinction between the control and antibiotic-treated group.ResultsAntibiotic treatment reduced diversity of maternal microbiota, but litter sizes remained unaffected. Effects of antibiotic treatment on immunity reached as far as the placenta. Four immunological features were identified by recursive feature selection to contribute to the most robust classification (splenic T helper 17 cells and CD5+ B cells, CD4+ T cells in mesenteric lymph nodes and RORγT mRNA expression in placenta).ConclusionIn the present study, antibiotic treatment was able to affect the carefully coordinated immunity during pregnancy. These findings highlight the importance of inclusion of immunological parameters when studying the effects of medication used during gestation.
Slowed Saccadic Reaction Times in Seemingly Normal Parts of Glaucomatous Visual Fields
Authors: Thepass Gijs , Lemij Hans G. , Vermeer Koenraad A. , van der Steen Johannes , Pel Johan J. M. 
Published: August 2021

Purpose: In eye movement perimetry, peripheral stimuli are confirmed by goal-directed eye movements toward the stimulus. The saccadic reaction time (SRT) is regarded as an index of visual field responsiveness, whereas in standard automated perimetry (SAP), the visual field sensitivity is tested. We investigated the relation between visual field sensitivity and responsiveness in corresponding locations of the visual field in healthy controls and in patients with mild, moderate and advanced glaucoma.Materials and Methods: Thirty-four healthy control subjects and 42 glaucoma patients underwent a 54-point protocol in eye movement perimetry (EMP) and a 24-2 SITA standard protocol in a Humphrey Field Analyzer. The visual field points were stratified by total deviation sensitivity loss in SAP into 6 strata. A generalized linear mixed model was applied to determine the influence of the various factors.Results: The generalized linear mixed model showed that the mean SRT increased with increasing glaucoma severity, from 479 ms in the control eyes to 678 ms in the eyes of patients with advanced glaucoma (p &lt; 0.001). Mean SRTs significantly increased with increasing SAP sensitivity loss. Even at the locations where no sensitivity loss was detected by SAP (total deviation values greater or equal than 0 dB), we found lengthened SRTs in mild, moderate and advanced glaucoma compared to healthy controls (p &lt; 0.05) and in moderate and advanced glaucoma compared to mild glaucoma (p &lt; 0.05). At locations with total deviation values between 0 and −3 dB, −3 and −6 dB and −6 and −12 dB, we found similar differences.Conclusions: The lengthened SRT in areas with normal retinal sensitivities in glaucomatous eyes, i.e., planning and execution of saccades to specific locations, precede altered sensory perception as assessed with SAP. Better understanding of altered sensory processing in glaucoma might allow earlier diagnosis of emerging glaucoma.
Literacy Level and Executive Control in Healthy Older Peruvian Adults
Authors: Soto-Añari Marcio , López Norman , Rivera-Fernández Claudia , Belón-Hercilla Verónica , Fernández-Guinea Sara 
Published: August 2021

Introduction: Early-life educational experiences are associated with cognitive performance in aging. Early literacy seems to improve executive control mechanisms, however, it is not clear whether early education would still be an advantage in countries like Peru, where access to and quality of education is highly variable.Aim: Our objective was to analyze the association of literacy level with executive control factors.Method: We evaluated 93 healthy older adults with a clinical protocol that included the Mini-Mental State Examination, the Geriatric Depression Scale and Global Dementia Staging. We also used a neuropsychological executive function battery which included the Trail-Making Test parts A and B, the Stroop Test, phonological and semantic verbal fluency tasks, Forward and Backward Digits, Numbers and Letters of the Wechsler Scale, and the Go/No-Go task. We used a principal component analysis for the dimensional reduction of the variables. To measure the level of literacy we used the word accentuation test (WAT).Results: We observed statistically significant correlations between the principal components (PCs) of working memory, cognitive flexibility and inhibitory control with the WAT scores. Furthermore, we observed that processing speed and WAT predict the scores on PCs factors better than years of education and age.Conclusions: Literacy level correlates more closely with better cognitive performance than years of education and thus, might improve executive control factors that could compensate and protect against brain changes in cognitive decline and dementia.
Intestinal Permeability and Circulating CD161+CCR6+CD8+T Cells in Patients With Relapsing–Remitting Multiple Sclerosis Treated With Dimethylfumarate
Authors: Buscarinu Maria C. , Gargano Francesca , Lionetto Luana , Capi Matilde , Morena Emanuele , Fornasiero Arianna , Reniè Roberta , Landi Anna C. , Pellicciari Giulia , Romano Carmela , Mechelli Rosella , Romano Silvia , Borsellino Giovanna , Battistini Luca , Simmaco Maurizio , Fagnani Corrado , Salvetti Marco , Ristori Giovanni 
Published: August 2021

Background: The changes of the gut-brain axis have been recently recognized as important components in multiple sclerosis (MS) pathogenesis.Objectives: To evaluate the effects of DMF on intestinal barrier permeability and mucosal immune responses.Methods: We investigated intestinal permeability (IP) and circulating CD161+CCR6+CD8+T cells in 25 patients with MS, who met eligibility criteria for dimethyl-fumarate (DMF) treatment. These data, together with clinical/MRI parameters, were studied at three time-points: baseline (before therapy), after one (T1) and 9 months (T2) of treatment.Results: At baseline 16 patients (64%) showed altered IP, while 14 cases (56%) showed active MRI. During DMF therapy we found the expected decrease of disease activity at MRI compared to T0 (6/25 at T1, p = 0.035 and 3/25 at T2, p &lt; 0.00), and a reduction in the percentage of CD161+CCR6+CD8+ T cells (16/23 at T2; p &lt; 0.001). The effects of DMF on gut barrier alterations was variable, without a clear longitudinal pattern, while we found significant relationships between IP changes and drop of MRI activity (p = 0.04) and circulating CD161+CCr6+CD8+ T cells (p = 0.023).Conclusions: The gut barrier is frequently altered in MS, and the CD161+ CCR6+CD8+ T cell-subset shows dynamics which correlate with disease course and therapy.
Elevated Serum Inflammatory Markers in Subacute Stroke Are Associated With Clinical Outcome but Not Modified by Aerobic Fitness Training: Results of the Randomized Controlled PHYS-STROKE Trial
Authors: Kirzinger Bernadette , Stroux Andrea , Rackoll Torsten , Endres Matthias , Flöel Agnes , Ebinger Martin , Nave Alexander Heinrich 
Published: August 2021

Background: Inflammatory markers, such as C-reactive Protein (CRP), Interleukin-6 (IL-6), tumor necrosis factor (TNF)-alpha and fibrinogen, are upregulated following acute stroke. Studies have shown associations of these biomarkers with increased mortality, recurrent vascular risk, and poor functional outcome. It is suggested that physical fitness training may play a role in decreasing long-term inflammatory activity and supports tissue recovery.Aim: We investigated the dynamics of selected inflammatory markers in the subacute phase following stroke and determined if fluctuations are associated with functional recovery up to 6 months. Further, we examined whether exposure to aerobic physical fitness training in the subacute phase influenced serum inflammatory markers over time.Methods: This is an exploratory analysis of patients enrolled in the multicenter randomized-controlled PHYS-STROKE trial. Patients within 45 days of stroke onset were randomized to receive either four weeks of aerobic physical fitness training or relaxation sessions. Generalized estimating equation models were used to investigate the dynamics of inflammatory markers and the associations of exposure to fitness training with serum inflammatory markers over time. Multiple logistic regression models were used to explore associations between inflammatory marker levels at baseline and three months after stroke and outcome at 3- or 6-months.Results: Irrespective of the intervention group, high sensitive CRP (hs-CRP), IL-6, and fibrinogen (but not TNF-alpha) were significantly lower at follow-up visits when compared to baseline (p all ≤ 0.01). In our cohort, exposure to aerobic physical fitness training did not influence levels of inflammatory markers over time. In multivariate logistic regression analyses, increased baseline IL-6 and fibrinogen levels were inversely associated with worse outcome at 3 and 6 months. Increased levels of hs-CRP at 3 months after stroke were associated with impaired outcome at 6 months. We found no independent associations of TNF-alpha levels with investigated outcome parameters.Conclusion: Serum markers of inflammation were elevated after stroke and decreased within 6 months. In our cohort, exposure to aerobic physical fitness training did not modify the dynamics of inflammatory markers over time. Elevated IL-6 and fibrinogen levels in early subacute stroke were associated with worse outcome up to 6-months after stroke.Clinical Trial Registration:ClinicalTrials.gov, NCT01953549.
Influence of FMO3 and CYP3A4 Polymorphisms on the Pharmacokinetics of Teneligliptin in Humans
Authors: Park Jin-Woo , Kim Kyoung-Ah , Kim Jong-Min , Park In-Hwan , Park Ji-Young 
Published: August 2021

Teneligliptin, a dipeptidyl peptidase-4 inhibitor, is used to treat type 2 diabetes mellitus. FMO3 and CYP3A4 metabolize teneligliptin into teneligliptin sulfoxide. This study examined the effects ofFMO3(rs909530, rs1800822, rs2266780, and rs2266782) andCYP3A4(rs2242480) polymorphisms on teneligliptin pharmacokinetics at a steady state among 23 healthy participants administered 20 mg teneligliptin daily for 6 days. Subjects withFMO3rs909530, rs2266780, and rs2266782 polymorphisms exhibited a significant gene dosage-dependent increase in maximum steady-state plasma drug concentration (Cmax,ss) and area under the drug concentration vs time curve (AUC) (p&lt;0.05). However, the Cmaxvalues significantly decreased but the AUC values did not significantly vary in subjects withCYP3A4polymorphism (rs2242480). These results suggest thatFMO3andCYP3A4polymorphisms affect teneligliptin pharmacokinetics in humans. The findings of this study provide a scientific basis for the inter-individual variation in teneligliptin disposition.
Applied Improvisation Enhances the Effects of Behavioral Activation on Symptoms of Depression and PTSD in High School Students Affected by the Great East Japan Earthquake
Authors: Sugiyama Chikaze , Koseki Shunsuke , Niikawa Yoko , Ito Daisuke , Takahashi Fumito , Ishikawa Rie 
Published: August 2021

BackgroundThe education system can serve as a community-based resource to support the provision of long-term follow-up care after large-scale disasters. While school-based interventions conducted after a disaster have been confirmed to reduce symptoms of depression and posttraumatic stress disorder (PTSD), adolescents often exhibit low treatment motivation. Traditional methods used to encourage treatment motivation include fun activities, such as applied improv (AIM). This study evaluated the intervention effects and improved motivation of an intervention program combining AIM with the behavioral activation approach (BAA).MethodsParticipants were 253 tenth graders, who were in fifth grade at the time the Great East Japan Earthquake of 2011, and 239 students were included in the analyses. Participants were divided into two groups: the BAA and AIM + BAA groups. Students in each group participated in one class-wide intervention session, which lasted 60 min. Depression, PTSD symptoms, behavioral activation, avoidance, and resilience were evaluated using psychological scales. A participant’s evaluations of the intervention were confirmed using the impression sheet consisting of six items that measure comprehension, difficulty, efficacy, generalization, confirmation of a specific situation, and motivation.ResultsA two-way analysis of variance (ANOVA) conducted using data from the psychological scale did not reveal a significant effect from the intervention program. However, the Mann-Whitney U-test, which used data from the impression sheet, showed a significant effect on comprehension (p = 0.001), generalization (p = 0.023), and motivation (p = 0.025).ConclusionThis study did not confirm the effectiveness of the BAA in reducing symptoms of depression and PTSD in adolescents. Regarding treatment motivation, the AIM + BAA group reported higher motivation than the BAA group. Thus, one session of AIM may contribute to improved treatment motivation in adolescents. AIM creates a safe environment and encourages engagement and participation in interventions. Treatment motivation is an important issue in adolescent therapy, and AIM may help solve this problem.