bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of healthcare efficiency in China: a three-stage data envelopment analysis of directional slacks-based measure
Authors: Fang Bingxue , Li Mincai 
Published: May 2024

BackgroundA consensus on the changing pattern of healthcare efficiency in China is current absent. This study tried to identify temporal fluctuations in healthcare efficiency from 2012 to 2021, and conducted a comparative analysis on the performance of 31 regions in China using region-level balanced panel data.MethodsEmploying three-stage data envelopment analysis (DEA) as the analytical framework, we measured healthcare efficiency and its changes using the directional slacks-based measure and global Malmquist-luenberger (GML) indexes. We also decomposed the sources of healthcare inefficiency and extended our analysis to changes in healthcare efficiency across different primary medical service levels and regional economic development tiers.ResultsThe average efficiency score of medical institutions (0.956) was slightly higher than that of hospitals (0.930). We found that the average GML indexes of medical institutions in China stood at 0.990, while the average technical change (TC) index was 0.995 and the average efficiency change (EC) index was 0.998 from 2012 to 2021. The GML indexes, TC indexes, and EC indexes of hospitals were 1.002, 1.009, and 0.994, respectively. The healthcare inefficiency for both inputs and desirable outputs in medical institutions was primarily attributed to the redundant numbers of institutions, outpatient visits slacks and inpatient surgery volume slacks, accounting for 50.040, 49.644, and 28.877%, respectively. The undesirable output inefficiency values of medical institutions concerning in-hospital mortality stood at 0.012, while the figure for hospital regarding the average length of stay (LOS) was 0.002. Additionally, healthcare efficiency in both medical institutions and hospitals exhibited an upward trend from 2012 to 2021, corresponding to an increase in the volume of primary medical services, primary medical staff, and the total gross domestic product (GDP).ConclusionTotal factor productivity (TFP) of medical services declined in China from 2012 to 2021. The excessive number of medical institutions and the slack of medical service volumes were the main sources of healthcare inefficiency. Regions prioritizing primary medical services and boasting higher GDP levels exhibited superior healthcare efficiency. These findings are expected to inform policymakers' efforts in building a value-based and efficient health service system in China.
The risk of low energy availability among athlete females in Saudi Arabia: a cross-sectional study
Authors: Khatib Mai A. , Aljaaly Elham A. , Hafiz Maryam S. , Alamri Alkhuzama , Alzahrani Wejdan 
Published: May 2024

IntroductionLow energy availability (LEA) is a state of inadequate energy reserves that results from a negative energy balance. This condition can lead to severe health risks such as amenorrhea and osteoporosis. Various causes for LEA, such as eating disorders and exercise addiction, have been reported in the literature. However, data in Saudi Arabia are lacking. This cross-sectional study measures the prevalence of LEA, eating disorders, and exercise addiction among adult females in Saudi Arabia and identifies possible associated risk factors.MethodsThe sample comprised 119 female athletes who filled out an online survey adapted from the LEA in Females Questionnaire, the Eating Disorder Examination Questionnaire, and the Exercise Addiction Inventory.ResultsParticipants showed a high prevalence of LEA (66.4%), eating disorder (33.6%), and exercise addiction (10.1%), confirming the association between normal weight and LEA in females living in Saudi Arabia (p &lt; 0.00).Discussion and conclusionWith an increasing number of females in the country interested in following a healthy lifestyle, there is a need to raise the awareness of the population on the issues of LEA, eating disorders, and exercise addiction and their effects on the body by developing educational programs about energy intake and healthy physical activity routines.
The feasibility of wildlife immersion experiences for Veterans with PTSD
Authors: Perry Donna J. , Crawford Sybil L. , Mackin Jill M. , Averka Jesse J. , Smelson David A. 
Published: May 2024

IntroductionAnimal-assisted interventions (AAI) offer potential physical and psychological health benefits that may assist Veterans with post-traumatic stress disorder. However, more feasibility studies are needed regarding intervention details, adverse events, reasons for study withdrawal, and animal welfare.MethodsThis mixed methods feasibility trial involved a modified crossover study in which Veterans with PTSD/PTSD symptoms were provided a series of 8 nature and wildlife immersion experiences to evaluate feasibility and preliminary efficacy. The sample included 19 Veterans with PTSD/PTSD symptoms who were followed for a mean of 15.1 weeks. The intervention was comprised of a baseline forest walk, assisting with wildlife rehabilitation, observation in a wildlife sanctuary, and bird watching. Post study bird feeders were provided for sustainability. The theory of transcendent pluralism, which is grounded in mutual human and ecological dignity, guided the study. We viewed feasibility from the perspective of pattern integration with the natural world.ResultsThis AAI nature/wildlife immersion intervention was feasible, acceptable, and safe to administer to Veterans with PTSD/PTSD symptoms with appropriate support. Logistical and relational facilitators were identified that supported the wildlife immersion activities. Participants reported greatly enjoying the activities. Attention to animal welfare and care was an important ethical foundation that also contributed to feasibility.DiscussionAAI immersion experiences with wildlife are feasible and can safely be administered to Veterans with PTSD/PTSD symptoms. Logistical and relational facilitators are important to support nature and wildlife immersion activities.
Stress factors in veterinary medicine—a cross-sectional study among veterinary students and practicing vets in Austria
Authors: Neubauer Viktoria , Gächter Afsaneh , Probst Thomas , Brühl Deianira , Dale Rachel , Pieh Christoph , Humer Elke 
Published: May 2024

BackgroundAlthough the issue of high mental health burden among veterinarians is well-documented in previous studies, little is known about the specific occupational stress factors associated with mental health issues. Therefore, the aims of this study were twofold: (1) to assess occupational stress factors within the veterinary profession, with a particular emphasis on comparing the expectations of veterinary students with the experiences of practicing veterinarians and (2) to link the experienced stress with mental health indicators in veterinarians.MethodsAll registered veterinarians and veterinary-medicine students in Austria were invited to participate in a cross-sectional online survey. The data collection took place during the winter of 2022/2023 and included standardized questionnaires on mental well-being (WHO-5), depression (PHQ-9), anxiety (GAD-7), stress (PSS-4), and insomnia (ISI-2). Additionally, participants were asked about various estimated (students) or experienced (vets) occupational stress factors, which were to be rated on a 5-point Likert scale ranging from “not at all” to “very strongly”. An open question invited respondents to identify in free text further experienced/anticipated sources of work-related stressors in veterinary practice.ResultsA total of 430 students and 440 veterinarians participated in the study. The results of a repeated measures analysis of variance (ANOVA) indicate that the burden of bureaucracy is perceived as less stressful by students than experienced by veterinarians, all other areas are perceived as more stressful by students than by veterinarians. In veterinarians, bureaucracy is experienced as the most burdensome, followed by animal suffering, and communication with animal owners. Further analysis of possible associations between the extent of perceived stressors and indicators of mental health shows that while bureaucracy is the most burdensome, it has the smallest correlation with mental health indicators. On the other hand, financial concerns, which are not ranked among the main stressors, have the strongest correlation with impaired mental health.ConclusionThe results suggest that financial security for veterinarians is crucial to safeguard their mental health. The training of veterinary medicine students and practicing veterinarians in the areas of administration, time management, handling animal suffering, and communication with animal owners might be beneficial in reducing their job-related stressors.
Aspirin eugenol ester affects ileal barrier function, inflammatory response and microbiota in broilers under lipopolysaccharide-induced immune stress conditions
Authors: Zhang Ruilin , Bai Dongying , Zhen Wenrui , Hu Xiaodi , Zhang Haojie , Zhong Jiale , Zhang Yi , Ito Koichi , Zhang Bingkun , Yang Yajun , Li Jianyong , Ma Yanbo 
Published: May 2024

AimsThe aim of this study was to investigate the effects of aspirin eugenol ester (AEE) on ileal immune function in broilers under lipopolysaccharide (LPS)-induced immune stress.MethodsTwo hundred and forty one-day-old male Arbor Acres chicks were randomly divided into four groups (saline, LPS, saline + AEE and LPS + AEE) with six replicates of ten broilers each. The saline group and LPS group were fed the normal diet, while the other two groups received normal diet plus 0.1 g/kg AEE. Broilers in the LPS and LPS + AEE groups were injected intraperitoneally with 0.5 mg/kg B.W LPS in saline for seven consecutive days beginning at 14 days of age, while broilers in the saline and saline + AEE groups were injected with saline only.ResultsThe results showed that AEE improved the ileal morphology and increased the ratio of villus height to crypt depth of immune-stressed broilers. LPS-induced immune stress significantly reduced the expression of the genes for the tight junction proteins occludin, zonula occludens-1 (ZO-1), claudin-1 and claudin-2, in the ileum, while AEE significantly up-regulated the expression of these genes. Compared with the saline group, the LPS-treated chickens showed significantly increased mRNA expression of the inflammatory factors tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-10 (IL-10), cyclooxygenase-2 (COX-2), and microsomal Prostaglandin E Synthesase-1 (mPGES-1) in the ileum, while they were significantly decreased by AEE supplementation. In addition, analysis of the ileal bacterial composition showed that compared with saline and LPS + AEE groups, the proportion of Firmicutes and Lactobacillus in the LPS group was lower, while the proportion of Proteobacteria and Escherichia-Shigella was higher. Similarly, Line Discriminant Analysis Effect Size (LEfSe) analysis showed that compared with the LPS group, Brevibacillus was dominant in the saline group, while the LPS + AEE group was rich in Rhizobium, Lachnoclostridium, Ruminococcaceae, Faecalibacterium, Negativibacillus, Oscillospiraceae, and Flavonifractor.ConclusionThese results indicate that dietary supplementation with 0.1 g/kg AEE could protect the intestinal health by improving the intestinal villus morphology, enhancing the expression of tight junction genes and alleviating inflammation to resist the immune stress caused by LPS stimulation in broilers, and the mechanism may involve COX-2-related signal transduction and improved intestinal microbiota composition.
Mapping Breeding Birds in a Karstic Sinkhole with a Comparison between Different Sampling Methods
Authors: Battisti Corrado , Crucitti Pierangelo , Dodaro Giuseppe , Giardini Marco , Marini Francesca 
Published: May 2024

Karstic sinkholes are peculiar structures hosting specific biological communities. Birds are still little studied in this regard. This note reports, for the first time, original data relating to the density of breeding species occurring within a sinkhole in central Italy obtained with a fine-grained and time-expensive sampling technique (mapping method). The results were compared with data sampled with the point counts method carried out in the same phenological period. We recorded 22 breeding species, all typical of meso-thermophilous forests and ecotonal habitats of hilly central Italy. Among them, two species (Turdus merula and Troglodytes troglodytes), typical of shady, undergrowth habitats, were recorded in the deepest part of the sinkhole (−70 m from the top). No significant differences emerged between the relative frequencies of the species obtained with the two methods, except for Luscinia megarhynchos (overestimated with the mapping method) and Aegithalos caudatus (underestimated). At the community level, the comparison of the two methods revealed similar values in univariate diversity metrics, Whittaker plots did not show a significant difference (ANCOVA test), and ordinary least squares regression between the frequencies showed a highly significant correlation. Therefore, in these peculiar habitats, data obtained from the two methods are comparable: since the point counts method needs lower sampling effort, it appeared to be more effective when compared to the mapping method to study these peculiar habitats.
Identification and Functional Analysis of KH Family Genes Associated with Salt Stress in Rice
Authors: Xie Qinyu , Zhang Yutong , Wu Mingming , Chen Youheng , Wang Yingwei , Zeng Qinzong , Han Yuliang , Zhang Siqi , Zhang Juncheng , Chen Tao , Cai Maohong 
Published: May 2024

Salinity stress has a great impact on crop growth and productivity and is one of the major factors responsible for crop yield losses. The K-homologous (KH) family proteins play vital roles in regulating plant development and responding to abiotic stress in plants. However, the systematic characterization of the KH family in rice is still lacking. In this study, we performed genome-wide identification and functional analysis of KH family genes and identified a total of 31 KH genes in rice. According to the homologs of KH genes in Arabidopsis thaliana, we constructed a phylogenetic tree with 61 KH genes containing 31 KH genes in Oryza sativa and 30 KH genes in Arabidopsis thaliana and separated them into three major groups. In silico tissue expression analysis showed that the OsKH genes are constitutively expressed. The qRT-PCR results revealed that eight OsKH genes responded strongly to salt stresses, and OsKH12 exhibited the strongest decrease in expression level, which was selected for further study. We generated the Oskh12-knockout mutant via the CRISPR/Cas9 genome-editing method. Further stress treatment and biochemical assays confirmed that Oskh12 mutant was more salt-sensitive than Nip and the expression of several key salt-tolerant genes in Oskh12 was significantly reduced. Taken together, our results shed light on the understanding of the KH family and provide a theoretical basis for future abiotic stress studies in rice.
Red-Haired People’s Altered Responsiveness to Pain, Analgesics, and Hypnotics: Myth or Fact?—A Narrative Review
Authors: Augustinsson Annelie , Franze Elisabeth , Almqvist Martina , Warrén Stomberg Margareta , Sjöberg Carina , Jildenstål Pether 
Published: May 2024

Red hair has been linked to altered sensitivity to pain, analgesics, and hypnotics. This alteration may be impacted by variants in the melanocortin-1 receptor (MC1R) gene, which are mainly found in redheads. The aim of this narrative review was to explore and present the current state of knowledge on red hair and its plausible associations with altered responsiveness to pain, analgesics, and hypnotics. Structured searches in the PubMed, CINAHL Complete, and Scopus electronic databases were conducted. Evidence suggests that women with red hair have an increased sensitivity to pain. Conversely, data also indicate a higher pain tolerance in homozygous carriers of MC1R variant alleles. Varied responses to analgesia have been reported, with both increased analgesic responsiveness in homozygous carriers of MC1R variant alleles and less analgesia in redheads. Data indicate an increased need for hypnotics in redheads. However, failed attempts to find statistical associations between red hair and altered responsiveness to hypnotics are also evident. Even though there seems to be an association between red hair and an altered responsiveness to pain, analgesics, and/or hypnotics, the results of this narrative review are inconclusive. Further research studies with larger populations and MC1R testing are needed.
The Effectiveness of Speech-Language Intervention on Expressive Vocabulary and Social Communication in Preschool-Aged Children with Language Delay
Authors: Shaaban Tahany S. 
Published: May 2024

Objectives: This study investigates the effectiveness of speech-language intervention in improving the expressive vocabulary and social communication skills of preschoolers with language delay, as well as the perceptions and experiences of speech therapists and parents regarding this intervention. Method: e-Mail interviews were conducted with five speech therapists and seven parents from Egypt, and data are analyzed thematically. Results: The results suggest that play-based strategies, parent education in speech-language intervention, and collaborative goal setting could enhance children’s language development. For positive outcomes, speech therapists, parents, and educators must collaborate in the intervention process. Despite the study’s limitations, such as the small sample size and self-reported data, future research should take these into considerations. Conclusion: The findings of this study emphasize how important early intervention and collaboration are for children’s language development, which can have significant implications for speech therapists, teachers, and parents.
رأس المال الاجتماعي وأمن الأحياء في مجتمع الإمارات: دراسة سوسيولوجيّة على عيّنة من أحياء إمارة الشّارقة
Authors: Algharbawi Fatima , Alhourani Mohammed , Nashwan Ayat 
Published: May 2024

الأهداف: تهدف الدّراسة إلى الكشف عن أمن الأحياء في مجتمع الإمارات بالتّركيز على الأبعاد الأمنيّة الوقائيّة الماديّة المتدفّقة عبر شبكات رأس المال الاجتماعي في أحياء إمارة الشّارقة، وذلك من خلال مكونات الأمن) الوقائي / المادي(.
المنهجية: جرى الاعتماد على المنهج الكّمي من خلال المسح الاجتماعي على عيّنة عشوائيّة عنقوديّة من مجموع المناطق في إمارة الشّارقة، من خلال توزيع استبانة على(500) مفردة ذكورًا وإناثًا من المواطنين الإماراتيين القاطنين في المناطق التّالية:
الموافجة، والرحمانية، والزاهية، والمنطقة الوسطى(الذيد)، والساحل الشرقي من خورفكان.
النتائج: أظهرت النّتائج أن رأس المال الاجتماعي ركيزة أساسيّة للأمن الوقائي المادي؛ حيث تبيّن أنّ شبكة العلاقات الاجتماعيّة في أحياء إمارة الشّارقة قوية ويُعاد إنتاجها على نحو مستمر خلافًا للأحياء المختلطة. ومن أبرز أبعاد الأمن الوقائي في الأحياء: أولًا: الأمن النّفعي (الاقتصادي الاجتماعي) والمتمثّل في العون المادي والوصول لأصحاب القرار. ثانيًا أمن الممتلكات ويتمثل في عدم الخوف على المقتنيات، والأمان على المنزل. ثالثًا: الأمن الصّحّي والمتمثل في التّواصل المُساهم في الوقاية من المرض، وتعرُّف الأطبّاء المختلفين. رابعًا الأمن البيئي المتمثّل في حل مشكلات الصّرف الصّحّي وضمان سلامة المرافق العامّة.
الخلاصة: تؤكّد نتائج الدّراسة أن شبكة العلاقات الاجتماعيّة في الحي التي حرصت الدّولة على تدعيمها وإعادة إنتاجها على نحو مدروس توفّر الأمن الوقائي المادي للمواطنين في الأحياء غير المختلطة. وهذا يدلّل على تدفّق مؤشّرات رأس المال الاجتماعي ضمن أبعاد الأمن الوقائي المادي وتأثيرها المباشر في شعور الأفراد وحالتهم الأمنيّة ويعكس مدى نجاح التّوجه الذي فرضته الدّولة؛ حيث تمثّل القبيلة والحي مصدر الأمن الأوّل قبل الخروج للمؤسّسات القانونيّة والأمنيّة.
Study of Analysis of Beta Human Chorionic Gonadotropin (hCG) Levels Before and After Hysterectomy in Gestational Trophoblastic Neoplasia (GTN) Patients: A Single Center Observational Study at Dr. M. Djamil General Hospital, Padang, Indonesia
Authors: Wella Novile Izora  , Rikarni  , Dwi Yulia  
Published: May 2024

Background: Gestational trophoblastic neoplasia (GTN) is a malignant tumor originating from placental trophoblast which causes mortality due to bleeding. Trophoblast produces beta hormone human chorionic gonadotropin (hCG). Quantitative examination of serum beta hCG is used to support the diagnosis and management of GTN. Hysterectomy is performed in bleeding conditions as the main therapy besides chemotherapy. This study aims to analyze differences in beta hCG levels before and after hysterectomy in GTN patients at Dr. M. Djamil General Hospital Padang.
Methods: Retrospective observational analytical research design cross-sectional from 21 samples of GTN patients for the period July 2021 to June 2023 at Dr. M. Djamil General Hospital Padang. Quantitative beta hCG level examination is carried out before and after the hysterectomy. The Shapiro-Wilk test was carried out for data normality and continued with the Wilcoxon nonparametric tests to find out significant differences in beta hCG levels.
Results: The most common characteristics of GTN patients were age ≥35 years, namely 15 (71.4%) patients, multiparity in 14 (66.7%) patients, and indication for hysterectomy due to bleeding in 14 (66.7%) patients. The median beta hCG level before hysterectomy was 46,000 (117.10-653,874) mIU/mL and the median after hysterectomy was 113.3 (0.12-3,693) mIU/mL. Beta hCG levels after hysterectomy were found to be normal (<5 mIU/mL) in five patients (23.8%). There was a significant difference in beta hCG levels before and after hysterectomy (p <0.001).
Conclusion: Beta hCG levels after hysterectomy decreased compared to before hysterectomy. Hysterectomy therapy is useful for reducing beta hCG levels in GTN patients.
Characteristics of Open Coal Mine Wastewater Conditions in Tanah Bumbu District, South Kalimantan, Indonesia
Authors: SUJIMAN Sujiman 
Published: May 2024

This research aims to determine the condition of waste in terms of the quality of the elements Fe, Mn, pH and TSS, and to determine the tendency of this waste in the settling pond of coal mines in Tanah Bumbu Regency, South Kalimantan. The research results show that at the settling pond location of the open coal mine the concentration of Fe quality is between (0.023 – 6.50) mg/lt and Mn (0.02-2.14) mg/lt, and the TSS quality is 76 mg/lt to 801 mg/lt and the pH is between 6.40 to 8.10. Trends in Fe waste Most of the results are still below environmental quality standards, only in July 2022 the quality will increase to 6.5 mg/lt. Meanwhile, Mn waste for a year is still below the government's standard environmental quality standards, but the highest quality is in September 2024 reaching 3.35 mg/lt, this quality is still below environmental quality standards. The trend in pH quality in general is still normal, only in February 2024 the quality exceeds environmental quality standards, increasing to 8.10 mg/lt. Finally, for TSS quality, the trend is from January to August 2024 to decrease, then in September it increases significantly to 801 mg/lt and then gradually decreases until December 2024 to 182 mg/lt.
Keywords : Environmental quality standards, Coal mine wastewater, trends quality.