• 제목/요약/키워드: B.T.X

검색결과 1,086건 처리시간 0.085초

Dietary Supplementation of Magnesium Sulfate during Late Gestation and Lactation Affects the Milk Composition and Immunoglobulin Levels in Sows

  • Hou, W.X.;Cheng, S.Y.;Liu, S.T.;Shi, B.M.;Shan, A.S.
    • Asian-Australasian Journal of Animal Sciences
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    • 제27권10호
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    • pp.1469-1477
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    • 2014
  • This experiment was conducted to investigate the effects of dietary supplementation of magnesium sulfate ($MgSO_4$) during late gestation and lactation on sow and litter performance, fecal moisture, blood biochemistry parameters, immunoglobulin levels and milk composition in sows. Forty-eight sows ($Yorkshire{\times}Landrace$, 4th to 5th parity) were randomly allocated to 1 of 4 dietary treatments supplemented with 0, 200, 400, or 600 mg/kg $MgSO_4$ (n = 12). The experiment started on day 90 of gestation and continued through day 21 of lactation. Blood samples were collected on day 107 of gestation, day 0 (farrowing) and 21 (weaning) of lactation for the analyses of the blood biochemistry parameters and immunoglobulin levels. The colostrum and milk samples were obtained on day 0 and 14 of lactation, respectively. Fecal samples were collected from the sows on day 107 of gestation as well as day 7 and 20 of lactation to determine fecal moisture content. The results showed that the survival percentage of piglets and the litter weight at weaning were decreased linearly (p<0.05) and other parameters of the sow or litter performance were not influenced (p>0.05) by $MgSO_4$ supplementation. The fecal moisture content of the sows were increased (p<0.05) linearly as dietary $MgSO_4$ increased on day 7 and 20 of lactation. Supplementation with $MgSO_4$ increased the plasma magnesium (Mg) level linearly (p<0.05) and had a trend to increase total protein level (p>0.05 and p<0.10). However, an increase in the dietary $MgSO_4$ level resulted in a linear decrease in the colostrum fat content (p<0.05). Dietary $MgSO_4$ supplementation enhanced the immunoglobulin G (IgG) level (linear, p<0.05) in plasma on day of farrowing and immunoglobulin A (IgA) level in colostrum (quadratic, p<0.05) and milk (linear, p<0.05) of the sows. These results indicated that supplementation with $MgSO_4$ during late gestation and lactation may have the potential to prevent sow constipation, but may also result in some negative effects.

Bioimpedence to Assess Breast Density as a Risk Factor for Breast Cancer in Adult Women and Adolescent Girls

  • Maskarinec, Gertraud;Morimoto, Yukiko;Laguana, Michelle B;Novotny, Rachel;Guerrero, Rachael T Leon
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권1호
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    • pp.65-71
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    • 2016
  • Although high mammographic density is one of the strongest predictors of breast cancer risk, X-ray based mammography cannot be performed before the recommended screening age, especially not in adolescents and young women. Therefore, new techniques for breast density measurement are of interest. In this pilot study in Guam and Hawaii, we evaluated a radiation-free, bioimpedance device called Electrical Breast Densitometer$^{TM}$ (EBD; senoSENSE Medical Systems, Inc., Ontario, Canada) for measuring breast density in 95 women aged 31-82 years and 41 girls aged 8-18 years. Percent density (PD) was estimated in the women's most recent mammogram using a computer-assisted method. Correlation coefficients and linear regression were applied for statistical analysis. In adult women, mean EBD and PD values of the left and right breasts were $230{\pm}52$ and $226{\pm}50{\Omega}$ and $23.7{\pm}15.1$ and $24.2{\pm}15.2%$, respectively. The EBD measurements were inversely correlated with PD ($r_{Spearman}=-0.52$, p<0.0001); the correlation was stronger in Caucasians ($r_{Spearman}=-0.70$, p<0.0001) than Asians ($r_{Spearman}=-0.54$, p<0.01) and Native Hawaiian/Chamorro/Pacific Islanders ($r_{Spearman}=-0.34$, p=0.06). Using 4 categories of PD (<10, 10-25, 26-50, 51-75%), the respective mean EBD values were $256{\pm}32$, $249{\pm}41$, $202{\pm}46$, and $178{\pm}43{\Omega}$ (p<0.0001). In girls, the mean EBD values in the left and right breast were $148{\pm}40$ and $155{\pm}54{\Omega}$; EBD values decreased from Tanner stages 1 to 4 ($204{\pm}14$, $154{\pm}79$, $136{\pm}43$, and $119{\pm}16{\Omega}$ for stages 1-4, respectively) but were higher at Tanner stage 5 ($165{\pm}30{\Omega}$). With further development, this bioimpedance method may allow for investigations of breast development among adolescent, as well as assessment of breast cancer risk early in life and in populations without access to mammography.

Deoxynivalenol- and zearalenone-contaminated feeds alter gene expression profiles in the livers of piglets

  • Reddy, Kondreddy Eswar;Jeong, Jin young;Lee, Yookyung;Lee, Hyun-Jeong;Kim, Min Seok;Kim, Dong-Wook;Jung, Hyun Jung;Choe, Changyong;Oh, Young Kyoon;Lee, Sung Dae
    • Asian-Australasian Journal of Animal Sciences
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    • 제31권4호
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    • pp.595-606
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    • 2018
  • Objective: The Fusarium mycotoxins of deoxynivalenol (DON) and zerolenone (ZEN) cause health hazards for both humans and farm animals. Therefore, the main intention of this study was to reveal DON and ZEN effects on the mRNA expression of pro-inflammatory cytokines and other immune related genes in the liver of piglets. Methods: In the present study, 15 six-week-old piglets were randomly assigned to the following three different dietary treatments for 4 weeks: control diet, diet containing 8 mg DON/kg feed, and diet containing 0.8 mg ZEN/kg feed. After 4 weeks, liver samples were collected and sequenced using RNA-Seq to investigate the effects of the mycotoxins on genes and gene networks associated with the immune systems of the piglets. Results: Our analysis identified a total of 249 differentially expressed genes (DEGs), which included 99 upregulated and 150 downregulated genes in both the DON and ZEN dietary treatment groups. After biological pathway analysis, the DEGs were determined to be significantly enriched in gene ontology terms associated with many biological pathways, including immune response and cellular and metabolic processes. Consistent with inflammatory stimulation due to the mycotoxin-contaminated diet, the following Kyoto encyclopedia of genes and genomes pathways, which were related to disease and immune responses, were found to be enriched in the DEGs: allograft rejection pathway, cell adhesion molecules, graft-versus-host disease, autoimmune thyroid disease (AITD), type I diabetes mellitus, human T-cell leukemia lymphoma virus infection, and viral carcinogenesis. Genome-wide expression analysis revealed that DON and ZEN treatments downregulated the expression of the majority of the DEGs that were associated with inflammatory cytokines (interleukin 10 receptor, beta, chemokine [C-X-C motif] ligand 9), proliferation (insulin-like growth factor 1, major facilitator superfamily domain containing 2A, insulin-like growth factor binding protein 2, lipase G, and salt inducible kinase 1), and other immune response networks (paired immunoglobulin-like type 2 receptor beta, Src-like-adaptor-1 [SLA1], SLA3, SLA5, SLA7, claudin 4, nicotinamide N-methyltransferase, thyrotropin-releasing hormone degrading enzyme, ubiquitin D, histone $H_2B$ type 1, and serum amyloid A). Conclusion: In summary, our results demonstrated that high concentrations DON and ZEN disrupt immune-related processes in the liver.

휠체어에서 엉덩이 들기 동작 동안 발위치가 척수손상환자의 어깨 근활성도, 최대 족저압, 무릎굽힘 각도, 운동자각도에 미치는 효과 비교 (Comparison of the Effects of Different Foot Positions During Body-lifting in Wheelchair on Shoulder Muscle Activities, Peak Plantar Pressure, Knee Flexion Angle, and Rating Perceived Exertion in Individuals With Spinal Cord Injury)

  • 이왕재;임원빈;윤병구;이범석;이충휘
    • 한국전문물리치료학회지
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    • 제24권2호
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    • pp.1-8
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    • 2017
  • Background: Individuals with spinal cord injury (SCI) rely on their upper limbs for body-lifting activity (BLA). While studies have examined the electromyography (EMG) and kinematics of the shoulder joints during BLA, no studies have considered foot position during BLA. Objects: This study compared the effects of different foot positions during BLA on the shoulder muscle activities, peak plantar pressure, knee flexion angle, and rating perceived exertion in individuals with SCI. Methods: The study enrolled 13 mens with motor-complete paraplegic SCI, ASIA (American Spinal Injury Association) A or B. All subjects performed BLA with the feet positioned on the wheelchair footrest and on the floor independently. Surface EMG was used to collect data from the latissimus dorsi, pectoralis major, serratus anterior, and triceps brachii. The peak plantar pressure was measured using pedar-X and the knee flexion angle with Image J. Borg's rating perceived exertion scale was used to measure the physical activity intensity level. The paired t-test was used to compare the shoulder muscle activities, peak plantar pressure, knee flexion angle, and rating perceived exertion between the two feet positions during BLA. Results: The activity of the latissimus dorsi, pectoralis major, serratus anterior, and triceps brachii and rating perceived exertion decreased significantly and the peak plantar pressure and knee flexion angle increased significantly when performing BLA with the feet positioned on the wheelchair footrest compared with on the floor (p<.05). Conclusion: These findings suggest that individuals with SCI may perform BLA with the feet positioned on the wheelchair footrest for weight-relief lifting to decrease the shoulder muscle activities and the rating perceived exertion and to increase the peak plantar pressure and the knee flexion angle.

Glucose와 Phosphate가 제거된 M-TALP 배지에서의 난구세포 공배양에 의한 임신율 향상에 관한 연구 (Improvement of Pregnancy Rates by Coculture of Human Embryos with Cumulus Cells in Glucose and Phosphate Free M-TALP Media)

  • 정범식;장우현;이문희;김지연;방지호;김규현;서태광
    • Clinical and Experimental Reproductive Medicine
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    • 제26권1호
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    • pp.75-81
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    • 1999
  • The beneficial effect of glucose and phosphate ions in culture medium on the development of human embryos in vitro has not been fully elucidated. The purpose of this study was to evaluate the influence of fertilization and culture of embryos in glucose/phosphate-free m-TALP medium on pregnancy rates in IVF-ET program. The patients in 244 IVF-ET cycles received GnRH agonist + HMG regimens. A does of 10,000 IU HCG was administered when two or more dominent follicles reached 18mm in diameter. Thirty-six hours after HCG, oocytes were recovered transvaginally using ultrasound guidance. Aspirated oocytes were matured for 4 to 6 h in TCM-199 supplemented with 10% follicular fluid (FF). Insemination was carried out with 50,000 motile spermatozoa in TCM-199 + 10% FF or m-TALP + 5% FF + 5% fetal cord serum (FCS) according to experimental design. After 6 h, oocytes were washed 3 to 4 times and cultured in each fresh medium. After 20 h, oocytes were freed from cumulus/corona cells and examined for the presence of pronuclei. Fertilized oocytes were transferred into each co-culture drops and cultured for further incubation. On day 3, embryo transfer was performed with grade 1 and 2 embryos. Monolayers for co-culture of embryos were prepared by plating $1{\times}10^5$ cumulus cells/ml in 10ul drop of TCM-199 + 10% FF or m-TALP + 5% FF + 5% FCS media 24 h prior to the onset of co-culture. Development to 4 to 16 cell stage was observed at 70x magnification following two days of incubation. Pregnancy was confirmed by detecting increasing serum ${\beta}$-hCG concentrations for 11 days following embryo transfer. Data were analyzed by ${\chi}^2$-test. Oocytes from 244 IVF-ET cycles were randomized. The number of cycles and mean age of patients were 97 and 147, 31.3 yrs and 31.2 yrs for TCM-199 (control) and m-TALP groups, respectively. The mean number of retrieved oocytes/cycle, fertilization rates, number of embryos transferred/ET and pregnancy rates were 11.1 and 10.3, 65.1% and 67.3%, 4.1 and 4.7, 28.9% and 43.8% for TCM-199 and m-TALP groups, respectively. Differences in the pregnancy rates were found between control and m-TALP groups (p<0.05). The pregnancy rate of patients divided according to maternal age groups of ${\leq}30$, 31-35, $36{\leq}$ were 44.4% and 49.0%, 26.1% and 41.3%, 29.2% and 41.2% for control and m-TALP groups, respectively. These data indicate that culture of human embryos in glucose/phosphate-free m-TALP medium improves pregnancy rates.

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고등학생의 영양 관련 문제점 분석 및 영양 교육 프로그램 개발 ( I ) - 영양교육 목표 설정을 위한 식생활 문제점 분석 - (Problems Analysis Related to Nutrition and the Development of Nutrition Education Programs for High School Students( I ) - A Study Centered on Analyzing Problems of Dietary Life for Nutrition Education Goal Setting -)

  • 이은주;소혜경;최봉순
    • 동아시아식생활학회지
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    • 제17권3호
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    • pp.338-350
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    • 2007
  • The objectives of this study were to analyze nutrition-related problems and to develop the nutrition education programs for high school students A survey was conducted with 500 students in the second grade level at high schools in Daegu who differed in socio-economic characteristics. In addition, body composition analysis was accomplished by the Inbody 3.0. The developed questionnaires were distributed and 481 questionnaires were collected with a 96.2% of response rate. Statistical data analysis was completed using SPSS WIN(ver.12.0) for descriptive analysis, reliability analysis, factor analysis, t-tests and $X^2$-tests. We first analyzed students' problems related to nutrition and environmental factors. In a question addressing skipping breakfast, only 11.5% answered they "do not eat" breakfast. In regards to BMI, the male students' degree of obesity was higher. Second, we analyzed living environments, which greatly influence dietary behavior. For the snacks-related categories, most of the students liked bread, cake and other snacks. When they chose the snacks, they mainly considered taste. There were significant difference among the males and females(p<.01) in terms of snacks intake habits, where 43.1 % of the males answered they snack "occasionally" and 43.4% of the females answered they snack "according to how they feel". In the case of beverages, the males consumed significantly more(p<.001). Based on their regional groups, the area A group preferred milk and milk products, and the area B group preferred soft drinks. As for the time of beverage intake, 77.6% of the females answered "with snacks", which was significantly higher than 61.4% of the males(p<.001), 12.2% of the males drank beverages after exercise. For late snacking, 68.0% of the male students and 71.1 % of the female students consumed late snacks. Most of them preferred bread, cake and other snacks. The reasons for taking a late snack were "when I feel hungry" by 61.8% of the males which was higher than the females(p<.001), 23.6% of the females consumed late snacks "impulsively". Ideally, in order to improve the food habits of high school students effective and practical nutrition education programs that consider gender and regional school group, should be carried out.

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입원환자의 의료보장형태에 따른 가정간호 이용의사에 대한 연구 (A Study on Hospitalized Patients' Intent to Use Home Care Nursing According to the Types of Medical Security)

  • 김명희;조은지;박형숙;강인순
    • 가정간호학회지
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    • 제12권2호
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    • pp.63-86
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    • 2005
  • Purpose: This study is a descriptive research which is designed to investigate hospitalized patients' intent to use home care nursing according to the types of medical security. Method: This researcher surveyed 236 patients who were hospitalized at B medical center located in Busan,. Data were collected from Sep. 1 to Nov. 30, 2005 using a questionnaire survey, medical records, face-to-face interviews and observations. Collected data were analyzed in terms of frequency, percentage, mean and standard deviation through $x^2$-test and t-test under SPSS WIN 10.0 Program. Result: Out of the total subjects, 59.3% were medical aid clients and the remaining 40.7%, health insurance ones. The hospitalized period and frequency of the former group were 38.0 days and 4.0 times, respectively, while those of the latter, 37.7 and 3.4. When home care nursing clients were examined using a given classification device, it was found that out of the total 236 subjects, 205(86.9%) were needed to receive home care nursing, 121, medical aid and the other 84, health insurance. 24.0% of medical aid clients heard about home care nursing ever before, lower than 39.3% of health insurance clients. 43.8% of the former clients said cost for home care nursing was high while, 47.6% of the latter group responded expense for the nursing intervention was low. 30.6% of medical aid clients had intent to use home care nursing, lower than 47.6% of health insurance clients. 71.7% of those patients whose monthly income was 99 million won or below had no intent to use home care nursing, higher than 62.5% of those who were 100 million or over in monthly income(p<.05). 76.4% of those clients who had no nursing provider intented to use home care nursing, higher than those who had nursing provider(p<.05). Concerning contents of home care nursing, 85.1% of medical aid clients needed education, training and counseling while, 77.4% of health insurance aids wanted medication and injection. Conclusion: In conclusion, the use of home care nursing by medical aid clients should be promoted through improving conditions for home care nursing in terms of expense, family and residence and making public relations about activities and contents of the home care nursing.

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Association of a Methanol Extract of Rheum undulatum L. Mediated Cell Death in AGS Cells with an Intrinsic Apoptotic Pathway

  • Hong, Noo Ri;Park, Hyun Soo;Ahn, Tae Seok;Jung, Myeong Ho;Kim, Byung Joo
    • 대한약침학회지
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    • 제18권2호
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    • pp.26-32
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    • 2015
  • Objectives: Rheum undulatum L. has traditionally been used for the treatment of many diseases in Asia. However, its anti-proliferative activity in cancer has still not been studied. In the present study, we investigated the anti-cancer effects of methanol extract of Rheum undulatum L. (MERL) on human adenocarcinoma gastric cell lines (AGS). Methods: To investigate the anti-cancer effect of MERL on AGS cells, we treated the AGS cells with varying concentrations of MERL and performed 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assays. Cell cycle analyses, measurements of the mitochondrial membrane potential (MMP), caspase activity assays and Western blots were conducted to determine whether AGS cell death occurred by apoptosis. Results: Treatment with MERL significantly inhibited growth of AGS cells in a concentration dependent manner. MERL treatment in AGS cells leaded to increased accumulation of apoptotic sub G1 phase cells in a concentration dependent manner. In control cultures, 5.38% of the cells were in the sub G1 phase. In MERL treated cells, however, this percentage was significantly increased (9.95% at $70{\mu}g/mL$, 15.94% at $140{\mu}g/mL$, 26.56% at $210{\mu}g/mL$ and 38.08% at $280{\mu}g/mL$). MERL treatment induced the decreased expression of pro-caspase-8 and -9 in a concentration dependent manner, whereas the expression of the active form of caspase-3 was increased. A subsequent Western blot analysis revealed increased cleaved levels of poly (ADP-ribose) polymerase (PARP) protein. Also, treatment with MERL increased the activities of caspase-3 and -9 compared with the control. MERL treatment increased the levels of the pro-apoptotic truncated Bid (tBid) and Bcl2 Antagonist X (Bax) proteins and decreased the levels of the anti-apoptotic B-cell lymphoma 2 (Bcl-2) protein, whose is the stabilization of mitochondria. However, inhibitions of p38, extracellular signal regulated kinases (ERKs) and C-Jun N-terminal kinases (JNK) by MERL treatment did not affect cell death. Conclusion: These results suggest that MERL mediated cell death is associated with an intrinsic apoptotic pathway in AGS cells.

여대생의 골밀도와 식이 및 비식이 요인들 간의 상관성 (Dietary and Non-dietary Factors Related to Bone Mineral Density in Female College Students)

  • 임지혜;배현숙;이승민;안홍석
    • 대한지역사회영양학회지
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    • 제13권3호
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    • pp.418-425
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    • 2008
  • The purpose of this study was to investigate correlations between bone mineral density (BMD) and dietary and non-dietary factors in female college students. The BMD of the subjects (n = 38) was measured using DEXA (Dual Energy X-ray Absorptiometry) at lumbar spine and three femoral sites including femoral neck, ward's triangle, and femoral trochanter. Three-day 24-hour dietary recall data were collected from each subject to assess consumption levels of nutrients and food groups. The mean (${\pm}SD$) values of age, age of menarche, height, weight, body mass index (BMI), waist-to-hip ratio (WHR), fat mass, and % body fat of the subjects were 21.34 (${\pm}1.73$) years, 13.1 (${\pm}1.2$) years, 161.3 (${\pm}5.0$) cm, 53.7 (${\pm}7.2$) kg, 20.6 (${\pm}2.6$) $kg/m^2$, 0.80 (${\pm}0.04$), 15.4 (${\pm}4.4$) kg, and 28.2 (${\pm}4.7$), respectively. The BMD values of lumbar spine, femoral neck, ward's triangle, and femoral trochanter as T-value were $1.150{\pm}0.13\;g/cm^2$, $0.932{\pm}0.11\;g/cm^2$, $0.850{\pm}0.13\;g/cm^2$, and $0.721{\pm}0.10\;g/cm^2$, respectively. The daily mean energy intake of the subjects was 1660.6 kcal. The intake levels of carbohydrate, calcium, iron, vitamin C, and folic acid were lower than the KDRIs, while those of fat, phosphorus, sodium, vitamin A, and vitamin $B_6$ were higher than the KDRIs. Significantly negative correlation were detected between consumption of fat and oils and the BMD of all sites measured (p < 0.05). Potato and starch intake was negatively correlated to the BMD of femoral neck and word's triangle (p < 0.05). The intake of cereals was found to be negatively correlated to the BMD of ward's triangle (p v 0.05). There was also negative correlation of intake of soybeans and products with the BMD of lumbar spine (p < 0.05). Weight and muscle mass were positively correlated to the BMD of both lumbar spine and femurs (p < 0.01). Significantly positive correlations between BMI, and fat mass and the BMD of lumbar spine were observed (p < 0.001). Additionally fat mass was positively correlated to the BMD of femoral neck. WHR and % body fat were positively correlated to the BMD of lumbar spine (p < 0.05). Negative correlation was found between a serum calcium level and the BMD of femoral neck (p < 0.05). In summary non-dietary factors generally showed significant correlations with the BMD of lumbar spine, while several dietary factors showed significant correlations with the BMD of femurs.

대학교 기숙사 급식소의 이용실태 조사 및 운영형태별 서비스 품질 영역에 대한 고객 만족도 평가 (Evaluation of Customer's Patronage Behaviors and Satisfaction Levels towards Service Quality Dimensions of University Residence Hall Foodservice)

  • 양일선;원지현;강혜승
    • 한국식생활문화학회지
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    • 제15권2호
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    • pp.79-94
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    • 2000
  • The purposes of this study were to : (a) analyze university students' perception and patronage behaviors to the service quality dimensions, and (b) assist university residence hall foodservices in formulating improved managerial strategies. Questionnaires were hand delivered and mailed to 1,210 university students residing in the residence hall and 13 foodservice managers. A total of 1,011 was usable; resulting in 83.6% response rate. The survey was conducted between October, 1998 and May, 1999. Statistical data analysis was completed using the SAS/Win 6.12 for Descriptive Analysis, $x^2-test$, T-test, ANOVA, and Stepwise Multiple Regression. Forty-seven percent of the respondents indicated that 'taste' was their first priority when choosing a menu. The reasons behind choosing residence hall foodservice were 'location', 'board plan', 'price', 'taste', 'opening hours', and 'menu variety'. The main reasons of dissatisfaction with the residence hall foodservice were 'board plan', 'taste', 'menu variety'. The overall satisfaction score was 2.99 out of 5. The satisfaction score of ${\ulcorner}convenience{\lrcorner}$, ${\ulcorner}food\;quality{\lrcorner}$ and ${\ulcorner}menu\;variety{\lrcorner}$were 3.25, 2.94 and 2.76, respectively. Generally, male students were more satisfied than females. Graduate students and students living in residence halls over six semesters were the most dissatisfied with the residence hall foodservice. Residence hall students were dissatisfied with the variables ${\ulcorner}menu\;variety{\lrcorner}$ and ${\ulcorner}facilities{\lrcorner}$in 'self-operated' operations, whereas ${\ulcorner}food\;quality{\lrcorner}$, ${\ulcorner}menu\;variety{\lrcorner}$ and ${\ulcorner}price{\lrcorner}$ in 'contracted' operations. Foodservice operations with 'less than 1,000 meals serving per day' was the highest satisfaction score(3.36) among other serving sizes. Meal price with 'less than 1,300 won' was most satisfied with students. When overall customer satisfaction and service quality dimensions were analyzed by Stepwise Multiple Regression ${\ulcorner}food\;quality{\lrcorner}$(p<.001), ${\ulcorner}price{\lrcorner}$(p<.001), ${\ulcorner}facilities{\lrcorner}$(p<.001), ${\ulcorner}convenience{\lrcorner}$(p<.001), ${\ulcorner}menu\;variety{\lrcorner}$(p<.001), ${\ulcorner}manager's\;attitude{\lrcorner}$(p<.0l), and ${\ulcorner}atmosphere{\lrcorner}$(p<.01), in decreasing order, significantly impacted on ${\ulcorner}overall\;customer\;satisfaction{\lrcorner}$.

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