bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multimodal Monitoring in Large Hemispheric Infarction: Quantitative Electroencephalography Combined With Transcranial Doppler for Prognosis Prediction
Authors: Qi Yajie , Xing Yingqi , Wang Lijuan , Zhang Jie , Cao Yanting , Liu Li , Chen Ying 
Published: December 2021

Background: We aimed to explore whether transcranial Doppler (TCD) combined with quantitative electroencephalography (QEEG) can improve prognosis evaluation in patients with a large hemispheric infarction (LHI) and to establish an accurate prognosis prediction model.Methods: We prospectively assessed 90-day mortality in patients with LHI. Brain function was monitored using TCD-QEEG at the bedside of the patient.Results: Of the 59 (55.3 ± 10.6 years; 17 men) enrolled patients, 37 (67.3%) patients died within 90 days. The Cox regression analyses revealed that the Glasgow Coma Scale (GCS) score ≤ 8 [hazard ratio (HR), 3.228; 95% CI, 1.335–7.801; p = 0.009], TCD-terminal internal carotid artery as the offending vessel (HR, 3.830; 95% CI, 1.301–11.271; p = 0.015), and QEEG-a (delta + theta)/(alpha + beta) ratio ≥ 3 (HR, 3.647; 95% CI, 1.170–11.373; p = 0.026) independently predicted survival duration. Combining these three factors yielded an area under the receiver operating characteristic curve of 0.905 and had better predictive accuracy than those of individual variables (p &lt; 0.05).Conclusion: TCD and QEEG complement the GCS score to create a reliable multimodal method for monitoring prognosis in patients with LHI.
Body Fat Distribution and Associated Risk of Cardiovascular Disease in Adults With Cerebral Palsy
Authors: Shin Hyun Iee , Jung Se Hee 
Published: December 2021

Objective:Fat distribution has increasingly been acknowledged as a more significant health parameter than general obesity, in terms of the risk of cardiovascular disease (CVD). We aimed to investigate the regional fat distribution pattern and general body fat characteristics of adults with cerebral palsy (CP), and we explored the risk of CVD in this population.Methods:People aged ≥20 years who were diagnosed with CP were recruited between February 2014 and November 2014. The subjects underwent a structured interview, laboratory studies, and physical examination. The amount and distribution of fat were determined directly by dual-energy X-ray absorptiometry. Laboratory analysis was performed to measure total cholesterol and triglyceride, high-density lipoprotein (HDL), low-density lipoprotein, and fasting plasma glucose levels. The Framingham risk score (FRS) was used to present the 10-year risk for having CVD, and predictors such as sex, age, total cholesterol, HDL, systolic blood pressure, treatment for hypertension, and smoking status were used to calculate the FRS.Results:Ninety-nine adults (58 men, mean age 41.77 ± 8.95 years) with CP were included. The participants consisted of all five levels of the Gross Motor Function Classification System. The mean body mass index (BMI) was 22.52 ± 4.58 kg/m2. According to BMI criteria, 54.9% were overweight and 27.3% were obese. The fat mass index criteria revealed 10.1% excess fat and 7.6% obesity. In univariable regression analysis, age, the timing of physical function deterioration, and android fat percentage were associated with the FRS (p&lt;0.001,p&lt;0.001, andp= 0.007, respectively). In multiple regression analysis, the FRS was associated with age and android fat percentage, based on the following formula:“FRS=−18.549 + 0.410 ∗ Age + 0.577 ∗ Android percent fat (%) (R2=0.528)′′ (p<0.001).Conclusions:Body fat distribution in the android area is significantly associated with future CVD risk in adults with CP.
Bulk and Single-Cell Profiling of Breast Tumors Identifies TREM-1 as a Dominant Immune Suppressive Marker Associated With Poor Outcomes
Authors: Pullikuth Ashok K. , Routh Eric D. , Zimmerman Kip D. , Chifman Julia , Chou Jeff W. , Soike Michael H. , Jin Guangxu , Su Jing , Song Qianqian , Black Michael A. , Print Cristin , Bedognetti Davide , Howard-McNatt Marissa , O’Neill Stacey S. , Thomas Alexandra , Langefeld Carl D. , Sigalov Alexander B. , Lu Yong , Miller Lance D. 
Published: December 2021

BackgroundTriggering receptor expressed on myeloid cells (TREM)-1 is a key mediator of innate immunity previously associated with the severity of inflammatory disorders, and more recently, the inferior survival of lung and liver cancer patients. Here, we investigated the prognostic impact and immunological correlates of TREM1 expression in breast tumors.MethodsBreast tumor microarray and RNAseq expression profiles (n=4,364 tumors) were analyzed for associations between gene expression, tumor immune subtypes, distant metastasis-free survival (DMFS) and clinical response to neoadjuvant chemotherapy (NAC). Single-cell (sc)RNAseq was performed using the 10X Genomics platform. Statistical associations were assessed by logistic regression, Cox regression, Kaplan-Meier analysis, Spearman correlation, Student’s t-test and Chi-square test.ResultsIn pre-treatment biopsies, TREM1 and known TREM-1 inducible cytokines (IL1B, IL8) were discovered by a statistical ranking procedure as top genes for which high expression was associated with reduced response to NAC, but only in the context of immunologically “hot” tumors otherwise associated with a high NAC response rate. In surgical specimens, TREM1 expression varied among tumor molecular subtypes, with highest expression in the more aggressive subtypes (Basal-like, HER2-E). High TREM1 significantly and reproducibly associated with inferior distant metastasis-free survival (DMFS), independent of conventional prognostic markers. Notably, the association between high TREM1 and inferior DMFS was most prominent in the subset of immunogenic tumors that exhibited the immunologically hot phenotype and otherwise associated with superior DMFS. Further observations from bulk and single-cell RNAseq analyses indicated that TREM1 expression was significantly enriched in polymorphonuclear myeloid-derived suppressor cells (PMN-MDSCs) and M2-like macrophages, and correlated with downstream transcriptional targets of TREM-1 (IL8, IL-1B, IL6, MCP-1, SPP1, IL1RN, INHBA) which have been previously associated with pro-tumorigenic and immunosuppressive functions.ConclusionsTogether, these findings indicate that increased TREM1 expression is prognostic of inferior breast cancer outcomes and may contribute to myeloid-mediated breast cancer progression and immune suppression.
Financial Difficulties Correlate With Mental Health Among Bangladeshi Residents Amid COVID-19 Pandemic: Findings From a Cross-Sectional Survey
Authors: Siddique Abu Bakkar , Nath Sudipto Deb , Islam Md. Saiful , Khan Tausif Hasan , Pardhan Shahina , Amin M. Ziaul , Amin M. Imran Al , Shawon Zayed Bin Zakir , Koly Kamrun Nahar 
Published: December 2021

Background:The COVID-19 pandemic is a global threat which has challenged mental resilience and impacted the psychological well-being of people across all age groups globally. The present study aimed to investigate how financial difficulties during the pandemic correlate with mental health among residents of Bangladesh.Methods:A cross-sectional survey was conducted on 4,020 residents from different parts of Bangladesh between July and September 2020, during a period of elevated risk of COVID-19 infection. A self-reported online questionnaire comprising socio-demographic, financial difficulties and psychometric measures (to assess depression, anxiety and stress) was used to gather information from participants. Multivariable logistic regression analysis was performed to determine the factors associated with mental health consequences.Results:The prevalence of depression, anxiety, and stress in the sample were 71.1%, 62.3%, and 56.7%, respectively. Levels of depression, anxiety, and stress were significantly higher among participants who reported female sex, being unmarried, smaller families, higher monthly family income, poor self-perceived health status, living near people who had been infected by COVID-19, probability of decreased income, food scarcity (both during the pandemic and in the future) and the possibility of unemployment. However, due to the nature of the cross-sectional study performed with a convenience sampling method, the causal relationship between variables cannot be justified.Conclusions:After several months of the COVID-19 pandemic in Bangladesh, more than half of the respondents rated their mental health concerns as moderate to severe. The findings highlight the contributing factors of poor mental health which warrant the creation of interventions that address the economic, financial and mental health impacts of the pandemic.
Reliability of HOME FAST BRAZIL—Self-Reported Version for Community-Dwelling Older Adults
Authors: Ferreira Karina Stella Aoki , Gallo da Silva Tamires Terezinha , Melo Filho Jarbas , Bazanella Natacha Verônica , Vojciechowski Audrin Said , Mackenzie Lynette , Gomes Anna Raquel Silveira 
Published: December 2021

Objective: Verify the intra- and inter-rater reliability of the HOME FAST BRAZIL—Self-reported version and correlate household environmental risks with the history of falls by community-dwelling older adults.Method: Cross sectional study with 50 community-dwelling older adults who were screened by the cut-off point of the Mini Mental State Exam and replied to the HOME FAST BRAZIL—Self-reported version using two evaluators, on three occasions. The reliability analysis was determined by the Intra-class Correlation Coefficient (ICC), considering ICC &gt; 0.70 as adequate. To test the correlations, the Spearman test was used.Results: The mean age of the participants was 73.2 ± 5.8 years. The inter- rater reliability of HOME FAST BRAZIL—Self-reported version was ICC 0.83 (IC95%, 0.70–0.90) and the Intra- reliability ICC 0.85 (IC95%, 0.74–0.91). A risk of falls was verified in 88% of the sample and four environmental risks presented significant correlations with the history of falls.Conclusions: The HOME FAST BRAZIL—Self-reported version presented adequate reliability for the evaluation of household environmental risks for community-dwelling older adults. Risks such as inadequate armchairs/ sofas, the absence of anti-slip mats in the shower recess, the presence of pets and inadequate beds require attention in the evaluation of household risks, due to their correlation with the occurrence of falls.
Perioperative Morbidity and Complications in Patients With an Established Ileostomy Undergoing Major Abdominal Surgery: A Retrospective Study
Authors: Uribe Alberto A. , Weaver Tristan E. , Echeverria-Villalobos Marco , Periel Luis , Shi Haixia , Fiorda-Diaz Juan , Gonzalez-Zacarias Alicia , Abdel-Rasoul Mahmoud , Li Lin 
Published: December 2021

Background:Recently formed ileostomies may produce an average of 1,200 ml of watery stool per day, while an established ileostomy output varies between 600–800 ml per day. The reported incidence of renal impartment in patients with ileostomy is 8–20%, which could be caused by dehydration (up to 50%) or high output stoma (up to 40%). There is a lack of evidence if an ileostomy could influence perioperative fluid management and/or surgical outcomes.Methods:Subjects aged ≥18 years old with an established ileostomy scheduled to undergo an elective non-ileostomy-related major abdominal surgery under general anesthesia lasting more than 2 h and requiring hospitalization were included in the study. The primary outcome was to assess the incidence of perioperative complications within 30 days after surgery.Results:A total of 552 potential subjects who underwent non-ileostomy-related abdominal surgery were screened, but only 12 were included in the statistical analysis. In our study cohort, 66.7% of the subjects were men and the median age was 56 years old (interquartile range [IQR] 48-59). The median time from the creation of ileostomy to the qualifying surgery was 17.7 months (IQR: 8.3, 32.6). The most prevalent comorbidities in the study group were psychiatric disorders (58.3%), hypertension (50%), and cardiovascular disease (41.7%). The most predominant surgical approach was open (8 [67%]). The median surgical and anesthesia length was 3.4 h (IQR: 2.5, 5.7) and 4 h (IQR: 3, 6.5), respectively. The median post-anesthesia care unit (PACU) stay was 2 h (IQR:0.9, 3.1), while the median length of hospital stay (LOS) was 5.6 days (IQR: 4.1, 10.6). The overall incidence of postoperative complications was 50% (n= 6). Two subjects (16.7%) had a moderate surgical wound infection, and two subjects (16.7%) experienced a mild surgical wound infection. In addition, one subject (7.6%) developed a major postoperative complication with atrial fibrillation in conjunction with moderate hemorrhage.Conclusions:Our findings suggest that the presence of a well-established ileostomy might not represent a relevant risk factor for significant perioperative complications related to fluid management or hospital readmission. However, the presence of peristomal skin complications could trigger a higher incidence of surgical wound infections.
Management of Common Bile Duct Stones Encountered During Cholecystectomy in Patients With Previous Gastric Bypass
Authors: Popowicz Agnieszka , Sanamrad Susanne , Darkahi Bahman , Zacharias Rebecka , Sandblom Gabriel 
Published: December 2021

Background: Rapid weight loss following gastric bypass (GBP) predisposes to the development of gallstones, and in those who develop gallstone disease there is a high prevalence of common bile duct stones (CBDS). Furthermore, in these patients, CBDS are difficult to extract due to the altered upper gastrointestinal anatomy following GBP. The aim of the present study was to assess outcome after various management methods applied in the counties of Stockholm and Uppsala, Sweden.Methods: Data from the Swedish Register for Gallstone Surgery and ERCP (GallRiks) and the Swedish Obesity Surgery Register (SoReg) were crossmatched to identify all patients who had undergone gallstone surgery after GBP, where CBDS were found at intraoperative cholangiography, in the Stockholm and Uppsala counties 2009–2013. A retrospective review of patient records was performed for all patients identified.Results: In all, 55 patients were identified. These were managed as follows: expectancy (N = 11); transgastric ERCP (N = 2); laparoscopic choledochotomy (N = 3); open choledochotomy (N = 5); transcystic stone extraction (N = 12); and other approach (N = 13). In nine cases, data on management could not be found. There were nine cases of minor postoperative complication. No retained stones were registered. The operation time was longer for transgastric ERCP (p = 0.002), and the postoperative stay was longer following open and laparoscopic choledochotomy (p &lt; 0.001). There was no statistically significant difference between any of the methods regarding the incidence of postoperative complications (p = 0.098).Discussion: Further development of techniques for managing CBDS discovered in patients undergoing cholecystectomy after previous GBP are needed, as well as more comparative studies with greater statistical power.
Factores externos inmersos en el desarrollo financiero de los comerciantes de Portoviejo, Ecuador
Authors: Cedeño Palma Gema Gissella , Cedeño Erazo Carmen Katherine , Villamarin Sánchez Silvia Genith 
Published: December 2021

En el cantón Portoviejo, ubicado en la provincia de Manabí - Ecuador, se presentó un evento natural que destruyó más del 80% del sector céntrico comercial en el cual se desarrollaban negocios de diversos segmentos de mercado, demandados por los clientes que asistían diariamente a este sector. Tomando como referencia este antecedente, la presente investigación tiene como objetivo analizar los factores externos que están inmersos en el desarrollo de la actividad comercial de este cantón, después del terremoto suscitado el 16 de abril del 2016. Para cumplir con este objetivo se emplea una metodología basada en una investigación de campo y descriptiva, fundamentada en fuentes primarias y secundarias, que permitieron determinar que los factores externos como desastres naturales y recesión económica tienen inherencia en el desarrollo financiero de los comerciantes de Portoviejo. En tanto, se considera conveniente se cree un documento en el que se establezcan estrategias que fomenten el desarrollo de este sector tan vulnerable en la actualidad y sirva también como fuente de información para los interesados en el tema e investigaciones futuras.

Palabras clave: factores externos; desarrollo financiero; comercio; estrategias; desarrollo productivo.
Análisis primario de las cadenas de valor en el maíz Portoviejo, Ecuador
Authors: Analuisa Iván Alberto , García Caicedo Sonia Shirley , Rodríguez Ulcango Olga Maritza , Paredes Orozco Manuel Patricio 
Published: December 2021

El trabajo reporta una investigación inicial de la producción de maíz y actividades que se desarrollan dentro de las pequeñas y medianas empresas que dan valor agregado, presentar y analizar los procesos involucrados en la producción e importancia de esta. El objetivo de revisar literatura e iniciar en el debate de las pymes agrícolas en las cadenas de valor como opción para generar información en los procesos de gestión estratégica y soporte, además cuantificar el valor de producción, valor agregado, desarrolladas por actores de la cadena de valor del sector, considerando: fortalezas y oportunidades. Esta realidad amerita la preparación de instrumentos de recopilación de información con encuestas a grupos focales de la cadena de valor. Se aplicó técnicas y métodos para establecer la relación del entorno social, económico, ecológico, relacionado con la producción de maíz y subproductos. El principal resultado fue la interpretación, descripción y análisis de la fase inicial de la cadena de valor del maíz, la preparación de encuestas para validar por productos, teniendo en cuenta la presencia actores y sus funciones.

Palabras clave: microeconomía; comportamiento de la empresa; desarrollo sostenible
Evaluación de la gestión organizacional en unidades educativas de Jipijapa, Ecuador
Authors: Vásquez Paucar Maribel Celi , Herrera Velázquez María Del Rosario , Rodriguez Rodriguez Alberto , Vigoa Escobedo Yisel 
Published: December 2021

Con el objetivo de evaluar la situación actual de la gestión organizacional y el rendimiento laboral, se analizaron tres unidades educativas del distrito 13D03 pertenecientes a Jipijapa provincia de Manabí, Ecuador. La investigación fue de tipo descriptiva con la aplicación de modelos cualitativo-cuantitativo, se aplicaron técnicas documentales y de campo, mediante el desarrollo de encuestas construidas con base a la escala de Likert, las que se aplicaron a docentes y personal administrativo. Se efectuaron entrevistas especializadas a los rectores y vicerrectores de estas unidades. Los principales resultados de la evaluación evidencian que el distrito no cuenta con un modelo de gestión organizacional propio, el personal que labora en las instituciones educativas no conoce totalmente el modelo de gestión que aplica el Ministerio de Educación. Sobre la base de lo descrito, se concluye que es necesaria la implementación de un modelo propio de gestión organizacional para garantizar el desarrollo del sector educacional.

Palabras clave: administración; academia; organización; productividad.
La banca pública y su aporte al desarrollo. Microempresarial del cantón Portoviejo
Authors: Molina Molina Carina Asunción , Amén Carreño José Guillermo 
Published: December 2021

Este trabajo sobre la incidencia de la banca pública en el desarrollo microempresarial con énfasis en el cantón Portoviejo en Ecuador, tiene como objetivo analizar la contribución que ejerce la banca pública al desarrollo microempresarial, a partir de la concesión del crédito durante el periodo 2007- 2017. Parte de la premisa que, “el financiamiento del crédito es una herramienta que ayuda a las microempresas, no solo a su desarrollo, sino que contribuye al crecimiento económico del país”. Reconoce que, el racionamiento del crédito, obedece a factores como tasa de interés, plazo, garantías, entre otros. Para alcanzar el objetivo propuesto, se aplicó el método cuali- cuantitativo, lo que permitió fundamentar el objeto de análisis, definiendo otras realidades que inciden en el otorgamiento de créditos bancarios. Los datos son analizados estadísticamente con información primaria, que, expresados en la varianza, responden a la pregunta de investigación: ¿De qué forma, la banca pública incide en el desarrollo microempresarial del cantón Portoviejo?

Palabras clave: macroeconomía y economía monetaria; oferta monetaria; instituciones y servicios financieros; bancos; gobierno y financiación de la empresa; política pública y regulación.

Abstract
This research paper analyzed the impact of public banking on micro-enterprise development with an emphasis on Portoviejo Canton in Ecuador, hence its objective is to analyze the contribution of public banking to micro-enterprise development, starting with the granting of credit during the period 2007-2017. Part of the premise that, “credit financing is a tool that helps micro-enterprises, not only their development, but contributes to the country’s economic growth.” It recognizes that credit rationing is due to factors such as interest rate, term, guarantees, among others. To achieve the proposed objective, the qualitative and quantitative method was applied, which allowed to substantiate the object of analysis, defining other realities that affect the granting of bank loans. The data are statistically analyzed with primary information, which, expressed in the variance, answer the research question: ¿How public banking affects the micro-enterprise development of the canton of Portoviejo?

Keywords: macroeconomics and monetary economics; money supply; financial institutions and services; banks; government and financing of the company; public policy and regulation.