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Efficacy of a Strategy for Implementing Guidelines for the Control of Cardiovascular Risk in Primary Healthcare

World Journal of Cardiovascular Diseases 2020年第3期10卷 117-130页

作者： Maria Jesús Fernández-Luque Luis María Sánchez-Gómez Vicente Pastor y Aldeguer Carmen Suárez-Fernández Belén Sierra-García Soledad Mayayo-Vicente Marta Ruiz-López ángela Gallego-Arenas Rosa Sánchez Alcalde Pilar Loeches-Belinchón Javier López-González Francisco Rodríguez-Salvanés blanca novella-arribas Dirección General de Investigación Docencia y Documentación Consejería de Sanidad Comunidad de Madrid Madrid Spain Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa (IP) Madrid Spain Universidad Autónoma de Madrid Facultad de Medicina Madrid Spain Hospital Universitario de la Princesa SERMAS Consejería de Sanidad Comunidad de Madrid Madrid Spain Gerencia Asistencial de Atención Primaria D.G. de Coordinación de Asistencia Sanitaria SERMAS Consejería de Sanidad Comunidad de Madrid Madrid Spain Unidad de Evaluación de Tecnologías Sanitarias de Madrid Procesos Integrados de Salud Consejería de Sanidad Madrid Spain

Background: A number of strategies exist for the implementation of clinical practice guides (CPGs). Aim: To assess the efficacy of implementing a cardiovascular risk CPG based on an educational method involving opinion leaders, and the habitual method of dissemination among primary healthcare teams. Design and Setting: Controlled, blinded, community intervention trial randomised by clusters. Methods: 21 primary healthcare centres were randomly assigned to either the intervention arm (n = 11) or the control arm (n = 10). The study subjects were patients aged ≥45 years assigned to the centres. The overall impact of the intervention was measured as the difference between the increase in the proportion of patients whose medical records showed the recording of all the variables necessary to calculate cardiovascular risk in both arms. Analyses were performed with Generalized Lineal Model on an intention-to-treat basis. Results: 917 subjects were included at the beginning of the trial (437 in the intervention arm and 480 in the control arm). 826 subjects were included in the final evaluation (436 in the intervention group and 390 in the control arm). At the end of the trial, the recording of the variables necessary for the calculation of the cardiovascular risk in the intervention group had increased more than in the control group (difference between increases 7.49% (95% CI 4.62 - 10.35)) after adjusting for confounding variables. Conclusions: Compared to the habitual method of dissemination, the implementation of this CPG using an educational method involving opinion leaders, improved the recording of the variables needed to calculate patients’ cardiovascular risk.

关键词： Randomized Controlled Trial Cluster Analysis Clinical Practice Guidelines Primary Healthcare Risk Factors Cardiovascular Diseases

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DEVELOPABLE SURFACE PATCHES BOUNDED BY NURBS CURVES

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Journal of Computational Mathematics 2020年第5期38卷 715-731页

作者： Leonardo Fernandez-Jambrina Francisco Perez-arribas ETSI Navales Universidad Polit´ecnica de Madrid28040-MadridSpain

In this paper we construct developable surface patches which are bounded by two rational or NURBS curves,though the resulting patch is not a rational or NURBS surface in *** is accomplished by reparameterizing one of the boundary *** reparameterization function is the solution of an algebraic *** the relevant case of cubic or cubic spline curves,this equation is quartic at most,quadratic if the curves are B´ezier or splines and lie on parallel planes,and hence it may be solved either by standard analytical or numerical methods.

关键词： NURBS B´ezier Rational,Spline NURBS Developable surfaces

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A Principal Component Analysis(PCA)-based framework for automated variable selection in geodemographic classification

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Geo-Spatial Information Science 2019年第4期22卷 251-264,I0003页

作者： Yunzhe Liu Alex Singleton Daniel arribas-Bel Geographic Data Science Lab Department of Geography and PlanningUniversity of LiverpoolLiverpoolUK

A geodemographic classification aims to describe the most salient characteristics of a small area zonal ***,such representations are influenced by the methodological choices made during their *** particular debate are the choice and specification of input variables,with the objective of identifying inputs that add value but also aim for model *** this context,our paper introduces a principal component analysis(PCA)-based automated variable selection methodology that has the objective of identifying candidate inputs to a geodemographic classification from a collection of *** proposed methodology is exemplified in the context of variables from the UK 2011 Census,and its output compared to the Office for National Statistics 2011 Output Area Classification(2011 OAC).Through the implementation of the proposed methodology,the quality of the cluster assignment was improved relative to 2011 OAC,manifested by a lower total withincluster sum of square *** the UK,more than 70.2%of the Output Areas(OAs)occupied by the newly created classification(***-OAC)outperform the 2011 OAC,with particularly strong performance within Scotland and Wales.

关键词： Geodemographics variable selection UK census spatial data mining principal component analysis

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Combining flamelet-generated manifold and machine learning models in simulation of a non-premixed diffusion flame

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Energy and AI 2023年第4期14卷 173-188页

作者： Kaimeng Li Pourya Rahnama Ricardo novella Bart Somers Power&Flow–Department of Mechanical Engineering.Technical University of Eindhoven.P.O.Box 513 5600 MB EindhovenThe Netherlands CMT–Motores T´ermicos.Universidad Polit´ecnica de Valencia.Camino de Vera s/n E-46022 ValenciaSpain

Flamelet Generated Manifold(FGM)is an example of a chemistry tabulation or a flamelet method that is under attention because of its accuracy and speed in predicting combustion ***,the main problem in applying the model is a large amount of memory *** way to solve this problem is to apply machine learning(ML)to replace the stored tabulated *** different machine learning methods,including two Artificial Neural Networks(ANNs),a Random Forest(RF),and a Gradient Boosted Trees(GBT),are trained,validated,and compared in terms of various performance *** progress variable source term and transport properties are replaced with the ML *** attention was paid to the progress variable source term due to its high gradient and wide range of its value in the control variables *** preprocessing is shown to play an essential role in improving the performance of the *** ensemble models,namely RF and GBT,exhibit high training efficiency and acceptable *** the other hand,the ANN models have lower training errors and take longer to *** four models are then combined with a one-dimensional combustion code to simulate a counterflow non-premixed diffusion flame in engine-relevant *** predictions of the ML-FGM models are compared with detailed chemical simulations and the original FGM model for key combustion properties and representative species profiles.

关键词： Flamelet models Tabulated chemistry models Computational fluid dynamics Machine learning Non-premixed diffusion flame

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Molecular mechanisms contributing to glucocorticoid resistance in lymphoid malignancies

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Cancer Drug Resistance 2019年第3期2卷 647-664页

作者： blanca Scheijen Department of Pathology Radboud University Medical Center and Radboud Institute for Molecular Life SciencesGA 6525Nijmegenthe Netherlands

Despite the introduction of many novel therapies into the clinic to target hematological malignancies,glucocorticoids(GCs)still remain one of the cornerstone drugs in first-line treatment of lymphoid ***,a significant portion of the patients display acquired GC therapy *** review will describe the different molecular mechanisms that contribute to GC resistance in lymphoid *** include suppression of glucocorticoid receptor(GR)expression,activation of cell signaling pathways that modulate GR function,differential recruitment of transcriptional co-regulators,and changes in chromatin *** of these mechanisms are interconnected to genetic alterations associated with relapsed disease in lymphoid malignancies.

关键词： Glucocorticoid receptor therapy resistance acute lymphoblastic leukemia non-Hodgkin lymphoma multiple myeloma

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Comparison of clinical outcomes between unrelated single umbilical cord blood and"ex-vivo"T-cell depleted haploidentical transplantation in children with hematological malignancies

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World Journal of Pediatrics 2021年第6期17卷 609-618页

作者： Carmen Gomez-Santos Marta Gonzalez-Vicent blanca Molina Natalia Deltoro blanca Herrero Julia Ruiz Antonio Perez-Martinez Miguel A Diaz Department of Pediatrics Hematopoietic Stem Cell Transplantation UnitHospital Infantil Universitario"Nino Jesus"Menedez Pelayo 6528009 MadridSpain Hospital Infantil Universitario"La Pa"Madrid MadridSpain

Background Over the last two decades,umbilical cord blood(UCB)and haploidentical transplantation(HaploHSCT)have emerged as alternative sources of hematopoietic stem cell for allogeneic *** are few retrospective studies and no prospective studies comparing both types of alternative transplantation in pediatric *** We analyzed the data of 134 children with hematological malignancies who received a hematopoietic stem cell transplantation from a single umbilical cord blood(UCB)(n=42)or an"tex-vivo"T-cell depleted transplant from a haploi-dentical-related donor(HaploHSCT)(n=92)between 1996 and *** recovery was faster after HaploHSCT than the UCB transplant group(median times to neutrophil and platelet recovery:13 vs.16 days,10 vs.57 days,respectively)(P<0.001).The HaploHSCT group had a significantly early immune reconstitution based on NK and CD8+T cells compared with the UCB ***,after the first year *** had a lower number of CD4+ T and B lymphocytes compared with the UCB transplant *** cumulative incidence of TRM was 29±8%in the HaploHSCT group versus 40±5%in the UCB *** incidence was 21±7%in the HaploHSCT group and 19±8%in the UCB *** of DFS was 58±8%in the HaploHSCT group versus 40±9%in the UCB group(P=0.051).Conclusions TCD haploidentical transplant is associated with advantages in terms of engraftment and early immune reconstitution *** haploidentical transplant was associated with lower incidence of infectious and non-infectious complications,especially in the early phases of the transplant compared with UCB transplant ***,there are no advantages in transplant outcomes compared with UCB transplant.

关键词： Children Cord blood transplant Hematologic malignancies Immune reconstitution TCD haploidentical transplant

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Identifying key elements in Knowledge-Cities benchmarking

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学术界 2010年第3期 241-248页

作者： blanca C.Garcia Northern Borderlands Research College

This paper presentation explores four key aspects of the Identity capital existing in emerging cities and *** aspects are part of capital systems approaches such as the Generic System of Capitals （GCS）:a tool to benchmark how cities are leveraging their capacity for knowledge-based *** this opportunity,elements of GSC’s Identity Capital have been emphasized to observe a combination of clarity and differentiation aspects of a city identity in four distinct *** context-based identity seemingly illustrates how knowledge cities in the edge are building their identity advantage in the knowledge-based international arena.

关键词： Generic Capitals System Identity Capital Benchmarking Borderland Knowledge Cities

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Two-Level Schwarz Preconditioners for Super Penalty Discontinuous Galerkin Methods

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Communications in Computational Physics 2009年第2期5卷 398-412页

作者： Paola F.Antonietti blanca Ayuso MOX–Laboratory for Modeling and Scientific Computing Dipartimento di Matematica”F.Brioschi”Politecnico di Milanovia Bonardi 920133 MilanoItaly Departamento de Matematicas Universidad Autonoma de MadridCampus de CantoblancoCtra.de Colmenar Viejo28049 MadridSpain

We extend the construction and analysis of the non-overlapping Schwarz preconditioners proposed in[2,3]to the(non-consistent)super penalty discontinuous Galerkin methods introduced in[5]and[8].We show that the resulting preconditioners are scalable,and we provide the convergence *** also present numerical experiments confirming the sharpness of the theoretical results.

关键词： Schwarz preconditioners super penalty discontinuous Galerkin methods

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Biomaterial engineering strategies for modeling the Bruch's membrane in age-related macular degeneration

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Neural Regeneration Research 2024年第12期19卷 2626-2636页

作者： blanca Molins Andrea Rodríguez Víctor Llorenç Alfredo Adán Group of Ocular Inflammation:Clinical and Experimental Studies Institut d’Investigacions Biomèdiques AgustíPi I Sunyer(IDIBAPS)BarcelonaSpain Institut Clínic d’Oftalmologia(ICOF) Hospital Clínic BarcelonaSpain

Age-related macular degeneration,a multifactorial inflammatory degenerative retinal disease,ranks as the leading cause of blindness in the ***,there is a scarcity of curative therapies,especially for the atrophic advanced form of age-related macular degeneration,likely due to the lack of models able to fully recapitulate the native structure of the outer blood retinal barrier,the prime to rget tissue of age-related macular *** in vitro systems rely on 2D monocultures unable to adequately reproduce the structure and function of the outer blood retinal barrier,integrated by the dynamic interaction of the retinal pigment epithelium,the Bruch's membrane,and the underlying *** Bruch's membrane provides structu ral and mechanical support and regulates the molecular trafficking in the outer blood retinal barrier,and therefo re adequate Bruch's membrane-mimics are key for the development of physiologically relevant models of the outer blood retinal barrie *** the last years,advances in the field of biomaterial engineering have provided novel approaches to mimic the Bruch's membrane from a variety of *** review provides a discussion of the integrated properties and function of outer blood retinal barrier components in healt hy and age-related macular degeneration status to understand the requirements to adequately fabricate Bruch's membrane biomimetic ***,we discuss novel materials and techniques to fabricate Bruch's membrane-like scaffolds for age-related macular degeneration in vitro modeling,discussing their advantages and challenges with a special focus on the potential of Bruch's membrane-like mimics based on decellularized tissue.

关键词： age-related macular degeneration Bruch's membrane decellularization retinal pigment epithelium scaffold

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Recent advances in the search of BCRP- and dual P-gp/BCRP-based multidrug resistance modulators

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Cancer Drug Resistance 2019年第3期2卷 710-743页

作者： Silvia Dei Laura Braconi Maria novella Romanelli Elisabetta Teodori Department of Neuroscience PsychologyDrug Research and Child’s Health-Section of Pharmaceutical and Nutraceutical SciencesUniversity of Florencevia Ugo Schiff 6Sesto Fiorentino(FI)50019Italy

The development of multidrug resistance (MDR) is one of the major challenges to the success of chemotherapy treatment of cancer. This phenomenon is often associated with the overexpression of the ATP-binding cassette (ABC) transporters P-gp (P-glycoprotein, ABCB1), multidrug resistance-associated protein 1, ABCC1 and breast cancer resistance protein, ABCG2 (BCRP). These transporters are constitutively expressed in many tissues playing relevant protective roles by the regulation of the permeability of biological membranes, but they are also overexpressed in malignant tissues. P-gp is the first efflux transporter discovered to be involved in cancer drug resistance, and over the years, inhibitors of this pump have been disclosed to administer them in combination with chemotherapeutic agents. Three generations of inhibitors of P-gp have been examined in preclinical and clinical studies;however, these trials have largely failed to demonstrate that coadministration of pump inhibitors elicits an improvement in therapeutic efficacy of antitumor agents, although some of the latest compounds show better results. Therefore, new and innovative strategies, such as the fallback to natural products and the discover of dual activity ligands emerged as new perspectives. BCRP is the most recently ABC protein identified to be involved in multidrug resistance. It is overexpressed in several haematological and solid tumours together with P-gp, threatening the therapeutic effectiveness of different chemotherapeutic drugs. The chemistry of recently described BCRP inhibitors and dual P-gp/BCRP inhibitors, as well as their preliminary pharmacological evaluation are discussed, and the most recent advances concerning these kinds of MDR modulators are reviewed.

关键词： Cancer multidrug resistance multidrug resistance modulators ATP-binding cassette transporter inhibitors P-glycoprotein multidrug resistance-associated proteins breast cancer resistance protein

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