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Challenges and improvement strategies in the hospitalization of chronic multimorbid patients

World Journal of Clinical Cases 2025年第3期13卷 35-41页

作者： Andres Fontalba-Navas francisco pozo muñoz Rogelio Garcia Cisneros Maria Jose Garcia Larrosa Maria del Mar Callejon Gil Ignacio Garcia Delgado Maria Belen Jimenez Martinez Antequera Hospital Northern Málaga Integrated Healthcare AreaAntequera 29200AndalusiaSpain Department of Public Health and Psychiatry University of MálagaMálaga 29010Spain Antequera Hospital Northern Málaga Antequera Integrated Healthcare AreaAntequera 29200MálagaSpain

BACKGROUND Addressing the growing challenge of hospitalizing chronic multimorbid patients,this study examines the strain these conditions impose on healthcare systems at a local level,focusing on a pilot *** diseases and complex patients require comprehensive management strategies to reduce healthcare burdens and improve patient *** proven effective,this pilot model has the potential to be replicated in other healthcare settings to enhance the management of chronic multimorbid *** To evaluate the effectiveness of the high complexity unit(HCU)in managing chronic multimorbid patients through a multidisciplinary care model and to compare it with standard hospital *** The study employed a descriptive longitudinal approach,analyzing data from the Basic Minimum Data Set(BMDS)to compare hospitalization variables among the HCU,the Internal Medicine Service,and other services at Antequera Hospital throughout *** HCU,designed for patients with complex chronic conditions,integrates a patient-centered model emphasizing multidisciplinary care and continuity *** The study employed a descriptive longitudinal approach,analyzing data from the BMDS to compare hospitalization variables among the HCU,the Internal Medicine Service,and other services at Antequera Hospital throughout *** HCU,designed for patients with complex chronic conditions,integrates a patient-centered model emphasizing multidisciplinary care and continuity *** This study demonstrates the effectiveness of the HCU in managing patients with complex chronic diseases through a multidisciplinary *** coordinated care provided by the HCU results in improved patient outcomes,reduced unnecessary hospitalizations,and better management of patient *** superiority of the HCU compared to standard care is evident in key outcomes such as fewer readmissions and higher patient satisfaction,reinforcing its value as a model of ca

关键词： High complexity unit Chronic multimorbidity Patient-centered care Integrated care Healthcare management

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COVID-19 pandemic,as experienced in the surgical service of a district hospital in Spain

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World Journal of Clinical Cases 2021年第23期9卷 6582-6590页

作者： francisco Javier Pérez Lara Maria Belen Jimenez Martinez francisco pozo muñoz Andres Fontalba Navas Rogelio Garcia Cisneros Maria Jose Garcia Larrosa Ignacio Garcia Delgado Maria del Mar Callejon Gil Department of Surgery Hopital de AntequeraAntequera 29200MálagaSpain North Malaga Healthcare District Hopital de AntequeraAntequera 29200MálagaSpain

The coronavirus disease 2019,which is caused by severe acute respiratory syndrome coronavirus 2,was first identified in December 2019 in Wuhan,China,and has since spread rapidly,evolving into a full-blown *** would like to report our experience after 1 year of this pandemic in the surgical service of a district hospital in *** have been many changes(including new protocols)that our service and the hospital have undergone,to adapt to the new *** believe that this experience can be useful for other professionals who have lived and are living a similar situation.

关键词： COVID-19 Hospital Experience Surgery Service Treatment

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Novel pharmacological therapy in type 2 diabetes mellitus with established cardiovascular disease: Current evidence

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World Journal of Diabetes 2019年第5期10卷 291-303页

作者： Leonardo pozo Fatimah Bello Andres Suarez francisco E Ochoa-Martinez Yamely Mendez Chelsea H Chang Salim Surani University of Texas Rio Grande Valley-Doctors Hospital at Renaissance Internal Medicine Residency Program Faculty of Medicine Universidad Autonoma de Nuevo LeonUniversity Hospital "Dr. José Eleuterio González" Faculty of Medicine "Dr. Alberto Romo Caballero" Universidad Autonoma de Tamaulipas Medical Critical Care Services Christus Spohn Hospitals-Corpus Christi

Cardiovascular diseases(CVDs) remain the leading cause of death in the world and in most developed countries. Patients with type 2 diabetes mellitus(T2DM)suffer from both microvascular and macrovascular diseases and therefore have higher rates of morbidity and mortality compared to those without T2DM. If current trends continue, the Center for Disease Control and Prevention estimates that 1 in 3 Americans will have T2DM by year 2050. As a consequence of the controversy surrounding rosiglitazone and the increasing prevalence of diabetes and CVDs, in 2008 the Food and Drug Administration(FDA) established new expectations for the evaluation of new antidiabetic agents, advising for pre and,in some cases, post-marketing data on major cardiovascular events. As a direct consequence, there has been a paradigm shift in new antidiabetic agents that has given birth to the recently published American Diabetes Association/European Association for the Study of Diabetes consensus statement recommending sodium-glucose cotransporter-2 inhibitors(SGLT2i) and glucagon like peptide-1 receptor agonists(GLP-1RA) in patients with T2DM and established CVD. As a result of over a decade of randomized placebo controlled cardiovascular outcome trials, the aforementioned drugs have received FDA approval for risk reduction of cardiovascular(CV) events in patients with T2DM and established CV ***2i have been shown to have a stronger benefit in patients with congestiveheart failure and diabetic kidney disease when compared to their GLP-1RA counterparts. These benefits are not withstanding additional considerations such as cost and the multiple FDA Black Box warnings. This topic is currently an emerging research area and this mini-review paper examines the role of these two novel classes of drugs in patients with T2DM with both confirmed, and at risk for, CVD.

关键词： Type 2 diabetes mellitus Glucagon-like-peptide 1 agonists Sodium-glucose cotransporter-2 inhibitor Cardiovascular disease Major adverse cardiovascular event

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TopSTO:a 115-line code for topology optimization of structures under stationary stochastic dynamic loading

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Earthquake Engineering and Engineering Vibration 2023年第4期22卷 1081-1100页

作者： Sebastian pozo Fernando Gomez Thomas Golecki Juan Carrion Billie F.Spencer Jr. Civil and Environmental Engineering University of Illinois at Urbana-ChampaignUrbana 61801ILUSA College of Science and Engineering Universidad San Francisco de QuitoDiego de Robles y Vía InteroceanicaQuitoEcuador Skidmore Owings&MerrillLLPChicago 60604ILUSA Department of Civil Engineering University of CuencaCuencaEcuador

The use of topology optimization in structural design under dynamic excitation is becoming more prevalent in the *** many such applications utilize frequency or time domain formulations,relatively few consider stochastic dynamic *** paper presents an efficient and compact code called TopSTO for structural topology optimization considering stationary stochastic dynamic loading using a method derived from random vibration *** theory,described in conjunction with the implementation in the provided code,is illustrated for a seismically excited *** work demonstrates the efficiency of the approach in terms of both the computational resources and minimal amount of code *** code is intended to serve as a baseline for understanding the theory and implementation of this topology optimization approach and as a foundation for additional applications and developments.

关键词： topology optimization stochastic dynamics matlab python

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Association of accelerometer-derived step volume and intensity with hospitalizations and mortality in older adults:A prospective cohort study

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Journal of Sport and Health Science 2022年第5期11卷 578-585页

作者： Asier Manas Borja del pozo Cruz Ulf Ekelund JoséLosa Reyna Irene Rodríguez Gómez JoséAntonio Carnicero Carreno Leocadio Rodríguez Manas francisco J.García García Ignacio Ara GENUD Toledo Research Group University of Castilla-La ManchaToledo 45071Spain CIBER of Frailty and Healthy Aging(CIBERFES) Madrid 28029Spain Motivation and Behaviour Research Program Institute for Positive Psychology and EducationFaculty of Health SciencesAustralian Catholic UniversitySydneyNSW 2060Australia Department of Sports Medicine Norwegian School of Sport SciencesOslo 0806Norway Department of Chronic Diseases and Ageing Norwegian Institute of Public HealthOslo 0473Norway Geriatric Department Hospital Virgen del ValleToledo 45071Spain Geriatric Department Hospital Universitario de GetafeGetafe 28905Spain

Purpose:This study aimed to examine the associations of accelerometer-derived steps volume and intensity with hospitalizations and all-cause mortality in older ***:This prospective cohort study involved 768 community-dwelling Spanish older adults(78.8±4.9 years,mean±SD;53.9% females)from the Toledo Study for Healthy Aging(2012-2017).The number of steps per day and step cadence(steps/min) were derived from a hip-mounted accelerometer worn for at least 4 days at *** were followed-up over a mean period of 3.1 years for hospitalization and 5.7 years for all-cause *** proportional hazards regression models were used to estimate the individual and joint associations between daily steps and stepping intensity with hospitalizations and all-cause ***:Included participants walked 5835± 3445 steps/day with an intensity of 7.3± 4.1 steps/*** adjusting for age,sex,body mass index(BMI),education,income,marital status and comorbidities,higher step count(hazard ratio(HR)=0.95,95% confidence interval(95%CI:0.90-1.00,and HR=0.87,95%CI:0.81-0.95 per additional 1000 steps) and higher step intensity(HR=0.95,95%CI:0.91-0.99,and HR=0.89,95%CI:0.84-0.95 per each additional step/min) were associated with fewer hospitalizations and all-cause mortality risk,*** to the group having low step volume and intensity,individuals in the group having high step volume and intensity had a lower risk of hospitalization(HR=0.72,95%CI:0.52-0.98) and all-cause mortality(HR=0.60,95%CI:0.37-0.98).Conclusion:Among older adults,both high step volume and step intensity were significantly associated with lower hospitalization and all-cause mortality *** step volume and intensity may benefit older people.

关键词： Aging Follow-up Objective Physical activity Walking

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Role of STIM1 in neurodegeneration

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World Journal of Biological Chemistry 2018年第2期9卷 16-24页

作者： Carlos Pascual-Caro Noelia Espinosa-Bermejo Eulalia pozo-Guisado francisco Javier Martin-Romero Department of Biochemistry and Molecular Biology School of Life Sciences and Institute of Molecular Pathology Biomarkers University of Extremadura Department of Cell Biology School of Medicine and Institute of Molecular Pathology Biomarkers University of Extremadura

STIM1 is an endoplasmic reticulum(ER) protein with a key role in Ca^(2+)mobilization. Due to its ability to act as an ER-intraluminal Ca^(2+) sensor, it regulates store-operated Ca^(2+) entry(SOCE), which is a Ca^(2+) influx pathway involved in a wide variety of signalling pathways in eukaryotic cells. Despite its important role in Ca^(2+) transport, current knowledge about the role of STIM1 in neurons is much more limited. Growing evidence supports a role for STIM1 and SOCE in the preservation of dendritic spines required for long-term potentiation and the formation of memory. In this regard, recent studies have demonstrated that the loss of STIM1, which impairs Ca^(2+) mobilization in neurons, risks cell viability and could be the cause of neurodegenerative diseases. The role of STIM1 in neurodegeneration and the molecular basis of cell death triggered by low levels of STIM1 are discussed in this review.

关键词： Calcium Neurodegeneration Parkinson's disease Alzheimer's disease STIM1 Voltage-operated Ca2+ channels

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A Regional Climate Study of Heat Waves over the Iberian Peninsula

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Atmospheric and Climate Sciences 2014年第5期4卷 841-853页

作者： Hari Prasad Dasari Isaac pozo francisco Ferri-Yánez Miguel B. Araújo Centro de Geofisica de Evora University of EvoraEvoraPortugal museo Nacional de Ciencias Naturales CSICMadridSpain Centro de Biodiversidade e Recursos Genéticos(InBIO-CIBIO) University of EvoraEvoraPortugal Imperial College London Silwood Park CampusBerkshireUK

We present a regional climate simulation for the Iberian Peninsula for a 60-year period (1950-2009) using the WRF-ARW model with a focus on the simulation of summer maximum temperatures and associated extreme heat waves. The WRF model was designed at a 5 km horizontal resolution on a 5-month (May-September) seasonal scale, for every year, during the study period with initial/boundary conditions derived from NCEP 2.5 degree reanalysis. The comparison of simulated mean summer seasonal maximums and mean maximums of June, July, and August months with the corresponding E-OBS data sets indicates that the model is able to characterize the spatial variation of magnitudes of temperature change over the Iberian Peninsula. The mean extreme heat wave conditions during the climate period 1950-2009 are well simulated and match the observations well. The regional scale simulations clearly show the propagation of intense heat waves from the south west to north east of Iberia. The WRF-ARW model also simulated well the general trend of increase in heat waves over most parts of the Iberian Peninsula during the study period 1950-2009. The characteristics of the most severe heat waves years 2003 and 2006 are also well simulated by the model.

关键词： Downscaling Heat Waves Iberian Peninsula Regional Climate Modelling

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Response to McAvoy and Tudor-Locke on their commentary on our manuscript:“Association of accelerometer-derived step volume and intensity with hospitalizations and mortality in older adults:A prospective cohort study”

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Journal of Sport and Health Science 2022年第6期11卷 639-640页

作者： Asier Mañas Borja del pozo Cruz Ulf Ekelund JoséLosa Reyna Irene Rodríguez Gómez JoséAntonio Carnicero Carreño Leocadio Rodríguez Mañas francisco J.García García Ignacio Ara GENUD Toledo Research Group University of Castilla-La ManchaToledo 45071Spain CIBER of Frailty and Healthy Aging(CIBERFES) Instituto de Salud Carlos IIIMadrid 28029Spain Center UCM-ISCIII for Human Evolution and Behavior Madrid 28029Spain Faculty of Education Complutense University of MadridMadrid 28040Spain Biomedical Research and Innovation Institute of Cadiz(INiBICA)Research Unit Puerto Real University HospitalUniversity of CadizCadiz 11009Spain Department of Physical Education Faculty of Education SciencesUniversity of CadizCadiz 11009Spain Department of Sports Medicine Norwegian School of Sport SciencesOslo 0806Norway Department of Chronic Diseases and Ageing Norwegian Institute of Public HealthOslo 0473Norway Geriatric Department Hospital Universitario de GetafeGetafe 28905Spain Geriatric Department Hospital Virgen del ValleToledo 45071Spain

Dear Editor,We have read with interest the commentary by McAvoy and Tudor-Locke on our article entitled "Association of accelerometer-derived step volume and intensity with ho spitalizations and mortality in older adults:A prospective cohort study". The authors expressed some concerns about our methodology used to define accelerometer-derived step intensity and the analytical approach applied in our study.

关键词： accelerometer prospective mortality

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