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Occlusion with a Vascular Plug of a Congenital Circumflex Coronary Artery—Right Ventricle Fistula with Coronary Steal Phenomenon

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World Journal of Cardiovascular Diseases 2024年第11期14卷 689-694页

作者： Gilberto H. Acosta-Gutiérrez Camila Ponce-Acosta Roberto Cano-Zarate maria jose santa-ana-bayona jose A. Garcia-Montes Nilda Espinola-Zavaleta Nuclear Cardiology Department National Institute of Cardiology Ignacio Chavez Mexico City Mexico Mexican Faculty of Medicine La Salle University Mexico City Mexico Magnetic Resonance Department National Institute of Cardiology Ignacio Chavez Mexico City Mexico Pediatric Interventional Cardiology Department National Institute of Cardiology Ignacio Chavez Mexico City Mexico

Background: Coronary fistulas are abnormal communications with a worldwide prevalence of 0.002% in the general population. Aim: The aim of this study is to present a case of a congenital coronary artery fistula presented with coronary steal and describe this phenomenon. Methods: A systematic search was conducted to explore the relationship between the coronary steal phenomenon and coronary artery diseases using the PubMed database. Case Presentation: A seven-month-old female patient, was admitted to the hospital presenting diaphoresis on feeding and failure to thrive. Physical examination denotes continuous murmur in the fourth intercostal space left parasternal border (IV/VI) crescendo-decrescendo, wide and permanent unfolding of S2 (S1-A2-P2). An echocardiogram shows enlargement of right cavities, dilatation of the left coronary artery, circumflex artery connected to the right ventricle, and pulmonary artery systolic pressure of 45 mmHg. Tomography angiography demonstrated dilatation of the circumflex artery and a tortuous trajectory towards the posterior wall of the right ventricle, suggesting a coronary fistula. Results: The findings were corroborated by catheterization and a vascular plug (Amplatzer AVP II) was successfully placed. During follow-up complete obliteration was observed, with adequate weight gain and no associated symptoms. Conclusion: This case illustrates a distinctive clinical manifestation of congenital coronary artery fistula associated with the coronary steal phenomenon, establishing a new paradigm for the early diagnosis and management of this condition in the pediatric population.

关键词： Coronary Artery Disease Coronary Vessel Anomalies Embolization Therapeutics

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Challenges and improvement strategies in the hospitalization of chronic multimorbid patients

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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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Machine Learning-Based Radio Access Technology Selection in the Internet of Moving Things

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China Communications 2021年第7期18卷 13-24页

作者： Ramon Sanchez-Iborra Luis Bernal-Escobedo jose santa Dept.Engineering and Applied Techniques University Centre of Defence at the Spanish Air Force Academy30729 San JavierSpain Dept.Information and Communication Engineering University of Murcia30100 MurciaSpain Dept.of Electronics Computing Technology and ProjectsTechnical University of Cartagena30202 CartagenaSpain

The Internet of Moving Things(IoMT)takes a step further with respect to traditional static IoT *** this line,the integration of new eco-friendly mobility devices such as scooters or bicycles within the Cooperative-Intelligent Transportation Systems(C-ITS)and smart city ecosystems is crucial to provide novel *** this end,a range of communication technologies is available,such as cellular,vehicular WiFi or Low-Power Wide-Area Network(LPWAN);however,none of them can fully cover energy consumption and Quality of Service(QoS)***,we propose a Decision Support System(DSS),based on supervised Machine Learning(ML)classification,for selecting the most adequate transmission interface to send a certain message in a multi-Radio Access Technology(RAT)set *** ML algorithms have been explored taking into account computing and energy constraints of IoMT enddevices and traffic ***,a real implementation of a decision tree-based DSS for micro-controller units is presented and *** attained results demonstrate the validity of the proposal,saving energy in communication tasks as well as satisfying QoS requirements of certain urgent *** footprint of the real implementation on an Arduino Uno is 444 bytes and it can be executed in around 50µs.

关键词： internet of moving things multi-RAT CITS classification personal mobility

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The use of remote sensing to detect the consequences of erosion in gypsiferous soils

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International Soil and Water Conservation Research 2020年第4期8卷 383-392页

作者： maria jose Marques ana Alvarez Pilar Carral Blanca Sastre Ramón Bienes Geology and Geochemistry Department Autonomous University of MadridCalle Francisco Tomás y Valiente728040MadridSpain Department of Applied Research and Agrarian Extension IMIDRAFinca El Encín.Carretera A-2Km 38.8.Alcaláde Henares28800MadridSpain

Tillage practices on sloping ground often result in unsustainable soil losses impairing soil functions such as crop productivity,water and nutrients storage,and soil organic carbon(SOC)sequestration.A sloping olive grove(10%)was planted in shallow gypsiferous soils in *** was managed by minimum tillage;the most frequent management practice in central *** consequences of erosion were studied in soil samples(at 0-10,10-20,and 20-30 cm depths)by analyzing SOC,available water and gypsum content,and by detecting spectral signatures using an ASD FieldSpecPro(R)VIS/*** Brightness index(BI),Shape index(FI),and Normalized Difference Vegetation Index(NDVI)were derived from the ASD spectral signatures and from remote sensing(Sentinel-2 image)*** development of these young olive trees was estimated from the measured diameter of the trunks(17±18 cm diameter).In 20-30 cm of the soil,the carbon stock(38±18 Mg ha-1)as well as the available water content(12±6%)was scarce,affecting the productivity of the olive *** above-mentioned indices obtained from the laboratory samples and the pixels of the Sentinel-2 image were significantly(p<0.01)correlated,with a correlation coefficient of around *** BI was related to the gypsum content and the slope of the *** FI was related to the carbon and water *** NDVI derived from the satellite image identified the influence of soil degradation on the trees and the carbon *** spatialtemporal changes of the indices might help in tracking soil changes over time.

关键词： Tillage Erosion NDVI Gypsum Remote sensing Soil color

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T follicular helper expansion and humoral-mediated rejection are independent of the HVEM/BTLA pathway

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Cellular & Molecular Immunology 2017年第6期14卷 497-510页

作者： jose-Ignacio Rodriguez-Barbosa Carlos Fernandez-Renedo ana maria Bravo Moral Leo Biihler maria-Luisa del Rio Transplantation Immunobiology Section Institute of Biomedicine University of Leon and Castilla and Leon Regional Transplantation Coordination Leon University Hospital Leon Spain Department of Veterinary Clinical Sciences University of Santiago de Compostela Veterinary Faculty Lugo Spain Visceral and Transplantation Surgery Department of Surgery University Hospitals of Geneva and Faculty of Medicine Geneva Switzerland

The molecular pathways contributing to humoral-mediated allograft rejection are poorly defined. In this study, we assessed the role of the herpesvirus entry mediator/B- and T-lymphocyte attenuator （HVEM/BTLA） signalling pathway in the context of antibody-mediated allograft rejection. An experimental setting was designed to elucidate whether the blockade of HVEM/BTLA interactions could modulate de novo induction of host antidonor-specific antibodies during the course of graft rejection. To test this hypothesis, fully allogeneic major histocompatibility complex-mismatched skin grafts were transplanted onto the right flank of recipient mice that were treated with isotype control, anti-CD40L or modulatory antibodies of the HVEM/BTLA signalling pathway. The frequencies of CD4 T follicular helper （Tfh） cells （B220-, CD4＋ CXCR5＋ PD-lhigh）, extrafollicular helper cells （B220-, CD4＋ CXCR5- PD-1＋ and PD-1-） and germinal centre （GC） B cells （B220＋Fas＋ GL7＋） were analysed by flow cytometry in draining and non-draining lymph nodes at day 10 post transplantation during the acute phase of graft rejection. The host antidonor isotype-specific humoral immune response was also assessed. Whereas blockade of the CD40/CD40L pathway was highly effective in preventing the allogeneic humoral immune response, antibody-mediated blockade of the HVEM/BTLA-interacting pathway affected neither the expansion of Tfh cells nor the expansion of GC B cells. Consequently, the course of the host antidonor antibody-mediated response proceeded normally, without detectable evidence of impaired development. In summary, these data indicate that HVEM/BTLA interactions are dispensable for the formation of de novo host antidonor isotype-specific antibodies in transplantation.

关键词： BTLA (CD272) humoral immunity HVEM (TNFRSF14, CD270) T follicular helper cells transplantation

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TinyML-Based Fall Detection for Connected Personal Mobility Vehicles

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Computers, Materials & Continua 2022年第5期71卷 3869-3885页

作者： Ramon Sanchez-Iborra Luis Bernal-Escobedo jose santa Antonio Skarmeta University Center of Defense General Air Force AcademySan Javier30720Spain University of Murcia Murcia30100Spain Technical University of Cartagena Cartagena30202Spain

A new wave of electric vehicles for personal mobility is currently crowding public *** offer a sustainable and efficient way of getting around in urban environments,however,these devices bring additional safety issues,including serious accidents for ***,taking advantage of a connected personal mobility vehicle,we present a novel on-device Machine Learning(ML)-based fall detection system that analyzes data captured from a range of sensors integrated on an on-board unit(OBU)*** the typical processing limitations of these elements,we exploit the potential of the TinyML paradigm,which enables embedding powerful ML algorithms in constrained *** have generated and publicly released a large dataset,including real riding measurements and realistically simulated falling events,which has been employed to produce different TinyML *** attained results show the good operation of the system to detect falls efficiently using embedded *** considered algorithms have been successfully tested on mass-market low-power units,implying reduced energy consumption,flash footprints and running times,enabling new possibilities for this kind of vehicles.

关键词： Personal mobility machine learning on-board unit C-ITS IoT

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Modeling Alzheimer's disease:considerations for a better translational and replicable mouse model

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Neural Regeneration Research 2022年第11期17卷 2448-2449页

作者： Joshua D.Cho Mu Yang Ismael santa-maria Taub Institute for Research on Alzheimer's Disease and the Aging Brain Department of Pathology&Cell BiologyColumbia University The Mouse NeuroBehavior Core.Institute for Genomic Medicine Columbia University

Alzheimer's disease (AD) mouse models have proven to be an invaluable tool for deepening our understanding of disease mechanisms and for developing ***,one common frustration is the lack of replicability in behavioral *** we have discussed in our recent publication (Cho et al.,2021),in the htau mouse model,the cognitive impairment reported in the original study has not been consistently replicated by different labs over the past *** variability in behavioral findings seems to exist in many,if not all,AD mouse models that have been behaviorally evaluated.

关键词： Alzheimer tau

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Perceptions and emotions in postoperative recovery of patients with perianal diseases

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World Journal of Psychiatry 2025年第1期15卷 179-184页

作者： Bryan Adrian Priego-Parra jose maria Remes-Troche Digestive Physiology and Gastrointestinal Motility Lab Instituto de Investigaciones Médico-BiológicasUniversidad VeracruzanaVeracruz 91700Mexico

This article examines the complex relationship between disease perception,negative emotions,and their impact on postoperative recovery in patients with perianal *** conditions not only cause physical discomfort,but also carry a significant emotional burden,often exacerbated by social ***-logical factors,including stress,anxiety,and depression,activate neuroendocrine pathways,such as the hypothalamic–pituitary–adrenal axis,disrupting the gut microbiota and leading to *** disruption can delay wound healing,prolong hospital stay,and intensify *** on the findings of Hou et al,our article highlights the critical role of illness perception and negative emotions in shaping recovery *** advocates for a holistic approach that integrates psychological support and gut microbiota modulation,to enhance healing and improve overall patient outcomes.

关键词： Perianal disease Illness perception Gut microbiota Post-surgical outcomes Microbiota

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AMP-activated kinase in human spermatozoa： identification, intracellular localization, and key function in the reRulation of sperm motility

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Asian Journal of Andrology 2017年第6期19卷 707-714页

作者： Violeta Calle-Guisado ana Hurtado de Llera David Martin-Hidalgo jose Mijares maria C Gil Ignacio S Alvarez maria J Bragado Luis J Garcia-Marin Research Group of Intracellular Signalling and Technology of Reproduction (SINTREP) School of Veterinary Medicine University of Extremadura Caceres Spain Assisted Reproduction Unit at the-Minimally Invasive surgery Center Jesos Uson (CCMIJU) Caceres Spain Norba Clinic Caceres Spain Research Group of Reproduction and Embryo Development (REDES) University of Extremadura Badajoz Spain Extremadura Institute of Assisted Reproduction (IERA) Badajoz Spain.

AMP-activated kinase （AMPK）, a protein that regulates energy balance and metabolism, has recently been identified in boar spermatozoa where regulates key functional sperm processes essential for fertilization. This work＇s aims are AMPK identification, intracellular localization, and their role in human spermatozoa function. Semen was obtained from healthy human donors. Sperm AMPK and phospho-Thr172-AMPK were analyzed by Western blotting and indirect immunofluorescence. High- and low-quality sperm populations were separated by a 40%-80% density gradient. Human spermatozoa motility was evaluated by an Integrated Semen analysis System （ISAS） in the presence or absence of the AMPK inhibitor compound C （CC）. AMPK is localized along the human spermatozoa, at the entire acrosome, midpiece and tail with variable intensity, whereas its active form, phospho-Thr172-AMPK, shows a prominent staining at the acrosome and sperm tail with a weaker staining in the midpiece and the postacrosomal region. Interestingly, spermatozoa bearing an excess residual cytoplasm show strong AMPK staining in this subcellular compartment. Both AMPK and phospho-Thr172-AMPK human spermatozoa contents exhibit important individual variations. Moreover, active AMPK is predominant in the high motility sperm population, where shows a stronger intensity compared with the low motility sperm population. Inhibition of AMPK activity in human spermatozoa by CC treatment leads to a significant reduction in any sperm motility parameter analyzed： percent of motile sperm, sperm velocities, progressivity, and other motility coefficients. This work identifies and points out AMPK as a new molecular mechanism involved in human spermatozoa motility. Further AMPK implications in the clinical efficiency of assisted reproduction and in other reproductive areas need to be studied.

关键词： AMP-activated kinase human spermatozoa immunolocalization sperm motility sperm quality

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Composition of Fractional Orlicz Maximal Operators and A1-weights on Spaces of Homogeneous Type

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Acta Mathematica Sinica,English Series 2010年第8期26卷 1509-1518页

作者： ana L. BERNARDIS Gladis PRADOLINI maria LORENTE maria Silvina RIVEROS IMAL ( CONICET)-FIQ (UNL) Guemes 3450 (3000) Santa Fe Argentina Departamento de analisis Matemdtico Facultad de CienciasUniversidad de Malaga 29071-Malaga Spain FaMAF Universidad Nacional de Cordoba CIEM ( CONICET) 5000 Cordoba Argentina

For a Young function θ with 0 ≤α 〈 1, let Mα,θ be the fractional Orlicz maximal operator defined in the context of the spaces of homogeneous type （X, d, μ） by Mα,θf（x） = supx∈（B）α ｜｜f｜｜θ,B, where ｜｜f｜｜θ,B is the mean Luxemburg norm of f on a ball B. When α= 0 we simply denote it by Me. In this paper we prove that if Ф and ψare two Young functions, there exists a third Young function θ such that the composition Mα,ψ o MФ is pointwise equivalent to Mα,θ. As a consequence we prove that for some Young functions θ, if Mα,θf 〈∞a.e. and δ ∈（0,1） then （Mα,θf）δ is an A1-weight.

关键词： Orlicz maximal function spaces of homogeneous type weights

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