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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

Fundamentals of percutaneous coronary bifurcation interventions

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World Journal of Cardiology 2022年第3期14卷 108-138页

作者： Tamer Kırat Department of Cardiology Yücelen HospitalMuğla 48000Turkey

Coronary bifurcation lesions(CBLs)account for 15%-20%of all percutaneous coronary *** complex nature of these lesions is responsible for poorer procedural,early and late *** complex lesion subset has received great attention in the interventional cardiac community,and multiple stenting techniques have been *** these,the provisional stenting technique is most often the default strategy;however,the elective double stenting(EDS)technique is preferred in certain subsets of complex *** double kissing crush technique may be the preferred EDS technique because of its efficacy and safety in comparative trials;however,this technique consists of many steps and requires *** new methods have recently been added to the EDS techniques to provide better stent scaffolding and to reduce early and late adverse *** imaging is necessary to determine the interventional strategy and postinterventional *** review discusses the basic concepts,contemporary percutaneous interventional technical approaches,new methods,and controversial treatment issues of CBLs.

关键词： Percutaneous coronary intervention Coronary artery disease Drug-eluting stents Bifurcation lesion Stenting technique Left main intervention

One step at a time:new insights into double-stranded ribonucleic acid virus assembly

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Signal Transduction and Targeted Therapy 2024年第10期9卷 4160-4161页

作者： Virgile rat Alexander Borodavka Don C.Lamb Department of Chemistry LMU MünchenMünchen GermanyButenandtstrasse 5-1381377MunichGermany Department of Chemical Engineering and Biotechnology University of CambridgePhilippa Fawcett DriveCB30ASCambridgeUK

In a recent paper published in Cell,Xia et al.1 carried out 3D reconstructions of Blue Tongue Virus(BTV)particles and their assembly intermediates using a combination of cellular cryo-electron tomography(Cryo-ET)and single-particle cryo-electron microscopy(Cryo-EM).They were able to identify 11 structures,allowing them to refine our understanding of how double-stranded ribonucleic acid(dsRNA)viruses replicate in cells.

关键词： double assembly insight

Role of oxidative stress on growth responses of spring barley exposed to different environmental stressors

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Journal of Plant Ecology 2015年第6期8卷 605-616页

作者： Giedrė Kacienė Jūratė Žaltauskaitė Eglė Milčė Romualdas Juknys Department of Environmental Sciences Vytautas Magnus UniversityVileikos Street 8-223LT-44404 KaunasLithuania

Aims oxidative stress is one of the most important mechanisms in a plant’s reaction to the effects of different stressors;however,its role in plants’resistance is still poorly *** objective of this study is to evaluate an influence of oxidative stress induced by stress factors of different origin-ozone,ultraviolet(uV)-b radia-tion,drought,cadmium(Cd)and copper(Cu),to growth of spring barley and to check the hypothesis,that intensification of oxidative stress is the main factor of growth depression induced by strong treatments of different stressors;meanwhile,mitigation of oxidative stress determines eustress-induced growth *** a pot experiment was carried out in phytotron chambers with a controlled *** barley(Hordeum vulgare l.)plants were exposed to different doses of investigated environmental stress factors(O_(3),uV-b radiation,drought,Cd and Cu),and their effects on shoots growth,accumulation of superoxide(O_(2)^(˙−)),intensification of lipid peroxidation and antioxidative protection(superoxide dismutase,glutathione reductase and catalase activi-ties and concentration of carotenoids)were *** of variance(aNoVa)with classical eta-squared(η2)values was used to evaluate and to compare the contribution of non-specific oxi-dative stress and stressor-specific mechanisms on plants *** Findingslow doses of most stressors stimulated antioxidative protection and growth of barley shoots,reduced the concentration of o2˙−and/or intensity of lipid *** an impair-ment of growth and intensification of oxidative stress as well as a reduction in concentration of carotenoids and further increase in activity of antioxidative enzymes were noticed when the intensity of the stressors was *** the cases of ozone and uV-b stress,the effects of oxidative stress on plant growth was mitigated by strong antioxidative protection-highly increased catalase(CaT)and superoxide dismutase(SOD)activities,res

关键词： plant stress environmental stress factors superoxide lipid peroxidation eustress distress

Low Rm MHD Turbulence:The Role of Boundaries

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Journal of Iron and Steel research International 2012年第S1期19卷 514-518页

作者： Alban Pothérat Applied Mathematics research Centre Coventry University Priory StreetCoventry CV 15FBUK

In this Keynote lecture,we review the main known features of MHD turbulence at low magnetic reynolds number,that is when the flow isn't intense enough to disturb an externally applied magnetic *** emphasis is deliberately placed on the very specific physical mechanisms of this type of flows,rather than their numerical modelling. We also focus on homogeneous magnetic fields which have received most *** stress in particular that the tendency to two-dimensionality observed in these flows casts the boundaries of the domain into a leading role.

关键词： magnetic field MHD turbulence Lorentz force two-dimensionality three-dimensionality

Experimental investigation on combustion and emission characteristics of reactivity controlled compression ignition engine powered with iso-propanol/biodiesel blends

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Propulsion and Power research 2022年第2期11卷 224-239页

作者： Müjdat Fırat S¸ehmus Altun Mutlu Okcu Yasin Varola Department of Automotive Engineering Fırat UniversityElazıg23119Turkey Department of Mechanical Engineering Batman UniversityBatman72100Turkey Department of Electrical-Electronic Engineering Ardahan UniversityArdahan75002Turkey

recently, reactivity controlled compression ignition (RCCI) has been proposed inorder to achieve a higher thermal efficiency with lower emissions than conventional combustion. In RCCI mode, as the fuel types and their combinations affects the reactivity stratificationinside cylinder, thus combustion control, in present study, iso-propanol was evaluated as lowreactivity fuel (LRF) when petroleum diesel, commercial biodiesel and their blends were highreactivity fuels. It is of great importance that iso-propanol and biodiesel be used together inRCCI mode, as they significantly affect the in-cylinder stratification due to their high octane/cetane number. Therefore, the reactivity controlled compression ignition (RCCI) combustioncharacteristics was investigated in a diesel research engine using iso-propanol, petroleumdiesel, biodiesel and their blends as fuels. Tests were conducted on varying loadings (from20% to 60% of max torque) and premixed ratios of LRF (Rp Z 0, 0.15, 0.30, 0.45, and0.60) at a constant engine speed of 2400 rpm. results, which were compared with conventionaldiesel combustion (CDC), showed that, as the premixed ratio (Rp) of low-reactivity fuel (isopropanol) increased, ignition delay (ID) period prolonged while combustion duration (CD) and rate of pressure rise (RoPR) reduced assisted to reduce NO emissions and smoke opacity in theexhaust. NO and smoke opacity reduced simultaneously for biodiesel-propanol combinationsup to 40% under 20% load and 0.60 premixed ratio of LRF compared to CDC. Propanol premixed ratio of 0.30 at 60% load was found to be optimum concerning lowest emissions. In conventional mode, HC emissions reduced by up to 52% when biodiesel and its blends with dieselfuel are used, whereas they increased significantly in RCCI mode. According to overall results,it is concluded that RCCI performed better than CDC at entire load.

关键词： reactivity controlled compression ignition(RCCI) Propanol Biodiesel Combustion Emissions

Stem cell-derived exosomes-an emerging tool for myocardial regeneration

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World Journal of Stem Cells 2018年第8期10卷 106-115页

作者： Erzsebet Lazar Theodora Benedek Szilamer Korodi Nora rat Jocelyn Lo Imre Benedek Department of Internal Medicine Clinic of Haematology and Bone Marrow Transplantation University of Medicine and Pharmacy Tirgu Mures Department of Internal Medicine Clinic of Cardiology University of Medicine and Pharmacy Tirgu Mures Department of Advanced research in Multimodality Cardiac Imaging Cardio Med Medical Center Vagelos College of Physicians and Surgeons Columbia University

Cardiovascular diseases(CVDs) continue to represent the number one cause of death and disability in industrialized countries. The most severe form of CVD is acute myocardial infarction(AMI), a devastating disease associated with high mortality and disability. In a substantial proportion of patients who survive AMI, loss of functional cardiomyocytes as a result of ischaemic injury leads to ventricular failure, resulting in significant alteration to quality of life and increased mortality. Therefore, many attempts have been made in recent years to identify new tools for the regeneration of functional cardiomyocytes. regenerative therapy currently represents the ultimate goal for restoring the function of damaged myocardium by stimulating the regeneration of the infarcted tissue or by providing cellsthat can generate new myocardial tissue to replace the damaged tissue. Stem cells(SCs) have been proposed as a viable therapy option in these cases. However, despite the great enthusiasm at the beginning of the SC era, justified by promising initial results, this therapy has failed to demonstrate a significant benefit in large clinical trials. One interesting finding of SC studies is that exosomes released by mesenchymal SCs(MSCs) are able to enhance the viability of cardiomyocytes after ischaemia/reperfusion injury, suggesting that the beneficial effects of MSCs in the recovery of functional myocardium could be related to their capacity to secrete exosomes. Ten years ago, it was discovered that exosomes have the unique property of transferring miRNA between cells, acting as miRNA nanocarriers. Therefore, exosomebased therapy has recently been proposed as an emerging tool for cardiac regeneration as an alternative to SC therapy in the post-infarction period. This review aims to discuss the emerging role of exosomes in developing innovative therapies for cardiac regeneration as well as their potential role as candidate biomarkers or for developing new diagnostic tools.

关键词： Acute myocardial infarction Exosome Stem cell Cardiac regeneration Cardiovascular diseases

A unified analysis of a micro-beam,droplet and CNT ring adhered on a substrate:Calculation of variation with movable boundaries

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Acta Mechanica Sinica 2013年第1期29卷 62-72页

作者： Jian-Lin Liu re Xia School of Pipeline and Civil Engineering China University of Petroleum School of Power and Mechanical Engineering Wuhan University

In this study, we developed a general method to analytically tackle a kind of movable boundary problem from the viewpoint of energy variation. Having grouped the adhesion of a micro-beam, droplet and carbon nanotube （CNT） ring on a substrate into one framework, we used the developed line of reasoning to investigate the adhesion behaviors of these systems. Based upon the derived governing equations and transversality conditions, explicit solutions involving the critical parameters and morphologies for the three systems are successfully obtained, and then the parameter analogies and common characteristics of them are thor- oughly investigated. The presented method has been verified via the concept of energy release rate in fracture mechanics. Our analyses provide a new approach for exploring the mechanism of different systems with similarities as well as for understanding the unity of nature. The analysis results may be beneficial for the design of nano-structured materi- als, and hold potential for enhancing their mechanical, chemical, optical and electronic properties.

关键词： Variational theory - Transversality condition Beam adhesion Droplet adhesion Carbon nanotube ring adhesion

Energy use efficiency and greenhouse gas emissions(GHG)analysis of garlic cultivation in Turkey

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International Journal of Agricultural and Biological Engineering 2023年第4期16卷 63-67页

作者： Mehmet Fırat Baran Cihan Demir Ahmet Konuralp Eliçin Osman Gökdoğan Department of Biosystem Engineering Faculty of AgricultureUniversity of SiirtSiirtTurkey Department of Mechanical and Metal Technologies Vocational School of Technical SciencesUniversity of KırklareliKırklareliTurkey Department of Agricultural Machinery and Technologies Engineering Faculty of AgricultureUniversity of DicleDiyarbakırTurkey Department of Agricultural Machinery and Technologies Engineering Faculty of AgricultureIsparta University of Applied SciencesIspartaTurkey

This study has been conducted with the purpose of determining energy use efficiency and greenhouse gas emissions of garlic cultivation during the 2020-2021 cultivation season in Adıyaman province of ***,observations and field works were performed in 134 garlic farms in the region through simple random *** garlic cultivation,energy input was calculated as 32103.20 MJ/hm^(2)and energy output was calculated as 30096 MJ/hm^(2).With regards to the three highest inputs in garlic production,46.66%of the energy inputs consisted of chemical fertilizers energy(14979.26 MJ/hm^(2)),11.29%consisted of farmyard manure energy(3625.71 MJ/hm^(2))and 10.48%consisted of human labour energy(3363.36 MJ/hm^(2)).Energy use efficiency,specific energy,energy productivity and net energy in garlic cultivation were calculated as 0.94,1.71 MJ/kg,0.59 kg/MJ,and−2007.20 MJ/hm^(2),*** total energy input consumed in garlic cultivation was classified as 27.19%direct energy,72.81%indirect energy,35.17%renewable energy and 64.87%nonrenewable *** GHG emissions and GHG ratio were calculated as 8636.60 kg CO_(2)-eq/hm^(2)and 0.46 kg CO_(2)-eq/kg,respectively.

关键词： Energy use efficiency garlic greenhouse gas emissions specific energy Turkey