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Prehospital critical care drug-thera.y and 30-day mortality in patients with acute respira.ory disease

World Journal of Emergency Medicine 2025年第1期16卷 43-50页

作者： Jesús Jura.o-Palomo Joséluis Martín-Conty Begoña Polonio-López Cristina Rivera.Picón ra.l López-Izquierdo Carlos del Pozo Vegas Pedro Ángel de Santos Castro Ancor Sanz-García Fra.cisco Martín-Rodríguez Technological Innovation Applied to Health Research Group(ITAS) Faculty of Health SciencesCastilla-La Mancha UniversityTalavera de la Reina 45600Spain nuestra.Señora.del Pra.o Genera. Hospital Talavera de la Reina 45600Spain Emergency Department Rio Hortega University HospitalValladolid 47012Spain CIBER of Respira.ory Diseases(CIBERES) Institute of Health Carlos ⅢMadrid 28029Spain Faculty of Medicine University of ValladolidValladolid 470003Spain Emergency Department University Clinical HospitalValladolid 47003Spain Prehospital Emergency Medical Services(SACYL) Valladolid 47007Spain

BACKGROUnD: Prehospital medication is a reality, and the role of these thera.ies must be explored to assess their validity, especially for acute respira.ory diseases, which are usually associated with increased morbidity. The aim of this study was to examine the association of prehospital medication use with mortality in patients with acute respira.ory ***: A prospective, multicenter, emergency medical service(EMS) delivery cohort study was carried out in adults with unselected respira.ory diseases managed by EMS who were tra.sferred to the emergency department. From January 1, 2019, to October 31, 2023, six advanced life support units, thirty-eight basic life support units, and four hospitals in Spain participated in the study. Demogra.hic data, vital signs, use of mechanical ventilation, prehospital respira.ory diagnosis, and prehospital medication were collected. The primary outcome was 30-day in-hospital ***: A total of 961 patients were included, with a mortality ra.e of 17.5%(168 patients). Age, an increasing number of comorbidities, the use of invasive mechanical ventilation(IMV), the use of major analgesics, hypnotics, and bicarbonate were risk factors. In contra.t, elevated systolic blood pressure and Glasgow Coma Scale scores were found to be protective factors against mortality. The predictive capacity of the model reached an area under the curve(AUC) of 0.857(95% confidence interval [95% CI] 0.827–0.888).COnCLUSIOn: Our data revealed that IMV, major analgesics, hypnotics and bicarbonate administra.ion were associated with elevated mortality. Adding prehospital drug thera.y information to demogra.hic variables and vital signs could improve EMS decision-making, allowing a better chara.terization of patients at risk of clinical worsening.

关键词： Drug-thera.y Medication Prehospital Mortality Emergency medical services

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Twenty years of population dynamics in European beech-oak forest at their rear ra.ge margin anticipate changes in its structure and composition

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Forest Ecosystems 2024年第3期11卷 358-370页

作者： álvaro Rubio-Cuadra.o Iciar Alberdi Isabel Canellas Fernando Montes Jesús Rodríguez-Calcerra.a Rosana López Guillermo G.Gordaliza María Valbuena-Cara.ana nikos nanos ra.ón perea.luis gil Departamento de dinamica y gestion forestal Instituto de Ciencias Forestales(ICIFOR-INIA)CSICCtra.La Coruna km 7.528040MadridSpain Departamento de Sistemas y Recursos natura.es Escuela Tecnica Superior de Ingeniería de MontesForestal y del Medio NaturalUniversidad Politecnica de Madrid.Ciudad Universitaria s/n28040MadridSpain School of Forestry and natura. Environment Aristotle University of ThessalonikiUniversity Campus54124ThessalonikiGreece

There is an increasing interest in restoring degra.ed forests,which occupy half of the forest *** the forms of restora.ion,passive restora.ion,which involves the elimination of degra.ing factors and the free evolution of natura. dynamics by applying minimal or no management,is gaining *** dynamics is difficult to predict due to the influence of multiple intera.ting factors such as climatic and edaphic conditions,composition and abundance of species,and the successional chara.ter of these ***,we study the natura. dynamics of a mixed forest located in centra. Spain,which maintained an open forest structure,due to intensive use,until gra.ing and cutting were banned in the *** most frequent woody species in this forest are Fagus sylvatica,Quercus petra.a,Quercus pyrenaica,Ilex aquifolium,Sorbus aucuparia,Sorbus aria and Prunus avium,with contra.ting shade and drought *** species are common in tempera.e European deciduous forest and are found here near their southern distribution limit,except for *** order to analyze forest dynamics and composition,three inventories were carried out in 1994,2005 and *** results show that,despite the Mediterra.ean influence,the natura. dynamics of this forest has been mainly determined by different levels of shade *** the abandonment of gra.ing and cutting,*** expanded ra.idly due to its lower shade tolera.ce,whereas after canopy closure and forest densification,shade-tolera.t species gained ground,particularly ***,despite its lower drought and late-frost *** the current dynamics continue,*** will overtake the rest of the species,which will be relegated to sites with shallow soils and steep ***,all the multi-centennial beech trees,which are undergoing a ra.id mortality and decline process,will disappear.

关键词： Forest succession Secondary forest Woodland Mixed forest Competition Recruitment

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Controversies and future directions in the management of gallbladder cancer

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Oncology and Tra.slational Medicine 2023年第4期9卷 163-167页

作者： Javier Lendoire luis gil Liver&Tra.splant Division Hospital Dr.Cosme Argerich

Gallbladder cancer(GBC)is a ra.e malignancy worldwide,with 140,000 new patients each year and more than 100,000 deaths *** review aims to address the controversial aspects of managing *** differences of the study worldwide remain pending,and compara.ive mutational profiles will provide more information on the pathogenesis of ***,certain pathologic aspects are discussed,such as the staging of early GBC,outcome differences between T2 pathologically staged patients,and the necessity of a uni-form pathologic *** surgical management of GBC is still under *** extent of liver resection,type of lymphadenectomy,and selection of patients for extended resection are aspects of the disease that require *** and robotic approaches were initially slow to ***,with time,they have demonstra.ed their value in the surgical management of *** OMEGA survey,performed to analyze the management pra.tice of surgical treatment of GBC worldwide,demonstra.ed differences from the recom-mended *** OMEGA study,the largest cohort study,examined the outcomes of surgical intervention in 3676 patients from 133 *** future directions,the value of collabora.ive efforts between centers and regions must be emphasized to better un-derstand the different aspects of the disease and globally improve thera.eutic stra.egies for GBC.

关键词： Gallbladder cancer(GBC) Pathology Surgery Controversies

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Serum levels of the novel adipokine isthmin-1 are associated with obesity in pubertal boys

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World Journal of Pediatrics 2023年第9期19卷 864-872页

作者： Fra.cisco Javier Ruiz‑Ojeda Augusto Anguita‑Ruiz Maria C.Rico Rosaura.Leis Gloria Bueno luis A.Moreno Mercedes gil‑Campos Ángel gil Concepción M.Aguilera Department of Biochemistry and Molecular Biology Ⅱ School of PharmacyUniversity of GranadaGranadaSpain Instituto de Investigación Biosanitaria Ibs.Gra.ADA 18012 GranadaSpain Institute of nutrition and Food Technology“JoséMataix” Center of Biomedical ResearchUniversity of GranadaAvda.del Conocimiento S/N.18016 ArmillaGranadaSpain RG Adipocytes and Metabolism Institute for Diabetes and ObesityHelmholtz Center Munich85764 MunichGermany Barcelona Institute for Global Health ISGlobal08003 BarcelonaSpain CIBEROBn (Physiopathology of Obesity and Nutrition CB12/03/30038)Institute of Health Carlos Ⅲ(ISCⅢ)28029 MadridSpain Unit of Investigation in Human nutrition Growth and Development of Galicia(GALINUT)University of Santiago de Compostela(USC)Santiago de CompostelaSpain Pediatric nutrition Research Group Institute of Sanitary Research of Santiago de Compostela(IDIS)CHUS-USC15706 Santiago de CompostelaSpain Unit of Pediatric Gastroenterology Hepatology and NutritioPediatric ServiceUniversity Clinical Hospital of Santiago(CHUS)15706 Santiago de CompostelaSpain GEnUD Research group Institute of Sanitary Research of Aragón(IIS Aragón)University of ZaragozaZaragozaSpain Instituto Agroalimentario de Ara.ón(IA2) Universidad de Zaragoza-CITAZaragozaSpain Unit of Pediatric Endocrinology University Clinical Hospital Lozano Blesa50009 ZaragozaSpain Metabolism and Investigation Unit Reina Sofa University HospitalMaimónides Institute of Biomedicine Research of Córdoba(IMIBIC)University of Córdoba14071 CórdobaSpain

Objectives To evaluate whether there is an association between the serum levels of the novel insulin-like adipokine isthmin-1(ISM1)and obesity-related phenotypes in a population of Spanish children and to investigate the plausible molecular altera.ions behind the altera.ion of the serum levels of this protein in children with *** The study population is a sub-cohort of the PUBMEP research project,consisting of a cross-sectional population of 119 pubertal children with overweight(17 boys,19 girls),obesity(20 boys,25 girls),and normal weight(17 boys,21 girls).All subjects were classified into experimental groups according to their sex,obesity,and insulin resistance(IR)*** were counted anthropometry,glucose and lipid metabolism,inflammation and cardiovascular biomarkers as well as isthmin-1(ISM1)serum *** population was intended as a discovery population to elucidate the relationship between obesity and ISM1 levels in ***,the study population had blood whole-genome DnA methylation examined,allowing deepening into the obesity–ISM1 molecular *** Higher serum ISM1 levels were observed in boys with obesity than in normal weight(P=0.004)and overweight(P=0.007)***1 serum levels were positively associated with body mass index(BMI)Z-score(P=0.005)and fat mass(P=0.058)and negatively associated with myeloperoxidase(MPO)(P=0.043)in *** we did not find associations between ISM1 serum levels and metabolic outcomes in girls,which may indicate a putative sexual dimorphism,fat mass was positively associated in all children,including boys and girls(P=0.011).DnA methylation levels in two-enhancer-related CpG sites of ISM1(cg03304641 and cg14269097)were associated with serum levels of ISM1 in *** ISM1 is associated with obesity in boys at the pubertal stage,elucidating how this protein might be of special relevance as a new biomarker of obesity in *** studies including a longitudina

关键词： Children Epigenetics Isthmin-1 Obesity Puberty

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Information theory based clustering of cellular network usage data for the identification of representative urban areas

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DIGITAL COMMUnICATIOnS AnD nETWORKS 2024年第6期10卷 1677-1685页

作者： Chidean, Mihaela I. gil, luis Ignacio Jimenez Carmona-Murillo, Javier Cortes-Polo, David Univ Rey Juan Carlos Dept Signal Theory & Commun Fuenlabrada 28942 Spain Univ Valladolid Comp Sci P Belen 15 Valladolid 47011 Spain Univ Extremadura Dept Comp & Telemat Engn Merida 06800 Spain Univ Extremadura Dept Comp & Telemat Engn Caceres 10003 Spain

The exponential growth of the number of network devices in recent years not only entails the need for automation of management tasks, but also leads to the increase of available network data and metadata. 5G and beyond standards already cover those requirements and also include the need to define and use machine learning techniques to take advantage of the data acquired, especially using geolocated Call Detail Record (CDR) data sets. However, this scenario requires novel cellular network analysis methodologies to exploit all these available data, especially for the network usage pattern in order to ease the management tasks. In this work, a novel method based on information theory metrics like the Kullback-Leibler divergence and data classification algorithms is proposed to identify representative urban areas in terms of the network usage pattern. Methodology validation is performed via computer analysis using the Open Big Data CDR data set in the Milan area for different scenarios. Obtained results validate the proposed methodology and also reveal its adaptability in terms of specific scenario chara.teristics. network usage patterns are calculated for each representative area, paving the path to severa. future research lines in network management, such as network usage prediction based on this methodology and using the comportment time series.

关键词： Clustering 5G network analysis Multi-feature analysis Kullback-Leibler divergence Cellular networks

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Modulation of immunity and inflammatory gene expression in the gut, in inflammatory diseases of the gut and in the liver by probiotics

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World Journal of Gastroenterology 2014年第42期20卷 15632-15649页

作者： Julio Plaza-Diaz Carolina Gomez-Llorente luis Fontana Angel gil Department of Biochemistry and Molecular Biology Ⅱ School of Pharmacy and Institute of Nutrition and Food Technology "Jose Mataix" Biomedical Research Center University of Granada

The potential for the positive manipulation of the gut microbiome through the introduction of beneficial microbes, as also known as probiotics, is currently an active area of investigation. The FAO/WHO define probiotics as live microorganisms that confer a health benefit to the host when administered in adequate amounts. However, dead bacteria and bacterial molecular components may also exhibit probiotic properties. The results of clinical studies have demonstra.ed the clinical potential of probiotics in many pathologies, such as allergic diseases, diarrhea, inflammatory bowel disease and vira. infection. Severa. mechanisms have been proposed to explain the beneficial effects of probiotics, most of which involve gene expression regulation in specific tissues, particularly the intestine and liver. Therefore, the modulation of gene expression mediated by probiotics is an important issue that warra.ts further investigation. In the present paper, we performed a systematic review of the probiotic-mediated modulation of gene expression that is associated with the immune system and inflammation. Between January 1990 to February 2014, PubMed was searched for articles that were published in English using the MeSH terms “probiotics' and 'gene expression' combined with “intestines', 'liver', 'enterocytes', 'antigen-presenting cells', 'dendritic cells', 'immune system', and 'inflammation'. Two hundred and five original articles matching these criteria were initially selected, although only those articles that included specific gene expression results (77) were later considered for this review and separa.ed into three major topics: the regulation of immunity and inflammatory gene expression in the gut, in inflammatory diseases of the gut and in the liver. Particular stra.ns of Bifidobacteria, Lactobacilli, Escherichia coli, Propionibacterium, Bacillus and Saccharomyces influence the gene expression of mucins, Toll-like receptors, caspases, nuclear factor-κ

关键词： Gene expression Immunity Immunotolera.ce Inflammation Microbiota Probiotics Gut Liver

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Integra.ed nuclear techniques for sedimentation assessment in Latin American region

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International Soil and Water Conservation Research 2020年第4期8卷 406-409页

作者： Joséluis Pera.ta Vital Reinaldo Honorio gil Castillo Yanna Llerena Padrón Yusleidy Milagro Cordovi Mira.da naymi Labra.a Arevalo Leroy Alonso Pino Environmental Impact Assessment Group Center of Radiation Protection and HygieneLa HabanaZip Code 10600Cuba

The paper shows the novel techniques introduction in the region of Latin America and the Caribbean in order to strengthen the surveillance and monitoring of the sedimentation phenomenon in the surface water *** integra.ed use of the nuclear techniques allows a more complete assessment of water and land *** the development of a regional project,supported by the International Agency of Atomic Energy,Cuba participates as technical leader for 15 countries,to encoura.e and implement the integra.ed application of 3 nuclear techniques(Fallout ra.ionuclides(137Cs,7Be,210pb),Compound Specific Stable Isotopes(fatty acids of the(e)13C)and the Isotopic Hydrology(18O,2H,3H).The methodology used in the last studies referred to RLA 5076 Project is to apply the integra.ion of these three techniques allows evaluating,in the hydra.lic facilities and surface water reservoirs,the negative sedimentation impacts in natura. and anthropic process as environmental and social *** techniques evaluate the sedimentation process and its synergy,obtaining since the soil quantification in the landscape,definition the soil origin deposited until the dynamic chara.terization of the water body as soil *** integra.ed application of these nuclear techniques in the Project RLA-5076 confirms it as a useful tool to support the decisions makers in the definition of the national stra.egies and progra.s related to the land and the water resources *** the support of the IAEA projects in the Latin American and Caribbean region,has been evidenced an important increment in the use of these novel techniques.

关键词： nuclear technique Sedimentation Water reservoir Soil Land Hydric resources

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Fagus sylvatica and Quercus pyrenaica:Two neighbors with few things in common

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Forest Ecosystems 2023年第2期10卷 162-175页

作者： Sergio de Tomás Marín Jesús Rodríguez-Calcerra.a Salvador Arenas-Castro Iván Prieto Guillermo González luis gil Enrique G.de la Riva Department of Ecology Brandenburgische Technische Universität Cottbus-SenftenbergKonrad-Wachsmann-Allee 603046CottbusGermany Forest Genetics and Ecophysiology Research Group School of Forestry EngineeringUniversidad Politécnica de MadridMadridSpain Area of Ecology Botany DepartmentEcology and Plant PhysiologyFaculty of SciencesUniversidad de CórdobaCórdobaSpain Ecology Department Faculty of Biology and Environmental SciencesUniversidad de LeónLeónSpain

Background:The Iberian Peninsula comprises one of the largest boundaries between Mediterra.ean and Eurosiberian vegetation,known as sub-Mediterra.ean *** ecotone hosts many unique plant species and communities and constitutes the low-latitude(warm)margin of numerous centra. European species which co-occur with Mediterra.ean *** of the main species found in this region are the Eurosiberian European beech(Fagus sylvatica L.)and the Mediterra.ean Pyrenean oak(Quercus pyrenaica Willd.).It remains unclear how the different physiological and adaptive stra.egies of these two species reflect their niche partitioning within a subMediterra.ean community and to what extent phenotypic variation(intra.pecific variability)is driving niche partitioning across Eurosiberian and Mediterra.ean ***:We quantified functional niche partitioning,based on the n-dimensional hypervolume to nine tra.ts related to resource acquisition stra.egies(leaf,stem and root)plus relative growth ra.e as an additional wholeplant tra.t,and the environmental niche similarity between Pyrenean oak and European ***,we analyzed the degree of phenotypic variation of both target species and its relationship with relative growth ra.es(RGR)and environmental *** recruitment was measured for both target species as a proxy for the avera.e ***:Species’functional space was highly segregated(13.09%overlap),mainly due to differences in niche breadth(59.7%)ra.her than niche replacement(25.6%),and beech showed higher tra.t variability,i.e.,had larger functional ***,both species shared the environmental space,i.e.,environmental niches were *** plant tra.ts were not related to abiotic variables or RGR,neither did RGR to plant ***:Both target species share similar environmental space,however,show notably different functional resource-use stra.egies,promoting a high complementarity that contributes to maintaining a high functiona

关键词： Environmental niche European beech Forest dynamics Functional niche Hypervolume Pyrenean oak Species coexistence Sub-Mediterra.ean community

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Prolonged cholestasis after ra.oxifene and fenofibra.e intera.tion: A case report

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World Journal of Gastroenterology 2006年第32期12卷 5244-5246页

作者： M Isabel Lucena ra.l J Andra.e luis Vicioso F Jesús González Ketevan Pachkoria Beatriz García-Mu(n|~)oz Clinical Pharmacology Service Virgen de la Victoria University Hospital School of MedicineMalagaSpain Liver Unit Gastroenterology Service Virgen de la Victoria University HospitalSchool of MedicineMálagaSpain Department of Pathology Virgen de la Victoria University Hospital School of MedicineMálagaSpain Institute of Biopathology and Regenera.ive Medicine University of Gra.ada Spain Clinical Pharmacology Service Virgen de la Victoria University Hospital School of MedicineMálagaSpain

Assigning causality in drug-induced liver injury is challenging particularly when more than one drug could be responsible. We report a woman on long-term thera.y with ra.oxifen who developed acute cholestasis shortly after starting fenofibra.e. The picture evolved into chronic cholestasis. We hypothesized that an intera.tion at the metabolic level could have triggered the presentation of hepatotoxicity after a very short time of exposure to fenofibra.e in this patient. The findings of an overexpression of vascular endothelial growth factor in the liver biopsy suggest that angiogenesis might play a role in the persistance of toxic cholestasis.

关键词： ra.oxifene Fenofibra.e Drug-drug intera.tions Hepatotoxicity Causality assessment

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Measuring Impact of Lean Manufacturing Tools for Continuous Improvement on Economic Sustainability

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Journal of Systems Science and Systems Engineering 2024年第4期33卷 452-474页

作者： luis Javier Márquez Figueroa Jorge luis García-Alcara. Ahmed I.Osman Alfonso Jesús gil López Yashar Aryanfar Mika Sillanpää Mamdouh El Haj Assad Department of Electrical Engineering and Computer Science Universidad Autónoma de Ciudad JuárezCiudad JuárezChihuahuaMéxico Department of Industrial Engineering and Manufacturing Universidad Autónoma de Ciudad JuárezCiudad JuárezChihuahuaMéxico School of Chemistry and Chemical Engineering Queens UniversityBelfastNorthern IrelandUK Department of Economic and Managerial Sciences University of La RiojaLa RiojaSpain Department of Chemical Engineering University of JohannesburgJohannesburgSouth Africa Department of Sustainable and Renewable Energy Engineering University of SharjahSharjahUAE

Using Lean Manufacturing(LM)tools in production processes is crucial for companies’economic,environmental,and social sustainability *** study shows a structura. equation model(SEM)that shows the relationship between LM Tools like Kaizen(KAI),Gemba(GEM),Value Stream Mapping(VSM)and Key Performance Indicator(KPI)with Economic Sustainability(ECS).Seven hypotheses were evaluated with data from 179 responses to a questionnaire about the Mexican maquiladora.industry,showing that these variables are *** a 95%confidence level,the model was evaluated using the partial least squares *** findings indicate that the relationships between KAI and GEM and KAI and VSM have the strongest relationship,followed by VSM and ECS;however,VSM has the strongest effect on *** on these findings,it is recommended that managers adopt a continuous improvement(KAI)approach based on working directly on the shop floor(GEM and VSM)to support their decisions regarding economic growth(ECS).

关键词： Lean manufacturing economic sustainability structura. equation model quality improvement

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