检索结果-南通市图书馆

Relational coordination and healthcare management in lung cancer

World Journal of Clinical Cases 2014年第12期2卷 757-768页

作者： josé antonio Vinagre Romero Juan Del Llano Se?arís Carmen De Pablos Heredero Mark Nuijten Clinical Management Business Organization Entrepreneurship Health Administration Business Organization Universidad Rey Juan Carlos Respiratory Unit at La Paz University Hospital28046 Madrid Spain Community Health Gaspar Casal Foundation Universidad Pompeu Fabra-CRES 28006 Madrid Spain Economics Rey Juan Carlos University School of Social Sciences Doctoral Program in Business Organization and Entrepreneurship 28032 Madrid Spain Rotterdam School of Management Erasmus University University of Maastricht the University of Groningen 3062 PA Rotterdam The Netherlands

In the current socio-economic scenario characterized by a growing shortage of resources and progressive budget constraints, the need to better coordinate processes in health institutions appears as a relevant aspect to ensure the future sustainability of system. In this sense, Relational Coordination(RC) provides a valuable opportunity for the reconfiguration of clinical guidelines concerning isolated single-level considerations. In this research the RC model has been applied to explain best results in the process of diagnosing and offering clinical treatments for lung cancer. Lung cancer presents the higher rates of tumor's mortality worldwide. Through unstructured and informal interviews with clinicians at both levels(Primary/Specialist Care), a diagnosis of the situation in relation to joint management of lung cancer is provided. Solutions of continuity in terms of coordination are explained due to the observation of lack of effective knowledge transfer between the two levels. It is this disconnection which justifies the introduction of a modified model of RC for the study and implementation of transfer relations between the knowledge holders, in order to structure consolidated and cooperative evidence-based models that lead to a substantial shortening in the response times with a marked outcomes improvement. To our knowledge, the application of this model to a Public Health problem bringing together both levels of care, hasn't been made till now.

关键词： Relational Coordination Lung cancer Clinical pathway Dialogic practices High performance work systems Healthcare performance

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

T-cell allorecognition of donor glutathione S-transferase T1 in plasma cell-rich rejection

引用

World Journal of Hepatology 2017年第27期9卷 1115-1124页

作者： María josé Martínez-Bravo Berta Sánchez josé Manuel Sousa María josé Acevedo Miguel Angel Gómez-Bravo antonio Núnez-Roldán Isabel Aguilera Immunology Service Instituto de Biomedicina de Sevilla Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla Digestive Diseases Service Hospital Universitario Virgen del Rocío Liver Transplant Unit Hospital Universitario Virgen del Rocío

AIM To investigate the role of glutathione S-transferase T1 donor-specific T lymphocytes in plasma cell-rich rejection of liver *** The study group included 22 liver transplant patients. Among them, 18 patients were mismatched for the glutathione S-transferase T1(GSTT1) alleles(don+/rec-), and 4 were matched(don+/rec+). Seven of the mismatched patients produced anti-GSTT1 antibodies and developed plasma cell-rich rejection(former de novo immune hepatitis). For the detection of specific Tlymphocytes, peripheral blood mononuclear cells were collected and stored in liquid nitrogen. The memory T cell response was studied by adding to the cell cultures to a mix of 39 custom-made, 15-mer overlapping peptides, which covered the entire GSTT1 amino acid sequence. The specific cellular response to peptides was analyzed by flow cytometry using the markers CD8, CD4, IL-4 and IFNγ.RESULTS Activation of CD8^+ T cells with different peptides was observed exclusively in the group of patients with plasma-cell rich rejection(3 out of 7), with production of IL-4 and/or IFNγ at a rate of 1%-4.92% depending on the peptides. The CD4^+ response was most common and not exclusive for patients with the disease, where 5 out of 7 showed percentages of activated cells from 1.24% to 31.34%. Additionally, two patients without the disease but with the mismatch had cells that became stimulated with some peptides(1.45%-5.18%). Highly unexpected was the finding of a double positive CD4^+CD8^(low) T cell population that showed the highest degree of activation with some of the peptides in 7 patients with the mismatch, in 4 patients with plasma cell-rich rejection and in 3 patients without the disease. Unfortunately, CD4^+CD8^(low) cells represent 1% of the total number of lymphocytes, and stimulation could not be analyzed in 9 patients due to the low number of gated cells. Cells from the 4 patients included as controls did not show activation with any of the peptides. CONCLUSION Patients

关键词： Donor-specific glutathione S-transferase T1 antibodies Indirect presentation Glutathione S-transferase T1-memory T cells De novo immune hepatitis Donor/recipient mismatch

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Percutaneous radiofrequency ablation for early hepatocellular carcinoma: Risk factors for survival

引用

World Journal of Gastroenterology 2014年第6期20卷 1585-1593页

作者： Luciana Kikuchi Marcos Menezes Aline L Chagas Claudia M Tani Regiane SSM Alencar Marcio A Diniz Venncio AF Alves Luiz Augusto carneiro D’Albuquerque Flair josé Carrilho So Paulo Clínicas Liver Cancer Group Instituto do Cancer do Estado de So Paulo Hospital das Clínicas Department of Gastroenterology University of So Paulo School of Medicine So Paulo Clínicas Liver Cancer Group Instituto do Cancer do Estado de So Paulo Hospital das Clínicas Department of Radiology University of So Paulo School of Medicine So Paulo Clínicas Liver Cancer Group Instituto do Cancer do Estado de So Paulo Hospital das Clínicas Department of Pathology University of So Paulo School of Medicine

AIM: To evaluate outcomes of radiofrequency ablation (RFA) therapy for early hepatocellular carcinoma (HCC) and identify survival- and recurrence-related factors.

关键词： Hepatocellular carcinoma Radiofrequency ablation Overall survival Disease-free survival

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

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

引用

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

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Image processing methods to evaluate tomato and zucchini damage in post-harvest stages

引用

International Journal of Agricultural and Biological Engineering 2017年第5期10卷 126-133页

作者： josé antonio Alvarez-Bermejo Cynthia Giagnocavo Li Ming Encarnación Castillo Morales Diego P.Morales Santos Yang Xinting Department of Informatics CeiA3University of AlmeriaAlmeriaCP 04120Spain Cátedra(Chair)Coexphal-UAL of Horticulture Cooperative Studies and Sustainable DevelopmentUniversity of AlmeríaSpain Beijing Research Center for Information Technology in Agriculture/National Engineering Research Center for Information Technology in Agriculture/National Engineering Laboratory for Agri-product Quality Traceability/Key Laboratory for Information Technologies in Agriculture Ministry of AgricultureBeijing 100097China Department of Electronics and Computer Technology Facultad de CienciasGranadaCP 18071Spain

Through the supply chain,the quality or quality change of the products can generate important *** quality control in some steps is made manually that supposes a high level of subjectivity,controlling the quality and its evolution using automatic systems can suppose a reduction of the *** some automatic image analysis techniques in the case of tomatoes and zucchini is the main objective of this *** steps in the supply chain are considered,the feeding of the raw products into the handling chain(because low quality generates a reduction of the chain productivity)and the cool storage of the processed products(as the value at the market is reduced).It was proposed to analyze the incoming products at the head the processing line using CCD cameras to detect low quality and/or dirty products(corresponding to specific farmers/suppliers,it should be asked to improve to maintain the productivity of the line).The second stage is analyzing the evolution of the products along the cool chain(storage and transport),the use of an App developed to be use under Android was proposed to substitute the“visual”evaluation used in *** algorithms used,including stages of pre-treatment,segmentation,analysis and presentation of the results take account of the short time available and the limited capacity of the *** performance techniques were applied to the homography stage to discard some of the images,resulting in better *** threads and renderscript kernels were created to parallelize the methods used on the resulting images being able to inspect faster the *** proposed method achieves success rates comparable to,and improving,the expert inspection.

关键词： image processing color space smartphone efficient stitching homography controlled supervision artificial vision embedded parallel processing injury assessment traceability post-harvest control feature detection

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Tolerance in liver transplantation: Biomarkers and clinical relevance

引用

World Journal of Gastroenterology 2016年第34期22卷 7676-7691页

作者： Alberto Baroja-Mazo Beatriz Revilla-Nuin Pascual Parrilla Laura Martínez-Alarcón Pablo Ramírez josé antonio Pons Biomedical Research Institute of Murcia (IMIB-Arrixaca-UMU) 30120 Murcia Spain Division of Gastroenterology and Hepatology and Liver Transplant Unit University Hospital Virgen de la Arrixaca 30120 Murcia Spain

Transplantation is the optimal treatment for end-stage organ failure,and modern immunosuppression has allowed important progress in short-term outcomes. However,immunosuppression poorly influences chronic rejection and elicits chronic toxicity in current clinical practice. Thus,a major goal in transplantation is to understand and induce tolerance. It is well established that human regulatory T cells expressing the transcription factor Fox P3 play important roles in the maintenance of immunological self-tolerance and immune homeostasis. The major regulatory T cell subsets and mechanisms of expansion that are critical for induction and long-term maintenance of graft tolerance and survival are being actively investigated. Likewise,other immune cells,such as dendritic cells,monocyte/macrophages or natural killer cells,have been described as part of the process known as "operational tolerance". However,translation of these results towards clinical practice needs solid tools to identify accurately and reliably patients who are going to be tolerant. In this way,a plethora of genetic and cellular biomarkers is raising and being validated worldwide in large multicenter clinical trials. Few of the studies performed so far have provided a detailed analysis of the impact of immunosuppression withdrawal on pre-existing complications derived from the long-term administration of immunosuppressive drugs and the side effects associated with them. The future of liver transplantation is aimed to develop new therapies which increase the actual low tolerant vs non-tolerant recipients ratio.

关键词： Liver transplantation Operational tolerance Regulatory T cells Dendritic cells Biomarkers

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Plasma betatrophin levels in patients with liver cirrhosis

引用

World Journal of Gastroenterology 2015年第37期21卷 10662-10668页

作者： Maria Teresa Arias-Loste Maria Teresa García-Unzueta Susana Llerena Paula Iruzubieta Angela Puente Joaquín Cabezas Carmen Alonso antonio Cuadrado josé antonio Amado Javier Crespo Emilio Fábrega Gastroenterology and Hepatology Unit Marqués de Valdecilla University HospitalInstituto de Investigación Sanitaria ValdecillaAvenida Valdecilla s/n 39008 Santander Cantabria Spain Endocrinology Unit Marqués de Valdecilla University HospitalInstituto de Investigación Sanitaria Valdecilla Avenida Valdecilla s/n 39008 Santander Cantabria Spain

AIM: To investigate the plasma levels of betatrophin in patients with ***: Forty patients diagnosed at the clinic with liver cirrhosis according to biological, ultrasonographic,or histological criteria were *** severity of cirrhosis was classified according to Pugh's modification of Child's classification and MELD score. Insulin resistance(IR) was assessed by the Homeostasis Model Assessment. A total of 20 patients showed a MELD score higher than 14. The control group consisted in 15 sex-and aged-matched *** blood samples were obtained for subsequent analysis. Serum insulin was determined by Liaison automated immune chemiluminiscence assay(DiaSorin S.p.A.) using a sandwich assay. The sensitivity of the assay was 0.2 μU/mL. The intra and interassay variation coefficients were < 4% and < 10%,respectively. The normal values were between 2 and17 μU/mL. Human active betatrophin was analyzed by specific quantitative sandwich ELISA(Aviscera Bioscience). The sensitivity of the assay was 0.4 ng/mL, and the intra and interassay reproducibility were< 6% and < 10%, ***: Plasma betatrophin levels were significantly increased in patients with cirrhosis compared with those in healthy subjects(P = 0.0001). Betatrophin levels were also associated with disease severity, being higher in Child-Pugh C patients compared to Child-Pugh B(P< 0.0005) and in patients who displayed a MELD score higher than 14 points compared to patients with lower punctuation(P = 0.01). In addition, we found a positive correlation between plasma betatrophin levels and the severity of cirrhosis according to Child-Pugh classification(r = 0.53; P < 0.01) or MELD score(r = 0.45; P <0.01). In the overall cohort, a moderate correlation between serum betatrophin and plasmatic bilirrubin(r= 0.39; P < 0.01) has been observed, as well as an inverse correlation between betatrophin and albumin(r =-0.41; P < 0.01) or prothrombin time(r =-0.44;P <0.01). Moreover, insulin

关键词： Liver cirrhosis Betatrophin Insulin resistance Bet

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Multi-year analyses on three populations reveal the first stable QTLs for tolerance to rain-induced fruit cracking in sweet cherry (Prunus avium L.)

引用

Horticulture Research 2021年第1期8卷 1818-1833页

作者： jose Quero-Garcia Philippe Letourmy jose antonio Campoy Camille Branchereau Svetoslav Malchev Teresa Barreneche Elisabeth Dirlewanger INRAE Biologie du Fruit et PathologieUniversitéde BordeauxUMR 1332F-33140 Villenave d’OrnonFrance CIRAD UPR AIDAUniversity of MontpellierTA B-115/02Avenue Agropolis34398 Montpellier Cedex 5France Department of Chromosome Biology Max Planck Institute for Plant Breeding ResearchCarl-von-Linné-Weg50289 CologneGermany Fruit Growing Institute–Plovdiv 12 Ostromila Str.4004 PlovdivBulgaria

Rain-induced fruit cracking is a major problem in sweet cherry *** research has been conducted to disentangle the physiological and mechanistic bases of this complex phenomenon,whereas genetic studies have lagged *** objective of this work was to disentangle the genetic determinism of rain-induced fruit *** hypothesized that a large genetic variation would be revealed,by visual field observations conducted on mapping populations derived from well-contrasted cultivars for cracking *** populations were evaluated over 7–8 years by estimating the proportion of cracked fruits for each genotype at maturity,at three different areas of the sweet cherry fruit:pistillar end,stem end,and fruit *** original approach was adopted to integrate,within simple linear models,covariates potentially related to cracking,such as rainfall accumulation before harvest,fruit weight,and *** found the first stable quantitative trait loci(QTLs)for cherry fruit cracking,explaining percentages of phenotypic variance above 20%,for each of these three types of cracking tolerance,in different linkage groups,confirming the high complexity of this *** these and other QTLs,further analyses suggested the existence of at least two-linked QTLs in each linkage group,some of which showed confidence intervals close to 5 *** promising results open the possibility of developing marker-assisted selection strategies to select cracking-tolerant sweet cherry *** studies are needed to confirm the stability of the reported QTLs over different genetic backgrounds and environments and to narrow down the QTL confidence intervals,allowing the exploration of underlying candidate genes.

关键词： fir cultivar linkage

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Systematic Approach for Web Protection Runtime Tools’Effectiveness Analysis

引用

Computer Modeling in Engineering & Sciences 2022年第12期133卷 579-599页

作者： Tomás Sureda Riera Juan Ramón Bermejo Higuera Javier Bermejo Higuera Juan antonio Sicilia Montalvo josé Javier Martínez Herráiz Computer Science Department University of AlcaláMadrid28801Spain Escuela Superior de Ingeniería y Tecnología Universidad Internacional de La RiojaLogrono26006Spain

Web applications represent one of the principal vehicles by which attackers gain access to an organization’s network or ***,different approaches to protect web applications have been proposed to *** them,the two major approaches are Web Application Firewalls(WAF)and Runtime Application Self Protection(RASP).It is,thus,essential to understand the differences and relative effectiveness of both these approaches for effective decisionmaking regarding the security of web *** we present a comparative study between WAF and RASP simulated settings,with the aim to compare their effectiveness and efficiency against different categories of *** this,we used computation of different metrics and sorted their results using F-Score *** found that RASP tools scored better than WAF *** this study,we also developed a new experimental methodology for the objective evaluation ofweb protection tools since,to the best of our knowledge,nomethod specifically evaluates web protection tools.

关键词： Web Application Firewall(WAF) Runtime Application Self Protection(RASP) F-Score web attacks experimental methodology

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Applications of finite element simulation in orthopedic and trauma surgery

引用

World Journal of Orthopedics 2012年第4期3卷 25-41页

作者： antonio Herrera Elena Ibarz josé Cego?ino antonio Lobo-Escolar Sergio Puértolas Enrique López Jesús Mateo Luis Gracia Department of Orthopaedic and Trauma Surgery Miguel Servet University HospitalMedicine SchoolUniversity of Zaragoza Department of Mechanical Engineering University of Zaragoza

Research in different areas of orthopedic and trauma surgery requires a methodology that allows both a more economic approach and the ability to reproduce different situations in an easy way. Simulation models have been introduced recently in bioengineering and could become an essential tool in the study of any physiological unity, regardless of its complexity. The main problem in modeling with finite elements simulation is to achieve an accurate reproduction of the anatomy and a perfect correlation of the different structures, in any region of the human body. Authors have developed a mixed technique, joining the use of a three-dimensional laser scanner Roland Picza captured together with computed tomography(CT) and 3D CT images, to achieve a perfect reproduction of the anatomy. Finite element(FE) simulation lets us know the biomechanical changes that take place after hipprostheses or osteosynthesis implantation and biological responses of bone to biomechanical changes. The simulation models are able to predict changes in bone stress distribution around the implant, so allowing preventing future pathologies. The development of a FE model of lumbar spine is another interesting application of the simulation. The model allows research on the lumbar spine, not only in physiological conditions but also simulating different load conditions, to assess the impact on biomechanics. Different degrees of disc degeneration can also be simulated to determine the impact on adjacent anatomical elements. Finally, FE models may be useful to test different fixation systems, i.e., pedicular screws, interbody devices or rigid fixations compared with the dynamic ones. We have also developed models of lumbar spine and hip joint to predict the occurrence of osteoporotic fractures, based on densitometric determinations and specific biomechanical models, including approaches from damage and fracture mechanics. FE simulations also allow us to predict the behavior of orthopedic splints applied

关键词： Finite element simulation Hip prosthesis Lumbar spine Lumbar fixations Osteoporotic fractures Splints

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：