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Multicenter application of a nursing workload measurement scale in adult hospitalization units

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International Journal of Nursing Sciences 2022年第4期9卷 460-466,I0002页

作者： María Fuensanta Hellín Gil Marzena Mikla Ana Myriam Seva Llor María Dolores Roldán Valcárcel francisco javier Ibáñez-López María JoséLópez Montesinos University of Murcia MurciaSpain Biomedical Research Institute of Murcia(IMIB) MurciaSpain

Objectives:The study aimed to the multicenter application of a nursing workload measurement scale in the internal medicine and surgery adults hospitalization ***:The study design was a multicenter,observational,and descriptive study.A multicenter application of the MIDENF®nursing workload measurement scale was carried out,which consists of 21 items,and covers the four nursing functions(patient care items,teaching,manager,and researcher),in units of hospitalization of adults of internal medicine and surgery of four different *** item contains one or more of the nursing interventions of Nursing Interventions Classification(NIC)and has an assigned time,after comparing the real time it takes to perform each intervention with the North American Nursing Diagnosis Association(NANDA)standardized *** study was carried out during nine months of the year 2020,measuring two days each month in the three work shifts(morning,evening,and night)to all patients admitted on the days of measurement in the indicated ***:The descriptive and inferential analysis of 11,756 completed scales,5,695 in general surgery and 6,061 in internal medicine,showed a greater care load for the two units during the morning shift(227,034 min in general surgery,261,835 min in internal medicine),especially in the items of“self-care”,“medication”,“common invasive procedures”,“fluid therapy”,and“patient and family support”,while the managerial function was similar during the three work shifts in the two units studied,getting values between 57,348 and 62,*** the analysis by shift and unit,statistical significance was obtained both for the total workload and the four nursing functions(P<0.001).Conclusions:It is shown that the use of validated scales with the standardized language of nursing functions,adapted to the units,provides objective information to adjust the nursing staff to the real situation of care in any hospital and unit where it is applied,improving quality

关键词： Hospital Measurement Nursing administration research Workload

Diversity and Phenology of the Braconid Community (Hymenoptera: Braconidae) in the Mediterranean Protected Landscape of Sierra Calderona (Spain)

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Open Journal of Ecology 2014年第4期4卷 174-181页

作者： Jose Vicente Falcó-Garí francisco javier Peris-Felipo Ricardo Jiménez-Peydró Laboratory of Entomology and Pest Control Institute Cavanilles of Biodiversity and Evolutionary Biology Valencia Spain

The diversity of the Braconidae subfamilies (Hymenoptera) in the protected landscape of the Natural Park of Sierra Calderona (Eastern Spain) is analysed. Samplings have been carried out along 2010 in three different habitats: almond crop, Oak forest (Quercus suber L.) and Pine forest (Pinus halepensis Miller). In total, 2166 braconid specimens, belonging to 23 subfamilies, have been captured. Alpha, beta and gamma diversities are analysed. As a result, almond crop habitat is proven to show the greatest diversity. The structure of the community and the phenology in each habitat are also analysed.

关键词： Braconidae Diversity Community Mediterranean Landscapes Spain

Approximate Metric for a Rotating Deformed Mass

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International Journal of Astronomy and Astrophysics 2015年第1期5卷 1-10页

作者： francisco Frutos-Alfaro Paulo Montero-Camacho Miguel Araya javier Bonatti-González Space Research Center and School of Physics University of Costa Rica San José Costa Rica Nuclear Research Center and School of Physics University of Costa Rica San José Costa Rica

A new Kerr-like metric with quadrupole moment is obtained by means of perturbing the Kerr spacetime. The form of this new metric is simple as the Kerr metric. By comparison with the exterior Hartle-Thorne metric, it is shown that it could be matched to an interior solution. This approximate metric may represent the spacetime of a real astrophysical object with any Kerr rotation parameter a and slightly deformed.

关键词： Approximate Solutions of Einstein Equations Kerr Metric Erez-Rosen Metric Quadrupole

Use of Interventional Neuroradiology Devices (Solitaire AB and Cascade Net) in the Treatment of Complex Renal Aneurysms through Stent-Assisted Coil Embolisation

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Surgical Science 2021年第11期12卷 365-373页

作者： Eva Pampín Fernando López francisco javier Maynar Rebeca Bastida Amaya Iturralde Deparment of Interventional Radiology of HUA Spain

Introduction: The risk of rupture of true renal artery aneurysms is low but when they are bigger than 2 - 2.5 cm it increases significantly, making treatment essential. The need to use alternatives to conventional techniques in order to avoid predictable complications as coil migration is mandatory. Discussion: Routinely-used techniques in interventional neuroradiology such as flow diverters or those assisted with an occlusion balloon or stent have are suitable alternatives for complex aneurysms. Conclusion: Interventional neuroradiology devices such as the Cascade Net stent (Perflow Medical and Grupo Logsa) and Solitaire AB stent retriever (Medtronic) are valid and safe options. We describe the technique of such devices.

关键词： Embolisation Aneurysm Renal Technique Devices Neuroradiology

Determining the need for a thoracoscopic approach to treat a giant hiatal hernia when abdominal access is poor

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World Journal of Gastrointestinal Surgery 2023年第12期15卷 2739-2746页

作者： francisco javier Pérez Lara Rogelio Zubizarreta Jimenez Tatiana Prieto-Puga Arjona Pilar Gutierrez Delgado Juan Manuel Hernández Carmona Jose Manuel Hernández Gonzalez Maria Pitarch Martinez Department of Surgery Hopital de AntequeraAntequera 29200Spain DOXA MicrofluidicsRincon de la Victoria 29730Spain Department of Surgery HRU Carlos HayaUnidad Cirugia Hepatobiliopancreat&TrasplantesMalaga 29200Spain

BACKGROUND Giant hernias present a significant challenge for digestive *** approach taken(laparoscopic vs thoracoscopic)depends largely on the preferences and skills of each surgeon,although in most cases today the laparoscopic approach is *** To determine whether patients presenting inadequate laparoscopic access to the intrathoracic hernial sac obtain poorer postoperative results than those with no such problem,in order to assess the need for a thoracoscopic *** For the retrospective series of patients treated in our hospital for hiatal hernia(n=112),we calculated the laparoscopic field of view and the working area accessible to surgical instruments,by means of preoperative imaging tests,to assess the likely outcome for cases inaccessible to *** Patients with giant hiatal hernias for whom a preoperative calculation suggested that the laparoscopic route would not access all areas of the intrathoracic sac presented higher rates of perioperative complications and recurrence during follow-up than those for whom laparoscopy was *** difference was statistically ***,the insertion of mesh did not improve results for the non-accessible *** For patients with giant hiatal hernias,it is essential to conduct a preoperative evaluation of the angle of vision and the working area for *** parts of the intrathoracic sac are inaccessible laparoscopically,the thoracoscopic approach should be considered.

关键词： Hiatal hernia Abdominal surgery Laparoscopy Thoracoscopy surgery

Tenofovir vs lamivudine plus adefovir in chronic hepatitis B:TENOSIMP-B study

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World Journal of Gastroenterology 2017年第41期23卷 7459-7469页

作者： Manuel Rodríguez Juan Manuel Pascasio Enrique Fraga javier Fuentes Martín Prieto Gloria Sánchez-Antolín Jose Luis Calleja Esther Molina María Luisa García-Buey María Angeles Blanco javier Salmerón María Lucía Bonet Jose Antonio Pons Jose Manuel González Miguel Angel Casado francisco Jorquera 无 Division of Gastroenterology and Hepatology.Hospital Universitario Central de Asturias Unit for the Clinical Management of Digestive Diseases IBISHospital Universitario Virgen del Rocío Liver Transplantation and Hepatology Unit Gastroenterology ServiceHospital Universitario Reina Sofía Digestive Medicine Service Hospital Universitario Miguel Servet Hepatology Unit Digestive Medicine ServiceHospital Universitari i Politècnic La Fe Hepatology Unit Hospital Universitario Rio Hortega Liver Unit Hospital Universitario Puerta de Hierro de MajadahondaUniversidad Autónoma de Madrid Digestive Medicine Service Hospital Clínico de Santiago de Compostela Liver Unit Hospital Universitario de La Princesa Digestive Medicine Service Hospital General Universitario Gregorio Maranon Digestive Medicine Unit Complejo Hospitalario de Granada Digestive Medicine Service Hospital Universitario Son Espases Hepatology Unit IMIB Hospital Universitario Virgen de la Arrixaca Digestive Medicine Service Hospital Clínico Universitario de Valladolid Pharmacoeconomics and Outcomes Research Iberia Division of Gastroenterology and Hepatology Complejo Asistencial Universitario de León the TENOSIMP-B Research Group

AIM To demonstrate the non-inferiority(15% non-inferiority limit) of monotherapy with tenofovir disoproxil fumarate(TDF) vs the combination of lamivudine(LAM) plus adefovir dipivoxil(ADV) in the maintenance of virologic response in patients with chronic hepatitis B(CHB) and prior failure with *** This study was a Phase IV prospective, randomized, open, controlled study with 2 parallel groups(TDF and LAM+ADV) of adult patients with hepatitis B e antigen(HBe Ag)-negative CHB, prior failure with LAM, on treatment with LAM+ADV for at least 6 mo, without prior resistance to ADV and with an undetectable viral load at the start of the study, in 14 Spanish hospitals. The follow-up time for each patient was 48 wk after randomization, with quarterly visits in which the viral load, biochemical and serological parameters, adverse effects, adherence to treatment and consumption of hospital resources were *** Forty-six patients were evaluated [median age: 55.4 years(30.2-75.2); 84.8% male], including 22 patients with TDF and 24 with LAM+ADV. During study development, hepatitis B virus DNA(HBV-DNA) remained undetectable, all patients remained HBe Ag negative, and hepatitis B surface antigen(HBs Ag) positive. Alanine aminotransferase(ALT) values at the end of the study were similar in the 2 groups(25.1± 7.65, TDF vs 24.22 ± 8.38, LAM+ADV, P = 0.646). No significant changes were observed in creatinine or serum phosphorus values in either group. No significant differences between the 2 groups were noted in the identification of adverse effects(AEs)(53.8%, TDF vs 37.5%, LAM+ADV, P = 0.170), and none of the AEs which occurred were serious. Treatment adherence was 95.5% and 83.3% in the TDF and the LAM+ADV groups, respectively(P = 0.488). The costs associated with hospital resource consumption were significantly lower with the TDF treatment than the LAM+ADV treatment(€4943 ± 1059 vs €5811 ± 1538, respectively, P < 0.001).CONCLUSION TDF monotherapy proved to be safe

关键词： Tenofovir Lamivudine+Adefovir Efficacy Safety Adherence Costs Hepatitis B

Prevalence of hepatocarcinoma-related hepatitis B virus mutants in patients in grey zone of treatment

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World Journal of Gastroenterology 2019年第38期25卷 5883-5896页

作者： Ana Isabel Gil-García Antonio Madejón Irene francisco-Recuero Ana López-López Emiliana Villafranca Miriam Romero Araceli García Antonio Olveira Rocío Mena Juan Ramón Larrubia javier García-Samaniego Hepatology Unit Hospital Universitario La PazMadrid 28046Spain Centro de Investigación Biomédica en Red Instituto de Salud Carlos IIIMadrid 28029Spain Instituto de Investigación del Hospital Universitario la Paz Madrid 28046Spain Biochemistry Department Faculty of MedicineUniversidad Autónoma de MadridMadrid 28029Spain Instituto de Genética Médica y Molecular Hospital Universitario La PazMadrid 28046Spain Translational Hepatology Unit Hospital General Universitario de GuadalajaraGuadalajara 19002Castilla-La ManchaSpain

BACKGROUND Antiviral treatment of patients with chronic hepatitis B(CHB)in the grey zone of treatment comands risk management in order to optimize the health *** this sense,the identification of HBV mutants related with an increased risk of hepatocellular carcinoma(HCC)could be useful to identify subpopulations with potential indication of antiviral *** To analyze the prevalence/persistence of hepatitis B virus(HBV)preS and basal core promoter(BCP)/precore/core variants associated to HCC development in CHB patients in the grey *** Work was designed as a longitudinal retrospective study,including 106 plasma samples from 31 patients with CHB in the grey zone of treatment:Hepatitis B e antigen negative,HBV-DNA levels between 12-20000 IU/mL,normal or discordant transaminase levels during follow up and mild/moderate necroinflammatory activity in liver biopsy or Fibroscan(up to 9.5 kPa).Serum HBVDNA was tested using the Abbott Real Time HBV Assay and the BCP/precore/core and the hepatitis B surface antigen(HBsAg)coding regions were analyzed in positive samples by PCR/bulk-sequencing to identify the HCCrelated HBV *** High-risk HCC related mutants were detected in 24(77%)patients:19(61%)in the BCP/precore/core,and 7(23%)in the HBsAg coding region(2 preS1 and 5 preS2 deletions).The prevalence of preS deletions was genotype-dependent:3/5(60%)patients with preS2 deletions and 1/2 with preS1 deletions were infected with the HBV-E *** HBV-E was the most prevalent in sub-Saharan patients,a correlation between preS deletions and ethnicity was also found:6/8(75%)sub-Saharan vs 1/19(5%)Caucasian patients had preS deletions(P=0.00016).Remarkably,this correlation was maintained in those patients infected with HBV-A,a minor genotype in sub-Saharan patients:2/2 patients infected with HBV-A from West Africa vs 0/6 of Caucasian origin had preS *** HCC related variants were the major strains and persisted over time(up to 48 mo).Pa

关键词： Hepatitis B virus Hepatocellular carcinoma PreS deletions Hepatitis B virus treatment Grey zone

Management of nonalcoholic fatty liver disease:An evidence-based clinical practice review

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World Journal of Gastroenterology 2014年第34期20卷 12182-12201页

作者： Juan P Arab Roberto Candia Rodrigo Zapata Cristián Mu?oz Juan P Arancibia Jaime Poniachik Alejandro Soza francisco Fuster javier Brahm Edgar Sanhueza Jorge Contreras M Carolina Cuellar Marco Arrese Arnoldo Riquelme Departamento de Gastroenterología Escuela de MedicinaPontificia Universidad Católica de Chile8330024 SantiagoChile Sección de Gastroenterología Hospital del SalvadorEscuela de MedicinaUniversidad de Chile7500922 SantiagoChile Unidad de Gastroenterología Universidad del DesarrolloClínica Alemana7650568 SantiagoChile Unidad de Trasplante Hepático Hospital del SalvadorUnidad de GastroenterologíaClínica Las Lilas7510524 SantiagoChile Sección de Gastroenterología Departamento de MedicinaHospital Clínico Universidad de ChileChile8380456 SantiagoChile Sección de Gastroenterología Hospital Clínico Universidad de ChileEscuela de MedicinaUniversidad de Chile8380456 SantiagoChile Digestive Diseases Unit Clínica Re?aca2540364 Vi?a del MarChile Gastroenterology Department Clínica Las Condes6770128 SantiagoChile Centre for Medical Education Escuela de MedicinaPontificia Universidad Católica de Chile8330024 SantiagoChile

AIM: To build a consensus among Chilean specialists on the appropriate management of patients with nonalcoholic fatty liver disease (NAFLD) in clinical practice.

关键词： Nonalcoholic fatty liver disease Steatosis Consensus Evidence-based medicine Treatment

A tumor-associated heparan sulfate-related glycosaminoglycan promotes the generation of functional regulatory T cells

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Cellular & Molecular Immunology 2023年第12期20卷 1499-1512页

作者： Leticia Martín-Cruz Marcos Viñuela Ioanna Kalograiaki Alba Angelina Paola Oquist-Phillips Irene Real-Arévalo francisco javier Cañada JoséIgnacio Tudela Luis Moltó Jesús Moreno-Sierra JoséLuis Subiza Oscar Palomares Department of Biochemistry and Molecular Biology School of ChemistryComplutense University of MadridMadridSpain Inmunotek Alcaláde HenaresMadridSpain Fundación Investigación Hospital Clínico San Carlos Martin Lagos s/n28040MadridSpain Centro de Investigaciones Biológicas Margarita Salas CSICRamiro de Maetzu 928040MadridSpain CIBER de Enfermedades Respiratorias(CIBERES)Avda Monforte de Lemos3-528029MadridSpain Servicio de Urología Hospital Clínico San CarlosUniversidad Complutense de MadridMartín Lagos s/n28040MadridSpain

Functional Tregs play a key role in tumor development and progression,representing a major barrier to anticancer *** mechanisms by which Tregs are generated in cancer and the influence of the tumor microenvironment on these processes remain incompletely ***,by using NMR,chemoenzymatic structural assays and a plethora of in vitro and in vivo functional analyses,we demonstrate that the tumoral carbohydrate A10(Ca10),a cell-surface carbohydrate derived from Ehrlich’s tumor(ET)cells,is a heparan sulfate-related proteoglycan that enhances glycolysis and promotes the development of tolerogenic features in human ***10-stimulated human DCs generate highly suppressive Tregs by mechanisms partially dependent on metabolic reprogramming,PD-L1,IL-10,and ***10 also reprograms the differentiation of human monocytes into DCs with tolerogenic *** solid ET-bearing mice,we found positive correlations between Ca10 serum levels,tumor size and splenic Treg *** of isolated Ca10 also increases the proportion of splenic Tregs in tumor-free ***,we provide evidence supporting the presence of a circulating human Ca10 counterpart(Ca10H)and show,for the first time,that serum levels of Ca10H are increased in patients suffering from different cancer types compared to healthy *** note,these levels are higher in prostate cancer patients with bone metastases than in prostate cancer patients without ***,we reveal novel molecular mechanisms by which heparan sulfate-related structures associated with tumor cells promote the generation of functional Tregs in *** discovery of this novel structural-functional relationship may open new avenues of research with important clinical implications in cancer treatment.

关键词： Tumoral carbohydrate A10 Heparan sulfate-related proteoglycan Cancer immunology Dendritic cell Regulatory T cell