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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

A new strategy for corrosion protection of porous stainless steel using polypyrrole films

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Journal of Materials Science & Technology 2020年第2期37卷 85-95页

作者： c.garcia-cabezon c.garcia-Hernandez M.L.Rodriguez-Mendez F.Martin-Pedrosa Materials engineering E.I.I.Universidad de Valladolid47011 ValladolidSpain UVASeNS E.I.I.Universidad de Valladolid47011 ValladolidSpain

In this work,a method to improve the protection against corrosion of porous sintered stainless steel is *** is based on the electrodeposition of polypyrrole(PPy)layers doped with a large size counterion such as dodecylbenzenesulphonic acid(DBSA),a conducting polymer with high corrosion resistance and good *** efficacy of PPy coating depends on the adequate adhesion between the metal substrate and the coating *** protection against corrosion has been tested using 316 L stainless steel(SS)powder sintered at different conditions to evaluate the effect of the sintering atmosphere(nitrogen and vacuum)and cooling rates(furnace and water)on corrosion resistance,while wrought 316 L SS has been used as reference *** addition,two electrochemical deposition techniques have been tested to select the most *** circuit potential evolution,anodic polarization measurements and electrochemical impe.a.c. spectra have been used to evaluate corrosion protection in phosphate buffer saline *** has been evidenced that a more homogeneous and stable coating was obtained in the case of porous stainless *** corrosion potential shifted to nobler values and the anodic polarization branch became more *** porous samples have a good passivation performance with a lower stable passive current density and a higher breakdown *** transfer electronic resistance and the impe.a.c. module increase more than one order of ***,the porosity of sintered stainless steel is seen as an advantage for the improvement of the adherence of the PPy *** best corrosion protection is found for samples sintered in nitrogen and water-cooled.

关键词： Stainless steel Powder metallurgy Protection corrosion electrodeposited films Polymer coatings

How to Make capsules containing Rejuvenators for Their Use in Asphalt concrete

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武汉理工大学学报 2010年第17期32卷 18-21,34页

作者： garcia A ScHLANGeN e VAN De VeN M F c Faculty of civil engineering and Geosciences Delft University of TechnologyMICROLAB2628CN DelftThe Netherlands Faculty of civil engineering and Geosciences Road and Railway EngineeringDelft University of Technology2628CN DelftThe Netherlands

Rejuvenators are products designed to restore original properties to oxidized asphalt binders by restoring the original ratio of asphaltenes to maltenes. But,for a rejuvenator to be successful,it must penetrate the pavement surface. Besides,application of a rejuvenator will also reduce the skid resistance of the pavement. To solve this,these rejuvenators can be encapsulated and mixed in asphalt concrete. Once the stress in the capsules reaches a certain threshold,the particles break and the rejuvenator is released,giving back the original properties of the pavement. The objective of this paper is to show how these capsules behave and define the most appropriate testing methods to find their effect on asphalt concrete. For this,two different types of rejuvenators will be encapsulated and their effect on the properties of the capsules investigated. Besides,the release mechanisms of the capsules will be unravelled.

关键词： asphalt concrete rejuvenators encapsulation ageing

NecAB family of neuronal calcium-binding proteins in health and disease

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Neural Regeneration Research 2025年第5期20卷 1236-1243页

作者： Diones Bueno Michael K.e.Schafer Sudena Wang Michael J.Schmeisser Axel Methner Institute for Molecular Medicine University Medical Center of the Johannes Gutenberg-UniversityMainzGermany Department of Anesthesiology University Medical Center of the Johannes Gutenberg-UniversityMainzGermany Institute of Anatomy University Medical Center of the Johannes Gutenberg-UniversityMainzGermany

The N-terminal eF-hand calcium-binding proteins 1–3(NecAB1–3) constitute a family of predominantly neuronal proteins characterized by the presence of at least one eF-hand calcium-binding domain and a functionally less well characterized c-terminal antibiotic biosynthesis monooxygenase domain. All three family members were initially discovered due to their interactions with other proteins. NecAB1 associates with synaptotagmin-1, a critical neuronal protein involved in membrane trafficking and synaptic vesicle exocytosis. NecAB2 interacts with predominantly striatal G-protein-coupled receptors, while NecAB3 partners with amyloid-β A4 precursor protein-binding family A members 2 and 3, key regulators of amyloid-β production. This demonstrates the capacity of the family for interactions with various classes of proteins. NecAB proteins exhibit distinct subcellular localizations: NecAB1 is found in the nucleus and cytosol, NecAB2 resides in endosomes and the plasma membrane, and NecAB3 is present in the endoplasmic reticulum and Golgi apparatus. The antibiotic biosynthesis monooxygenase domain, an evolutionarily ancient component, is akin to atypical heme oxygenases in prokaryotes but is not wellcharacterized in vertebrates. Prokaryotic antibiotic biosynthesis monooxygenase domains typically form dimers, suggesting that calcium-mediated conformational changes in NecAB proteins may induce antibiotic biosynthesis monooxygenase domain dimerization, potentially activating some enzymatic properties. However, the substrate for this enzymatic activity remains uncertain. Alternatively, calcium-mediated conformational changes might influence protein interactions or the subcellular localization of NecAB proteins by controlling the availability of protein–protein interaction domains situated between the eF hands and the antibiotic biosynthesis monooxygenase domain. This review summarizes what is known about genomic organization, tissue expression, intracellular localization, interac

关键词： calcium eF hand mitochondria nervous system signal transduction

corrosion behavior of hypoeutectic Al-cu alloys in H_2SO_4 and Nacl solutions

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Acta Metallurgica Sinica(english Letters) 2009年第4期22卷 241-246页

作者： Wislei R.Osório Leandro c.Peixoto Leonardo R.garcia Amauri garcia Department of Materials engineering University of Campinas-UNICAMP

The aim of this work was to evaluate the electrochemical behaviour of hypoeutectic Al-cu alloys immersed in two different solutions containing sulphate and chloride ions, respectively. The influence of Al2cu associated to the dendritic arm spacing on the general corrosion resistance of such alloys is analysed. The typical microstructural pattern was examined by using scanning electron microscope. The corrosion tests were performed in both 0.5 M sulphuric acid and 0.5 M Nacl solutions at 25℃ by using an electrochemical impe.a.c. spectroscopy （eIS） technique and potentiodynamic polarization curves. equivalent circuits by using the ZView software, were also used to provide quantitative support for the discussions. It was found that as the cu content increased （i.e., increasing the Al2cu fraction）, a higher susceptibility to the corrosion action in the Nacl solution is detected. In contrast, the tests carried out in the H2SO4 solution resulted in similar corrosion,rates for the three different hypoeutectic alloys.

关键词： Al-cu alloys Al2cu corrosion Microstructure castings

corrosion and passive film characteristics of 3D-printed NiTi shape memory alloys in artificial saliva

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Rare Metals 2023年第9期42卷 3114-3129页

作者： Ming Liu Jia-Ning Zhu V.A.Popovich e.Borisov J.M.c.Mol Y.Gonzalez-garcia State Key Laboratory for Mechanical Behavior of Materials Center for Advancing Materials Performance from the Nanoscale(CAMP-Nano)Xi’an Jiaotong UniversityXi’an710049China Department of Materials Science and engineering Delft University of TechnologyAA Delft2600The Netherlands Peter the Great Saint-Petersburg Polytechnic University Saint Petersburg195251Russia

electrochemical tests and surface analysis were applied to study the corrosion behavior and passive film characteristics of three-dimensional-printed NiTi shape memory alloys fabricated by laser-powder bed fusion(LPBF) in artificial saliva at 37.c. The passivity of L-PBF NiTi shows to be influenced by the process parameters and resulting morphological and physicochemical surface properties. The results show that the defects at the surface of L-PBF Ni Ti can promote the passivation rate in the early stages of exposure but a slowly formed passive film shows the best corrosion protection. The thickness of the passive film is positively correlated with its corrosion protective performance. The L-PBF NiTi alloy prepared at a linear energy density of 0.2 J·m^(-1) and volumetric energy density of 56 J·mm^(-3) shows the least defects and best corrosion protection. An outer Ti-rich and inner Ni-rich dense passive film could be also obtained showing higher corrosion resistance.

关键词： NiTi Laser-powder bed fusion(L-PBF) Passive film corrosion resistance Artificial saliva

Microstructural Morphologies and experimental Growth Laws during Solidification of Monotectic and Hypermonotectic Al-Pb Alloys

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Journal of Materials Science & Technology 2014年第4期30卷 401-407页

作者： Adrina P.Silva Amauri garcia José e.Spinelli Department of Materials engineering University of Campinas-UNICAMP Department of Materials engineering Federal University of Sao Carlos-UFSCar

AI-Pb alloys with monotectic and hypermonotectic compositions were directionally solidified under unsteady- state heat flow conditions. The cooling curves recorded during solidification allowed solidification thermal parameters such as the cooling rate （T）, growth rate （v） and thermal gradient （G） to be experimentally determined. Different microstructural patterns have been associated with the alloy solute content, i.e., AI-1.2 and 2.1 wt% Pb. A sequence of morphologies from the bottom to the top of the A1-1.2 wt% Pb alloy casting （monotectic） can be observed： Pb-rich droplets in the aluminum-rich matrix, followed by a region of microstructural transition formed by droplets and fibers and finally by a mixture of fibers and strings of pearls. A completely fibrous structure （without transition） has been observed along the entire AI-2.1 wt% Pb alloy casting （hypermonotectic）. The interphase spacing （λ） was measured along the casting length, and experimental correlations between λand experimental solidification thermal parameters have been established. Power laws with a -2.2 exponent expressing λ as a function of the growth rate, v, were found to better represent the fibrous growth of both AI-Pb alloys. Moreover, a single experimental law expressing λ as a function of both G and v was found to describe the fibrous growth of both the monotectic and the hypermonotectic alloys experimentally examined.

关键词： Aluminum alloys casting Phase transformation

effects of TNF receptor blockade on in vitro cell survival and response to negative energy balance in dairy cattle

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Journal of Animal Science and Biotechnology 2018年第2期9卷 430-438页

作者： c.A.Martel L.K.Mamedova J.e.Minton M.garcia c.Legallet B.J.Bradford Department of Animal Sciences and Industry Kansas State University

Background: Associative data and some controlled studies suggest that the inflammatory cytokine tumor necrosis factor(TNF) α can induce fatty liver in dairy cattle. However, research demonstrating that TNFα is a necessary component in the etiology of bovine fatty liver is lacking. The aim of this work was to evaluate whether blocking TNFα signaling with a synthetic cyclic peptide(TNF receptor loop peptide; TRLP) would improve liver metabolic function and reduce triglyceride.a.c.mulation during feed ***: capability of TRLP to inhibit TNFα signaling was confirmed on primary bovine hepatocytes treated with recombinant bovine TNFα and 4 doses of TRLP(0, 1, 10, 50 μmol/L) over 24 h. Next, 4 lactating Holstein cows(parity 1.4 ± 0.5, 433 ± 131 d in milk) in an incomplete Latin rectangle design(3 × 2) were subcutaneously administered with different TRLP doses(0, 1.5, 3.0 mg/kg BW) every 4 h for 24 h, followed by an intravenous injection of TNFα(5 μg/kg BW). Before and for 2 h after TNFα injection, TRLP decreased plasma non-esterified fatty acid(Ne.a.c.ncentration(P ≤ 0.05), suggesting an altered metabolic response to inflammation. Finally, 10 non-pregnant, nonlactating Holstein cows(3.9 ± 1.1 yr of age) were randomly assigned to treatments: control(carrier: 57% DMSO in PBS)or TRLP(1.75 mg TRLP/kg BW per day). Treatments were administrated every 4 h for 7 d by subcutaneous injection to feed-restricted cows fed 30% of mainte.a.c. energy requirements. Daily blood samples were analyzed for glucose,insulin, β-hydroxybutyrate, NeFA, and haptoglobin concentrations, with no treatment effects detected. On d 7, cows completed a glucose tole.a.c. test(GTT) by i.v. administration of a dextrose bolus(300 mg glucose/kg BW). Glucose,insulin, and NeFA responses failed to demonstrate any significant effect of treatment during the GTT. However, plasma and liver analyses were not indicative of dramatic lipolysis or hepatic lipidosis, suggesting that the feed restriction protoc

关键词： Dairy cows Fatty liver Glucose tole.a.c. test Tumor necrosis factorα

Mitochondrial Sulfide Detoxification Requires a Functional Isoform O-Acetylserine（thiol）lyase c in Arabidopsis thaliana

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Molecular Plant 2012年第6期5卷 1217-1226页

作者： consolacien Alvarez Irene garcia Luis c Romero cecilia Gotor Instituto de Bioquimica Vegetal y Fotosintesis Consejo Superior de Investigaciones Cientificas y Universidad de Sevilla Avda. Am~rico Vespucio 49 41092Sevilla Spain

In non-cyanogenic species, the main source of cyanide derives from ethylene and camalexin biosyntheses. In mitochondria, cyanide is a potent inhibitor of the cytochrome c oxidase and is metabolized by the β-cyanoalanine synthase cYS-c1, catalyzing the conversion of cysteine and cyanide to hydrogen sulfide and β-cyanoalanine. The hydrogen sulfide released also inhibits the cytochrome c oxidase and needs to be detoxified by the O-acetylserine（thiol）lyase mitochondrial isoform, OAS-c, which catalyzes the incorporation of sulfide to O-acetylserine to produce cysteine, thus generating a cyclic pathway in the mitochondria. The loss of functional OAS-c isoforms causes phenotypic characteristics very similar to the loss of the cYS-c1 enzyme, showing defects in root hair formation. Genetic complementation with the OAS-cgene rescues the impairment of root hair elongation, restoring the wild-type phenotype. The mitochondria compromise their capacity to properly detoxify cyanide and the resulting sulfide because the latter cannot re-assimilate into cysteine in the oas-c null mutant. consequently, we observe an accumulation of sulfide and cyanide and of the alternative oxidase, which is unable to prevent the production of reactive oxygen species probably due to the.a.c.mulation of both toxic molecules. Our results allow us to suggest that the significance of OAS-c is related to its role in the proper sulfide and cyanide detoxification in mitochondria.

关键词： alternative oxidase Arabidopsis thaliana cysteine cyanide β-cyanoalanine synthase O-acetylserine(thiol)-lyase reactive oxygen species root hair sulfide.