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caregiver Burden in the management of Frail Elderly Patients with Diabetes in Internal medicine

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Health 2018年第10期10卷 1383-1391页

作者： Jose miguel Segui Ripoll Vicente Jesús Segui Llinares miguel J.Reig Pérez carles García Cervera Juan manuel núnez Cruz Pedro Esteve Atiénzar Sara Banón Escandell Alberto López Serrano maría Dolores Jover Ríos Juan méndez mora carmen Segui Pérez maría Josefa navarro navarro Pablo Roig Rico Department of Internal medicine University Hospital of San JuanAlicanteSpain Department of Clin.cal medicine Miguel Hernández UniversityElcheSpain Institute of Design and manufacturing Polytechnic University of ValenciaCampus of AlcoyAlicanteSpain Department of Internal medicine Hospital La Vega Baja of OrihuelaAlicanteSpain Secondary School Marist Brothers High SchoolAlicanteSpain Primary medicine BenillobaSpain

Aim: Advanced age and fragility often lead to dependence, making caregiver assistance necessary for performing the activities of daily living. Patients with diabetes are characterized by an elevated presence of comorbidities and subsequent frailty—a relevant consideration when making decisions regarding treatment goals. Health professionals may overlook the caregiver experience when assessing the circumstances surrounding frail elderly patients with diabetes, but this factor can have a large impact on relevant caregiver and patient outcomes. methods: An observational, retrospective study was carried out to assess the impact of improved management in diabetes on.caregiver burden. We assessed patients’ performance of activities of daily living using the Barthel scale. Our primary outcome was caregiver burden, as assessed using the Zarit scale. Results: At baseline, 81.4% of the caregivers reported severe overburden (>55 points on the Zarit scale). At three months, the proportion of caregivers reporting this level of burden had dropped to 76.7% and remained stable at six months (77.1%). In contrast, 8.5% of the caregivers reported moderate overburden (47 to 55 points) at baseline, compared to 13.3% at three months and 12.5% at six. The proportion of caregivers reporting no overburden (Conclusions: caregiver burden remained persistently high, decreasing only slightly after six months.

关键词： Elderly Diabetes Frail Patient Overload caregiver

multiplexed Biosensing Diagnostic Platforms Detecting Autoantibodies to Tumor-Associated Antigens from Exosomes Released by CRC Cells and Tissue Samples Showed High Diagnostic Ability for Colorectal cancer

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Engineering 2021年第10期7卷 1393-1412页

作者： Ana montero-calle Itziar Aranguren-Abeigon maría Garranzo-Asensio carmen Poves maría Jesús Fernández-Aceñero Javier martínez-Useros Rodrigo sanz Jana Dziaková Javier Rodriguez-Cobos Guillermo Solís-Fernández Eloy Povedano maria Gamella Rebeca magnolia Torrente-Rodríguez miren Alonso-navarro Vivian de los Ríos J.Ignacio casal Gemma Domínguez Ana Guzman-Aranguez Alberto Peláez-García Josémanuel Pingarrón Susana campuzano Rodrigo Barderas Chronic Disease Program(UFIEC) Carlos III Health InstituteMadrid E-28220Spain Department of Biochemistry and molecular Biology Faculty of Optics and OptometryComplutense University of MadridMadrid E-28040Spain Gastroenterology Unit San Carlos Clinical HospitalMadrid E-28040Spain Surgical Pathology Department San Carlos Clinical HospitalMadrid E-28040Spain Translational Oncology Division OncoHealth InstituteJimenez Diaz Foundation University HospitalMadrid E-28040Spain Department of Biochemistry Faculty of MedicineAlberto Sols Institute of Biomedical ResearchCSIC-UAMMadrid E-28029Spain Department of Analytical Chemistry Faculty of Chemical SciencesComplutense University of MadridMadrid E-28040Spain Center for Biological Research Spanish National Research Council(CSIC)MadridE-28040Spain molecular Pathology and Therapeutic Targets Group La Paz University Hospital(IdiPAZ)Madrid E-28046Spain

Colorectal cancer(CRC)is the second leading cause of cancer-related death *** five-year survival rate of CRC patients depends on the stage at diagnosis,being higher than 80%when CRC is diagnosed in the early stages but lower than 10%when CRC is diagnosed in advanced *** against specific CRC autoantigens(tumor-associated antigens(TAAs))in the sera of patients have been widely demonstrated to aid in early ***,we herein aim to identify autoantigens target of autoantibodies specific to CRC that possess a significant ability to discriminate between CRC patients and healthy individuals by means of liquid *** that end,we examined the protein content of the exosomes released by five CRC cell lines and tissue samples from CRC patients by means of immunoprecipitation coupled with mass spectrometry analysis.A total of 103 proteins were identified as potential autoantigens specific to *** bioinformatics and meta-analysis,we selected 15 proteins that are more likely to be actual CRC autoantigens in order to evaluate their role in CRC prognosis by Western blot(WB)and immunohistochemistry(IHC).We found dysregulation at the protein level for 11 of these proteins in both tissue and plasma exosome samples from patients,along with an association of nine of these proteins with CRC *** validation,all but one showed a statistically significant high diagnostic ability to distinguish CRC patients and individuals with premalignant lesions from healthy individuals,either by luminescence Halotag-based beads,or by a multiplexed biosensing platform involving the use of magnetic microcarriers as solid support modified with covalently immobilized Halotag fusion proteins constructed for CRC *** together,our results highlight the usefulness of the approach defined here to identify the TAAs specific to chronic diseases;they also demonstrate that the measurement of autoantibody levels in plasma against the TAAs identified here

关键词： Autoantibodies Diagnosis Colorectal cancer Exosomes Tumor microenviroment Humoral immune response Point of care Biosensors

Sudden Death in Sports: case Report and Review of an Ongoing Problem

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Health 2019年第1期11卷 67-80页

作者： maría Elena caparrós-Hernández món.ca García-Fernández carla miró-Vicedo maría del mar Ponce-Abellán Andrea Ruso-Ruso maría Dolores Jover-Ríos Juan méndez-mora Francisco caparrós-Hernández carmen Seguí-Pérez marc Seguí-Pérez Pedro Esteve-Atiénzar Jorge Peris-García David Bonet-Tur Pablo Roig-Rico Asunción Pérez-Fullana José miguel Seguí-Ripoll School of medicine Miguel Hernández University Elche (Alicante) Spain Department of Internal medicine Hospital La Vega Baja of Orihuela (Alicante) Spain Secondary School Marist Brothers High School Alicante Spain Department of Internal medicine University Hospital of San Juan Alicante Spain Department of Clin.cal medicine Miguel Hernández University Elche (Alicante) Spain

Background: Both competitive and recreational sports are considered a positive practice that is good for human health and quality of life, so it is difficult to understand how young, energetic and apparently healthy people can die while playing their usual sports. When these events occur in elite athletes during monitored events, they normally receive considerable media attention. Objective: To describe the case of sudden death in a young professional athlete who was successfully aided and resuscitated outside our hospital, and to review the literature about sudden death in sports. materials and method: We searched for Sudden Death (according to the International Classification of Diseases (ICD-9 and ICD-10)) in our hospital but found no other relevant cases. We performed a literature search on the state of the art in sudden death (Google Scholar, Pubmed, LILACS, Scielo and the Revista Española de cardiología). Results: Although we observed that the prevalence of sudden death is not very high, it still represents a potentially avoidable event. An adequate medical examination prior to regular sporting practice can decrease the incidence of sudden death in athletes under the age of 35. Data available in the literature support medical check-ups that include history-taking, physical examination and electrocardiogram. The findings of this evaluation may also prompt further assessment (electrocardiograph, ergometry). Conclusions: We could not identify standard, obligatory guidelines for screening possible heart diseases causing cardiorespiratory failure and sudden death. As a measure for primary prevention, we propose a protocol for reducing the risk of sudden death in athletes.

关键词： Sudden Death Sports Athletes cardiopulmonary Resuscitation Implantable Automatic Defibrillator

Genetic Diversity of Great Dane Breed Using Ten microsatellites: Impact of Breeding Control over the Breeding Line

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Open Journal of Genetics 2014年第2期4卷 78-86页

作者： Gino noris carla santana mariana Herrán-Aguirre marco Antonio meraz-Ríos mario Pérez-martínez carlos Esquivel-Lacroix Leonor C. Acosta-Saavedra Eduardo Rodríguez maría de la Paz Juaréz Emma S. calderón-Aranda Rocío Gómez BImODI (Biología molecular Diagnóstica) Querétaro Qro. México Departamento de Biomedicina molecular Cinvestav-IPN México D.F. México Departamento de morfología Facultad de Medicina Veteri-naria y Zootecnia Universidad Nacional Autónoma de México México D.F. México Departamento de Reproducción Facultad de Medicina Vete-rinaria y Zootecnia Universidad Nacional Autónoma de México México D.F. México Departamento de Toxicología Cinvestav-IPN. Av. Instituto Politécnico Nacional 2508 Col. San Pedro Zacatenco México D.F. México

The American Kennel Club and the Fédération Cynologique Internationale recognize two phenotypic variants of Great Dane breed denominated American and European varieties. Historically, these varieties have been segregated according to morphological characteristics. In an attempt to obtain a better characterization, breeders have been interested in the genetic parameters that could evaluate the within-breed diversity. In this document, we studied the genetic structure of Great Dane breed with 10 STR markers in 88 dogs using capillary electrophoresis. Cluster analysis, population differentiation and phylogenetic analyses revealed that American and European varieties are genetically independent. nevertheless, within the American variety a genetic stratification was found. Additionally, a high misclassification (28%) was detected, which could be due to wrong registration or false paternity. Our results support the importance to deem genetic markers as useful tools in breeding control. Similarly, these studies serve as an accurate reference to establish standards by dog breeding associations and for choosing among dogs for inter-breeding. nevertheless, genetic tools are only a complement of morphological methods, since both are reshuffling the control over the breeding line. notwithstanding, this database provides an overall and scape concerning the impact of genetic diversity within-breed. Unmistakably, more databases are needed to increase the quality of the breeding line as well as the number of STR in order to study, with more detail, the genetic structure in the Great Dane race.

关键词： Genetic Structure Great Dane Varieties microsatellites Population Genetics Population Stratification

基于μC/os-Ⅱ的CO_2焊波形控制软件开发

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焊接学报 2006年第7期27卷 45-48页

作者：刘嘉王三良杨帅殷树言北京工业大学机械工程与应用电子学院北京100022

基于mSP430F449控制系统对μC/os-Ⅱ进行研究,内容包括软件系统的结构分析、μC/os-Ⅱ在mSP430F449上的移植等工作。在此基础上针对CO2焊波形控制任务的需要开发了相应的控制程序。结果表明,软件系统运行稳定可靠,响应及时,维护简单。

关键词：焊接电源 μC/os-Ⅱ 实时操作系统焊接软件

Systematic review of the outcomes of surgical resection for intermediate and advanced Barcelona Clinic Liver cancer stage hepatocellular carcinoma:A critical appraisal of the evidence

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World Journal of Hepatology 2018年第6期10卷 433-447页

作者： Ye Xin Koh Hwee Leong Tan Weng Kit Lye Juinn Huar Kam Adrian Kah Heng Chiow Siong san Tan Su Pin Choo Alexander Yaw Fui Chung Brian Kim Poh Goh Department of Hepatopancreatobiliary and Transplant Surgery Singapore General HospitalSingapore 169608Singapore Center for Quantitative medicine Duke-NUS Graduate Medical SchoolSingapore 169857Singapore Department of General Surgery Hepatopancreatobiliary ServiceChangi General HospitalSingapore 529889Singapore Department of medical Oncology National Cancer Centre SingaporeSingapore 169610Singapore Duke-nUS Graduate medical School Singapore 169857Singapore

AIm To perform a systematic review to determine the survival outcomes after curative resection of intermediate and advanced hepatocellular carcinomas(HCC).mETHODS A systematic review of the published literature was performed using the Pubm ed database from 1 st January 1999 to 31 st Dec 2014 to identify studies that reported outcomes of liver resection as the primary curative treatment for Barcelona Clinic Liver cancer(BCLC) stage B or C HCC. The primary end point was to determine the overall survival(os) and disease free survival(DFS) of liver resection of HCC in BCLC stage B or C in patients with adequate liver reserve(i.e., Child's A or B status). The secondary end points were to assess the morbidity and mortality of liver resection in large HCC(defined as lesions larger than 10 cm in diameter) and to compare the os and DFS after surgical resection of solitary vs multifocal *** We identified 74 articles which met the inclusion criteria and were analyzed in this systematic review. Analysis of the resection outcomes of the included studies were grouped according to(1) BCLC stage B or C HCC,(2) Size of HCC and(3) multifocal tumors. The median 5-year os of BCLC stage B was 38.7%(range 10.0-57.0); while the median 5-year os of BCLC stage C was 20.0%(range 0.0-42.0). The collective median 5-year os of both stages was 27.9%(0.0-57.0). In examining the morbidity and mortality following liver resection in large HCC, the pooled RR for morbidity [RR(95%CI) = 1.00(0.76-1.31)] and mortality [RR(95%CI) = 1.15(0.73-1.80)] were not significant. Within the spectrum of BCLC B and C lesions, tumors greater than 10 cm were reported to have median 5-year os of 33.0% and multifocal lesions 54.0%.COnCLUSIOn Indication for surgical resection should be extended to BCLC stage B lesions in selected patients. Further studies are needed to stratify stage C lesions for resection.

关键词： Barcelona Clinic Liver cancer Hepatocellular carcinoma Hepatectomy milan criteria

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基于虚拟机监控器的类蜜罐实时内存取证

浙江大学学报（工学版） 2018年第2期52卷 387-397页

作者：赵宇韬李清宝张贵民程三军解放军信息工程大学数学工程与先进计算国家重点实验室河南郑州450001 信息保障技术重点实验室北京100072 河南省人民检察院河南郑州450000

为了解决传统的基于"镜像-分析"的内存取证技术面临的提取内存镜像时间过长及无法有效截获瞬时性内存攻击的问题,提出类蜜罐的实时内存取证方法(RTmF).利用虚拟机监控器针对性地提取内存片段,对提取的数据进行语义重构,以获得操作系统... 详细信息

为了解决传统的基于"镜像-分析"的内存取证技术面临的提取内存镜像时间过长及无法有效截获瞬时性内存攻击的问题,提出类蜜罐的实时内存取证方法(RTmF).利用虚拟机监控器针对性地提取内存片段,对提取的数据进行语义重构,以获得操作系统级语义信息.利用扩展页表机制设置关键内存页面的访问权限,将这些内存页面作为蜜罐;针对蜜罐的违规访问会触发扩展页表故障而陷入虚拟机监控器,实时拦截攻击.结果表明,在发现内存攻击后,RTmF既可记录攻击者对内存的修改历史,又可对攻击者追踪溯源.经微基准测试,该方法引入的性能开销在可接受的范围内.

关键词：实时取证蜜罐内存行为攻击载体页面访问权限

microhabitat heterogeneity associated with Vanilla *** its influences on the microbial community of leaf litter and soil

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Soil Ecology Letters 2020年第3期2卷 195-208页

作者： Gabriela montes de Oca-Vasquez Frank Solano-campos Bernal Azofeifa-Bolanos Amelia Paniagua-Vasquez Jose Vega-Baudrit Antonio Ruiz-navarro Ruben Lopez-mondejar Felipe Bastida national nanotechnology Laboratory National Center for High Technology10109 PavasSan JoseCosta Rica School of Biological Sciences Universidad NacionalCampus Omar Dengo86-3000 HerediaCosta Rica Asociacion nacional de Vainilleros Unidos San JoseCosta Rica Instituto de Investigacion y Servicios Forestales Universidad Nacional86-3000 HerediaCosta Rica Laboratory of Polymer Science and Technology School of ChemistryUniversidad NacionalCampus Omar Dengo86-3000 HerediaCosta Rica CEBAS-CSIC Department of Soil and Water ConservationCampus Universitario de Espinardo30100MurciaSpain Laboratory of Environmental microbiology Institute of Microbiology of the CASVidenska 1083Praha 414220Czech Republic

The impact of forest microhabitats on physiochemical properties of the soil and that of microbial communities on tropical soils remain poorly *** elucidate the effect of tropical forest stand on leaf litter and soil microbial communities,we studied enzyme activities,microbial biomass,and diversity in three distinct microhabitats in terms of plant richness,diameter at breast height(DBH),and physiochemical properties of soil and litter,each associated with a different Vanilla *** the soil,positive correlations were found between electrical conductivity(EC)and total organic carbon(TOC)with phosphatase activity,and between nitrogen(n)and water-soluble carbon(WSC)content with urease activity(UA).In the litter,the water content was positively correlated with bacterial and fungal biomass,and n and WSC contents were positively correlated with fungal *** correlations were found between plant richness and UA in the soil,plant richness and fungal biomass in the soil and litter,and DBH and fungal biomass in the *** sequencing revealed differences between microhabitats in the relative abundance of some fungal and bacterial taxa and in the bacterial community composition of both litter and *** richness and diversity were different between microhabitats,and,in litter samples,they were negatively correlated with DBH and plant richness,*** contrast,none of the soil and litter physiochemical properties were significantly correlated with microbial *** results show that significant shifts in enzyme activity,microbial biomass,and diversity in the microhabitats were driven by key abiotic and biotic factors depending on the soil or litter sample type.

关键词： Tropical rainforest Enzyme activity microbial community composition microbial biomass Plant richness

Post-Hospital Syndrome and Hyponatremia

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Health 2021年第8期13卷 846-856页

作者： José Bellod-Tonda Julio Blázquez-Encinar maría Dolores Jover-Ríos carmen Seguí-Pérez Juan méndez-mora Francisco caparrós-Hernández Álex méndez-Jover marc Seguí-Pérez David Baláž Leticia Espinosa del Barrio Jesús Corbacho-Redondo carles García-Cervera Juan manuel núñez-Cruz Isidro Hernández-Isasi Javier Guzmán-martínez Angie Gómez-Uranga Pedro Esteve-Atiénzar Jorge Peris-García Veron.ca martínez-Sempere Eliana Damonte-White Óscar Hernando Ruiz-Ariza Juan.carlos López-Corbalán Lourdes Lajara-Villar Andrea Riaño-Pérez Paloma Chazarra-Pérez maría Escamilla-Espínola maria Luisa Asensio-Tomás miguel Ángel Auladell-Alemany Laura Serna-Torres Asunción Pérez-Fullana Amparo Gómez-Siurana Sergio menargues-Irles José miguel Seguí-Ripoll Internal medicine Department University Hospital of San Juan Alicante Spain Internal medicine Department Torrevieja University Hospital Alicante Spain Internal medicine Department Hospital La Vega Baja of Orihuela Alicante Spain CEU cardinal Herrera University Veterinary Hospital Valencia Spain Secondary School Marist Brothers High School Alicante Spain Department of Clin.cal medicine Miguel Hernández University Elche Spain Primary care medicine Benilloba Spain Sub-Delegation of the Government Alicante Spain Chemical Engineering Department University of Alicante Alicante Spain

Introduction: Post-hospital syndrome (PHS) is defined as a period of vulnerability during the first 30 days after a patient is discharged from hospital, in which multiple factors come into play. Hyponatremia is the mo... 详细信息

ng>Introduction:ng> Post-hospital syndrome (PHS) is defined as a period of vulnerability during the first 30 days after a patient is discharged from hospital, in which multiple factors come into play. Hyponatremia is the most frequent hydroelectrolytic disorder in hospitalized patients and may be related to the appearance of PHS. ng>Objective: ng>The objective is to estimate the prevalence of PHS that is assessed as the rate of readmissions in the first 30 days after discharge, in patients with hyponatremia. ng>material and methods:ng> It is a descriptive observational study of patients with hyponatremia who were discharged from 1 September 2010 to 2 February 2020 at the Internal medicine Service of the Hospital University of san Juan (Alicante, Spain). ng>Results:ng> Of the 25 included patients, 5 (20%) were readmitted within a month of discharge, after a mean of 11.4 days (standard deviation [SD] 5.1). The overall mortality of the study was 20% (n = 5), with one case of death in the first 30 days post-hospitalization (4%). In 12 patients (48%) the origin of the hyponatremia was undetermined. The most frequently recorded etiology for the condition was pharmacological (n = 7, 28%), and there was pronounced variability in its clin.cal and laboratory study. The most widely used corrective measure was drug withdrawal, in 16 patients (64%). Water intake restriction was the most common treatment after discharge (5 patients, 20%), followed by urea (2 patients, 8%), while tolvaptan was not used. ng>Conclusion: ng>Hyponatremia may be the cause of PHS, which could increase the rate of early readmission. Hyponatremia is an underdiagnosed and undertreated entity, so it is necessary to apply an appropriate system to optimize its management and, in future studies, to assess its impact on PHS.

关键词： Hospitalization Hyponatremia Patient Readmission Inappropriate ADH Syndrome