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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 impedance 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 impedance 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

Effectiveness of intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine: An in silico pharmacological model

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Asian Pacific Journal of Tropical medicine 2020年第8期13卷 366-374页

作者： mila Nu Nu Htay Ian m Hastings Eva maria Hodel Katherine kay Liverpool School of Tropical medicine Liverpool L35QAUnited Kingdom Department of Community medicine Melaka-Manipal Medical CollegeManipal Academy of Higher Education(MAHE)MelakaMalaysia malawi-Liverpool-Wellcome Trust Clinical Research Programme BlantyreMalawi University of Liverpool Liverpool L693GFUnited Kingdom metrum Research Group TariffvilleConnecticut06081United States of America

Objective:To explore the efficacy of intermittent preventive treatment in pregnancy(IPTp)with sulfadoxine and pyrimethamine(SP)against sensitive ***:A pharmacological model was used to investigate the effectiveness of the previous recommended at least two-dose regimen,currently recommended three-dose regimen and 4,6,8-weekly regimens with specific focus on the impact of various nonadherence patterns in multiple transmission ***:The effectiveness of the recommended three-dose regimen is high in all the transmission intensities,i.e.>99%,98%and 92%in low,moderate and high transmission intensities *** simulated 4 and 6 weekly IPTp-SP regimens were able to prevent new infections with sensitive parasites in almost all women(>99%)regardless of transmission ***,8 weekly interval dose schedules were found to have 71%and 86%protective efficacies in high and moderate transmission areas,*** highlights that patients are particularly vulnerable to acquiring new infections if IPTp-SP doses are ***:The pharmacological model predicts that full adherence to the currently recommended three-dose regimen should provide almost complete protection from malaria infection in moderate and high transmission ***,it also highlights that patients are particularly vulnerable to acquiring new infections if IPTp doses are spaced too widely or if doses are *** to the recommended IPTp-SP schedules is recommended.

关键词： Intermittent preventive treatment in pregnancy Sulfadoxine-pyrimethamine malaria infection in pregnancy Three-dose regimen In silico pharmacological model

On SIR epidemic models with generally distributed infectious periods： Number of secondary cases and probability of infection

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International Journal of Biomathematics 2017年第2期10卷 157-169页

作者： A. Gomez-Corral m. Lopez-garcia Instituto de Ciencias matemdticas CSIC- UAM- UC3M- UCM Calle Nicolds Cabrera 13-15 Madrid 28049 Spain Department of Applied mathematics School of Mathematics University of Leeds Leeds LS29JT UK

Recently, Clancy [SIR epidemic models with general infectious period distribution, Statist. Prob. Left. 85 （2014） 1-5] has shown how SIR epidemics in which individuals＇ infection periods are not necessarily exponentially distributed may be modeled in terms of a piecewise-deterministic markov process （PDmP）. In this paper, we present a more detailed description of the underlying PDmP, from which we analyze the population transmission number and the infection probability of a certain susceptible individual.

关键词： Number of secondary cases piecewise-deterministic markov process proba-bility of infection SIR epidemic model.

metformin-associated lactic acidosis:A mini review of pathophysiology,diagnosis and management in critically ill patients

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World Journal of Diabetes 2024年第6期15卷 1178-1186页

作者： kay Choong See Department of medicine National University HospitalSingapore 119228Singapore

metformin is a common diabetes drug that may reduce lactate clearance by inhibiting mitochondrial oxidative phosphorylation,leading to metforminassociated lactic acidosis(mALA).As diabetes mellitus is a common chronic metabolic condition found in critically ill patients,pre-existing metformin use can often be found in critically ill patients admitted to the intensive care unit or the high dependency *** aim of this narrative mini review is therefore to update clinicians about mALA,and to provide a practical approach to its diagnosis and *** in critically ill patients may be suspected in a patient who has received metformin and who has a high anion gap metabolic acidosis,and confirmed when lactate exceeds 5 mmol/*** factors include those that reduce renal elimination of metformin(renal impairment from any cause,histamine-2 receptor antagonists,ribociclib)and excessive alcohol consumption(as ethanol oxidation consumes nicotinamide adenine dinucleotides that are also required for lactate metabolism).Treatment of mALA involves immediate cessation of metformin,supportive management,treating other concurrent causes of lactic acidosis like sepsis,and treating any coexisting diabetic *** mALA requires extracorporeal removal of metformin with either intermittent hemodialysis or continuous kidney replacement *** optimal time to restart metformin has not been *** is nonetheless reasonable to first ensure that lactic acidosis has resolved,and then recheck the kidney function post-recovery from critical illness,ensuring that the estimated glomerular filtration rate is 30 mL/min/1.73 m^(2) or better before restarting metformin.

关键词： Acid-base equilibrium Biguanides Oxidative phosphorylation Pyruvic acid Renal replacement therapy

Evaluating the Effect of Tillage on Carbon Sequestration Using the minimum Detectable Difference Concept

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Pedosphere 2008年第4期18卷 421-430页

作者： X. m. YANG C. F. DRURY m. m. WANDER B. D. kay Agriculture and Agri-Food Canada Harrow Ontario N0R 1G0 (Canada). Department of Natural Resources and Environmental Science University of Illinois at Urbana-Champaign Urbana IL61801 (USA) Department of Land Resources University of Guelph Guelph Ontario N1G 2W1 (Canada)

Three long-term field trials in humid regions of Canada and the USA were used to evaluate the influence of soil depth and sample numbers on soil organic carbon (SOC) sequestration in no-tillage (NT) and moldboard plow (mP) corn (Zea mays L.) and soybean (Glycine max L.) production systems. The first trial was conducted on a maryhill silt loam (Typic Hapludalf) at Elora, Ontario, Canada, the second on a Brookston clay loam (Typic Argiaquoll) at Woodslee, Ontario, Canada, and the third on a Thorp silt loam (Argiaquic Argialboll) at Urbana, Illinois, USA. No-tillage led to significantly higher SOC concentrations in the top 5 cm compared to mP at all 3 sites. However, NT resulted in significantly lower SOC in sub-surface soils as compared to mP at Woodslee (10-20 cm, P = 0.01) and Urbana (20-30 cm, P more SOC storage than mP at the Elora site (3.3 mg C ha-1) and at the Woodslee site (6.2 mg C ha-1) on an equivalent mass basis (1350 mg ha-1 soil equivalent mass). Similarly, NT had greater SOC storage than mP at the Urbana site (2.7 mg C ha-1) on an equivalent mass basis of 675 mg ha-1 soil. However, these differences disappeared when the entire plow layer was evaluated for both the Woodslee and Urbana sites as a result of the higher SOC concentrations in mP than in NT at depth. Using the minimum detectable difference technique, we observed that up to 1500 soil sample per tillage treatment comparison will have to be collected and analyzed for the Elora and Woodslee sites and over 40 soil samples per tillage treatment comparison for the Urbana to statistically separate significant differences in the SOC contents of sub-plow depth soils. Therefore, it is impracticable, and at the least prohibitively expensive, to detect tillage-induced differences in soil C beyond the plow layer in various soils.

关键词： carbon sequestration minimum detectable difference moldboard plow no-tillage soil depth

A Single JAZ Repressor Controls the Jasmonate Pathway in marchantia polymorpha

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molecular Plant 2019年第2期12卷 185-198页

作者： Isabel monte Jose m. Franco-Zorrilla Gloria garcia-Casado Angel m. Zamarreno Jose m. garcia-mina Ryuichi Nishihama Takayuki Kohchi Roberto Solano Department of Plant molecular Genetics Centro Nacional de Biotecnologia Consejo Superior de Investigaciones Cientificas (CNB-CSIC) 28049 Madrid Spain Genomics Unit Centro Nacional de Biotecnologia Consejo Superior de Investigaciones Cientificas (CNB-CSIC) 28049 Madrid Spain Environmental Biology Department University of Navarra Navarre Spain Graduate School of Biostudies Kyoto University Kyoto 606-8502 Japan

JAZ proteins are negative regulators of jasm onate responses,acting both as repressors of transcription factors and as co-receptors of JA-lle. The high redundancy of JAZ genes in angiosperms has hindered the characterization of a complete depletion of JAZ function. moreover, the recent discovery that dn- OPDA is the jasmonate ligand in marchantia polymorpha demonstrates that JA-lle is not the sole COI1/ JAZ ligand in land plants and highlights the importance of studying JAZ co-receptors in bryophytes? Here, we have exploited the low gene redundancy of the liverwort m. polymorpha to characterize the single mpJ4Z in this early diverging plant lineage. We clarify the phylogenetic history of the TIFY family, demonstrate that mpJAZ is the ortholog of AtJAZ with a conserved function, and characterize its repressor activity of dn-OPDA resp on ses. Our results show that, con sistent with previous findings in Arabidopsis, mpJAZ represses jasmonates biosynthesis, senescence, and plant defenses, and promotes cell growth and reproductive fitness, highlighting the power of studies in marchantia.

关键词： Jasmonate repressors marchantia Hormone signaling evolution gene redundancy

Bioleaching of zinc from gold ores using Acidithiobacillus ferrooxidans

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International Journal of minerals,metallurgy and materials 2009年第4期16卷 368-374页

作者： Pakawadee Kaewkannetra Francisco Jose garcia-garcia Tze Yen Chiu Department of Biotechnology Faculty of TechnologyKhon Kaen University Corrosion and Protection Centre School of MaterialsThe University of Manchester Centre of Water Science Cranfield University

The present work investigated microbial leaching of zinc from ore using Acidithiobacillus ferrooxidans （ATCC 14859）. The ore samples, consisted of 13wt% zinc, were obtained from a gold mine in north-eastern Thailand. A shake flask study was performed on the ore samples using a rotary shaker under the following fixed conditions （250 r·min^-1, 30℃ for 16 d）. The influence of various conditions, namely medium type （with and without iron）, particle ore size （〈20, 20-40, 40-60, 60-100, and 〉100 mesh）, ore density （20 kg·m^-3, 50 kg·m^-3, and 100 kg·m^-3）, and pH of the medium （2, 2.5, 2.8, and 3）, were investigated. The microbial leaching was assessed by determining the concentration of zinc in the medium and compared with the initial sample concentration. The results show that Acidithiobacillus ferrooxidans can successfully leach zinc by as much as 6 times compared with the control experiment （without Acidithiobacillus ferrooxidans ferrooxidans）. The maximum efficiency （92.3%） for microbial leaching is obtained in iron-containing medium, 20-40 mesh ore sizes, 20 kg·m^-3 ore density at pH 2.8, and the zinc content is found in the medium at about 120 mg·m^-1.

关键词： bioleaching Acidithiobacillusferrooxidans gold ores gold mine

Orchard Sports Injury and Illness Classification System (OSIICS) Version 15

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Journal of Sport and Health Science 2024年第4期13卷 599-604页

作者： John W.Orchard Ebonie Rio kay m.Crossley Jessica J.Orchard margo mountjoy School of Public Health University of SydneySydneyNSW 2006Australia La Trobe Sport and Exercise medicine Research Centre La Trobe UniversityMelbourneVIC 3083Australia Department of Family medicine McMaster UniversityHamilton L8S 4L8Canada

Background:Sports medicine(injury and illnesses)requires distinct coding systems because the International Classification of Diseases is insuf-ficient for sports medicine *** Orchard Sports Injury and Illness Classification System(OSIICS)is one of two sports medicine coding systems recommended by the International Olympic *** updates of coding systems are ***:For Version 15,updates for mental health conditions in athletes,sports cardiology,concussion sub-types,infectious diseases,and skin and eye conditions were considered particularly ***:Recommended codes were added from a recent International Olympic Committee consensus statement on mental health conditions in *** landmark sports cardiology papers were used to update a more comprehensive list of sports cardiology *** union protocols on head injury assessment were used to create additional concussion ***:It is planned that OSIICS Version 15 will be translated into multiple new languages in a timely fashion to facilitate international *** large number of recently published sport-specific and discipline-specific consensus statements on athlete surveillance warrant regular updating of OSIICS.

关键词： Sports cardiology Dermatology Eye injuries Concussion Infectious diseases Sports injury classification