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Challenges and improvement strategies in the hospitalization of chronic multimorbid patients

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 m.ria jose garcia larrosa m.ria del mar Callejon Gil Ignacio garcia Delgado m.ria 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

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COVID-19 pandemic,as experienced in the surgical service of a district hospital in Spain

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World Journal of Clinical Cases 2021年第23期9卷 6582-6590页

作者： Francisco Javier Pérez Lara m.ria Belen Jimenez martinez Francisco Pozo muñoz Andres Fontalba Navas Rogelio garcia Cisneros m.ria jose garcia larrosa Ignacio garcia Delgado m.ria del mar Callejon Gil Department of Surgery Hopital de AntequeraAntequera 29200MálagaSpain North malaga Healthcare District Hopital de AntequeraAntequera 29200MálagaSpain

The coronavirus disease 2019,which is caused by severe acute respiratory syndrome coronavirus 2,was first identified in December 2019 in Wuhan,China,and has since spread rapidly,evolving into a full-blown *** would like to report our experience after 1 year of this pandemic in the surgical service of a district hospital in *** have been many changes(including new protocols)that our service and the hospital have undergone,to adapt to the new *** believe that this experience can be useful for other professionals who have lived and are living a similar situation.

关键词： COVID-19 Hospital Experience Surgery Service Treatment

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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

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A versatile microfluidic device for multiple ex vivo/ in vitro tissue assays unrestrained from tissue topography

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microsystems & Nanoengineering 2020年第1期6卷 806-819页

作者： jose m.de Hoyos-Vega Alan m.Gonzalez-Suarez jose L.garcia-Cordero Unidad monterrey Centro de Investigacion y de Estudios Avanzados del IPNVia del conocimiento 201Parque PIITApodacaNL 66628Mexico

Precision-cut tissue slices are an important in vitro system to study organ function because they preserve most of the native cellular microenvironments of organs,including complex intercellular ***,during sample manipulation or slicing,some of the natural surface topology and structure of these tissues is lost or ***,we introduce a microfluidic platform to perform multiple assays on the surface of a tissue section,unhindered by surface *** device consists of a valve on one side and eight open microchannels located on the opposite side,with the tissue section sandwiched between these two *** the valve is actuated,eight independent microfluidic channels are formed over a tissue *** strategy prevents cross-contamination when performing assays and enables *** irregular tissues such as an aorta,we conducted multiple in vitro and ex vivo assays on tissue sections,including short-term culturing,a drug toxicity assay,a fluorescence immunohistochemistry staining assay,and an immune cell assay,in which we observed the interaction of neutrophils with lipopolysaccharide(LPS)-stimulated *** microfluidic platform can be employed in other disciplines,such as tissue physiology and pathophysiology,morphogenesis,drug toxicity and efficiency,metabolism studies,and diagnostics,enabling the conduction of several assays with a single biopsy sample.

关键词： metabolism topography versatile

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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

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Geodesic Vulnerability Approach for Identification of Critical Buses in Power Systems

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Journal of modern Power Systems and Clean Energy 2021年第1期9卷 37-45页

作者： Jesus Beyza Eduardo garcia-Paricio Hector F.Ruiz jose m.Yusta Instituto Tecnologico de morelia Avenida Tecnologico 1500Lomas de Santiaguito58120Mexico the Department of Electrical Engineering University of ZaragozaC/Maria de Luna 350018Spain

One of the most critical issues in the evaluation of power systems is the identification of critical buses. For this purpose, this paper proposes a new methodology that evaluates the substitution of the power flow technique by the geodesic vulnerability index to identify critical nodes in power *** methods are applied comparatively to demonstrate the scope of the proposed approach. The applicability of the methodology is illustrated using the IEEE 118-bus test system as a case study. To identify the critical components, a node is initially disconnected, and the performance of the resulting topology is evaluated in the face of simulations for multiple cascading faults. Cascading events are simulated by randomly removing assets on a system that continually changes its structure with the elimination of each component. Thus, the classification of the critical nodes is determined by evaluating the resulting performance of 118 different topologies and calculating the damaged area for each of the disintegration curves of cascading failures. In summary, the feasibility and suitability of complex network theory are justified to identify critical nodes in power systems.

关键词： Power system critical node complex network theory cascading failure load flow

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An Invasive Succulent Plant (Kalanchoe daigremontiana) Influences Soil Carbon and Nitrogen mineralization in a Neotropical Semiarid Zone

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Pedosphere 2018年第4期28卷 632-643页

作者： Ileana HERRERA jose R. FERRER-PARIS Diana BENZO Saul FLORES Belkis garcia Jafet m. NASSAR Ecuela de Ciencias Ambientales Universidad Espiritu Santo Guayaquil 091650 (Ecuador) Centro de Ecologla Instituto Venezolano de Investigaciones Cientificas (IVIC) Caracas 1020 (Venezuela) Centro de Estudios Botdnieos y Agroforestales Instituto Venezolano de Investigaeiones Cientificas Maracaibo 4005 (Venezuela)

It has long been recognized that plant invasions may alter carbon （C） and nitrogen （N） cycles, but the direction and magnitude of such alterations have been rarely quantified. In this study, we quantified the effects caused by the invasion of a noxious exotic plant, Kalanchoe daigrernontiana （Crassulaceae）, on C and N mineralization and enzymatic and microbial activities in the soil of a semiarid locality in Venezuela. We compared soil parameters associated with these processes （C and N mineralization time and the cumulative values, fluorescein diacetate hydrolytic activity, and activities of dehydrogenase, β-glucosidase, glucosaminidase, and urease） between invaded and adjacent non-invaded sites. In addition, correlations among these parameters and the soil physical-chemical properties were also examined to determine if a positive feedback exists between nutrient availability and K. daigremontiana invasion. Overall, our results showed that C mineralization and transformation of organic compounds to NH4^＋ were favored at sites colonized by K. daigrernontiana. With this species, we found the highest cumulative amounts of NH4^＋-N and C and the lowest mineralization time. These results could be explained by higher activities of urease and glueosaminidase in soils under the influence of K. daigremontiana. In addition, higher amounts of organic matter and moisture content in invaded soils might favor C and N mineralization. In conclusion, invasion of Neotropical semiarid zones by K. daigrernontiana may influence the chemical and biological properties of the soils covered by this species, increasing nutrient bioavailability, which, in time, can facilitate the invasion process.

关键词： Akaike Information Criterion C and N pools enzymatic activity NH4^+-N NO3^--N nutrient availability plant invasion

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Transformation of Supercapacitive Charge Storage Behaviour in a multi elemental Spinel Cumn_(2)O_(4) Nanofibers with Alkaline and Neutral Electrolytes

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Advanced Fiber materials 2021年第4期3卷 265-274页

作者： ria Kunwar Syam G.Krishnan Izan Izwan misnon Fatemeh Zabihi Shengyuan Yang Chun-Chen Yang Rajan jose Nanostructured Renewable materials Research Laboratory Faculty of Industrial Sciences and TechnologyUniversity Malaysia Pahang26300 KuantanMalaysia Graphene&Advanced 2D materials Research Group(GAmRG) School of Engineering and TechnologySunway UniversityNo.5 Jalan UniversitiBandar Sunway47500 Petaling JayaSelangorMalaysia State Key Laboratory for modification of Chemical Fibers and Polymer materials International Joint Laboratory for Advanced Fiber and Low-Dimension MaterialsCollege of Materials Science and EngineeringDonghua UniversityShanghaiPeople’s Republic of China Battery Research Center for Green Energy Ming Chi University of TechnologyNew Taipei CityTaiwan

Electrode material has been cited as one of the most important determining factors in classifying an energy storage system’s charge storage mechanism,i.e.,as battery-type or *** this paper,we show that along with the electrode material,the electrolyte also plays a role in determining the charge storage behaviour of the *** the purpose of our research,we chose multi-elemental spinal type Cumn_(2)O_(4) metal oxide nanofibers to prove the *** material is synthesized as nanofibers of diameter~120 to 150 nm in large scales by a pilot scale electrospinning set *** was then tested in three different electrolytes(1 m KOH,1 m Na_(2)SO_(4) and 1 m Li_(2)SO_(4)),two of which are neutral and the third is alkaline(KOH).The cyclic voltammograms and the galvanostatic charge-discharge of the electrode material in a three-electrode sys-tem measurement showed that it exhibit different charge storage mechanism in different electrolyte *** the neutral electrolytes,a capacitive behaviour was observed whereas a battery-type behaviour was seen for the alkaline *** leads us to conclude that the charge storage mechanism,along with the active material,also depends on the electrolyte used.

关键词： Energy storage materials Electrochemical double layer capacitors Capacitive charge storage Ternary manganates Pseudocapacitors

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Filling the Gaps to Solve the Extensin Puzzle

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molecular Plant 2018年第5期11卷 645-658页

作者： Eliana marzol Cecilia Borassi mauro Bringas Ana Sede Diana Rosa Rodriguez garcia Luciana Capece jose m. Estevez Fundacion Instituto Leloir and Instituto de Investigaciones Bioquimicas de Buenos Aires (IIBBA-CO.NICEr) Avenida Patricias Argentinas 435 Buenos AiresCP C1405BWE Argentina Departamento de Quimica Inorganica Analitica y Quimica Fisica Facultad de Ciencias Exactas y Naturales Universidad de Buenos Aires (INQUIMAE-CONICET)Buenos Aires CP C1428EGA Argentina Instituto de Investigaciones en Ingenierfa Genetica y Biologia molecular Dr. Hector Torres (INGEBI-CONICET) Vuelta de Obligado 2490 Buenos Aires C1428ADNArgentina

Extensins （EXTs） are highly repetitive plant O-glycoproteins that require several post-translational modifi- cations （PTms） to become functional in plant cell walls. First, they are hydroxylated on contiguous proline residues; then they are O-glycosylated on hydroxyproline and serine. After secretion into the apoplast, O-glycosylated EXTs form a tridimensional network organized by inter- and intra-Tyr linkages. Recent studies have made significant progress in the identification of the enzymatic machinery required to process EXTs, which includes prolyl 4-hydroxylases, glycosyltransferases, papain-type cysteine endopeptidases, and peroxidases. EXTs are abundant in plant tissues and are particularly important in rapidly expanding root hairs and pollen tubes, which grow in a polar manner. Small changes in EXT PTms affect fastgrowing cells, although the molecular mechanisms underlying this regulation are unknown. In this review, we highlight recent advances in our understanding of EXT modifications throughout the secretory pathway, EXT assembly in cell walls, and possible sensing mechanisms involving the Catharanthus roseus cell surface sensor receptor-like kinases located at the interface between the apoplast and the cytoplasmic side of the plasma membrane.

关键词： Arabidopsis thaliana cysteine endopeptidases extensins glycosyltransferases peroxidases prolyl 4-hydroxylases

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Land-use change and windstorms legacies drove the recolonization dynamics of laurel forests in Tenerife, Canary islands

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Forest Ecosystems 2023年第1期10卷 113-124页

作者： Vicente Rozas m.ria A.garcia-Lopez jose m.Olano Gabriel Sanguesa-Barreda miguel garcia-Hidalgo Susana Gomez-Gonzalez Roberto Lopez-Rubio jose m.Fernandez-Palacios Ignacio garcia-Gonzalez Laura Lozano-Lopez Paula garcia-Gonzalez Ana I.garcia-Cervigon EiFAB-iuFOR Universidad de ValladolidCampus Duques de Soria42004SoriaSpain Departamento de Biologia-IVAGRO Universidad de CadizCampus Rio San Pedro11510Puerto RealSpain Center for Climate and Resilience Research(CR)2 Blanco Encalada 20028370449SantiagoChile Area de Biodiversidad y Conservacion Universidad Rey Juan Carlosc/Tulipan s/n28933MostolesSpain Grupo de Ecologia y Biogeografia Insular Universidad de La Laguna38206La LagunaTenerifeSpain BIOAPLIC Departamento de BotanicaEscola Politecnica Superior de EnxenariaCampus TerraUniversidade de Santiago de CompostelaLugo27002Spain

Laurel forests are quite relevant for biodiversity conservation and are among the island ecosystems most severely damaged by human *** the past,Canary laurel forests have been greatly altered by logging,livestock and *** remains of laurel forests are currently protected in the Canary Islands(Spain).However,we miss basic information needed for their restoration and adaptive management,such as tree longevity,growth potential and responsiveness to natural and anthropogenic *** dendrochronological methods,we studied how forest dynamic is related to land-use change and windstorms in two well-preserved laurel forests on Tenerife *** cores were collected from over 80 trees per stand at three stands per *** used ring-width series to estimate tree ages and calculate annual basal area increments(BAI),cumulative diameter increases,and changes indicative of released and suppressed *** tree species were found in all stands,with Laurus novocanariensis,Ilex canariensis and morella faya being the most common *** some individuals were over 100 years old,61.8%-88.9% of the trees per stand established between 1940 and 1970,coinciding with a post-war period of land abandonment,rural exodus and the onset of a tourism *** trees have shown growth rates larger than 1 cm diameter per year and most species have had increasing BAI trends over the past *** growth releases occurred after windstorms at both sites,but the effects of windstorms were site-dependent,with the 1958 storm affecting mainly the eastern tip of the island(Anaga massif)and the 1991 storm the western tip(Teno massif).Given the great ability of laurel forest trees to establish after land use cessation and to increase growth after local disturbances such as windstorms,passive restoration may be sufficient to regenerate this habitat in currently degraded areas.

关键词： Canary islands Dendroecology Disturbance Forest structure macaronesia management cessation Tree rings

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