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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

Translocator protein and neurodegeneration: insights from Alzheimer’s disease

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Neural Regeneration Research 2025年第4期20卷 1090-1091页

作者： Arpit Kumar Pradhan Rainer Rupprecht Gerhard Rammes Klinik für Anaesthesiologie und Intensivmedizin der Technischen Universität münchen Klinikum rechts der IsarMunichGermany Graduate School of Systemic Neurosciences Ludwig-Maximilians-Universität MünchenMartinsriedGermany department of Psychiatry and Psychotherapy University RegensburgRegensburgGermany

The 18 kDa translocator protein(TSPO)located on the outer mitochondrial membrane regulates several key cellular processes including mitochondrial homeostasis,cholesterol transport,apoptosis,cell proliferation,and maintenance of mitochondrial health(Rupprecht et al.,2022,2023).TSPO is expressed in both peripheral organs and the central nervous system,with a more pronounced expression in tissues that produce *** main reason why TSPO has garnered so much attention is because it plays a key role in neurosteroidogenesis by transferring cholesterol from the outer to the inner mitochondrial membrane,which is the rate-limiting step in neurosteroid synthesis.A cholesterol-recognizing amino acid consensus domain has been identified in the cytosolic C terminus of the TSPO protein by both in vitro and site-directed mutagenesis experiments(Li et al.,2001).However,the role of TSPO in the process of neurosteroid synthesis has been challenged by several studies,particularly TSPO knockout models,which suggest that TSPO removal does not affect the phenotype or the system’s viability(Tu et al.,2014).However,ligands targeting TSPO have been shown to enhance levels of neurosteroids which suggests that neurosteroidogenesis is one of the major functional roles mediated by the TSPO protein.

关键词： cholesterol organs

S-acylation of Ca^(2+)transport proteins in cancer

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Chronic Diseases and Translational medicine 2024年第4期10卷 263-280页

作者： Sana Kouba Nicolas Demaurex department of Cell Physiology and metabolism Centre Médical UniversitaireUniversity of GenevaGenevaSwitzerland

Alterations in cellular calcium(Ca^(2+))signals have been causally associated with the development and progression of human *** Ca^(2+)signals are generated by channels,pumps,and exchangers that move Ca^(2+)ions across membranes and are decoded by effector proteins in the cytosol or in organelles.S-acylation,the reversible addition of 16-carbon fatty acids to proteins,modulates the activity of Ca^(2+)transporters by altering their affinity for lipids,and enzymes mediating this reversible post-translational modification have also been linked to several types of ***,we compile studies reporting an association between Ca^(2+)transporters or S-acylation enzymes with specific cancers,as well as studies reporting or predicting the S-acylation of Ca^(2+)*** then discuss the potential role of S-acylation in the oncogenic potential of a subset of Ca^(2+)transport proteins involved in cancer.

关键词： Ca^(2+)signaling Ca^(2+)transport proteins cancer S-acylation S-palmitoylation

Gradient‑Layered mXene/Hollow Lignin Nanospheres Architecture Design for Flexible and Stretchable Supercapacitors

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Nano-micro Letters 2025年第2期17卷 447-462页

作者： Haonan Zhang Cheng Hao Tongtong Fu Dian Yu Jane Howe Kaiwen Chen Ning Yan Hao Ren Huamin Zhai Jiangsu Provincial Key Lab of Sustainable Pulp and Paper Technology and Biomass materials NanJing Forestry UniversityNanjing 210037People’s Republic of China department of Chemical Engineering and Applied Chemistry University of Toronto200 College StreetTorontoON M5S 3E5Canada department of materials Science and Engineering University of Toronto184 College StreetTorontoON M5S 3E4Canada College of materials Science and Engineering Nanjing Forestry UniversityNanjing 210037People’s Republic of China

With the rapid development of flexible wearable electronics,the demand for stretchable energy storage devices has *** this work,a novel gradient-layered architecture was design based on single-pore hollow lignin nanospheres(HLNPs)-intercalated two-dimensional transition metal carbide(Ti_(3)C_(2)T_(x) mXene)for fabricating highly stretchable and durable *** depositing and inserting HLNPs in the mXene layers with a bottom-up decreasing gradient,a multilayered porous mXene structure with smooth ion channels was constructed by reducing the overstacking of mXene ***,the micro-chamber architecture of thin-walled lignin nanospheres effectively extended the contact area between lignin and mXene to improve ion and electron accessibility,thus better utilizing the pseudocapacitive property of *** these strategies effectively enhanced the capacitive performance of the *** addition,HLNPs,which acted as a protective phase for mXene layer,enhanced mechanical properties of the wrinkled stretchable electrodes by releasing stress through slip and deformation during the stretch-release cycling and greatly improved the structural integrity and capacitive stability of the *** electrodes and symmetric flexible all-solid-state supercapacitors capable of enduring 600%uniaxial tensile strain were developed with high specific capacitances of 1273 mF cm^(−2)(241 F g^(−1))and 514 mF cm^(−2)(95 F g^(−1)),***,their capacitances were well preserved after 1000 times of 600%stretch-release *** study showcased new possibilities of incorporating biobased lignin nanospheres in energy storage devices to fabricate stretchable devices leveraging synergies among various two-dimensional nanomaterials.

关键词： Hollow lignin nanospheres mXene Gradient-layered architecture Wrinkled electrodes Stretchable supercapacitors

PTEN in liver diseases and cancer

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World Journal of Gastroenterology 2010年第37期16卷 4627-4633页

作者： marion Peyrou Lucie Bourgoin michelangelo Foti department of Cellular Physiology and metabolism Geneva Medical Faculty Centre Médical Universitaire

The phosphoinositide 3-kinase (PI3K)/phosphatase and tensin homolog (PTEN)/Akt axis is a key signal transduction node that regulates crucial cellular functions, including insulin and other growth factors signaling, lipid and glucose metabolism, as well as cell survival and apoptosis. In this pathway, PTEN acts as a phosphoinositide phosphatase, which terminates PI3Kpropagated signaling by dephosphorylating PtdIns(3,4)P2 and PtdIns(3,4,5)P3. However, the role of PTEN does not appear to be restricted only to PI3K signaling antagonism, and new functions have been recently discovered for this protein. In addition to the well-established role of PTEN as a tumor suppressor, increasing evidence now suggests that a dysregulated PTEN expression and/or activity is also linked to the development of several hepatic pathologies. Dysregulated PTEN expression/activity is observed with obesity, insulin resistance, diabetes, hepatitis B virus/hepatitis C virus infections, and abusive alcohol consumption, whereas mutations/deletions have also been associated with the occurrence of hepatocellular carcinoma. Thus, it appears that alterations of PTEN expression and activity in hepatocytes are common and recurrent molecular events associated with liver disorders of various etiologies. These recent f indings suggest that PTEN might represent a potential common therapeutic target for a number of liver pathologies.

关键词： Phosphatase and tensin homolog Obesity Insulin resistance Non-alcoholic fatty liver diseases Steatosis Steatohepatitis Fibrosis Hepatocellular carcinoma Viral hepatitis Alcohol

modeling and Comprehensive Review of Signaling Storms in 3GPP-Based mobile Broadband Networks:Causes,Solutions,and Countermeasures

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Computer modeling in Engineering & Sciences 2025年第1期142卷 123-153页

作者： muhammad Qasim Khan Fazal malik Fahad Alturise Noor Rahman department of Computer Science Iqra National UniversityPeshawar25000Pakistan department of Cybersecurity College of ComputerQassim UniversityBuraydah52555Saudi Arabia department of Computer Science and Engineering Al-Fayha CollegeAl Jubayl31961Saudi Arabia

Control signaling is mandatory for the operation and management of all types of communication networks,including the Third Generation Partnership Project(3GPP)mobile broadband ***,they consume important and scarce network resources such as bandwidth and processing *** have been several reports of these control signaling turning into signaling storms halting network operations and causing the respective Telecom companies big financial *** paper draws its motivation from such real network disaster incidents attributed to signaling *** this paper,we present a thorough survey of the causes,of the signaling storm problems in 3GPP-based mobile broadband networks and discuss in detail their possible solutions and *** provide relevant analytical models to help quantify the effect of the potential causes and benefits of their corresponding *** important contribution of this paper is the comparison of the possible causes and solutions/countermeasures,concerning their effect on several important network aspects such as architecture,additional signaling,fidelity,etc.,in the form of a *** paper presents an update and an extension of our earlier conference *** our knowledge,no similar survey study exists on the subject.

关键词： Signaling storm problems control signaling load analytical modeling 3GPP networks smart devices diameter signaling mobile broadband data access data traffic mobility management signaling network architecture 5G mobile communication

Impact of Pollutant Concentration and Particle Deposition on the Radiative Flow of Casson-micropolar Fluid between Parallel Plates

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Computer modeling in Engineering & Sciences 2025年第1期142卷 665-690页

作者： Ghaliah Alhamzi Badr Saad T.Alkahtani Ravi Shanker Dubey Vinutha Kalleshachar Neelima Nizampatnam department of mathematics and Statistics College of ScienceImam Mohammad Ibn Saud Islamic University(IMSIU)Riyadh11564Saudi Arabia department of mathematics College of ScienceKing Saud UniversityRiyadh11989Saudi Arabia department of mathematics Amity School of Applied SciencesAmity University RajasthanJaipur302002RajasthanIndia department of Studies in mathematics Davangere UniversityDavangere577002India department of Electronics and Communication Engineering Amrita School of EngineeringAmrita Vishwa VidyapeethamBengaluru560035India

Assessing the behaviour and concentration of waste pollutants deposited between two parallel plates is essential for effective environmental *** the effectiveness of treatment methods in reducing pollution scales is made easier by analysing waste discharge *** waste discharge concentration analysis is useful for assessing how effectively wastewater treatment techniques reduce pollution *** study aims to explore the Casson micropolar fluid flow through two parallel plates with the influence of pollutant concentration and thermophoretic particle *** explore the mass and heat transport features,thermophoretic particle deposition and thermal radiation are *** governing equations are transformed into ordinary differential equations with the help of suitable similarity *** Runge-Kutta-Fehlberg’s fourthfifth order technique and shooting procedure are used to solve the reduced set of equations and boundary *** integration of a neural network model based on the Levenberg-marquardt algorithm serves to improve the accuracy of predictions and optimize the analysis of *** outcomes are displayed to analyze the characteristics of the relevant dimensionless parameters in the current *** reveal that concentration upsurges as the micropolar parameter *** concentration reduces with an upsurge in the thermophoretic *** upsurge in the external pollutant source variation and the local pollutant external source parameters enhances mass *** surface drag force declines for improved values of porosity and micropolar parameters.

关键词： micropolar fluid thermal radiation porous medium thermophoretic particle deposition waste discharge concentration

Temporal dynamics of neonatal hypoxic-ischemic encephalopathy injuries on magnetic resonance imaging

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Neural Regeneration Research 2025年第11期20卷 3144-3150页

作者： Holly Flyger Samantha J.Holdsworth Alistair J.Gunn Laura Bennet Hamid Abbasi mātai medical Research Institute Tairāwhiti GisborneNew Zealand department of Anatomy&medical Imaging Faculty of Medical and Health SciencesThe University of AucklandAucklandNew Zealand Center for Brain Research The University of AucklandAucklandNew Zealand Auckland Bioengineering Institute The University of AucklandAucklandNew Zealand

moderate to severe perinatal hypoxic-ischemic encephalopathy occurs in~1 to 3/1000 live births in high-income countries and is associated with a significant risk of death or neurodevelopmental *** assessment is important to help identify highrisk infants,to help families,and to support appropriate interventions.A wide range of monitoring tools is available to assess changes over time,including urine and blood biomarkers,neurological examination,and *** present,magnetic resonance imaging is unique as although it is expensive and not suited to monitoring the early evolution of hypoxic-ischemic encephalopathy by a week of life it can provide direct insight into the anatomical changes in the brain after hypoxic-ischemic encephalopathy and so offers strong prognostic information on the long-term outcome after hypoxic-ischemic *** review investigated the temporal dynamics of neonatal hypoxic-ischemic encephalopathy injuries,with a particular emphasis on exploring the correlation between the prognostic implications of magnetic resonance imaging scans in the first week of life and their relationship to long-term outcome prediction,particularly for infants treated with therapeutic hypothermia.A comprehensive literature search,from 2016 to 2024,identified 20 pertinent *** review highlights that while the optimal timing of magnetic resonance imaging scans is not clear,overall,it suggests that magnetic resonance imaging within the first week of life provides strong prognostic *** challenges limit the timing consistency,particularly the need for intensive care and clinical ***,although most reports examined the prognostic value of scans taken between 4 and 10 days after birth,there is evidence from small numbers of cases that,at times,brain injury may continue to evolve for weeks after *** suggests that in the future it will be important to explore a wider range of times after hypo

关键词： magnetic resonance imaging neonatal hypoxic-ischemic encephalopathy neurodevelopmental outcomes prognostic biomarkers in neuroimaging scan timing therapeutic hypothermia

Current perspectives and the future of disease-modifying therapies in type 1 diabetes

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World Journal of Diabetes 2025年第1期16卷 12-21页

作者： Sunetra mondal Joseph m Pappachan department of Endocrinology NRS Medical College and HospitalKolkata 700014West BengalIndia department of Endocrinology and metabolism Lancashire Teaching Hospitals NHS TrustPreston PR29HTUnited Kingdom Faculty of Science Manchester Metropolitan UniversityManchester M156BHUnited Kingdom department of Endocrinology Kasturba Medical CollegeManipal 576104India

Use of immunomodulating agents to prevent the progression of autoimmuneβ-cell damage leading to type 1 diabetes mellitus(T1Dm)is an interesting area for *** include non-specific anti-inflammatory agents,immunologic vaccination and anti-inflammatory agents targeting specific immune cells or *** is an anti-CD3-molecule that binds to and leads to the disappearance of the CD3/TCR complex and rendering the T cell anergic to its target *** and clinical trials have demonstrated its efficacy in reducing the decline in serum C-peptide levels and the need for insulin therapy if used early in the disease process of *** benefits have been apparent as early as six months to as long as seven years after *** has recently been approved by the Food and Drug Administration to delay the onset of clinical(stage 3)type 1 diabetes in children above 8 years of *** their recent metaanalysis published in the World Journal of Diabetes,ma et al found that those in the teplizumab treatment group have a greater likelihood of reduction in insulin use,change in C-peptide response,and better glycemic control compared to the control group with a good safety ***,all the included randomized control trials have been conducted in high-income *** cost of therapy and unknown utility of the molecule in stage 3 disease limit its widespread use.

关键词： Teplizumab Type 1 diabetes mellitus Disease modifying therapy β-cell function C-peptide Immunotherapy