O relacionamento interpessoal no ensino híbrido de enfermagem / Interpersonal relationships in hybrid nursing education / Relaciones interpersonales en la educación híbrida de enfermería

Objetivo: Analisar as potencialidades do relacionamento interpessoal no ensino híbrido de enfermagem. Métodos: Estudo de reflexão com abordagem qualitativa e descritiva com a proposta dialógica, de forma que proporcione reflexões importantes para o desenvolvimento do ensino híbrido na enfermagem. Alguns aspectos são importantes a serem considerados como o relacionamento interpessoal no ensino híbrido e as tecnologias favoráveis a reflexão para o relacionamento interpessoal, visando a autonomia do aluno nas atividades de ensino-aprendizagem. Resultados: O professor tem como oportunidade de ser o mediador do conhecimento no aprendizado do discente através de um relacionamento interpessoal baseado em competências previstas no projeto político pedagógico do curso. Na formação do enfermeiro é evidenciado a importância do relacionamento interpessoal em sua formação porque no seu cotidiano assistencial esse processo comunicativo ocorre entre a equipe multidisciplinar, a própria equipe de enfermagem, bem como nos cuidados desenvolvidos com a clientela assistida. Conclusão: As mudanças pedagógicas a partir do ensino híbrido proporcionam várias possibilidades de convivência com vistas a um aprendizado colaborativo de acordo com o cenário de ensino. (AU)

Objective: Reflection article with the objective of analyzing the potentialities of interpersonal relationships in hybrid nursing education. Methods: The approach used in this article is qualitative and descriptive with the dialogical proposal, so that it provides important reflections for the development of hybrid teaching in nursing. Some aspects are important to be considered as interpersonal relationships in hybrid teaching and technologies favorable to reflection for interpersonal relationships, aiming at student autonomy in teaching-learning activities. Results: Teacher has the opportunity to be the mediator of knowledge in the student's learning through an interpersonal relationship based on competencies foreseen in the political pedagogical project of the course. In nursing education, the importance of interpersonal relationships in their education is evidenced because in their daily care this communicative process occurs between the multidisciplinary team, the nursing team itself, as well as in the care developed with the assisted clientele. Conclusion: The pedagogical changes from hybrid teaching provide several possibilities of coexistence with a view to collaborative learning according to the teaching scenario. (AU)

Objetivo: Artículo de reflexión con el objetivo de analizar las potencialidades de las relaciones interpersonales en la educación híbrida de enfermería. Métodos: El enfoque utilizado en este artículo es cualitativo y descriptivo con la propuesta dialógica, por lo que proporciona importantes reflexiones para el desarrollo de la enseñanza híbrida en enfermería. Algunos aspectos son importantes para ser considerados como relaciones interpersonales en la enseñanza híbrida y tecnologías favorables a la reflexión para las relaciones interpersonales, apuntando a la autonomía del estudiante en las actividades de enseñanza-aprendizaje. Resultados: El docente tiene la oportunidad de ser el mediador del conocimiento en el aprendizaje del alumno a través de una relación interpersonal basada en competencias previstas en el proyecto político pedagógico del curso. En la educación de enfermería, la importancia de las relaciones interpersonales en su educación se evidencia porque en su cuidado diario este proceso comunicativo ocurre entre el equipo multidisciplinario, el propio equipo de enfermería, así como en los cuidados desarrollados con la clientela asistida. Conclusión: Los cambios pedagógicos de la enseñanza híbrida proporcionan varias posibilidades de convivencia con vistas al aprendizaje colaborativo según el escenario de enseñanza. (AU)

Construction and self-activation detection of yeast two-hybrid bait plasmid of human programmed cell death ligand 1 immunoglobulin variable region domain gene / 中国生物制品学杂志

@#Objective To construct a yeast two-hybrid recombinant bait plasmid of human programmed cell death ligand 1(PD-L1)immunoglobulin variable region(IgV)domain gene,detect its expression in yeast and detect the cytotoxicity and self-activation of PD-L1 IgV protein as well as the interaction between PD-L1 IgV and human thioredoxin(hTrx).Methods Human PD-L1 was analyzed by bioinformatics method,and primers were designed to amplify PD-L1 IgV domain based on the coding region of PD-L1 gene registered in NCBI GenBank database. PCR amplification was carried out with pENTERPD-L1 plasmid as template,and then cloned into yeast two-hybrid bait vector pGBKT7. The recombinant bait plasmid and pGBKT7 empty vector were transformed into Y2HGold yeast cells respectively,and the PD-L1 IgV gene and its expression were detected by PCR and Western blot;Meanwhile,the protein toxicity and self-activation of PD-L1 IgV were detected,and the interaction between PD-L1 IgV and hTrx was detected by drip plate method.Results The bioinformatics analysis results of PD-L1 were consistent with related reports. The recombinant bait plasmid pGBKT7-PD-L1 IgV was correctly constructed,and Y2HGold positive clone was obtained,in which PD-L1 IgV was stably expressed. The empty vector pGBKT7 and recombinant bait plasmid pGBKT7-PD-L1 IgV grew well on SD/-Trp and SD/-Trp/X-α-Gal plates with the same colony size and number and white colony,but they did not grow on SD/-Trp/X-α-Gal/AbA plates,which indicated that PD-L1 IgV protein had no toxicity and no self-activation effect on yeast. The results of drip plates test showed that all experimental groups grew well on SD/-Trp/-Leu plate,while only positive control group grew on SD/-Trp/-Leu/X-α-Gal/AbA plate and showed blue color,which indicated that bait protein PD-L1 IgV and hTrx did not self-activate,and there was no interaction between them.Conclusion Recombinant human PD-L1 IgV bait plasmid was successfully constructed. PD-L1 IgV protein showed no toxicity and self-activation effect on yeast cells,and there was no interaction between PD-L1 IgV and hTrx. Subsequently,hTrx can be used to construct a peptide aptamer library,from which peptide aptamers that specifically bind to PD-L1 IgV can be screened.

Analysis on clinical efficacy of anterior cervical Hybrid surgery and posterior cervical expansive open-door laminopasty for multilevel cervical spondylotic myelopathy / 吉林大学学报(医学版)

Objective:To analyze the efficacy of anterior cervical Hybrid surgery and posterior cervical expansive open-door laminoplasty(EODL)in the treatment of multilevel cervical spondylotic myelopathy,and to discuss the selection of surgical methods for the patients with multilevel cervical spondylotic myelopathy.Methods:The retrospective analysis was conducted of 70 patients with multilevel cervical spondylotic myelopathy who underwent surgery at Affilated Beijing Traditional Chinese Medicine Hospital of Capital Medical University from July 2017 to July 2020.Based on the different surgical methods,the patients were divided into anterior group(n=35)and posterior group(n=35).The patients in anterior group underwent Hybrid surgery[anterior cervical discectomy and fusion(ACDF)combined with artificial cervical disc replacement(ACDR)],and the patients in posterior group underwent EODL.The hospitalization time,operation time,intraoperative blood loss,and postoperative drainage volume of the patients in two groups were recorded;the efficacy was evaluated by Japanese orthopaedic association(JOA)score,JOA improvement rate,neck disability index(NDI),visual analogue scale(VAS)for pain,and postoperative satisfaction score;the complications of the patients in two groups after surgery were recorded.Results:Compared with posterior group,the intraoperative blood loss,postoperative drainage volume,hospitalization time,and operation time of the patients in anterior group were significantly decreased(P<0.01),and the preoperative score had no significant difference(P>0.05).At the final follow-up after surgery,compared with posterior group,the JOA score and JOA improvement rate of the patients in anterior group were significantly increased(P<0.01),and the NDI score and VAS score were significantly decreased(P<0.01).Compared with before surgery,the JOA scores of the patients in two groups at the final follow-up after surgery were increased(P<0.01),and the NDI and VAS scores were significant decreased(P<0.01).The postoperative satisfaction of the patients in two groups was high based on the postoperative satisfaction score.There was no significant difference in the incidence of postoperative complication of the patients between two groups(P>0.05).Conclusion:Both the anterior cervical Hybrid surgery and EODL achieve the satisfactory results in the treatment of multilevel cervical spondylotic myelopathy.Hybrid surgery has the advantages of less bleeding and shorter surgery time,and the most suitable surgical method should be chosen clinically based on the actual situation of the patients.

Diagnosis and treatment status quo of major aortopulmonary collateral arteries in congenital heart disease with decreased pulmonary blood flow / 国际儿科学杂志

The congenital heart disease with decreased pulmonary blood flow is one type of congenital heart disease characterized by reduced pulmonary blood flow. Common clinical types include tetralogy of Fallot，pulmonary atresia，double outlet right ventricle，and other complex malformations associated with pulmonary artery stenosis. Due to the lack of pulmonary blood supply from the right ventricle，children with this condition often have major aortopulmonary collateral arteries（MAPCAs）or the ductus arteriosus participating in pulmonary circulation for blood supply. Research has revealed that MAPCAs are important factors which cause the increase of mechanical ventilation time，intensive care unit stay time，complication rate and mortality after radical surgical treatment of congenital heart disease with decreased pulmonary blood flow. Therefore，the treatment of MAPCAs in perioperative period is crucial. This article summarizes the research progress of MAPCAs distribution and influence，diagnosis and evaluation，and treatment methods，to provide the reference for clinicians to standardize MAPCAs treatment.

Recent progress in hybrid surgery for tandem carotid artery stenosis / 介入放射学杂志

Clinically,tandem carotid artery stenosis(TCAS)is a relatively rare atherosclerotic disease,and with the development of interventional techniques,its treatment has become more and more minimally invasive,and the technical feasibility of hybrid surgery(HS)has been already confirmed for long time.In recent years,with the increasing of the number of patients and the deepening of research both at home and abroad,it has been found that the safety and effectiveness of HS for TCAS are still questionable,and it is particularly important to choose the appropriate treatment for such patients.This article aims to make a comprehensive review about the HS for TCAS,focusing on its surgical process,comparison of its surgical methods,and the current controversies over the treatment of TCAS,with the hope that clinicians can get a more comprehensive understanding about this surgical method.(J Intervent Radiol,2024,32:95-99)

Experience and learning curve of single-line suspension suction rod-assisted hybrid cavity-building thyroid surgery via the oral vestibular approach / 中华内分泌外科杂志

Objective:To explore the experience and learning curve of single-line suspension suction rod-assisted hybrid cavity-building thyroid surgery via the oral vestibular approach.Methods:Clinical data of 138 patients undergoing single-line suspension suction rod-assisted hybrid cavity-building thyroid surgery via oral vestibular approach from Sep. 2019 to Dec. 2021 in the Department of Thyroid and Breast Surgery of Affiliated Hospital of North Sichuan Medical College were retrospectively analyzed. The cumulative sum (CUSUM) method and best-fit curve analysis were used to compare the differences in each index such as operative time, intraoperative bleeding, number of lymph nodes cleared in the central region and postoperative related complications at various stages of the learning curve.Results:All 138 patients underwent single-line suspension rod-assisted hybrid cavity-building thyroid surgery via the oral vestibular approach, and one patient was converted to open surgery due to large intraoperative bleeding in the mass. There were 14 males and 124 females, mean age (36.07±8.49) years (20-55 years), thyroid tumor size (7.74±6.49) mm (2.4-50mm), 5 cases underwent Subtotal thyroidectomy, 129 cases underwent Unilateral lobectomy + lymph node dissection in the middle region, and 4 cases total thyroidectomy + central zone lymph node dissection. The number of surgical cases corresponding to the apex of the CUSUM learning curve was 45, and the learning curve was divided into two stages: the learning improvement stage (1-45 cases) and the mastery stage (46-138 cases). The operative time, intraoperative bleeding, postoperative hospital stay, and chin numbness were all lower in the proficiency period than in the learning and training period ( P<0.05), and the number of lymph nodes cleared in the central region was larger than that in the learning and improvement stage ( P<0.05), while the differences in other indexes between the two stages were not statistically significant ( P>0.05) . Conclusion:The single-line suspension suction rod-assisted hybrid cavity-building thyroid surgery via the oral vestibular approach has clinical application value and is worth promoting, and the number of surgical cases to be accumulated to master this technique is 45.

Exploration of BOPPPS-based online and offline hybrid teaching model of evidence-based medicine course / 中华医学教育探索杂志

The online and offline hybrid teaching model of evidence-based medicine (EBM) is currently in the stage of development. Previous teaching focused on the teaching process in the classroom, and did not organically combine all the course contents before, during, and after class. The BOPPPS model can be used to establish coherence and integrity in the EBM teaching process. Considering the discipline characteristics and teaching objectives of EBM, this study initially explored and designed a BOPPPS-based online and offline hybrid teaching model. Taking the "diagnostic evidence" module as an example, the teaching implementation details were introduced. A pre-designed questionnaire was used to conduct baseline survey and follow-up survey on students before and after class to evaluate the teaching model and effect. The surveys showed that half of the students (77/154) preferred the new online and offline hybrid teaching model of EBM. The students found that all aspects of BOPPPS teaching were generally acceptable and satisfactory. Compared with before teaching, the students' proficiency in EBM was significantly improved after the teaching ( P<0.001), particularly in their ability to retrieve literature and evaluate the quality of evidence, which is of great significance for expanding their knowledge and clinical thinking.

Application of SPOC-based hybrid scenario simulation teaching method in undergraduate clinical teaching of pediatric dentistry / 中华医学教育探索杂志

Objective:To investigate the effects of the hybrid scenario simulation teaching method based on small private online courses (SPOC) in undergraduate clinical teaching of pediatric dentistry.Methods:A total of 44 students of dentistry practicing in the Department of Pediatric Dentistry, The Third Affiliated Hospital, The Air Force Military Medical University, from January 2020 to December 2021 were selected, with 23 students practicing from January to December 2020 in control group (receiving traditional teaching) and 21 students practicing from January to December 2021 in experimental group (employing SPOC-based hybrid scenario simulation teaching method). At the end of the internship, an exam was given to assess the students' doctor-patient communication and standardized operation, and parental satisfaction and students' satisfaction were scored. SPSS 20.0 software was used to perform the independent samples t test for data analysis. Results:Compared with the control group, the experimental group had significantly higher scores of doctor-patient communication [(82.83±2.09) points vs. (88.40±2.22) points] and standardized operation [(82.26±4.38) points vs. (86.67±2.62) points] as well as significantly higher scores of parental satisfaction and students' satisfaction [(18.85±1.73) points vs. (20.71±0.85) points] and [(17.37±0.98) points vs. (20.57±0.66) points; all P<0.05]. Conclusions:The SPOC-based hybrid scenario simulation teaching method can effectively improve the quality of clinical teaching for undergraduate internships in pediatric dentistry, especially for cultivating doctor-patient communication ability.

Effectiveness analysis of hybrid endoscopic submucosal dissection in patients with colorectal epithelium-derived tumors / 中华内科杂志

Objective:To compare the clinical benefits of classic endoscopic submucosal dissection (ESD) and hybrid ESD for the treatment of colorectal epithelium-derived tumors.Methods:The current investigation was a retrospective multicenter study of 418 patients who underwent ESD between January 2015 and April 2021 at Beijing Jishuitan Hospital. The patients were assigned to one of two groups based on the surgical procedure they underwent; a classic ESD group or a hybrid ESD group. The primary outcome was the rate of en bloc resection and complete resection. SPSS 26.0 was used for statistical analysis. Homogeneity of variance was assessed via Cochran′s test. Normally distributed data with homogeneity of variance were analyzed via the t-test for independent samples. Non-normally distributed data and data with unequal variance were analyzed via the Kruskal-Wallis non-parametric test. Categorical data were analyzed via the Chi-square test or Fisher′s exact test. Multivariable assessment was performed via logistic regression analysis. Results:The en bloc resection rates [89.4% (84/94) vs. 87.0% (194/223), χ2=0.34, P=0.558] and complete resection rates [85.1% (80/94) vs. 82.1% (183/223), χ2=0.33, P=0.510] were similar. Compared with classic ESD, procedures were shorter in the hybrid ESD group [22(7, 213) vs. 47(12, 680) min, Z=0.23, P<0.001], dissection was completed more rapidly [0.14(0.02, 0.32) vs. 0.10(0.02, 0.41) cm 2/min, Z=0.08, P<0.001], and there was a higher rate of perforation (9.6% vs. 2.2%, χ2=2.67, P=0.006). Laterally spreading tumor granular type nodular mixed, non-granular type pseudo-depressed, flat-elevated type (odds ratio 2.826, P=0.012), and tumor location (odds ratio 6.970, P=0.005) were independently associated with complete resection in the hybrid ESD group. Conclusion:Classic ESD and hybrid ESD had similar en bloc and complete resection rates for colorectal epithelium-derived tumors, but hybrid ESD had shorter operation times. With respect to hybrid ESD, factors associated with failure of complete resection included lesion type and crossing tissue boundaries.

Two-stage retrograde hybrid repair in the surgical treatment of acute aortic dissection complicated with distal malperfusion syndrome / 中国胸心血管外科临床杂志

@#Objective To evaluate the clinical efficacy of two-stage retrograde hybrid repair for acute aortic dissection involving the aortic arch complicated with distal malperfusion syndrome. Methods From May 2019 to December 2022, the patients presented with acute aortic dissection involving the aortic arch complicated with distal malperfusion syndrome treated in the Department of Cardiovascular Surgery of West China Hospital, Sichuan University were enrolled. After preoperative evaluation, all patients underwent priority emergency interventional surgery to improve distal malperfusion, and then underwent two-stage hybrid surgery to repair proximal aortic lesions. The perioperative clinical and imaging data were retrospectively analyzed. Results Five patients were collected, including 4 males and 1 female, with a median age of 58 years. The main manifestations were lower limb ischemia and renal insufficiency in 3 patients, and poor intestinal perfusion in 2 patients. All patients were given priority to interventional surgery to implant graft stents or bare stents and necessary branch artery intervention, and then successfully performed two-stage hybrid surgery, including type Ⅰhybrid surgery for 2 patients, type Ⅱ hybrid surgery for 1 patient and type Ⅲ hybrid surgery for the other 2 patients, with a success rate of 100.0%. All patients were discharged successfully, and the function of the organs with poor perfusion returned to normal. Only 1 patient recovered to grade 4 muscle strength of the diseased lower limbs upon discharge. No adverse events such as amputation, exploratory laparotomy and intestinal resection or long-term hemodialysis occurred. Conclusion The application of two-stage retrograde hybrid repair in the surgical treatment of acute aortic dissection involving the aortic arch complicated with distal malperfusion syndrome is safe and effective, and is helpful to improve the perioperative survival rate, and clinical outcomes of such patients.

Case Study on Deductive Teaching of "Doctor-patient Communication" / 中国医学伦理学

By introducing the connotation of deductive teaching and analyzing the significance of early contact clinical course of "doctor-patient communication", the author reinterpreted the educational concept of deductive teaching combined with the characteristics of medical humanities, and reformed the early contact clinical course of "doctor-patient communication" by introducing deductive teaching method. Taking the early contact clinical course of "doctor-patient communication" of a medical university as an example, the teaching framework was designed to share experience from three aspects: teaching content, teaching process and teaching effect evaluation. At the same time, combined with the characteristics of the course and the needs of students, found out the problems encountered in the teaching process, and put forward constructive opinions and strategies, in order to provide theoretical and practical reference for the teaching of medical humanities course.

Systematic characterization and identification of the chemical constituents of the Schisandra chinensis decoction based on a hybrid scanning technique of UHPLC/IM-QTOF-MS / 药学学报

italic>Schisandra chinensis is a traditional Chinese medicine with the functions of reinforcing deficiency, strengthening, and inducing astringency, appliable to treat the chronic cough and deficiency in breath, palpitation, and insomnia, etc. A hybrid mass spectrometry scanning strategy (high-definition data-independent/data-dependent acquisition, HDDIDDA), enabling the ion mobility separation and alternating data-independent acquisition/data-dependent acquisition, was established, which, in combination with in-house library-driven automatic peak annotation workflows facilitated by the UNIFI software, was utilized to systematically characterize the multi-classes of chemical components from S. chinensis. The use of an HSS T3 column (100 mm × 2.1 mm, 1.8 μm), 0.1% formic acid in H2O-acetonitrile as the mobile phase running at the flow rate of 0.3 mL·min-1, and column temperature at 35 ℃, could enable good separation of the S. chinensis components within 42 min. HDDIDDA scan in both the positive and negative ion modes was employed for data acquisition. Based on the automatic peak annotation, reference standards comparison, MS2 data interpretation, and literature analysis, we were able to identify or tentatively characterize 105 compounds in the S. chinensis decoction, involving 56 terpenoids, 42 lignans, five glycosides, one organic acid, and one flavonoid. HDDIDDA scanning can improve the coverage of data acquisition and improve the accuracy of identification, while CCS prediction analysis provides the possibility to distinguish isomers by the ion mobility technology. The results provide reference for the intelligent material basis research of TCM.

Logic-gated tumor-microenvironment nanoamplifier enables targeted delivery of CRISPR/Cas9 for multimodal cancer therapy

Recent innovations in nanomaterials inspire abundant novel tumor-targeting CRISPR-based gene therapies. However, the therapeutic efficiency of traditional targeted nanotherapeutic strategies is limited by that the biomarkers vary in a spatiotemporal-dependent manner with tumor progression. Here, we propose a self-amplifying logic-gated gene editing strategy for gene/H2O2-mediated/starvation multimodal cancer therapy. In this approach, a hypoxia-degradable covalent-organic framework (COF) is synthesized to coat a-ZIF-8 in which glucose oxidase (GOx) and CRISPR system are packaged. To intensify intracellular redox dyshomeostasis, DNAzymes which can cleave catalase mRNA are loaded as well. When the nanosystem gets into the tumor, the weakly acidic and hypoxic microenvironment degrades the ZIF-8@COF to activate GOx, which amplifies intracellular H+ and hypoxia, accelerating the nanocarrier degradation to guarantee available CRISPR plasmid and GOx release in target cells. These tandem reactions deplete glucose and oxygen, leading to logic-gated-triggered gene editing as well as synergistic gene/H2O2-mediated/starvation therapy. Overall, this approach highlights the biocomputing-based CRISPR delivery and underscores the great potential of precise cancer therapy.

Hybrid Treatment of Multiple Coronary Aneurysms with a Pulmonary Artery Fistula / 日本心臓血管外科学会雑誌

A computed tomography (CT) scan was performed for a man in his 60s to investigate a continuous murmur. An 18-mm coronary aneurysm with a fistula with the pulmonary artery was found on the anterior aspect of the main pulmonary artery (MPA),and a 10-mm coronary aneurysm was found on the lateral aspect. Abnormal inflow vessels originating from the right sinus of Valsalva and the left anterior descending artery (LAD) formed a complicated network around the MPA. Although the patient was asymptomatic, the aneurysms were saccular and considered to be an indication for surgery to prevent rupture. In addition, heart failure, embolism, and myocardial ischemia could be prevented by treatment. We planned a hybrid therapy of open surgery and percutaneous coil embolization. Surgical repair was performed through a median sternotomy. The abnormal vessel originating from the right sinus of Valsalva was ligated under cardiopulmonary bypass. After cardiac arrest, the 18-mm aneurysm located on the anterior surface of the MPA was incised and the orifice of the fistula and inflow vessels were closed from the inside of the aneurysm. The anomalous vessels originating from the LAD and the 10-mm aneurysm on the lateral aspect of the MPA were located near the LAD; therefore, we avoided surgical repair of these lesions. An additional percutaneous coil embolization was performed postoperatively for the remaining lesions. A post-embolization CT scan showed no residual aneurysms or fistula. A hybrid treatment may be a useful method to reduce the risk of complications of each therapy for reliable closures of fistula and aneurysms.

Arterial Blood Pressure Wave Signal Reconstruction Using Photoplethysmography by CNN-LSTM Model / 生物化学与生物物理进展

ObjectiveDirect continuous monitoring of arterial blood pressure is invasive and continuous monitoring cannot be achieved by traditional cuffed indirect blood pressure measurement methods. Previously, continuous non-invasive arterial blood pressure monitoring was achieved by using photoplethysmography (PPG), but it is discrete values of systolic and diastolic blood pressures rather than continuous values constructing arterial blood pressure waves. This study aimed to reconstruct arterial blood pressure wave signal based on CNN-LSTM using PPG to achieve continuous non-invasive arterial blood pressure monitoring. MethodsA CNN-LSTM hybrid neural network model was constructed, and the PPG and arterial blood pressure wave synchronized recorded signal data from the Medical Information Mart for Intensive Care (MIMIC) were used. The PPG signals were input to this model after noise reduction, normalization, and sliding window segmentation. The corresponding arterial blood pressure waves were reconstructed from PPG by using the CNN-LSTM hybrid model. ResultsWhen using the CNN-LSTM neural network with a window length of 312, the error between the reconstructed arterial blood pressure values and the actual arterial blood pressure values was minimal: the values of mean absolute error (MAE) and root mean square error (RMSE) were 2.79 mmHg and 4.24 mmHg, respectively, and the cosine similarity is the optimal. The reconstructed arterial blood pressure values were highly correlated with the actual arterial blood pressure values, which met the Association for the Advancement of Medical Instrumentation (AAMI) standards. ConclusionCNN-LSTM hybrid neural network can reconstruct arterial blood pressure wave signal using PPG to achieve continuous non-invasive arterial blood pressure monitoring.

Effect of loading protocol on peri-implant marginal bone loss: randomized clinical trial / Efeito do protocolo de carregamento na perda óssea marginal peri-implantar: ensaio clínico randomizado

Objective: This clinical study was conducted to evaluate the effect of loading protocol using hybrid ceramic resinous material on marginal bone loss. Material and Methods: This study was conducted in the fixed prosthodontics department, at Ain Shams University on 30 titanium endosseous tapered threaded implants which were placed in 30 patients in the upper premolar area. Patients were divided randomly according to the loading protocol into 3 groups (10 patients each): Group I (IFLV): patients received CAD/CAM polymer infiltrated ceramic (VITA-ENAMIC) crowns (immediate functional loading), Group II (IFLP): patients received CAD/CAM PMMA crowns (in occlusion for 3 months) followed by CAD/CAM polymer infiltrated ceramic (VITA-ENAMIC) crowns (functional loading), and Group III (INFLP): patients received CAD/CAM PMMA crowns (out of occlusion for 3 months) followed by CAD/CAM VITA-ENAMIC crowns (functional loading). Results: After three months; the highest value of marginal bone loss (mm) was found in IFLV, followed by IFLP, while the lowest value was found in INFLP. After six months, the highest value was found in IFLP, followed by IFLV, while the lowest value was found in INFLP. Also, after twelve months, the highest value was found in IFLV, followed by IFLP, while the lowest value was found in INFLP. Marginal bone loss values were within the accepted values for clinical success for all the tested groups. Conclusion: Immediate non-functional loading provided more acceptable outcomes than immediate functional loading. Also, immediately functional and non-functional implant loading using hybrid ceramic as permanent material has shown promising results with proper patient selection (AU)

Objetivo: Este estudo clínico foi realizado para avaliar o efeito do protocolo de carregamento utilizando material resinoso cerâmico híbrido na perda óssea marginal. Material e Métodos: Este estudo foi realizado no departamento de prótese fixa da Universidade Ain Shams em 30 implantes endósseos cônicos de titânio que foram instalados em 30 pacientes na região de pré-molares superiores. Os pacientes foram divididos aleatoriamente de acordo com o protocolo de carregamento em 3 grupos (10 pacientes cada): Grupo I (IFLV): os pacientes receberam coroas usinadas em CAD/CAM de cerâmica infiltrada com polímero (VITA-ENAMIC) (carga imediata), Grupo II (IFLP): os pacientes receberam coroas usinadas em CAD/CAM de PMMA (em oclusão por 3 meses) seguidas por coroas de cerâmica infiltrada com polímero (VITA-ENAMIC) (carga funcional), e Grupo III (INFLP): os pacientes receberam coroas usinadas em CAD/CAM de PMMA (infraoclusão por 3 meses) seguido de coroas de VITA-ENAMIC (carga funcional). Resultados: Após três meses; o maior valor de perda óssea marginal (mm) foi encontrado no IFLV, seguido pelo IFLP, enquanto o menor valor foi encontrado no INFLP. Após seis meses, o maior valor foi encontrado no IFLP, seguido do IFLV, enquanto o menor valor foi encontrado no INFLP. Além disso, após doze meses, o maior valor foi encontrado no IFLV, seguido pelo IFLP, enquanto o menor valor foi encontrado no INFLP. Os valores de perda óssea marginal estavam todos dentro de valores aceitáveis para sucesso clínico para todos os grupos testados. Conclusão: A carga funcional não imediata proporcionou resultados mais aceitáveis do que a carga imediata. Além disso, o carregamento funcional imediato e não imediato de implantes utilizando coroas finais de cerâmica híbrida mostrou resultados promissores com a seleção adequada dos pacientes.(AU)

Hybrid Therapies for Supporting Critically Ill Patients with Acute Kidney Injury: When, how, and for Whom?

ABSTRACT Acute kidney injury (AKI) is common in critically ill patients. There is no specific pharmacological treatment for established severe AKI. Therefore, the conventional therapeutic strategy is limited to the use of kidney replacement therapy (KRT) to maintain homeostasis. Hybrid therapies optimize the advantages of intermittent and continuous modalities of KRT, combining lower hourly efficiency, longer application time, at lesser cost, but also adding different physicochemical principles of extracorporeal clearance. The sum of convection and diffusion, with or without adsorption or apheresis, and in different time combinations gives hybrid techniques great flexibility in prescribing a personalized treatment adapted to the needs of each patient at any given time. Hybrid therapies are increasingly being used due to their flexibility, which is determined by the combination of equipment, membranes, and available resources (machines and health-care personnel experience). The required technology is widely available in most intensive care units and uses low-cost consumables compared to other types of AKI treatment modalities, favoring its widespread use. Hybrid therapies are feasible and provide a viable form of KRT, either alone or as a transition therapy from continuous kidney replacement therapy to intermittent hemodialysis.

Minimally Invasive Direct Coronary Artery Bypass and Percutaneous Coronary Intervention Followed by Transcatheter Aortic Valve Implantation: A Promising Concept in High?risk Octogenarians

Objectives: In this article, we present our initial clinical experience with staged minimally invasive direct coronary bypass (MIDCAB), percutaneous coronary intervention (PCI), and transcatheter aortic valve implantation (TAVI) in high?risk octogenarians (Hybrid). Background: The use of percutaneous techniques for managing structural heart diseases, especially in elderly high?risk patients, has revolutionized the treatment of structural heart diseases. These procedures are present predominantly being offered as isolated interventions. The feasibility, clinical benefit, and outcomes of combining these techniques with MIDCAB have not been sufficiently explored and have subsequently been underreported in the contemporary literature. Methods: Four consecutive octogenarians with severe aortic stenosis (AS) and complex coronary artery disease (CAD) that were at high risk for conventional surgery with extracorporeal circulation (ECC) were discussed in our Multidisciplinary Heart Team(MDH). Our MDH consisted of an interventional cardiologist, cardiac surgeon, and cardiac anesthesiologist. A hybrid approach with the alternative strategy comprising of MIDCAB, PCI, and TAVI in a staged fashion was agreed on. All 4 patients had both PCI/stenting and MIDCAB prior to deployment of the TAVI?prosthesis. Results: From January 2019 to December 2020, 4 consecutive patients aged between 83 and 85 (3male/1 female) years were scheduled for MIDCAB/ PCI followed by percutaneous treatment of severe symptomatic AS. Intraoperatively, one patient was converted to full sternotomy, and surgery was performed by off?pump coronary artery bypass grafting. The overall procedural success rate was 100% in all 4 patients with resolution of their initial presenting cardiopulmonary symptoms. There were no severe complications associated with all hybrid procedures. There was no 30?day mortality in all patients. All patients were discharged home with a median hospital stay ranging between 9 and 25days. All patients have since then been followed?up regularly. There was one noncardiac?related mortality at 6?months postsurgery. All other patients were well at 1?year follow?up with improved NewYork Heart Association Class II. Conclusions: In a selected group of elderly, high prohibitive risk patients with CAD and severe symptomatic AS, a staged approach with MIDCAB and PCI followed by TAVI can be safely performed with excellent outcomes. We advocate a MDH?based preliminary evaluation of this patient cohort in selecting suitable patients and appropriate timing of each stage of the hybrid procedure.

Potential larvicidal bioefficacy of copper sulfide-based hybrid nanoemulsions of eucalyptus oil against Aedes aegypti (Linnaeus)

Background & objectives: Nanotechnology, an emerging field, has acquired considerable attention for the control of vectors. The present study aimed to synthesize, characterize copper sulfide- and eucalyptus oil-based hybrid nanoemulsions and investigate their larvicidal potential against Aedes aegypti by studying larvicidal bioassay, morphological aberrations, histopathological alterations, biochemical analysis and evaluation of risk assessment in non-target organisms. Methods: Hybrid nanoemulsions were prepared by mixing aqueous copper sulfide nanoparticles (CuSNPs) with non-polar eucalyptus oil in five ratios (1:1, 1:2, 1:3, 1:4 and 1:5) by sonication, screened and characterized using Transmission electron microscopy (TEM). Larvicidal activity was recorded and toxicity values were calculated by log-probit method. Morphological, histological and biochemical changes were examined in Aedes aegypti larvae after treatment. Nanohybrids were also tested under simulated conditions and against non-target organism. Results: The nanohybrid ratio of 1:5 was found to be stable after thermodynamic stability tests. TEM studies revealed average size of 90±7.90 nm with globular shape. LC50 and LC90 toxicity values of prepared CuSNPs were calculated out to be 5.00 and 5.81ppm after 24 hours treatment. Effective concentration of prepared nanohybrid (6.5ppm) tested under simulated conditions showed maximum larvicidal mortality after 48 hours of exposure. No toxicity towards the Mesocyclops spp. was observed after treatment of these nanohybrids even up to 21 days. Interpretation & conclusion: Copper sulfide based hybrid nanoemulsions were found to show efficient larvicidal property which can be used for the formulation of ecofriendly bio-larvicide against Aedes aegypti.

Light-driven CO2 conversion system: construction, optimization and application / 生物工程学报

The use of light energy to drive carbon dioxide (CO2) reduction for production of chemicals is of great significance for relieving environmental pressure and solving energy crisis. Photocapture, photoelectricity conversion and CO2 fixation are the key factors affecting the efficiency of photosynthesis, and thus also affect the efficiency of CO2 utilization. To solve the above problems, this review systematically summarizes the construction, optimization and application of light-driven hybrid system from the perspective of combining biochemistry and metabolic engineering. We introduce the latest research progress of light-driven CO2 reduction for biosynthesis of chemicals from three aspects: enzyme hybrid system, biological hybrid system and application of these hybrid system. In the aspect of enzyme hybrid system, many strategies were adopted such as improving enzyme catalytic activity and enhancing enzyme stability. In the aspect of biological hybrid system, many methods were used including enhancing biological light harvesting capacity, optimizing reducing power supply and improving energy regeneration. In terms of the applications, hybrid systems have been used in the production of one-carbon compounds, biofuels and biofoods. Finally, the future development direction of artificial photosynthetic system is prospected from the aspects of nanomaterials (including organic and inorganic materials) and biocatalysts (including enzymes and microorganisms).