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Uncertainties about the efficacy of influenza vaccination for populations with heart failure (HF) in preventing cardiovascular outcomes, as well as lack of effective vaccination strategies, may contribute to low vaccine coverage rate (VCR) in China and globally. We assessed the feasibility of a strategy to promote influenza vaccines in patients hospitalized with acute HF in China and to inform the design of a hybrid effectiveness-implementation cluster randomized trial to evaluate this strategy on mortality and hospital re-admission. We conducted a cluster randomized pilot trial involving 11 hospitals in Henan Province in China, with mixed-methods evaluation between December 2020 and April 2021. A process evaluation involved interviews with 51 key informants (patients, health professionals, policy makers). The intervention included education about influenza vaccination and availability of free vaccines administered prior to hospital discharge for HF patients, while usual care included attending community-based points of vaccination (PoV) for screening and vaccination. Implementation outcomes focused on reach, fidelity, adoption, and acceptability. Recruitment rates were assessed for trial feasibility. Effectiveness outcomes were influenza VCR, HF-specific rehospitalizations and mortality at 90 days. A total of 518 HF patients were recruited from 7 intervention and 4 usual care hospitals (mean of 45 participants per hospital per month). VCR was 89.9% (311/346, 86.1-92.8%) in the intervention group and 0.6% (1/172, 0.0-3.7%) in the control group. The process evaluation demonstrated reach to patients with lower socioeconomic and education status. There was good fidelity of the intervention components, with education and PoV set up processes being adapted to local hospital workflow and workforce capacity. Intervention was acceptable and adopted by patients and health professionals. However, outside of a trial setting, concerns were raised around vaccination reimbursement costs, workforce accountability and capacity. The intervention strategy appears feasible and acceptable for improving VCR in HF patients at county-level hospitals in China. Trial registration: This pilot trial is registered with the acronym PANDA II Pilot (Population Assessment of Influenza and Disease Activity) at ChiCTR.org.cn (ChiCTR2000039081).

The aim of the present study was to explore the risk factors of postoperative airway complications in children with oral floor mass. The first choice of auxiliary examination method for children with oral floor mass is also proposed. This retrospective study included 50 children with floor-of-mouth (FOM) masses. Medical records were reviewed, and information on age of onset, functional impacts present, age at consultation, imaging findings, history of preoperative aspiration, pathology findings, properties of biopsied fluid, treatment modality, postoperative outcomes, and operation were recorded. A total of 20 patients exhibited functional impacts such as difficulty in breathing and feeding. Ultrasound examination was performed in 28 cases; and magnetic resonance imaging, in 38 cases. The diagnosis was lymphatic malformation in 12 cases, developmental cyst in 29 cases, and solid mass in 7 cases. There were 28 cases of surgical resection, 9 cases underwent multiple puncture volume reduction followed by surgery, 11 cases treated using sclerotherapy injection, and 1 case treated using sclerotherapy injection and surgical resection. Young age, functional impact, and high grade of lymphatic duct malformation increased the risk of surgical treatment. B-scan ultrasound is the first choice for the diagnosis of FOM masses in children.

In order to further control the springback of advanced high-strength steel in stamping,a method to reduce the bending springback by increasing the variable closing pressure (VCP) through servo hydraulic equipment without increasing the material forming margin was proposed. For U-shaped benchmark parts of 1 180 MPa dual-phase (DP1180) steel formed by stamping, the feasibility of increasing VCP to control springback was analyzed by using the finite element method, and the mechanism of increasing VCP to reduce springback was studied from the perspective of residual stress and dislocation. The results show that the proposed method can reduce the residual stress and the dislocation density of the formed material, thus increasing the inelastic recovery and achieving the effect of reducing the springback angle of the target part by 22.3%. Because this method is only applied at the end of part forming, which does not affect the plastic flow in the material forming process, there is no need to increase the additional material forming ability and shaping process, which can be applied to actual industry without changing the production rhythm, and has a broad application prospect.

Background: Nonischemic cardiomyopathy (NISCM) is a clinical challenge with limited therapeutic targets. This study aims to identify promising drug targets for NISCM. Methods: We utilized cis-pQTLs from the deCODE study, which includes data from 35,559 Icelanders, and SNPs from the FinnGen study, which includes data from 1,754 NISCM cases and 340,815 controls of Finnish ancestry. Mendelian randomization (MR) analysis was performed to estimate the causal relationship between circulating plasma protein levels and NISCM risk. Proteins with significant associations underwent false discovery rate (FDR) correction, followed by Bayesian colocalization analysis. The expression of top two proteins, LILRA5 and NELL1, was further analyzed using various NISCM datasets. Descriptions from the Human Protein Atlas (HPA) validated protein expression. The impact of environmental exposures on LILRA5 was assessed using the Comparative Toxicogenomics Database (CTD), and molecular docking identified the potential small molecule interactions. Results: MR analysis identified 255 circulating plasma proteins associated with NISCM, with 16 remaining significant after FDR correction. Bayesian colocalization analysis identified LILRA5 and NELL1 as significant, with PP.H4 > 0.8. LILRA5 has a protective effect (OR = 0.758, 95% CI, 0.670–0.857) while NELL1 displays the risk effect (OR = 1.290, 95% CI, 1.199–1.387) in NISCM. Decreased LILRA5 expression was found in NISCM such as diabetic, hypertrophic, dilated, and inflammatory cardiomyopathy, while NELL1 expression increased in hypertrophic cardiomyopathy. HPA data indicated high LILRA5 expression in neutrophils, macrophages and endothelial cells within normal heart and limited NELL1 expression. Immune infiltration analysis revealed decreased neutrophil in diabetic cardiomyopathy. CTD analysis identified several small molecules that affect LILRA5 mRNA expression. Among these, Estradiol, Estradiol-3-benzoate, Gadodiamide, Topotecan, and Testosterone were found to stably bind to the LILRA5 protein at the conserved VAL-15 or THR-133 residues in the Ig-like C2 domain. Conclusion: Based on European Ancestry Cohort, this study reveals that LILRA5 and NELL1 are potential therapeutic targets for NISCM, with LILRA5 showing particularly promising prospects in diabetic cardiomyopathy. Several small molecules interact with LILRA5, implying potential clinical implication. [ABSTRACT FROM AUTHOR]

At present, in most coal mines, the coal pillar width of goaf-side roadway driving is determined by the average mining thickness. However, the thickness of the same coal seam could be varied greatly by various factors during the formation process. The large variation of mining thickness in the fully mechanized working face leads to large difference of surrounding rock deformation and complex damage mechanism of the goaf-side roadway driving. In order to solve the above problems, FLAC3D software is used to establish a roadway model so as to analyze the surrounding rock deformation and damage law under the average mining thickness, and determine the reasonable coal pillar width. When the average mining thickness is 18 m, on the side of the solid coal, the peak supporting pressure in the coal is positively correlated with the coal pillar width. Moreover, when the coal pillar width is greater than 8 m, the growth rate of the supporting pressure slows down. Therefore, the reasonable coal pillar width should be 8 m. This paper studies the influence of mining thickness on the stability of the surrounding rock of goaf-side roadway driving in the context of determined coal pillar width. The results show that when the coal pillar width is 8 m, with the increase of mining thickness, the shear damage area of roof increases, and the rock deformation range and the roof subsidence increase. However, the shear damage area of two sides and the distance between the two sides decrease. When the mining thickness is less than 18 m, the peak support pressure in the coal pillar is negatively correlated with the mining thickness. When the mining thickness is greater than 18 m, the peak support pressure in the coal pillar is positively correlated with the mining thickness, but the growth is small. According to the simulation analysis results, it is concluded that the increase of mining thickness is beneficial to the control of the surrounding rock along the two sides of the goaf roadway, but not beneficial to the roof maintenance. For areas with large mining thickness, anchor rods should be added to strengthen support in time. The actual application on site verifies the reliability and validity of the research in this paper.

This paper addresses the trajectory tracking problem for a class of uncertain manipulator systems under the effect of external disturbances. The main challenges lie in the input constraints and the lack of measurements of joint velocities. An extend‐state‐observer is utilized to estimate the velocity signals; then, a neural‐network‐based adaptive controller is proposed to solve the problem, where a term based on the nominal model is included to enhance the tracking ability, and the effect of uncertainties and disturbances are compensated by a neural‐network term. Compared with the existing methods, the main distinctive features of the presented approach are: (i) The control law is guaranteed to be bounded by design, instead of directly bounded by a saturation function. (ii) The trade‐off between the performance and robustness of the presented controller can be easily tuned by a parameter that depends on the size of model uncertainties and external disturbances. By virtue of the Lyapunov theorem, the convergence properties of the proposed controller are rigorously proved. The performance of the controller is validated via both simulations and experiments conducted on a two‐degree‐of‐freedom robot manipulator. [ABSTRACT FROM AUTHOR]