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Introduction Children with special healthcare needs (CSHCN) often experience vaccination delays or missed vaccines in China. The coverage rate of the age-appropriate National Immunisation Programme vaccine was suboptimal. This study aimed to explore attitudes, behaviours, and suggestions regarding the improvement of routine vaccination services for CSHCN among healthcare providers.Methods This study conducted local, cross-sectional interviews involving vaccination services for CSHCN. A purposive sampling strategy was used to recruit interviewees including primary care providers, paediatricians and immunisation programme administrators. The interview guide explored attitudes towards and suggestions for establishing immunisation advisory clinics and referral networks, updating immunisation guidance documents and vaccine package inserts and strengthening the education of vaccination providers.Results 21 representative healthcare providers were interviewed. 10 measures were proposed to promote routine immunisation for children with special needs: (1) using immunisation advisory clinics to provide vaccination services for CSHCN; (2) establishing a referral network and specifying which cases necessitate referral to advisory clinics; (3) using an interconnected information system to identify, document and follow-up the CSHCN; (4) supporting high-quality clinical research to update immunisation protocols; (5) providing clear and definite immunisation recommendations to parents of eligible CSHCN; (6) seeking immunisation advice from specialised professionals to enhance primary care capability; (7) creating quality improvement programmes; (8) considering immunisation status a mandatory assessment during specialist visits; (9) supporting off-label use of vaccines legally and (10) encouraging pharmaceutical companies to update vaccine package inserts.Conclusion Vaccine uptake among CSHCN in China is suboptimal, highlighting the need for a referral network and a standard immunisation protocol. The National Immunisation Programme should develop clear recommendations and an education programme for regional Centers for Disease Control and Prevention to train local providers. A quality assurance and improvement programme, along with regular feedback, is essential to ensure CSHCN receive necessary vaccinations and protection against infectious diseases.

Abstract Purpose This study aims to investigate the potential role of Caprini risk assessment model (RAM) in predicting the risk of venous thromboembolism (VTE) in patients undergoing total hip or knee arthroplasty (THA/TKA). No national study has investigated the role of Caprini RAM after primary THA/TKA. Methods Data from The National Sample of Healthcare Cost and Utilization Project (HCUP) in 2019 were utilized for this study. The dataset consisted of 229,134 patients who underwent primary THA/TKA. Deep vein thrombosis (DVT) and pulmonary embolism (PE) were considered as VTE. The incidence of thrombosis was calculated based on different Caprini scores, and the risk of the Caprini indicator for VTE events was evaluated using a forest plot. Results The prevalence of VTE after primary THA/TKA in the U.S. population in 2019 was found to be 4.7 cases per 1000 patients. Age, body mass index (BMI), and Caprini score showed a positive association with the risk of VTE (P

To optimize the robotic MIG welding process for joining 316 L stainless steel sheets and to clearly understand the process, a new numerical model for a combined heat source, based on a Gaussian surface and Gaussian cylinder, was developed using ANSYS software. After confirming the proper welding parameter combination for producing a weld bead with a good appearance, the model could be developed using the parameter combination. The influence of four parameters—effective heat delivery radius, the depth and heat distribution coefficients of the Gaussian surface, and the Gaussian cylinder heat source effects on the bead width and penetration—was explored using the model, and then a general and convenient method was proposed to effectively and reasonably set the parameters of the combined heat source. Finally, the numerical calculation results for the shape of the fusion line of the weld bead section could be obtained under different input powers and different welding speeds. The numerical calculation results had small errors compared to the experiments results. Hence, this model could realize temperature field simulation and weld bead formation prediction. This work can be used to accurately and effectively predict the robotic MIG welding process in the academic research and supply references for actual production.

ABSTRACT: Gliotoxin (GT) belongs to the epipolythiodioxopiperazine (ETP) family, which is considered a crucial virulence determinant among the secondary metabolites produced by Aspergillus fumigatus. The metabolites are commonly found in food and feed, contributing to the invasion and immune escape of Aspergillus fumigatus, thereby posing a significant threat to the health of livestock, poultry, and humans. Heterophil extracellular traps (HETs), a novel form of innate immune defense, have been documented in the chicken's innate immune systems for capturing and eliminating invading microbes. However, the effects and mechanisms of GT on the production of duck HETs in vitro remain unknown. In this study, we first confirmed the presence of HETs in duck innate immune systems and further investigated the molecular mechanism underlying GT-induced HETs release. Our results demonstrate that GT can trigger typical release of HETs in duck. The structures of GT-induced HETs structures were characterized by DNA decoration, citrullinated histones 3, and elastase. Furthermore, NADPH oxidase, glycolysis, ERK1/2 and p38 signaling pathway were found to regulate GT-induced HETs. In summary, our findings reveal that gliotoxin activates HETs release in the early innate immune system of duck while providing new insights into the immunotoxicity of GT towards ducks.

Abstract Background Postnatal period is a critical transitional phase in the lives of mothers and newborn babies. In recent years the importance on promoting a positive experience of care following childbirth is increasingly emphasized. Yet published evidence of the methodological and psychometric quality of instruments to evaluate women’s experience of comprehensive postnatal care is still lacking. Objective This study aimed to develop and validate a unique scale (the Chinese version of the Postnatal Care Experience Scale, PCES) to measure women’s overall experience of care during postnatal periods. Methods The PCES instrument was developed and validated over three phases, including item development, scale development, and scale evaluation. The item pool of the PCES was generated through existing literature and in-depth semi-structured interviews, followed by assessment of content validity and rating of importance and feasibility of items through two-round Delphi surveys. Psychometric properties were examined in a convenience sample of 736 postpartum women. Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to assess the construct validity of the developed PCES. The relationship between the total PCES score and the global item construct was estimated using Pearson product-moment coefficient. Reliability was assessed using Cronbach’s alpha and Spearman Brown coefficients. Results The content validity index of the Chinese version PCES was 0.867. Following item reduction analysis, this instrument consisted of 30 five-point Likert items. The Kaiser-Meyer-Olkin statistic was 0.964 and the chi-square value of the Bartlett spherical test was 11665.399 (P

Abstract Introduction Deep venous thrombosis (DVT) prediction after total hip and knee arthroplasty remains challenging. Early diagnosis and treatment of DVT are crucial. This research aimed to develop a nomogram for early DVT prediction. Methods A total of 317 patients undergoing primary total hip and knee arthroplasty in Sun Yat-sen Memorial Hospital were enrolled between May 2020 and September 2022. Data from May 2020 to February 2022 were used as the development datasets to build the nomogram model (n = 238). Using multivariate logistic regression, independent variables and a nomogram for predicting the occurrence of DVT were identified. Datasets used to validate the model for internal validation ranged from March 2022 to September 2022 (n = 79). The nomogram’s capacity for prediction was also compared with the Caprini score. Results For both the development and validation datasets, DVT was found in a total of 38 (15.97%) and 9 patients (11.39%) on post-operative day 7 (pod7), respectively. 59.6% patients were symptomatic DVT (leg swelling). The multivariate analysis revealed that surgical site (Knee vs. Hip), leg swelling and thrombin-antithrombin complex (TAT) were associated with DVT. The previously indicated variables were used to build the nomogram, and for the development and validation datasets, respectively. In development and validation datasets, the area under the receiver operating characteristic curve was 0.836 and 0.957, respectively. In both datasets, the predictive value of the Nomogram is greater than the Caprini score. Conclusions A proposed nomogram incorporating surgical site (Knee vs. Hip), leg swelling, and thrombin antithrombin complex (TAT) may facilitate the identification of patients who are more prone to develop DVT on pod7.

Trans-acting hammerhead ribozyme inherits the advantages of being the smallest and best-characterized RNA-cleaving ribozyme, offering high modularity and the ability to cleave any desired sequence without the aid of any protein, as long as the target sequence contains a cleavage site. However, achieving precise control over the trans-acting hammerhead ribozyme would enable safer and more accurate regulation of gene expression. Herein, we described an intracellular selection of hammerhead aptazyme that contains a theophylline aptamer on stem II based on toxin protein IbsC. Based on the intracellular selection, we obtained three new cis-acting hammerhead aptazymes. Moreover, the corresponding trans-acting aptazymes could be efficiently induced by theophylline to knock down different targeted genes in eukaryotic cells. Notably, the best one, T195, exhibited a ligand-dependent and dose-dependent response to theophylline, and the cleavage efficiency could be enhanced by incorporating multiplex aptazymes.

The study focused on the effects of a triply periodic minimal surface (TPMS) scaffolds, varying in porosity, on the repair of mandibular defects in New Zealand white rabbits. Four TPMS configurations (40%, 50%, 60%, and 70% porosity) were fabricated with β-tricalcium phosphate bioceramic via additive manufacturing. Scaffold properties were assessed through scanning electron microscopy and mechanical testing. For proliferation and adhesion assays, mouse bone marrow stem cells (BMSCs) were cultured on these scaffolds. In vivo, the scaffolds were implanted into rabbit mandibular defects for 2 months. Histological staining evaluated osteogenic potential. Moreover, RNA-sequencing analysis and RT-qPCR revealed the significant involvement of angiogenesis-related factors and Hippo signaling pathway in influencing BMSCs behavior. Notably, the 70% porosity TPMS scaffold exhibited optimal compressive strength, superior cell proliferation, adhesion, and significantly enhanced osteogenesis and angiogenesis. These findings underscore the substantial potential of 70% porosity TPMS scaffolds in effectively promoting bone regeneration within mandibular defects.

Quadruped robots equipped with manipulators need fast and precise grasping and detection algorithms for the transportation of disaster relief supplies. To address this, we developed a framework for these robots, comprising a Grasp Detection Controller (GDC), a Joint Trajectory Planner (JTP), a Leg Joint Controller (LJC), and a Manipulator Joint Controller (MJC). In the GDC, we proposed a lightweight grasp detection CNN based on DenseBlock called DES-LGCNN, which reduced algorithm complexity while maintaining accuracy by incorporating UP and DOWN modules with DenseBlock. For JTP, we optimized the model based on quadruped robot kinematics to enhance wrist camera visibility in dynamic environments. We integrated the network and model into our homemade robot control system and verified our framework through multiple experiments. First, we evaluated the accuracy of the grasp detection algorithm using the Cornell and Jacquard datasets. On the Jacquard dataset, we achieved a detection accuracy of 92.49% for grasp points within 6 ms. Second, we verified its visibility through simulation. Finally, we conducted dynamic scene experiments which consisted of a dynamic target scenario (DTS), a dynamic base scenario (DBS), and a dynamic target and base scenario (DTBS) using an SDU-150 physical robot. In all three scenarios, the object was successfully grasped. The results demonstrate the effectiveness of our framework in managing dynamic environments throughout task execution.

Objectives To investigate the effect of the X‐ray incidence angle on cup version measurements and the reliability and validity of standing lateral (SL) radiography for measuring cup versions. Methods Cup versions under different X‐ray incidence angles were investigated by the 3D simulation analysis. Ninety‐three patients, who underwent primary total hip arthroplasty (THA) with postoperative SL radiographs and CT scans between April 2020 and December 2021, were retrospectively analyzed. SL radiography was taken under naturally standing position, correcting for the measurement error of pelvic tilt in cross‐table lateral (CL) radiography. Cup versions were measured on SL radiographs and CT images by two qualified orthopedic physicians. The intra‐ and inter‐observer reliabilities were assessed by intra‐class correlation coefficient. The consistency between radiographic and CT measurements was evaluated using Pearson correlation coefficient. Results No significant differences in cup version measurements were observed between groups of different X‐ray incidence angles (P = 0.663) in the 3D simulation analysis. All measurements had excellent intra‐ and inter‐observer reliabilities, with an intraclass correlation coefficient of >0.95. Mean cup version measurements from SL radiographs correlated well with those from CT scans (r = 0.853, P

Abstract Aim Early predictive markers of venous thromboembolism (VTE) after total hip arthroplasty (THA)/total knee arthroplasty (TKA) remain unclear. Our study identified early predictive markers for VTE after THA/TKA. Methods A single-institution retrospective review study was conducted between May 2020 and April 2022 (n = 256). All patients underwent Doppler ultrasounds exam in preoperation and seventh day after surgery. Deep vein thrombosis (DVT) was defined by Doppler ultrasound of the lower extremities, which revealed thrombosis. Thrombin-antithrombin complex (TAT), thrombomodulin (TM), and plasmin-antiplasmin complex (PIC) concentration were tested from each patient’s preoperative and postoperative days 1, 4, 7, 14. These values were then accessed via receiver operating characteristic (ROC) curve analysis and further quantified the level of this risk by concentration. Results On postoperative day 1 (pod-1), all patients’ TAT and PIC concentrations were significantly higher than those preoperatively (p

Tick-borne viruses (TBVs) have increasingly caused a global public health concern. This study collected Rhipicephalus ticks in Guangdong, southern China to identify RNA viruses. Meta-transcriptome analysis revealed the virome in Rhipicephalus ticks, resulting in the discovery of 10 viruses, including Lihan tick virus, Brown dog tick phlebovirus 1 and 2 in the family Phenuiviridae, Mivirus and Wuhan tick virus 2 in the family Chuviridae, Wuhan tick virus 1 in the family Rhabdoviridae, bovine hepacivirus in the family Flaviviridae, Guangdong tick quaranjavirus (GTQV) in the family Orthomyxoviridae, Guangdong tick orbivirus (GTOV) in the family Reoviridae, and Guangdong tick Manly virus (GTMV) of an unclassified family. Phylogenetic analysis showed that most of these TBVs were genetically related to the strains in countries outside China, and GTQV, GTOV, and GTMV may represent novel viral species. These findings provided evidence of the long-distance spread of these TBVs in Guangdong, southern China, suggesting the necessity and importance of TBV surveillance.

Souvenirs play an important role in tourism development. They act not only as mementos, enabling tourists to relive and retain the memory of a particular journey, but also as main income sources for tourism destinations and stakeholders. Many intangible cultural heritages (ICH) have been developed into souvenirs, especially products made by traditional craftsmanship. ICH souvenirs facilitate cultural value that is understandable to tourists, who appreciate the design of the ICH souvenirs and their contributions to a pleasure and memorable journey. Based on the theory of beauty and the preference-for-prototypes theory, this study explored how symmetry design of ICH souvenirs influences tourist’s aesthetic pleasure. As ICH souvenirs development is a commercialization process, and over-commodification would lead to cultures being lost and tourists’ disappointment, the authenticity concept is applied in order to address over-commodification. Thus, this study analyzed the moderating role of tourists’ authenticity perception of ICH souvenirs. Two lab-based between-subjects design experiments were employed to test the proposed hypotheses. Data analysis entailed multiple regression analysis, one-way ANOVA, and two-way ANOVA. The findings showed that symmetry of ICH souvenir design had a positive impact on tourists’ aesthetic pleasure. Under the symmetric-design condition, tourists’ typicality perception of ICH souvenirs positively mediated the main relationship, while under the asymmetric-design condition, tourists’ novelty perception had a negative mediating effect. The moderated mediation effects were in accord with hypotheses to some extent; at a relatively high level of authenticity perception (above mean value), the indirect effect of symmetry on aesthetic pleasure via typicality perception increased as authenticity perception rose; at a relatively low level of authenticity perception (under mean value), the indirect effect of symmetry on aesthetic pleasure via novelty perception declined as authenticity perception rose. This study identified critical factors influencing tourists’ aesthetic pleasure with ICH souvenirs, and it revealed the internal influencing mechanisms and moderating effects under different design conditions. These findings give some insights to ICH practitioners for using souvenir design to improve tourists’ aesthetic pleasure.

Abstract Background Cross-table lateral (CL) radiography is a convenient and feasible method to assess cup version angle (VA) after total hip arthroplasty; However, pelvic tilt (PT) may contribute to its measurement inaccuracy. How PT affects CL radiographic measurements have not been well studied. We sought (1) to determine the effect of the PT on cup version measurement on CL radiography and (2) to develop a method for reducing measurement errors caused by the PT. Methods We used 3D technique to construct standard model and capture CL radiography simulation. A linear regression model was created to analyze the relationship between PT and VA. CL radiography and computed tomography (CT) were performed for the enrolled patients after surgery. The consistency between CL and CT measurements were verified by intra-class correlation coefficient (ICC). Results There was a high correlation between the VA and PT. For each 1-degree increased in the PT, the VA decreased by 0.76° (R2 = 0.995, p