The influence of night shift work and associated factors on serum uric acid in aircraft maintenance workers.

BACKGROUND AND OBJECTIVE: The prevalence of 12-hour shift work is increasing in various occupations. Shift work has been linked to circadian rhythm disruption, which may lead to hormonal changes and metabolic disorders, including alterations in glucose, lipid, and purine metabolism. Despite this, there is limited research on the potential connection between work shifts and abnormal serum uric acid (SUA) levels. Furthermore, the factors that contribute to abnormal SUA levels in shift workers are not well-understood. Therefore, this study aimed to analyze the SUA levels of shift workers employed in an aircraft maintenance company, investigate the potential association between shift work and SUA levels, and explore the factors that may influence abnormal SUA levels in shift workers. METHODS: A total of 2263 male workers from an aircraft maintenance company were included in this study using the cluster sampling method. The workers were divided into two groups based on their working shifts: night shift (N = 1047, 46.27%) and day working (N = 1216, 53.73%). A survey was conducted between April 1st and June 30th, 2022 to gather information on work, lifestyle, physical examination results, and other relevant factors. The survey included a self-designed demographic information questionnaire to collect data on workers' characteristics, medical history, years of employment, smoking and drinking habits, and main lifestyle behaviors. The workers' SUA levels were measured using uricase colorimetry. One-way ANOVA was used to compare the difference in the abnormal detection rate of SUA between the two groups, and multi-factor logistic regression analysis was used to identify the factors that influence abnormal SUA levels. RESULTS: The study indicated that 48.9% of night shift workers and 43.8% in the regular day workers had abnormal SUA levels, with a significant difference between the two groups (χ2 = 6.125, P = 0.013). Factors such as circadian rhythm type, shift work, age, the taste of diet, type of diet, smoking, overweight or obesity based on body mass index (BMI), concentration of urine creatinine (CREA), total cholesterol, triglyceride, and low-density lipoprotein cholesterol were found to be correlated with SUA abnormalities (P < 0.05). The risk of developing SUA abnormalities was found to be higher in individuals with an intermittent (OR = 1.34, 95% CI: 0.83-2.12, P < 0.05) or evening circadian rhythm type (OR = 1.45, 95% CI: 0.86-2.43, P > 0.05) compared to those with a morning type. Additionally, factors such as night shift work, a high-sodium diet, smoking, a diet high in meat and low in vegetables, being overweight or obese, and higher levels of CREA were also found to increase the risk of developing SUA abnormalities. The study also revealed a significant dose-response relationship between BMI and abnormal uric acid levels. After controlling for other factors, the risk of developing SUA abnormalities was found to be 1.18 times higher in the night shift work group than in the day work group (OR = 1.18, 95% CI:1.02-1.34, P = 0.01). CONCLUSION: Shift work has been linked to a higher risk of developing SUA abnormalities, and there are several factors that may contribute to this risk. To prevent diseases, it is recommended that enterprises implement better health monitoring and management practices for shift workers.

Increased population susceptibility to seasonal influenza during the COVID-19 pandemic in China and the United States.

To the best of our knowledge, no previous study has quantitatively estimated the dynamics and cumulative susceptibility to influenza infections after the widespread lifting of COVID-19 public health measures. We constructed an imitated stochastic susceptible-infected-removed model using particle-filtered Markov Chain Monte Carlo sampling to estimate the time-dependent reproduction number of influenza based on influenza surveillance data in southern China, northern China, and the United States during the 2022-2023 season. We compared these estimates to those from 2011 to 2019 seasons without strong social distancing interventions to determine cumulative susceptibility during COVID-19 restrictions. Compared to the 2011-2019 seasons without a strong intervention with social measures, the 2022-2023 influenza season length was 45.0%, 47.1%, and 57.1% shorter in southern China, northern China, and the United States, respectively, corresponding to an 140.1%, 74.8%, and 50.9% increase in scale of influenza infections, and a 60.3%, 72.9%, and 45.1% increase in population susceptibility to influenza. Large and high-intensity influenza epidemics occurred in China and the United States in 2022-2023. Population susceptibility increased in 2019-2022, especially in China. We recommend promoting influenza vaccination, taking personal prevention actions on at-risk populations, and monitoring changes in the dynamic levels of influenza and other respiratory infections to prevent potential outbreaks in the coming influenza season.

Prediction of Medical Disputes Between Health Care Workers and Patients in Terms of Hospital Legal Construction Using Machine Learning Techniques: Externally Validated Cross-Sectional Study.

BACKGROUND: Medical disputes are a global public health issue that is receiving increasing attention. However, studies investigating the relationship between hospital legal construction and medical disputes are scarce. The development of a multicenter model incorporating machine learning (ML) techniques for the individualized prediction of medical disputes would be beneficial for medical workers. OBJECTIVE: This study aimed to identify predictors related to medical disputes from the perspective of hospital legal construction and the use of ML techniques to build models for predicting the risk of medical disputes. METHODS: This study enrolled 38,053 medical workers from 130 tertiary hospitals in Hunan province, China. The participants were randomly divided into a training cohort (34,286/38,053, 90.1%) and an internal validation cohort (3767/38,053, 9.9%). Medical workers from 87 tertiary hospitals in Beijing were included in an external validation cohort (26,285/26,285, 100%). This study used logistic regression and 5 ML techniques: decision tree, random forest, support vector machine, gradient boosting decision tree (GBDT), and deep neural network. In total, 12 metrics, including discrimination and calibration, were used for performance evaluation. A scoring system was developed to select the optimal model. Shapley additive explanations was used to generate the importance coefficients for characteristics. To promote the clinical practice of our proposed optimal model, reclassification of patients was performed, and a web-based app for medical dispute prediction was created, which can be easily accessed by the public. RESULTS: Medical disputes occurred among 46.06% (17,527/38,053) of the medical workers in Hunan province, China. Among the 26 clinical characteristics, multivariate analysis demonstrated that 18 characteristics were significantly associated with medical disputes, and these characteristics were used for ML model development. Among the ML techniques, GBDT was identified as the optimal model, demonstrating the lowest Brier score (0.205), highest area under the receiver operating characteristic curve (0.738, 95% CI 0.722-0.754), and the largest discrimination slope (0.172) and Youden index (1.355). In addition, it achieved the highest metrics score (63 points), followed by deep neural network (46 points) and random forest (45 points), in the internal validation set. In the external validation set, GBDT still performed comparably, achieving the second highest metrics score (52 points). The high-risk group had more than twice the odds of experiencing medical disputes compared with the low-risk group. CONCLUSIONS: We established a prediction model to stratify medical workers into different risk groups for encountering medical disputes. Among the 5 ML models, GBDT demonstrated the optimal comprehensive performance and was used to construct the web-based app. Our proposed model can serve as a useful tool for identifying medical workers at high risk of medical disputes. We believe that preventive strategies should be implemented for the high-risk group.

TCF7/SNAI2/miR-4306 feedback loop promotes hypertrophy of ligamentum flavum.

BACKGROUND: Hypertrophy of ligamentum flavum (HLF) is the mainly cause of lumbar spinal stenosis (LSS), but the precise mechanism of HLF formation has not been fully elucidated. Emerging evidence indicates that transcription factor 7 (TCF7) is the key downstream functional molecule of Wnt/ß-catenin signaling, which participated in regulating multiple biological processes. However, the role and underlying mechanism of TCF7 in HLF is still unclear. METHODS: We used mRNAs sequencing analysis of human LF and subsequent confirmation with RT-qPCR, western blot and immunohistochemistry to identified the TCF7 in HLF tissues and cells. Then effect of TCF7 on HLF progression was investigated both in vitro and in vivo. Mechanically, chromatin immunoprecipitation, dual-luciferase reporter assays, and rescue experiments were used to validate the regulation of TCF7/SNAI2/miR-4306 feedback loop. RESULTS: Our results identified for first time that the TCF7 expression was obviously elevated in HLF tissues and cells compared with control, and also found that TCF7 expression had significant positive correlation with LF thickness and fibrosis score. Notably, TCF7 inhibition suppressed the hyper-proliferation and fibrosis phenotype of HLF cells in vitro and ameliorated progression of HLF in mice in vivo, whereas TCF7 overexpression promoted hyper-proliferation and fibrosis phenotype of HLF cells in vitro. Our data further revealed that TCF7 interacted with SNAI2 promoter to transactivated the SNAI2 expression, thereby promoting hyper-proliferation and fibrosis phenotype of HLF cells in vitro. Furthermore, miR-4036 negatively regulated by SNAI2 could negatively feedback regulate TCF7 expression by directly binding to TCF7 mRNA 3'-UTR, thus inhibiting the hyper-proliferation and fibrosis phenotype of HLF cells in vitro. CONCLUSIONS: Our study demonstrated that TCF7 inhibition could suppress HLF formation by modulating TCF7/SNAI2/miR-4306 feedback loop, which might be considered as a novel potential therapeutic target for HLF.

Multiple configuration transitions of soft actuators under single external stimulus.

Soft actuators have a wide range of applications in medical instruments, soft robotics, 3D electronics, and deployable structures, where configuration transitions are crucial for their function realization. However, most soft actuators can only morph from the initial configuration directly to the final configuration under a single external stimulus. Herein, we report a novel soft actuator by 3D printing parallel strips with crescent cross-sections onto a thin PDMS film. Multiple configuration transitions are observed when the soft actuator swells in ethyl acetate. Four factors, i.e., the geometric asymmetry of the strips, the fabrication-induced heterogeneity of the film, the differential swelling ratios of the strips and the film, and the geometric parameters of the actuator, are demonstrated to synergistically regulate the multiple configuration transitions of the actuator. Particularly, the underlying mechanisms for the configuration transitions are systematically investigated through experiments and theoretical analysis, and verified via finite element simulation. Benefitting from the multiple configuration transitions, the grasp-release-re-grab function of the actuator is demonstrated under a single stimulus. This work contributes to fundamental understanding of the morphing behaviors and the novel design of soft actuators.

Effects of different oxygen concentrations on the proliferation, survival, migration, and osteogenic differentiation of MC3T3-E1 cells.

In physiological and pathological environments, the concentration of oxygen around osteoblasts varies widely. No studies have systematically evaluated the effects of different oxygen concentrations on the proliferation, survival, migration, and osteogenic differentiation of osteoblasts. In this study, we cultured the osteoblast precursor cell line MC3T3-E1 in small individual chambers with oxygen concentrations of 1%, 3%, 6%, 9%, and 21%. Cell proliferation was evaluated by the proliferation index test and EdU staining. To test cell survival, a live/dead assay was performed. A tablet scratch assay was performed to detect the migratory ability of the cells. Bone nodule formation experiments and immunofluorescence and Western blotting analyses of osteogenic-related proteins were performed to assess the osteogenic differentiation of the cells. We found that the proliferation and osteogenic differentiation ability of MC3T3-E1 cells in different oxygen concentrations were both approximately bell-shaped curves and that the optimal oxygen concentrations were approximately 6% and 9%, respectively. The live/dead assay showed that the survival of MC3T3-E1 cells in different oxygen concentrations was affected by the amount of serum. The tablet scratch experiment showed that there was greater cell migration with oxygen concentrations of 1%, 3%, and 21% than with oxygen concentrations of 6% and 9%. Our results have significant reference value for the intervention of the pathological processes involving osteoblasts, such as fracture, osteoporosis, and some vascular diseases. These results also have an important guiding role for the new scientific idea that osteoblasts can function as treatment cells to repair bone defects.

Porous nano-hydroxyapatite/collagen scaffold containing drug-loaded ADM-PLGA microspheres for bone cancer treatment.

To develop adriamycin (ADM)-encapsulated poly(lactic-co-glycolic acid) (PLGA) nanoparticles in a porous nano-hydroxyapatite/collagen scaffold (ADM-PLGA-NHAC). To provide novel strategies for future treatment of osteosarcoma, the properties of the scaffold, including its in vitro extended-release properties, the inhibition effects of ADM-PLGA-NHAC on the osteosarcoma MG63 cells, and its bone repair capacity, were investigated in vivo and in vitro. The PLGA copolymer was utilized as a drug carrier to deliver ADM-PLGA nanoparticles (ADM-PLGA-NP). Porous nano-hydroxyapatite and collagen were used to materials to produce the porous nano-hydroxyapatite/collagen scaffold (NHAC), into which the ADM-PLGA-NP was loaded. The performance of the drug-carrying scaffold was assessed using multiple techniques, including scanning electron microscopy and in vitro extended release. The antineoplastic activities of scaffold extracts on the human osteosarcoma MG63 cell line were evaluated in vitro using the cell counting kit-8 (CCK8) method and live-dead cell staining. The bone repair ability of the scaffold was assessed based on the establishment of a femoral condyle defect model in rabbits. ADM-PLGA-NHAC and NHAC were implanted into the rat muscle bag for immune response experiments. A tumor-bearing nude mice model was created, and the TUNEL and HE staining results were observed under optical microscopy to evaluate the antineoplastic activity and toxic side effects of the scaffold. The composite scaffold demonstrated extraordinary extended-release properties, and its extracts also exhibited significant inhibition of the growth of osteosarcoma MG63 cells. In the bone repair experiment, no significant difference was observed between ADM-PLGA-NHAC and NHAC by itself. In the immune response experiments, ADM-PLGA-NHAC exhibited remarkable biocompatibility. The in vivo antitumor experiment revealed that the implantation of ADM-PLGA-NHAC in the tumor resulted in a improved antineoplastic effect and fewer adverse side effects than direct intraperitoneal injection of ADM. The ADM-PLGA-NHAC developed in this study exhibited excellent extended-release drug properties, bone repairing and antineoplastic efficacy, which make it a promising osteoconductivity material with the capability to inhibit osteosarcoma.

Pyrroloquinoline quinone protects nucleus pulposus cells from hydrogen peroxide-induced apoptosis by inhibiting the mitochondria-mediated pathway.

PURPOSE: Intervertebral disc cell apoptosis has been suggested to play a key role in promoting disc degeneration, and many studies have shown that the mechanism may be related to oxidative stress. Pyrroloquinoline quinone (PQQ), a redox cofactor for bacterial dehydrogenases, possesses the potential to scavenge reactive oxygen species (ROS) and inhibit cell apoptosis. The objective of this study was to evaluate the effects of PQQ on cultured rat nucleus pulposus (NP) cells under conditions of oxidative injury induced by hydrogen peroxide (H2O2) and to investigate the underlying mechanisms in vitro. METHODS: Cell viability was determined by CCK8 assay. Changes in the apoptosis rate, intracellular ROS levels and the mitochondrial membrane potential were measured by flow cytometry. Extracellular matrix (ECM)-related proteins (collagen-2 and aggrecan) and apoptosis-related proteins (Bcl-2, Bax, cytochrome c, and caspase-3) were investigated by western blotting. RESULTS: The results show that NP cells pretreated with PQQ before H2O2 exposure exhibited increased cell viability, decreased ROS formation, maintained mitochondrial membrane potential, and reduced apoptosis. In the presence of PQQ, ECM production was maintained by the cells despite being in an apoptotic environment. In addition, pretreatment with PQQ increased the expression of Bcl-2, inhibited the release of mitochondrial cytochrome c, and decreased the expressions of Bax and cleaved caspase-3. CONCLUSIONS: Our results suggest that PQQ can protect rat NP cells against oxidative stress via a mitochondria-mediated pathway. PQQ might be useful as a potential pharmaceutical agent in the prevention of intervertebral disc degeneration.

[Current situation and countermeasures of medical damage risk sharing system in China].

Although medical damage risks really exist, an effective medical risk sharing system is still not available in China right now. By analyzing the status quo of Chinese medical damage risks sharing system, the authors put forward the following suggestions to improve the current system: Upgrading the preventive strategy for medical disputes, establishing multi-level and multi-channel comprehensive medical damage risks sharing system, promoting the effective cooperation between insurance relief systems and mediation system for medical disputes, and constructing highly effective pathways to resolve the medical disputes.

Employees' seeking preference towards influenza vaccination in organization: A discrete choice experiment in China.

To clarify the preferences of employees seeking influenza vaccination, a discrete choice experiment aims to understand the essential factors that close the gap between intention and behavior. A total of 866 employees with vaccination willingness willing to participated in a discrete choice experiment (DCE) between October 31st and December 6th, 2022 in China including the following attributes: price, vaccination setting, appointment mode, and service time. The data was analyzed using mixed logit models. Employees from smaller enterprises were more likely to get vaccinated collectively. For employees willing to get the influenza vaccine, 95.08 % of their choice was dominated by price. Employees' behavior varied according to their socioeconomic characteristics. Only female employees strongly favored work-site-based vaccination. Price was the primary factor considered by employees for getting the influenza vaccine. DCE would help to develop influenza vaccination intervention targeted at different groups in future studies.

Pyramid-Shaped Superhydrophobic Surfaces for Underwater Drag Reduction.

Superhydrophobic surfaces hold immense potential in underwater drag reduction. However, as the Reynolds number increases, the drag reduction rate decreases, and it may even lead to a drag increase. The reason lies in the collapse of the air mattress. To address this issue, this paper develops a pyramid-shaped robust superhydrophobic surface with wedged microgrooves, which exhibits a high gas fraction when immersed underwater and good ability to achieve complete spreading and recovery of the air mattress through air replenishment in the case of collapse of the air mattress. Pressure drop tests in a water tunnel confirm that with continuous air injection, the drag reduction reaches 64.8% in laminar flow conditions, substantially greater than 38.4% in the case without air injection, and can achieve 50.8% drag reduction in turbulent flow. This result highlights the potential applications of superhydrophobic surfaces with air mattress recovery for drag reduction.

Evaluating the efficacy of a long-read sequencing-based approach in the clinical diagnosis of neonatal congenital adrenocortical hyperplasia.

Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders predominantly characterized by impaired corticosteroid synthesis. Clinical phenotypes include hypoadrenocorticism, electrolyte disturbances, abnormal gonadal development, and short stature, of which severe hyponadrenocorticism and salt wasting can be life-threatening. Genetic analysis can help in the clinical diagnosis of CAH. However, the 21-OHD-causing gene CYP21A2 is arranged in tandem with the highly homologous CYP21A1P pseudogene, making it difficult to determine the exact genotypes using the traditional method of multiplex ligation-dependent probe amplification (MLPA) plus Sanger sequencing or next-generation sequencing (NGS). We applied a long-read sequencing-based approach termed comprehensive analysis of CAH (CACAH) to 48 newborns with CAH that were diagnosed by clinical features and the traditional MLPA plus Sanger sequencing method for retrospective analysis, to evaluate its efficacy in the clinical diagnosis of neonatal CAH. Compared with the MLPA plus Sanger sequencing method, CACAH showed 100 % consistency in detecting SNV/indel variants located in exons and exon-intron boundary regions of CAH-related genes. It can directly determine the cis-trans relationship without the need to analyze parental genotypes, which reduces the time to diagnosis. Moreover, CACAH was able to distinguish different CYP21A1P/CYP21A2 and TNXA/TNXB chimeras, and detect additional variants (CYP21A2 variants c.-121C > T, c.*13G > A, c.*52C > T, c.*440C > T, c.*443 T > C, and TNXB variants c.12463 + 2 T > C, c.12204 + 5G > A). We also identified the TNXB variant c.11435_11524 + 30del alone instead of as a part of the TNXA/TNXB-CH-1 chimera in two newborns, which might be introduced by gene conversion. All of these characteristics enabled clinicians to better explain the phenotype of subjects and manage them more effectively. CACAH has a great advantage over the traditional MLPA and Sanger sequencing methods, showing substantial potential in the genetic diagnosis and screening of neonatal CAH.

Water Impalement Resistance and Drag Reduction of the Superhydrophobic Surface with Hydrophilic Strips.

Superhydrophobic surfaces (SHS) offer versatile applications by trapping an air layer within microstructures, while water jet impact can destabilize this air layer and deactivate the functions of the SHS. The current work presents for the first time that introducing parallel hydrophilic strips to SHS (SHS-s) can simultaneously improve both water impalement resistance and drag reduction (DR). Compared with SHS, SHS-s demonstrates a 125% increase in the enduring time against the impact of water jet with velocity of 11.9 m/s and a 97% improvement in DR at a Reynolds number of 1.4 × 104. The key mechanism lies in the enhanced stability of the air layer due to air confinement by the adjacent three-phase contact lines. These lines not only impede air drainage through the surface microstructures during water jet impact, entrapping the air layer to resist water impalement, but also prevent air floating up due to buoyancy in Taylor-Couette flow, ensuring an even spread of the air layer all over the rotor, boosting DR. Moreover, failure modes of SHS under water jet impact are revealed to be related to air layer decay and surface structure destruction. This mass-producible structured surface holds the potential for widespread use in DR for hulls, autonomous underwater vehicles, and submarines.

ACSM5 inhibits ligamentum flavum hypertrophy by regulating lipid accumulation mediated by FABP4/PPAR signaling pathway.

BACKGROUND: Ligamentum flavum (LF) hypertrophy is the main cause of lumbar spinal canal stenosis (LSCS). Previous studies have shown that LF hypertrophy tissue exhibits abnormal lipid accumulation, but the regulatory mechanism remains unclear. The objective of this study was to explore the function and potential mechanism of ACSM5 in LF lipid accumulation. METHODS: To assess the ACSM5 expression levels, lipid accumulation and triglyceride (TG) level in LF hypertrophy and normal tissue, we utilized RT-qPCR, western blot, oil red O staining, and TG assay kit. The pearson correlation coefficient assay was used to analyze the correlation between ACSM5 levels and lipid accumulation or TG levels in LF hypertrophy tissue. The role of ACSM5 in free fatty acids (FFA)-induced lipid accumulation in LF cells was assessed in vitro, and the role of ACSM5 in LF hypertrophy in mice was verified in vivo. To investigate the underlying mechanisms of ACSM5 regulating lipid accumulation in LF, we conducted the mRNA sequencing, bioinformatics analysis, and rescue experiments. RESULTS: In this study, we found that ACSM5, which was significantly down-regulated in LF tissues, correlated with lipid accumulation. In vitro cell experiments demonstrated that overexpression of ACSM5 significantly inhibited FFA-induced lipid accumulation and fibrosis in LF cells. In vivo animal experiments further confirmed that overexpression of ACSM5 inhibited LF thickening, lipid accumulation, and fibrosis. Mechanistically, ACSM5 inhibited lipid accumulation of LF cells by inhibiting FABP4-mediated PPARγ signaling pathway, thereby improving hypertrophy and fibrosis of LF. CONCLUSIONS: our findings elucidated the important role of ACSM5 in the regulation of LF lipid accumulation and provide insight into potential therapeutic interventions for the treatment of LF hypertrophy. This study further suggested that therapeutic strategies targeting lipid deposition may be an effective potential approach to treat LF hypertrophy-induced LSCS.

LncRNA XIST facilitates hypertrophy of ligamentum flavum by activating VEGFA-mediated autophagy through sponging miR-302b-3p.

BACKGROUND: Increasing evidences have shown that long non-coding RNAs (lncRNAs) display crucial regulatory roles in the occurrence and development of numerous diseases. However, the function and underlying mechanisms of lncRNAs in hypertrophy of ligamentum flavum (HLF) have not been report. METHODS: The integrated analysis of lncRNAs sequencing, bioinformatics analysis and real-time quantitative PCR were used to identify the key lncRNAs involved in HLF progression. Gain- and loss-function experiments were used to explore the functions of lncRNA X inactive specific transcript (XIST) in HLF. Mechanistically, bioinformatics binding site analysis, RNA pull-down, dual-luciferase reporter assay, and rescue experiments were utilized to investigate the mechanism by which XIST acts as a molecular sponge of miR-302b-3p to regulate VEGFA-mediated autophagy. RESULTS: We identified that XIST was outstandingly upregulated in HLF tissues and cells. Moreover, the up-regulation of XIST strongly correlated with the thinness and fibrosis degree of LF in LSCS patients. Functionally, knockdown of XIST drastically inhibited proliferation, anti-apoptosis, fibrosis and autophagy of HLF cells in vitro and suppressed hypertrophy and fibrosis of LF tissues in vivo. Intestinally, we uncovered that overexpression of XIST significantly promoted proliferation, anti-apoptosis and fibrosis ability of HLF cells by activating autophagy. Mechanistic studies illustrated that XIST directly medullated the VEGFA-mediated autophagy through sponging miR-302b-3p, thereby enhancing the development and progression of HLF. CONCLUSION: Our findings highlighted that the XIST/miR-302b-3p/VEGFA-mediated autophagy axis is involved in development and progression of HLF. At the same time, this study will complement the blank of lncRNA expression profiles in HLF, which laid the foundation for further exploration of the relationship between lncRNAs and HLF in the future.

The Efficacy of Rule of Law Publicity Short Video Platforms in the Prevention of Medical Disputes Among Healthcare Professionals: A Propensity Score Analysis.

Background: Medical disputes are a recurrent and pressing issue in hospitals, posing significant challenges to the functioning of medical institutions. We aimed to investigate whether receiving rule of law publicity on short video platforms is relevant to preventing medical disputes among healthcare professionals. Methods: We collected the data from 37,978 medical professionals from 130 tertiary public hospitals. Participants were classified into two groups according to the presence of receiving rule of law publicity on short video platforms. A subgroup analysis was performed before and after propensity score analysis, and multiple logistic regression was used to identify risk factors for medical disputes. Results: Among all participants, 46.1% (17,506/37,978) experienced medical disputes. Before propensity score analysis, the prevalence of medical disputes among participants who received rule of law publicity on short video platforms was similar to that among participants who did not (P = 0.639). However, after propensity score analysis, participants who received the rule of law publicity on short video platforms did not show a benefit effect. These participants had a significantly higher rate of suffering from medical disputes than participants who did not receive publicity on this platform (P=0.020). Multiple logistic regression analysis confirmed that receiving the rule of law publicity through short video platforms (P=0.010) or MicroBlog (P = 0.016), and previously facing legal issues outside of medical work (P < 0.001) were risk factors for medical disputes; participating in legal training organized by hospitals (P=0.004) and the hospital rule of law being very good (P=0.045) were protective factors. Conclusion: Medical disputes are a common occurrence within the healthcare profession. However, using short video platforms to promote the rule of law is not an effective method to prevent disputes. Instead, healthcare professionals can benefit from participating in legal training and having a well-established rule of law within the hospital construct.

Effects of Pretreatment of the Dorsal Meningovertebral Ligaments on the Incidence of Intraoperative Cerebrospinal Fluid Leakage: A Comparative Study.

Cerebrospinal fluid leakage can lead to postoperative refractory headaches and meningitis. Dural injury is the main cause of postoperative cerebrospinal fluid leakage. Previously, we performed a comprehensive anatomic study on the dorsal meningovertebral ligaments in the lumbosacral regions and concluded that these ligaments are an anatomic factor leading to dural laceration. However, no clinical study has examined the relationship between dorsal meningovertebral ligaments and the incidence of intraoperative cerebrospinal fluid leakage. The goal of this study was to investigate the effect of prophylactic intraoperative pretreatment of the meningovertebral ligaments on the incidence of cerebrospinal fluid leakage during surgery. [Orthopedics. 2023;46(1):e66-e71.].

Attitudes Regarding Influenza Vaccination Among Public Health Workers during COVID-19 Pandemic - China, September 2022.

What is already known about this topic?: Public health workers (PHWs) were listed as a priority group recommended for influenza vaccination during the coronavirus disease 2019 (COVID-19) pandemic. Understanding the drivers of influenza vaccine hesitancy among PHWs can promote influenza vaccination in the COVID-19 pandemic. What is added by this report?: The study found that 10.7% of PHWs were hesitant to get an influenza vaccination. Drivers associated with vaccine hesitancy were assessed based on "3Cs model." The absence of a government or workplace requirement and concerns about vaccine safety were the biggest obstacles for PHWs to recommend influenza vaccination. What are the implications for public health practice?: Interventions are needed to improve PHWs' influenza vaccine coverage to prevent the co-circulation of influenza and COVID-19.

Acceptability for the influenza virus vector COVID-19 vaccine for intranasal spray: A cross-sectional survey in Beijing, China.

The intranasal spray COVID-19 vaccine was made available for the first time in China, it is necessary to understand receivers' satisfaction and experience toward the vaccine to help optimize vaccination service. A self-administered multicenter cross-sectional questionnaire survey was conducted in Beijing, China, in December 2022. The vaccination experience was evaluated through three dimensions: immediate tolerance, smooth progress, and time-saving. Vaccine acceptability was measured by receivers' preference for the intranasal spray over intramuscular injection after vaccination and their recommendation willingness. Stepwise multinomial and binary logistic regression models were applied to investigate factors associated with vaccine acceptability. Among 10,452 participants included in the analysis, 92.6% felt no discomfort during the inoculation, 99.8% thought the vaccination process went well, and 89.4% deemed it a time-saving option. For vaccine acceptability, 5566 (53.3%) participants were willing to recommend the vaccine to others, 534 (5.1%) refused, and 4352 (41.6%) had not decided yet; 6142 (58.8%) participants preferred the intranasal spray, 873 (8.4%) preferred the intramuscular injection, and 3437 (32.9%) had no preferences. The most concerned aspects of the intranasal spray vaccine were vaccine effectiveness and safety. Receivers who perceived higher vaccine effectiveness or safety were more likely to recommend it to others (OR, 95%CI: 4.41, 3.24-6.00; 6.11, 4.52-8.27) or prefer it over intramuscular injection after vaccination (OR, 95%CI: 5.94, 4.62-7.65; 8.50, 6.70-10.78). Receivers showed good acceptability and experience toward the intranasal spray COVID-19 vaccine. Vaccine effectiveness and safety were the most concerned aspects, and corresponding publicity and education efforts may help improve vaccine acceptability.

Healthcare Workers' Attitudes toward Influenza Vaccination: A Behaviour and Social Drivers Survey.

This study aimed to understand the intention and correlation of receiving and recommending influenza vaccine (IV) among healthcare workers (HCWs) in China during the 2022/2023 season using the behavior and social drivers (BeSD) tools. A self-administered electronic survey collected 17,832 participants on a media platform. We investigated the willingness of IV and used multivariate logistic regression analysis to explore its associated factors. The average scores of the 3Cs' model were compared by multiple comparisons. We also explored the factors that potentially correlated with recommendation willingness by partial regression. The willingness of IV was 74.89% among HCWs, and 82.58% of the participants were likely to recommend it to others during this season. Thinking and feeling was the strongest domain independently associated with willingness. All domains in BeSD were significantly different between the hesitancy and acceptance groups. Central factors in the 3Cs model were significantly different among groups (p < 0.01). HCWs' willingness to IV recommendation was influenced by their ability to answer related questions (r = 0.187, p < 0.001) after controlling for their IV willingness and perceived risk. HCWs' attitudes towards IV affect their vaccination and recommendation. The BeSD framework revealed the drivers during the decision-making process. Further study should classify the causes in detail to refine HCWs' education.