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Globally, the rollout of COVID-19 vaccine had been faced with a significant barrier in the form of vaccine hesitancy. This study adopts a multi-stage perspective to explore the prevalence and determinants of COVID-19 vaccine hesitancy, focusing on their dynamic evolutionary features. Guided by the integrated framework of the 3Cs model (complacency, confidence, and convenience) and the EAH model (environmental, agent, and host), this study conducted three repeated national cross-sectional surveys. These surveys carried out from July 2021 to February 2023 across mainland China, targeted individuals aged 18 and older. They were strategically timed to coincide with three critical vaccination phases: universal coverage (stage 1), partial coverage (stage 2), and key population coverage (stage 3). From 2021 to 2023, the surveys examined sample sizes of 29 925, 6659, and 5407, respectively. The COVID-19 vaccine hesitation rates increased from 8.39% in 2021 to 29.72% in 2023. Urban residency, chronic condition, and low trust in vaccine developer contributed to significant COVID-19 vaccine hesitancy across the pandemic. Negative correlations between the intensity of vaccination policies and vaccine hesitancy, and positive correlations between vaccine hesitancy and long COVID, were confirmed. This study provides insights for designing future effective vaccination programs for emerging vaccine-preventable infectious X diseases.

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BACKGROUND: Vaccination plays an important role in preventing COVID-19 infection and reducing the severity of the disease. There are usually differences in vaccination rates between urban and rural areas. Measuring these differences can aid in developing more coordinated and sustainable solutions. This information also serves as a reference for the prevention and control of emerging infectious diseases in the future. OBJECTIVE: This study aims to assess the current coverage rate and influencing factors of COVID-19 (second booster) vaccination among Chinese residents, as well as the disparities between urban and rural areas in China. METHODS: This cross-sectional study used a stratified random sampling approach to select representative samples from 11 communities and 10 villages in eastern (Changzhou), central (Zhengzhou), western (Xining), and northeast (Mudanjiang) Mainland China from February 1 to February 18, 2023. The questionnaires were developed by experienced epidemiologists and contained the following: sociodemographic information, health conditions, vaccine-related information, information related to the Protective Motivation Theory (PMT), and the level of trust in the health care system. Vaccination rates among the participants were evaluated based on self-reported information provided. Binary logistic regression models were performed to explore influencing factors of vaccination among urban and rural participants. Urban-rural disparities in the vaccination rate were assessed using propensity score matching (PSM). RESULTS: A total of 5780 participants were included, with 53.04% (3066/5780) being female. The vaccination rate was 12.18% (704/5780; 95% CI 11.34-13.02) in the total sample, 13.76% (341/2478; 95% CI 12.40-15.12) among the rural participants, and 10.99% (363/3302; 95% CI 9.93-12.06) among the urban participants. For rural participants, self-reported health condition, self-efficacy, educational level, vaccine knowledge, susceptibility, benefits, and trust in the health care system were independent factors associated with vaccination (all P＜.05). For urban participants, chronic conditions, COVID-19 infection, subjective community level, vaccine knowledge, self-efficacy, and trust in the health care system were independent factors associated with vaccination (all P＜.05). PSM analysis uncovered a 3.42% difference in vaccination rates between urban and rural participants. CONCLUSIONS: The fourth COVID-19 vaccination coverage rate (second booster) among the Chinese population was extremely low, significantly lower than the previous vaccine coverage rate. Given that COVID-19 infection is still prevalent at low levels, efforts should focus on enhancing self-efficacy to expand the vaccine coverage rate among the Chinese population. For rural residents, building awareness of the vaccine's benefits and improving their overall health status should be prioritized. In urban areas, a larger proportion of people with COVID-19 and patients with chronic illness should be vaccinated.

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This study aimed to evaluate how the duration of travel affects the behavior of urban and rural residents regarding free COVID-19 vaccination, and provide scientific evidence for promoting free vaccination and building an immune barrier to cope with future epidemics. From August 3, 2022 to February,18,2023, A follow-up survey was conducted in urban and rural adults in four cities in China to collect information on socio-demographic factors, vaccination status and travel time for vaccination. Propensity score matching (PSM) analysis was deployed to measure the net difference of the enhanced vaccination rate between urban and rural residents in different traffic time distribution. A total of 5780 samples were included in the study. The vaccination rate of the booster dose of COVID-19 vaccine among rural residents was higher than that of urban residents with a significant P-value (69.36% VS 64.49%,p < .001). The traffic time had a significant negative impact on the COVID-19 booster vaccination behavior of urban and rural residents. There was a significant interaction between the travel time to the vaccination point and the level of trust in doctors. Travel time had a negative impact on the free vaccination behavior of both urban and rural residents. The government should optimize and expand the number of vaccination sites and enhance residents' trust in the medical system. This is crucial for promoting free vaccination and effective epidemic management in the future.

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BACKGROUND: The public health service capability of primary healthcare personnel directly affects the utilization and delivery of health services, and is influenced by various factors. This study aimed to examine the status, factors, and urban-rural differences of public health service capability among primary healthcare personnel, and provided suggestions for improvement. METHODS: We used cluster sampling to survey 11,925 primary healthcare personnel in 18 regions of Henan Province from 20th to March 31, 2023. Data encompassing demographics and public health service capabilities, including health lifestyle guidance, chronic disease management, health management of special populations, and vaccination services. Multivariable regression analysis was employed to investigate influencing factors. Propensity Score Matching (PSM) quantified urban-rural differences. RESULTS: The total score of public health service capability was 80.17 points. Chronic disease management capability scored the lowest, only 19.60. Gender, education level, average monthly salary, professional title, health status, employment form, work unit type, category of practicing (assistant) physician significantly influenced the public health service capability (all P < 0.05). PSM analysis revealed rural primary healthcare personnel had higher public health service capability scores than urban ones. CONCLUSIONS: The public health service capability of primary healthcare personnel in Henan Province was relatively high, but chronic disease management required improvement. Additionally, implementing effective training methods for different subgroups, and improving the service capability of primary medical and health institutions were positive measures.

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Objective: To evaluate the prevalence and influencing factors of long COVID, and measure the difference in health status between long COVID and non-long COVID cases. Methods: A cross-sectional survey was conducted from February 1 to 8, 2023, using a stratified random sampling method in four regions (eastern [Changzhou], central [Zhengzhou], western [Xining] and northeastern [Mudanjiang]) of China. The survey collected COVID-19 patients' socio-demographic characteristics and lifestyles information. The scores of lifestyles and health status range from 5 to 21 and 0 to 100 points, respectively. The criteria of "persistent health problems after 4 weeks of COVID-19 infection" issued by the US Centers for Disease Control and Prevention was used to assess long COVID. Multiple linear regression was used to analyze the influencing factors of the health. The bootstrap method was used to analyze the lifestyles' mediating effect. Propensity score matching (PSM) was used to evaluate the net difference in health scores between long COVID and non-long COVID cases. Results: The study included 3165 COVID-19 patients, with 308 (9.73%) long COVID cases. The health score of the long COVID cases (74.79) was lower than that of the non-long COVID cases (81.06). After adjusting for potential confounding variables, we found that never focused on mental decompression was a common risk factor for the health of both groups. Lifestyles was the mediating factor on individuals' health. After PSM, the non-long COVID cases' health scores remained higher than that of long COVID cases. Conclusion: The proportion of long COVID cases was low, but they were worse off in health. Given the positive moderating effect of healthy lifestyles on improving the health of long COVID cases, healthy lifestyles including mental decompression should be considered as the core strategy of primary prevention when the epidemic of COVID-19 is still at a low level.

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During the COVID-19 pandemic, the vaccine hesitancy has significantly affected the vaccination. To evaluate the booster vaccine hesitancy and its influencing factors among urban and rural residents, as well as to estimate the net difference of booster vaccine hesitancy between urban and rural residents. We conducted a nationwide, cross-sectional Internet survey on 1-8 February 2023, and employed stratified random sampling technique to select participants (≥18 years old) from urban and rural areas. Multivariate logistic regression was used to determine the factors impacting booster vaccine hesitancy. Propensity Score Matching was used to estimate the net difference of COVID-19 booster vaccine hesitancy between urban and rural residents. The overall COVID-19 booster vaccine hesitancy rate of residents was 28.43%. The COVID-19 booster vaccine hesitancy rate among urban residents was found to be 34.70%, among rural residents was 20.25%. Chronic diseases, infection status, vaccination benefits, and trust in vaccine developers were associated with booster vaccine hesitancy among urban residents. Barriers of vaccination were associated with booster vaccine hesitancy among rural residents. PSM analysis showed that the urban residents have a higher booster vaccine hesitancy rate than rural residents, with a net difference of 6.20%. The vaccine hesitancy rate increased significantly, and the urban residents have a higher COVID-19 booster vaccine hesitancy than rural residents. It becomes crucial to enhance the dissemination of information regarding the advantages of vaccination and foster greater trust among urban residents toward the healthcare system.

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Endoscopic thyroidectomy (ET), a surgical procedure widely accepted by surgeons, has been proven to be feasible. The aim of this systematic review is to evaluate the effectiveness and safety of ET compared to conventional open thyroidectomy (COT) in the treatment of papillary thyroid microcarcinoma (PTMC) through a meta-analysis. Medical literature databases, including PubMed, Embase, Cochrane Library, CBM,CNKI, Wanfang, and VIP, were systematically searched for relevant studies on ET and COT for the treatment of PTMC. The search period was from January 2000 to June 2023. Two researchers independently performed literature screening and data extraction according to the inclusion and exclusion criteria, and the Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included studies. Meta-analysis was conducted using Revman 5.3 software. Six studies were eventually included, involving a total of 440 patients with PTMC. The meta-analysis results demonstrated that the ET group had shorter incision length (MD = -2.96, 95 % CI: -4.27 to -1.65, P < 0.05) and less intraoperative blood loss (MD = -18.06, 95 % CI: -32.76 to -3.37, P = 0.02 < 0.05). There was no statistically significant difference between the two groups in terms of operative time (MD = -0.83, 95 % CI: -19.64 to 17.98, P = 0.93 > 0.05), lymph node dissection (MD = 1.03, 95 % CI: -1.47 to 3.54, P = 0.42 > 0.05), postoperative hospital stay (MD = -0.96, 95 % CI: -2.00 to 0.08, P = 0.07 > 0.05), and transient recurrent laryngeal nerve paralysis (OR = 3.32, 95 % CI: 0.65 to 16.90, P = 0.15 > 0.05). Compared with COT, ET has the advantages of shorter incision length, less intraoperative blood loss, better prognosis and comparable safety, making it a worthy choice for clinical application.

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BACKGROUND: COVID-19 is still prevalent in most countries around the world at the low level. Residents' lifestyle behaviors and emotions are critical to prevent COVID-19 and keep healthy, but there is lacking of confirmative evidence on how residents' lifestyle behaviors and emotional expressivity affected COVID-19 infection. METHODS: Baseline study was conducted in August 2022 and follow-up study was conducted in February 2023. Baseline survey collected information on residents' basic information, as well as their lifestyle behaviors and emotions. Follow-up study was carried out to gather data on COVID-19 infection condition. Binary logistic regression was utilized to identify factors that may influence COVID-19 infection. Attributable risk (AR) was computed to determine the proportion of unhealthy lifestyle behaviors and emotional factors that could be attributed to COVID-19 infection. Sensitivity analysis was performed to test the robustness of the results. RESULTS: A total of 5776 participants (46.57% males) were included in this study, yielding an overall COVID-19 infection rate of 54.8% (95%CI: 53.5 - 56.0%). The findings revealed that higher stress levels [aOR = 1.027 (95%CI; 1.005-1.050)] and lower frequency in wearing masks, washing hands, and keeping distance [aOR = 1.615 (95%CI; 1.087-2.401)], were positively associated with an increased likelihood of COVID-19 infection (all P < 0.05). If these associations were causal, 8.1% of COVID-19 infection would have been prevented if all participants had normal stress levels [Attributable Risk Percentage: 8.1% (95%CI: 5.9-10.3%)]. A significant interaction effect between stress and the frequency in wearing masks, washing hands, and keeping distance on COVID-19 infection was observed (ß = 0.006, P < 0.001), which also was independent factor of COVID-19 infection. CONCLUSIONS: The overall COVID-19 infection rate among residents is at a medium level. Residents' increasing stress and decreasing frequency in wearing masks and washing hands and keeping distance contribute to increasing risk of infection, residents should increase the frequency of mask-wearing, practice hand hygiene, keep safe distance from others, ensure stable emotional state, minimize psychological stress, providing evidence support for future responses to emerging infectious diseases.

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A metal-organic framework (MOF) having a redox active 1,4,5,8-naphthalenetetracarboxdiimide (NDI) derivative in its organic linker shows excellent rate performance as an electrode material for aqueous batteries thanks to its large pores. Among aqueous electrolytes examined, K+-based ones exhibit the highest rate performance, which is caused by the highest mobility of the smallest hydrated K+ ion not only in the aqueous electrolyte but also in the electrode. Since the use of a counter electrode with insufficiently small pores for the full-cell configuration offsets this merit, our study may lead to a conclusion that the maximum rate performance for aqueous batteries will be accomplished only through further elaboration of both electrode materials with sufficiently large pores, in which hydrated ions can travel equally fast as those in the electrolyte.

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Drying is an effective method to reduce potato storage loss. However, potatoes have high porosity with high water content. Shrinkage during drying can lead to folding and cracking of the dried product form. Therefore, this study explored the correlation between the 3D morphology and temperature distribution changes of potato slices during drying, with the aim of providing a reference for the detection of quality changes. An online automatic acquisition device to obtain 3D morphology and temperature information was designed and built. Hot air-drying experiments were conducted on the potato slices. 3D morphology images and temperature images of the potato slices were acquired by 3D and temperature sensors, and the two images were registered using the random sample consensus (RANSAC) algorithm. The region of interest of each image was extracted by algorithms such as threshold segmentation, hole filling and morphological erosion, and the 3D morphology information and temperature information were obtained. The mapping, range and average of each acquisition point were calculated for correlation analysis. Spearman's rank correlation coefficients and Maximum Information Coefficient (MIC) values were selected as measures for the correlation study. The results showed that the Spearman's rank correlation coefficients between average height and average temperature were mostly above 0.7 in absolute value, and the MICs were mostly above 0.9. The average values of the 3D information and temperature information exhibited an extremely strong correlation. This paper gives a new approach to investigate the morphological changes in the drying process by quantifying the relationship between 3D morphology and temperature distribution. This can guide the improvement of potato drying and processing methods.

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This study investigated the effects of different drying methods on the drying characteristics, three-dimensional (3D) appearance, color, total polysaccharide content (TPC), antioxidant activity, and microstructure of Pleurotus eryngii slices. The drying methods included hot air drying (HAD), infrared drying (ID), and microwave drying (MD). The results showed that the drying method and conditions significantly influenced the drying time, with MD having a significant advantage in reducing the drying time. The 3D appearance of P. eryngii slices was evaluated based on shrinkage and roughness as quantitative indexes, and the best appearance was obtained by hot air drying at 55 and 65 °C. HAD and ID at lower drying temperatures obtained better color, TPC, and antioxidant activity, but MD significantly damaged the color and nutritional quality of P. eryngii. The microstructure of dried P. eryngii slices was observed using scanning electron microscopy, and the results showed that drying methods and conditions had an obvious effect on the microstructure of P. eryngii slices. Scattered mycelia were clearly observed in P. eryngii samples dried by HAD and ID at lower drying temperatures, while high drying temperatures led to the cross-linking and aggregation of mycelia. This study offers scientific and technical support for choosing appropriate drying methods to achieve a desirable appearance and quality of dried P. eryngii.

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Granulomatous lobular mastitis (GLM) is a rare and chronic benign inflammatory disease of the breast. Difficulties exist in the management of GLM for many front-line surgeons and medical specialists who care for patients with inflammatory disorders of the breast. This consensus is summarized to establish evidence-based recommendations for the management of GLM. Literature was reviewed using PubMed from January 1, 1971 to July 31, 2020. Sixty-six international experienced multidisciplinary experts from 11 countries or regions were invited to review the evidence. Levels of evidence were determined using the American College of Physicians grading system, and recommendations were discussed until consensus. Experts discussed and concluded 30 recommendations on historical definitions, etiology and predisposing factors, diagnosis criteria, treatment, clinical stages, relapse and recurrence of GLM. GLM was recommended as a widely accepted definition. In addition, this consensus introduced a new clinical stages and management algorithm for GLM to provide individual treatment strategies. In conclusion, diagnosis of GLM depends on a combination of history, clinical manifestations, imaging examinations, laboratory examinations and pathology. The approach to treatment of GLM should be applied according to the different clinical stage of GLM. This evidence-based consensus would be valuable to assist front-line surgeons and medical specialists in the optimal management of GLM.

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Hot air drying is a common method for drying potato slices. In this paper, the three-dimensional (3D) morphological changes incurred during hot air drying of potato slices were investigated. The effect of drying on the thickness and diameter of potato slices was of special interest. The results showed that the potato slices underwent stages of regular warping, collapse, and curling during the drying process. After classifying the numerical variation in characteristics into the standard deviation in mean height (SDMH) and the rate of change in mean height (RCMH) of potato slices, the RCMH was selected to describe the 3D morphological changes in the potato drying process. A critical point and a termination point for RCMH of potato slices in the drying process were observed. Samples varied widely after the critical point was reached. A logarithmic function model was used to assess differences in the RCMH at the critical point and the termination point. The R-squared (R2) value of 0.9 suggested a strong correlation between the parameters of the experiment and changes in slice thickness and diameter. The model proposed in this paper could accurately characterize the late-stage changes in potato slice qualities during hot air drying of potato slices.

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BACKGROUND: Food processing induces various modifications that affect the structure, physical and chemical properties of food products and hence the acceptance of the product by the consumer. In this work, the evolution of volatile components, 2-thiobarbituric acid reactive substances (TBARS), moisture content (MC) and microstructural changes of pork was investigated by hyperspectral (HSI) and confocal imaging (CLSM) techniques in synergy with gas chromatography-ion mobility spectrometry (GC-IMS). Models based on partial least squares regression (PLSR) were developed using the full HSI spectrum variables as well as optimum variables selected through a competitive adaptive reweighted sampling algorithm. RESULTS: Prediction results for MC and TBARS using multiplicative scatter correction pre-processed spectra models demonstrated greater efficiency and predictability with determination coefficient of prediction of 0.928, 0.930 and root mean square error of prediction of 0.114, 1.002, respectively. Major structural changes were also observed during CLSM imaging, which were greatly pronounced in pork samples oven cooked for 15 and 20 h. These structural changes could be related to the denaturation of the major meat components, which could explain the loss of moisture and the formation of TBARS visualized from the HSI chemical distribution maps. GC-IMS identified 35 volatile components, including hexanal and pentanal, which are also known to have a higher lipid oxidation specificity. CONCLUSION: The synergistic application of HSI, CLSM and GC-IMS enhanced data mining and interpretation and provided a convenient way for analyzing the chemical, structural and volatile changes occurring in meat during processing. © 2021 Society of Chemical Industry.

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BACKGROUND: Various spectral profiles, including reflectance, absorbance, and Kubelka-Munk spectra, have been derived from hyperspectral images and used to develop multivariate models to evaluate changes in the quality of meat and meat products as a function of processing. However, none of these has the capacity to produce images of the structural changes often associated with processing. This study explored the feasibility of combining hyperspectral imaging (HSI) with confocal laser scanning microscopy (CLSM) to examine the impact of processing on microstructural changes and the evolution of moisture. Reflectance spectra features were obtained and transformed into absorbance and Kubelka-Munk spectra and their ability to predict moisture content using models established on partial least-squares regression were evaluated. RESULTS: The partial least-squares regression model (full-band wavelength) dubbed Rs-MSC yielded the best result, with R c 2 = 0.967 , RMSEC = 0.127, R cv 2 = 0.949 , RMSECV = 0.418, R p 2 = 0.937 , RMSEP = 0.824. Next, a total of 16 optimum wavelengths were selected using the competitive adaptive reweighted sampling algorithm. These wavelengths also yielded good results for Rs-MSC, with R c 2 = 0.958 , RMSEC = 0.840, R cv 2 = 0.931 , RMSECV = 0.118, R p 2 = 0.926 , RMSEP = 0.121. Regarding moisture distribution and microstructure analysis, HSI and CLSM were able to reveal moisture content distribution and conformational differences in microstructure in the test samples. CONCLUSION: Using HSI in synergy with CLSM may offer a reliable means for assessing both the chemical and structural changes that occur in other congener food products during processing. © 2020 Society of Chemical Industry.

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BACKGROUND: To determinate the association relationship of breast cancer bone metastasis and cancer characteristics and molecular subtype. Furthermore, to evaluate the impact of molecular subtype on prevalence and prognosis of bone metastasis from the breast cancer base on a large population real-word program, the Surveillance, Epidemiology, and End Results (SEER) database. METHODS: We collected and analyzed the data obtained from SEER, which showed molecular subtype information for each patient. The prevalence and outcome of bone metastasis in breast cancer were estimated as per the different molecular subtypes. RESULTS: Occurrence of bone metastasis in conformity with four different molecular subtypes in all 42684 breast cancer patients was 6.2, 9.4, 7.9, and 6.4%, respectively. The most unfavorable subtype was the triple-negative breast cancer (TNBC), followed by the luminal A, luminal B, and HER2 subtypes (hazard ratio [HR] of luminal A compared with TNBC, 0.533, 95% confidence interval, 0.444-0.641; HR of luminal B, 0.482, 95% CI 0.419-0.555; HR of HER2 subtype, 0.542, 95% CI 0.484-0.608). Brain metastasis impacts overall survival (OS) (p < 0.001) fundamentally, and visceral metastases also significantly decreased OS (p < 0.001). CONCLUSION: Bone metastasis patients present a more favorable oncological survival consequence than other metastases, and the TNBC subtype with bone metastasis showed the poorest tumor outcome compared with the other three molecular subtypes.

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Drying and ß-carotenes retention kinetics were predicted using models in relative humidity (RH) drying condition. This was achieved by drying carrot slices using RH-convective hot-air dryer at 60, 70 and 80 °C under RH (10% 20% and 30%) conditions at 2.0 m/s air velocity. Three mathematical models describing thin layer were compared to their goodness of fit in terms of coefficient of correlation (R2), root mean square error (RMSE) and reduced Chi square ( χ 2 ). The Wang and Singh model could satisfactorily describe RH-convective drying of carrot slices with R2, RMSE and χ 2 in the ranges of 0.996-0.999, 5.4 × 10-4-9.4 × 10-4 and 0.0150-0.03353 respectively. The results reveal that a range of 3.61-8.2% retention of ß-carotene was observed for every 10% increase in RH in various drying air temperature. In summary, higher temperatures were mainly responsible for ß-carotenes degradation however this can be mitigated when drying is conducted under higher RH.

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Rapid construction of phase diagrams is a central tenet of combinatorial materials science with accelerated materials discovery efforts often hampered by challenges in interpreting combinatorial X-ray diffraction data sets, which we address by developing AgileFD, an artificial intelligence algorithm that enables rapid phase mapping from a combinatorial library of X-ray diffraction patterns. AgileFD models alloying-based peak shifting through a novel expansion of convolutional nonnegative matrix factorization, which not only improves the identification of constituent phases but also maps their concentration and lattice parameter as a function of composition. By incorporating Gibbs' phase rule into the algorithm, physically meaningful phase maps are obtained with unsupervised operation, and more refined solutions are attained by injecting expert knowledge of the system. The algorithm is demonstrated through investigation of the V-Mn-Nb oxide system where decomposition of eight oxide phases, including two with substantial alloying, provides the first phase map for this pseudoternary system. This phase map enables interpretation of high-throughput band gap data, leading to the discovery of new solar light absorbers and the alloying-based tuning of the direct-allowed band gap energy of MnV2O6. The open-source family of AgileFD algorithms can be implemented into a broad range of high throughput workflows to accelerate materials discovery.

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