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Objective To conduct hazard vulnerability analysis(HVA) in a blood bank, aimed to identify high-risk events and optimize emergency management measures. Methods The risk event evaluation index system was established by referring to the Kaiser model and the situation of Guangzhou Blood Center, and risk events were ranked by risk matrix and Borda count. Results The top five events with the highest risk values identified by Kaiser model were information system emergencies (39.61%), extreme weather (38.03%), major public sentiment (37.86%), public health events (37.37%) and policy changes (37.24%). The results of risk matrix and Borda count revealed 1 extremely high-risk indicator as information system emergency, 5 high-risk indicators with the highest risk being major public sentiment, 11 medium-risk indicators with the highest risk being major medical disputes and 1 low-risk indicator as external fires. Conclusion Conducting HVA in combination with the actual situation of blood banks can effectively identify high-risk events and provide theoretical basis for improving emergency management measures.

ObjectiveTo understand the vaccination situation of non-national immunization program （non-NIP） vaccines in Changning District， and to provide evidence for further strengthening the management of vaccination services and guiding community health service centers to construct vaccination clinics for children and adults.MethodsNumber of non-NIP vaccine doses in community health service centers， Changning District， was collected from Shanghai Immunization Information System from 2016 to 2020. Descriptive epidemiological analysis was conducted.ResultsIn 2020， the overall number of non-NIP vaccine doses， proportion of non-NIP vaccine doses and average number of non-NIP vaccine doses in the community health service centers， Changning District， reached up to 115 361 doses， 63.41% and 1 664.54 per 10 000 persons， respectively. Furthermore， the proportion of non-NIP vaccine doses showed a significantly upward trend （χtrend2=131.110， P18 years. Human papillomavirus vaccines （HPV） and influenza vaccines （InfV） had the highest increase in vaccine doses. Additionally， non-NIP vaccination peaked from September to December in adults.ConclusionAlong with the number of non-NIP vaccine doses increase， it is necessary to strengthen the management of non-NIP vaccination and explore effective measures for construction of adult vaccination clinics to meet the public demand for vaccination.

The innovative design of teaching methods of Civics classes in colleges and universities is an effective measure to help the teaching of Civics classes in colleges and universities. In this paper, the significance of innovative Civics teaching methods is addressed, and a novel path for teaching Civics courses in colleges and universities is proposed. Through feature selection, the K-Means clustering algorithm is optimized, and after optimal selection of the initial clustering center, balanced discriminant function, and combing of the optimization process, the model is applied to the actual innovation of Civics and Political Science teaching, quantitatively assessing the behavioral characteristics of the students and constructing the prediction model to achieve dynamic monitoring of students’ performance. The empirical teaching analysis method is aimed at quantitatively assessing the path proposed in this paper. The clustering results show that consistent with the preset, the model divides students’ learning behavioral characteristics into four categories with clear boundaries and good clustering effect, and most of the student’s grades are concentrated around 60-80 points, according to which the teachers can adjust their teaching strategies in time to improve the teaching effect. Through the control experiment, we know that for the students who have gone through the innovative Civics teaching mode, the mean value of Civics achievement is 71.594, which is 19.329 points higher than the students who have studied in traditional Civics teaching, which is confirmed by the P-value in the t-test of independence which is less than 0.05. It indicates that the innovative teaching method for civics has a significant effect on improving students’ civics achievement.

ObjectiveTo assess the coverage and effectiveness of COVID-19 vaccines in the elderly.MethodsThis study was conducted in Changning District of Shanghai， targeting people aged 60 years and above. Vaccination data between 21 December 2020 and 28 February 2022 was retrieved from the Shanghai Collective Immunization System. Information on confirmed cases of COVID-19 from March 2022 through May 2022 was collected from the National Notifiable Diseases Reporting System. Vaccine effectiveness was calculated using the screening method.ResultsAs of 28 February 2022， 69.89% of people aged ≥60 years had received ≥1-dose vaccine， 63.80% had received full primary vaccination and 31.91% had received a booster dose. Vaccination coverage declined over age， with the lowest coverage in the elderly aged ≥80 years. Moreover， COVID-19 vaccination provided the highest protection against severe/critical illness and death due to the Omicron variants in the elderly aged ≥60 years. Full primary vaccination showed 96.15%（95%CI：84.15‒99.06）of vaccine effectiveness and booster vaccination showed 100% of the effectiveness against severe/critical COVID-19 and death.ConclusionsFull primary and booster vaccination coverage in the elderly is low， especially in those aged 80 and above. Our study finds high protection against COVID-19 associated severe/critical illness and death from both full primary and booster vaccination of inactivated COVID-19 vaccines in the elderly aged ≥60 years.

This paper delves into the ethical dimensions and public perceptions surrounding dolphin tourism, both seeing them in the wild and in the marine park. Using a comprehensive analysis of social media data over seven years, we focus on dolphins as a central element of marine mammal tourism, investigating how digital narratives shape tourist attitudes and behaviours towards these intelligent creatures. Informed by a multi-method data analysis approach, this study reveals an "echo chamber" effect in social media, perpetuating selective exposure to information that aligns with visitor motivations: hedonism, relevance and reverence. The theoretical contributions of this research extend the existing literature on wildlife tourism by offering a deeper understanding of how public sentiments towards animals in tourism settings evolve and influence tourism practices. The finding underscores the need for informed, ethical communication strategies that consider the complex interplay of entertainment, education, and conservation in wildlife tourism. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Materials and Methods Results Conclusions To evaluate and compare the accuracy of task‐autonomous robot‐assisted implant surgery (RAIS) and dynamic computer‐assisted implant surgery (dCAIS) for zygomatic implant placement.Ten atrophic edentulous maxilla models requiring zygomatic implant (ZI) placement were randomly divided into the RAIS and dCAIS groups. Osteotomies and implant placement were performed under the guidance of a task‐autonomous robotic system or dynamic navigation system. A total of 20 ZIs were analyzed. The angular, coronal, lateral coronal, coronal depth, apical, lateral apical, and apical depth deviations were measured and analyzed between the two groups. The primary outcome parameters were the angular deviations between the planned and the placed ZIs. Data was subjected to descriptive and comparative statistical analysis. The significance of inter‐group differences for continuous variables was assessed with Student's two‐sample t‐tests, Welch two‐sample t‐tests, and Mann–Whitney U tests according to the distribution normality and variance homogeneity.ZI placement deviations were compared between the RAIS and dCAIS groups, showing a mean angular deviation of 0.92 ± 0.40° versus 2.03 ± 0.53° (p < 0.001), a mean (±SD) coronal deviation of 0.48 ± 0.25 mm versus 1.29 ± 0.46 mm (p < 0.001), and a mean apical deviation of 0.88 ± 0.28 mm versus 1.96 ± 0.46 mm (p < 0.001).For computer‐guided ZI placement, task‐autonomous RAIS was superior to dCAIS in terms of accuracy. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Purpose Methods and Materials Results Conclusions The learning curve effect of dynamic computer‐assisted implant surgery (D‐CAIS) was observed among inexperienced novice surgeons. The learning curves can provide valuable information for novice surgeons and valid comparisons between new and conventional techniques. Recently, robotic computer‐assisted implant surgery (R‐CAIS) has shown promise as a novel dental implant surgical technique for both partially and edentulous patients. However, its learning curve remains unknown.The aim of this study was to explore the learning curve of dental implant placement surgery with a task‐autonomous robotic system among young dentists with different specialties.Four young dentists (mean age: 25.3 ± 1.5 years at the beginning of their first attempt) with equal representation of males and females and with different specialties participated in this study. None of the participants had prior experience in R‐CAIS. Each operator placed eight implants over eight attempts using a semi‐active task‐autonomous robotic system. Among the eight implants, four were straight lateral incisor implants, and four were 30°‐tilted premolar implants. The implants were placed in each dental quadrant of the maxillary and mandibular jaw modules. The operation time was recorded. Coronal, apical, and angular deviations between the planned and actual sites of implant placement were measured by merging preoperative and postoperative cone‐beam computed tomography (CBCT) scans. The data were analyzed with repeated‐measures ANOVA (α = 0.05).The mean time for implant placement was associated with the number of attempts (p < 0.01). The time taken for the second attempt was significantly shorter than that of the first attempt (33.26 vs. 30.47 min; p < 0.001) then it plateaued. Three‐dimensional (3D) angular (p = 0.31), coronal deviation (p = 0.26), and apical deviation (p = 0.06) did not differ significantly among attempts. The mean values and standard deviations of 3D coronal deviation, 3D apical deviation, and 3D angular deviation were 0.71 ± 0.31 mm, 0.72 ± 0.30 mm, and 0.94 ± 0.58°, respectively. Neither the position of the jaw (p > 0.59) nor the tilt angle of the implant (straight or 30°‐tilted, p > 0.85) was related to implant placement accuracy.Dentists quickly learned the basic workflow of R‐CAIS and thus facilitated the clinicians in the mastery of implant placement on edentulous jaw modules, leading to a comparable operating speed and high precision. Moreover, the accuracy of placement of straight and tilted implants in both the maxilla and mandible with R‐CAIS was satisfactory. [ABSTRACT FROM AUTHOR]

Morphine has been suggested to affect cancer cell dynamics and decrease survival rates in lung cancer patients at specific doses, but the precise mechanisms poorly understood. In this study, we aimed to investigate the molecular mechanisms by which morphine modulates the malignant characteristics of non-small cell lung cancer. Cell proliferation was assessed via the Cell Counting Kit-8 assay, and cell migration and invasion were examined via wound healing and Transwell assays. We employed immunofluorescence staining to evaluate E-cadherin expression in A549 and Lewis lung cancer (LLC) cell lines and immunohistochemistry to evaluate E-cadherin expression in nude mice tumours. Additionally, the in vivo effects of morphine on lung cancer progression were explored in a xenograft tumour experiments, in which naloxone was used as a morphine antagonist. Western blot analysis was performed to detect E-cadherin, phosphorylated mTOR (p-mTOR), mTOR, phosphorylated AKT (p-AKT), AKT, phosphorylated PI3K (p-PI3K), and PI3K protein levels in A549 and LLC cells as well as in tumour samples. Morphine (10 µM) significantly increased the proliferation of A549 and LLC cells in vitro (p < 0.05). It also enhanced the migratory and invasive capacities of these cell lines (p < 0.01). Mechanistically, morphine treatment (10 µM) led to a reduction in the expression of E-cadherin, and an increase in the phosphorylation of PI3K, AKT, and mTOR in A549 and LLC cells (p < 0.01). Morphine treatment (1.5 mg/kg) also reduced E-cadherin expression in xenograft tumours and promoted tumour growth in vivo (p < 0.05). This effect was reversed by naloxone (0.1 mg/kg). The results demonstrated that morphine stimulates the malignant proliferation of A549 and LLC cell lines and promotes xenograft tumour growth. Perhaps by specifically targeting MOR, morphine triggers a signalling cascade that activates the PI3K/AKT/mTOR pathway while inhibiting the EMT marker E-cadherin, which may consequently promote the progression of lung cancer. [ABSTRACT FROM AUTHOR]