Objective: To understand the allocation and use of safety seats for preschool children and explore its related factors, so as to provide a scientific reference for promoting the usage of safety seats. Methods: A stratified random cluster sampling method was used to select 3 143 parents of preschool children aged 3 to 6 from six kindergartens in Shunyi District, Beijing from January 3 to 10, 2022. An online questionnaire survey was conducted to collect and evaluate the equipment and use of child safety seats in different characteristics of preschool children, as well as their scores of health beliefs. Multiple factor Logistic regression analysis was used to investigated the related factors of safety seat configuration and use. Results: The equipping rate and usage rate of safety seats for preschool children were 66.56% and 58.45%, respectively. The proportion of equipped and used safety seats for preschool children in core families (69.52%, 62.23%) were higher than that in large families (64.35%, 55.62%), only child families ( 72.39 %, 64.87%) were higher than non only child families (61.49%, 52.86%), and urban families (71.63%, 63.04%) were higher than rural families (52.31%, 45.51%) ( χ 2=9.23, 13.86; 41.72, 46.44; 101.96 ,76.97,all P <0.05) . As the educational level of parents ( χ 2 trend =154.23,98.76) and annual income of the family ( χ 2 trend =155.78,127.69) rised, the reporting rates of the equipped and used child safety seats in the family also increased(all P <0.05 ). There were statistically significant differences in the scores of different dimensions of health beliefs for the provision ( t =-20.22-18.16) and use ( t =24.32-24.17) of safety seats for preschool children(all P <0.05). After adjusting for child sex, child age, family annual income, parental education level, family type, whether the child was an only child, and place of residence，multivariate Logistic regression analysis showed that preschool children with higher perceived susceptibility score( OR =1.11, 1.08), higher self efficacy score( OR =1.23, 1.33), and higher suggestive factors score( OR =1.08, 1.12) were more likely to have and use safety seats in their families, while preschool children with higher perceived impairments score( OR =0.82, 0.80) were less likely to have and use safety seats in their families (all P <0.05). Conclusions The installation rate of child safety seats needs to be improved, and there is also a certain gap in their use after installation. Parents of preschool children should improve susceptibility and self efficacy to safety seat equipment and use, and perceptual barriers should be reduced.

Neurocritical care involves complex pathophysiological mechanisms, and its incidence is higher, injuries are more severe, and treatment is more challenging in high-altitude environments. This consensus, based on the latest domestic and international evidence-based medical data, establishes a standardized, goal-oriented framework for neurocritical care management applicable in high-altitude regions and nationwide. The consensus was developed following international standards for evidence quality assessment and underwent two rounds of Delphi expert consultation, resulting in 32 recommendation statements covering three parts: management systems, monitoring and assessment, and core strategies. Key updates include: advocating for the establishment of independent neurocritical care units and implementing precise tiered diagnosis and treatment based on the "Five Differences in Critical Care" concept; constructing a "trinity" multimodal brain monitoring system centered on cerebral blood flow, cerebral oxygenation, and brain function, emphasizing routine bedside transcranial Doppler ultrasound, cerebral oximetry, and continuous electroencephalography monitoring; shifting management strategies from mild hypothermia therapy to targeted temperature management, and defining the "446" target management pathway for the supercritical stage; emphasizing the assessment of static and dynamic cerebrovascular autoregulation functions through multimodal methods to achieve individualized optimal mean arterial pressure management; elevating cerebrospinal fluid management goals to the level of "glymphatic system" function maintenance; implementing a multidisciplinary collaborative, whole-process management model focusing on patients' long-term neurological functional outcomes; de-escalation criteria include multidimensional indicators such as recovery of brain structure, restoration of cerebrovascular autoregulation, improvement in cerebrospinal fluid dynamics, and reduction in biomarker levels; and integrating cutting-edge technologies like artificial intelligence into post-critical care management and rehabilitation planning. This consensus systematically integrates the entire process of neurocritical care management, reflecting the modern connotation of goal-oriented, dynamic, and multimodal integration in neurocritical care medicine. It aims to adapt to new trends such as deepening understanding of pathophysiological mechanisms, the integration of medicine and engineering, and the empowerment of artificial intelligence, thereby further advancing the discipline of critical care medicine.

Objective To propose a lung artery segmentation method that integrates shape and position prior knowledge, aiming to solve the issues of inaccurate segmentation caused by the high similarity and small size differences between the lung arteries and surrounding tissues in CT images. Methods Based on the three-dimensional U-Net network architecture and relying on the PARSE 2022 database image data, shape and position prior knowledge was introduced to design feature extraction and fusion strategies to enhance the ability of lung artery segmentation. The data of the patients were divided into three groups: a training set, a validation set, and a test set. The performance metrics for evaluating the model included Dice Similarity Coefficient (DSC), sensitivity, accuracy, and Hausdorff distance (HD95). Results The study included lung artery imaging data from 203 patients, including 100 patients in the training set, 30 patients in the validation set, and 73 patients in the test set. Through the backbone network, a rough segmentation of the lung arteries was performed to obtain a complete vascular structure; the branch network integrating shape and position information was used to extract features of small pulmonary arteries, reducing interference from the pulmonary artery trunk and left and right pulmonary arteries. Experimental results showed that the segmentation model based on shape and position prior knowledge had a higher DSC (82.81%±3.20% vs. 80.47%±3.17% vs. 80.36%±3.43%), sensitivity (85.30%±8.04% vs. 80.95%±6.89% vs. 82.82%±7.29%), and accuracy (81.63%±7.53% vs. 81.19%±8.35% vs. 79.36%±8.98%) compared to traditional three-dimensional U-Net and V-Net methods. HD95 could reach (9.52±4.29) mm, which was 6.05 mm shorter than traditional methods, showing excellent performance in segmentation boundaries. Conclusion The lung artery segmentation method based on shape and position prior knowledge can achieve precise segmentation of lung artery vessels and has potential application value in tasks such as bronchoscopy or percutaneous puncture surgery navigation.

ObjectiveTo systematically evaluate the public health governance capacity of 40 cities in Jiangsu, Zhejiang, and Anhui Provinces, providing a scientific evaluation basis for building a "Healthy Yangtze River Delta". MethodsA comprehensive collection of policy documents, public information reports, and research literature related to public health governance capacity in Jiangsu, Zhejiang, and Anhui Provinces was conducted, totaling 6 920 policy documents, 1 720 information reports, and 1 200 literature pieces. Based on the evaluation standards for an appropriate public health system established by the research team, the basic status of public health governance capacity was assessed to identify the strengths and weaknesses of the 40 cities. ResultsIn 2022, the public health governance capacity score for the 40 cities in Jiangsu, Zhejiang, and Anhui Provinces was (562.5±38.0) points. In terms of specific areas, the emergency response field received the highest score of (791.4±49.7) points, while the chronic disease prevention and control field received the lowest score of (368.2±29.6) points. The Jiangsu-Zhejiang-Anhui region has largely achieved the strategic priority of health, gradually improved public health legal regulations, and established a basic organizational framework with a solid foundation for information and data infrastructure. However, challenges still need to be addressed, such as unstable government funding for public health, unclear departmental responsibilities, and barriers to information interoperability. ConclusionThe public health governance capacity of the 40 cities in Jiangsu, Zhejiang, and Anhui Province has been at a moderate level, but disparities have still existed across regions and fields. In the future, while continuing to deepen existing advantages, it is essential to accurately identify the causes of problems, establish a long-term and stable investment mechanism, enhance information connectivity mechanisms, further clarify departmental responsibilities, and promote the achievement of the "Healthy Yangtze River Delta" goal.

Objective: To examine the relationship among physical education core literacy, exercise self efficacy, physical self esteem and subjective exercise experience among middle school students, and to analyze the latent classes of exercise self efficacy, so as to provide evidence for enhancing adolescents subjective exercise experience. Methods: Using stratified cluster random sampling, 2 569 students from 12 provinces, autonomous regions or municipality directly under the central govement (Jiangxi, Guangdong, Hunan, Guizhou, Henan, Guangxi, Yunnan, Chongqing, Sichuan, Shandong, Hubei, Hebei) were surveyed from September to November in 2024 with Core Competency Scale of Physical Education, Subjective Exercise Experiences Scale, Exercise Self Efficacy Scale, and Physical Self esteem Scale. Pearson correlation analysis was conducted to explore the relationships among physical education core literacy, exercise self efficacy, physical self esteem, and subjective exercise experience. Mediation models with Bootstrap testing were employed to examine the mediating roles of exercise self efficacy and physical self esteem in the relationship between physical education core literacy and subjective exercise experience. Latent profile analysis (LPA) of exercise self efficacy was performed using Mplus 8.3. Results: Pearson correlation analysis revealed positive associations between physical education core literacy and exercise self efficacy ( r =0.21), physical self esteem ( r =0.38), and subjective exercise experience ( r =0.40); exercise self efficacy was positively correlated with physical self esteem ( r =0.25) and subjective exercise experience ( r =0.45); and physical self esteem was positively correlated with subjective exercise experience ( r =0.34) (all P <0.01). Mediation analysis indicated that physical education core literacy positively predicted subjective exercise experience ( β =0.41, P <0.05), with exercise self efficacy and physical self esteem serving as partial mediators (effect size=0.14, P <0.01), accounting for 34% of the total effect. LPA identified three latent classes of exercise self efficacy:low (14.71%, n =378), moderate (65.51%, n =1 683), and high (19.78%, n =508) exercise self efficacy groups. Conclusion Adolescents exercise self efficacy demonstrates heterogeneity, and both exercise self efficacy and physical self esteem mediate the relationship between physical education core literacy and subjective exercise experience.

Objective To investigate the eye lens and hand dose levels of interventional radiology workers in Baoji City, China, and to provide data reference for radiation protection. Methods In two general hospitals, the eye lens and finger doses of 121 interventional radiology workers were monitored between 2021 and 2023. The average annual dose levels and dose distribution were analyzed based on years, job positions, surgical sites, and duties during surgery. Results The average annual dose to the eye lens was 3.36 mSv, with the highest dose of 16.36 mSv. The average annual dose to the fingers was 3.38 mSv, with the highest dose of 17.72 mSv. The average annual dose to the eye lens and fingers decreased from 2021 to 2023. The average annual dose to the eye lens of the interventional surgeons was higher than those of the technicians and nurses, while the average annual dose to the fingers of the interventional surgeons was higher than that of the technicians. The average annual doses to the eye lens and fingers of the first operator were similar to those of the second operator, but both were higher than other personnel involved in the interventional surgery, and the differences were statistically significant (all P < 0.05). There were linear regression relationships between the annual doses to the eye lens and fingers and the effective whole-body dose of the interventional radiology workers. A paired test was conducted on the annual dose to the eye lens and fingers of the interventional workers for different surgical sites. The cardiovascular and peripheral vascular interventional workers had higher average annual doses to the eye lens than to the fingers, the cerebrovascular interventional workers had a higher average annual dose to the fingers than to the eye lens, and the differences were statistically significant. Conclusion The annual doses to the eye lens and fingers of the interventional radiology workers in Baoji City were lower than the national limits. However, some workers showed eye lens annual doses close to the new international standard limit (20 mSv). Special attention should be given to interventional physicians, especially the first and second surgeons.

Objective: To understand the dynamic temporal evolution pathways of Internet addiction among university students and to identify the core driving nodes, so as to provide theoretical evidences for the precise implementation of targeted interventions. Methods: Using a convenient cluster sampling method, a total of 1 066 full time freshmen and sophomores were recruited from three universities in Guizhou, Jiangxi, and Guangdong Provinces for a follow up survey (T1:January-March 2024; T2:January-March 2025). The Revised Chen Internet Addiction Scale (CIAS-R) was employed to assess the status of Internet addiction among university students, and cross sectional as well as cross lagged panel network models were constructed to analyze Internet addiction and its multidimensional influencing factors. Results: The T1 network comprised 19 nodes and 114 non zero edges, while the T2 network comprised 19 nodes and 126 non zero edges. Cross sectional network analysis revealed the strongest association between "insufficient sleep" and "daytime fatigue"; the core nodes were "first thought upon waking for going online" and "feeling low after disconnection" (characteristics of psychological dependence) at T1, while the core nodes shifted to "impaired health" and "excitement when online" (characteristics of functional impairment and addictive psychodynamic features) at T2. Cross lagged network analysis further indicated that "reduced leisure" directly predicted "sleep compression", and a bidirectional relationship was observed between "needing more time to achieve satisfaction" and "academic decline". Conclusions Internet addiction among university students exhibits dynamic evolutionary characteristics. Stage specific targeted interventions focusing on core driving nodes are needed, integrating behavioral regulation and academic support to break the vicious cycle and enhancing the ability to cope with real life demands.

In order to further standardize the vaccination of kidney transplant candidates and recipients in China, the Branch of Organ Transplantation of Chinese Medical Association has organized experts in kidney transplantation and infectious diseases. Based on the "Vaccination of Solid Organ Transplant Candidates and Recipients: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice", and in combination with the clinical reality of infectious diseases and vaccination after organ transplantation in China, as well as referring to relevant recommendations from home and abroad in recent years, these guidelines are formulated from aspects such as epidemiology, types of vaccines, vaccination principles, target population, and specific vaccine administration. The "Guidelines for Vaccination of Kidney Transplant Candidates and Recipients in China" aims to provide theoretical reference for medical workers in the field of kidney transplantation in China, regarding the vaccination of kidney transplant candidates and recipients. It is expected to better guide the vaccination of kidney transplant candidates and recipients, reduce the risk of postoperative infection, and improve survival outcomes.

Objective: To investigate the knowledge and behaviors related to hepatitis B prevention and control among carriers of hepatitis B surface antigen (HBsAg), so as to provide the basis for conducting health education and interventions for HBsAg carriers. Methods: Based on the seroepidemiological survey of hepatitis B among individuals aged 1 to 69 years in Shaanxi Province, HBsAg carriers were selected as the study subjects. Basic information, knowledge and behaviors about hepatitis B prevention and control were collected through questionnaire surveys. The awareness of hepatitis B prevention and control knowledge and related behaviors among HBsAg carriers were analyzed. Results: A total of 107 HBsAg carriers were enrolled, including 52 males (48.60%) and 55 females (51.40%), and had a median age of 47.04 (interquartile range, 19.78) years. The awareness of hepatitis B prevention and control knowledge ranged from 56.07% to 87.85% among HBsAg carriers, with the highest awareness for "hepatitis B vaccination can effectively prevent hepatitis B "(87.85%), and the lowest awareness for "sharing meals with HBsAg carriers or hepatitis B patients will not lead to infection" (56.07%) and "hepatitis B can be treated with antiviral drugs" (61.68%). The proportions of those who did not seek medical consultation, undergo regular check-ups, or receive treatment were relatively high, at 65.42%, 72.90% and 77.57%, respectively. Conclusions The awareness of hepatitis B transmission routes and treatment-related knowledge among HBsAg carriers is relatively low, and their medical-seeking behaviors are relatively passive. There is a need to enhance the dissemination of hepatitis B prevention and control knowledge, improve medical-seeking behaviors, and reduce the risk of hepatitis B virus transmission.