The Cronobacter sakazakii-infecting phage JC03 was isolated and characterized. Its genome is composed of 177,089 bp of double-stranded DNA, contains 268 predicted open reading frames (ORFs) and two tRNA genes, and it has a G + C content of 44.67

Enterococcus faecalis (E. faecalis) is a major pathogen responsible for refractory apical periodontitis (RAP). It can penetrate deep into dentinal tubules, form persistent biofilms, and exhibit antibiotic resistance, thereby limiting the efficacy of conventional antimicrobial treatments. Bacteriophages (phages), due to their strong lytic activity and host specificity, have emerged as promising alternatives. In this study, a novel strictly lytic phage, ZXL-01, was isolated from lake water in Jilin, China. ZXL-01 demonstrated remarkable stability under extreme conditions, including thermal tolerance at 60 °C for 1 h and a wide pH range (4–11). Whole-genome sequencing (GenBank accession number: ON113334) revealed a genome of 40,804 bp with no virulence or tRNA genes, confirming its identity as an E. faecalis phage. Importantly, ZXL-01 exhibited potent antibiofilm activity, reducing biofilm biomass by approximately 69.4% in the inhibition group and 68.4% in the lysis group (both p < 0.001). In an in vitro root canal infection model induced by E. faecalis, scanning electron microscope (SEM) observations confirmed that ZXL-01 effectively inhibited biofilm formation and disrupted mature biofilms. These findings highlight the potential of ZXL-01 as a novel antimicrobial agent for the treatment of E. faecalis-associated apical periodontitis.

This study aims to isolate and characterize the lytic phage XC1 targeting Acinetobacter nosocomialis and systematically analyze its biological properties and genomic structure, providing theoretical support for developing novel treatments against antibiotic-resistant infections. Phage XC1 was isolated and purified from lake water. Its morphology, optimal multiplicity of infection (MOI), thermal stability, and pH tolerance were analyzed. Genomic sequencing and functional annotation were performed to identify its lysis-associated genes. Phage XC1 demonstrated a short latent period (20 min) and high burst size (310 plaque-forming units per cell, PFU/cell). It remained stable under temperatures of 50–60 °C and at pH 7, indicating good environmental stability. Genomic analysis revealed a 45,324 bp genome with a GC content of 38.21%, including 84 open reading frames (ORFs), without any lysogenic, virulence, or antibiotic-resistance genes, confirming its safety. Average Nucleotide Identity (ANI) analysis shows that the ANI values between phage XC1 and other phages range from 80% to 95%. As the ANI value between strains of the same species is typically ≥95%, this suggests that phage XC1 may be a previously undiscovered new phage. Classified within the genus Obolenskvirus (class Caudoviricetes), phage XC1 is a virulent bacteriophage with rapid lytic activity and extreme environmental tolerance. Its therapeutic potential against multidrug-resistant infections, either as a monotherapy or in synergy with antibiotics, warrants further investigation.

The global surge in multidrug-resistant (MDR) bacterial pathogens has created an urgent imperative for innovative antimicrobial strategies. Enterococcus faecalis, Staphylococcus aureus, and Acinetobacter baumannii demonstrate remarkable antibiotic resistance and dominate hospital-acquired infections. These bacteria often form biofilms, a complex community structure that shields them from immune system phagocytosis, resists antibiotic penetration, and enhances their survival in hostile environments. In clinical cases, these bacteria often form mixed biofilms and lead to treatment failures. Phages and their derivatives have emerged as promising candidates in the fight against drug-resistant bacteria. Lys22, an endolysin derived from an enterococcus phage, has been cloned and demonstrated to possess a broad host range, effectively targeting E. faecalis, various Staphylococcus species, and A. baumannii. When applied to the biofilms formed by these bacteria, Lys22 was found to significantly inhibit both simple and complex biofilms in vitro. Virulent genes, including agrA, sarA, and icaA in S. aureus; asa1, cylA, and gelE in E. faecalis; and OmpA and lpsB in A. baumannii were also downregulated by Lys22. Notably, Lys22 also exhibited a robust protective effect against dual or triple infections involving E. faecalis, S. aureus, and A. baumannii in a zebrafish embryos model, highlighting its potential as a therapeutic agent in combatting multi-bacterial infections.

This review aims to provide a comprehensive overview of the mucosal immune system and assess the potential of mucosal vaccines, particularly for COVID-19, as a promising approach in combating respiratory pathogens like SARS-CoV-2. Mucosal immunization has emerged as a viable strategy for COVID-19 vaccination. Various mucosal vaccines, including oral and intranasal formulations, are currently undergoing clinical evaluation in multiple countries. This review examines these vaccine strategies, their status, and highlights recent advancements in the field. This review focuses on mucosal vaccination as a strategic defense against respiratory pathogens by leveraging innate immunity, mucosal antibodies, and memory lymphocytes. While the approach offers significant potential, it faces substantial challenges that limit the effectiveness of current COVID-19 mucosal vaccines. The article outlines these obstacles and proposes targeted strategies to overcome them, contributing to improved pandemic control measures.

Abuse of antibiotics has led to increased rates of resistance in extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae and an acceleration in the emergence of drug-resistant strains, which can have serious consequences for nosocomial infections. In this study, phage MY02, which infects ESBL-producing Klebsiella pneumoniae, was isolated from sewage and characterized. Phage MY02 was found to have an optimal multiplicity of infection of 0.001, with a lysis period of up to 40 minutes and an average burst of about 80 plaque-forming units per cell. The phage was found to be stable over a temperature range of -20 to 60°C and a pH range of 3–11 and to have a broad host range. Whole-genome sequencing showed that the genome of phage MY02 is ??171,821?? bp in length and contains 293 open reading frames. Sequence comparisons and phylogenetic analysis showed that phage MY02 belongs to the genus Marfavirus in the class Caudoviricetes. This novel broad-spectrum Klebsiella pneumoniae phage has potential applications against bacterial infections.

Background. Despite the emphasis on the importance of implementing evidence-based practices, nurses did not adopt this approach as a standard. For those who have attempted to implement evidence-based practice in health care settings, the behaviour is rarely simple or straightforward. Therefore, exploring the mechanism that motivates nurses' evidence-based practice behaviour is essential to promote this practice. Aims. The aim of this study was to investigate the effect of the organizational climate for evidence-based practice on evidence-based practice behaviour among nurses through the mediating role of evidence-based practice competence, work control, and the intention to implement evidence-based practice. Methods. This study consisted of a cross-sectional design and convenience sampling to recruit 641 nurses employed in 6 hospitals in China. Five self-report instruments were used to collect the data. A structural equation model was adopted to verify the research hypotheses. IBM SPSS 26.0 and AMOS 24.0 were used for statistical analysis of the data. Results. The organizational climate for evidence-based practice was significantly and positively related to the nurses' evidence-based practice behaviour (p<0.01). Direct effects accounted for 45.93% of the total effect. Evidence-based practice competence, work control, and the intention to implement evidence-based practice partially mediated the association between the organizational climate and evidence-based practice behaviour. The indirect effect accounted for 54.07% of the total effect. Conclusion. The organizational climate for evidence-based practice is critical for predicting and enhancing evidence-based practice behaviour. Evidence-based practice competence, work control, and the intention to implement evidence-based practice are intervening mechanisms that explain how the organizational climate promotes evidence-based practice behaviour. Implications for Nursing Management. Nursing managers should be aware of the interaction of individual and organizational factors that influence evidence-based practice behaviours among nurses. Administrators should improve the organizational climate by providing nurses with cultural and team support, mentoring, training projects, resource provisions, and more autonomy and authority at work, which are beneficial to the nurses' evidence-based practice competence, work control, and intentions to adopt evidence-based practices.

Infections with vancomycin-resistant Enterococcus (VRE) have been increasingly reported, especially in immunocompromised patients. Bacteriophages (phages) are often considered as potential therapeutic candidates in treating infectious diseases. To search for therapeutic phages as antimicrobial agents for the treatment of Enterococcus faecium infections, eight E. faecium phages were isolated from the environments. One of these, phage φEc-ZZ2, which was capable of eliciting efficient lysis of E. faecium, was selected for analysis. Transmission electron microscopy revealed its resemblance to members of the family Siphoviridae, with a tail 200 nm long and an icosahedral head 45 nm in diameter. Phage φEc-ZZ2 exhibited rapid adsorption (> 99% adsorbed in 10 min), a short latency period of 20 min and a large burst size of 180 PFU/cell. Host range determination shows that φEc-ZZ2 has a relatively broader host range (specificity for 54.5% of tested E. faecium strains). Furthermore, when φEc-ZZ2 alone was incubated at different pH, the phage was stable over a wide pH range (5 to 9). These characteristics of φEc-ZZ2 will provide useful information for further research on the interaction between Enterococcus phages and their hosts. Moreover, in consideration of its pH stability and broader host range, φEc-ZZ2 may be a good candidate as a therapeutic/disinfectant agent to control nosocomial infections caused by E. faecium.

ObjectiveOverweight and obesity among adolescents are grave public health issues around the world. Although the conditions that contribute to obesity have been extensively researched, little is known about how multiple conditions interact to cause overweight and obesity. The current study intends to investigate the histomorphic configuration pathways of several conditions of adolescent overweight and obesity by gender.MethodThe data came from a social survey conducted in June 2021 in Changchun, Jilin Province, China. The sample collected was 14-year-old adolescents, including 167 boys and 137 girls. The school physicians examined the participants' weight and height, and questionnaires were used to collect risk indicators from adolescents, such as sleep duration, electronic screens times, consumption of sugary drinks and fried foods, and physical activity. Simultaneously, a Fuzzy Qualitative Comparative Analysis will be performed to investigate the combinations of diverse conditions.ResultWe found that there is no determining necessary condition that, once present, directly determines that an individual is in a state of overweight and obesity. Simultaneously, this study revealed nine alternative configurational paths of overweight and obesity in teenagers of different genders, with a concordance of 0.805 for six male groupings and 0.916 for three female groupings. The outcomes of overweight obesity in adolescents under different genders are similar but not identical.ConclusionThis study examined the interactions of a number of conditions from the individual, behavioral, learning and living environment that led to the same overweight obese outcome among adolescents of different genders. Our research will be useful to policymakers in that interventions should take into account the combined effects of a number of different aspects rather than focusing on a single factor that causes overweight and obesity.

Introduction Amid sudden public health crises, preserving the well-being and optimal working states of frontline healthcare professionals is imperative for efficaciously managing the emergences. However, there is a paucity of research investigating the health status of frontline healthcare professionals through the perspective of work-family conflict. This study sought to elucidate the complex interrelations between work-family conflict, work engagement, job burnout, and self-rated health among public health emergency responders within the context of the COVID-19 pandemic.Methods A convenience sampling method was employed to survey 1,309 public health emergency responders at the Jilin Provincial Center for Disease Control and Prevention. An online survey was administered utilizing a self-constructed questionnaire. The hypothesized relationships between the variables were tested using structural equation modeling.Results The direct impact of work-family conflict on self-rated health is not significant. The association between work-family conflicts and self-rated health was significantly mediated by work engagement and job burnout, respectively. Meanwhile, work engagement and job burnout had a chain mediating effect on work-family conflict and self-rated health.Conclusion Work-family conflict plays a critical role in shaping the health and work status of public health emergency responders during public health crises. Organizations and managers should, in their workplace management practices, focus not only on work-related factors but also give due consideration to family-related factors. Supportive policies, including family-friendly initiatives, should be developed to safeguard the health and work engagement of public health emergency responders.

Background As a global pandemic, The Corona Virus Disease 2019 (COVID-19) has brought significant challenges to the primary health care (PHC) system. Health professionals are constantly affected by the pandemic’s harmful impact on their mental health and are at significant risk of job burnout. Therefore, it is essential to gain a comprehensive understanding of how their burnout was affected. The study aimed to examine the relationship between COVID-19 event strength and job burnout among PHC providers and to explore the single mediating effect of job stress and work engagement and the chain mediating effect of these two variables on this relationship. Methods Multilevel stratified convenience sampling method was used to recruit 1148 primary medical staff from 48 PHC institutions in Jilin Province, China. All participants completed questionnaires regarding sociodemographic characteristics, COVID-19 event strength, job stress, work engagement, and job burnout. The chain mediation model was analyzed using SPSS PROCESS 3.5 Macro Model 6. Results COVID-19 event strength not only positively predicted job burnout, but also indirectly influenced job burnout through the mediation of job stress and work engagement, thereby influencing job burnout through the “job stress → work engagement” chain. Conclusions This study extends the application of event systems theory and enriches the literature about how the COVID-19 pandemic impacted PHC medical staff job burnout. The findings derived from our study have critical implications for current and future emergency response and public policy in the long-term COVID-19 disease management period.

Background: Intention to smoke is an important predictor of future smoking among adolescents. The purpose of our study was to examine the interaction between academic performance and parents/peer tobacco use on adolescents’ intention to smoke. Methods: A multi-stage stratified sampling was used to select participants, involving 9394 students aged between 9–16 years in Changchun city, northeastern China. Multiple logistic regression analyses were conducted to examine the individual effect of academic performance and peer/parental smoking behavior. Stratified logistic regressions were conducted to examine the protective effect of academic performance based on peer or parental smoking. Interaction effects of academic performance × peer/parental smoking on adolescents’ intention to smoke were tested. Results: Of all the non-smoking students sampled, 11.9% intended to smoke within the next five years. The individual effect of academic performance and peer/parental smoking was significant. The protective effect of academic performance on the intention to smoke was significant regardless of whether peers smoked or not. However, the protective effect was not significant among adolescents with only maternal smoking and both parental smoking. The current study found the significant interaction effects of academic performance × peer smoking and the academic performance × both parents’ smoking. Students with poor academic performance were more likely to intend to smoke if their peers or both parents smoked. Conclusion: These preliminary results suggest that peer smoking or smoking by both parents reinforces the association between low academic performance and the intention to smoke among adolescents. Enhancing school engagement, focusing on social interaction among adolescents with low academic performance, and building smoke-free families may reduce adolescents’ intention to smoke.

Objective: Based on balanced scored card management, the Delphi method was applied to set up the evaluation system of health supervision and law enforcement, so as to provide references for the practice use of health supervision and law enforcement. Methods: Taking the balanced scored card model as the theoretical framework, the primary indicator system was constructed. Next, the Delphi expert consultation group was established, and the questionnaire was sent to the experts to understand the opinions of the experts on the evaluation indicators, thus reaching a consensus among their opinions. Results: the experts’ responses were 100%, the experts’ authoritative coefficients were above 0.7. The index system of health supervision and law enforcement was obtained, including the capacity, efficiency, effect, and beneficial result of health supervision. The index system of health supervision and law enforcement was categorized into 4 first-level indicators, 14 second-level indicators, and 56 third-level indicators. Conclusion: In the evaluation of health supervision and law enforcement effectiveness, attention should be paid to the whole process and all-around evaluation of the four dimensions, i.e., capacity, efficiency, effect, and beneficial result of health supervision. The evaluation process should be systematic, comprehensive, and objective. The personnel, establishment, funds, law enforcement equipment, and information construction of health supervision institutions are the main factors that affect the effectiveness of law enforcement. In the practice of health supervision and law enforcement, implementers should focus on the main responsibility and goal of administrative law enforcement, implement the "double random, one open" supervision and inspection mode, improve the quality and efficiency of law enforcement and case handling, which can establish the environment with the strict, standardized, impartial and civilized law enforcement, and improve the public’s understanding of the law, and optimize the public satisfaction with health supervision and law enforcement.

Objective:To comprehensively evaluate the law enforcement effectiveness of county-level health supervision insti-tutions in Henan province,to understand the current situation of law enforcement effectiveness,and propose corresponding improve-ment measures,so as to enhance the enforcement effectiveness of health supervision and promote the sustainable development of health supervision.Methods:Ten county-level health supervision institutions in Henan province were selected as the evaluation objects.The weighted sum comprehensive evaluation method,TOPSIS method,and RSR method were collectively used to compre-hensively evaluate and rank the law enforcement effectiveness of health supervision agencies in 2021 from four dimensions:supervi-sion capacity,supervision efficiency,supervision effect,and supervision benefit.Accordingly,the main factors affecting the law enforcement effectiveness were studied and explored.Results:Among the four dimensions,supervision efficiency had the highest score(0.80),followed by supervision capacity(0.56),and supervision effect had the lowest score(0.32).Among them,the scores for human resources,funding input,facilities and equipment,emergency response capability,law enforcement and case handling,departmental evaluation,health benefit and social benefit were relatively low.The TOPSIS evaluation results showed that among the ten county-level health supervision agencies,County A ranked first in the law enforcement effectiveness.Combined with the RSR method,the evaluation results were divided into three levels,with County A and County F rated as"excellent",County G rated as"poor",and the remaining seven counties rated as"average".Conclusion:There are significant differences in the law enforcement effectiveness of county-level health supervision institutions in Henan province,the effect and beneficial result of law enforcement should be improved,and more investment is needed to bolster weak spots.

A. Baumannii is an opportunistic nosocomial pathogen which has severe antibiotic resistance. However, the epidemiology is less clearly understood in Jilin province and China. Thus, 89 A. baumannii isolates from a single hospital in Jilin province between 2013–2017 were performed by MLST. In order to better understanding of the epidemiology of Jilin isolates, Chinese strains originated from other domestic regions and worldwide isolates in MLST database were analyzed by silico phylogenetic tools together. A total of 22 STs in Jilin were identified, and 10 STs were found to be novel. The top three predominant sequence types are ST195 ( n = 34, 38.2%), ST208 ( n = 14, 15.7%) and ST540 ( n = 13, 14.6%). ST369 is predicted to be group founder and ST195, ST540 are subgroup founders of the majority STs in Jilin Province. Some newly discovered singletons showed close relationship with strains from other countries, which suggest that nation-cross transmission is one of important origin of Jilin strains. The majority of Jilin STs showed clonality and close relationship with the majorities from other regions of China. But occupation of individual STs in Jilin were different from that of other domestic regions. The aggregation trend and genetic relationship proved that predominant Jilin STs continue to mutate during transmission. Drug resistance facilitated transmission of Jilin A.baumannii isolates because more than 94% of isolates are resistant to at least one carbapenem and the STs with strong resistance to carbapenems usually has more isolates. In conclusion, high diversity and different occupation of STs, and occupation of novel STs proved that epidemiology of A. baumannii in Jilin has special regional characteristics, and drug resistance facilitated transmission of domestic strains and foreign strains.

ObjectivesThis study aimed to investigate the relationship between the functional limitation and happiness among Chinese older people and examined the multiple mediating effects of intergenerational support (instrumental support and financial support) and intergenerational relationship.MethodData was drawn from the Chinese Family Panel Survey (CFPS) 2018 and 2020. Structural equation modeling was adopted to analyze the association among functional limitations, intergenerational support, intergenerational relationship, and the older adults happiness.ResultsThere was a significant association between the functional limitations and the lower happiness levels among the older adults. The instrumental support from adult children positively mediated the relationship between the functional limitation and the happiness. However, intergenerational relationships were reduced due to the dysfunction of the older adults, and played a negatively mediated role between the functional limitation and the happiness. In addition, instrumental and financial support play chain-mediating roles between functional limitation and happiness in older adults through intergenerational relationships.ConclusionIntergenerational relationships and instrumental support enhance the happiness of older adults with functional impairments, but their role is limited by the changing structure of modern families. Long-term care programs combined with the intergenerational support from families for people with functional impairments in old age would be more effective to reduce the burden on adult children and maintain the quality of life of the older adults.

Abstract Background As a global pandemic, The Corona Virus Disease 2019 (COVID-19) has brought significant challenges to the primary health care (PHC) system. Health professionals are constantly affected by the pandemic's harmful impact on their mental health and are at significant risk of job burnout. Therefore, it is essential to gain a comprehensive understanding of how their burnout was affected. The study aimed to examine the relationship between COVID-19 event strength and job burnout among PHC providers and to explore the single mediating effect of job stress and work engagement and the chain mediating effect of these two variables on this relationship. Methods We used multilevel stratified convenience sampling to recruit participants from PHC institutions in Jilin Province, China. A total of 1148 medical professionals completed questionnaires regarding sociodemographic characteristics, COVID-19 event strength, job stress, work engagement, and job burnout. The chain mediation model was analysed using SPSS PROCESS 3.5 Macro Model 6. Results COVID-19 event strength not only positively predicted job burnout, but also indirectly influenced job burnout through the mediation of job stress and work engagement, thereby influencing job burnout through the "job stress → work engagement" chain. Conclusions This study extends the application of event systems theory and enriches the literature about how the COVID-19 pandemic impacted PHC medical staff job burnout. The findings derived from our study have critical implications for current and future emergency response and public policy in the long-term COVID-19 disease management period.

Participation by patients with chronic diseases under primary health care requires more attention to achieve effective disease management and better health outcomes. In 2016, China proposed accelerating the establishment of a system of family doctors (FDs) and strengthening doctor-patient communication to better meet residents’ health service needs. This study aimed to describe perceived participation in primary health care among patients with chronic diseases in northeastern China and explore the impact of FD contract services and patient’s trust on patients’ perceived participation. A cross-sectional survey of 847 patients with chronic diseases in 16 primary healthcare institutions was conducted in Jilin Province, China. Among all participants, 453 patients reported signing up for FD contract services (62.93%). The perceived participation of patients with chronic diseases was at a low level (mean = 6.71 and SD = 3.35). After controlling for sociodemographic variables and health-related variables, FD contract services directly and indirectly influenced patients’ perceived participation. The patient’s trust was a mediator in the relationship between FD contract services and perceived participation. This study confirmed the valuation of family doctor contract services and provided a theoretical basis for the formulation of primary health service policies. Health organizations should continue to enhance the capacity of primary health services and attract more chronic disease patients to contract with FD teams, thereby enhancing doctor-patient trust and increasing patient’s participation in primary health care.

The lytic bacteriophage JC01 was isolated using a strain of Cronobacter sakazakii previously isolated from powdered infant formula (PIF). The complete genome sequence of phage JC01 was determined. The double-stranded DNA genome of phage JC01 is composed of 61,736 bp with a G + C content of 58.9%, and it contains 76 putative open reading frames (ORFs) without any tRNA genes. The predicted ORFs were classified into functional groups, including DNA manipulation, transcription, phage packaging, phage structure, host lysis, and hypothetical proteins. Based on overall nucleotide sequence comparisons, calculation of phage intergenomic similarities, and phylogenetic analysis, JC01 appears to be a novel bacteriophage infecting C. sakazakii.

目的:了解吉林省基层医疗卫生机构居民就诊满意度现状,分析卫生资源及服务能力因素对居民就诊满意度的影响,为提升基层卫生机构居民就诊满意度、改善卫生服务质量提供参考.方法:对吉林省12家基层医疗卫生机构及其就诊居民进行问卷调查,通过描述性分析、单因素分析和多重线性回归对居民满意度的影响因素进行分析.结果:居民就诊满意度总均分为(3.78±0.45),医疗机构卫生资源服务能力指标中就诊医疗机构医护比、工作年限≥20年卫生技术人员所占比例、辖区内每万服务人口的家庭医生团队数、基本药物配备比例对居民满意度有显著影响(P<0.05).结论:基层医疗机构卫生资源及服务能力因素会对居民就诊满意度产生影响,提示应进一步落实分级诊疗和国家基本药物制度,建设家庭医生团队,完善卫生人力资源配置,进而提高居民就诊满意度.