Efficacy of neuroendoscopic-assisted surgery in the management of symptomatic sacral perineural (Tarlov) cysts: a technical report.

Introduction: The Tarlov cysts are pathological enlargements of the cerebrospinal fluid spaces between the endoneurium and perineurium, which can cause intolerable sciatic pain, motor impairment of lower limbs, and bladder/bowel dysfunction. Currently, the treatment results are unsatisfactory due to the low cure rates and extensive surgical trauma. Thus, there is an ongoing exploration of surgical techniques for Tarlov treatment. In the current study, we present a novel neuroendoscopic-assisted technique that combines the fenestration, leakage sealing, and tamponade of the Tarlov cyst. Methods: Between January 2020 and December 2021, a total of 32 Tarlov patients were enrolled and received neuroendoscopic-assisted surgery. Their pre- and post-surgical Visual Analogue Scale (VAS) scores, major complaints, and MR imaging were recorded for comparison. Results: 27 of 32 patients (84.4%) patients demonstrated immediate pain relief as their VAS scores decreased from 5.6 ± 1.5 to 2.5 ± 1.1 (p < 0.01) on the first day after surgery. At the 3-month follow-up, the patients' average VAS score continued to decrease (1.94 ± 0.8). Meanwhile, saddle paresthesia, urinary incontinence, and constipation were relieved in 6 (50%), 4 (80%), and 5 (41.7%), respectively, according to patients self-report. No surgical-related complication was observed in any of the cases. Discussion: We conclude that neuroendoscopic-assisted surgery is an effective surgical method for symptomatic Tarlov cysts with minimized complications.

High spatial-resolved source-specific exposure and risk in the city scale: Influence of spatial interrelationship between PM2.5 sources and population on exposure.

Research on High Spatial-Resolved Source-Specific Exposure and Risk (HSRSSER) was conducted based on multiple-year, multiple-site synchronous measurement of PM2.5-bound (particulate matter with aerodynamic diameter<2.5 µm) toxic components in a Chinese megacity. The developed HSRSSER model combined the Positive Matrix Factorization (PMF) and Land Use Regression (LUR) to predict high spatial-resolved source contributions, and estimated the source-specific exposure and risk by personal activity time- and population-weighting. A total of 287 PM2.5 samples were collected at ten sites in 2018-2020, and toxic species including heavy metals (HMs), polycyclic aromatic hydrocarbons (PAHs) and organophosphate esters (OPEs) were analyzed. The percentage non-cancer risk were in the order of traffic emission (48 %) > industrial emission (22 %) > coal combustion (12 %) > waste incineration (11 %) > resuspend dust (7 %) > OPE-related products (0 %) ≈ secondary particles (0 %). Similar orders were observed in cancer risk. For traffic emission, due to its higher source contributions and large population in central area, non-cancer and cancer risk fraction increased from 23 % to 48 % and 20 % to 46 % after exposure estimation; while for industrial emission, higher source contributions but small population in suburb area decreased the percentage non-cancer and cancer risk from 38 % to 22 % and 39 % to 24 %, respectively.

Syringo-Subarachnoid Shunt with Tube Versus T-Tube via the Dorsal Root Entry Zone Approach for Eccentric Syringomyelia.

OBJECTIVE: This study compared the clinical therapeutic efficacy of syringo-subarachnoid shunt placement with direct tube and T-tube via the dorsal root entry zone (DREZ) approach for treatment of eccentric syringomyelia. METHODS: A retrospective study was performed of 41 patients with idiopathic or secondary eccentric syringomyelia from November 2011 to December 2022. Syringo-subarachnoid shunt placement with direct tube or T-tube via the DREZ approach was performed. The modified Japanese Orthopaedic Association low back pain scale was used to investigate the severity of clinical symptoms. Magnetic resonance imaging was used to investigate therapeutic efficacy（reduction of the cavity volume by >10% was considered an improvement and 50% was considered a significant improvement). RESULTS: Incision length of the spinal cortex in the direct tube group was shorter than in the T-tube group (3.10 ± 0.28 cm vs. 5.03 ± 0.19 cm), with a significant difference between the 2 groups (t = -52.56, P < 0.001). Modified Japanese Orthopaedic Association score 3 months postoperatively was significantly better than the preoperative score in both the direct tube group（t = 40.954, P < 0.001） and the T-tube group（t = 24.769, P < 0.001）. Statistical comparison revealed there was no difference in imaging improvement between the direct tube group and T-tube group 3 months (χ2 = 0.20, P = 0.655) and 12 months (χ2 = 0.21, P = 0.647) postoperatively. CONCLUSIONS: Syringo-subarachnoid shunt placement with direct tube via the DREZ approach for treatment of eccentric syringomyelia is safer than with T-tube via the DREZ approach due to smaller incision length and less of a space-occupying effect with same therapeutic efficacy.

Developmental toxicity and metabolomics analyses of zebrafish (Danio rerio) embryos exposed to Fenoxaprop-p-ethyl.

Fenoxaprop-p-ethyl (FEN) is an aryloxy phenoxy propionate herbicide that has been widely used in paddy fields. Previous studies have indicated that FEN is highly toxic to aquatic organisms, but little is known about the developmental effects of FEN. This study investigated acute and developmental toxicity, malondialdehyde (MDA) levels, superoxide dismutase (SOD) and catalase (CAT) activities, and metabolomic analyses in zebrafish embryos after 96 h of exposure. FEN exhibited high acute toxicity to zebrafish embryos and larvae. Exposure to FEN could reduce heartbeat and hatching rates and increase malformation rates in embryos. Oxidative damage was also caused in embryos. The results of metabolomics analysis showed that 102 differentially abundant metabolites were found in zebrafish embryos in the 0.05 mg/L FEN treatment group, and 60 differentially abundant metabolites were found in the 0.20 mg/L FEN treatment group. These differentially abundant metabolites mainly belonged to 9 metabolic pathways, of which folate pathways and ABC transport protein pathways had the greatest impact. These results suggested that FEN induced high acute and developmental toxicity in zebrafish embryos.

Proteogenomic characterization of small cell lung cancer identifies biological insights and subtype-specific therapeutic strategies.

We performed comprehensive proteogenomic characterization of small cell lung cancer (SCLC) using paired tumors and adjacent lung tissues from 112 treatment-naive patients who underwent surgical resection. Integrated multi-omics analysis illustrated cancer biology downstream of genetic aberrations and highlighted oncogenic roles of FAT1 mutation, RB1 deletion, and chromosome 5q loss. Two prognostic biomarkers, HMGB3 and CASP10, were identified. Overexpression of HMGB3 promoted SCLC cell migration via transcriptional regulation of cell junction-related genes. Immune landscape characterization revealed an association between ZFHX3 mutation and high immune infiltration and underscored a potential immunosuppressive role of elevated DNA damage response activity via inhibition of the cGAS-STING pathway. Multi-omics clustering identified four subtypes with subtype-specific therapeutic vulnerabilities. Cell line and patient-derived xenograft-based drug tests validated the specific therapeutic responses predicted by multi-omics subtyping. This study provides a valuable resource as well as insights to better understand SCLC biology and improve clinical practice.

A carboxy-terminal ubiquitylation site regulates androgen receptor activity.

Degradation of unliganded androgen receptor (AR) in prostate cancer cells can be prevented by proteasome inhibition, but this is associated with only modest increases in polyubiquitylated AR. An inhibitor (VLX1570) of the deubiquitylases associated with the proteasome did not increase ubiquitylation of unliganded AR, indicating that AR is not targeted by these deubiquitylases. We then identified a series of AR ubiquitylation sites, including a not previously identified site at K911, as well as methylation sites and previously identified phosphorylation sites. Mutagenesis of K911 increases AR stability, chromatin binding, and transcriptional activity. We further found that K313, a previously reported ubiquitylation site, could also be methylated and acetylated. Mutagenesis of K313, in combination with K318, increases AR transcriptional activity, indicating that distinct posttranslational modifications at K313 differentially regulate AR activity. Together these studies expand the spectrum of AR posttranslational modifications, and indicate that the K911 site may regulate AR turnover on chromatin.

Synthesizing nuclear power plant fouling with fractal characteristics enables an in-depth study of concerned nuclear safety issues.

Fouling deposit on nuclear fuel cladding causes wick boiling and boron hideout, resulting in localized corrosion and power shift with great potential security and economic risks. Herein, a cost-effective time-saving adjustable reproduction method combining sol-gel with ceramic sintering is presented to enable wide coverage of fouling's morphologies and microstructures. Based on fractal analysis, structurally self-similar fouling deposits from different reactors conform to proposed porosity-fractal dimension law under 3% relative error. Wick boiling and boron hideout numerical simulation based on fractal dimension is implemented to treat different morphologies and structures in a unified way. Cladding surface underneath fouling deposit has a maximum 9.243 K temperature increasement due to thermal resistance, and H3BO3 is concentrated 11.274 times by mean of wick boiling, causing Li2B4O7 precipitation under extreme conditions with low porosity and high heat flux. The insights in this study provide a precise approach for quantitative evaluation of localized corrosion and power shift.

Understanding Flow Fouling Deposition and Solute Hideout-Return Behavior at the Phase Change Interface.

Nuclear energy is a competitive green energy, yet corrosion deposition and boron hideout on pressurized water reactor fuel cladding surfaces could cause localized corrosion and power shift, resulting in huge safety and economic risks. Alleviation of these problems requires the understanding of the corrosion deposition mechanism and related boron behavior. In this study, we explore corrosion product deposition in typical fuel assembly channels under subcooled boiling conditions and propose a boron hideout and return mechanism to explain the reason for the failure of the power reduction inhibiting a power shift. Porous corrosion depositions with the same morphology and thickness as the real depositions in a fuel cycle are obtained in a week via the accelerated deposition method simulating a real subcooled boiling and water chemical environment. Stronger subcooled boiling generates more bubbles, resulting in higher supersaturation of corrosion products at the gas-liquid interface. The corresponding precipitated stable crystals are smaller, and the formed deposition layer is looser and thicker with smaller particles. On the basis of the above characterizations, the effect of subcooled boiling, solute concentration, and water chemistry on the corrosion deposition mechanism is revealed. High-resolution characterization methods indicate that boron hides within the depositions mainly in the form of H3BO3 and Li2B4O7. The boron coolant concentration increases by 307.9 ppm after power reduction, confirming the return behavior of porous hidden boron. Hidden boron return behavior brings potential challenges for estimating critical conditions and plant response operations. The results of this study provide a precise method for understanding the corrosion product deposition and boron hideout-return behavior to further develop mitigation strategies for power shift and localized corrosion security issues.

Local Boundary Fuzzified Rough K-Means-Based Information Granulation Algorithm Under the Principle of Justifiable Granularity.

Information granularity and information granules are fundamental concepts that permeate the entire area of granular computing. With this regard, the principle of justifiable granularity was proposed by Pedrycz, and subsequently a general two-phase framework of designing information granules based on Fuzzy C-means clustering was successfully developed. This design process leads to information granules that are likely to intersect each other in substantially overlapping clusters, which inevitably leads to some ambiguity and misperception as well as loss of semantic clarity of information granules. This limitation is largely due to imprecise description of boundary-overlapping data in the existing algorithms. To address this issue, the rough k -means clustering is introduced in an innovative way into Pedrycz's two-phase information granulation framework, together with the proposed local boundary fuzzy metric. To further strengthen the characteristics of support and inhibition of boundary-overlapping data, an augmented parametric version of the principle is refined. On this basis, a local boundary fuzzified rough k -means-based information granulation algorithm is developed. In this manner, the generated granules are unique and representative whilst ensuring clearer boundaries. The validity and performance of this algorithm are demonstrated through the results of comparative experiments.

DEFECTIVE KERNEL 56 functions in mitochondrial RNA editing and maize seed development.

Proper seed development is essential for achieving grain production, successful seed germination, and seedling establishment in maize (Zea mays). In the past few decades, pentatricopeptide repeat (PPR) proteins have been proven to play an essential role in regulating the development of maize kernels through posttranscriptional RNA modification of mitochondrial genes. However, the underlying mechanisms remain largely unknown. Here, we characterized a mutant of DEFECTIVE KERNEL 56 (DEK56) with defective kernels that exhibited arrested development of both the embryo and endosperm. Accordingly, we isolated DEK56 through a map-based cloning strategy and found that it encoded an E subgroup PPR protein located in the mitochondria. Dysfunction of DEK56 resulted in altered cytidine (C)-to-uridine (U) editing efficiency at 48 editing sites across 21 mitochondrial transcripts. Notably, the editing efficiency of the maturase-related (matR)-1124 site was substantially reduced or abolished in the dek56 mutant. Furthermore, we found that the splicing efficiency of NADH dehydrogenase subunit 4 (nad4) Introns 1 and 3 was substantially reduced in dek56 kernels, which might be a consequence of the defective MatR function. Through a protein-protein interaction test, we hypothesized that DEK56 carries out its function by recruiting the PPR-DYW protein PPR motif, coiled-coil, and DYW domain-containing protein 1 (PCW1). This interaction is facilitated by Multiple Organellar RNA Editing Factors (ZmMORFs) and Glutamine-Rich Protein 23 (ZmGRP23). Based on these findings, we developed a working model of PPR-mediated mitochondrial processing that plays an essential role in the development of maize kernels. The present study will further broaden our understanding of PPR-mediated seed development and provide a theoretical basis for maize improvement.

Defective ferrocene-based metal-organic frameworks for efficient solar-powered water oxidation via the ligand competition and etching effect.

Two-dimensional metal-organic frameworks are considered to be promising electrocatalytic materials due to their ultrathin lamellar structure, ultrahigh porosity and large surface area, but there are still many challenges such as the embedding of organic ligands leading to low density of active sites and poor conductivity. Herein, we synthesize two-dimensional ferrocene-based metal-organic frameworks nanosheet electrocatalysts via the one-step hydrothermal hydrogen peroxide etching method. The prepared FcNi-BDC-H2O2/NF exhibits excellent oxygen evolution reaction performance with a current density of 100 mA·cm-2 at only 258 mV and a small driving potential of 1.542 V (10 mA·cm-2) is required to achieve overall water splitting. Significantly, an overall water-cracked cell using a solar cell assembly achieves the solar hydrogen conversion efficiency of 19.5%. The introduction of high electronegativity ferrocene and the etching of H2O2 increase the Ni3+ content of FcNi-BDC-H2O2, and expose more unsaturated active sites, which improve the intrinsic activity of the catalysts and the mass transfer rate during the catalytic process. Moreover, the FcNi-BDC-H2O2/NF demonstrates significant urea oxidation reaction performance, achieving a potential of 1.35 V and producing 10 mA·cm-2. This study presents a viable approach to investigating highly efficient electrocatalysts for oxygen evolution reaction and urea oxidation reaction using MOF-based bifunctional catalysts.

Nonmetallic-Bonding Fe-Mn Diatomic Pairs Anchored on Hollow Carbonaceous Nanodisks for High-Performance Li-S Battery.

The issues of polysulfide shuttling and lethargic sulfur redox reaction (SROR) kinetics are the toughest obstacles of lithium-sulfur (Li-S) battery. Herein, integrating the merits of increased density of metal sites and synergistic catalytic effect, a unique single-atom catalyst (SAC) with nonmetallic-bonding Fe-Mn diatomic pairs anchored on hollow nitrogen-doped carbonaceous nanodisk (denoted as FeMnDA@NC) is successfully constructed and well characterized by aberration-corrected high-angle annular dark-field scanning transmission electron microscopy, X-ray absorption spectroscopy, etc. Density functional theory calculation indicates that the Fe-Mn diatomic pairs can effectively inhibit the shuttle effect by enhancing the adsorption ability retarding the polysulfide migration and accelerate the SROR kinetics. As a result, the Li-S battery assembled with FeMnDA@NC modified separator possesses an excellent electrochemical performance with ultrahigh specific capacities of 1419 mAh g-1 at 0.1 C and 885 mAh g-1 at 3.0 C, respectively. An outstanding specific capacity of 1165 mAh g-1 is achieved at 1.0 C and maintains at 731 mAh g-1 after 700 cycles. Notably, the assembled Li-S battery with a high sulfur loading of 5.35 mg cm-2 harvests a practical areal capacity of 5.70 mAh cm-2 at 0.2 C. A new perspective is offered here to construct advanced SACs suitable for the Li-S battery.

Measurement and prediction of the Aspergillus niger spore detachment from a vesicle unit subjected to air-blowing.

Detachment of fungal spores from growing colonies results in human exposure. Thus far, the distribution of the binding forces of the spores in a fungal unit is unknown, so that precise prediction of the spores detachment is quite challenging. This investigation used centrifugal separation to measure the binding forces of the spores. Aspergillus niger (A. niger) colonies on a culture plate were placed in a centrifuge, the detached spores were counted, and this number was used to obtain the distribution of binding forces. Next, the air-blowing of an A. niger unit was modeled by computational fluid dynamics (CFD). A spore was judged to be detached if the air-imposed drag force was greater than the binding force. For model validation, the predicted spore detachment ratios were compared with the ratios measured in a wind tunnel test. The results revealed that the binding forces of the spores obeyed the log-normal distribution. The binding forces of the distal spores from colonies with a growth age of 66 h ranged from 0 nN to 4.0 nN and had a mean of 0.65 nN. The CFD modeling predicted the detachment ratios of the distal spores with good accuracy.

Single-Atom Ru Alloyed with Ni Nanoparticles Boosts CO2 Methanation.

Designing catalysts to proceed with catalytic reactions along the desired reaction pathways, e.g., CO2 methanation, has received much attention but remains a huge challenge. This work reports one Ru1Ni single-atom alloy (SAA) catalyst (Ru1Ni/SiO2) prepared via a galvanic replacement reaction between RuCl3 and Ni nanoparticles (NPs) derived from the reduction of Ni phyllosilicate (Ni-ph). Ru1Ni/SiO2 achieved much improved selectivity toward hydrogenation of CO2 to CH4 and catalytic activity (Turnover frequency (TOF) value: 40.00 × 10-3 s-1), much higher than those of Ni/SiO2 (TOF value: 4.40 × 10-3 s-1) and most reported Ni-based catalysts (TOF value: 1.03 × 10-3-11.00 × 10-3 s-1). Experimental studies verify that Ru single atoms are anchored onto the Ni NPs surface via the Ru1-Ni coordination accompanied by electron transfer from Ru1 to Ni. Both in situ experiments and theoretical calculations confirm that the interface sites of Ru1Ni-SAA are the intrinsic active sites, which promote the direct dissociation of CO2 and lower the energy barrier for the hydrogenation of CO* intermediate, thereby directing and enhancing the CO2 hydrogenation to CH4.

Ferroelectricity of ice nanotube forests grown in three-dimensional graphene: the electric field effect.

Generating diverse ferroelectric ice nanotubes (NTs) efficiently has always been challenging, but matters in nanomaterial synthesis and processing technology. In the present work, we propose a method of growing ice NT forests in a single cooling process. A three-dimensional (3D) graphene structure was selected to behave as a representative container in which a batch of (5, 0) ice NTs was formed simultaneously under the cooling process from molecular dynamics simulation. Other similar 3D graphene structures but with different hole configurations, like uniform triangle or both triangle and pentagon, were also tested, revealing that ice NTs with different tube indices, i.e. both (3, 0) and (5, 0), could also be formed at the same time. Intriguingly, the orientations of the dipole moments of the water molecules of an ice NT formed were independent of each other, making the net ferroelectricity of the whole system weakened or even cancelled. An electric field could help change the orientation of the water molecules of the already obtained ice NTs and even twist the tube to be a spiral (5, 1) one if it was applied during the cooling process, such that the net ferroelectricity was greatly improved. The underlying physical mechanism of all phase transition phenomena, including the improvement of the ferroelectricity under an electric field, were explored in depth from the phase transition curves and structural point of view. The obtained results are of significant application value for improving the preparation efficiency of nano-ferroelectric materials, which are prosperous in nano-devices.

Stable Aluminum Metal Anode Enabled by Dual-Functional Molybdenum Nanoparticles.

Constructing robust anode with strong aluminophilicity and rapid desolvation kinetics is essential for achieving high utilization, long-term durability, and superior rate performance in Al metal-based energy storage, yet remains largely unexplored. Herein, molybdenum nanoparticles embedded onto nitrogen-doped graphene (Mo@NG) are designed and prepared as Al host to regulate the deposition behavior and achieve homogeneous Al plating/stripping. The monodispersed Mo nanoparticles reduce the desolvation energy barrier and promote the deposition kinetics of Al. Additionally, Mo nanoparticles act as aluminophilic nucleation sites to minimize the Al nucleation overpotential, further guiding uniform and dense Al deposition. As a result, the dual-functional Mo@NG endows Al anodes with low voltage hysteresis, reversible Al plating/stripping with high coulombic efficiency, and excellent high-rate capability under 5 mA cm-2 . Moreover, the as-designed Al metal full batteries deliver a high capacity retention of 92.8% after 3000 cycles at 1 A g-1 . This work provides an effective solution to optimize the electrochemical properties of Al metal anode from the perspective of desolvation and deposition reactions, towards the development of high-safety and long-cycling aluminum-ion batteries.

Virus-Like Particles Based on the Novel Goose Parvovirus (NGPV) VP2 Protein Protect Ducks against NGPV Challenge.

Novel goose parvovirus (NGPV), a genetic variant of goose parvovirus, has been spreading throughout China since 2015 and mainly infects ducklings with the symptoms of growth retardation, beak atrophy, and protruding tongue, leading to huge economic losses every year. A safe and effective vaccine is urgently needed to control NGPV infection. In this study, virus-like particles (VLPs) of NPGV were assembled and evaluated for their immunogenicity. The VP2 protein of NGPV was expressed in Spodoptera frugiperda insect cells using baculovirus as vector. The VP2 protein was efficiently expressed in the nucleus of insect cells, and the particles with a circular or hexagonal shape and a diameter of approximately 30 nm, similar to the NGPV virion, were observed using transmission electron microscopy (TEM). The purified particles were confirmed to be composed of VP2 using western blot and TEM, indicating that the VLPs of NGPV were successfully assembled. Furthermore, the immunogenicity of the VLPs of NGPV was evaluated in Cherry Valley ducks. The level of NGPV serum antibodies increased significantly at 1-4 weeks post-immunization. No clinical symptoms or deaths of ducks occurred in all groups after being challenged with NGPV at 4 weeks post-immunization. There was no viral shedding in the immunized group. However, viral shedding was detected at 3-7 days post-challenge in the non-immunized group. Moreover, VLPs can protect ducks from histopathological lesions caused by NGPV and significantly reduce viral load in tissue at 5 days post-challenge. Based on these findings, NGPV VLPs are promising candidates for vaccines against NGPV.

1D/2D core-shell structure Ni-Mo-S@NiFe LDH grown on nickel foam: a bifunctional electrocatalyst for efficient oxygen evolution and urea oxidation reactions.

The construction of bifunctional catalysts for the oxygen evolution reaction (OER) and urea oxidation reaction (UOR) is important for accelerating the development of the hydrogen economy. Herein, a novel three-dimensional core-shell heterostructure (Ni-Mo-S@NiFeLDH/NF) was prepared by vertically growing NiFe layered double hydroxide (NiFe LDH) nanosheets on nickel foam (NF)-supported arrays of Ni-Mo-S (Ni3S2, Ni0.96S, Mo2S3) nanorods via a hydrothermal-sulfide-hydrothermal process. Benefiting from the unique core-shell structure with numerous exposed active sites, the optimized Ni-Mo-S@NiFe LDH/NF shows excellent OER/UOR activity, with an overpotential of only 274 mV for OER to reach 100 mA cm-2 and 1.318 V for UOR to reach 10 mA cm-2. Moreover, the assembled Ni-Mo-S@NiFe LDH||Pt/C urea electrolytic system requires only 1.348 V to achieve 10 mA cm-2, as much as 159 mV lower than pure water electrolysis. This work provides an idea for researching NiFe LDH-based OER/UOR bifunctional catalysts.

The occupational burnout among medical staff with high workloads after the COVID-19 and its association with anxiety and depression.

Objective: After the end of COVID-19, medical staff were immediately faced with a high workload, leading to widespread occupational burnout. This study aims to explore the level and influencing factors of burnout among medical staff during this period, as well as its relationship with anxiety and depression. Methods: The participants' levels of burnout were assessed using Maslach Burnout Inventory-Human Services Survey (MBI-HSS), and the reliability and validity of the questionnaire were evaluated through Cronbach's α and Confirmatory Factor Analysis (CFA). Independent sample t-test, chi-square test, and Pearson analysis were employed to determine the correlation between two sets of variables. Univariate and multivariate logistic regression analyses were conducted to identify significant factors influencing burnout. Finally, nomograms were used to predict the probability of burnout occurrence. Results: This study collected a total of 1,550 questionnaires, and after excluding 45 questionnaires that were duplicates or incomplete, a sample of 1,505 (97.1%) participants were included in the final statistical analysis. Both Cronbach's α and the fit indices of CFA demonstrated excellent adaptability of the Chinese version of MBI-HSS in this study. The overall prevalence rates for emotional exhaustion (EE), depersonalization (DP), and diminished personal accomplishment (PA) were 52.4, 55.3, and 30.6%, respectively. Obtaining psychological support, health condition, relationship with family members, and insufficient sleep were identified as common contributing factors to burnout among medical staff. Additionally, age and promotion pressure were also associated with burnout among doctors, and exceeding legal working hours was an important factor for nurse burnout. The C-index for the nomograms predicting burnout among doctors and nurses was 0.832 and 0.843, respectively. Furthermore, burnout exhibited a significant linear correlation with anxiety and depression. Conclusion: After the end of COVID-19, medical staff in high workload environments were facing severe burnout, which might lead to anxiety and depression. The occupational burnout of medical staff needed to be taken seriously and actively intervened.

Genome degradation promotes Salmonella pathoadaptation by remodeling fimbriae-mediated proinflammatory response.

Understanding changes in pathogen behavior (e.g. increased virulence, a shift in transmission channel) is critical for the public health management of emerging infectious diseases. Genome degradation via gene depletion or inactivation is recognized as a pathoadaptive feature of the pathogen evolving with the host. However, little is known about the exact role of genome degradation in affecting pathogenic behavior, and the underlying molecular detail has yet to be examined. Using large-scale global avian-restricted Salmonella genomes spanning more than a century, we projected the genetic diversity of Salmonella Pullorum (bvSP) by showing increasingly antimicrobial-resistant ST92 prevalent in Chinese flocks. The phylogenomic analysis identified three lineages in bvSP, with an enhancement of virulence in the two recently emerged lineages (L2/L3), as evidenced in chicken and embryo infection assays. Notably, the ancestor L1 lineage resembles the Salmonella serovars with higher metabolic flexibilities and more robust environmental tolerance, indicating stepwise evolutionary trajectories towards avian-restricted lineages. Pan-genome analysis pinpointed fimbrial degradation from a virulent lineage. The later engineered fim-deletion mutant, and all other five fimbrial systems, revealed behavior switching that restricted horizontal fecal-oral transmission but boosted virulence in chicks. By depleting fimbrial appendages, bvSP established persistent replication with less proinflammation in chick macrophages and adopted vertical transovarial transmission, accompanied by ever-increasing intensification in the poultry industry. Together, we uncovered a previously unseen paradigm for remodeling bacterial surface appendages that supplements virulence-enhanced evolution with increased vertical transmission.