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Background: Burnout is a well-recognized problem among resident physicians. The COVID-19 pandemic impacted the dynamics of the patient/resident relationship and introduced new stressors for medical trainees, such as new restrictions in the hospital, increased patient death, and uncertainty around safety. There is limited research on the implementation of group therapy for residents to address issues of wellbeing and burnout during the pandemic. Method: In response to perceived burnout amongst internal medicine residents, a university-based internal medicine residency program in the Northeast United States implemented process groups, a form of group therapy, in the curriculum. These sessions were held hourly once every five weeks for each cohort of twelve residents during the academic year. We sought to measure resident burnout and identify themes that impacted wellbeing to facilitate the intervention of process groups during the pandemic. In 2021 and 2022, internal medicine residents were invited to complete the Maslach Burnout Inventory (MBI) and answer two open-ended questions about the factors that most negatively and positively influenced their wellness. Results: Of the 134 participants, 82% had high emotional exhaustion or depersonalization. The most prevalent themes hindering wellness were negative personal interactions at work, most notably rude behavior by patients, unsupportive attendings, residency program expectations, and work intensity. Findings unique to the pandemic include social isolation from family, distress from poor outcomes, and fear of contracting or spreading the virus. The most prevalent themes for supporting wellness were personal life, camaraderie, professional satisfaction, and program structured support. Conclusions: Our findings suggest that programs can tailor structured support to improve wellness, despite the presence of significant stressors. Full article

(1) Background: In most cases, passive isolation control methods are commonly used for the seismic isolation design in bridge engineering. However, passive seismic isolation devices, due to their non-adjustable performance parameters, struggle to achieve effective seismic isolation across a wide frequency range of 0 Hz to 20 Hz in response to random and varying seismic loads. (2) Methods: The sensitivity of the design parameters of the seismic isolation bearing was analyzed using the optimization center gradient method, and an improved genetic algorithm was employed to quickly optimize and obtain the optimal design parameters. (3) Results: The effectiveness of the three-dimensional seismic isolation bearing was validated through experiments. (4) Conclusions: The multi-factor sensitivity analysis approach used in this study for designing novel isolation bearings is applicable not only to seismic design in bridges but also serves as a reference for parameter design in isolation bearings requiring medium to high precision in seismic performance. Full article

The aim of this study was to obtain extracts of anthocyanin pigments from red and purple-fleshed potato juices characterized by stable color. For this purpose, potato juices were pasteurized at different temperatures or fruit and vegetable concentrates were added to them. Color stability tests of the obtained pigments were carried out in model pH and temperature conditions and after adding to natural yogurt. Both the pasteurization process and the addition of fruit and vegetable concentrates to the potato juices positively affected their color and its stability in time. However, the pasteurization of the potato juices had a negative effect on the content of biologically active compounds, in contrast to the juices stabilized with the addition of fruit and vegetable concentrates. Anthocyanin pigments from red-fleshed potato juices were more stable than those isolated from the purple-fleshed potato juices. The results of model tests of the anthocyanin pigment concentrates from the colored-flesh potatoes and natural yoghurts with their addition confirmed the high stability of the tested concentrates. Full article

Introduction: Schistosomiasis, a tropical disease affecting humans and animals, affected 251.4 million people in 2021. Schistosoma mansoni, S. haematobium, S. intercalatum, and S. japonicum are primary human schistosomes, causing tissue damage, granulomas, ulceration, hemorrhage, and opportunistic pathogen entry. The gut and urinary tract microbiota significantly impact a host’s susceptibility to schistosomiasis, disrupting microbial balance; however, this relationship is not well understood. This systematic review and meta-analysis explores the intricate relationship between schistosomiasis and the host’s microbiota, providing crucial insights into disease pathogenesis and management. Methods: This systematic review used PRISMA guidelines to identify peer-reviewed articles on schistosomiasis and its interactions with the host microbiome, using multiple databases and Google Scholar, providing a robust dataset for analysis. The study utilized Meta-Mar v3.5.1; descriptive tests, random-effects models, and subgroups were analyzed for the interaction between Schistosomiasis and the microbiome. Forest plots, Cochran’s Q test, and Higgins’ inconsistency statistic (I²) were used to assess heterogeneity. Results: The human Schistosoma species were observed to be associated with various bacterial species isolated from blood, stool, urine, sputum, skin, and vaginal or cervical samples. A meta-analysis of the interaction between schistosomiasis and the host microbiome, based on 31 studies, showed 29,784 observations and 5871 events. The pooled estimates indicated a significant association between schistosomiasis and changes in the microbiome of infected individuals. There was considerable heterogeneity with variance effect sizes (p < 0.0001). Subgroup analysis of Schistosoma species demonstrated that S. haematobium was the most significant contributor to the overall heterogeneity, accounting for 62.1% (p < 0.01). S. mansoni contributed 13.0% (p = 0.02), and the coinfection of S. haematobium and S. mansoni accounted for 16.8% of the heterogeneity (p < 0.01), contributing to the variability seen in the pooled analysis. Similarly, praziquantel treatment (RR = 1.68, 95% CI: 1.07–2.64) showed high heterogeneity (Chi² = 71.42, df = 11, p < 0.01) and also indicated that Schistosoma infections in males (RR = 1.46, 95% CI: 0.00 to 551.30) and females (RR = 2.09, 95% CI: 0.24 to 18.31) have a higher risk of altering the host microbiome. Conclusions: Schistosomiasis significantly disrupts the host microbiota across various bodily sites, leading to increased susceptibility to different bacterial taxa such as E. coli, Klebsiella, Proteus, Pseudomonas, Salmonella, Staphylococcus, Streptococcus, and Mycobacterium species (M. tuberculosis and M. leprae). This disruption enables these bacteria to produce toxic metabolites, which in turn cause inflammation and facilitate the progression of disease. The impact of schistosomiasis on the vaginal microbiome underscores the necessity for gender-specific approaches to treatment and prevention. Effective management of female genital schistosomiasis (FGS) requires addressing both the parasitic infection and the resulting microbiome imbalances. Additionally, praziquantel-treated individuals have different microbiome compositions compared to individuals with no praziquantel treatment. This suggests that combining praziquantel treatment with probiotics could potentially decrease the disease severity caused by an altered microbiome. Full article

Clavulanic acid is a potent β-lactamase inhibitor produced by Streptomyces clavuligerus, widely used in combination with β-lactam antibiotics to combat antimicrobial resistance. This systematic review analyzes the most successful methodologies for clavulanic acid overproduction, focusing on the highest yields reported in bench-scale and bioreactor-scale fermentations. Studies have demonstrated that glycerol is the preferred carbon source for clavulanic acid production over other sources like starch and dextrins. The optimization of feeding strategies, especially in fed-batch operations, has improved glycerol utilization and extended the clavulanic acid production phase. Organic nitrogen sources, particularly soybean protein isolates and amino acid supplements such as L-arginine, L-threonine, and L-glutamate, have been proven effective at increasing CA yields both in batch and fed-batch cultures, especially when balanced with appropriate carbon sources. Strain engineering approaches, including mutagenesis and targeted genetic modifications, have allowed for the obtainment of overproducer S. clavuligerus strains. Specifically, engineering efforts that overexpress key regulatory genes such as ccaR and claR, or that disrupt competing pathways, redirect the metabolic flux towards CA biosynthesis, leading to high clavulanic acid titers. The fed-batch operation at the bioreactor scale emerges as the most feasible alternative for prolonged clavulanic acid production with both wild-type and mutant strains, allowing for the attainment of high titers during cultivations. Full article

Background: The issue of Helicobacter pylori (H. pylori) resistance to clarithromycin (CLR) has consistently posed challenges for clinical treatment. Hence, a rapid susceptibility testing (AST) method urgently needs to be developed. Methods: In the present study, 35 isolates of H. pylori were isolated from 203 gastritis patients of the Guangzhou cohort, and the antimicrobial resistance phenotypes were associated with their genomes to analyze the relevant mutations. Based on these mutations, a rapid detection system utilizing high-resolution melting (HRM) curve analysis was designed and verified by the Shenzhen cohort, which consisted of 38 H. pylori strains. Results: Genomic analysis identified the mutation of the 2143 allele from A to G (A2143G) of 23S rRNA as the most relevant mutation with CLR resistance (p < 0.01). In the HRM system, the wild-type H. pylori showed a melting temperature (Tm) of 79.28 ± 0.01 °C, while the mutant type exhibited a Tm of 79.96 ± 0.01 °C. These differences enabled a rapid distinction between two types of H. pylori (p < 0.01). Verification examinations showed that this system could detect target DNA as low as 0.005 ng/μL in samples without being affected by other gastric microorganisms. The method also showed a good performance in the Shenzhen validation cohort, with 81.58% accuracy, and 100% specificity. Conclusions: We have developed an HRM system that can accurately and quickly detect CLR resistance in H. pylori. This method can be directly used for the detection of gastric microbiota samples and provides a new benchmark for the simple detection of H. pylori resistance. Full article

Raman spectroscopy is a technique which involves quantitative and qualitative molecular analysis based on the interaction between incident light and isolation of scattered wavelengths in generating a molecular fingerprint. It has a broad array of potential scientific applications, encompassing areas as diverse as food science and forensics. However, it may also be highly useful in clinical oncology. A recent focus of research in oncology has been in achieving the individualisation of care. Two important strategies to achieve a so-called “precision oncology” approach may include the detection of circulating tumour DNA (ctDNA) in more objectively evaluating treatment response and guiding de-escalation and intensification approaches in systemic therapy and therapeutic drug monitoring (TDM). Therapeutic drug monitoring involves the quantitation of plasma drug levels in order to tailor medication dosing in optimizing outcomes. The existing approaches to characterize small molecules, such as fluorescence-based and chromatographic strategies, may be limited by high costs, long turnaround times, and bulky equipment. Surface-enhanced Raman spectroscopy (SERS) may be deployed by utilizing a handheld device, with the potential for point of care, rapid turnaround, low-cost assessment of clinically relevant parameters, and prompt implementation of attendant changes in treatment. Although there is a growing body of data supporting the implementation of TDM and evaluation of ctDNA in achieving precision medicine, the uptake of such approaches remains relatively limited outside of clinical trials. As stated, the nature of existing analytical methodologies may prove to be a significant barrier to the routine clinic-based implementation of such approaches. Therefore, we provide the existing evidence for SERS in alleviating these barriers. We also provide insights into how SERS could contribute to clinical oncology. Full article

Therapeutic communities face high drop-out rates and general distrust of their effectiveness among substance users. Actively involving users early in treatment promotes greater compliance with the treatment and is predictive of better outcomes. However, users often occupy a passive and subordinate role, exacerbated by the lack of research that explores their perspectives, beliefs, and experiences. This study examined the discourses of 57 consumers who were part of a community for less than 15 days, investigating the meanings attributed to service entry and treatment. A protocol of four written open-ended questions was employed and analysed through discourse analysis and positioning theory. The results indicate that participants configure the community as a place symbolically and spatially distinct from the rest of the world, where they isolate themselves to seek support during times of extreme difficulty. However, what they are seeking is a solution to acute distress caused by substance use, intertwined with social, economic, and relational issues. The concept of treatment is built on the image of the substance user as an individual making a weak request for help, attributing the problem solely to drugs and exhibiting reduced agency in addressing their issues. The collected texts provide a better understanding of the experiences of new users, highlighting the importance of co-constructing personalised projects that empower consumers to feel actively involved in their own change, exploring their theories and definitions of self to structure pathways based strictly on their needs. Full article

With increasing interest in integrating solar power into the utility grid, multilevel inverters are gaining much more attention for medium- and high-power applications due to their high-quality waveform, low voltage stress across active components, and low total harmonic distortion in output voltage. However, to achieve these benefits, a large number of active and passive components are required. A transformer is also required to provide galvanic isolation, which increases its size and weight and reduces its power density and efficiency. In order to overcome the disadvantages posed by transformer-based inverters, research is being conducted on the transformerless topology of multilevel inverters. The first aim of this review article is to summarize traditional transformerless multilevel inverters (TMLIs) considering both single- and three-phase topologies. Secondly, the main aim of this article is to provide a detailed overview of the hybrid topologies of TMLIs that employ fewer components for photovoltaic applications. In addition, this study compares traditional and hybrid single-/three-phase topologies in terms of component count and performance factors, which will be useful to researchers. Full article

Critical structures such as hospitals, high-precision manufacturing facilities, telecommunications centers, and fire stations, especially, need to maintain their functionality even during severe earthquakes. In this sense, seismic isolation technology serves as a vital design method for preserving their functionality. Seismic isolators, also known as earthquake isolation systems, are used to reduce the effects of earthquakes on buildings by isolating them from the ground they are located on. By ensuring that less acceleration and force demand is transmitted to the superstructure, both the building and the equipment and the devices in the building are prevented from being damaged by earthquakes. This experimental study aims to conduct vibration tests on a small-scale multi-story steel-building model equipped with a specially designed rolling-type seismic base isolation system. The relationship between the test model and the prototype was achieved by frequency simulation. The tests will be performed on a shake table under six different earthquake accelerations to examine the model’s dynamic behavior. The primary goal is to evaluate the isolation performance of the rolling-type seismic base isolator under seismic loads, with a focus on recording the vibrations at the top of the test building. It has been observed that the isolator placed at the base of the building significantly reduced the peak acceleration and displacement values of the floor motion. Under the most severe earthquake record applied to the shake table, the acceleration at the top of the building with the isolator was found to be reduced by approximately 50%, compared to the non-isolated case. Full article

Eclipta prostrata (Asteraceae) is employed as a hemostatic agent in many traditional medicines, owing to its sulfated flavonoid content. In this study, we obtained crude drug samples from three provinces collected in different years and analyzed their sulfated flavonoid contents using liquid chromatography–mass spectrometry (LC–MS) for quality evaluation. Because sulfated flavonoids are unstable and difficult to isolate from extracts, this study first synthesized a variety of sulfated flavonoids and accumulated spectral data in order to identify the compounds in E. prostrata. The LC–MS analysis of six crude drug samples revealed the presence of luteolin 7-sulfate, apigenin 7-sulfate, diosmetin 7-sulfate, and diosmetin 3′-sulfate. The samples without luteolin 3′-sulfate featured high apigenin 7-sulfate content. Although the samples were collected from the same locality, their compositions differed depending on the year of collection. Further, they were classified according to three patterns: (1) samples with luteolin 7-sulfate as the main component, (2) samples with apigenin 7-sulfate as the main component, and (3) samples with relatively high diosmetin sulfate content. Luteolin 7-sulfate typically exhibits relatively high erythrocyte aggregation efficiency and fibrinogen aggregation rate. These results demonstrate that the analysis of sulfated flavonoids is beneficial for the quality evaluation of E. prostrata for hemostatic applications. Full article

This study evaluated the antioxidant and antibacterial properties of methanolic extracts derived from oilseed cakes of Lactuca sativa (lettuce), Nigella sativa (black seed), Eruca sativa (rocket), and Linum usitatissimum (linseed). Lettuce methanolic extract showed the highest potential, so it was selected for further investigation. High-performance liquid chromatography (HPLC-DAD) analysis and bioassay-guided fractionation of lettuce seed cake extract led to the isolation of five compounds: 1,3-propanediol-2-amino-1-(3′,4′-methylenedioxyphenyl) (1), luteolin (2), luteolin-7-O-β-D-glucoside (3), apigenin-7-O-β-D-glucoside (4), and β-sitosterol 3-O-β-D-glucoside (5). Compound (1) was identified from Lactuca species for the first time, with high yield. The cytotoxic effects of the isolated compounds were tested on liver (HepG2) and breast (MCF-7) cancer cell lines, compared to normal cells (WI-38). Compounds (2), (3), and (4) exhibited strong activity in all assays, while compound (1) showed weak antioxidant, antimicrobial, and cytotoxic effects. The anti-inflammatory activity of lettuce seed cake extract and compound (1) was evaluated in vivo using a carrageenan-induced paw oedema model. Compound (1) and its combination with ibuprofen significantly reduced paw oedema, lowered inflammatory mediators (IL-1β, TNF-α, PGE2), and restored antioxidant enzyme activity. Additionally, compound (1) showed promising COX-1 and COX-2 inhibition in an in vitro enzymatic anti-inflammatory assay, with IC₅₀ values of 17.31 ± 0.65 and 4.814 ± 0.24, respectively. Molecular docking revealed unique interactions of compound (1) with COX-1 and COX-2, suggesting the potential for targeted inhibition. These findings underscore the value of oilseed cakes as a source of bioactive compounds that merit further investigation. Full article

The epigenetic variation in protoplast regeneration is a topic that has attracted interest recently. To elucidate the role of DNA methylation in the regeneration of protoplasts from the ponkan (Citrus reticulata), this study employs the methylation-sensitive amplification polymorphism (MSAP) molecular marker technique to analyze changes in DNA methylation levels and patterns during the isolation and culture of protoplasts from ponkan and tobacco. Additionally, differential DNA methylation fragments are cloned, sequenced, and subjected to bioinformatics analysis. The results reveal that, for non-regenerable ponkan mesophyll protoplasts, DNA methylation levels increase by 3.98% after isolation and then show a trend of initial decrease followed by an increase during culture. In contrast, for regenerable ponkan callus protoplasts and tobacco mesophyll protoplasts, DNA methylation levels decrease by 1.75% and 2.33%, respectively, after isolation. During culture, the DNA methylation levels of ponkan callus protoplasts first increase and then decrease, while those of tobacco mesophyll protoplasts show an opposite trend of initial decrease followed by an increase. Regarding DNA methylation patterns, ponkan mesophyll protoplasts exhibit primarily hypermethylation changes accompanied by a small amount of gene demethylation, whereas ponkan callus protoplasts are dominated by demethylation changes with some genes undergoing hypermethylation. The methylation exhibits dynamic changes in protoplast isolation regeneration. By recovering, cloning, sequencing, and performing BLASTn alignment analysis on specific methylation modification sites in the ponkan, 18 DNA sequences with high homology are identified which are found to be involved in various biological functions, thereby establishing a foundational basis for genetic editing in protoplasts. Full article

The Namib Desert is characterized by a number of abiotic stresses, including high temperature, high salinity, osmotic pressure, alkaline pH, and limited water availability. In such environments, dry soils typically exhibit a low water potential, scarce nutrients, and high concentrations of dissolved ions, collectively creating a challenging habitat for microbial life. In this study, 89 bacterial isolates belonging to 20 genera were identified. Bacteria demonstrated significant osmotolerance, with some strains thriving at polyethylene glycol (PEG) concentrations exceeding 20%. Furthermore, these bacteria demonstrated halotolerance, high pH tolerance, and capacity to produce plant growth-promoting (PGP) traits under conditions of osmotic stress. Osmotolerant bacteria exhibited higher proficiency in siderophore production, potassium solubilization, and phosphorus solubilization, all of which are critical for supporting plant growth in nutrient-scarce and stressful environments, such as deserts. However, alginate production was higher in isolates that were less osmotolerant, indicating the potential for a compensatory mechanism in strains that were more sensitive. These findings highlight the complex strategies employed by desert bacteria to survive and support host plants in extreme environments. The present study not only enhances our understanding of microbial adaptations in arid ecosystems, but also provides important information for the development of potential applications for these bacteria in the reclamation of arid land and agricultural practices aimed at improving crop resilience to abiotic stress. Full article

The prevalence of plant parasitic nematodes (PPN) in the Irish peatlands was investigated in five different peatland habitats—raised bog, cutover scrub/woodlands, fens and peat grasslands, which were further sub-categorised into fourteen different sub-habitats. Within the raised bog habitat were healthy bog hummock (HBH), healthy bog lawn (HBL), degraded bog hummock (DBH) and degraded bog lawn (DBL) and the fen habitats were fen peat (FP) and rich fen peat (R-FP). Cutover scrub or woodland habitat included cutover scrub rewetted (C-RW), cutover scrub non-rewetted (C-NRW), woodlands rewetted (W-RW) and woodlands non-rewetted (W-NRW). Grassland included wasted peat (WP), rough grazing (RG-I) and improved fen peat grassland (IFPG-RW and IFPG-NRW). Soil samples from peatlands were all collected between July and December 2023 when the temperature ranged from 12 to 20 °C. One half of each sample was used for molecular nematode analysis and the other half for morphological identification of nematodes. For the morphological identification, a specific nematode extraction protocol was optimised for peatland soils, and the extracted nematodes were fixed onto slides to be studied under a high-power light microscope. Subsequently, the other part of the soil was processed to isolate total DNA, from which the 18S rRNA gene was sequenced for the identification of nematode taxa. The extracted DNA was also used for randomly amplified polymorphic DNA (RAPD) fingerprinting analysis to determine banding patterns that could classify different bog habitats based on PPN random primers. Compared to that in the climax habitats (HBH, HBL, DBH, DBL, FP, R-FP), PPN prevalence was recorded as being higher in grasslands (WP, RG-I, IFPG-RW and IFPG-NRW) and scrub/woodland ecosystems (C-RW, C-NRW, W-RW, W-NRW). The results indicate that nematode populations are different across the various bog habitats. Emerging and current quarantine PPN belonging to the families Pratylenchidae, Meloidogynidae, Anguinidae and Heteroderidae were noted to be above the threshold limits mentioned under EPPO guidelines, in grassland and wooded peatland habitats. Future actions for PPN management may need to be considered, along with the likelihood that these PPN might impact future paludiculture and other crops and trees growing in nearby agricultural lands. Full article