Search

Background: Burnout in medical profession can reduce the work output and affect the clinical decision making. Objectives: To estimate the proportion of medical residents experiencing burnout. Methodology: In this cross-sectional study, 172 medical residents working in the hospitals affiliated with Kasturba Medical College, Mangalore were assessed for presence of burnout. Permission was obtained from the Institutional Ethics Committee before the commencement of the study. Copenhagen Burnout Inventory scale was used to determine the presence of burnout syndrome among the participants. Results: The mean age of the participants was 27.6 years and a high proportion (n=93, 53.8%) of the participants were males. Forty-eight percent (n=83) of the participants in our study had burnout. A high proportion (n=35, 42.2%) of the participants with burnout were from first year of residency. Burnout was observed in the majority of unmarried males. Burnout was also seen to be highest in younger residents, and those who lacked adequate sleep. Conclusion: The proportion of occupational burnout among medical residents in our study was found to be very high. Early identification of the presence of burnout in the healthcare profession and initiating steps to reduce it can help them to provide uncompromised quality care to the patients.

Arun Sivananthan1,2 *, Victoria Nicholas3 *, Georgina Kerry,4 Christopher Harlow,5 Pratyasha Saha,6 Helen-Cara Younan,7 Stephanie Williams,8 Lewis David,9 Clifford Lisk,10 Louise Schofield11 1Institute of Global Health Innovation, Imperial College London, London, UK; 2Department of Gastroenterology, Imperial College Healthcare NHS Trust, London, UK; 3Department of Medicine, Chelsea and Westminster NHS Foundation Trust, London, UK; 4Department of Gastroenterology, St George’s University Hospital NHS Foundation Trust, London, UK; 5Department of Cardiology, Epsom and St Heliers University Hospital, London, UK; 6Department of Rheumatology, University College London NHS Trust, London, UK; 7Department of Intensive Care Medicine, Imperial College Healthcare NHS Trust, London, UK; 8Department of Acute Medicine, Royal Free NHS Trust, London, UK; 9Department of Endocrinology, Bart’s Health NHS Trust, London, UK; 10Department of Geriatrics, Royal Free NHS Trust, London, UK; 11Department of Palliative Medicine, Royal Free NHS Trust, London, UK*These authors contributed equally to this workCorrespondence: Arun Sivananthan, Institute of Global Health Innovation Imperial College London, 10th Floor QEQM Building, London, W2 1NY, UK, Tel +44 0203 3126666, Email a.sivananthan@nhs.netIntroduction: The Covid-19 pandemic brought significant disruption to post-graduate medical education. Lecture-based training days were rapidly converted to webinars. This study aims to assess the perceptions of digital training in internal medical trainees.Methods: IMTs (internal medicine trainees) nationally were surveyed on their perceptions of digital training, ease of access, engagement, and interactivity via a 10-item questionnaire. A mixed-method approach using qualitative and quantitative questions was used. Likert scales were analysed using a mean result of above 3 to indicate agreement.Results: 359 trainees responded. Trainees agreed that they preferred digital training to face-to-face teaching (mean 3.68); digital training was more engaging (mean 4.25), easier to access (mean 4.49), and as effective for learning as face-to-face teaching (mean 4.69). The most reported advantages were no travel (89%) and the ability to watch later on (88%). 63% of trainees reported loss of social interaction as a disadvantage.Discussion: This survey suggests that digital teaching has a potential role in IMT training beyond the pandemic.Keywords: medical education, digital training, IMT, webinar, post-graduate training

The demand for glucose monitoring devices has witnessed continuous growth from the rising diabetic population. The traditional approach of blood glucose (BG) sensor strip testing generates only intermittent glucose readings. Interstitial fluid-based devices measure glucose dynamically, but their sensing approaches remain either minimally invasive or prone to skin irritation. Here, a sweat glucose monitoring system is presented, which completely operates under rest with no sweat stimulation and can generate real-time BG dynamics. Osmotically driven hydrogels, capillary action with paper microfluidics, and self-powered enzymatic biochemical sensor are used for simultaneous sweat extraction, transport, and glucose monitoring, respectively. The osmotic forces facilitate greater flux inflow and minimize sweat rate fluctuations compared to natural perspiration-based sampling. The epidermal platform is tested on fingertip and forearm under varying physiological conditions. Personalized calibration models are developed and validated to obtain real-time BG information from sweat. The estimated BG concentration showed a good correlation with measured BG concentration, with all values lying in the A+B region of consensus error grid (MARD = 10.56% (fingertip) and 13.17% (forearm)). Overall, the successful execution of such osmotically driven continuous BG monitoring system from passive sweat can be a useful addition to the next-generation continuous sweat glucose monitors.

Abstract: We incorporate Se into the 3D halide perovskite framework using the zwitterionic ligand: SeCYS (+NH3(CH2)2Se−), which occupies both the X− and A+ sites in the prototypical ABX3 perovskite. The new organoselenide‐halide perovskites: (SeCYS)PbX2 (X=Cl, Br) expand upon the recently discovered organosulfide‐halide perovskites. Single‐crystal X‐ray diffraction and pair distribution function analysis reveal the average structures of the organoselenide‐halide perovskites, whereas the local lead coordination environments and their distributions were probed through solid‐state 77Se and 207Pb NMR, complemented by theoretical simulations. Density functional theory calculations illustrate that the band structures of (SeCYS)PbX2 largely resemble those of their S analogs, with similar band dispersion patterns, yet with a considerable band gap decrease. Optical absorbance measurements indeed show band gaps of 2.07 and 1.86 eV for (SeCYS)PbX2 with X=Cl and Br, respectively. We further demonstrate routes to alloying the halides (Cl, Br) and chalcogenides (S, Se) continuously tuning the band gap from 1.86 to 2.31 eV–straddling the ideal range for tandem solar cells or visible‐light photocatalysis. The comprehensive description of the average and local structures, and how they can fine‐tune the band gap and potential trap states, respectively, establishes the foundation for understanding this new perovskite family, which combines solid‐state and organo‐main‐group chemistry.

The Sonogashira reaction (SNR) is undeniably the most applicable and efficient scheme in chemical synthesis, which involves the formation of C-C bonds by cross-coupling reaction (CCR) with terminal alkyne and halides of aryl or vinyl system. Typically, Pd serves as a catalyst for this reaction, with Cu serving as a co-catalysts and bases can be phosphine or amine. The applicability of such reactions lies in synthesizing medicines, heterocycles, and imitators in products of nature, biologically active complex compounds, nanomaterials, and other organic compounds. In this research, we could implement the SNR effectively without the need for the chemicals mentioned above reagents by using sodium aluminate (NaAlO2) as a base and catalyst as zinc under microwave irradiation (MWR) in water. The approach bears the potential to be in coherence with the principles of green chemistry and make reactions more atom-friendly. In order to achieve inexpensive and eco-friendly energy conditions, we developed one of the straightforward, concise, convergent protocols for sequential coupling and cyclization from Acetylenic species of quinoline-8-ol synthesized in situ by the CCR under MWR. Furthermore, the reaction used zinc as a catalyst and NaAlO2 as a base in the aqueous phase.

Purpose: Teacher leadership distinguishes, implicitly or explicitly, among teachers based on their expertise, but the notion of teaching expertise is contested, even among educators. Despite the potential for expert teachers to positively influence their colleagues' practices, we know little about the supports and obstacles to expert teacher leadership. This study examines the ways that the leadership of a particular group of expert teachers--National-Board-certified teachers--is understood and enacted in schools. Methods: Survey data from staff in six elementary schools were used to analyze Board-certified teachers' centrality in their schools' work-related social networks. Survey results were used to select 26 participants for semistructured interviews focused on their understandings of the relationships between teaching expertise, Board certification, and leadership, which were analyzed using alternating rounds of open and closed coding. Findings: Board-certified teachers were more central to their schools' networks than non-Board-certified teachers, although Board-certified teachers interacted with one another more than with non-Board-certified teachers. Board-certified teachers were seen as having expanded influence beyond their classrooms, which some saw as supporting their leadership, but others saw as disconnected from, or even undermining, their leadership. Implications for Research and Practice: Teacher leadership requires a supporting infrastructure in the form of leadership positions, routines, and tools that align with leaders' expertise. Developing a shared understanding of teaching expertise is key to Board-certified teacher leadership, as well as other teacher leadership efforts.

With the budding interests of structural and functional network characteristics as potential parameters for abnormal brains, an essential and thus simpler representation and evaluations have become necessary. Eigenvector centrality measure of functional magnetic resonance imaging ("fMRI") offer region wise network representations through "fMRI" diagnostic maps. The article investigates the suitability of network node centrality values to discriminate ASD subject groups compared to typically developing controls following a boxplot formalism and a classification and regression tree model. Region wise differences between normal and ASD subjects primarily belong to the frontoparietal, limbic, ventral attention, default mode and visual networks. The reduced number of regions-of-interests (ROI) clearly suggests the benefit of automated supervised machine learning algorithm over the manual classification method.

Industrial cellulosic ethanol production is a challenge due to the high cost of cellulases for hydrolysis when lignocellulosic materials are used as feedstock. In this study, direct ethanol production from cellulose was performed by consortium of Trichoderma reesei and Candida molischiana. Cellulose was hydrolyzed by a fully enzymatic saccharification process using Trichoderma reesei cellulases. The produced reducing sugar was further utilized by Candida molischiana for ethanol production. Because the optimal temperature for the cellulase system is approximately 50°C, the effect of temperature rise from 30°C to 50°C on cellulose hydrolysis was investigated. The results showed that the temperature rise from 30°C to 50°C after 36 h of cultivation was the best for reducing sugar and glucose production. Under these conditions, the maximum concentrations of reducing sugar and glucose produced by T. reesei were 8.0 g/L and 4.6 g/L at 60 h, respectively. The maximum production of ethanol by C. molischiana was 3.0 g/L after 120 h.

In the present work we solve the problem of finding the fuzzy distance between two subsets of a fuzzy metric space for which we use a non-self fuzzy contraction mapping from one set to the other. It is a fuzzy extension of the proximity point problem which is by its nature a problem of global optimization. The contraction is defined here by two control functions. We define a geometric property of the fuzzy metric space. The main result is illustrated with an example. Our result extends a fuzzy version of the Banach contraction mapping principle.

ConspectusCreating a living system from nonliving matter is a great challenge in chemistry and biophysics. The early history of life can provide inspiration from the idea of the prebiotic RNA World established by ribozymes, in which all genetic and catalytic activities were executed by RNA. Such a system could be much simpler than the interdependent central dogma characterizing life today. At the same time, cooperative systems require a mechanism such as cellular compartmentalization in order to survive and evolve. Minimal cells might therefore consist of simple vesicles enclosing a prebiotic RNA metabolism.The internal volume of a vesicle is a distinctive environment due to its closed boundary, which alters diffusion and available volume for macromolecules and changes effective molecular concentrations, among other considerations. These physical effects are mechanistically distinct from chemical interactions, such as electrostatic repulsion, that might also occur between the membrane boundary and encapsulated contents. Both indirect and direct interactions between the membrane and RNA can give rise to nonintuitive, emergent behaviors in the model protocell system. We have been examining how encapsulation inside membrane vesicles would affect the folding and activity of entrapped RNA.Using biophysical techniques such as FRET, we characterized ribozyme folding and activity inside vesicles. Encapsulation inside model protocells generally promoted RNA folding, consistent with an excluded volume effect, independently of chemical interactions. This energetic stabilization translated into increased ribozyme activity in two different systems that were studied (hairpin ribozyme and self-aminoacylating RNAs). A particularly intriguing finding was that encapsulation could rescue the activity of mutant ribozymes, suggesting that encapsulation could affect not only folding and activity but also evolution. To study this further, we developed a high-throughput sequencing assay to measure the aminoacylation kinetics of many thousands of ribozyme variants in parallel. The results revealed an unexpected tendency for encapsulation to improve the better ribozyme variants more than worse variants. During evolution, this effect would create a tilted playing field, so to speak, that would give additional fitness gains to already-high-activity variants. According to Fishers Fundamental Theorem of Natural Selection, the increased variance in fitness should manifest as faster evolutionary adaptation. This prediction was borne out experimentally during in vitro evolution, where we observed that the initially diverse ribozyme population converged more quickly to the most active sequences when they were encapsulated inside vesicles.The studies in this Account have expanded our understanding of emergent protocell behavior, by showing how simply entrapping an RNA inside a vesicle, which could occur spontaneously during vesicle formation, might profoundly affect the evolutionary landscape of the RNA. Because of the exponential dynamics of replication and selection, even small changes to activity and function could lead to major evolutionary consequences. By closely studying the details of minimal yet surprisingly complex protocells, we might one day trace a pathway from encapsulated RNA to a living system.

Plants release a wealth of metabolites into the rhizosphere that can shape the composition and activity of microbial communities in response to environmental stress. The connection between rhizodeposition and rhizosphere microbiome succession has been suggested, particularly under environmental stress conditions, yet definitive evidence is scarce. In this study, we investigated the relationship between rhizosphere chemistry, microbiome dynamics, and abiotic stress in the bioenergy crop switchgrass grown in a marginal soil under nutrient-limited, moisture-limited, and nitrogen (N)-replete, phosphorus (P)-replete, and NP-replete conditions. We combined 16S rRNA amplicon sequencing and LC-MS/MS-based metabolomics to link rhizosphere microbial communities and metabolites. We identified significant changes in rhizosphere metabolite profiles in response to abiotic stress and linked them to changes in microbial communities using network analysis. N-limitation amplified the abundance of aromatic acids, pentoses, and their derivatives in the rhizosphere, and their enhanced availability was linked to the abundance of bacterial lineages from Acidobacteria, Verrucomicrobia, Planctomycetes, and Alphaproteobacteria. Conversely, N-amended conditions increased the availability of N-rich rhizosphere compounds, which coincided with proliferation of Actinobacteria. Treatments with contrasting N availability differed greatly in the abundance of potential keystone metabolites; serotonin and ectoine were particularly abundant in N-replete soils, while chlorogenic, cinnamic, and glucuronic acids were enriched in N-limited soils. Serotonin, the keystone metabolite we identified with the largest number of links to microbial taxa, significantly affected root architecture and growth of rhizosphere microorganisms, highlighting its potential to shape microbial community and mediate rhizosphere plant-microbe interactions.

Control and analytics retrofits in commercial buildings provide owners and operatorswith tools for improved maintenance and operations, and are an effective strategy for advancingthe ambitious carbon reduction objectives mandated by state and federal governments. However,current retrofit processes are labor-intensive, error-prone, and expensive, thereby limitingscalability. There are two primary issues. First, control sequences are: a) typically manuallyspecified in English language using non-standard terminology; b) often not tested prior toinstallation; and c) more complex when they aim for higher performance (greater efficiency,grid-flexibility). Second, naming conventions used to label the data are often inconsistent, andmay vary by practitioner and project. These problems result in significant manual labor andincreased cost, lead to malfunctioning operation, and limit scaled deployment of new, highperformance control sequences such as needed for heat pump plants with energy storage.This paper presents recent progress towards digitization of these processes, facilitated bytwo new ASHRAE standards that underwent first public review in 2024. Standard 231Pfacilitates vendor-neutral, machine-readable representations of control sequences, enablingcreation of vendor-agnostic libraries of high performance control sequences that can betranslated digitally to building automation systems. Standard 223P facilitates interoperabilitybetween controls/analytics and building systems by enabling semi-automatic configuration usingsemantic models.We first provide a preliminary glimpse into the content of these new standards. Second,we describe their relationships with the established ASHRAE Standard 135 (BACnetcommunication protocol) and Guideline 36 (high-performance control sequences), and suggesthow new automated techniques can be integrated with current human-centric practices. Finally,we discuss how the proposed workflows could impact different industry stakeholders, includingowners, designers, control vendors, installers, commissioning agents, and facilities managers.These standards and guidelines enable new workflows that can significantly reducedeployment efforts and costs, and provide a path for scaled deployment of new sequences suchas needed for combined chiller and heat pump plants.

Microtransit is a mobility service that dynamically routes and schedules 6- to 20-seat vehicles to serve passengers within a defined region. Microtransit services are similar to ride-pooling services operated by Transportation Network Companies (e.g., Uber, Lyft); however, microtransit services are owned by cities or transit agencies. Integrating microtransit services with traditional fixed-route transit (FRT) has been touted as a means to attract more riders to public transit generally, improve mobility and sustainable transportation outcomes (e.g., reduce greenhouse gasses and local pollutants), and provide better accessibility to disadvantaged travelers. However, few academic studies have evaluated these claims. To address this gap, we surveyed California transit agencies that currently operate or recently operated microtransit services to obtain insights into integration challenges. We also developed an agent- and simulation-based modeling framework to evaluate alternative system designs for integrating FRT and microtransit in downtown San Diego and Lemon Grove, a suburban area in San Diego County.

California aims to replace gasoline and diesel light-duty vehicles (LDVs) with zero-emission LDVs, many of which will be plug-in battery electric vehicles (BEVs) and achieve 100% zero-carbon electricity by 2045. Large-scale plug-in BEV deployment will substantially increase electricity demand, particularly during peak hours (4:00pm to 9:00pm) when renewable energy is in short supply. Popular strategies for charging BEVs with electricity produced from renewable energy include smart charging and creating more energy storage that soaks up renewable energy during the day and dispenses it later when needed. These strategies, however, may not be enough. Consumer acceptance limits smart charging, and increased energy storage capacity is expensive. Another potential strategy involves lowering the overall demand for electricity by shifting BEV trips to electric-powered bicycles (e-bikes). While e-bikes cannot entirely replace BEV trips, they are ideal for short trips (five miles or less). Currently, 64% of US vehicle trips fall into the short trip category.

[This corrects the article DOI: 10.1039/D3SC04478E.].

The relationship between genotype and phenotype, or the fitness landscape, is the foundation of genetic engineering and evolution. However, mapping fitness landscapes poses a major technical challenge due to the amount of quantifiable data that is required. Catalytic RNA is a special topic in the study of fitness landscapes due to its relatively small sequence space combined with its importance in synthetic biology. The combination of in vitro selection and high-throughput sequencing has recently provided empirical maps of both complete and local RNA fitness landscapes, but the astronomical size of sequence space limits purely experimental investigations. Next steps are likely to involve data-driven interpolation and extrapolation over sequence space using various machine learning techniques. We discuss recent progress in understanding RNA fitness landscapes, particularly with respect to protocells and machine representations of RNA. The confluence of technical advances may significantly impact synthetic biology in the near future.

High temperature is one of the most important environmental stresses causing heavy reduction in yield of eggplant (Solanum melongena L.) in India. Therefore, development of heat tolerant eggplant variety is an important breeding objective. The present investigation was conducted to assess genetic variation among 62 eggplant lines including heat tolerant and susceptible lines in order to identify novel heat tolerant lines in changing climate in India. We employed 15 simple sequence repeat (SSR) markers to study polymorphisms among eggplant lines obtained from eggplant breeding program. The observations were analyzed using Power Marker version 3.5. The range of amplified number of bands was from 2 to 3 in each of 15 markers. The allele frequency was ranged from 0.5 to 0.7931 with an average of 2.067 alleles per locus. Among the 15 polymorphic SSR markers, 67% markers had PIC value higher than 0.3 with heterozygosity of individual loci was ranged from 0.00 to 0.1667. The marker emf01C03 had higher number of allele (3) and the marker emd03C01 had maximum PIC value and gene diversity. The NJ dendrogram obtained by 15 SSR markers divides 62 lines into 7 clusters where the cluster VII comprised of most heat tolerant lines (DBL-21, Guhala Chatua Local). The amplification pattern of heat tolerant lines also differ which implies different genetic architecture of heat tolerant lines. The research work will be very useful to combine these diverse sources of genetic variability to develop heat tolerant variety (s) in eggplant.