Marine symbiotic and epiphyte microorganisms are sources of bioactive or structurally novel natural products. Metabolic blockade-based genome mining has been proven to be an effective strategy to accelerate the discovery of natural products from both terrestrial and marine microorganisms. Here, the metabolic blockade-based genome mining strategy was applied to the discovery of other metabolites in a sea anemone-associated Streptomyces sp. S1502. We constructed a mutant Streptomyces sp. S1502/Δstp1 that switched to producing the atypical angucyclines WS-5995 A–E, among which WS-5995 E is a new compound. A biosynthetic gene cluster (wsm) of the angucyclines was identified through gene knock-out and heterologous expression studies. The biosynthetic pathways of WS-5995 A–E were proposed, the roles of some tailoring and regulatory genes were investigated, and the biological activities of WS-5995 A–E were evaluated. WS-5995 A has significant anti-Eimeria tenell activity with an IC₅₀ value of 2.21 μM. The production of antibacterial streptopyrroles and anticoccidial WS-5995 A–E may play a protective role in the mutual relationship between Streptomyces sp. S1502 and its host. Full article

As a result of screening a panel of marine organisms to identify lead molecules for the stimulation of endochondral bone formation, the calcareous sponge Pericharax heteroraphis was identified to exhibit significant activity during endochondral differentiation. On further molecular networking analysis, dereplication and chemical fractionation yielded the known clathridine A-related metabolites 3–6 and the homodimeric complex (clathridine A)₂ Zn²⁺ (9), together with the new unstable heterodimeric complex (clathridine A–clathridimine)Zn²⁺ (10). With the presence of the zinc complexes annotated through the LC-MS analysis of the crude extract changing due to the instability of some metabolites and complexes constituting the mixture, we combined the isolation of the predicted molecules with their synthesis in order to confirm their structure and to understand their reactivity. Interestingly, we also found a large quantity of the contaminant benzotriazoles BTZ (7) and its semi-dimer (BTZ)₂CH₂ (8), which are known to form complexes with transition metals and are used for preventing corrosion in water. All isolated 2-aminoimidazole derivatives and complexes were synthesized not only for structural confirmation and chemical understanding but to further study their bioactivity during endochondral differentiation, particularly the positively screened imidazolone derivatives. Compounds leucettamine B, clathridine A and clathridimine were found to increase type X collagen transcription and stimulate endochondral ossification in the ATDC5 micromass model. Full article

With the rapid development of the South Korean economy, human activities have extensively affected Korea’s coastal environment. A precise ecological quality assessment remains paramount despite the relatively lower impact of human activities on the East Sea compared to the West and South Seas of South Korea. Accurate ecological quality assessments can provide valuable marine environmental protection and management references. In our study, we employed seven indices based on heavy metals and macrobenthos to comprehensively assess ecological quality. Our results indicated the final ecological quality in the central East Sea of South Korea was acceptable at most stations; however, the ecological quality in winter marginally falls short compared to that in spring. The concentration of heavy metals emerges as a significant determinant of the final ecological quality, underscoring the need for subsequent studies to investigate the origins of heavy metals in the central East Sea of South Korea and the influence of anthropogenic activities on heavy metal concentrations. Furthermore, employing a single biotic index proves challenging for accurately assessing ecological quality in the East Sea of South Korea. Full article

The timely and precise prediction of cardiovascular disease (CVD) risk is essential for effective prevention and intervention. This study proposes a novel framework that integrates the two-phase Taguchi method (TPTM), the hyperparameter artificial neural network (HANN), and a genetic algorithm (GA) called TPTM-HANN-GA. This framework efficiently optimizes hyperparameters for an artificial neural network (ANN) model during the training stage, significantly enhancing prediction accuracy for cardiovascular disease (CVD) risk. The proposed TPTM-HANN-GA framework requires far fewer experiments than a traditional grid search, making it highly suitable for application in resource-constrained, low-power computers, and edge artificial intelligence (edge AI) devices. Furthermore, the proposed TPTM-HANN-GA framework successfully identified the optimal configurations for the ANN model’s hyperparameters, resulting in a hidden layer of 4 nodes, a tan h activation function, an SGD optimizer, a learning rate of 0.23425849, a momentum rate of 0.75462782, and seven hidden nodes. This optimized ANN model achieves 74.25% accuracy in predicting the risk of cardiovascular disease, which exceeds the existing state-of-the-art GA-ANN and TSTO-ANN models. The proposed TPTM-HANN-GA framework enables personalized CVD prediction to be efficiently conducted on low-power computers and edge-AI devices, achieving the goal of point-of-care testing (POCT) and empowering individuals to manage their heart health effectively. Full article

The filamentous fungus Aspergillus oryzae (A. oryzae) has been extensively used for the biosynthesis of numerous secondary metabolites with significant applications in agriculture and food and medical industries, among others. However, the identification and functional prediction of metabolites through genome mining in A. oryzae are hindered by the complex regulatory mechanisms of secondary metabolite biosynthesis and the inactivity of most of the biosynthetic gene clusters involved. The global regulatory factors, pathway-specific regulatory factors, epigenetics, and environmental signals significantly impact the production of secondary metabolites, indicating that appropriate gene-level modulations are expected to promote the biosynthesis of secondary metabolites in A. oryzae. This review mainly focuses on illuminating the molecular regulatory mechanisms for the activation of potentially unexpressed pathways, possibly revealing the effects of transcriptional, epigenetic, and environmental signal regulation. By gaining a comprehensive understanding of the regulatory mechanisms of secondary metabolite biosynthesis, strategies can be developed to enhance the production and utilization of these metabolites, and potential functions can be fully exploited. Full article

Allergic rhinitis (AR) is a systemic allergic disease that has a considerable impact on patients’ quality of life. Current treatments include antihistamines and nasal steroids; however, their long-term use often causes undesirable side effects. In this context, traditional Asian medicine (TAM), with its multi-compound, multi-target herbal medicines (medicinal plants), offers a promising alternative. However, the complexity of these multi-compound traits poses challenges in understanding the overall mechanisms and efficacy of herbal medicines. Here, we demonstrate the efficacy and underlying mechanisms of these multi-compound herbal medicines specifically used for AR at a systemic level. We utilized a modified term frequency–inverse document frequency method to select AR-specific herbs and constructed an herb–compound–target network using reliable databases and computational methods, such as the Quantitative Estimate of Drug-likeness for compound filtering, STITCH database for compound-target interaction prediction (with a high confidence score threshold of 0.7), and DisGeNET and CTD databases for disease-gene association analysis. Through this network, we conducted AR-related targets and pathway analyses, as well as clustering analysis based on target-level information of the herbs. Gene ontology enrichment analysis was conducted using a protein–protein interaction network. Our research identified 14 AR-specific herbs and analyzed whether AR-specific herbs are highly related to previously known AR-related genes and pathways. AR-specific herbs were found to target several genes related to inflammation and AR pathogenesis, such as PTGS2, HRH1, and TBXA2R. Pathway analysis revealed that AR-specific herbs were associated with multiple AR-related pathways, including cytokine signaling, immune response, and allergic inflammation. Additionally, clustering analysis based on target similarity identified three distinct subgroups of AR-specific herbs, corroborated by a protein–protein interaction network. Group 1 herbs were associated with the regulation of inflammatory responses to antigenic stimuli, while Group 2 herbs were related to the detection of chemical stimuli involved in the sensory perception of bitter taste. Group 3 herbs were distinctly associated with antigen processing and presentation and NIK/NF-kappa B signaling. This study decodes the principles of TAM herbal configurations for AR using a network pharmacological approach, providing a holistic understanding of drug effects beyond specific pathways. Full article

Introduction: Intra-abdominal cystic formations represent heterogeneous pathologies with varied localization and clinical manifestation. The first challenge of a giant intra-abdominal cystic lesion is identifying the organ of origin. The clinical presentation of intra-abdominal cystic lesions varies from acute manifestations to non-specific symptoms or accidental discovery. Case presentation: A 2-year-old girl presents to the emergency unit with a fever of 38.5 Celsius, loss of appetite, and apathy. The investigations showed a gigantic intra-abdominal mass whose organ belonging could not be specified. Postoperatively, a giant mesenteric lymphangioma was evident, which was completely excised. Discussion: Giant cystic formations modify the anatomical reports and become space-replacing formations, and the starting point is even more challenging to assess preoperatively. Nevertheless, the careful evaluation of the characteristics of the formation, the effect on the adjacent organs, the age of the patient, and the clinical picture can provide elements of differential diagnosis. The stated purpose of this work is to systematize intra-abdominal lesions according to the organ of origin and to make the preoperative diagnosis of an intra-abdominal cystic lesion in the pediatric patient easy to perform starting from the presented case. Full article

With the development of social media, the internet, and sensing technologies, multimodal data are becoming increasingly common. Integrating these data into knowledge graphs can help models to better understand and utilize these rich sources of information. The basic idea of the existing methods for entity alignment in knowledge graphs is to extract different data features, such as structure, text, attributes, images, etc., and then fuse these different modal features. The entity similarity in different knowledge graphs is calculated based on the fused features. However, the structures, attribute information, image information, text descriptions, etc., of different knowledge graphs often have significant differences. Directly integrating different modal information can easily introduce noise, thus affecting the effectiveness of the entity alignment. To address the above issues, this paper proposes a knowledge graph entity alignment method based on multimodal data supervision. First, Transformer is used to obtain encoded representations of knowledge graph entities. Then, a multimodal supervised method is used for learning the entity representations in the knowledge graph so that the vector representations of the entities contain rich multimodal semantic information, thereby enhancing the generalization ability of the learned entity representations. Finally, the information from different modalities is mapped to a shared low-dimensional subspace, making similar entities closer in the subspace, thus optimizing the entity alignment effect. The experiments on the DBP15K dataset compared with methods such as MTransE, JAPE, EVA, DNCN, etc., all achieve optimal results. Full article

Retinoblastoma (RB) is the most common malignant intraocular tumor in early childhood. Gene expression profiling revealed that the gastric inhibitory polypeptide receptor (GIPR) is upregulated following trefoil factor family peptide 1 (TFF1) overexpression in RB cells. In the study presented, we found this G protein-coupled transmembrane receptor to be co-expressed with TFF1, a new diagnostic and prognostic RB biomarker for advanced subtype 2 RBs. Functional analyses in two RB cell lines revealed a significant reduction in cell viability and growth and a concomitant increase in apoptosis following stable, lentiviral GIPR overexpression, matching the effects seen after TFF1 overexpression. In chicken chorioallantoic membrane (CAM) assays, GIPR-overexpressing RB cells developed significantly smaller CAM tumors. The effect of GIPR overexpression in RB cells was reversed by the GIPR inhibitor MK0893. The administration of recombinant TFF1 did not augment GIPR overexpression effects, suggesting that GIPR does not serve as a TFF1 receptor. Investigations of potential GIPR up- and downstream mediators suggest the involvement of miR-542-5p and p53 in GIPR signaling. Our results indicate a tumor suppressor role of GIPR in RB, suggesting its pathway as a new potential target for future retinoblastoma therapy. Full article

The additive manufacturing (AM) of functional copper (Cu) parts is a major goal for many industries, from aerospace to automotive to electronics, because Cu has a high thermal and electrical conductivity as well as being ~10× cheaper than silver. Previous studies on AM of Cu have concentrated mainly on high-energy manufacturing processes such as Laser Powder Bed Fusion, Electron Beam Melting, and Binder Jetting. These processes all require high-temperature heat treatment in an oxygen-free environment. This paper shows an AM route to multi-layered microparts from novel nanoparticle (NP) Cu feedstocks, performed in an air environment, employing a low-power (<10 W) laser sintering process. Cu NP ink was deposited using two mechanisms, inkjet printing, and bar coating, followed by low-power laser exposure to induce particle consolidation. Initial parts were manufactured to a height of approximately 100 µm, which was achieved by multi-layer printing of 15 (bar-coated) to 300 (inkjetted) layers. There was no evidence of oxidised copper in the sintered material, but they were found to be low-density, porous structures. Nonetheless, electrical resistivity of ~28 × 10⁻⁸ Ω m was achieved. Overall, the aim of this study is to offer foundational knowledge for upscaling the process to additively manufacture Cu 3D parts of significant size via sequential nanometal ink deposition and low-power laser processing. Full article

From powering our homes to driving our economies, energy lies at the heart of humanity’s complex challenges in the modern era. This paper reviews the evolution of smart energy systems, examining their technological advancements and societal implications while proposing a future design framework emphasizing four key pillars: holistic resource optimization, adaptive intelligence, environmental harmony, and human-centered design. While they offer numerous benefits, such as enhanced energy efficiency and reduced carbon emissions, smart energy systems also face challenges. These include cybersecurity risks, the complexity of integrating diverse energy sources seamlessly, high upfront costs, and potential compatibility issues arising from evolving technologies. Overcoming these challenges will be crucial for unleashing the full potential of smart energy systems and facilitating their global adoption. Abundant opportunities for further research and development exist in this domain, awaiting exploration and advancement. Full article

Placental nutrient transport capacity influences fetal growth and development; however, it is affected by environmental factors, which are poorly understood. The objective of this study was to understand the impact of the ovine placentome morphological subtype, tissue type, and maternal parenteral supplementation of arginine mono-hydrochloride (Arg) on nutrient transport capacity using a gene expression approach. Placentomal tissues of types A, B, and C morphologic placentome subtypes were derived from 20 twin-bearing ewes, which were infused thrice daily with Arg (n = 9) or saline (Ctrl, n = 11) from 100 to 140 days of gestation. Samples were collected at day 140 of gestation. Expression of 31 genes involved in placental nutrient transport and function was investigated. Differential expression of specific amino acid transporter genes was found in the subtypes, suggesting a potential adaptive response to increase the transport capacity. Placentomal tissues differed in gene expression, highlighting differential transport capacity. Supplementation with Arg was associated with differential expressions of genes involved in amino acid transport and angiogenesis, suggesting a greater nutrient transport capacity. Collectively, these results indicate that the morphological subtype, tissue type, and maternal Arg supplementation can influence placental gene expression, which may be an adaptive response to alter the transport capacity to support fetal growth in sheep. Full article

The plants of the Opuntia genus mainly grow in arid and semi-arid climates. Although the highest variety of wild species is found in Mexico, Opuntia spp. is widely distributed throughout the world. Extracts of these cacti have been described as important sources of bioactive substances that can have beneficial properties for the prevention and treatment of certain metabolic disorders. The objective of this review is to summarise the presently available knowledge regarding Opuntia ficus-indica (nopal or prickly pear), and some other species (O. streptacantha and O. robusta) on obesity and several metabolic complications. Current data show that Opuntia ficus-indica products used in preclinical studies have a significant capacity to prevent, at least partially, obesity and certain derived co-morbidities. On this subject, the potential beneficial effects of Opuntia are related to a reduction in oxidative stress and inflammation markers. Nevertheless, clinical studies have evidenced that the effects are highly contingent upon the experimental design. Moreover, the bioactive compound composition of nopal extracts has not been reported. As a result, there is a lack of information to elucidate the mechanisms of action responsible for the observed effects. Accordingly, further studies are needed to demonstrate whether Opuntia products can represent an effective tool to prevent and/or manage body weight and some metabolic disorders. Full article

The aim of this study was to review the current literature regarding the effects of intra-articularly applied, fat-derived orthobiologics (FDO) in the treatment of primary knee osteoarthritis over a mid-term follow-up period. A systematic literature search was conducted on the online databases of Scopus, PubMed, Ovid MEDLINE, and Cochrane Library. Studies investigating intra-articularly applied FDO with a minimum number of 10 knee osteoarthritis patients, a follow-up period of at least 2 years, and at least 1 reported functional parameter (pain level or Patient-Reported Outcome Measures) were included. Exclusion criteria encompassed focal chondral defects and techniques including additional arthroscopic bone marrow stimulation. In 28 of 29 studies, FDO showed a subjective improvement in symptoms (pain and Patient-Reported Outcome Measures) up to a maximum follow-up of 7.2 years. Radiographic cartilage regeneration up to 3 years postoperatively, as well as macroscopic cartilage regeneration investigated via second-look arthroscopy, may corroborate the favorable clinical findings in patients with knee osteoarthritis. The methodological heterogeneity in FDO treatments leads to variations in cell composition and represents a limitation in the current state of knowledge. However, this systematic review suggests that FDO injection leads to beneficial mid-term results including symptom reduction and preservation of the affected joint in knee osteoarthritis patients. Full article

The phenomenon of melting in metal–organic frameworks (MOFs) has recently garnered attention. Crystalline MOF materials can be transformed into an amorphous glassy state through melt-quenching treatment. The resulting MOF glass structure eliminates grain boundaries and retains short-range order while exhibiting long-range disorder. Based on these properties, it emerges as a promising candidate for high-performance separation membranes. MOF glass membranes exhibit permanent and accessible porosity, allowing for selective adsorption of different gas species. This review summarizes the melting mechanism of MOFs and explores the impact of ligands and metal ions on glassy MOFs. Additionally, it presents an analysis of the diverse classes of MOF glass composites, outlining their structures and properties, which are conducive to gas adsorption and separation. The absence of inter-crystalline defects in the structures, coupled with their distinctive mechanical properties, renders them highly promising for industrial gas separation applications. Furthermore, this review provides a summary of recent research on MOF glass composite membranes for gas adsorption and separation. It also addresses the challenges associated with membrane production and suggests future research directions. Full article

The Internet of Things (IoT) has become a transformative technological infrastructure, serving as a benchmark for automating and standardizing various activities across different domains to reduce human effort, especially in hazardous environments. In these networks, devices with embedded sensors capture valuable information about activities and report it to the nearest server. Although IoT networks are exceptionally useful in solving real-life problems, managing duplicate data values, often captured by neighboring devices, remains a challenging issue. Despite various methodologies reported in the literature to minimize the occurrence of duplicate data, it continues to be an open research problem. This paper presents a sophisticated data aggregation approach designed to minimize the ratio of duplicate data values in the refined set with the least possible information loss in IoT networks. First, at the device level, a local data aggregation process filters out outliers and duplicates data before transmission. Second, at the server level, a dynamic programming-based non-metric method identifies the longest common subsequence (LCS) among data from neighboring devices, which is then shared with the edge module. Simulation results confirm the approach’s exceptional performance in optimizing the bandwidth, energy consumption, and response time while maintaining high accuracy and precision, thus significantly reducing overall network congestion. Full article

Magnesium (Mg) deficiency is a major factor limiting the growth and development of plants. Mulberry (Morus alba L.) is an important fruit tree crop that requires Mg for optimal growth and yield, especially in acid soils. However, the molecular mechanism of Mg stress tolerance in mulberry plants remains unknown. In this study, we used next-generation sequencing technology and biochemical analysis to profile the transcriptome and physiological changes of mulberry leaves under different Mg treatments (deficiency: 0 mM, low: 1 mM, moderate low: 2 mM, sufficiency: 3 mM, toxicity: 6 mM, higher toxicity: 9 mM) as T1, T2, T3, CK, T4, T5 treatments, respectively, for 20 days. The results showed that Mg imbalance altered the antioxidant enzymatic activities, such as catalase (CAT), peroxidase (POD), and superoxide dismutase (SOD), and non-enzymatic, including soluble protein, soluble sugar, malondialdehyde (MDA), and proline (PRO), contents of the plant. The Mg imbalances disrupted the ultrastructures of the vital components of chloroplast and mitochondria relative to the control. The transcriptome data reveal that 11,030 genes were differentially expressed (DEGs). Genes related to the photosynthetic processes (CAB40, CAB7, CAB6A, CAB-151, CAP10A) and chlorophyll degradation (PAO, CHLASE1, SGR) were altered. Antioxidant genes such as PER42, PER21, and PER47 were downregulated, but DFR was upregulated. The carbohydrate metabolism pathway was significantly altered, while those involved in energy metabolism processes were perturbed under high Mg treatment compared with control. We also identified several candidate genes associated with magnesium homeostasis via RT-qPCR validation analysis, which provided valuable information for further functional characterization studies such as promoter activity assay or gene overexpression experiments using transient expression systems. Full article

Triptolide is a natural compound in herbal remedies with anti-inflammatory and anti-proliferative properties. We studied its effects on critical signaling processes within the cell, including Notch1 and STAT3 signaling. Our research showed that triptolide reduces cancer cell proliferation by decreasing the expression of downstream targets of these signals. The levels of each signal-related protein and mRNA were analyzed using Western blot and qPCR methods. Interestingly, inhibiting one signal with a single inhibitor alone did not significantly reduce cancer cell proliferation. Instead, MTT assays showed that the simultaneous inhibition of Notch1 and STAT3 signaling reduced cell proliferation. The effect of triptolide was similar to a combination treatment with inhibitors for both signals. When we conducted a study on the impact of triptolide on zebrafish larvae, we found that it inhibited muscle development and interfered with muscle cell proliferation, as evidenced by differences in the staining of myosin heavy chain and F-actin proteins in confocal fluorescence microscopy. Additionally, we noticed that inhibiting a single type of signaling did not lead to any significant muscle defects. This implies that triptolide obstructs multiple signals simultaneously, including Notch1 and STAT3, during muscle development. Chemotherapy is commonly used to treat cancer, but it may cause muscle loss due to drug-related adverse reactions or other complex mechanisms. Our study suggests that anticancer agents like triptolide, inhibiting essential signaling pathways including Notch1 and STAT3 signaling, may cause muscle atrophy through anti-proliferative activity. Full article

Lentigo maligna (LM) is a melanoma in situ that is prevalent in chronically sun-damaged skin. Characterized by a slow growth pattern and high mutation rates due to chronic UV exposure, LM poses diagnostic and therapeutic challenges, particularly given its tendency to mimic other skin lesions and its occurrence in cosmetically sensitive areas. Its diagnosis is based on an integrated approach using dermoscopy and reflectance confocal microscopy (RCM). Despite its slow progression, LM can evolve into lentigo maligna melanoma (LMM), making its treatment necessary. Treatment modalities encompass both surgical and non-surgical methods. Surgical treatments like Wide Local Excision (WLE) and Mohs Micrographic Surgery (MMS) aim for clear histological margins. WLE, a standard melanoma surgery, faces challenges from LM’s subclinical extensions, which increase the recurrence risk. MMS, effective for large or poorly defined lesions, is defined by precise margin control while considering cosmetic outcomes. Non-surgical options, including radiotherapy and imiquimod, are alternatives for non-surgical candidates. Radiotherapy has been effective since the 1950s, offering good control and cosmetic results, especially for older patients. Imiquimod, an immunomodulator, shows promise in treating LM, though its application remains off-label. The increasing incidence of LM/LMM necessitates a balance in treatment choices to minimize recurrence and maintain cosmetic integrity. A multidisciplinary approach, integrating clinical examination with dermoscopy and RCM and histological assessment, is essential for accurate diagnosis and effective LM management. Full article

The application of pulse power discharge (PPD) technology in the crushing and dismantling of concrete structures has characteristics related to both green and environmental protection, as well as safety and reliability, with broad application prospects in the construction and municipal engineering fields in dense urban areas. Nevertheless, the research into using this technology to break reinforced concrete (RC) slabs is very limited, while the influence of key parameters on the crushing effect of reinforced concrete slabs is not clear. To solve this problem, a finite element model of an RC slab was established by ABAQUS. The effect of a shock wave generated by PPD on the surrounding concrete was simulated by an explosion-load equivalent, and the development process of concrete crack was simulated by a cohesive force model. Based on the results of the model analysis, the effects of reinforcement spacing, as well as diameter and concrete strength on the crushing effect of RC slabs were investigated. The results show that the increase in reinforcement diameter and the decrease in reinforcement spacing have a significant effect on limiting the development of cracks. According to the development of cracks, they can be divided into three types: edge cracks, cracks between central holes, and cracks between edge holes. The influence of reinforcement spacing and diameter on the first two crack widths is the most obvious. The increase in concrete strength also reduces the width of cracks. Based on the analysis results, the calculation expressions of the crushing effect of the PPD technique on RC slabs were established, which provides theoretical support for the popularization and application of this technique. Full article

People living in nursing homes have the right to self-determination, and difficulty in accommodating this right can create moral distress in staff. This study aimed to explore experiences of situations of moral distress and to identify nursing home staffs’ needs to act with moral agency. Six group interviews were conducted with nursing home staff. Content analysis of the interview responses showed that moral distress can be rooted in both concrete situations with residents and factors related to the work environment and policy requirements. Personnel can address moral distress through both active and passive means. Staff acted to address moral distress mainly in situations with residents and sometimes in relation to co-workers, but they did not try to influence the policy level. Full article

This paper explores innovative strategies to enhance sustainable healthcare quality, emphasizing the pivotal role of organizational culture and placing a special focus on employee job satisfaction. Recognizing the indispensable nature of contented employees in delivering superior patient care, our discussion explores how an organizational culture that prioritizes optimized work processes, and a supportive work environment can significantly boost employee well-being. By mitigating workplace stress through the refinement of operations and the minimization of waste, healthcare organizations can foster a setting that greatly enhances job satisfaction. This enhancement, in turn, catalyzes superior patient care and underscores the healthcare system’s dedication to sustainability and the well-being of its employees. Our analysis indicates that concentrating on employee satisfaction, deeply rooted in the organizational culture, is not merely advantageous but essential for nurturing a sustainable, high-quality healthcare system. The insights offered aim to guide healthcare organizations toward embracing strategies such as Green Lean Six Sigma, with a heightened focus on improving workforce well-being through the lens of organizational culture. This approach is expected to produce a synergistic improvement in healthcare quality by promoting operational efficiency and advancing environmental sustainability in tandem. Full article