The Mediating Role of Emotional Exhaustion in the Relationship between Abusive Supervision and Employee Cyberloafing Behaviour.

Cyberloafing is becoming a common problem in every organization that directly affects organizational productivity. In this study we are going to study the influence of abusive supervision on cyberloafing, further, we are studying the mediating effect of emotional exhaustion generated due to abusive supervision behaviour, motivating employees towards cyberloafing. The data were collected from 150 employees working in Saif Textile Mills Ltd & Kohat Textile Mills Ltd, Pakistan through questionnaires. The study sample was drawn using a convenience sampling technique. This study used SPSS 25 and process Hayes (2013) model 4 for data analysis and for model fitness we used CFA (AMOS 22). The data findings demonstrate that abusive supervision significantly and positively affects cyberloafing and also emotional exhaustion mediates this relation significantly. Therefore we conclude that abusive supervision is the main factor for employees to be exhausted and ultimately move towards cyberloafing. Based on these finding managers plays a vital role to maintain organization environment friendly

The Role of Mediation on Work Practices and Employee Involvement

Organizations face many challenges regarding employee engagement and employee job satisfaction. To increase the level of employee job satisfaction, HIWP must be implemented in order to have an impact on employee performance satisfaction. The purpose of this study was to examine the relationship between high-involvement work practices (HIWP) and job satisfaction with the mediating effect of employee engagement; HIWPs consist of four main attributes: (a) power (b) information (c) reward (d) knowledge. This study investigates the relationship between the three variables. Here, convenience sampling was used and data were collected through questionnaires from 185 organizational respondents in the banking sector. Regression analysis was used to test the hypothesis and Andrew F. Hayes model 4 was used to examine the mediating effect. The results showed that there was a significant relationship between the mediating variables and the effect of employee engagement. This study expands on HIWP employment and job satisfaction. The practical implication of this research is to measure the level of job satisfaction of employees by using HIWP can be implemented for managers and employees

Determine the Severity of Acute Respiratory Infections by Using Pediatric Respiratory Severity Score (PRESS) in Children Visiting Federal Govt. Polyclinic hospital, Islamabad

Objective: To determine the severity of acute respiratory infections in children by using Pediatric Respiratory Severity Score (PRESS). Methodology: This descriptive cross sectional study was conducted at the outpatient and emergency paediatric department of the Federal Govt. Polyclinic hospital, Islamabad, from October 2017 to December 2019. One hundred and seventeen children with acute respiratory infections were enrolled in the study by a non-probability sampling technique. Epidemiologic variables of interest included age, sex, and breastfeeding or not. Clinical variables of interest included respiratory rate, use of accessory respiratory muscle, wheeze on auscultation, and oxygen saturation at room air.  PRESS assessed tachypnea, wheezing, accessory muscle use, SpO2 and feeding difficulties with each component given a score of 0 or 1, and the total score were categorized as a mild(0-1), moderate (2-3) or severe(4-5). Results: Out of 117 children, 98 (83.8%) belonged to the age group > 2 months– 12 months, while 19 (16.2%) belonged to the age group > 12 months– 24 months. Among them, 17 (14.5%) were mild, 53 (45.3%) were moderate, and 47 (40.2%) were severe according to their severity of respiratory distress. The hospitalization rate for moderate infection was 84.9% while 100% for severe infection and none of the patient with mild infection was hospitalized (p<0.001). Conclusion: Early assessment by simple bedside technique will help in managing the respiratory distress according to its severity, reducing the undue investigation and improving the outcome of illness. Moreover it can be easily administered at primary health care facilities for triage of pediatric patients with respiratory distress

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Heterologous expression of cobalamin dependent methanol:CoM methytransferases from environmental archaea

The increasing environmental concerns due to greenhouse gas emissions have shifted the focus from fossil-based products to renewable resources by developing more sustainable processes and replacing the energy matrix worldwide. The world has pledged to cut CO2 emissions in the future and sequestration has fallen out of favor for a variety of geological and sociological reasons. In such a circumstance, there is a growing interest in turning CO2 into usable products or fuels. Methanogens are involved in CO2 reduction and methane production, so they play an important part in the global carbon cycle. Their distinct characteristics, particularly those of Methanococcus maripaludis, suggest that they could be used in wastewater treatment, value- added chemical production, carbon capture and utilization, GTL (Gas to Liquid) applications, and methane production from renewable hydrogen. This study is focused on two aims: to increase substrate scope and to extend the product scope. The first goal is to increase the substrate specificity of Methanococcus maripaludis by the heterologous expression of Methanol:Coenzyme M methyltransferase (MtaABC) complex from Methanospaera stadtmanae in Methanococcus maripaludis along with the corrinoid activation protein (MAP). The methylation of Coenzyme M using methanol is catalyzed by the MtaABC complex. The initial methyl group transfer from methanol to the subunit MtaC is catalyzed by MtaB and the second transfer of the methyl group from the MtaC-bound methyl-cobamide to Coenzyme M is catalyzed by MtaA, followed by the reduction to methane with methyl-coenzyme M reductase. Therefore, MtaA and MtaBC genes were amplified with PstI site edited later using site directed mutagenesis to avoid the strain specific cleavage of PstI site in M. maripaludis. The goal of the objective was the enabling of M. maripaludis growth on an unnatural substrate methanol as it is genetically tractable. Another objective of the study was the heterologous expression of MtaAC complex from Candidatus Syntrophoarchaeum caldarius. The goal was to obtain biochemical data to verify if these genes are involved in the downstream transfer of propyl group from propyl:Coenzyme M. Alignment of MtaAC complex and corrinoid activation protein from Ca. Syntrophoarchaeum butanivorans and Ca. Syntrophoarchaeum caldarius revealed four genes namely, MAP protein (Corrinoid activation protein), Corrinoid Methyltransferase (MtaC), Methylcobamide: CoM methyltransferase (MtaA) and Methylcobalamin:CoM methyltransferase (MtaA) responsible for MtaAC complex in Ca. Syntrophoarchaeum caldarius. These four genes were amplified from the genomic DNA of caldarius and cloned into pet28b plasmid, followed by expression in Escherichia coli BL21 cells. Hence, the project was focused on providing further understanding of methyltransferase and alkyl transferase complexes for their potential involvement in anaerobic alkane oxidation

Cotrimoxazole‐induced hyperkalemia in renal transplant patient—Case report

Abstract We present the case of a 55‐year‐old male patient who developed hyperkalemia after using Cotrimoxazole (TMP‐SMX). There was a marked increase in potassium levels from 3.3 mEq/L on Day 5 when cotrimoxazole was started to 6.2 mEq/L on Day 11 when the drug was withheld

Structured Long Interview and Clinical Examination (SLICE) as Formative Assessment Tool in Clinical Clerkship: Medical Students Perspective

Objective: This study aimed to assess the medical students’ opinions and views on undertaking SLICE as a formative assessment. Methods: This was a qualitative, exploratory study. Purposive sampling technique was used to select final year medical students who have undertaken a formative assessment through SLICE in their clerkship rotation. Total 32 students participated in this study .Four sets of focus group discussions (FGD) were conducted from medical students who had recently gone through their clinical clerkship modules for Pediatrics, General Medicine, General Surgery and Gynecology& Obstetrics. Each recorded FGD was transcribed verbatim. Thematic analysis was conducted manually. Themes were identified from the transcribed data, coded and analyzed. In order to achieve adequate coding and researcher reliability, investigator triangulation was performed. The initial thematic analysis was performed by the primary investigator. Thereafter, two more investigators independently analyzed the data. Before the data was finalized, all the three investigators reached a final consensus upon the themes that had emerged, ensuring triangulation of the analyzed data. Results: A four staged thematic analysis was conducted, in which five major themes and five sub-themes emerged. The main themes being: Purpose, Learning, Timing, Relevancy and Fairness of SLICE. Conclusion: The students generally thought that SLICE was effective in enhancing their clinical skills learning and should be conducted more frequently with minor adjustments. Continuous..

Antimicrobial strategies for scaffolds aided periodontal regeneration- road so far systematic review

Objective: To give a comprehensive understanding of the efficacy of antimicrobial-loaded scaffolds as drug delivery system for periodontal regeneration, and to review the recent advances in the field of periodontal regeneration. Methods: The literature was reviewed using key words “antimicrobial releasing periodontal scaffolds” on Science Direct, PubMed and Web of Science search engines. Shortlisted articles were evaluated on the basis of specific inclusion-exclusion criteria. Results: Of the 544 studies found, 34(6.25%) met the inclusion criteria. The trend indicated an increase in use of antimicrobial-loaded scaffolds that caused inhibition of periodontal pathogenic bacteria, accompanied with greater cellular interaction, and differentiation for alveolar bone healing. Contemporary treatment tactics clinically prove the ability to limit disease progression, but complete periodontal regeneration needs to be validated yet. Conclusion: Emerging trends are not only improving the inhibitory effect of bacterial growth, but are also making a favourable environment for cell proliferation and differentiation, resulting in alveolar bone repair and re-growth. Key Words: Periodontal scaffolds, Antimicrobials, Alveolar bone regeneration

High Occurrence of Multidrug-Resistant <i>Escherichia coli</i> Strains in Bovine Fecal Samples from Healthy Cows Serves as Rich Reservoir for AMR Transmission

Objectives: Antibiotics are valuable therapeutics. However, the unwarranted and excessive use of these antimicrobials in food animals and the consequent contamination of the environment have been associated with the emergence and spread of antimicrobial resistance. Continuous surveillance and monitoring of antimicrobial resistance among E. coli isolates is recommended, not only for bovine health but also for public health. This study aims to assess the antimicrobial resistance profile, virulence potential, and genetic characterization of fecal E. coli isolates from healthy cows. Methodology: The in vitro, phenotypic antibiotic resistance of isolates was measured via the Kirby–Bauer disc-diffusion method against twenty-seven antibiotics. The β-lactamase enzymatic activities of the strains were also investigated. For the assessment of virulence potential, fecal E. coli isolates were subjected to several in vitro pathogenicity assays, including biofilm formation ability, blood hemolysis, complement resistance, and growth in human urine. Phylogroup determination and virulence-associated genes were detected via multiplex PCR. Results: In vitro antibiotic resistance profiling showed that 186/200 (93%) of the isolates were multidrug-resistant (MDR), with the highest resistance against penicillin, tetracycline, fluoroquinolone, and macrolide classes of antibiotics. Of particular concern was the phenotypic resistance to colistin in 52/200 isolates (26%), though 16% of the total isolates harbored mcr1, the genetic determinant of colistin. Despite the scarce use of fluoroquinolone, cephalosporin, and carbapenem in the agricultural sector, resistance to these classes was evident due to the presence of extended-spectrum β-lactamase (ESBL) in 41% of E. coli isolates. The β-lactamase genotyping of E. coli isolates showed that 47% of isolates harbored either blaCTX or blaTEM. Approximately 32% of isolates were resistant to serum complement, and their growth in human urine was evident in 18% of isolates, indicating a possible infection of these isolates in high nitrogenous condition. Phylogrouping showed that the most prevalent phylogenetic group among fecal E. coli isolates was phylogroup B1 (57%), followed by phylogroups A (33%), D (6%), and B2 (4%). The most prevalent virulence-associated genes in fecal E. coli were fimH, iss and tatT. Results showed that ten isolates (5%) harbored the stx1 gene, the genetic marker of enterohemorrhagic E. coli. This study provides insights into the antibiotic resistance and virulence profiling of the fecal E. coli isolates from healthy cows. These results emphasize the need for imposing regulations on the proper use of antibiotics and growth promoters in food-producing animals