Neonatal hyperbilirubinemia in infants with G6PD c563C \u3e T variant

Background: There is a strong correlation between glucose-6-phosphate dehydrogenase (G6PD) deficiency and neonatal hyperbilirubinemia with a rare but potential threat of devastating acute bilirubin encephalopathy. G6PD deficiency was observed in 4–14% of hospitalized icteric neonates in Pakistan. G6PD c.563C \u3e T is the most frequently reported variant in this population. The present study was aimed at evaluating the time to onset of hyperbilirubinemia and the postnatal bilirubin trajectory in infants having G6PD c.563C \u3e T. Methods: This was a case–control study conducted at The Aga Khan University, Pakistan during the year 2008. We studied 216 icteric male neonates who were re-admitted for phototherapy during the study period. No selection was exercised. Medical records showed that 32 were G6PD deficient while 184 were G6PD normal. Each infant was studied for birth weight, gestational age, age at the time of presentation, presence of cephalhematoma, sepsis and neurological signs, peak bilirubin level, age at peak bilirubin level, days of hospitalization, whether phototherapy or exchange blood transfusion was initiated, and the outcome. During hospital stay, each baby was tested for complete blood count, reticulocyte count, ABO and Rh blood type, direct antiglobulin test and quantitative G6PD estimation [by kinetic determination of G6PDH]. G6PDgenotype was analyzed in 32 deficient infants through PCR-RFLP analysis and gene sequencing. Results: G6PD variants c.563C \u3e T and c.131 C \u3e G were observed in 21 (65%) and three (9%) of the 32 G6PD deficient infants, respectively. DNA of eight (25%) newborns remained uncharacterized. In contrast to G6PD normal neonates, infants with c.563C \u3e T variant had significantly lower enzyme activity (mean ± 1SD; 0.3±0.2 U/gHb vs. 14.0±4.5 U/gHb, p\u3c0.001) experienced higher peak levels of total serum bilirubin (mean ± 1SD; 16.8±5.4 mg/dl vs. 13.8±4.6 mg/dl, p=0.008) which peaked earlier after birth (mean ± 1SD 2.9±1.6 vs. 4.3±2.3 days, p=0.007). No statistically significant difference was observed in mean weight, age at presentation, hemoglobin, reticulocyte count, TSH level, hospital stay or in the frequency of initiation of phototherapy or blood exchange between the two groups. Conclusions: We concluded that infants with G6PD c.563C \u3e T variant developed jaundice earlier than infants with normal G6PD enzyme levels. Compared to G6PD normal infants, G6PD c.563C \u3e T carrying infants had significantly low G6PD activity

Positioning Depression as a Critical Factor in Creating a Toxic Workplace Environment for Diminishing Worker Productivity

This study determined how a toxic workplace environment can influence worker productivity, directly and indirectly, using work depression as a mediating variable. A toxic workplace environment with multiple dimensions (harassment, bullying, ostracism, and incivility) was used in this study. We used a questionnaire survey approach to evaluate the data. A total of 53 items were used in the questionnaire with a five-point Likert scale. The data were collected from 23 branches of five Chinese banks in the vicinity of Shanghai. The authors distributed 250 questionnaires among targeted employees (senior managers, middle managers, and administrative staff) and received 186 filled questionnaires, among which six were incomplete. Thus, the completed sample size of the research was 180, and the overall response rate was 72%. To estimate the proposed relationships in the research model, we used partial least-squares structural equation modeling (PLS-SEM 3.2). The outcomes of this study indicate that for direct and indirect relationships, a toxic workplace environment negatively influences worker productivity. Moreover, the outcomes of this study also show that work depression negatively impacts worker productivity. The study concludes with a discussion, limitations, and future research directions

CUSTOMERS TRUST PROPENSITY: MEDIATING EFFECT OF SALESPERSONS CHARACTERISTICS: Rameesha Maqbool, Dr. Amna Noor, Dr. Kaneez Fatima, Suheera Khalid, Nabeeha Maqbool

With the ongoing changes in the way buyer and seller communicate, organizations are concentrating on continuously improving their sales strategies. This study revolves around the basic concept of trust between buyer and seller. Much research is available on how the buyer-seller interaction can be improved but less research is available on how the past experiences of buyers or propensity to trust salespeople effect such relationship. Thus, this research mostly concentrates on these variables. The data for this research was collected in the form of questionnaires from both customers and salespeople. The data was tested through a Multi-Level Model in SPSS. The results from this research specify that the past experiences of customers and their propensity to trust salespeople has an extensive impact on the formation of trust between the buyer and seller. Furthermore, this study concludes that certain salespersons characteristics impact the relationship between the buyer and seller

Public, health professional and legislator perspectives on the concept of psychiatric disease : a population-based survey

Objective To assess which mental health-related states of being are perceived as diseases by psychiatrists, non-psychiatric physicians, nurses, parliament members and laypeople. Design and setting A population-based, mailed survey in Finland. Participants Respondents from a random sample of 3000 laypeople, 1500 physicians, 1500 nurses and all 200 members of the parliament (MPs) of Finland. Primary outcome measures Respondents' perspectives on 20 mental health-related states of being as diseases, measuring the extent of agreement with the claim: '[This state of being] is a disease'. Results Of the 6200 people approached, we received 3259 eligible responses (53%). Two conditions (schizophrenia and autism) were considered to be diseases by at least 75% and two states (grief and homosexuality) were considered not to be diseases by at least 75% in each group. A majority (at least 50% in each group) considered seven states as diseases (anorexia, attention deficit hyperactivity disorder, bulimia, depression, generalised anxiety disorder, panic disorder and personality disorder) and three not to be diseases (absence of sexual desire, premature ejaculation and transsexualism). In six states, there was a wide divergence of opinion (alcoholism, drug addiction, gambling addiction, insomnia, social anxiety disorder and work exhaustion). Psychiatrists were significantly more inclined to considering states of being as diseases relative to other groups, followed by non-psychiatric physicians, nurses, MPs and laypeople. Conclusions Respondents agreed that some conditions, such as schizophrenia and autism, are diseases and other states, such as grief and homosexuality, are not; for others, there was considerable disagreement. Psychiatrists are more inclined to consider mental health-related states of being as diseases compared with other physicians, who, in turn, are more inclined than other constituencies. Understanding notions of disease may underlie important debates in public policy and practice in areas of mental health and behaviour, and have implications for resource allocation and stigma.Peer reviewe

Measuring and restructuring the risk in forecasting drought classes: An application of weighted Markov chain based model for standardised precipitation evapotranspiration index (SPEI) at one-month time scale

Drought monitoring and forecasting play a vital role in making drought mitigation policies. In previous research, several drought monitoring tools based on the probabilistic models have been developed for precise and accurate inferences of drought severity and its effects. However, the risk of inaccurate determination of drought classes always exists in probabilistic models. The aim of this paper is to reconnaissance the advantage of the weighted Markov chain (WMC) model to accommodate the erroneous drought classes in the monthly classifications of drought. It was assumed that to increase the precision in drought prediction, the role of standardised self-correlation coefficients as weight may incorporate to establish and restructure the accurate probabilities of risk for incoming expected drought classes in the WMC framework. Consequently, the current research is based on the experimental findings of seventeen meteorological stations located in the Northern Areas of Pakistan. In this study, the standardised precipitation evapotranspiration index (SPEI) at a 1-month time scale based drought monitoring approach is applied to quantify the historical classification of drought conditions. The exploratory analysis shows that the proportion of each drought class varies from zone to zone. However, a high proportion of near-normal drought classes has been observed in all the stations. For the prediction of future drought classes, transition probability matrices have been computed using R statistical software. Our findings show that the probability of occurrences of near-normal is very high. Overall, the results associated with this study show that the WMC method for drought forecasting is sufficiently flexible to incorporate the change of drought conditions; it may change both the transition probability matrix and the autocorrelation structure