Leaders as the targets of workplace bullying - prevalence and outcomes.

PURPOSE: Bullying of leaders is an underexplored topic in organizational research. To fill this knowledge gap, the aims of this study were to determine the prevalence of bullying of leaders and to examine whether holding a formal leadership position influences the relationships between exposure to bullying and the outcomes job satisfaction and depression. METHODS: Data from two separate surveys were employed: (1) A cross-sectional occupation specific sample comprising 678 Norwegian child welfare social workers; (2) A nationally representative probability sample of 1,608 Norwegian employees with two time-points (6 months' time-lag). RESULTS: Analyzing multiple indicators of workplace bullying, holding a formal leadership position had no impact on the initial risk of being bullied. Analyses of prospective data showed that leaders report a somewhat stronger increase in levels of bullying over time compared to non-leaders, although the effect size was small. With exception of a small buffering effect on the cross-sectional association between exposure to bullying behaviors and job satisfaction in the second sample, holding a leadership position had no effect on the strength of the association between bullying and outcomes. CONCLUSION: The findings show that leaders have the same risk of being bullied and are influenced by bullying in roughly the same manner as non-leaders. Organizational measures and interventions against bullying should therefore consider leaders as a risk group in line with other employees.

Biodesulfurization of organosulfur compounds by a trehalose biosurfactant producing Gordonia sp. isolated from crude oil contaminated soil.

Certain factors hinder the commercialization of biodesulfurization process, including low substrate-specificity of the currently reported desulfurizing bacteria and restricted mass transfer of organic-sulfur compounds in biphasic systems. These obstacles must be addressed to clean organic-sulfur rich petro-fuels that pose serious environmental and health challenges. In current study, a dibenzothiophene desulfurizing strain, Gordonia rubripertincta W3S5 (source: oil contaminated soil) was systematically evaluated for its potential to remove sulfur from individual compounds and mixture of organic-sulfur compounds. Metabolic and genetic analyses confirmed that strain W3S5 desulfurized dibenzothiophene to 2-hydroxybiphenyl, suggesting that it follows the sulfur specific 4 S pathway. Furthermore, this strain demonstrated the ability to produce trehalose biosurfactants (with an EI24 of 53%) in the presence of dibenzothiophene, as confirmed by TLC and FTIR analyses. Various genome annotation tools, such as ClassicRAST, BlastKOALA, BV-BRC, and NCBI-PGAP, predicted the presence of otsA, otsB, treY, treZ, treP, and Trehalose-monomycolate lipid synthesis genes in the genomic pool of strain W3S5, confirming the existence of the OtsAB, TreYZ, and TreP pathways. Overall, these results underscore the potential of strain W3S5 as a valuable candidate for enhancing desulfurization efficiency and addressing the mass transfer challenges essential for achieving a scaled-up scenario.

A Case Series of Positional Variations in the Spine of Henle: A Surgical Conundrum.

The temporal bone is a complex anatomical space that houses the middle ear and its ossicles, as well as the inner ear, which includes the vestibule, cochlea, and the semicircular canals. Henle's spine, also known as the suprameatal spine/spina suprameatica/ is found to guide the lateral wall of the mastoid antrum [J Res Med Dent Sci 8(7):420-422, Stat-Pearls Publishing, Treasure Island. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559153/]. It is found that the Henle's spine is present in 85% of the human skulls and when present, it could be used as a reliable anatomical landmark for isolating various foramina during skull base surgeries [J Laryngol Otol 119:856-861], and to assess the location of handle of malleus and subsequently the mastoid antrum, in many cases. We present here 3 cases in which tympanoplasty was planned, and the position of spine of Henle was found to be anterosuperior and so was the handle of malleus. Antrostomy was done by following the spine of Henle in all cases to establish patency and maintain ventilation in the post-operative ear. These 3 cases had a much more anteriorly placed spine. Such cases need to be reported so that it creates a paradigm shift in the way that mastoid surgeries are being done. Any variation in the positioning of the spine of henle points to variability in the position of the mastoid antrum. This is extremely important while drilling the mastoid in the correct position and also to prevent drilling over the sigmoid sinus or the dura. To conclude, an anteriorly placed spine of Henle corresponds to anteriorly placed mastoid antrum.

Artificial Intelligence to Improve Antibiotic Prescribing: A Systematic Review.

Introduction: The use of antibiotics leads to antibiotic resistance (ABR). Different methods have been used to predict and control ABR. In recent years, artificial intelligence (AI) has been explored to improve antibiotic (AB) prescribing, and thereby control and reduce ABR. This review explores whether the use of AI can improve antibiotic prescribing for human patients. Methods: Observational studies that use AI to improve antibiotic prescribing were retrieved for this review. There were no restrictions on the time, setting or language. References of the included studies were checked for additional eligible studies. Two independent authors screened the studies for inclusion and assessed the risk of bias of the included studies using the National Institute of Health (NIH) Quality Assessment Tool for observational cohort studies. Results: Out of 3692 records, fifteen studies were eligible for full-text screening. Five studies were included in this review, and a narrative synthesis was carried out to assess their findings. All of the studies used supervised machine learning (ML) models as a subfield of AI, such as logistic regression, random forest, gradient boosting decision trees, support vector machines and K-nearest neighbours. Each study showed a positive contribution of ML in improving antibiotic prescribing, either by reducing antibiotic prescriptions or predicting inappropriate prescriptions. However, none of the studies reported the engagement of AB prescribers in developing their ML models, nor their feedback on the user-friendliness and reliability of the models in different healthcare settings. Conclusion: The use of ML methods may improve antibiotic prescribing in both primary and secondary settings. None of the studies evaluated the implementation process of their models in clinical practices. Prospero Registration: (CRD42022329049).

Untangling the complexity of heat shock protein 27 in cancer and metastasis.

Heat shock protein 27 is a type of molecular chaperone whose expression gets up-regulated due to reaction towards different stressful triggers including anticancer treatments. It is known to be a major player of resistance development in cancer cells, whereby cells are sheltered against the therapeutics that normally activate apoptosis. Heat shock protein 27 (HSP27) is one of the highly expressed proteins during various cellular insults and is a strong tumor survival factor. HSP27 influences various cellular pathways associated with cancer cell survival and growth such as apoptosis, autophagy, metastasis, angiogenesis, epithelial to mesenchymal transition, etc. HSP27 is molecular machinery which prevents the clumping of numerous substrates or client proteins which get mutated in cancer. It has been reported in several studies that targeting HSP27 is difficult because of its dynamic structure and absence of an ATP-binding site. Here, in this review, we have summarized different modulators of HSP27 and their mechanism of action as well. Effect of deregulated HSP27 in various cancer models, limitations of targeting HSP27, resistance against the conventional drugs generated due to the overexpression of HSP27, and measures to counteract this effect have also been discussed here in detail.

Collaboration to reduce antibiotic use and resistance and identify opportunities for improvement and awareness (CARA).

INTRODUCTION: CARA is a five-year Health Research Board (HRB) project. Superbugs cause resistant infections that are difficult to treat and pose a serious threat to human health. Providing tools to explore the prescription of antibiotics by GPs may help identify gaps where improvements can be made. CARA's aim is to combine, link and visualise data on infections, prescribing and other healthcare information. METHODS: The CARA team is creating a dashboard to provide GPs with a tool to visualise their own practice data and compare this with other GPs in Ireland. Anonymous patient data can be uploaded and visualised to show details, current trends and changes in infections and prescribing. The CARA platform will also provide easy options to generate audit reports. RESULTS: After registration, a tool for anonymous data upload will be provided. Through this uploader, data will be used to create instant graphs and overviews as well as comparisons with other GP practices. With selection options, graphical presentations can be further explored or audits generated. Currently, few GPs are involved in the development of the dashboard to ensure it will be efficient. Examples of the dashboard will be shown at the conference. DISCUSSION: The CARA project will provide GPs with a tool to access, analyse and understand their patient data. GPs will have secure accounts accessible through the CARA website to allow easy anonymous data upload in a few steps. The dashboard will show comparisons of their prescribing with other (unknown) practices, identify areas for improvement and conduct audit reports.

The Effectiveness of Interactive Dashboards to Optimise Antibiotic Prescribing in Primary Care: A Systematic Review.

Governments and healthcare organisations collect data on antibiotic prescribing (AP) for surveillance. This data can support tools for visualisations and feedback to GPs using dashboards that may prompt a change in prescribing behaviour. The objective of this systematic review was to assess the effectiveness of interactive dashboards to optimise AP in primary care. Six electronic databases were searched for relevant studies up to August 2022. A narrative synthesis of findings was conducted to evaluate the intervention processes and results. Two independent reviewers assessed the relevance, risk of bias and quality of the evidence. A total of ten studies were included (eight RCTs and two non-RCTs). Overall, seven studies showed a slight reduction in AP. However, this reduction in AP when offering a dashboard may not in itself result in reductions but only when combined with educational components, public commitment or behavioural strategies. Only one study recorded dashboard engagement and showed a difference of 10% (95% CI 5% to 15%) between intervention and control. None of the studies reported on the development, pilot or implementation of dashboards or the involvement of stakeholders in design and testing. Interactive dashboards may reduce AP in primary care but most likely only when combined with other educational or behavioural intervention strategies.

Exposure to Client-Perpetrated Violence in the Child Welfare Service: Prevalence and Outcomes Using Two Different Measurement Methods.

This study compared how two different measurement methods of client-perpetrated violence influence findings on prevalence rates and mental health outcomes in a probability sample of 660 Norwegian public sector child welfare workers. Using a single-item self-labeling approach, 15.4% reported exposure to physical violence, and 19.3% reported exposure to threats. Using a 15-item behavioral experience inventory, the prevalence rates ranged from 4.4% to 65.7%. A comparison of these methods uncovered a high number of false negatives when using the single-item approach as 62.2% of those who indicated that they had not experienced any workplace violence when answering the single-item questions reported being exposed 1 to 2 times when responding to the behavioral inventory. Results based on the behavioral inventory further revealed that the most frequently occurring actions in the child welfare service were direct and indirect forms of threats (24.5%-65.7%), while the least reported behaviors were threats and violence including objects (4.4.%-9.1%). Although client-perpetrated violence was significantly associated with mental health problems (e.g., symptoms of anxiety, depression, and post-traumatic stress [PTS]) for both assessment methods, the magnitude of the effect sizes differed from η2 = .000 to η2 = .121. These findings highlight that the use of different measurement methods for workplace violence has significant consequences for the assessment of prevalence rates, as well as on results of associated outcomes. Consequently, the decision on how to assess workplace violence has practical implications for uncovering how prominent the issue is, as well as the way in which this negative workplace exposure is subsequently addressed and counteracted. Therefore, both scholars and the child welfare service, and similar fields in which workplace violence frequently occurs, should take these findings into consideration for future assessments.

Workplace mistreatment and insomnia: a prospective study of child welfare workers.

OBJECTIVE: This study examines how workplace mistreatment relates to insomnia among child welfare workers. The main aim was to determine the impact of three different forms of mistreatment, namely client perpetrated violence, cyber harassment, and colleague perpetrated bullying, on changes in levels of insomnia over time. A secondary aim was to examine whether these three forms of mistreatment represent overlapping or distinct and unique phenomena. METHODS: The study was based on a probability sampled prospective survey of 424 Norwegian child welfare workers. Time lag between baseline and follow-up was six months. A confirmatory factor analysis determined the dimensionality of the indicators of mistreatment. TwoStep cluster analysis was used to examine patterns of exposure. Between and within group changes in insomnia was determined with linear regression analyses and repeated measures ANOVA. Dominance analysis was used to investigate the relative impact the predictor variables had on insomnia. RESULTS: Client perpetrated violence and colleague perpetrated bullying were associated with increased levels of insomnia over time. Exposure to bullying was established as the most prominent predictor. Client perpetrated violence, cyber harassment, and colleague perpetrated bullying represent unique and distinct constructs. Child welfare workers mainly report exposure to one form of mistreatment rather than a combination of different types. CONCLUSIONS: Client perpetrated violence and colleague perpetrated bullying were established as risk factors for insomnia among child welfare workers. Employers and human resource personnel should prioritize developing effective primary, secondary, and tertiary strategies to prevent and handle these hazards and thereby reduce the risk of insomnia among workers.

Our Experience with Nasolabial Flaps in Soft Tissue Reconstruction of Oral Malignancy; Feasible Option in Rural Set Up.

In this era of microvascular expertise, free flaps are the preferred option by reconstructive surgeons but has technical limitation in rural set up. Nasolabial flaps has been widely mentioned in literature for smaller defect reconstruction with minimal morbidity. It is a robust flap for soft tissue reconstruction in early stage lesion of oral cavity. We present a series of single stage oral cavity reconstruction using inferiorly based islanded nasolabial flaps in small to moderate soft tissue defects. This is a retrospective study which included biopsy proven 10 patients diagnosed with early stage oral cavity malignancy. All the patients underwent single stage islanded nasolabial flap for small to moderate oral defects. Follow up of all patients were recorded with respect to clinical photographs, mouth opening, tongue mobility, deglutition, speech and patient satisfaction. All operated patients had good functional outcome in terms of swallowing, speech and tongue mobility. All patients were satisfactory with the postoperative results. In early stage oral malignancy patients, this option justifies a reliable and cost effective approach. Inferiorly based islanded nasolabial flaps provides a single stage, safer, faster and reliable option for small to moderate oral cavity defects.

Correction: Haque et al. Marine Natural Products in Clinical Use. Mar. Drugs 2022, 20, 528.

The authors would like to make corrections to a recently published paper [...].

Type III Second Branchial Cleft Cyst: A Rare Presentation.

The second branchial cleft cyst (BCC) is the most common type of BCC. Bailey proposed a classification of the second BCC into four types, among which a Bailey type II cyst is the most common presenting lateral to the carotid space. A Bailey type III cyst, which extends between internal and external carotid arteries is an extremely rare occurrence. Complete surgical excision is the treatment modality of choice for branchial cysts and this warrants thorough imaging to see the detailed extent of the cyst. Contrast-enhanced computed tomography and Magnetic resonance imaging, both aid in diagnosis. Here we report a rare case of Type III second BCC, which presented with dysphagia, along with an elaboration of findings on imaging and treatment details.

Marine Natural Products in Clinical Use.

Marine natural products are potent and promising sources of drugs among other natural products of plant, animal, and microbial origin. To date, 20 drugs from marine sources are in clinical use. Most approved marine compounds are antineoplastic, but some are also used for chronic neuropathic pain, for heparin overdosage, as haptens and vaccine carriers, and for omega-3 fatty-acid supplementation in the diet. Marine drugs have diverse structural characteristics and mechanisms of action. A considerable increase in the number of marine drugs approved for clinical use has occurred in the past few decades, which may be attributed to increasing research on marine compounds in laboratories across the world. In the present manuscript, we comprehensively studied all marine drugs that have been successfully used in the clinic. Researchers and clinicians are hopeful to discover many more drugs, as a large number of marine natural compounds are being investigated in preclinical and clinical studies.

Molecular chaperones in DNA repair mechanisms: Role in genomic instability and proteostasis in cancer.

Cells are exposed to several environmental or chemical stressors that may cause DNA damage. DNA damage alters the normal functioning of the cell and contributes to several diseases, including cancer. Cells either induce DNA damage repair pathways or programmed cell death pathways to prevent disease formation depending on the severity of the stress and the damage caused. The DNA repair mechanisms are crucial to maintaining genome stability. During this adaptive response, the heat shock proteins (HSPs) are the key players. HSPs are overexpressed during genotoxic stress, but the role of different molecular players in the interaction between HSPs and DNA repair proteins is still poorly understood. As DNA damage promotes genomic instability and proteotoxic stress, modulating the protein quality control systems like the HSPs network could be a promising strategy for targeting disease pathologies associated with genomic instability, such as cancer. Hence, this review highlights the role of HSPs in DNA repair pathways. Further, the review also provides an outlook on the role of genomic instability and protein homeostasis in cancer, which is crucial to understanding the mechanisms behind its survival and developing novel targeted therapies.

Assessing Workplace Bullying and Its Outcomes: The Paradoxical Role of Perceived Power Imbalance Between Target and Perpetrator.

This study investigates the role of perceived power relation between target and perpetrator regarding victimization and turnover intent following exposure to bullying behavior at the workplace. We hypothesized that (1) targets of bullying behavior who self-label as victims experiences a larger power imbalance with the perpetrator compared to targets who do not self-label as victims, and (2) that the association between exposure to bullying behavior and intent to leave the job is stronger when there is power balance between target and perpetrator than when there is a power imbalance. The hypotheses were tested in a probability sample of employees working in the child welfare service in Oslo municipality, Norway, and that had been exposed to at least one instance of mistreatment from a colleague at their workplace (N = 374). Targets of bullying behavior whom self-labeled as victims reported a larger power imbalance with the perpetrator. Supporting the study hypothesis, and representing a reverse buffering effect, exposure to bullying behavior was most strongly associated with intent to leave among targets in power balance with the perpetrator. For targets in a perceived power imbalance, both low and high exposure to bullying behavior were associated with higher levels of intent to leave. These findings highlight the importance of implementing measures directed at preventing bullying and other forms of mistreatment, irrespective of the power relation between the two parties.

Public Health Interventions to Improve Antimicrobial Resistance Awareness and Behavioural Change Associated with Antimicrobial Use: A Systematic Review Exploring the Use of Social Media.

INTRODUCTION: Over the years there have been several interventions targeted at the public to increase their knowledge and awareness about Antimicrobial Resistance (AMR). In this work, we updated a previously published review by Price et al. (2018), on effectiveness of interventions to improve the public's antimicrobial resistance awareness and behaviours associated with prudent use of antimicrobials to identify which interventions work best in influencing public behaviour. METHODS: Five databases-Medline (OVID), CINAHL (EBSCO), Embase, PsycINFO, and Cochrane Central Register of Controlled Trials (CENTRAL-OVID)-were searched for AMR interventions between 2017 and 2021 targeting the public. All studies which had a before and after assessment of the intervention were considered for inclusion. RESULTS: In total, 17 studies were found to be eligible for inclusion in the review. Since there was a variety in the study interventions and in particular outcomes, a narrative synthesis approach was adopted for analysis. Whereas each study showed some impact on awareness and knowledge, none measured long-term impact on behaviours towards antibiotic use, awareness, or knowledge. Engagement was higher in interventions which included interactive elements such as games or videos. Social media was not used for recruitment of participants or as a mode of communication in any AMR interventions included in this review.

Crosstalk Between ROS and Autophagy in Tumorigenesis: Understanding the Multifaceted Paradox.

Cancer formation is a highly regulated and complex process, largely dependent on its microenvironment. This complexity highlights the need for developing novel target-based therapies depending on cancer phenotype and genotype. Autophagy, a catabolic process, removes damaged and defective cellular materials through lysosomes. It is activated in response to stress conditions such as nutrient deprivation, hypoxia, and oxidative stress. Oxidative stress is induced by excess reactive oxygen species (ROS) that are multifaceted molecules that drive several pathophysiological conditions, including cancer. Moreover, autophagy also plays a dual role, initially inhibiting tumor formation but promoting tumor progression during advanced stages. Mounting evidence has suggested an intricate crosstalk between autophagy and ROS where they can either suppress cancer formation or promote disease etiology. This review highlights the regulatory roles of autophagy and ROS from tumor induction to metastasis. We also discuss the therapeutic strategies that have been devised so far to combat cancer. Based on the review, we finally present some gap areas that could be targeted and may provide a basis for cancer suppression.

Validated Ossicular Measurements on High-Resolution Computed Tomography (CT) in Live and Cadaveric Temporal Bones.

Objective The present study was undertaken to study the utility of high-resolution computed tomography (HRCT) temporal bone in live patients for providing the parameters of ossicular dimensions (OD), using standard assessment protocols, devised by the authors, with regard to the plane of CT scans and axes of measurement of ossicles. Methods This observational study was conducted from January 2021 to February 2022 at Acharya Vinoba Bhave Rural Hospital, Sawanghi, Meghe, Maharashtra, India, in the Department of Otorhinolaryngology and Department of Radiodiagnosis. HRCT scan was performed on temporal bones, 10 in live subjects with no otological complaints and 10 in cadaveric temporal bones. HRCT was also performed for all three ossicles after dissecting them out from the respective cadaveric temporal bones. Measurements of OD were taken using Universalmednet Software and vernier calipers and compared with published anatomic data. Results The measurements taken using HRCT scans of the live subject and cadaveric bone as well as the ossicles taken using calipers fall within the range of published studies. Slight variation is seen in the measurements of stapes and incus, stapes total height is 3.17mm, less than 3.3. Conventional HRCT temporal bone in live patients when performed under set circumstances can be adopted as a standard method for measurement of ossicular sizes for the generation of normative data for different races, ethnicity and sex. Conclusion The results of our study can have implications in terms of translational research as the measurements obtained can help in better understanding of middle ear biomechanics, prosthesis designing, developing ideal tympanoplasty methods in terms of size, shape and placement of autograft.

Role of Zinc and Clinicopathological Factors for COVID-19-Associated Mucormycosis (CAM) in a Rural Hospital of Central India: A Case-Control Study.

Introduction Coronavirus disease 2019 (COVID-19)has been a difficult enemy to beat for healthcare professionals around the world. However, even before the end of the COVID-19 pandemic, there has been an emergence of a new combatant in the form of opportunistic fungal infections with a high rate of morbidity and mortality, creating havoc throughout the globe. Methods A case-control single-center study was conducted in Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra. All the subjects who were included in the study were tested positive for COVID-19 through the reverse transcriptase-polymerase chain reaction (RT-PCR) method and the cases were defined as patients with biopsy-proven mucormycosis, whereas control were subjects who did not develop mucormycosis. The duration of the study was three months, from June 2021 to August 2021. Result A total of 55 cases and 50 controls were enrolled in the study. The use of zinc was found to be significantly associated with COVID-19-associated mucormycosis, with 89.1% of the cases having a history of zinc intake and only 52% of controls having a history of zinc intake( p-value <0.001). Diabetes mellitus was found to be significantly associated with COVID-19-associated mucormycosis with 83.6% of the cases and 16% of the controls having diabetes mellitus (p-value <0.001). Although the use of steroids in cases was more with 98.2% of the cases and 54% of the control receiving steroids; this difference was not significant statistically (p-value of 1.00). Conclusion We conclude that apart from diabetes mellitus and other immunosuppressive states, zinc might be the hidden culprit behind the sudden surge of COVID-19-associated mucormycosis worldwide owing to the self-administration of zinc by the patients to acquire innate immunity and over-prescription of multivitamins by the treating clinicians. However, this association required further studies in order to be proved.

Effect of Exercises on Central and Endocrine System for Pain Modulation in Primary Dysmenorrhea.

Dysmenorrhea is the term for describing complex menstrual flow and painful spasmodic cramps during menstruation, and pain without any pathology is considered Primary Dysmenorrhea (PD). It is the most frequent ailment among women of all ages and races. The pain is dull and throbbing in character and occurs in the lower back and abdomen. Symptoms commonly appear 6 to 12 months after menarche, with the most significant incidence in the late teen and early twenties. Physical exercise is nearly a new non-medical intervention to relieve PD associated pain. Aerobics, stretching and Resistive exercises for 8-12 weeks, either supervised or unsupervised, relieves pain. Exercises are believed to cause hormonal changes in the uterine lining, which reduces PD symptoms. Researchers have presumed different pain-relieving methods, ranging from non-opioids to opioids to hormonal for variations in pain sensitivity. Exercise-induced analgesia provides the central pathway as the primary mechanism for pain reduction while, another way to reducing pain in PD may be a hormonal interaction. The hormonal changes causing exercise-induced pain modulation during the menstruation cycle is not clearly understood and the interaction and activation of all the central and endocrine components, which is a complex mechanism, is also not explained clearly. This study briefly reviews the physiological mechanism of Exercise-induced analgesia and its potent roles in controlling the pathogenesis of PD for pain relief.