From crisis to responsibility: The role of industry type, leadership style, and regulatory environment in shaping post-COVID-19 CSR initiative

Corporate social responsibility (CSR) is a major concern in modern industries. Chinese industries are growing rapidly and delivering products and services to the market. The Covid-19 pandemic has changed the working style of every type of industry. The objective of this research was to determine the influence of leadership style and industry type on the regulatory environment. This research also aims to determine the impact of the regulatory environment on CSR from the perspective of Chinese industries. Data based on a sample size of 599 was used for data analysis, and Smart PLS 3.0 was used for the results of measurement model assessment and structural model assessment. This study highlighted that industry type and leadership style have a significant positive impact on the regulatory environment and CSR. The framework of this research is based on the identified research gap, and the findings of this study are significant for Chinese policymakers. Furthermore, the research also asserted practical implications that are reliable to advance practices in the regulatory environment and achieve CSR by Chinese firms. This study has several limitations that are required to be significantly addressed for the sustainability of organizations.

Investigating silent pauses in connected speech: integrating linguistic, neuropsychological, and neuroanatomical perspectives across narrative tasks in post-stroke aphasia

Introduction

Silent pauses are regarded as integral components of the temporal organization of speech. However, it has also been hypothesized that they serve as markers for internal cognitive processes, including word access, monitoring, planning, and memory functions. Although existing evidence across various pathological populations underscores the importance of investigating silent pauses' characteristics, particularly in terms of frequency and duration, there is a scarcity of data within the domain of post-stroke aphasia.

Methods

The primary objective of the present study is to scrutinize the frequency and duration of silent pauses in two distinct narrative tasks within a cohort of 32 patients with chronic post-stroke aphasia, in comparison with a control group of healthy speakers. Subsequently, we investigate potential correlation patterns between silent pause measures, i.e., frequency and duration, across the two narrative tasks within the patient group, their performance in neuropsychological assessments, and lesion data.

Results

Our findings showed that patients exhibited a higher frequency of longer-duration pauses in both narrative tasks compared to healthy speakers. Furthermore, within-group comparisons revealed that patients tended to pause more frequently and for longer durations in the picture description task, while healthy participants exhibited the opposite trend. With regard to our second research question, a marginally significant interaction emerged between performance in semantic verbal fluency and the narrative task, in relation to the location of silent pauses-whether between or within clauses-predicting the duration of silent pauses in the patient group. However, no significant results were observed for the frequency of silent pauses. Lastly, our study identified that the duration of silent pauses could be predicted by distinct Regions of Interest (ROIs) in spared tissue within the left hemisphere, as a function of the narrative task.

Discussion

Overall, this study follows an integrative approach of linguistic, neuropsychological and neuroanatomical data to define silent pauses in connected speech, and illustrates interrelations between cognitive components, temporal aspects of speech, and anatomical indices, while it further highlights the importance of studying connected speech indices using different narrative tasks.

The CSR perspective: Interplay of technological innovation, ethical leadership and government regulations for sustainable financial performance

The financial performance of Chinese public and private sector banks is changing over time. There is no stability in the financial performance of Chinese banks which hurts businesses and the market. The purpose of current research was to determine the influence of corporate social responsibility (CSR) on driving the sustainable financial performance of Chinese banks. From methodological perspective, data was collected from 329 banking sector employees from China to partial least square-structural equation model (PLS-SEM) is employed for data analysis. The research used SPSS 24 and Smart PLS 4 as statistical analysis tools. This research confirmed that achieving sustainability in financial performance for Chinese banks can be achieved with CSR influenced by technological innovation, ethical leadership, and government regulations. This research has statistically confirmed that transformational leadership leading to CSR with technological innovation, ethical leadership, and government regulations can make significant improvements in financial performance. The framework developed by current research is a novel contribution to the literature. The findings of this research improve the literature on the banking sector and advanced performance. Furthermore, this research has highlighted significant ways that can help the banking sector employees to improve their financial performance with sustainability.

Newer teaching-learning methods and assessment modules in anaesthesia education

The National Medical Commission in its recent guidelines has stated that postgraduate training in anaesthesiology should have clear objectives and be competency based. This means that the existing teaching–learning (TL) methods need a major face-lift. E-learning and blended learning including learning management systems, virtual classrooms, app-based learning, flipped classroom, podcasts, webinars, web-based collaborative education, reflective feedback, problem-based discussions and mentorship are some newer TL methods that can be adopted. Simulation can help teach technical and non-technical skills such as leadership, teamwork and communication. In line with TL methods, newer assessment methods have to be applied to revolutionise postgraduate anaesthesia education. Formative assessment and assessment of clinical skills are important and to do this, workplace-based assessment methods such as mini-clinical evaluation exercise, direct observation of procedural skills, multisource feedback, logbook and E-portfolio can be applied. Objective structured clinical examination, simulation-based assessment and E-assessment are other useful evaluation methods.

Swallowed toothbrush: Case series

Toothbrush swallowing is rare, and most cases are seen in young women with anorexia nervosa or bulimia or associated with mental retardation or schizophrenia. Prompt removal is recommended because no cases of spontaneous passage have been reported. There is no previously reported case series on swallowed toothbrush in mentally normal young men. Here, we report three cases of swallowed toothbrush found in the esophagus and stomach on endoscopy. In our case series, successful removal of the toothbrush was done without endotracheal intubation or over tube, without any complications. To our knowledge, this is the first documented case series of swallowed toothbrush managed successfully endoscopically.

Rapid detection of infectious bursal disease by loop-mediated isothermal amplification for field analysis

Infectious bursal disease (IBD) is an immunosuppressive, acute and highly contagious illness of growing-poultry stock infected with infectious bursal disease virus (IBDV). It is common in Pakistan, causing potential economic losses throughout the year. The objective of the study is to propose a rapid, sensitive and specific diagnostic tool, and compare it with existing commonly used reverse transcriptase polymerase chain reaction (RT-PCR) method for IBDV. Different primers were used for RT-PCR and reverse transcriptase loop-mediated isothermal amplification (RT-LAMP) to target the IBD virus. RT-LAMP primers showed prodigious specificity without cross reaction to the other animal pathogens. Moreover, RT-LAMP was found to have 10 times higher selectivity for IBDV identification as compared to RT-PCR. RT-LAMP detected 9.2% more field samples than RT-PCR. Sequences of PCR products were determined and phylogenetic analysis of research isolates revealed its maximum similarity with indigenous and Indian IBDV isolates. RT-LAMP was found to be simple, specific, less laborious and a better technique as compared to RT-PCR for quick analysis. In general, RT-LAMP was declared positive on observing turbidity or adding fluorescence staining reagent such as SYBR Green I. The options of direct use of field sample homogenate and viewing directly the peaks in the graph shown on a monitor/laptop have made it much more convenient and time saving than gel based RT-PCR.

Anaesthesiologist and social media: Walking the fine line

Social media use is pervasive in society and has been rapidly amalgamated into the lives of anaesthesiologists. Using social media as an educational resource and ensuring an appropriate online presence is essential for professional growth. However, there are huge lacunae in editorial responsibility, peer review, and accountability of educational content on social media networks. The anaesthesiologist needs to be aware of the numerous shortcomings and must use social media responsibly. Following etiquettes, adopting a code of conduct and a high sense of professionalism is expected from the anaesthesiologist while posting on social media. Anaesthesiologists need to decide on their social media goals, like interaction with colleagues, continuing medical education or patient education, and then register for social media accounts accordingly. The need of the hour is comprehensive social media guidelines for anaesthesiologists, endorsed by institutions, societies, and professional health-care associations in India.

Core competencies for UK occupational health nurses: a Delphi study

Background

Occupational health nurses (OHNs) play a pivotal role in the delivery of occupational health (OH) services. Specific competency guidance has been developed in a number of countries, including the UK. While it is acknowledged that UK OHN practice has evolved in recent years, there has been no formal research to capture these developments to ensure that training and curricula remain up-to-date and reflect current practice.

Aims

To identify current priorities among UK OHNs of the competencies required for OH practice.

Methods

A modified Delphi study undertaken among representative OHN networks in the UK. This formed part of a larger study including UK and international occupational physicians. The study was conducted in two rounds using a questionnaire based on available guidance on training competencies for OH practice, the published literature, expert panel reviews and conference discussions.

Results

Consensus among OHNs was high with 7 out of the 12 domains scoring 100% in rating. 'Good clinical care' was the principal domain ranked most important, followed by 'general principles of assessment & management of occupational hazards to health'. 'Research methods' and 'teaching & educational supervision' were considered least important.

Conclusions

This study has established UK OHNs' current priorities on the competencies required for OH practice. The timing of this paper is opportune with the formal launch of the Faculty of Occupational Health Nursing planned in 2018 and should inform the development of competency requirements as part of the Faculty's goals for standard setting in OHN education and training.

Recanalization of TIPSS via transsplenic puncture

Transjugular intrahepatic portosystemic shunt (TIPSS) has important role in the management of Budd-Chiari syndrome (BCS). Stent dysfunction rate up to 80% at 2 years limits the use of TIPSS. Reintervention is required if shunt develops occlusion or stenosis. Different techniques have been reported for the catheterization of TIPSS in cases of an occluded stent. In those failing a standard transvenous approach, the Colapinto needle technique, a combined transvenous transhepatic approach or transplenic approaches have been described. Here, we report our experience in a challenging TIPSS recanalization using a transsplenic approach.

Anesthetic management for lobectomy of a 2-month-old infant with bronchogenic cyst: Case report along with review of literature

Bronchogenic cyst, a benign congenital cystic lesion of the lung, is a rare cause of respiratory distress in children comprising 7.5% of all mediastinal masses. A thorough preoperative evaluation is crucial to plan for definitive intra- and post-operative management. All patients should be thoroughly evaluated for the presence of compression, deviation or distortion of airways and great veins. The easiest means of providing one lung ventilation in pediatrics is to intubate the main stem bronchus of the nonoperated lung. Other options available for pediatric one lung ventilation are single lumen endobronchial tubes, micro cuff tubes, Marraro bilumen tubes, and bronchial blockers. We hereby present a case report of a 2-month-old infant posted for excision of bronchogenic cyst along with a review of literature.

Cardiopulmonary Resuscitation: Evaluation of Knowledge, Efficacy, and Retention in Young Doctors Joining Postgraduation Program

Background:

High-quality cardiopulmonary resuscitation (CPR) and rapid defibrillation the cornerstone for resuscitation from cardiac arrest and increase the incidence of return of spontaneous circulation. Regular CPR training imparted to health-care personnel increases knowledge and helps in skill enhancing.

Aims:

The aim of this study is to evaluate background knowledge, percentage improvement in the skills, and residual knowledge after a period of 6 months of postgraduate (PG) students as well as the efficacy of the designed teaching program for CPR.

Design:

The study type was interventional, nonrandomized with end point classification as efficacy study. Study Interventional model was single group assignment.

Methods:

A questionnaire-based study was conducted on 41 first year PG students. Their educational qualification was Bachelor of Medicine and Bachelor of Surgery. The study was conducted; 3 months after, these PG students joined hospital for their PG studies. The questionnaire designed by the Department of Anesthesiology and Critical Care was given as the pretest (before the CPR training program was initiated), posttest (immediately after the CPR training program was concluded), and residual knowledge test (conducted after 6 months of the CPR training program). After collection of data, a descriptive analysis was performed to evaluate results.

Statistical Analysis:

Statistical analysis was conducted for determining the test of significance using two-tailed, paired t-test.

Results:

The average overall score was 25.58 (±5.605) marks out of a maximum of 40 marks in the pretest, i.e., 63.97%. It improved to 33.88 (±3.38) marks in posttest, i.e., 84.74%. After 6 months in the residual knowledge test, the score declined to 26.96 (±6.09) marks, i.e., 67.4%.

Conclusion:

The CPR training program being conducted was adequately efficacious, but a refresher course after 6 months could help taking the knowledge and skills acquired by our PG students a long way.

MRI Determination of Conus Medullaris Level in an Adult Population in Turkey

The level of the conus medullaris (CM) in adults has been described in many studies with cadavers and living people. T1-weighted sagittal spin-echo MR images of the lumbar spine were reviewed in 364 consecutive patients (207 women, 157 men) with a mean age of 45 years (range 18–80). The most common level of CM was the L1-L2 intervertebral disc level in females and the T12-L1 intervertebral disc level in males. The distribution of CM location in a large adult population was shown to range from the T11-T12 intervertebral disc level to L2-L3 intervertebral disc level.

Comparative Evaluation of Smear Layer and Debris on the Canal Walls prepared with a Combination of Hand and Rotary ProTaper Technique using Scanning Electron Microscope

INTRODUCTION

The effect of smear layer and debris on the success rate of endodontic treatment has not yet been definitely determined. So the present study was aimed to evaluate the amount of smear layer and debris on the canal walls prepared with a combination of hand and rotary ProTaper technique using NaOCl and ethylenediaminetetraacetic acid (EDTA) alternately as root canal irrigants using scanning electron microscope (SEM).

MATERIALS AND METHODS

Eighty intact freshly extracted human permanent mandibular premolar teeth were collected and randomly divided equally into four groups. In group I canals were prepared with hand K-Flexofiles; group II with rotary ProTaper instruments; group III with rotary ProTaper instruments and final instrumentation was done with hand K-Flexofile; group IV with rotary ProTaper instruments and final instrumentation was done with RC-Prep and irrigated with 1 mL of normal saline. In all groups canals were irrigated using NaOCl and EDTA alternately. After instrumentation, the teeth were prepared for SEM examination using five-score indices for debris and smear layer at coronal, middle, and apical third levels. Statistical analysis was performed using chi-square test (p < 0.05) and Kruskal-Wallis test (p < 0.05).

RESULTS

Statistically significant difference was observed between the groups in cleaning the apical third. Groups I and III showed better canal cleanliness compared to group II. The use of EDTA and NaOCl in group III was more effective in removing debris and smear layer compared to EDTA and normal saline in group IV. Regardless of the instrumentation technique employed and the irrigant used, the cleaning ability decreased in the apical third, resulting in higher debris and smear layer scores compared to coronal and middle third levels.

CONCLUSION

None of the instrumentation techniques in the present study could completely eliminate the smear layer and debris from the canal walls. Instrumentation of the canals with hand files after automated rotary preparation could result in cleaner canal walls.

CLINICAL SIGNIFICANCE

Alternate irrigation with NaOCl and EDTA is effective in the removal of debris and smear layer in the coronal and middle level, but the effectiveness in the apical third is less.

A comparative study on effect of addition of clonidine and fentanyl as adjuvants to local anaesthetics for subarachnoid block in patients undergoing lumbar laminectomies

Background:

The synergism between local anesthetic agents such as bupivacaine with intrathecal adjuvants such as opioids and clonidine is well established.

Aims:

This study evaluates the clinical efficacy of clonidine75 μg versus fentanyl 25 μg as adjuvants to bupivacaine for spinal anesthesia.

Settings and Design:

A prospective, randomized, parallel arm study was conducted over a period of 12 months in a tertiary care hospital.

Materials and Methods:

Sixty patients were divided randomly into two groups, Group C and Group F. Patients in Group C received 2.5 ml of 0.5% bupivacaine heavy mixed with 0.5 ml (75 μg) clonidine intrathecally, and patients in Group F received 2.5 ml of 0.5% bupivacaine heavy mixed with 0.5 ml (25 μg) fentanyl intrathecally.

Statistical Analysis:

Data were analyzed using statistical tests for comparison of means.

Results:

The mean durations of sensory block was 253.3 and 249.6 minutes in group C and group F respectively, which was statistically not significant (P = 0.76). The mean durations of motor block were 302.3 and 293.6 min, respectively, in Group C and Group F, which were also statistically not significant (P = 0.53). The mean durations of postoperative analgesia were 653.4 and 611.2 min, respectively, in Group C and Group F, which were statistically not significant (P = 0.09). Mean heart rate after 10 min was 82.5 in Group C and 87.2 in Group F, which was statistically not significant (P = 0.29), and mean arterial pressure in mmHg after 10 min was 96.3 in Group C and 97.3 in Group F, which was also statistically not significant (P = 0.86).

Conclusion:

Both clonidine 75 μg and fentanyl 25 μg when used as adjuvants to bupivacaine in the subarachnoid block have comparable beneficial results in terms of duration of analgesia, duration of motor blocks, and hemodynamic stability and also have a comparable incidence of complications.

Assessment of Toxicity, Antifeedant Activity, and Biochemical Responses in Stored-Grain Insects Exposed to Lethal and Sublethal Doses of Gaultheria procumbens L. Essential Oil

The present study was undertaken to investigate the insecticidal activity of chemically characterized Gaultheria procumbens essential oil (EO) and its mode of action against the Coleopteran insects Sitophilus oryzae and Rhyzopertha dominica. Gas chromatography-mass spectrometry results depicted methyl salicylate (MS) as the major compound (96.61%) of EO. EO and its major compound methyl salicylate (MS) showed 100% mortality at 150 and 5.0 μL/L air against S. oryzae and R. dominica, respectively, on 24 h of exposure. The in vivo percent inhibition of AChE activity ranged between 6.12 and 27.50%. In addition, changes in the antioxidative defense system, superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH), and oxidized glutathione (GSSG), in test insects were estimated. A significant dose-dependent response in all test parameters was observed. The results demonstrated that G. procumbens EO could play a significant role in the formulation of EO-based insecticides for the management of stored-grain insects.

A comparative study of complications and long term outcomes of Surgical Tracheostomy and two techniques of Percutaneous Tracheostomy

Context:

The operative technique for surgical tracheostomy has remained unchanged, but different techniques for percutaneous tracheostomy have evolved due to interest in minimally invasive procedures for the critically ill patient.

Aims:

To compare the periprocedural complications and long term outcomes of bedside surgical tracheostomy (ST) with two percutaneous tracheostomy (PCT) techniques, namely serial guide wire dilating forceps (GWDF) and PercuTwist (PT).

Settings and Design:

This prospective observational study was carried out in ICU of a tertiary referral centre over three year period on adult intubated patients needing elective tracheostomy.

Materials and Methods:

Patients with anticipated difficult neck anatomy were assigned for ST based on discretion of intensivist. Patients included for PCT were randomly assigned to the GWDT and PT technique. 90 patients underwent either bedside ST (n = 30), PCT by GWDF technique (n = 30) or PCT with PercuTwist (n = 30) and were followed up with fibreoptic bronchoscopy monthly for 06 months.

Statistical Analysis Used:

Data was analyzed by applying chi square tests for categorical variables.

Results:

Periprocedural complications during PCT included major bleeding (>100ml) in two patients in GWDF group which required conversion to ST. Periprocedural bleeding was also the main complication in ST. Increased incidence of granulation tissue and tracheal narrowing in long term was seen in both ST and PCT groups. All of the P values analysed for the intra operative, post operative complications or long term outcomes were >0.05.

Conclusions:

There was no statistically significant difference in incidence of complications of ST and two techniques of PCT. Proper case selection makes PCT as safe as ST.

Stroke and aphasia quality of life scale in Kannada-evaluation of reliability, validity and internal consistency

Background:

Quality of life (QoL) dwells in a person's overall well-being. Recently, QoL measures have become critical and relevant in stroke survivors. Instruments measuring QoL of individuals with aphasia are apparently rare in the Indian context. The present study aimed to develop a Kannada instrument to measure the QoL of people with aphasia. Study objectives were to validate Stroke and aphasia quality of life-39 (SAQOL-39) into Kannada, to measure test–retest reliability and internal consistency.

Materials and Methods:

The original English instrument was modified considering socio-cultural differences among native English and Kannada speakers. Cross-linguistic adaptation of SAQOL-39 into Kannada was carried out through forward–backward translation scheme. The scale was administered on 32 people from Karnataka (a state in India) having aphasia. For a direct understanding of the subject's QoL, scores were categorized into QoL severity levels. Item reliability of the Kannada version was examined by measuring Cronbach's alpha. Test–retest reliability was examined by calculating the intraclass correlation coefficient (ICC).

Results:

Kannada SAQOL-39 showed good acceptability with minimum missing data and excellent test–retest reliability (ICC = 0.8). Value of Cronbach's α observed for four items modified in the original version was 0.9 each and the mean α of all Kannada items was 0.9, demonstrating high internal consistency.

Conclusions:

The present study offers a valid, reliable tool to measure QoL in Kannada-speaking individuals with aphasia. This tool is useful in a cross-center, cross-national comparison of QoL data from people with aphasia. This instrument also permits direct translation into other Indian languages as the items are culturally validated to the Indian population. This study promotes future research using the Kannada SAQOL-39.

Posterior tracheal wall leading to life-threatening obstruction of tracheostomy tube

This is a case report of a 28-year-old male patient with severe traumatic brain injury and Glasgow coma scale score = 8: E2 M5 V_T, who required a tracheotomy for airway protection. On day 5, a surgical tracheotomy was performed with size 8 tracheotomy tube (TT). On the 4^th day of post-tracheostomy, he developed a sudden onset respiratory distress while on T-piece. Immediate fiber optic bronchoscopy revealed almost a complete closure of TT due to posterior tracheal wall indrawing into the TT with every inspiratory effort.