Background During the last six decades, extensive use of antibiotics has selected resistant strains, increasing the rate of fatal infectious diseases, and exerting an economic burden on society. This situation is widely accepted as a global problem, yet its degree is not well elucidated in many regions of the world. Up till now, no systemic analysis of Antimicrobial resistance (AMR) in Pakistan has been published. The current study aims to describe the antibiotic-resistance scenario of Pakistan from human samples of the last 10 y, to find the gaps in surveillances and methodology and recommendations for researchers and prescribers founded on these outcomes. Methods Original research articles analyzed the pattern of Antibiotic resistance of any World Health Organization (WHO) enlisted priority pathogens in Pakistan (published onward 2009 till March 2020), were collected from PubMed, Google scholar, and PakMedi Net search engines. These articles were selected based on predefined inclusion and exclusion criteria. Data about the study characteristics and antibiotic-resistance for a given bacterium were excluded from literature. Antibiotic resistance to a particular bacterium was calculated as a median resistance with 95% Confidence Interval (CI). Results Studies published in the last 10 y showed that Urinary Tract Infection (UTI) is the most reported clinical diagnosis (16.1%) in Pakistan. E. coli were reported in 28 (30.11%) studies showing high resistance to antibiotics’ first line. Methicillin-resistant Staphylococcus aureus (MRSA) was found in 49% of S. aureus’ total reported cases. Phenotypic resistance pattern has mostly been evaluated by Disk Diffusion Method (DDM) (82.8%), taken Clinical Laboratory Standards Institute (CLSI) as a breakpoint reference guideline (in 79.6% studies). Only 28 (30.11%) studies have made molecular identification of the resistance gene. blaTEM (78.94% in Shigella spp) and blaNDM-1 (32.75% in Klebsiella spp) are the prominent reported resistant genes followed by VanA (45.53% in Enterococcus spp), mcr-1 (1.61% in Acinetobacter spp), and blaKPC-2 (31.67% in E. coli). Most of the studies were from Sindh (40.86%), followed by Punjab (35.48%), while Baluchistan’s AMR data was not available. Conclusion Outcomes of our study emphasize that most of the pathogens show high resistance to commonly used antibiotics; also, we find gaps in surveillances and breaches in methodological data. Based on these findings, we recommend the regularization of surveillance practice and precise actions to combat the region’s AMR.
While it is well known that individual integrins are critical mediators of cell behavior, recent work has shown that when multiple types of integrins simultaneously engage the ECM, cell functions are enhanced. However, it is not known how integrins spatially coordinate to regulate cell adhesion because no reliable method exists to segregate integrins on the cell membrane. Here, we use a microcontact printing-based strategy to pattern multiple ECMs that bind distinct integrins in order to study how integrins might interact. In our technique, proteins are first adsorbed uniformly to a poly(dimethyl siloxane) stamp, and then selectively “de-inked.” Our strategy overcomes several inherent limitations of conventional microcontact printing, including stamp collapse and limited functionality of the surface patterns. We show that integrins spatially segregate on surfaces patterned with multiple ECMs, as expected. Interestingly, despite spatial segregation of distinct integrins, cells could form adhesions and migrate across multicomponent surfaces as well as they do on single component surfaces. Together, our data indicate that although cells can segregate individual integrins on the cell surface to mediate ECM-specific binding, integrins function cooperatively to guide cell adhesion and migration.
PurposeThis paper aims to present the development of a knowledge-based system (KBS) to support the implementation of Lean Six Sigma (L6s) principles applied to enhance quality management (QM) performance within a health-care environment. Design/methodology/approachThe process of KBS building has been started by acquiring knowledge from experts in field of L6σ and QM in health care. The acquired knowledge has been represented in a rule-based approach for capturing L6σ practices. These rules are produced in IF […].THEN way where IF is the premise and THEN is the action. The produced rules have been integrated with gauging absence pre-requisites (GAP) technique to facilitate benchmarking of best practice in a health-care environment. A comprehensive review of the structure of the system is given, detailing a typical output of the KBS. FindingsImplementation of L6s principles to enhance QM performance in a health-care environment requires a pre-assessment of the organisation’s competences. The KBS provides an enhanced strategic and operational decision-making hierarchy for achieving a performance benchmark. Research limitations/implicationsThe KBS needs validation in real health-care environment, which will be done in Oman’s hospitals. Practical implicationsThe paper is intended to benefit QM practitioners in the health-care sector during decision-making to achieve performance improvement against a best practice benchmark. Originality/valueThis research presents a novel application of a hybrid KBS with GAP methodology to support the implementation of L6s principles to enhance QM performance in a health-care environment.
This study analyzes the sector-wise dividend payment behavior of Karachi Stock Exchange (KSE) for the period 2009 through 2013. First, the trend of dividend payment of 5 years with respect to all 32 sectors is assessed through descriptive analysis. Second, the unit root test for panel data and pooled ordinary lest square (POLS) test were used on 15 non-financial sectors. Results show that the earning per share has a positive impact on dividend payment in eight sectors including beverages, travel and leisure, fixed-line telecommunication, food processors, household goods, personal goods, automobiles, and electricity; however, forestry (paper and board) is negatively associated with the dividend payout ratio. In addition, free cash flow has a positive impact on dividend payment in fixed-line telecommunication, and a negative impact on chemical, forestry, construction and material, engineering, beverages, tobacco, travel and leisure, food processor, household goods, pharmaceutical and biotech, and automobiles.
The type of plant layout has very significant impact on the structure and operation of a manufacturing system. The current common and intuitive methods of selecting a suitable type of layout by using simple graphs of production volume versus number of parts manufactured in the plant, or production volume versus flexibility, can result in inaccurate decisions for such an important issue. This paper presents an alternative approach to the choice of plant layouts, which applies the Analytic Hierarchy Process (AHP). The methodology considers three main objectives for the selection of layouts: increasing flexibility, increasing production volume and reducing manufacturing costs. Each objective has a number of subobjectives. Three main types of layout are considered: functional (process) layout, group technology (cellular) layout and transfer (flow) lines. The AHP methodology has been applied as a knowledge-based system, which is integrated with another three knowledge-based systems for the technical and social conditions required for the successful implementation of each of the above types of layout. An example of the application of the AHP methodology is presented, which represents an important step towards proper validation of the methodology.
PurposeEnergy-saving behavior of individuals is essential to minimize energy use and reduce the emission of toxic gases. This study's actual focus is to find out the determinants of the energy-saving behavior of individuals in the workplace.Design/methodology/approachAs a theoretical research model, the extended theory of planned behavior (TPB) has been used to analyze the determinants of energy-saving intentions. A survey method is used to collect 289 valid data, and structural equation modeling (SEM) is used to analyze the data.FindingsThe final result shows that the variables attitude at home, subjective norm (SN) and descriptive norms positively impact intention to save energy at the workplace. In contrast, the construct attitude and perceived behavior control is insignificant in this research. On the other hand, the personal moral norm (PMN) is a powerful predictor of individual energy-saving intentions at the workplace.Originality/valueThis research provides insights that will help the organizations understand the behavior of individuals at the workplace for energy-saving intentions to formulate such policies that will enhance individuals' practice for energy savings.
Bradford Scholars -how to deposit your paper Overview Copyright check• Check if your publisher allows submission to a repository.• Use the Sherpa RoMEO database if you are not sure about your publisher's position or email openaccess@bradford.ac.uk.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.