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PurposeThis study aims to examine the relationship between green human resource management (GHRM) practices and green transformational leadership toward inducing employees' green creativity. Specifically, drawing upon the ability, motivation and opportunity theory, the authors tested how green perceived organizational support (green POS) mediates the link between GHRM practices and employees' green creativity. Furthermore, based on the firm's resource-based view, the authors examine the moderating role of green transformational leadership on the relationship between GHRM practice and green POS.Design/methodology/approachUsing a survey questionnaire, this research was conducted with a multi-source sample of 201 supervisors and their 428 subordinates from organizations working in grocery, food and personal care products in Pakistan.FindingsThe findings of structural equation modeling revealed that green POS plays a mediating role between GHRM and employees' green creativity. The study findings also highlighted that green transformational leadership moderates the positive relationship between GHRM practices and green POS.Practical implicationsOrganizations need to implement GHRM practices to achieve environmental performance. Individuals are likely to recognize themselves with organizations that are engaged in green practices, and therefore, organizations can get benefits from implementing GHRM practices.Originality/valueThis research explores green POS and green transformational leadership as novel mechanisms through which GHRM practices influence employees' green creativity in organizations. In addition, the authors empirically examined our theorized relationships in the South Asian context.

In our population, the Broselow tape is an ineffective tool to predict weight in more than 50% of pediatric trauma patients. This may lead to the underdosing of emergency medications and blood products.

Introduction. Gallbladder agenesis (GA) is a rare congenital malformation, and majority are asymptomatic; however, symptomatic patients present with a clinical picture similar to biliary colic. Work up usually shows contracted gallbladder (GB) on ultrasound (US), and HIDA scan shows nonvisualization. Magnetic resonance cholangiopancreatography (MRCP) can be helpful in the diagnosis; however, the diagnosis without the latter can only be established intraoperatively. Management should be conservative treatment with antispasmodic drugs. Case Report. A 35-year-old female presented to the emergency department with nausea, vomiting, and worsening right upper quadrant (RUQ) abdominal pain. Vitals and laboratory values were unremarkable except for mild leukocytosis, and RUQ US reported “contracted GB, cholelithiasis, 4.2 mm wall thickness, and no ductal dilation.” Surgical consultation was prompted by the diagnosis of acute cholecystitis. The patient was transferred to the operating room for laparoscopic cholecystectomy; however, no GB was found, which was confirmed by intraoperative indocyanine green cholangiography. The procedure was aborted. Postoperatively, CT scan showed absent GB. A HIDA scan showed nonvisualization of the GB after 4 hours. Gastroenterology consultation was suggested to assess for peptic ulcer disease, stricture, or other etiology for her presenting symptoms, and the upper endoscopy showed gastritis. Upper GI with small bowel follow-through study showed mild delayed gastric emptying and contrast in the colon in 45 minutes. Conclusion. When US imaging findings are equivocal for nonvisualization of GB in a patient with no known history of prior cholecystectomy, additional imaging is required considering the diagnosis of gallbladder agenesis. MRCP is the test of choice. Management is usually conservative with smooth muscle relaxants without the need for surgical operation.

BackgroundAnaerobes are a major component of gut flora. They play an important role in the pathogenesis of infections resulting from breaches in mucus membranes. Because of the difficulties in cultivating and identifying it, their role continues to be undermined. The purpose of this paper is to report a case of Prevotella loescheii bacteremic skin and soft tissue infection and review the literature.Case presentationA 42-year-old Caucasian man was admitted for an elective bariatric surgery. A lengthy intensive care unit stay and buttocks decubitus ulcers complicated his post-operative course. After being transferred to a long-term care facility, the decubitus ulcer became secondarily infected with multiple bacteria including P. loescheii; an anaerobe that grew in blood and wound cultures. The patient was treated successfully with aggressive surgical debridement, antibiotics and subsequent wound care.ConclusionP. loescheii colonizes the gut and plays an important role in periodontal infections. In rare occasions and under suitable circumstances, it can infect skin and soft tissues as well as joints. Given the difficulties in isolating anaerobes in the microbiology lab, considering this bacterium alongside other anaerobes in infections of devitalized tissue is indicated even if cultures were reported negative.