Browse Articles

Sensemaking at work: How rationalized knowledge hiding and communication patterns affect decision quality

This paper employs sensemaking theory to examine the relationships between rationalized knowledge hiding, communication patterns, and the quality of decision-making in information technology firms. Additionally, this study operationalized sensemaking processes as a mediator in the above mentioned relationships. The study employed a three-time lag approach with a 45-day gap, utilizing data from 348 managers, supervisors, and leaders. Partial least squares structural equation modeling and SmartPLS 4 are employed for the analyses. The results indicate that rationalized knowledge-hiding and communication patterns have a significant impact on decision-making quality. Moreover, sensemaking processes partially/complementary mediate the relationship between rationalized knowledge hiding, communication patterns, and decision-making quality. Incorporating sensemaking processes into the study model provides deeper insight into managers’ decisions and maps the temporal nature of these relationships. These valuable findings shed light on new meanings and directions for theoretical perspectives and their relevance in management and organizational behavior.

Herpesvirus reactivation is associated with mortality in critically ill ICU patients with COVID-19: Insights from a retrospective single-center analysis of 455 cases

Background Critically ill patients with COVID-19 frequently develop viral reactivation, yet the clinical significance of herpes simplex virus type 1 (HSV-1) and cytomegalovirus (CMV) remains a matter of debate. Methods We conducted a retrospective single-center study of 455 consecutive intensive care unit (ICU) patients with confirmed SARS-CoV-2 infection between March 2020 and December 2021. Patients underwent screening for HSV-1 and CMV in whole blood and respiratory samples. A multivariable model was used to independently investigate risk factors associated with mortality. Results The mean age was 57 years (range: 13–94 years), and 316 (69%) were male. During a median ICU stay of 14 (0–90) days, viral reactivation (either HSV-1 or CMV or both) occurred in 164 (36%) patients. HSV-1 and CMV co-reactivation was detected in 57 (13%) patients, isolated HSV-1 reactivation was observed in 54 (12%) patients and isolated CMV reactivation in 53 (12%) patients. Median time from ICU admission to viral detection was 4 days, with a stepwise increase with longer ICU stay. Detection of HSV-1 was associated with decreased ICU survival (32% versus 67%; p < 0.001) which remained significant after multivariable adjustment. Detection of HSV-1 but not CMV was associated with an increased need for invasive mechanical ventilation, veno-venous extracorporeal membrane oxygenation therapy, and the need for renal replacement therapy. Higher neutrophil-lymphocyte ratios were independently associated with an increased risk of ICU mortality and correlated with detection of HSV-1 and CMV. Conclusion Herpesvirus reactivation was common in critically ill patients with COVID-19. HSV-1 reactivation was associated with a more severe course of disease and increased ICU mortality.

Teaching persuasive essay writing online to first-year undergraduates: A phenomenological study of instructional design and learning experiences

The teaching and learning of academic essays faced difficulties in in-person classes. Challenges in academic essay instruction were exacerbated in online learning environments during COVID-19. Yet some institutions arranged sophisticated platforms to share instructional materials for imparting English language education online. The focal university was one such progressive institution. Like other courses, English language education was delivered through ‘Arwa’, an online platform developed by the university to support teaching and learning during the pandemic. The phenomenological study aimed to understand how instructional materials designed for an English foundation course contributed to first-year undergraduates’ experiences of learning persuasive essay writing. Data were collected primarily through semi-structured interviews and supplemented by an open-ended questionnaire administered to the same eight participants. Phenomenological thematic analysis was applied to interpret the data. The findings reveal how participants experienced the instructional design and materials as supporting their engagement with outlining, drafting, editing, and revising persuasive essays. Participants also described collaborative writing and rubric-guided peer feedback as meaningful learning experiences that supported their engagement with persuasive essay writing. From a phenomenological perspective, the study contributes to understanding how learners make sense of persuasive essay writing through structured online instruction, collaborative writing, and rubric-guided peer feedback. Pedagogically, the findings highlight the value of sequenced instructional materials, collaborative writing, and guided peer interaction in supporting students’ engagement with persuasive writing in online and blended learning environments.

Chemsex among men who have sex with men (MSM) in Yangon, Myanmar: Prevalence, practices, and associated risk factors

Introduction Chemsex is the intentional use of psychoactive substances to facilitate, enhance, or prolong sexual encounters. It is notably common among men who have sex with men (MSM), contributing to high-risk sexual behaviors. However, limited research has focused on chemsex among MSM in Myanmar. This study aimed to assess the prevalence, practices, and associated risk factors of chemsex among MSM in Yangon, Myanmar. Materials and methods Between December 2024 and January 2025, a cross-sectional online survey was conducted among MSM aged 18 and older living in Yangon. Participants were recruited through social media platforms, including Facebook and Telegram, as well as dating apps. Data were collected using the KoboCollect platform and analyzed in SPSS. Descriptive statistics summarized demographic and behavioral data, and multivariate analyses identified factors associated with chemsex. Results The study included 415 MSM participants with a mean age of 30.1 years. The majority (71.3%) were between 18 and 34 years old. Most identified as gay (76%), had a university or postgraduate degree (62%), and 60% were employed. Approximately 26% reported engaging in chemsex at some point, with 20.7% having done so within the past six months. The most commonly reported substances were methamphetamine (69.8%), poppers (33.7%), and cannabis (19.8%). Injection and inhalation were the most common routes of administration. Chemsex sessions mostly took place in hotels (76.7%) and homes (54.7%), and for nearly half of participants, sessions lasted between 4 and 12 hours. Only 10% reported consistent condom use during chemsex, while group sex was frequent – about 40% engaged with 4–5 partners, and nearly 60% participated in threesomes. Chemsex within the last 14 days was reported by 46.5%. Factors significantly associated with chemsex included identifying as gay (aOR = 3.0, 95% CI:1.5–5.9, p = 0.001), smoking (aOR = 2.8, 95% CI:1.2–4.0, p = 0.006), participation in group sex (aOR = 4.0, 95% CI: 2.4–6.6, p < 0.001), and having multiple partners (aOR = 3.3, 95% CI:1.7–6.3, p < 0.001). Conclusion Chemsex prevalence among MSM in Yangon is alarmingly high and associated with risky behaviors. There is an urgent need for targeted interventions that focus on education, harm reduction, and improved access to MSM-specific health services.

Dipyrrole-Fused Naphthalene Diimide as a Building Block for High-Performance Organic Semiconductors

New integrative methodology for the excavation and study of mass graves and partially commingled remains

The resolution of commingled human skeletal remains is a phenomenon increasingly encountered by archaeologists and anthropologists. Its difficulty is due to the complexity of the task itself, but also to the limited methodological resources available for researchers. Parallelly, its importance derives from the fact that individualized skeletons are a prerequisite for any anthropological analysis that aims to provide results. In this paper, we put forward a new methodological approach that aims to integrate different tools and techniques already available. The basis of this methodology is the analysis of the spatial relationships of the human skeletal remains. To facilitate its use and maximize its effectiveness, we have developed a set of specific tools and protocols that include a list of information to be directly recorded in Geographical Information System (GIS) software, as well as a new coding system for skeletal remains showing different levels of completeness. Results show that the application of such a methodology helped in the resolution of a large, commingled assemblage exhumed from a 16 th -century-CE burial located in southwestern Hungary. The original number of complete skeletons (those individualized in their entirety during the fieldwork) was substantially increased, and for several other skeletal elements, potential matches were found during the laboratory work. We found this methodology to be a good filter prior to the utilization of the more standardized techniques such as osteometric sorting, articulation, visual pair-matching or process of elimination, as it would increase their effectiveness. Additionally, the novel coding system has proven to be useful in inventorying and storing human skeletal remains. This project shows that the addition of GIS technology and spatial analysis does increase the success rate in the reassociation of commingled human skeletal remains.

First-generation medical school applicants: A quantitative study designed to identify areas of educational support

First-generation (First Gen) students are unique medical school applicants. Due to their lived experience, they approach patient care by prioritizing trust, comfort and understanding. They have proven ability to overcome obstacles and were found to be more resilient than their continuing generation (Cont Gen) peers. Despite these notable attributes, they face unique challenges in gaining medical school acceptance. There are very few quantitative studies examining this student subpopulation, and our study identifies characteristics of first-generation medical school applicants while highlighting areas of needed support. This cross-sectional study used deidentified Application and Matriculating Student Questionnaire survey data that was obtained from the AAMC for 286,656 total applicants for the 2017–2024 period, in which 12.5% identified as First Gen. Descriptive statistics, Mann-Whitney U, independent-samples t - tests, and Chi-square tests were performed to define medical school applicant characteristics, evaluate applicants’ motivations to study medicine, and obstacles to medical school acceptance. All First Gen applicants who reported socioeconomic status (SES) come from low SES backgrounds and are motivated to study medicine by establishing a secure future, eliminating career debt, and affecting social change. First Gen applicants had lower acceptance (43% vs. 57%, p < 0.001) and matriculation rates (42% vs. 56%, p < 0.001). Obstacles to admission include First Gen and low SES statuses, age at matriculation, and time spent in family obligations, each significantly associated with lower acceptance rates (p < 0.001). First Gen medical school applicants and matriculants face disproportionate challenges as they navigate careers in medicine. This diverse group of medical school applicants has much to contribute to the future of medicine. Our study highlights a continued need for academic intervention to reduce barriers in the pre-matriculation stage and throughout medical training for First Gen medical school applicants and matriculants.

TBX20 promotes doxorubicin resistance in breast cancer cells through enhanced ABCC1 expression and inhibition of mitophagy

This study aimed to investigate the role and mechanism of T-box transcription factor 20 (TBX20) in doxorubicin resistance in breast cancer cells. RNA-seq data from breast cancer samples in the TCGA database were analyzed. Lentiviral vectors were used to establish TBX20 overexpression and silencing models in MCF-7 and MDA-MB-231 cells. Gene and protein expression were detected by qPCR and Western blot, respectively. Cell viability and the half-maximal inhibitory concentration of doxorubicin were measured using the CCK-8 assay. Apoptosis, migration, and invasion were analyzed by flow cytometry, wound healing assay, and Transwell assay. Mitophagy levels were assessed via immunofluorescence staining and western blotting. ChIP and dual-luciferase reporter assays were performed to validate the transcriptional regulation of ABCC1 by TBX20. Results showed that TCGA data analysis revealed a high expression of TBX20 in breast cancer tissues, which was positively correlated with ABCC1 expression. In MCF-7 and MDA-MB-231 cells, TBX20 overexpression significantly enhanced cell proliferation, migration, invasion, and resistance to doxorubicin, while suppressing the expression of mitophagy-related proteins LC3-II/LC3-I, PINK1, and BNIP3. ChIP and dual-luciferase reporter assays confirmed that TBX20 directly binds to and activates the ABCC1 promoter. Silencing of ABCC1 or restoration of mitophagy by CCCP reversed TBX20 overexpression‑induced doxorubicin resistance. TBX20 enhances the resistance of breast cancer cells to doxorubicin by transcriptionally upregulating ABCC1 and is correlated with the suppression of mitophagy.

Easy conic intersection with the common self-polar triangle

Intersecting two conics is a classical problem that is frequently encountered in many different areas of science, engineering, and art. For example, under perspective projection (e.g., in camera images), any degree-two curve (a conic) or surface (a quadric) projects to a conic. This is important since polynomials of degree two are commonly used to approximate the contour or surface of many real-world objects. This manuscript describes a simple solution to the conic intersection problem using a change of projective coordinates. Exploiting the properties of self-polar triangles, we show how to reduce the task to simply solving an eigenvalue problem of degree three and a quadratic equation in one variable. The self-polar triangle method provides an attractive alternative to more common methods, especially in settings that require explicit algorithmic solutions.

Sequential administration of sclerostin antibody and parathyroid hormone differentially modulates fracture healing in a murine tibial osteotomy model

Anabolic agents such as parathyroid hormone (PTH) analogs and sclerostin antibody (Scl-Ab) enhance fracture healing through distinct mechanisms, but whether the order of administration affects healing remains unclear. In a murine tibial osteotomy model, we compared PTH monotherapy (40 μg/kg), Scl-Ab monotherapy (25 mg/kg), and two sequential regimens with matched treatment duration and cumulative exposure between sequential groups: PTH followed by Scl-Ab (PTH → Scl-Ab) and Scl-Ab followed by PTH (Scl-Ab → PTH). Treatment was started on postoperative day 1, and the sequential groups changed agents after 1 week. PTH monotherapy significantly increased mineralized callus volume, whereas Scl-Ab monotherapy produced higher callus volumetric bone mineral density (vBMD) and greater mechanical strength. Among the sequential regimens, Scl-Ab → PTH resulted in significantly higher callus vBMD and ultimate load to failure than PTH → Scl-Ab, despite comparable callus volumes. Histological analysis showed a higher proportion of cartilaginous tissue in the PTH monotherapy and PTH → Scl-Ab groups, suggesting persistence of an earlier phase of endochondral ossification. These findings indicate that early Scl-Ab administration followed by PTH promotes earlier callus mineralization and mechanical recovery than the reverse sequence in this murine model. Although the study was limited primarily to early healing time points, the results suggest that the temporal sequence of anabolic signaling, rather than agent selection alone, can influence early fracture repair.

A phase III double-blind, placebo-controlled, randomized withdrawal trial of 5‑aminolevulinic acid hydrochloride with sodium ferrous citrate for efficacy and safety in patients diagnosed as Leigh syndrome

Objective A phase III, double-blind, placebo-controlled, randomized withdrawal trial of SPP‑004 (5‑aminolevulinic acid hydrochloride and sodium ferrous citrate) was conducted to confirm the efficacy and safety of SPP-004 for maintenance of clinical response in patients diagnosed with Leigh syndrome (LS) showing central nervous system disorders. Methods Fifty-four patients entered a 24-week open-label period of SPP-004 administration. Among them, 28 patients who showed improvement on the Newcastle Paediatric Mitochondrial Disease Scale (NPMDS) for cranial nervous symptoms and myopathy symptoms proceeded to a 48-week double-blind (DB) period, where they were randomized (1:1) to receive SPP‑004 or placebo ( n  = 14 each). Efficacy was evaluated using NPMDS for the full analysis set (FAS) during the DB‑period (SPP-004 n  = 13, Placebo n  = 14) and the entire study period ( n  = 54). Safety evaluation focused on adverse events (AEs) in all 54 patients administered SPP-004. Results The primary endpoint, the proportion of patients who discontinued due to inadequate efficacy at 48 weeks, was lower in the SPP-004 group (15.4% [95% CI: 1.9–45.4%]) compared to the placebo group (50.0% [23.0–77.0%]). Over 80% of the SPP-004 group showed maintained efficacy (p = 0.0486). All adverse drug reactions were mild, with no notable differences in AEs between groups. Conclusion These findings suggest that SPP-004 is safe and may provide therapeutic effect for LS patients who achieved an initial clinical response.

Enhancing medical intern competence in urethral catheterization: Impact of simulation-based training on knowledge, self-efficacy, and clinical outcomes

Introduction Urethral catheterization is a common procedure, yet most related complications occur when performed by new medical interns. Studies have shown inadequate training and knowledge among junior doctors. This study evaluated the declarative knowledge of new interns regarding urethral catheterization and assessed the effectiveness of a simulation-based urology session in improving their knowledge, confidence, and perceived self-efficacy. Methods A one-day urology simulation workshop was conducted for 40 new interns at a university hospital. Participants completed a pre-session online questionnaire assessing demographics, urinary catheterization knowledge, and self-reported confidence and self-efficacy. The workshop included three modules: an interactive presentation, instructional videos, and hands-on simulation on male and female models. Post-session assessments measured changes in knowledge, confidence, and self-efficacy scores using standardized evaluation tools. Results Forty new medical interns participated. Only 15% felt adequately prepared before training. Knowledge gaps were identified regarding catheter types and sizes (92.5%), optimal patient positioning (62%), proper meatus exposure, and balloon inflation technique (100%). Following the workshop, mean knowledge scores increased from 7.7 ± 1.24 to 12.2 ± 1.11, self-reported confidence from 6.60 ± 1.79 to 8.66 ± 0.94, and perceived self-efficacy from 3.32 ± 0.94 to 4.32 ± 0.62 (all p < 0.001). At six-month follow-up, participants collectively performed 274 urethral catheterizations with a 93% success rate and a low complication rate of 4% (n = 11), reflecting effective transfer of learning from the simulation to clinical practice. Discussion New medical interns demonstrated insufficient baseline knowledge of urethral catheterization. The structured urology simulation session significantly improved their declarative knowledge, confidence, and perceived self-efficacy, underscoring the value of simulation-based training in early postgraduate medical education.

Briefing Chat: Sweet! Elusive sugar molecules found in space

Multicenter Electronic Interactions Driving Active Phase Formation in NiFe-MOFs for Anion-Exchange Membrane Water Electrolysis

The pharmacist’s role in the periprocedural management of anticoagulation in Canada: A qualitative study protocol

Anticoagulants are crucial for both the immediate and ongoing management of thromboembolic disorders, including atrial fibrillation and venous thromboembolism, and for patients with mechanical heart valves. However, their management during the periprocedural period requires carefully balancing thromboembolic and bleeding risks, underscoring the need for coordinated and structured periprocedural anticoagulation management (PAM). Pharmacists, with their comprehensive training and expertise in medication management, are well positioned to deliver PAM. However, empirical evidence related to the roles of Canadian pharmacists in PAM, or the barriers, facilitators, and organizational structures that shape their practice is lacking. This protocol paper outlines a qualitative study that uses a qualitative description design grounded in constructionism and naturalism. The study aims to provide an in-depth understanding of pharmacists’ roles and experiences in PAM across Canada, while exploring variations by demographic and practice characteristics. Using purposeful maximum variation sampling, licensed Canadian pharmacists with at least 6 months of current PAM experience will be recruited to take part in one semi-structured interview conducted virtually using Microsoft Teams. Interviews will be recorded and transcribed verbatim and analyzed using conventional qualitative content analysis to inductively generate codes and categories. The findings of this research will address gaps in the literature by providing a detailed description of pharmacists’ roles in PAM and the contextual factors influencing practice across diverse regions and settings in Canada. Findings may inform future PAM service models, professional training, and health system policies to support optimal care coordination and improved patient outcomes in the Canadian anticoagulation care landscape.

Man’s ability to make sperm restored after testicular tissue transplant: what scientists think

Energy localization and spatiotemporal pattern evolution mechanism of spatial thin-film structures under parametric excitation

This paper investigates energy localization and spatiotemporal pattern evolution in spatial thin-film structures subjected to parametric excitation. A nonlinear thin-shell model is established by combining geometric nonlinearity, time-varying in-plane tension, damping, and multimodal coupling. A second-order multiple-scales perturbation procedure is then used to derive slow-flow modulation equations, and a high-fidelity finite element platform verifies the resulting localization and pattern-selection predictions. The analysis shows that pronounced localization occurs near the combined-resonance condition ω 1   +   ω 2 ) / 2 , when the normalized tension fluctuation exceeds approximately γ   >   0 . 20 . The nonlinear modal coupling strength κ controls topology selection: stationary breathers dominate for κ   <   0 . 35 , whereas traveling patterns emerge for κ   >   0 . 40 , with a transition centered near κ c   ≈   0 . 375 . The pattern wavelength follows λ / L   ≈   0 . 28 for square and near-square membranes, while highly anisotropic geometries require direction-dependent correction. Long-term simulations over 2000 excitation cycles show decay rates below 3%, indicating attractor-like persistence within the verified numerical horizon. Frequency-wavenumber spectra further confirm selective modal amplification at resonance. The results provide quantitative criteria for pretension management, hot-spot prediction, and placement of stiffeners, dampers, or active actuators in deployable aerospace membrane structures.

Why pain hurts more when we’re lonely, and the myth of original sin: Books in brief

Physical measures of physical functioning as prognostic factors in predicting outcomes for neck pain: Protocol for a prospective longitudinal cohort study

Introduction Neck pain is a common musculoskeletal condition that contributes to significant global burden. Evidence on physical measures of functioning as prognostic factors for neck pain remains limited. The objective of this study is to investigate whether physical measures of physical functioning as prognostic factors predict outcomes for people with neck pain. Methods This protocol for a prospective longitudinal cohort study will recruit approximately 156 adults with neck pain of any duration. Physical measures of physical functioning including impairment, performance, and activity measures in a real environment, will be assessed as prognostic factors. Outcomes at 12-month follow-up will include pain, disability, and overall changes, assessed using the Numeric Pain Rating Scale (NPRS), Neck Disability Index (NDI), and Global Rating of Change (GROC), respectively. Hierarchical regression analyses will be conducted separately for each physical measure and outcome. Physical measures will first be entered alone to examine the initial unadjusted (bivariate) association with the outcome, followed by adjustment for covariates (age, sex and baseline NPRS/NDI). Additional contribution will be evaluated using changes in explained variance ΔR 2 and F-change statistics. Physical measures demonstrating additional contribution will subsequently be entered into the final penalized multivariable regression model using least absolute shrinkage and selection operator (LASSO) regression to reduce overfitting and identify the most relevant prognostic factors. Sensitivity analyses comparing penalized and non-penalized multivariable regression models will also be conducted to examine the consistency and stability of the findings. Prognostic effects will be reported as beta coefficients (β) or odds ratios (OR) with 95% confidence intervals (CIs). Each model will be internally validated using bootstrapping, with model performance evaluated using calibration and discrimination. Discussion This study will provide new insights into how physical measures of physical functioning relate to outcomes for neck pain. The resulting prognostic models have the potential to strengthen clinical decision-making, support personalized care, and guide the development of targeted interventions for people with neck pain. Registration number The protocol has prospectively registered on the Open Science Framework (OSF). The link is https://doi.org/10.17605/OSF.IO/HG6PJ .

Incidence and risk factors of postoperative delirium in children with congenital heart disease

Background Postoperative delirium (POD) is an important neurocognitive complication following congenital heart disease (CHD) surgery in pediatric patients. While recognized for its association with adverse clinical outcomes, comprehensive population-based studies examining POD incidence and risk factors in this vulnerable population remain scarce. Methods Using the Nationwide Inpatient Sample (NIS) database (2010–2019), a retrospective study was performed of pediatric patients (<18 years) undergoing CHD-related surgeries. We evaluated demographics (race, sex, age), hospital characteristics (region of the hospital, type of admission, bed size of hospital, teaching status of hospital, type of insurance, location of hospital), mortality, length of stay (LOS), total charges, perioperative complications, and comorbidities. Results Among 187,272 CHD surgery patients identified, POD was diagnosed in 3,857 (incidence 2.1%). Children with POD exhibited higher comorbidity burdens, increased total medical costs, prolonged LOS and increased rates of in-hospital mortality (P < 0.001). Independent predictors of POD included coagulopathy, fluid and electrolyte disorders, and preexisting paralysis. Additionally, POD was associated with in-hospital complications, including prolonged mechanical ventilation, acute renal failure, acute myocardial infarction, pneumonia, and respiratory failure. Conclusions Although the incidence of POD following CHD surgery in children is relatively low, investigating its predisposing factors is clinically valuable for optimizing patient management and improving outcomes.