This study extended the research on the association between cognitive flexibility and entrepreneurial intention by developing a moderated mediation model. This research examined whether ...entrepreneurial alertness mediates this association. This study also investigated whether entrepreneurial self-efficacy moderates this mediation model by conducting a moderated mediation model. The sample of this study comprised 486 medical university students of Pakistan. Data gathered using a self-report administered questionnaire and hypotheses were tested with SEM structural equation modeling technique through AMOS user-defined estimates and developed a syntax based on Hayes model 15 of process macro. The results revealed that cognitive flexibility is positively related to entrepreneurial alertness and entrepreneurial intentions. Furthermore, findings showed that the indirect relationship of entrepreneurial alertness via entrepreneurial self-efficacy on cognitive flexibility and the entrepreneurial intention was also significant. This study contributes to the emerging research on psychology and entrepreneurship as well as concludes that individuals with a high level of cognitive flexibility, entrepreneurial alertness, and entrepreneurial self-efficacy are more inclined to pursue a career in entrepreneurship.
This study investigated the impact of transformational leadership on affective organizational commitment and job performance with the mediating role of employee engagement. This study gathered data ...from 845 hotel employees in China and the structural equation modeling technique was used to verify the results. The findings indicated that transformational leadership has a positive effect on affective organizational commitment and job performance. Meanwhile, results showed that employee engagement partially mediates in the relationship between transformational leadership, affective organizational commitment, and job performance. This study contributes to the research on transformational leadership in the Chinese hospitality sector and analyzes its effects on work performance metrics. Furthermore, theoretical and practical implications were also discussed in this article.
This study aimed to unfold the implicit interplay of open innovation (OI) and perceived insider status (PIS) between the relationship of proactive personality (PP) and innovative work behavior (IWB). ...The phenomenon studied the moderated mediation of OI and PIS through the combined optic of the theory of innovation and the broaden-and-build theory. The nature of this study was post-positivist. The two-step approach of structural equation modeling was implemented. First, quantitative data were collected through an online questionnaire from the employees of IT industries in China. The study sample consisted of 460 responses used for data analysis in SPSS and AMOS version 26. This study was based on mediated moderation, which was statistically similar to Model 15 of the process macro. There were six hypotheses based on the theoretical framework. The result of H6 was rejected, which demonstrated that the conditional direct effect of OI and PIS mediated moderation on PP and IWB. The results comprehensively testified to the theoretical framework.
The rate of alcoholic hepatitis (AH) has risen in recent years. AH can cause as much as 40-50% mortality in severe cases. Successful abstinence has been the only therapy associated with long-term ...survival in patients with AH. Thus, it is crucial to be able to identify at-risk individuals in order to implement preventative measures. From the patient database, adult patients (age 18 and above) with AH were identified using the ICD-10 classification from November 2017 to October 2019. Liver biopsies are not routinely performed at our institution. Therefore, patients were diagnosed with AH based on clinical parameters and were divided into "probable" and "possible" AH. Logistic regression analysis was performed to determine risk factors associated with AH. A sub-analysis was performed to determine variables associated with mortality in AH patients. Among the 192 patients with alcohol dependence, there were 100 patients with AH and 92 patients without AH. The mean age was 49.3 years in the AH cohort, compared to 54.5 years in the non-AH cohort. Binge drinking (OR 2.698; 95% CI 1.079, 6.745;
= 0.03), heavy drinking (OR 3.169; 95% CI 1.348, 7.452;
= 0.01), and the presence of cirrhosis (OR 3.392; 95% CI 1.306, 8.811;
= 0.01) were identified as characteristics more commonly found in the AH cohort. Further, a higher inpatient mortality was seen in those with a probable AH diagnosis (OR 6.79; 95% CI 1.38, 44.9;
= 0.03) and hypertension (OR 6.51; 95% CI 9.49, 35.7;
= 0.02). A higher incidence of mortality was also noted among the non-Caucasian race (OR 2.72; 95% CI 4.92; 22.3;
= 0.29). A higher mortality rate despite a lower incidence of alcohol use among non-Caucasian patients may indicate healthcare disparities.
This research aims to identify the investor's decision-making styles and their impact on entrepreneurial opportunities through the mediation role of entrepreneurial intention and moderation effect of ...social capital in the healthcare sector of Pakistan. This study applied a structural equation modeling (SEM) to test the hypotheses on a sample of 400 healthcare investors. Our findings reveal that the conditional indirect relationship of entrepreneurial intention through social capital was significant on opportunity creation and an insignificant influence on opportunity discovery from decision-making styles. This study provides implications for policymakers to enhance entrepreneurial opportunity creation by providing robust social environment investors and encouraging them to create business ventures in the healthcare sector.
To compare the clinical outcomes in patients with congestive heart failure who are transferred to an acute care hospital from non-acute care centers with patients who are admitted as regular hospital ...admissions.
This was a retrospective cohort study.
We utilized the National Inpatient Sample database from 2016 to 2018.
Our cohort consisted of hospitalized patients who were at least 18 years old with a primary diagnosis of congestive heart failure.
These patients were either transferred from non-acute centers or presented as regular hospital admissions.
We matched patients in a greedy nearest neighbor 1:1 model with caliper set at 0.2. Multivariable logistic regression, adjusted for age, sex, race and comorbidities, was used to compare mortality in our matched cohort.
This study included 35,010 non-acute care transfers and 951,189 regularly admitted patients. Compared to patients who were not transferred, non-acute care transfers were older, predominantly female, White and less racially diverse. After matching, there were 6689 patients in each cohort. When adjusted for age, race, sex and comorbidities, non-acute care transfers with congestive heart failure had 2.20 times higher odds of suffering in-hospital mortality compared to regular, non-transferred admissions (aOR 2.20, 95 % CI: 1.85–2.61; p < 0.001).
Our findings illustrate that non-acute care transfers are a vulnerable population that require additional medical support in the acute care setting.
•Non-acute care transfers were older, predominantly female and White.•Non-acute care transfers had 2.20 times higher odds of in-hospital mortality.•Every race had higher rates of mortality in the non-acute care transfer cohort.
Nonelective transcatheter aortic valve replacement (TAVR) requires additional research to be fully understood.
Using the National Inpatient Sample database (2016-2019), we conducted a retrospective ...cohort study comparing nonelective vs elective TAVR. The primary outcome of interest was the in-hospital mortality rate among patients undergoing nonelective TAVR, compared to that among patients undergoing elective TAVR. We matched patients in a greedy nearest-neighbor 1:1 model and multivariable logistic regression, which was adjusted for demographics, hospital factors, and comorbidities, and was used to compare mortality in our matched cohort.
Each cohort had 4389 patients in each cohort. When adjusted for age, race, sex, and comorbidities, nonelective TAVR patients had 1.99 times higher odds of suffering in-hospital mortality compared to elective admissions (adjusted odds ratio 1.99, 95% confidence interval: 1.42-2.81; P < 0.001). When separated by transfer status, nonelective patients admitted as regular hospital admissions or transferred from other acute-care centres also had higher odds of suffering in-hospital mortality compared to elective admissions.
Our findings illustrate that nonelective TAVR patients are a vulnerable population that require additional medical support in the acute-care setting. As the demand for TAVR increases, further discussions regarding access to healthcare in underserved regions, the national physician shortage, and the future of the TAVR industry are imperative.
Le remplacement valvulaire aortique par cathéter (RVAC) d’urgence nécessite plus de recherche pour être bien compris.
À partir de la base de données National Inpatient Sample (2016-2019), nous avons réalisé une étude rétrospective de cohortes comparant le RVAC non urgent et le RVAC d’urgence. Celle-ci avait pour principal critère d’évaluation la comparaison du taux de mortalité à l’hôpital chez les patients soumis à un RVAC d’urgence à celui noté chez ceux qui subissent un RVAC non urgent. Nous avons apparié les patients selon le modèle du plus proche voisin, avec un rapport 1:1, et utilisé une régression logistique multivariée, ajustée en fonction des caractéristiques démographiques, des facteurs hospitaliers et des affections concomitantes, pour comparer le taux de mortalité dans les cohortes appariées.
Chaque cohorte comportait 4 389 patients. Après correction pour tenir compte de l’âge, de l’origine ethnique, du sexe et des affections concomitantes, nous avons constaté que le risque des patients ayant subi un RVAC d’urgence de mourir à l’hôpital était 1,99 fois plus élevé que celui des patients chez qui un RVAC non urgent a été effectué (rapport des risques ajustés : 1,99; intervalle de confiance à 95 % : 1,42 à 2,81; p < 0,001). De plus, les patients chez qui l’intervention a été pratiquée d’urgence courraient également un risque plus élevé de décéder à l’hôpital que ceux soumis à un RVAC non urgent, qu’ils aient été admis directement à l’hôpital ou transférés d’autres centres de soins de courte durée.
Nos conclusions montrent que les patients ayant subi un RVAC d’urgence forment une population vulnérable qui requiert un soutien médical supplémentaire dans un milieu de soins de courte durée. Comme la demande pour des RVAC augmente, d’autres discussions sur l’accès aux soins de santé dans les régions mal desservies, la pénurie nationale de médecins et l’avenir de l’industrie du RVAC s’imposent.
Study the clinical outcomes associated with the number of concomitant vasopressors used in critically ill COVID-19 patients.
A single-center retrospective cohort study was conducted on patients ...admitted with COVID-19 to the intensive care unit (ICU) between March and October 2020.
Rush University Medical Center, United States.
Adult patients at least 18 years old with COVID-19 with continuous infusion of any vasopressors were included.
60-day mortality in COVID-19 patients by the number of concurrent vasopressors received.
A total of 637 patients met our inclusion criteria, of whom 338 (53.1 %) required the support of at least one vasopressor. When compared to patients with no vasopressor requirement, those who required 1 vasopressor (V1) (adjusted odds ratio aOR 3.27, 95 % confidence interval (CI) 1.86–5.79, p < 0.01) (n = 137), 2 vasopressors (V2) (aOR 4.71, 95 % CI 2.54–8.77, p < 0.01) (n = 86), 3 vasopressors (V3) (aOR 26.2, 95 % CI 13.35–53.74 p < 0.01) (n = 74), and 4 or 5 vasopressors(V4–5) (aOR 106.38, 95 % CI 39.17–349.93, p < 0.01) (n = 41) were at increased risk of 60-day mortality. In-hospital mortality for patients who received no vasopressors was 6.7 %, 22.6 % for V1, 27.9 % for V2, 62.2 % for V3, and 78 % for V4-V5.
Critically ill patients with COVID-19 requiring vasopressors were associated with significantly higher 60-day mortality.
Summary Patients labelled as ‘hypospadias cripples’ pose a challenge to reconstructive surgeons because of the complexity of the problem and limited options for reconstruction. The two-staged Bracka ...method is a versatile technique that is relatively easy to learn and applicable in difficult cases of salvage hypospadias. Over a period of 8 years, we applied this technique to 100 patients with hypospadias cripples who had previously undergone multiple (3–16) procedures. In the first stage, a full-thickness graft of skin or buccal mucosa was used for urethral plate reconstruction after release of chordee. Stage II was carried out at least 6 months after the first procedure. Meatal opening at the tip of the glans was achieved in 94 patients, straightening of the penis in 96 and proper urinary stream in 92 patients. Fistula formation occurred in nine patients. In our opinion, the two-staged Bracka technique is a useful strategy to deal with the myriad abnormalities encountered in crippled hypospadias. This technique not only creates a neourethra successfully, but also gives the penis a near-normal shape and appearance.
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