Digital Commons Network^™

Transformational Leadership Influence On Employee Commitment And Retention In The Business Process Outsourcing Industry, Kalu Umachi Umachi, Leilani I. De Guzman

Journal of Management for Global Sustainability

This study examined the impact of transformational leadership on employee commitment and retention in two business process outsourcing (BPO) companies in Lagos, Nigeria. Grounded in transformational leadership theory and the three-component organizational commitment model, it analyzed leadership practices and their relationship with employee commitment and retention. Using a descriptive-correlational research design and purposive sampling, the study collected data from 259 employees out of a population of 785. The findings revealed that transformational leadership practices, particularly individualized consideration and inspirational motivation, were highly observed among leaders. Employees reported high levels of normative, affective, and continuance commitment, while indicators such as training …

Future Of Work: Implication Of Green Economy On Employment Dynamics In Egypt, Sarah Adel Elgohary

Theses and Dissertations

Is Egypt's green economy a reality or just a policy-level aspiration? This thesis explores the tangible impact of the green economy on Egypt's labor market by examining key sectors—automotive, agriculture, and renewable energy. Through qualitative interviews and focus group discussions with private sector representatives, the study assesses the true implications of the green transition from a business-level perspective, beyond the propaganda and hype surrounding climate policies. What is the current scale of the green economy in Egypt's labor market? What existing policies and regulatory frameworks are in place to support the green economy transition? how urgent is the transition to …

The Social Standing Versus The Mind Standing Of Older Adults In Egypt: Cross-Sectional Analysis Of The Relationship Between Social Capital And Cognitive Functions, Shaza H. Shinaishen Dr

Theses and Dissertations

Introduction: Egypt's population, much like that of other countries, is expected to age considerably over the course of the coming decades. Although biological and socioeconomic predictors of cognitive function have been studied widely, personal level social capital remains unexplored, especially in LMICs.

Purpose: This study primarily investigates the relationship between individual social capital and cognitive functioning among older adults aged 65 years and older in Egypt using the structural and cognitive components of social capital, including group membership, civic engagements, and caregiving roles.

Methods: A cross-sectional survey on 363 older individuals in different geographical and demographic segments of Egypt using …

Ways Of Living And Knowing, Reem El Hassan Mohamed

Theses and Dissertations

After decades of sedentarization, the Muzeina tribe in South Sinai now has new generations born into sedentary lifestyles, never experiencing nomadism like their ancestors once did. This shift has impacted their knowledge system, traditionally shaped by interactions and kinship with nature. Exposure to social media is influencing younger generations' ways of living, raising the older generations’ concerns about their Bedouin identity. Despite being one of the largest tribes in South Sinai, the Muzeina are rarely represented in literature.

This ethnography explores the impact of sedentarization and contextual developments on the Muzeina's knowledge system, inherited from their ancestors. Muzeina’s relationship, and …

Finding Meaning In Loss: The Role Of Attachment Styles, Coping Strategies, And Resilience, Salma Seyam

Theses and Dissertations

Grief is a deeply personal yet universal experience impacted by personal, social, and cultural factors. The present study examines how attachment styles, coping mechanisms, and resilience impact both grief intensity and the ability to find meaning after a loss, within an Egyptian sample. While previous studies have explored the experience of grief, few have looked at these factors within a Middle Eastern cultural context. A total of 140 bereaved Egyptians who experienced the loss of a loved one within the past three years completed standardized measures assessing grief intensity (Prolonged Grief Disorder-Revised; PG-13-R), coping strategies (Brief COPE), meaning-making (Grief and …

Opportunistic Networks On The Move: A Context-Aware Framework For Opportunistic Networking Under Heterogeneous Mobility Settings, Sara Elsingergy

Theses and Dissertations

Most computer networks require continuous end-to-end connectivity between sending and destination nodes for data transfer. However, in certain scenarios—such as disaster zones, geographically remote areas with intermittent or no connectivity, or regions facing peak network loads—such continuous communication paths may be unavailable. A notable example of this challenge occurred during Hurricane Milton in 2024 and the Los Angeles wildfires in 2025, where Starlink provided free satellite internet to support disaster relief efforts and enable communication in affected areas. However, while offering satellite services at no cost can be effective in emergencies, it may not always be feasible on a global …

Exploring The Role Of Religious Media In Shaping Public Perceptions Towards Climate Change In Egypt, Hebatullah Ashour Abdel Fatah Ibrahim Ashour

Theses and Dissertations

Climate change poses significant threats globally, with particular vulnerability noted in developing nations like Egypt. While effective communication is crucial for societal engagement, the role of influential actors like religious media within specific cultural contexts remains under-explored. This thesis investigates the role and communication practices of religious media (Islamic and Coptic Christian) concerning climate change in Egypt, a country where religious institutions command significant public trust and influence. Existing literature highlights gaps in understanding how these specific media outlets navigate and frame climate change discourse.

Employing Framing Theory and Communication for Development (DevCom) Theory as a combined framework, this study …

Clinical And Psychosocial Changes In Adults With Opioid Use Disorder And Chronic Pain Using Medical Cannabis: A Brief Report., Michelle R. Lent, Ryan Keen, Michael Ruiz, Hannah R Callahan, Katherine E. Galluzzi, Karen L Dugosh

PCOM Scholarly Works

BACKGROUND: Medical cannabis (MC) is approved for the treatment of opioid use disorder (OUD) in Pennsylvania, but little is known about how MC impacts illicit opioid use or the clinical and psychosocial factors including pain severity levels that can precede illicit opioid use. This observational study examined the extent to which changes in rates of illicit opioid use and in pain and psychosocial functioning were observed following the first three months of MC treatment.

METHODS: A referred sample of 47 adults taking buprenorphine/naloxone for OUD with a minimum pain severity rating of 5/10 enrolled from March 2022-April 2023. Participants were …

In-Service Teachers’ Awareness And Professional Development In Egyptian Public Schools, Hanan Mohamed Metawea

Theses and Dissertations

Neuroscience is an emergent field that focuses on studying brain structure and understanding its significance in the learning process. There has been a recent movement in how to bridge the gap between neuroscience concepts and education by incorporating neuroscience principles into the teaching process. However, there have been limited studies in Egypt on how educators understand and utilize neuroscience principles in the classroom. This qualitative exploratory case study examines Egyptian teachers’ understanding of neuroscience concepts and how they apply them in their teaching practices. This case study was carried out in two government schools, including interviews with 11 teachers representing …

Assessing The Impact Of Digital Transformation On Regulatory Processes And Systems Compared To Traditional Paper-Based Processes At The Egyptian Drug Authority, Rania Aa Soliman

Theses and Dissertations

In the past several decades, the rate of scientific and technological advancements in drug development and digital fields have been extraordinary. Internet of Things and block chain technologies are currently viable in the mature cloud computing industry, these transformative examples contrast starkly with the current pharmaceutical regulatory submission, review, and approval process of the EDA. However, with the emergence of initiatives that aim to improve and expedite regulatory decision-making, there is a promising future ahead. These initiatives, if successful, will not only transform the current transactional structure but also leverage scientific and technological advances to deliver patient-centric therapies. This radical …

“Redefining The Fortress” Migrant Experiences, Adaptation And Connection Within Serbian Borderlands, Nicholas J. Leone

Theses and Dissertations

Abstract This thesis seeks to examine migrant experiences due to Serbia's geopolitical significance along the so-called Balkan route, and how this is specifically exemplified in the northern autonomous region of Vojvodina. Serbia’s position outside the external border of the European Union has caused it to be a strategic transit point for migrants en route to desired destinations, typically within Western and Northern Europe. However, the European Union’s externalization policies in partnership with Serbian authorities have played an extensive role in migration mobility patterns and humanitarian conditions for migrants traversing within the Serbian borderlands, specifically along the border with Hungary. The …

Mucin4 (Muc4) Antibody Labeled With An Nir Dye Brightly Targets Pancreatic Cancer Liver Metastases And Peritoneal Carcinomatosis, Sunidhi Jaiswal, Siamak Amirfakhri, Javier Bravo, Keita Kobayashi, Abhijit Aithal, Sumbal Talib, Kavita Mallya, Maneesh Jain, Aaron M. Mohs, Robert M. Hoffman, Surinder K. Batra, Michael Bouvet

Journal Articles: Biochemistry & Molecular Biology

BACKGROUND/OBJECTIVES: Pancreatic cancer is the fourth leading cause of deaths related to cancer. It is a highly aggressive malignancy and often metastasizes quickly to other parts of the body and organs. The most effective cure is surgical resection, which also is limited by tumor identification and clear tumor margin visualization. Previously, we used MUC4 antibodies labeled with IRDye800CW (anti-MUC4-IR800) to target primary human pancreatic cancer in orthotopic cell line mouse models.

METHODS: In the present study, we established a pancreatic cancer liver metastasis mouse model by implanting a tumor fragment in the liver and a peritoneal carcinomatosis mouse model by …

Treatment Outcomes Of Successful M1 Versus M2 Thrombectomy For Low-Aspects Stroke Patients, Huanwen Chen, Marco Colasurdo, Hidetoshi Matsukawa, Conor Cunningham, Ilko Maier, Pascal Jabbour, Joon-Tae Kim, Stacey Quintero Wolfe, Ansaar Rai, Robert M Starke, Marios-Nikos Psychogios, Amir Shaban, Nitin Goyal, Shinichi Yoshimura, Hugo Cuellar, Brian Howard, Ali Alawieh, Ali Alaraj, Mohamad Ezzeldin, Daniele G Romano, Omar Tanweer, Justin Mascitelli, Isabel Fragata, Adam Polifka, Fazeel Siddiqui, Joshua Osbun, Roberto Crosa, Ramesh Grandhi, Charles Matouk, Min S Park, Michael R Levitt, Waleed Brinjikji, Mark Moss, Ergun Daglioglu, Richard Williamson, Pedro Navia, Shakeel Chowdhry, David J Altschul, Alejandro M Spiotta, Peter Kan

Faculty, Staff and Students Publications

Background

The effectiveness of endovascular thrombectomy (EVT) for low Alberta Stroke Program Early CT score (ASPECTS) stroke patients with occlusion of the second segment of the middle cerebral artery (M2) is unclear.

Methods

This was a multicenter retrospective study. Patients with M1 or M2 occlusions and low ASPECTS (< 6) who underwent successful EVT (modified treatment in cerebral ischemia score of 2b or higher) were included. Primary outcome was futile EVT reperfusion (defined as 90-day modified Rankin scale of 5 or 6). Other outcomes of interest include acceptable outcomes (modified Rankin scale of 3 or less) and intracranial hemorrhage (ICH), and all-cause 90-day mortality. Outcomes for M1 patients were compared to M2 patients with multivariable logistic regression models accounting for potential confounders.

Results

173 patients with M1 or M2 occlusions and low ASPECTS (< 6) who underwent successful EVT were identified. After multivariable adjustments, M2 patients had significantly higher odds of futile reperfusion (OR 5.48 [95%CI 1.91 to 15.7], p = 0.002), lower odds of acceptable outcomes (OR 0.33 [95%CI 0.12 to 0.89], p = 0.028), and higher odds of all-cause mortality (OR 4.90 [95%CI 1.65 to 14.5], p = 0.004). These findings suggest that EVT's efficacy for low-ASPECTS stroke patients may be diminished for patients with M2 occlusions. M2 occlusion was not significantly associated with ICH.

Conclusions

Among low-ASEPCTS stroke patients who underwent successful EVT, those with M2 occlusions had significantly higher odds of poor outcome compared to those with M1 occlusions.

Psychological Interventions Added To Standard Care Improve Pain And Function Outcomes In Knee Osteoarthritis: A Systematic Review And Meta‐Analysis, Tim Phelps, Jonathan Gilby, Joanne Hosking, Jonathon Gill

School of Health Professions

Objective: Knee osteoarthritis is a primary cause of disability across the world and current standard care fails to address all biopsychosocial contributions to pain. The current review aims to evaluate randomised controlled trials examining the effect of adding cognitive behavioural therapy or pain coping skills training to standard care on pain and function outcomes for individuals with knee osteoarthritis. Data sources: Systematic searches were conducted of CINAHL, EMBASE (OVID), Medline (EBSCO) and PsycINFO databases until July 2024 with no date restrictions. Methods: This systematic review followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Risk of bias …

Therapy, Safety, And Logistics Of Preoperative Vs Postoperative Stereotactic Radiation Therapy: A Preliminary Analysis Of A Randomized Clinical Trial, Debra Nana Yeboa, Jing Li, Ruitao Lin, Sujit S Prabhu, Thomas H Beckham, Kristina Woodhouse, Todd Allen Swanson, Jeffrey S Weinberg, Xuemei Wang, Xiaohan Chi, Chinenye Lynette Ejezie, Dima Suki, Chenyang Wang, Chibawanye Ene, Ian E Mccutcheon, Susan Mcgovern, Mary Frances Mcaleer, Martin Tom, Amol Ghia, Subha Perni, Wen Jiang, Brian De, Caroline Chung, Betty Y S Kim, Barbara J O'Brien, Jason T Huse, Jeffrey S Wefel, Laurence Court, Hussein Tawbi, Filip Janku, Nandita Guha-Thakurta, J Matthew Debnam, Jason Johnson, Ceylan Altintas Taslicay, Christopher Alvarez-Breckenridge, Shaan M Raza, Amy B Heimberger, Franco Demonte, Robert North, Tina M Briere, John F De Groot, Raymond Sawaya, David Grosshans, Frederick F Lang, Ganesh Rao, Sherise D Ferguson

Faculty, Staff and Student Publications

Importance: Preoperative stereotactic radiation therapy (SRT) vs postoperative SRT logistics and toxic effects provides clinically significant data on management outcomes.

Objective: To determine preoperative SRT logistics and safety profile compared with postoperative in patients with brain metastases.

Design, setting, and participants: This single-institution phase 3 randomized clinical trial included patients 18 years and older and undergoing a planned surgical resection. Patients were required to have an Eastern Cooperative Oncology Group Performance Status score of 2 or greater and be candidates for SRT within 30 days of surgical resection. Patients with radiosensitive histologies (eg, small cell lung cancer and lymphoma), brain …

Integrating Endocannabinoid Signaling, Cck Interneurons, And Hippocampal Circuit Dynamics In Behaving Animals, Shreya Malhotra, Florian Donneger, Jordan S Farrell, Barna Dudok, Attila Losonczy, Ivan Soltesz

Faculty, Staff and Students Publications

The brain's endocannabinoid signaling system modulates a diverse range of physiological phenomena and is also involved in various psychiatric and neurological disorders. The basic components of the molecular machinery underlying endocannabinoid-mediated synaptic signaling have been known for decades. However, limitations associated with the short-lived nature of endocannabinoid lipid signals had made it challenging to determine the spatiotemporal specificity and dynamics of endocannabinoid signaling in vivo. Here, we discuss how novel technologies have recently enabled unprecedented insights into endocannabinoid signaling taking place at specific synapses in behaving animals. In this review, we primarily focus on cannabinoid-sensitive inhibition in the hippocampus in …

Oncolytic Adeno-Immunotherapy Improves Allogeneic Adoptive Her2car-Nk Function Against Pancreatic Ductal Adenocarcinoma, Greyson Biegert, Amanda Rosewell Shaw, Daisuke Morita, Caroline Porter, Ryu Matsumoto, Lisa Jatta, Noah Crooks, Mae Woods, Qizhi Cathy Yao, Robin Parihar, Masataka Suzuki

Faculty, Staff and Students Publications

Pancreatic ductal adenocarcinoma (PDAC) responds poorly to conventional treatments and immunotherapy. We previously developed a binary oncolytic/helper-dependent adenovirus system (CAdTrio) that facilitated oncolysis and expressed the immunomodulatory molecule interleukin-12 and a programmed death ligand 1 (PD-L1) blocking mini-antibody. Given that CAdTrio enhanced endogenous natural killer (NK) cell anti-tumor activity in humanized mice bearing PDAC tumors and that NK cells can be adoptively transferred to patients safely in the allogeneic setting, we hypothesized that a combination of CAdTrio and allogeneic NK cells expressing a HER2-specific chimeric antigen receptor (HER2.CAR-NK) would be an effective, entirely “off-the-shelf” treatment against …

Final 2025 Residential Metals Abatement Program (Rmap) Quality Assurance Project Plan (Qapp) Annual Update (Residential Parcels), Pioneer Technical Services, Inc.

Silver Bow Creek/Butte Area Superfund Site

No abstract provided.

Final Unreclaimed Sites Quality Assurance Project Plan (Qapp), Pioneer Technical Services, Inc.

Silver Bow Creek/Butte Area Superfund Site

No abstract provided.

Final 2025 Residential Metals Abatement Program (Rmap) Quality Assurance Project Plan (Qapp) Annual Update (Non-Residential Parcels And Residential Daycares), Pioneer Technical Services, Inc.

Silver Bow Creek/Butte Area Superfund Site

No abstract provided.

Osteopathic Graduates In Plastic Surgery: How Can We Improve The Pipeline?, Kristof S. Gutowski, Irene Yau, Ariel E. Figueroa, Alice Yau, Marina A. Lentskevich, Kristyn N. Kraus, Jordan E. Wiebe, Gregory A. Greco, Arun K. Gosain

Student Publications

Background: Integrated plastic surgery residency is one of the most competitive specialties for medical students to match into. This study was performed to identify trends in osteopathic applicants to plastic surgery and current osteopathic trainees within the field. Furthermore, we explore osteopathic students’ perception of plastic surgery and identify methods that our national societies can utilize to foster exposure to the field.

Methods: All integrated and independent plastic surgery training programs were identified from the Accreditation Council for Graduate Medical Education. Trainees’ medical education was obtained via program websites and public profiles. An anonymous survey was distributed to Student Affairs …

Exploring The Interplay Between Kidney Dysfunction And Cardiovascular Disease, Rajesh Yadav, Aqsa Kaim Abubakar, Richa Mishra, Saurabh Gupta, Neelesh Kumar Maurya, Vivek Kashyap, Sarvesh Rustagi, Deependra Pratap Singh, Sanjay Kumar

School of Medicine Publications

This article reveals the various types of complications that are associated with dialysis and kidney-associated disease, including left ventricular hypertrophy, heart failure, vascular heart disease, arrhythmias, diabetes mellitus, intradialytic hypertension, and coronary heart disease. The molecular mechanisms underlying the development of cardiovascular disease in patients with chronic kidney disease (CKD), including the role of nitric oxide (NO) signaling, have been extensively studied. Patients suffering from CKD need treatment with hemodialysis at the end stages. The kidney is considered the chief excretory organ in humans, which excretes various types of waste materials from the body and balances the acid–base ratio, due …

The "Dual-Port" Approach To The Posterior Incisura: A Quantitative Cadaver Study Of A Combined Endoscopic Paramedian Supracerebellar Infratentorial And Occipital Interhemispheric Transtentorial Approach, Wesley Shoap, Ezequiel Goldschmidt, Roberto Rodriguez Rubio

School of Medicine Faculty Publications

BACKGROUND: The posterior incisura is a deep and surgically challenging area with complex neurovasculature. Endoscopic paramedian supracerebellar infratentorial approaches (EPSCITAs) have improved access and visualization of this region. However, endoscope and instrument conflict within this deep and narrow corridor remains a key limitation. This study evaluates the feasibility of a combined EPSCITA and endoscopic occipital interhemispheric transtentorial approach (EOIHTTA) with the aim of improving surgical freedom and visualization in this region. METHODS: Five embalmed and latex-injected cadaveric donors were dissected bilaterally (10 sides total). Measurements were taken at the EPSCITA port and then were repeated after addition of the EOIHTTA …

Graph-Based Ai Compiler, Rhodes Floyd Davis Jr.

Defensive Publications Series

This disclosure describes compiler-based techniques of automatic code generation using large language models (LLMs). In contrast to traditional LLM-based code generation, which uses context windows of limited lengths and which stores context globally and not on a per-file basis, the described techniques leverage the graph structure of the codebase to store context. A node of the graph is collapsed to code when all its dependencies are collapsed as well. A prompt is converted to code by collapsing each node to code. The techniques work well for software projects of arbitrary sizes, including projects with very large codebases. In contrast to …

Creative Movement In Action: An Adapted Dance Workshop, Baillie R. Ollila

International Symposium of Adapted Physical Activity and International Symposium on Physical Activity and Visual Impairment and Deafblindness

Dance, as both a type of physical activity and an art of self-expression, may provide a variety of physical, social, and psychological benefits for people with and without disabilities. Adapted dance is a non-traditional physical activity that can allow participants with disabilities to explore movement through the fine art of dance. Adapted dance programming should promote creativity, confidence, and physical activity in a structured setting. This presentation aims to provide professionals with the necessary information to develop and implement adapted dance programming in various settings, thus creating additional opportunities for individuals with disabilities in their areas. The audience will be …

Exploring Enablers Of Creating Inclusive Opportunities, Tracey-Lee Dalton Dr

International Symposium of Adapted Physical Activity and International Symposium on Physical Activity and Visual Impairment and Deafblindness

The National Youth Strategy in Ireland emphasizes "active and healthy physical and mental well-being," a goal that aligns with Sport New Zealand's strategy to provide quality opportunities and experiences for disabled individuals. This aims to create a New Zealand where everyone can benefit from being active. In New Zealand, 11% of youth (ages 8-15) identify as disabled, and face limited opportunities for physical activity. The “Hauora Inclusion” initiative seeks to address this by enhancing wellbeing and creating purposeful opportunities for students with disabilities to engage in physical activity and inclusion. Hauora, a holistic Māori wellbeing concept recognized by the World …

Ipepas Inclusive Aquatics Practical For Practitioners, Eileen Sayers

International Symposium of Adapted Physical Activity and International Symposium on Physical Activity and Visual Impairment and Deafblindness

Abstract ISAPA 2025

Title: IPEPAS Inclusive Aquatics Practical for Practitioners

According to the World Health Organisation there are currently 1.3 billion people with disabilities in the world. The Irish Sports Monitor report in 2023 found that aquatics was one of the most popular physical activities for people with disabilities. The purpose of this practical/CPD is to provide education and training skills to teachers, coaches, tutors, aqua professionals, paraprofessionals and volunteers. It will offer attendees practical tools and knowledge they can apply in their own work, creating new opportunities for them to thrive in their work as inclusive aquatics practitioners. It …

The Adventure Toolkit; Enhancing The Therapy Experience Using Adventures In Blue And Green Spaces, Philip G. Stallard, Jasmin A. Stallard

International Symposium of Adapted Physical Activity and International Symposium on Physical Activity and Visual Impairment and Deafblindness

Adventure therapy combines evidence-based therapy work with purposeful adventures in nature. The impact and efficacy of therapy can be enhanced when creative tools and activities support participants’ therapeutic objectives.

The common factors (therapeutic alliance, empathy, expectations), known to support good outcomes in therapy, are enhanced by messaging that is clear, engaging, and relevant.

This active and engaging approach brings in more than the simple experience of nature, it provides opportunities to explore language, to visualise possibilies, and to consider new ideas through adventures and metaphors in nature.

This workshop introduces participants to the Adventure Therapy Toolkit; a collection of tools …

Comparison Of Functional Movement Screen And Balance Assessments After 6-Week Corrective Exercise Programs Developed For Deaf And Hard-Of-Hearing Individuals, Pelin Aksen, Pamela Beach, Lauren Lieberman, Melanie Perreault, Sean Flanagan

International Symposium of Adapted Physical Activity and International Symposium on Physical Activity and Visual Impairment and Deafblindness

The aim of this study was to compare Functional Movement Score (FMS) and balance assessments after 6-week corrective exercise programs developed for hard-of-hearing and Deaf Individuals. 17 participants studying at Rochester Institute of Technology National Technical Institute for the Deaf with a total FMS score of 14 and above were divided into two groups as experimental (EG) (21.30±2.31 years) and control (CG) (27.71±10.29 years). Body mass index (BMI) was assessed using the FMS Test kit for FMS analysis, and balance was assessed using the Biodex balance device. The 6-week corrective exercise program significantly improved body composition, movement quality, and balance …

The Relationship Between Weight Stigma And Exercise Avoidance: Exploring The Role Of Internalized Weight Stigma And Social Anxiety, Qingqing Li, Yun Li

International Symposium of Adapted Physical Activity and International Symposium on Physical Activity and Visual Impairment and Deafblindness

Introduction Appearance-related and weight-related stigma have been identified as factors influencing an individual’s engagement in physical activities and exercise. However, the social-psychological mechanisms underlying the avoidance of these activities remain insufficiently explored. This study aims to investigate the impact of weight stigma on exercise avoidance behaviors among university students and examine the mediating roles of internalized weight stigma and social anxiety.

Methodology The study recruited 1,397 Chinese university students (ages 17-25) through an online survey, assessing their perceptions of weight stigma, internalized weight stigma, social anxiety, and exercise avoidance behaviors. A chained mediation analysis was conducted using the PROCESS macro …