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Low Remnant Cholesterol And In-Hospital Bleeding Risk After Ischemic Stroke Or Transient Ischemic Attack, Zhiyuan Wu, Haiping Zhang, Yi Xu, Xia Li, Xingang Li, Lois Balmer, Xiuhua Guo, Qi Zhang, Xiang Han, Lixin Tao

Research outputs 2022 to 2026

BACKGROUND: Bleeding risk brought by intensive lipid-lowering therapy and low low-density lipoprotein cholesterol is concern-ing, while evidence regarding the relationship between remnant cholesterol and bleeding is frightening. This study aimed to investigate the association between remnant cholesterol at admission and an in-hospital bleeding event after acute ischemic stroke or transient ischemic attack (TIA). METHODS AND RESULTS: A total of 3222 eligible patients admitted to Shanghai Huashan Hospital between 2015 and 2021 with complete lipid data were analyzed. Patients were classified into low (<20.0 mg/dL), moderate (20.0–29.9 mg/dL), and high (≥30 mg/dL) groups by remnant cholesterol. The mean age of patients was 63.0± 13.1 years, including 2301 (71.4%) men and 651 (20.2%) with TIA. The median (interquartile range) of remnant cholesterol was 18.6 (13.5–25.9) mg/dL. After adjustment for confounding variables, patients with low remnant cholesterol had a higher risk of bleeding events (odds ratio, 2.56 [95% CI, 1.12–6.67]) than those with moderate remnant cholesterol. The high remnant cholesterol group was not significantly associated with bleeding risk. Combined assessment of low-density lipoprotein cholesterol and remnant cholesterol further identi-fied patients with the highest risk of bleeding events. CONCLUSIONS: Low remnant cholesterol levels were associated with bleeding events during the acute stage of ischemic stroke and TIA. The assessment of remnant cholesterol could inform the bleeding risk during hospitalization both for patients and physicians in clinical practice.

Resting State Electrophysiological Profiles And Their Relationship With Cognitive Performance In Cognitively Unimpaired Older Adults: A Systematic Review, Brenda Chino, David López-Sanz, Sandra Doval, Lucía Torres-Simón, Jaisalmer De Frutos Lucas, Lydia Giménez-Llort, Jonathan Zegarra-Valdivia, Fernando Maestú

Research outputs 2022 to 2026

Background: Aging is a complex and natural process. The physiological decline related to aging is accompanied by a slowdown in cognitive processes, which begins shortly after individuals reach maturity. These changes have been sometimes interpreted as a compensatory sign and others as a fingerprint of deterioration. Objective: In this context, our aim is to uncover the mechanisms that underlie and support normal cognitive functioning in the brain during the later stages of life. Methods: With this purpose, a systematic literature search was conducted using PubMed, Scopus, and Web of Science databases, which identified 781 potential articles. After applying inclusion and …

Allopurinol: Clinical Considerations In The Development And Treatment Of Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis, And Other Associated Drug Reactions, Kathryn M. Dillman, Alison M. Hawkins, Amanda R. Ragland, Grace C. Wester, Driskell R. Greene, Giustino Varrassi, Peyton Moore, Raju Behara, Shahab Ahmadzadeh, Harish Siddaiah, Sahar Shekoohi, Alan D. Kaye

School of Medicine Faculty Publications

Allopurinol lowers urate production through the inhibition of xanthine oxidase. It is oxidatively hydroxylated to oxypurinol and is the most prescribed medication for gout treatment. Although it has a beneficial effect in the treatment of this common disease, like many medications, it is also known for having numerous adverse effects. Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), diseases that exist on a spectrum, are two of the most dangerous adverse effects associated with allopurinol use. These immune-mediated disease processes involve almost every organ system. They are essential to recognize as early as possible, as they could potentially be deadly, …

Dietary Acculturation Is Associated With Altered Gut Microbiome, Circulating Metabolites, And Cardiovascular Disease Risk In Us Hispanics And Latinos: Results From Hchs/Sol, Yi Wang, Guo-Chong Chen, Zheng Wang, Kai Luo, Yanbo Zhang, Yang Li, Amanda C Mcclain, Marta M Jankowska, Krista M Perreira, Josiemer Mattei, Carmen R Isasi, Maria M Llabre, Bharat Thyagarajan, Martha L Daviglus, Linda Van Horn, David Goldsztajn Farelo, Luis E Maldonado, Steven R Levine, Bing Yu, Eric Boerwinkle, Rob Knight, Robert D Burk, Robert C Kaplan, Qibin Qi, Brandilyn A Peters

Faculty, Staff and Student Publications

Background: Dietary acculturation, or adoption of dominant culture diet by migrant groups, influences human health. We aimed to examine dietary acculturation and its relationships with cardiovascular disease (CVD), gut microbiota, and blood metabolites among US Hispanic and Latino adults.

Methods: In the HCHS/SOL (Hispanic Community Health Study/Study of Latinos), US exposure was defined by years in the United States (50 states and Washington, DC) and US nativity. A dietary acculturation pattern was derived from 14 172 participants with two 24-hour dietary recalls at baseline (2008-2011) using least absolute shrinkage and selection operator regression, with food groups as predictors of US …

Association Between Psychological Distress And Diabetic Retinopathy Among U.S. Adults, Claret Ijeoma Onukogu

Walden Dissertations and Doctoral Studies

Diabetes can lead to diabetic retinopathy, an eye disease that causes damaged blood vessels and the growth of abnormal ones, leading to vision loss. The two stages of the disease are non-proliferative and proliferative diabetic retinopathy. In the non-proliferative stage, diabetics develop macular edema and ischemia with shortage of blood in the macula region of the eye, and the vision eventually becomes blurry. However, the proliferative stage is the advanced stage of the disease involves neovascularization and retinal detachment. The quantitative study employed the socioecological model as the theoretical framework to examine the relationship between psychological distress and diabetic retinopathy …

Mutant Androgen Receptor Induces Neurite Loss And Senescence Independently Of Are Binding In A Neuronal Model Of Sbma, Jordyn Karliner, Y Liu, Diane Merry

Department of Biochemistry and Molecular Biology Faculty Papers

Spinal and bulbar muscular atrophy (SBMA) is a slowly progressing neuromuscular disease caused by a polyglutamine (polyQ)-encoding CAG trinucleotide repeat expansion in the androgen receptor (AR) gene, leading to AR aggregation, lower motor neuron death, and muscle atrophy. AR is a ligand-activated transcription factor that regulates neuronal architecture and promotes axon regeneration; however, whether AR transcriptional functions contribute to disease pathogenesis is not fully understood. Using a differentiated PC12 cell model of SBMA, we identified dysfunction of polyQ-expanded AR in its regulation of neurite growth and maintenance. Specifically, we found that in the presence of androgens, polyQ-expanded AR inhibited neurite …

Extracellular Vesicles, Circadian Rhythms, And Cancer: A Comprehensive Review With Emphasis On Hepatocellular Carcinoma, Baharan Fekry, Lierni Ugartemendia, Nestor F Esnaola, Laura Goetzl

Faculty, Staff and Student Publications

This review comprehensively explores the complex interplay between extracellular vesicles (ECVs)/exosomes and circadian rhythms, with a focus on the role of this interaction in hepatocellular carcinoma (HCC). Exosomes are nanovesicles derived from cells that facilitate intercellular communication by transporting bioactive molecules such as proteins, lipids, and RNA/DNA species. ECVs are implicated in a range of diseases, where they play crucial roles in signaling between cells and their surrounding environment. In the setting of cancer, ECVs are known to influence cancer initiation and progression. The scope of this review extends to all cancer types, synthesizing existing knowledge on the various roles …

Enhancing The Carbon Monoxide Oxidation Performance Through Surface Defect Enrichment Of Ceria-Based Supports For Platinum Catalyst, Shaohua Xie, Yue Lu, Kailong Ye, Wei Tan, Sufeng Cao, Chunying Wang, Daekun Kim, Xing Zhang, Jeremia Loukusa, Yaobin Li, Yan Zhang, Lu Ma, Steven N Ehrlich, Nebojsa S Marinkovic, Jiguang Deng, Maria Flytzani-Stephanopoulos, Fudong Liu

Faculty, Staff and Student Publications

Effective synthesis and application of single-atom catalysts on supports lacking enough defects remain a significant challenge in environmental catalysis. Herein, we present a universal defect-enrichment strategy to increase the surface defects of CeO2-based supports through H2 reduction pretreatment. The Pt catalysts supported by defective CeO2-based supports, including CeO2, CeZrOx, and CeO2/Al2O3 (CA), exhibit much higher Pt dispersion and CO oxidation activity upon reduction activation compared to their counterpart catalysts without defect enrichment. Specifically, Pt is present as embedded single atoms on the CA support with enriched surface defects (CA-HD) based on which the highly active catalyst showing embedded …

Biophysics Of Protein-Lipid Interactions, Paula A Bender, Vasanthi Jayaraman

Faculty, Staff and Student Publications

The biological phenomenon of protein-lipid interactions in cell membranes underlies the diversity of peripheral membrane protein function and physical properties of the membrane. To summarize novel findings in the field, this research highlight focuses on recent publications in Biophysical Journal.

Soft Matter Physics Of The Ground Beneath Our Feet, Anne Voigtländer, Morgane Houssais, Karol A. Bacik, Ian C. Bourg, Justin C. Burton, Karen E. Daniels, Sujit S. Datta, Emanuela Del Gado, Nakul S. Deshpande, Olivier Devauchelle, Behrooz Ferdowsi, Rachel Glade, Lucas Goehring, Ian J. Hewitt, Douglas Jerolmack, Ruben Juanes, Arshad Kudrolli, Ching Yao Lai, Wei Li, Claire Masteller, Kavinda Nissanka, Allan M. Rubin, Howard A. Stone, Jenny Suckale, Nathalie M. Vriend, John S. Wettlaufer, Judy Q. Yang

Physics

The soft part of the Earth's surface - the ground beneath our feet - constitutes the basis for life and natural resources, yet a general physical understanding of the ground is still lacking. In this critical time of climate change, cross-pollination of scientific approaches is urgently needed to better understand the behavior of our planet's surface. The major topics in current research in this area cross different disciplines, spanning geosciences, and various aspects of engineering, material sciences, physics, chemistry, and biology. Among these, soft matter physics has emerged as a fundamental nexus connecting and underpinning many research questions. This perspective …

A Multicenter, Phase 1, Adult Brain Tumor Consortium Trial Of Oral Terameprocol For Patients With Recurrent High-Grade Glioma (Gator), Manmeet Ahluwalia, Ahmad Ozair, Atulya Khosla

All Publications

Recurrent high-grade gliomas (rHGGs) have a dismal prognosis, where the maximum tolerated dose (MTD) of IV terameprocol (5 days/month), a transcriptional inhibitor of specificity protein 1 (Sp1)-regulated proteins, is 1,700 mg/day with median area under the plasma concentration-time curve (AUC) of 31.3 μg∗h/mL. Given potentially increased efficacy with sustained systemic exposure and challenging logistics of daily IV therapy, here we investigate oral terameprocol for rHGGs in a multicenter, phase 1 trial (GATOR). Using a 3 + 3 dose-escalation design, we enroll 20 patients, with median age 60 years (range 31-80), 70% male, and median one relapse (range 1-3). Fasting patients …

Early Bolus Epinephrine Administration During Pediatric Cardiopulmonary Resuscitation For Bradycardia With Poor Perfusion: An Icu-Resuscitation Study, Amanda O'Halloran, Ron Reeder, Robert Berg, Tageldin Ahmed, Michael Bell, Robert Bishop, Matthew Bochkoris, Candice Burns, Joseph Carcillo, Todd Carpenter, J. Michael Dean, J. Wesley Diddle, Myke Federman, Richard Fernandez, Ericka Fink, Deborah Franzon, Aisha Frazier, Stuart Friess, Kathryn Graham, Mark Hall, David Hehir, Christopher M Horvat, Leanna Huard, Martha Kienzle, Todd Kilbaugh, Tensing Maa, Arushi Manga, Patrick Mcquillen, Kathleen Meert, Peter Mourani, Vinay Nadkarni, Maryam Naim, Daniel Notterman, Murray Pollack, Anil Sapru, Carleen Schneiter, Matthew Sharron, Neeraj Srivastava, Bradley Tilford, Alexis Topjian, Shirley Viteri, David Wessel, Heather Wolfe, Andrew Yates, Athena Zuppa, Robert Sutton, Ryan Morgan

Department of Pediatrics Faculty Papers

BACKGROUND: Half of pediatric in-hospital cardiopulmonary resuscitation (CPR) events have an initial rhythm of non-pulseless bradycardia with poor perfusion. Our study objectives were to leverage granular data from the ICU-RESUScitation (ICU-RESUS) trial to: (1) determine the association of early epinephrine administration with survival outcomes in children receiving CPR for bradycardia with poor perfusion; and (2) describe the incidence and time course of the development of pulselessness.

METHODS: Prespecified secondary analysis of ICU-RESUS, a multicenter cluster randomized trial of children (< 19 years) receiving CPR in 18 intensive care units in the United States. Index events (October 2016-March 2021) lasting ≥ 2 min with a documented initial rhythm of bradycardia with poor perfusion were included. Associations between early epinephrine (first 2 min of CPR) and outcomes were evaluated with Poisson multivariable regression controlling for a priori pre-arrest characteristics. Among patients with arterial lines, intra-arrest blood pressure waveforms were reviewed to determine presence of a pulse during CPR interruptions. The temporal nature of progression to pulselessness was described and outcomes were compared between patients according to subsequent pulselessness status.

RESULTS: Of 452 eligible subjects, 322 (71%) received early epinephrine. The early epinephrine group had higher pre-arrest severity of illness …

Mapping The Contribution Of The C-Linker Domain To Gating Polarity In Cnbd Channels, Jenna L Lin, Yongchang Chang, Debanjan Tewari, John Cowgill, Baron Chanda

2020-Current year OA Pubs

Ion channels of the cyclic nucleotide-binding domain (CNBD) family play a crucial role in the regulation of key biological processes, such as photoreception and pacemaking activity in the heart. These channels exhibit high sequence and structural similarity but differ greatly in their functional responses to membrane potential. The CNBD family includes hyperpolarization-activated ion channels and depolarization-activated ether-à-go-go channels. Structural and functional studies show that the differences in the coupling interface between these two subfamilies' voltage-sensing domain and pore domain may underlie their differential response to membrane polarity. However, other structural components may also contribute to defining the polarity differences in …

If At First We Don't Succeed, Should We Try, Try Again?, Kriti Puri, Susan W Denfield

Faculty, Staff and Students Publications

No abstract provided.

Annual Progress In Global Carbon Capture, Utilization, And Storage In 2023, Siyuan Fang, Yun Hang Hu

Michigan Tech Publications

Since the industrial revolution, global anthropogenic CO2 emissions have surged dramatically to unsustainable levels, resulting in severe issues, such as global warming, extreme weather events, and species extinction. In response to this critical situation, extensive efforts have been undertaken across academia, industry, and policymaking sectors to deploy carbon capture, utilization, and storage (CCUS) technologies. Here, we present the annual summary of global CCUS for the year 2023. We begin by discussing the trends of anthropogenic CO2 emissions and atmospheric CO2 concentrations, and then offer an up-to-date summary of progress in academia, industry, and policy, respectively. In academia, we analyze the …

Analysis Of The Potential For Enhancing The Efficiency Of A Floating Photovoltaic (Fpv) System, How-Ping Wu, Ching-Yi Tseng, Chuan-Chung Jen, Yuan-Ching Chiang, Sih-Li Chen

Journal of Marine Science and Technology–Taiwan

This study examined the power generation capabilities of FPV systems and the advantages of employing active cooling on floating solar panels. Floating solar panels exhibit improved efficiency due to operating at lower temperatures facilitated by the cooling effect of water evaporation. Additionally, the high availability of water renders the application of the active cooling technique economically viable. This study developed a comprehensive simulation of a floating solar system, integrating a mathematical model to validate experimental findings and a temperature model derived from an energy equation specific to floating solar panels. This model calculates the heat transfer among the three different …

Sustaining America's Non-Jurisdictional Wetlands Post-Sackett Through Conservation, Shawna Bligh

UMKC Law Review

Part I of this Article discusses the functional role of wetlands in meeting the intended purpose of the Clean Water Act (“CWA”). The intended purpose of the CWA is to "restore and maintain the chemical, physical and biological integrity of the Nation's waters." The Court's decision in Sackett undermines the intended purpose of the CWA. Wetlands play an essential role in meeting this objective. Wetlands are hydrologically connected to and an embedded part of the overall aquatic ecosystem. The Sackett decision leaves wetlands subject to further degradation.

Part II of this Article provides an overview of the CWA, how we …

How I (We!) Got Involved With Treating Those With Special Needs

New Orleans Dental Association News

This article recounts how a dentist and his wife support the oral health of patients with special needs and their work to educate others, including dental students and state representatives.

Noda News Summer 2024

New Orleans Dental Association News

New Orleans Dental Association (NODA) News includes regular columns with regional news impacting the New Orleans membership including: columns from the President and Executive Director, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

Seeing Race & Sexuality: Child Welfare & Forced Labor, Annie Isabel Fukushima, Jens Nilson, Kaden Richards

Arkansas Law Review

This Article examines how child welfare responds to children who are forced to labor through a case study of California. We use an intersectional framework to argue that a conceptualization of current sociolegal responses to human trafficking cannot be delinked from racialized and sexualized forms of governmentality. In using an intersectional framework, we hope to draw upon intersectionality as a way to “point[] to the ways that structural inequality, persistent disadvantages, and structural abandonment are some of the root causes of microlevel violent interactions and at the same time influence how effective macrolevel justice policies are at responding to or …

Fractal-Based Connectivity In Spherical Spiking Neural Networks (Snn), Renee Gagnon

Defensive Publications Series

This document introduces a novel fractal-based connectivity method for Spherical Spiking Neural Networks (SNNs). This approach significantly enhances the initialization and resource efficiency of the network, making it suitable for large-scale models and extending the usability of older hardware. The fractal method can potentially accelerate network setup by up to 50% and improve long-term energy efficiency based on tests on older hardware.

Effects Of Two Grazing Conditions On The Reproductive Achievement Of Male Alpaca In The Northern Peru Grasslands, C Pinares, E Malpartida, S Cortez

IGC Proceedings (1977-2023)

Alpaca have recently been introduced to the northern Peru grasslands (Jalca). Effects of two systems of grazing management, co-grazing (with sheep) under fair grassland condition (CGFC) versus exclusive grazing under good grassland condition (EGGC), upon the reproductive achievement was examined from the 6th to the 16th month of age. Each system involved 20 Huacaya animals, managed by individual herders. Availability of herbage preferred by alpaca (HMA) and animal measurements (herbage intake, liveweight, testicle size, penis release from preputial attachments, plasma testosterone) were monitored monthly. Puberty, judged by the penis release from the preputial attachments, was achieved by 7 …

Experiences Of Eight Ohio Beef And Sheep Producers With Year Round Grazing, H M. Bartholomew, S L. Boyles, B Carter, E Vollborn, D Miller, R M. Sulc

IGC Proceedings (1977-2023)

Livestock producers participated in a demonstration project to extend the grazing season and evaluate dormant forage quality and yield. Differences were not detected in yields among forage species but yield differences existed among sites. Yield estimates did not change over time across all forage species but some sites were only able to participate for two months. Producers utilizing fescue beyond November had reductions in herbage mass. Crude protein, available crude protein, acid detergent fiber, and neutral detergent fiber content differed among forage species and sites. Energy and lignin content were similar for all forage species and sites. Sodium and copper …

Forage Production Of Irrigated Lecerne- Grass Mixtures Grazed By Sheep, M L. Enrique, D P. Minon

IGC Proceedings (1977-2023)

The forage production and botanical changes of lucerne cultivars in pure stands and in grass mixtures were studied in a split-plot experiment with irrigation and sheep grazing. The non dormant lucerne cultivars (Medicago sativa) CUF 101, Monarca SPINTA, P 30 and common were the main plots, and tall fescue (Festuca arundinacea), canarygrass (Phalaris aquatica), cocksfoot (Dactylis glomerata), tall wheatgrass (Thynopirum ponticum) and prairie grass (Bromus catharticus) were the subplots. The experiment was grazed 3, 6 and 4 times during 3 years. Total yield was similar for all lucerne …

Oat Grazing: Forage Composition And Supplementation Response, A J. Freddi, M J. Arzadun, A A. Pissani, P Sastre

IGC Proceedings (1977-2023)

Oat forage (Avena sativa), which has low soluble carbohydrates (SC) and high soluble protein (SP) content, can reduce liveweight gain of grazing animals; supplementation with grain and low degradability protein may serve to counteract the effect. A grazing trial was carried out on two soils with different nitrogen (NO3 -) availability, from 16 April 1994 to 6 September 1994. Steers were randomly allocated to 3 treatments: low nitrogen (LN), high nitrogen (HN) and high nitrogen with supplementation (HNS). Forage of LN showed lower SP (p<0.05) during the first month of grazing, and higher SC (p<0.05), than HN during the first two months of the trial. Animal liveweight gain was: 892, 909 and 775 g/an/day for LN, HNS and HN, respectively, with animals in HN of significantly lower liveweight gain (p<0.05). Under the conditions of this trial, animals grazing on oat forage with lower SC and higher SP had lower liveweight gain and responded to supplementation.

Native And Introduced Forage Systems For Cow-Calf Production, S W. Coleman, W A. Phillips, J D. Volesky

IGC Proceedings (1977-2023)

The objectives of this study was to compare a highly productive introduced warm-season perennial grass to native range for cowcalf production over two years. Three systems, 1) native range with pelleted soybean or cottonseed meal as winter protein supplement (NC); 2) native range with wheat pasture (NW); and 3) Plains Bluestem with wheat pasture (PB) were compared. Protein supplements were given twice weekly and cows grazing wheat pasture were allowed 6 hrs to graze. Cows on NW were heavier with higher condition at breeding in the spring of 1994 than those on NC and cows on PB were heavier and …

Rotational Stocking And Soil Nutrient Distribution On Hawaiian Grasslands, B W. Mathews, J P. Tritschler, L E. Sollenberger

IGC Proceedings (1977-2023)

A naturalized kikuyu (Pennisetum clandestinum Hochst. ex Chiov.) grassland was grazed by heifers (Bos taurus) for 2 years to determine the effects of two rotational stocking methods (short vs. long grazing periods) on soil N, P, K, Ca, Mg, and S distribution in paddocks with natural shade. Additionally, kikuyugrass-greenleaf desmodium (Desmodium intortum Urb.) paddocks were used to evaluate soil nutrient distribution in rotationally stocked paddocks (long grazing periods) without shade. In the study with shade, soil N, P, and K distribution did not differ between stocking methods. These nutrients accumulated within 15 m of shade, but did not …

Relationship Between Height And Sward Quality In Rotational Dairy Systems, M R. Mosquera-Losada, A Gonzalez-Rodriguez

IGC Proceedings (1977-2023)

Height is a good guide for management in dairy systems.Intake by dairy cows depends on amount offered and quality of pasture and for this reason a relationship between that offered and pasture quality with height should be studied. The experiment was conducted in NW of Spain with three different stocking rates in dairy systems. A lower quality sward was found in the taller offered pasture as indicated by its higher ADF and lower CP percentages. Total sward ADF (kg x ha-a) was higher in taller offered pasture, which indicated a lower pasture quality, however the total CP was positively related …

Non-Destructive Methods For The Estimation Of Sward Production, M R. Mosquera-Losada, A Gonzalez-Rodriguez

IGC Proceedings (1977-2023)

Two non- destructive methods of grass production were compared: grassmeter and sward stick, in order to find an equation for transforming one into the other in dairy rotational systems. Linear, logarithmic and quadratic equations were fitted to the data. Linear equation was preferred by simplicity. General equations which included all the year periods showed no differences between sward stick and grassmeter. A detailed study of the different phenology states showed lower heights with grassmeter than with the sward stick method, which should take into account grazing management height recommendations.

Pawsitive Purpose: The Impact Of Autism Assistance Dogs On The Occupations Of Autistic Children, Morgan Starkweather, Amie E. Germain, Christine A. Kivlen

The Open Journal of Occupational Therapy

Background. The World Health Organization recognizes that participation is important to individuals’ well being; yet, autistic children participate in fewer activities compared to neurotypical children. This article aims to describe the role of autism assistance dogs (AADs) in promoting participation and engagement in occupations and activities of daily living (ADLs) for autistic children.

Method. A qualitative interpretative phenomenological design was used. Two semi-structured interviews from a narrative perspective were conducted with each participant. Four volunteer parents and primary handlers of their child’s AAD participated in the study. Inductive analysis was used to interpret open-ended questions. Following transcription, Creswell’s …