Digital Commons Network^™

Outcomes Of Witnessed Versus Unwitnessed Patients With Stroke After Endovascular Therapy In The Extended Time Window, Liisa Tomppo, Nicolas Martinez-Majander, Muhammad M Qureshi, Thanh N Nguyen, Raul G Nogueira, Simon Nagel, Jelle Demeestere, Volker Puetz, Hilde Henon, Marta Olive-Gadea, João Pedro Marto, Anne Dusart, Peter A Ringleb, Osama O Zaidat, Diogo C Haussen, Mahmoud H Mohammaden, Mohamad Abdalkader, Jean Raymond, Santiago Ortega-Gutierrez, Sunil A Sheth, Hiroshi Yamagami, João Nuno Ramos, Francois Caparros, Daniel P O Kaiser, Marc Ribo, Sergio Salazar-Marioni, Kanta Tanaka, Pekka Virtanen, Ajit S Puri, James E Siegler, Syed F Zaidi, Mouhammad Jumaa, Eugene Lin, Jordi Mayol, Rita Ventura, Simon Winzer, Piers Klein, Flavio Bellante, Jorge Cespedes, Anke Wouters, Hesham E Masoud, Liqi Shu, Alicia C Castonguay, Christian Herweh, Monica Cheng, Wei Hu, Daniel Roy, Shadi Yaghi, Robin Lemmens, Charlotte Cordonnier, Markus A Möhlenbruch, Daniel Strbian

Faculty, Staff and Student Publications

Background: It remains unclear whether outcomes of patients treated with endovascular thrombectomy with large-vessel occlusion and unwitnessed onset of stroke differ from those with witnessed onset in the extended time window.

Methods: We enrolled patients with anterior circulation large-vessel occlusion (internal carotid artery, M1, or M2 segment of the middle cerebral artery) undergoing endovascular thrombectomy within 6 to 24 hours from the time last seen well, from 2014 to 2022, at 66 sites in Europe, North America, and Asia. Patients with a prestroke modified Rankin Scale score of >3 or age < 18 were excluded. We categorized patients by onset mode as witnessed or unwitnessed. The primary outcome was the modified Rankin Scale shift at 90 days. Secondary outcomes were functional independence, a composite of functional independence or return of Rankin to prestroke level, symptomatic intracranial hemorrhage, mortality, and a composite of severe disability or mortality at 90 days. We applied inverse probability of treatment weighting to compare outcomes between the groups.

Results: Of 5098 patients assessed for eligibility, we included …

Uterine Tachysystole And Associated Outcomes: A Systematic Review And Meta-Analysis, Fabrizio Zullo, Benedetta Licitra, Nandini Raghuraman, Alison G Cahill, Aaron W Roberts, Stephanie Roth, Daniele Di Mascio, Antonella Giancotti, Giuseppe Rizzo, Kristen A Cagino, Hector Mendez-Figueroa, Anthony C Sciscione, Suneet P Chauhan

Faculty, Staff and Student Publications

Objective: To determine whether uterine tachysystole is associated with adverse neonatal and maternal outcomes.

Data sources: A search strategy for PubMed (National Library of Medicine) was created, and the medical librarian translated the search for every database. The search strategy was peer reviewed by another medical librarian following the Peer Review of Electronic Search Strategies checklist. The databases included in this search were PubMed, Embase.com, Cochrane CENTRAL, CINAHL Ultimate, and Scopus; a combination of key words and subject headings was used.

Methods of study selection: Trials of nulliparous or multiparous parturients exposed to uterine tachysystole were included. Included studies compared …

Sleep-Disordered Breathing In Newborns After Myelomeningocele Repair, Renée A Shellhaas, Fauziya Hassan, Thornton A Mason, Jagruti Anadkat, Ellen Bendel-Stenzel, Stephanie Eyerly-Webb, Cindy K Jon, Robin M Lloyd, Julie S Moldenhauer, Ramesha Papanna, John E Pascoe, Stefanie Riddle, Regina Reynolds, Brandon G Rocque, Narong Simakajornboon, Marjorie C Treadwell, R Bradley Troxler, Lydia S Youmans, Niko A Kaciroti, Harlan Mccaffery, Hemant A Parmar, Lora Merley, Stephanie Md Rau, Ronald D Chervin, John D E Barks

Faculty, Staff and Student Publications

Background & objective: Sleep-disordered breathing (SDB) may be a remediable contributor to abnormal cognitive outcomes for children with myelomeningocele. We investigated the frequency of SDB among neonates with fetal vs postnatal myelomeningocele repair.

Methods: In this nine-center, prospective, observational study, neonates with myelomeningocele born at more than 30 weeks gestational age underwent a 10-hour bedside polysomnogram at at least 35 weeks postmenstrual age, before hospital discharge. The primary outcome was SDB severity, reflected by the apnea-hypopnea index (AHI; number of respiratory events per hour of sleep). Decisions regarding surgical timing (fetal vs postnatal), technique (open fetal vs fetoscopic approach), and …

Association Of Intended Mode Of Delivery With Neonatal And Maternal Outcomes At 22-25 Weeks Of Gestation, Jameaka L Hamilton, Paula L Mcgee, Baha M Sibai, Michael W Varner, Alan T N Tita, Monica Longo, Edward F Bell, Barbara J Stoll, John M Thorp, Uma M Reddy, Heather A Frey, Emily S Miller, Dwight J Rouse, Hyagriv N Simhan, Jennifer L Bailit, Lorraine Dugoff, George R Saade

Faculty, Staff and Student Publications

Objective: To compare the risk of neonatal and maternal morbidity and mortality among individuals who delivered between 22 and 25 weeks of gestation by intended mode of delivery.

Methods: This was a secondary analysis of an observational cohort including participants with a singleton pregnancy delivered by planned cesarean delivery or after a trial of labor from 22 0/7 to 25 6/7 weeks of gestation. This analysis was limited to those who received both antenatal steroids and neonatal resuscitation. The primary outcome was a composite of neonatal death or severe neonatal morbidity. Secondary outcomes included neonatal mortality and measures of neonatal …

Bayesian Posthoc Trial Analysis Of Cerclage Management In Preterm Prelabor Rupture Of The Membranes, Beth L Pineles, Kyung Hyun Lee, Baha M Sibai

Faculty, Staff and Student Publications

Background: There is inadequate evidence on whether to retain or remove a cervical cerclage after preterm prelabor rupture of the membranes (PPROM). The PROMCerclage trial was the only study to randomize patients to cerclage retention or immediate cerclage removal after PPROM. The trial was terminated early, and results were not statistically significant but the cerclage retention group had shorter latency and more chorioamnionitis. Bayesian post-hoc trial analysis maximizes available clinical trial data by formally integrating information from preexisting studies or prior beliefs into statistical modeling to estimate the probability of a treatment effect.

Objective: To re-analyze published results of the …

The Long-Term Effectiveness Of The Anti-Obesity Medication Phentermine (Leap) Trial: Rationale, Design, And Baseline Characteristics, Caroline Blackwell Young, Emily Rives, Kimberly A Gudzune, Byron C Jaeger, Courtney G Simmons, Brian N White, Stephanie A Hooker, Deborah B Horn, Deborah R Young, Jennifer Vesely, Amanda Velazquez, Catherine Price, Shelly D Cook, Katy Martin-Fernandez, Galina Inzhakova, Nicholas M Pajewski, Jamy D Ard, Kristina H Lewis

Faculty, Staff and Student Publications

Background: Current clinical practice guidelines support the long-term use of pharmacotherapy for obesity treatment. Historically, phentermine has been one of the most prescribed obesity medications (OMs), however, its long-term efficacy and safety have never been evaluated in a randomized trial as its market approval predates such requirements. Here we describe the design, rationale, and baseline characteristics for a 24-month, double-blind, randomized controlled trial evaluating the efficacy, cardiovascular risk, and safety of phentermine in adults with overweight or obesity.

Methods: This multicenter trial will compare outcomes among participants randomized to phentermine 24 mg daily versus placebo for 24 months. All participants …

Cardiometabolic Parameter Change By Weight Regain On Tirzepatide Withdrawal In Adults With Obesity: A Post Hoc Analysis Of The Surmount-4 Trial, Deborah B Horn, Bruno Linetzky, Melanie J Davies, Luke J Laffin, Hui Wang, Madhumita A Murphy, Sarah Zimner-Rapuch, Eva Lau, Avigdor D Arad, Clare J Lee

Faculty, Staff and Student Publications

Importance: In the SURMOUNT-4 trial, most adults with obesity who had tirzepatide withdrawn following a 36-week treatment regained weight. The association between the degree of weight regain and cardiometabolic parameters after tirzepatide withdrawal is unknown.

Objective: To assess changes in cardiometabolic parameters by degree of weight regain after withdrawal of tirzepatide.

Design, setting, and participants: This post hoc analysis of the SURMOUNT-4 trial included tirzepatide-treated participants with 10% or greater weight reduction at week 36 initially randomized to placebo. Data were collected from March 2021 to May 2023, and data were analyzed from February 2024 to March 2025.

Interventions: After …

Preliminary In Vivo Evaluation Of Coracoclavicular Ligament Mechanics During Shoulder Elevation After Acromioclavicular Joint Reconstruction, Jason Konrath, Sydney Wheaton, Alonso Figueroa, James Gregory, Payam Zandiyeh

Faculty, Staff and Student Publications

Background: Persistent instability and altered scapular mechanics after acromioclavicular joint (ACJ) reconstruction may stem from inadequate replication of native coracoclavicular (CC) ligament function. However, in vivo data on postoperative CC ligament behavior during dynamic shoulder motion remain lacking.

Purpose: To assess in vivo functional distance and timing characteristics of the conoid and trapezoid ligaments during active shoulder elevation after ACJ reconstruction, using dynamic stereo x-ray (DSX) imaging and patient-specific 3-dimensional (3D) models.

Study design: Cross-sectional study; Level of evidence, 3.

Methods: Twelve participants (10 men and 2 women, mean age 39 ± 10 years, mean body mass 92 ± 17 …

Medical Aid In Dying: A Narrative Review Of The Recent Academic Literature In The United States, Anjiya Sulaiman, Courtney Nguyen, Caroline G Snider, Gabriel M Aisenberg

Faculty, Staff and Student Publications

Medical aid in dying (MAiD) is a practice in which a healthcare professional provides assistance to a terminally ill patient seeking to end their life. To assess how academic discourse may shape public opinion and policy in the United States, we conducted a narrative review of the literature published between 2020 and 2024. Articles were categorized as supportive, opposing, or neutral, and patterns were examined across authorship, disciplinary focus, and target populations. Our findings reveal that most recent publications adopt supportive or neutral stances toward MAiD, with a slight increase in opposition beginning in 2022. Authorship discipline strongly influenced position, …

Optimization Of Pressure And Flow Rate For Co2 Microbubble Generation Using Porous Ceramic Membrane: Insights For Co₂ Geological Storage, Malek Jalilian, Tawanda Matamba, David Tang, Alireza Keshavarz, Stefan Iglauer

Research outputs 2022 to 2026

CO2 microbubbles show significant potential in carbon capture and storage (CCS) through enhancing CO2 dissolution and improving the residual trapping mechanism. To take full advantage of microbubbles, maximizing their generation by selecting the optimal operational conditions, including injection pressure and flow rate, is essential. In this study, we examined a wide range of experimental conditions to quantitatively evaluate the potential of a porous ceramic membrane for producing CO2 microbubbles in a chemical-free manner. In particular, the effects of injection pressure (5.0–10.0 MPa) and CO2 flow rate (0.25–5 mL/min) on mean bubble diameter (DMB) and microbubble yield efficiency (YMB) were systematically …

Dual Self-Construal Integration (Dsci) And Romantic Relationships In Singapore: Enhancing Romantic Relationship Satisfaction Through Creativity, Kenneth Tan, Chi-Ying Cheng, Gloria J. Lai, Daniel Ho

Research Collection School of Social Sciences

Research has shown that independent vs. interdependent self-construals are largely shaped by culture and can predict the endorsement of distinct relational schemes when dealing with close others. Intriguingly, individuals exposed to both Eastern and Western cultures can develop both independent and interdependent self-construals and possess the two seemingly conflicting self-construals simultaneously. What is less explored is how different management of both independent and interdependent self-construals influence individuals' navigation of relational schemas in their romantic relationships. The current research examines the influence of how one's dual self-construal integration (DSCI)—an individual difference measure that captures the degree to which individuals perceive independent …

The Powerful Teacher: A Power Hypothesis For The Benefits Of Learning-By-Teaching, Sarah Shi Hui Wong, Stephen Lim

Research Collection School of Social Sciences

Why does teaching others enhance one's learning? This study advanced a novel power hypothesis of learning-by-teaching: When assuming the role of a teacher, students experience a heightened sense of power in influencing others, which increases their own learning. University students (N = 242) studied a scientific text using one of three learning methods: notetaking, explaining, or teaching. The notetaking group prepared to be tested and wrote study notes about the topic; the explaining group prepared to explain and wrote an explanation about the topic as how they would write a textbook for their peers; the teaching group prepared to teach …

How Consistent Friendlike Conversation With Ai Companions Influences Our Attitudes And Perceptions Toward Ai: An Exploratory Experiment, Qi Hui Jerlyn Ho, Meilan Hu, Adalia Yin Hui Goh, Emma Jane Pragasam, Andree Hartanto

Research Collection School of Social Sciences

Despite skepticism and distrust in artificial intelligence (AI), it is increasingly integrated into daily life, with its potential benefits drawing interest. Yet little is known about the attitudinal and psychological effects of human–AI interactions, and whether consistent interactions with AI chatbots can change users’ attitudes and perceptions. Our within-subjects experiment (N = 52) investigated how five days of socially oriented, friendlike interactions with an AI chatbot, versus a journaling control, influenced changes in attitudes and perceptions of AI. Participants’ attitudes towards AI, trust, perceived empathy, anthropomorphism, animacy, likeability, perceived intelligence and safety, dependency, and exploratory well-being indicators were recorded. Results …

Vulnerability Of Marine Megafauna To Global At-Sea Anthropogenic Threats, Michelle Vancompernolle, Juliet Morris, Hannah J. Calich, Jorge P. Rodríguez, Sarah A. Marley, Jessica R. Pearce, Briana Abrahms, Katya Abrantes, André S. Afonso, Alex Aguilar, Andrews Agyekumhene, Tomonari Akamatsu, Susanne Åkesson, Nyimale G. Alawa, Joanna Alfaro-Shigueto, R. C. Anderson, Tycho Anker-Nilssen, Javier A. Arata, Gonzalo Araujo, Martin C. Arostegui, Haritz Arrizabalaga, Chandra P. Salgado Kent

Research outputs 2022 to 2026

Marine megafauna species are affected by a wide range of anthropogenic threats. To evaluate the risk of such threats, species’ vulnerability to each threat must first be determined. We build on the existing threats classification scheme and ranking system of the International Union for Conservation of Nature (IUCN) Red List of Threatened Species by assessing the vulnerability of 256 marine megafauna species to 23 at-sea threats. The threats we considered included individual fishing gear types, climate-change-related subthreats not previously assessed, and threats associated with coastal impacts and maritime disturbances. Our ratings resulted in 70 species having high vulnerability (v > 0.778 …

Animal Taxa Threatened By Adverse Fire Regimes In Western Australia: A Synthesis And Outlook, Tim S. Doherty, Mark G. Allen, Karlene Bain, Stephen J. Beatty, Allan H. Burbidge, Renee A. Catullo, Sarah Comer, Ben Corey, Saul J. Cowen, Robert A. Davis, Martin A. Dziminski, J. Anthony Friend, Bruce Greatwich, Mark S. Harvey, Hannah Killian, Michael W. Klunzinger, Damian C. Lettoof, Nicola J. Mitchell, Melinda Moir, Harry A. Moore, David L. Morgan, Ian J. Radford, Michael G. Rix, Tom Vigilante, Adrian F. Wayne, Corey Whisson

Research outputs 2022 to 2026

Adverse fire regimes threaten biodiversity, potentially leading to population declines and increased extinction risk. Understanding how varying fire regimes affect threatened species is essential for effective ecosystem management, including in Western Australia where diverse ecosystems are exposed to wildfires, Indigenous burning, and prescribed fire. We compiled and synthesised data on the threat of adverse fire regimes to threatened animal taxa in Western Australia. Using a threat classification scheme, we ranked adverse fire regimes as having either no, low, medium, high, or unknown impact on each taxon. A total of 212 taxa were reviewed, 153 (72%) of which are considered fire-threatened: …

Beyond The Hype: Organisational Adoption Of Generative Ai Through The Lens Of The Toe Framework–A Mixed Methods Perspective, Laurie Hughes, Fern Davies, Keyao Li, Senali Madugoda Gunaratnege, Tegwen Malik, Yogesh K. Dwivedi

Research outputs 2022 to 2026

It is widely accepted that the impact of Generative Artificial Intelligence (GenAI) has been nothing short of transformational, with tangible impacts on industry, education, healthcare and government. But beyond the headlines, how are organisations actually using GenAI, what are the key challenges experienced by decision makers and has the reality on the ground matched the hype? This study adopts a mixed-methods approach, utilising the Technology-Organisation-Environment (TOE) framework to reveal greater insights to how organisations are adopting GenAI, the drivers that affect decision making and the key challenges associated with greater use of the technology. This research adopts a mixed method …

Contemporary Structures, Processes, And Outcomes Of Critical Care Nursing Education: An Integrative Review, Farida Saghafi, Carol Grech, Belinda Causby, Angelique Clarke, Jacqueline Jauncey-Cooke, Deb Massey, Kaye Rolls, Kylie Thompson, Melanie Greenwood

Research outputs 2022 to 2026

Objective: The critical care workforce requires nurses who are specialised, educated, and adaptable to manage complex situations, with the capability to make informed decisions for optimal patient care. The Australian College of Critical Care Nurses supports evidence-based practice through an education position statement, which is periodically updated to reflect evolving needs. In this review, our aim was to inform revisions to the position statement on critical care nurse education by examining the structure, processes, and outcomes of contemporary education programs designed to enhance the capability of registered nurses working in critical care environments internationally. Review method used: An integrative review …

In-Situ Carbon Mineralization Through Injection Of Co2-Saturated Water Into Basalts: Effects On Pore Network, Seyi Philemon Akanji, Lionel Esteban, Ausama Giwelli, Joel Sarout, Alireza Keshavarz, Stefan Iglauer

Research outputs 2022 to 2026

Carbon capture and storage (CCS) offers the potential to remove and safely store significant quantities of carbon dioxide from the atmosphere, thereby limiting global warming. Conventional geological storage involves injecting CO2, in gaseous or supercritical state, into porous rock reservoirs, relying on geological top seals, capillary forces and/or dissolution in groundwater as the primary “locking-in” processes. An alternative method injects CO2-saturated water into mafic rocks (basalts), chemically inducing in-situ mineralization of CO2 to form solid carbonate minerals. This mechanism offers the lowest risk of carbon returning to the atmosphere. This review synthesizes field and laboratory studies on CO2 mineralization in …

Intrapartum Experiences Of Gestational Surrogates And Intended Parents In Australia: A Qualitative Study, Jutharat Attawet, Leo Ng, Evie Kendal, Yunjing Qiu, Myles Ojabo, Sarah Jefford, Micah D.J. Peters

Research outputs 2022 to 2026

Background Gestational surrogacy is an increasingly visible, though tightly regulated, pathway to parenthood in Australia, yet intrapartum care remains under-examined. Existing maternity models are grounded in woman-centred care and offer limited guidance for births involving surrogates and intended parents within a triadic care relationship. Objectives To describe the intrapartum experiences of gestational surrogates and intended parents in Australia and to identify care processes that support or hinder respectful, inclusive practice. Methods A descriptive qualitative study was conducted with purposive sampling. Seventeen participants took part between December 2024 and May 2025, comprising nine gestational surrogates and eight intended parents who had …

Machine Learning-Enriched Distributionally Robust Optimization And Hybrid Decomposition To Joint Optimization Of Transportation Hub Network Design And Pricing, Seyed Ashkan Hosseini Shekarabi, Reza Kiani Mavi, Flavio Romero Macau, Ali Papi, Ashkan Teymouri

Research outputs 2022 to 2026

Freight transportation within the hub-assisted systems enhances economies of scale for carriers by consolidating logistics operations through central hubs, thereby increasing efficiency and reducing costs. Optimally designing such transportation systems creates competitive advantages for carriers, enabling them to reduce shipping prices and, consequently, capture a larger share of the market from shippers’ demand. This research addresses the joint optimization of intermodal transportation hub network design and pricing decisions under price-dependent and uncertain demand, with the objective of maximizing carrier's profit. Since the uncertain shipping demand follows a nonlinear relation with price, the carrier not only optimizes shipping network design but …

Mitigating Malware Prevalence In Networks With Arbitrary Topologies: A Flip-It Cyber Game Approach Integrated With Epidemic Modeling, Mousa Tayseer Jafar, Lu Xing Yang, Gang Li, Robin Doss, Kon Mouzakis, Rajesh Vasa, Helge Janicke, Ahmed Ibrahim, Ahmed Mohsin, Iqbal H. Sarker, Kristen Moore, Seyit Camtepe, Diksha Goel

Research outputs 2022 to 2026

Cyber threats have evolved in complexity, aiming at a wide range of sectors using advanced methods and tools. This evolving threat landscape challenges existing cybersecurity frameworks, many of which lack the adaptability to counteract the complex tactics of sophisticated adversaries. Developing robust cyber defense strategies requires simulating dynamic interactions between attackers and defenders across high, moderate, and low-impact scenarios. The Flip-It cyber game serves as an intelligent framework for simulating these interactions, enabling the analysis of adaptive strategies in cybersecurity. This paper aims to address the problem of mitigating malware prevalence with full consideration of attack/defense capabilities in arbitrary network …

Personal Resources Among Pre-Service Teachers: An Examination Of Links With Subjective Vitality And Occupational Commitment, Helena Granziera, Rebecca J. Collie, Caroline Mansfield

Research outputs 2022 to 2026

The retention of pre-service teachers presents persistent and significant challenges for education and society alike. An emerging body of research suggests that the cultivation of personal resources may serve as a means to foster PSTs wellbeing, which is integral to fostering positive experiences within teacher education. We sought to examine this potential association in a sample of 664 Australian teachers by investigating the associations between five personal resources - adaptability, workplace buoyancy, psychological detachment, optimism, and social self-efficacy - and two teaching-related outcomes: subjective vitality at work and occupational commitment. Using structural equation modelling, analysis of data collected from PSTs …

Evaluation Of Host-Immune Biomarker Signatures As Multiplex Qpcr Diagnostic Assays: A Pilot Study Toward Meeting Who Target Product Profiles For Tb Diagnosis In India, Harriet N. Garlant, Kalaiarasan Ellappan, Noyal Mariya Joseph, Carrie Turner, Vishnukanth Govindaraj, Saka Vinod Kumar, Sanjeev Kumar, Seshadri S. Vasan, Karen Elizabeth Kempsell

Research outputs 2022 to 2026

Background: Tuberculosis (TB) remains the leading cause of death from a single infectious agent. Current diagnostic tools are limited, especially in low-resource settings. The World Health Organization's (WHO) Target Product Profiles (TPPs) call for rapid, non-sputum-based diagnostics with high sensitivity and specificity. This study evaluates our previously published TB-associated host-immune biomarkers alongside small-size signatures from other studies, in our previously published non-human primate (NHP) TB infection study dataset (GSE76703) and two previously published human datasets (GSE144127, GSE42834), which include other disease group comparators, including sarcoidosis. These were also evaluated in a small-scale, exploratory qPCR pilot study to assess the feasibility …

Treatment And Valorization Of Spent Caustic Brine: A Critical Review With Emphasis On Membrane Technologies, Rouba D. Al Bostami, Amani Al Othman, Muhammad Tawalbeh, Kerry N. Mcphedran, Mohammad Mahdi A. Shirazi

Research outputs 2022 to 2026

Spent caustic brine (SCB) is a hazardous yet resource-rich industrial waste, primarily composed of sodium hydroxide, water, and contaminants such as sulfides, phenols, organic compounds, heavy metals, and valuable minerals. Originating from industries such as oil and gas, metal finishing, and food processing, SCB poses high pH ('11), high total dissolved solids (up to 58,000 ppm), heavy metal content, and elevated chemical oxygen demand (COD). In this work, treatment and valorization methods for SCB are categorized into three groups: traditional techniques without caustic or water recovery, conventional techniques with limited recovery, and membrane technologies offering effective caustic and water recovery …

Addressing Systemic Workforce Challenges In General Practice—A Qualitative Study Of General Practitioners In Ireland, Uzair Shabbir, Ray O’Connor, Joe Macdonagh, Andrew O’Regan

Research Outputs: 2025-Present

Background General practice across Europe faces a workforce crisis, with a projected shortfall of up to 1660 general practitioners in Ireland by 2028. While policy interventions have been proposed, a gap remains between the Irish health system's strategic objectives and the day-to-day realities experienced by general practitioners. Objective The aim of this study is to explore the perspectives of Irish general practitioners in addressing recruitment and retention challenges in general practice. Specific objectives include identifying solutions and the supports necessary for sustainable future general practice. Methods A qualitative study design was employed, utilizing semi-structured online interviews with general practitioners recruited …

A Social Norm Perspective On Distorted Information In China, Zhe Li, Massimo Massa, Nianhang Xu, Hong Zhang

Research Collection Lee Kong Chian School Of Business

Can social norms give rise to distorted information in China? We observe that China’s leading social norm related to alcohol consumption and social drinking enhance earnings management. An analysis of toxic alcohol scandals supports a causal interpretation. Further evidence suggests that the influence of alcohol may come from the negative externality that it creates, which is propagated by corporate leaders and cannot be attenuated by market-oriented institutions. Our results reveal a social norm externality that may have important normative implications.

Are Less Hierarchical Firms Organized Around Stronger Cultures? Evidence From Big Data, Arianna Marchetti, Phanish Puranam

Research Collection Lee Kong Chian School Of Business

Research Summary: Are less hierarchical firms organized around stronger cultures instead? We analyze 1.5 million employee reviews on Glassdoor.com from 23,000 US-based firms, alongside data on managerial hierarchy estimated from 42 million professional social media profiles. Our findings confirm a negative association between managerial hierarchy and organizational culture strength. We explore two potential explanations for this association: Functional equivalence between the two, and culture fragmentation caused by managerial hierarchy. Multiple correlational tests show support for functional equivalence as a plausible explanation for the observed negative correlation. Our findings enhance our understanding of the complex relationships between organizational structure and culture …

The Distinctiveness Effect: How Cross-Country Dissimilarities Influence Governance Decisions, Ilya Cuypers, Gokhan Ertug, Niels G. Noorderhaven, Korcan Kavusan

Research Collection Lee Kong Chian School Of Business

Transaction cost theory is one of the most commonly used theories to explain how firms govern their economic activities. In the context of cross-border collaborations, transaction cost theory proposes that dissimilarities between the partners’ home countries, which constitute a key source of behavioral uncertainty, affect how collaborations are governed (i.e. whether firms opt for equity joint ventures or non-equity alliances). Although many firms are likely to face more than one dimension of dissimilarity—for example, in terms language and religion, as well as culture—studies in transaction cost theory typically focus on how each source of dissimilarity impacts governance choices independently, in …

Agency Mbs As Safe Assets, Zhiguo He, Zhaogang Song

Research Collection Lee Kong Chian School Of Business

Measured as yield spreads against Treasury securities and AAA corporate bonds, the convenience premium of newly issued agency MBS averages more than half of the long-term Treasury convenience premium. The agency MBS convenience premium and issuance amount vary negatively with mortgage rate, consistent with a prepayment-driven channel. Placing agencies into conservatorship in 2008 and introducing liquidity regulations in 2013 significantly affected MBS convenience premium, consistent with government guarantee and regulatory treatment channels. Analyses of dispersion of dealers’ prepayment forecasts, seasoned MBS, and investors’ MBS holdings deliver further economic implications for agency MBS as safe assets.

Efficient Bilateral Trade With Interdependent Values: The Use Of Two-Stage Mechanisms, Takashi Kunimoto, Cuiling Zhang

Research Collection School Of Economics

Efficient, voluntary bilateral trades are generally not implementable in an interdependent values environment with two-sided asymmetric information. To obtain more positive results, we consider two-stage mechanisms in which (i) the outcome (e.g., allocation of the goods) is determined first; (ii) the agents partially learn the state via their own outcome-decision payoffs; and (iii) transfers are finally made. We propose the approximate shoot-the-liar (AS) mechanism and identify Assumption 1, under which “approximately” efficient, voluntary trades are implementable. We further illustrate the permissiveness of the assumption, and characterize it in terms of the nature of interdependence in valuation functions – delineating the …