One-month Interval Research Articles

Enhancing Nerve Function and Reviving the Unrecordable: A Comprehensive Analysis of the Effects of a Dual Hydrodissection Protocol on Clinical and Nerve Conduction Parameters in Mild-Moderate and Severe Carpal Tunnel Syndrome.

This study evaluates the efficacy of a sequential dual one-month interval hydrodissection (HD) protocol in mild-moderate as well as severe carpal tunnel syndrome (CTS) cases, with a comprehensive analysis of clinical and electrophysiological outcomes. A retrospective analysis was conducted on 286 patients (379 wrists) treated between 2021 and 2024 at two centers in India. The enrolled patient population was divided into mild-moderate and severe CTS subgroups. The dual HD protocol comprised an initial HD with methylprednisolone acetate followed by another with 5% dextrose in water (D5W) one month later. Clinical and electrophysiological characteristics were assessed and compared at baseline and three months after initiating the treatment. Outcomes were measured in terms of Visual Analog Scale (VAS) scores, Boston Carpal Tunnel Questionnaire (BCTQ) scores, and nerve conduction studies (NCS) parameters. The number of patients categorized into mild-moderate and severe subgroups was 239 (321 wrists) and 47 (58 wrists), respectively. Significant improvements were noted among both subgroups. In the mild-moderate subgroup, mean VAS scores decreased from 2.03 to 0.12 (p<0.001). BCTQ functional and severity scores also showed a significant improvement (p<0.001). In the severe subgroup, mean VAS scores decreased from 7.43 to 2.12 (p<0.001), and BCTQ scores also decreased significantly (p<0.001). The key highlight of the study was significant electrophysiological improvement, with 71% of the severe CTS patients showing recordable sensory nerve action potentials (SNAPs) that were non-recordable at baseline. The dual HD protocol was efficacious in improving clinical as well as electrophysiological outcomes in both mild-moderate and severe CTS patients. This study presents the dual HD strategy as a potentially effective minimally invasive alternative to surgery in severe cases where surgical intervention is the conventional treatment. Further randomized controlled trials with a longer follow-up period are warranted to validate these findings.

Is it feasible to prolong the flushing interval for totally implantable venous access devices (TIVADs)? A systematic review and meta-analysis.

To ascertain the effects of prolonging flushing intervals (FIs) for Totally Implantable Venous Access Devices (TIVADs) on catheter-related complications in the off-treatment period. A preliminary search of PubMed, EMBASE, Cochrane, Web of Science, Web of Science, Scopus, CNKI, and SinoMed was conducted from inception to 6th June 2023, using the keywords "vascular access devices", "interval", "occlusion", and "complication". Two independent reviewers performed studies screening, quality assessment, and data extraction. The methodological quality of included articles was assessed using the Newcastle-Ottawa Scale (NOS) and Risk of Bias (ROB) tools. Meta-analysis and trial sequential analysis (TSA) was performed to calculate the risk ratios and 95% confidence interval (CI). Eleven studies with 4,924 participants were included. Extending FIs to two or three months increased the risk of catheter occlusion compared to one-month intervals [RR = 1.50 (1.18-1.92), P = 0.001], but this finding was not confirmed by sensitivity analysis and TSA. Extending FIs to three months showed no significant effect on overall complications rates [RR = 1.21 (0.99-1.48), P = 0.49], consistent with sensitivity analysis and TSA results. For other catheter-related complications, the results showed extending the FIs to three months was feasible, but with weak measurements due to insufficient data. Data from the current included studies tended to support the feasibility of extending the flushing interval to every three months, with no expected increase in catheter occlusion or overall catheter complications. However, due to the inherent limitations of the included study, the findings of the current study should be interpreted with caution.

Once is enough! An analogue study on repeated validity assessment in adults with ADHD

Performance validity tests (PVTs) can be seen as gatekeepers for valid neuropsychological assessment, by marking cognitive test scores that may not reflect true ability levels. The present study explored the significance of repeated validity testing of adults with attention-deficit/hyperactivity disorder (ADHD), by exploring the potential value of performance consistency across assessments. The operational definition of performance consistency was determined by calculating the mean variation in a participant’s PVT scores across three separate assessments. Neuropsychological test data of 24 individuals diagnosed with ADHD were complemented by an analogue study involving 69 typically developing individuals who were allocated to either a control group or a simulation group instructed to feign ADHD. All individuals were assessed with embedded and stand-alone PVTs three times with one-month intervals between each assessment. The rate of failed validity testing remained rather stable across assessments. Significant differences in neuropsychological performance scores occurred between individuals with ADHD and experimental simulators, however, mostly nonsignificant effects of small size emerged when considering performance consistency. Our data demonstrate that the consistency of cognitive performance over repeated assessments may be no effective approach to complement validity assessment. Replication is needed in independent research on larger samples.

Matching Is Best: Enhancing Effects of Future Orientation and Construal Level on Green Consumption.

The 2024 Report on the Work of the Chinese Government promotes trade in consumer goods and green consumption. Therefore, better understanding is needed of consumer attitudes and behaviors toward environmental protection and sustainable development. The relationships among future orientation, construal level, and green consumption were explored using a delayed-effect design to conduct two surveys at one-month intervals with 160 participants (100 women and 60 men). The results showed that (1) future orientation positively predicted green consumption intention and green consumption behavior, and (2) the construal level significantly moderated the influence of future orientation on green consumption. Specifically, a high construal level and high future orientation predicted the greatest green consumption intention, green consumption behavior, and green consumption decisions, while at a high construal level, future orientation positively predicted green consumption intention and behavior, with a greater tendency to purchase environmentally friendly rather than hedonic products. At a low construal level, future orientation had no significant effect on green consumption intention, behavior, and intention to purchase environmentally friendly products. This study is important for promoting public awareness of the importance of green consumption and encouraging green consumption behaviors to achieve the goals of sustainable development and protect the environment and social well-being.

A stepped wedge randomised controlled trial assessing the efficacy and patient acceptability of virtual clinical pharmacy in rural and remote Australian hospitals

BackgroundDespite medication being the most common healthcare intervention and medication-related incidents being common in hospitals, many rural and remote hospitals in Australia lack onsite pharmacy services due to resource constraints. A Virtual Clinical Pharmacy Service (VCPS) staffed by two senior, rural generalist hospital pharmacists assigned to four hospitals each was implemented in rural and remote facilities to determine whether the VCPS increased adherence to National Safety and Quality Health Service Standards (NSQHS).MethodsA stepped-wedge randomised controlled trial was employed to sequentially implement a telehealth pharmacy service at one-month intervals in eight hospitals. The primary outcomes were patient-level medication reconciliation completion rates on admission and discharge. Secondary measures evaluated compliance with other NSQHS standards (including Best Possible Medication History, Medication Reconciliation and venous thromboembolism risk assessment), patient outcomes (including representation within 48 h, readmission within 28 days and length of stay), and detection of potential medication-related harms (including pharmacist identified medication related problems, reported medication errors and falls). Patients were invited to complete a patient-reported experience questionnaire. Data were collected from electronic medical records and analysed using mixed logistic regression models to estimate the effectiveness of the VCPS. Antimicrobial usage, falls, and medication errors were analysed at the facility level, while other data were analysed at the patient level.ResultsCompared to control (n = 535), patients in the intervention period (n = 527) were more likely to have an admission medication reconciliation completed (Odds Ratio (OR) 11.16, 95% confidence interval (CI) 5.59–22.30, p < 0.001) in models adjusted for the study period. A similar improvement was observed for discharge medication reconciliation completion (OR 4.07, CI 2.38–6.95, p < 0.001), whereas a 33-fold improvement was seen in Best Possible Medication History completion (OR 33.27, CI 17.53–63.14, p < 0.001). The VCPS documented 879 medication related problems, with 61% of patients having at least one medication-related problem documented by a pharmacist. There was no change in length of stay, falls, readmission rates or reported medication error rates; however, the study was not powered to detect these changes. Patient feedback was positive and comparable to in-person care, with 95% (179/189) reporting their overall experience as ‘good’ or ‘very good.’ No unintended harms were reported.ConclusionsThe VCPS improved compliance with national standards for medication safety, had high patient acceptability and resulted in the detection of clinically relevant medication-related issues in rural and remote settings. The applicability of virtual pharmacy should be explored in further rural and remote locations in addition to other settings such as metropolitan locations with no onsite clinical pharmacists.Ethics numberGWHREC 2019/ETH13355.Trial registrationANZCTR registration number ACTRN12619001757101. Registered on 11/12/2019. Published trial protocol: A stepped wedge trial of efficacy and scalability of a virtual clinical pharmacy service (VCPS) in rural and remote NSW health facilities.

Pediatric genital warts successfully treated with photodynamic therapy

Genital warts (GWs) are the most common sexually transmitted infections worldwide, caused by the human papillomavirus (HPV). In adults, the primary mode of transmission is through sexual contact, whereas in children it can occur through skin-to-skin or skin-to-mucosa contact and be sexual or non-sexual. The increasing prevalence of GWs in children has renewed the interest in therapeutic management which still presents a unique challenge, being influenced by many variables including size, quantity, and location of warts, as well as the presence of comorbidities. Photodynamic therapy (PDT) has already shown encouraging results in treating viral warts in adult patients, but its use is still not standardized in the pediatric population. On this topic, we report the case of an otherwise healthy 5-year-old child affected by GWs, successfully treated with three sessions of PDT with 10% 5-aminolaevulinic acid (ALA), at one-month intervals. Our case is paradigmatic of the potentiality of PDT to treat difficult lesions in a pediatric setting.

How the workplace usage of AI in China influences proactive behaviour? The role of pride and shame

ABSTRACT Based on the cognitive appraisal theory of emotions, we investigated the impact of AI usage on individuals’ positive and negative emotions as well as their proactive behaviour. Through a survey study conducted in China among 203 employees who have work experiences with AI with a one-month interval, we revealed the influence pathway between AI usage and proactive behaviour, which is mediated by two types of self-conscious emotions: pride and shame, and the satisfaction of competence need can moderate the relationship between AI usage and pride. The theoretical and implications of this study were discussed.

Uncertainty tolerance moderates the link between job insecurity and service performance: evidence from China’s hotel frontline employees

The pandemic crisis outbreak has impacted the hospitality industry tremendously. This study investigated the effect of job insecurity on service performance and examined the mediating role of cognitive appraisal and the moderating effect of uncertainty tolerance from the perspectives of cognitive appraisal theory of stress. The study collected a questionnaire from 316 hotel employees at three time points, with a one-month interval between the two time points. The SPSS PROCESS macro and MPLUS are used to test the research hypotheses. The results highlighted that the mediating role of challenge-hindrance appraisal, affirming that job insecurity positively impacts service performance via increasing challenge appraisal, and job insecurity negatively impacts service performance via increasing hindrance appraisal. Furthermore, the results show that uncertainty tolerance moderates the relationship between job insecurity and cognitive appraisal and also moderated the indirect effect of job insecurity on service performance through cognitive appraisal. The research results provide implications for human resource management in the hospitality industry.

Managing massive submacular hemorrhage using intravitreal brolucizumab in combination with subretinal tissue plasminogen activator and non-expansile gas – A case report

We report a case of a 60-year-old lady presented to us with a sudden painless diminution of vision in the left eye (LE). Her best-corrected visual acuity (BCVA) was counting fingers close to face in the LE. She was diagnosed with submacular hemorrhage (SMH) secondary to polypoidal choroidal vasculopathy (PCV). We performed a standard 25-gauge pars plana vitrectomy with subretinal tissue plasminogen activator injection along with an intravitreal injection of brolucizumab and perfluoro propane (C3F8) gas injection. Six weeks after the procedure, her BCVA improved to counting fingers at three meters. After another two injections of brolucizumab at one-month intervals, the BCVA improved to 6/9, N6. We present the long-term follow-up of this eye for nearly 18 months with improved visual acuity, that is, 6/36, N24 at the final visit. This technique shows favorable results in the case of massive SMH due to PCV.

Hybrid work stressors and psychological withdrawal behavior: A moderated mediation model of emotional exhaustion and proactive personality

This study proposes a theoretical model of challenge/hindrance stressors of hybrid work on emotional and behavioral reactions based on the conservation of resources theory. We investigate a mediation model by incorporating emotional exhaustion as a mediator to connect the relationship between two stressors and psychological withdrawal behavior. In addition, we identify proactive personality as a key personal resource to moderator the above mediating effects. The two-wave panel data was collected through online questionnaire surveys with a one-month interval. This study targeted at employees worked in the United States and 213 valid questionnaires were collected. Our results show that: (1) challenge/hindrance stressors of hybrid work are positively related to emotional exhaustion; (2) emotional exhaustion mediates the relationship between challenge/hindrance stressors of hybrid work and psychological withdrawal behavior; (3) proactive personality weakens the positive relationship between challenge stressors of hybrid work and emotional exhaustion. However, the moderating effect of proactive personality on the indirect effect of hindrance stressors of hybrid work on psychological withdrawal behavior via emotional exhaustion was not found. The implications of this study for theory and practice are discussed.

An Electronic Health Record-Based Strategy to Enhance Detection of Alpha-1 Antitrypsin Deficiency.

Because alpha-1 antitrypsin deficiency is severely underrecognized and delayed diagnosis is associated with harm, strategies to enhance early detection of alpha-1 antitrypsin deficiency are needed. The study intervention was placing a reminder to test for alpha-1 antitrypsin deficiency within an electronic medical record health maintenance dashboard that houses prompts to providers to implement guideline-based recommendations. This recommendation was for all patients assigned a diagnosis of COPD based on relevant International Classification of Diseases, Tenth Revision codes. The rate of testing for and detecting individuals with alpha-1 antitrypsin deficiency was assessed in 12 one-month intervals before and after implementing the dashboard. After the prompt, whereas testing was still performed in only a small percentage of guideline-concordant instances, the rate of testing for alpha-1 antitrypsin deficiency increased 3.8-fold (ie, from 1.2% to 4.6%, P < .05). This did not result in detection of new patients with alpha-1 antitrypsin deficiency. The rate of testing increased both for alpha-1 antitrypsin serum levels and genotypes in each month after the intervention, though the rate of genotype testing was 2-5-fold lower than the rate of testing for serum level. The results of this preliminary study of a detection strategy for alpha-1 antitrypsin deficiency show that placing a reminder to test for alpha-1 antitrypsin deficiency when indicated in an electronic medical record health maintenance dashboard significantly increased the frequency of testing. Still, that only 4.6% of those in whom testing for alpha-1 antitrypsin deficiency was indicated were tested in the post-intervention period shows that, as for all other alpha-1 antitrypsin deficiency-targeted detection interventions to date, the impact of the intervention was marginal and that other strategies remain needed to mitigate underrecognition. A focus on combining targeted detection strategies (eg, coupling enhanced awareness with free testing) and population-based screening for alpha-1 antitrypsin deficiency is suggested.

An open-label, parallel-group, randomized clinical trial of different silver diamine fluoride application intervals to arrest dental caries

BackgroundSilver diamine fluoride (SDF) is an antimicrobial agent and alternative treatment option that can be used to arrest dental decay. While there is optimism with SDF with regard to caries management, there is no true consensus on the number and frequency of applications for children. The purpose of this study was to examine the effectiveness of 38% SDF to arrest early childhood caries (ECC) at three different application regimen intervals.MethodsChildren with teeth that met International Caries Detection and Assessment System codes 5 or 6 criteria were recruited from community dental clinics into an open-label, parallel-group, randomized clinical trial from October 2019 to June 2021. Participants were randomized to one of three groups using sealed envelopes that were prepared with one of three regimens inside: visits one month, four months, or six months apart. Participants received applications of 38% SDF, along with 5% sodium fluoride varnish (NaFV), at the first two visits to treat cavitated carious lesions. Lesions were followed and arrest rates were calculated. Lesions were considered arrested if they were hard on probing and black in colour. Statistics included descriptive and bivariate analyses (Kruskal one-way analysis of variance and Pearson’s Chi-squared test). A p-value of ≤ 0.05 was considered significant.ResultsEighty-four children participated in the study (49 males and 35 females, mean age: 44.4 ± 14.2 months). Treatment groups were well matched with 28 participants per group. A total of 374 teeth and 505 lesions were followed. Posterior lesions represented only 40.6% of affected surfaces. Almost all SDF treated lesions were arrested for the one-month (192/196, 98%) and four-month (159/166, 95.8%) interval groups at the final visit. The six-month group experienced the lowest arrest rates; only 72% (103/143) of lesions were arrested (p < 0.001). The duration of application intervals was inversely associated with improvements in arrest rates for all lesions.ConclusionsTwo applications of 38% SDF and 5% NaFV in one-month and four-month intervals were comparable and very effective in arresting ECC. Applications six months apart were less effective and could be considered inferior treatment.Trial registrationClinicalTrials.gov NCT04054635 (first registered 13/08/2019).

Comparison of matrix metalloproteinase levels in periodontal pockets treated with chlorhexidine and propolis

Natural antimicrobial products are attracting interest in the treatment of periodontal diseases due to their minimal or nonexistent side effects. Propolis, a complex resin content produced by bees, has drawn particular interest for its antibacterial effects, including inhibitory effects on periodontopathogenic bacterial species. This study compared the effects of propolis, a natural product, and chlorhexidine, the gold standard antimicrobial agent, on MMP-1 and MMP-9 levels in gingival crevicular fluid (GCF). Subgingival irrigations of chlorhexidine and propolis solutions were performed in selected deep periodontal pockets of periodontitis patients along with scaling and root planing. The treatment protocol was administered three times at one-month intervals starting from the initial day of the study. GCF MMP-1 and MMP-9 levels, along with clinical periodontal parameters, were evaluated before and after treatment. The study results showed that a statistically significant decrease in clinical periodontal parameters in both groups (p&amp;lt;0.001). Biochemical analysis revealed a statistically significant decrease in levels of GCF MMP-1 and MMP-9 in both groups (p&amp;lt;0.005). Additionally, the decrease in GCF MMP-1 levels was found to be significantly greater in the propolis group compared to the chlorhexidine group (p&amp;lt;0.001).

Impacts of work-related rumination on employee’s innovative performance: based on the conservation of resources theory

PurposeThis paper aims to examine the double-edged sword effects of work-related rumination on employees’ innovative performance. Drawing upon Conservation of Resources (COR) theory, this study developed a model to reveal the mechanism through which work-related rumination affects employees’ innovative performance.Design/methodology/approachData were collected from a sample of employees and their managers at an information technology services firm in China. A two-wave data collection method with a one-month interval was employed. The analysis was conducted using structural equation modeling on 482 paired manager-subordinate responses.FindingsOur findings highlight the complex interplay between work-related rumination and innovative performance. Specifically, affective rumination was found to detract from employees’ innovative performance, whereas problem-solving pondering had a positive effect. Notably, creative self-efficacy emerged as a key mediator in these relationships. Furthermore, employees’ perceived organizational support moderated the impact of rumination on creative self-efficacy and, consequently, on innovative performance, buffering the negative effects of affective rumination and enhancing the positive effects of problem-solving pondering.Originality/valueFirstly, it enriches the existing literature on work-related rumination by exploring its nuanced influence on employees’ innovative performance. Secondly, it illuminates the underlying mechanism through which work-related rumination affects innovative performance, mediated by creative self-efficacy. Lastly, it highlights the crucial role of perceived organizational support in moderating these relationships, offering valuable insights for practitioners seeking to foster a more innovative work environment.

Exploring the Non-Invasive Approaches to Carpal Tunnel Syndrome in Routine Clinical Practice: A Focus on the Role of Acetylcholinesterase Inhibitors.

The prevalence of N. medianus compression neuropathies remains high in clinical practice. The objective was to evaluate modalities of conservative treatments for carpal tunnel syndrome (CTS) focusing on the role of acetylcholinesterase inhibitors. This observational study involved 51 adult outpatients diagnosed with CTS. Patients were observed during routine clinical protocols and we compared two groups of 25 and 26 individuals, with the first group receiving basic therapy for CTS and 20 mg of ipidacrine (Neiromidin®) two or three times a day per os, while the second group received only basic therapy. The condition of all patients was assessed twice, with at least a one-month interval. The parameters evaluated included the Boston Carpal Tunnel Questionnaire (BCTQ); the Disabilities of the Arm, Shoulder, and Hand scale (DASH); and pain intensity on the Numeric Rating Scale (NRS). The mean reduction in DASH score was 12.3 (SD 7.7) in Group 1 and 7.1 (SD 6.3) in Group 2 (p < 0.01). Also, other scores showed statistically significant differences between the two groups: -2.3 vs. -1.0 for NRS, -0.89 vs. -0.44 for SSS, and -0.68 vs. -0.31 for FSS, respectively (p < 0.01). Moreover, these findings correlated positively with the global improvement (CGI-I) between the groups. The addition of ipidacrine to basic therapy led to improved recovery in patients with CTSs of varying severity.

Test-Retest Reliability of EEG Aperiodic Components in Resting and Mental Task States.

Aperiodic activity is derived from the electroencephalography (EEG) power spectrum and reflects changes in the slope and shifts of the broadband spectrum. Studies have shown inconsistent test-retest reliability of the aperiodic components. This study systematically measured how the test-retest reliability of the aperiodic components was affected by data duration (1, 2, 3, 4, and 5min), states (resting with eyes closed, resting with eyes open, performing mental arithmetic, recalling the events of the day, and mentally singing songs), and methods (the Fitting Oscillations and One-Over-F (FOOOF) and Linear Mixed-Effects Regression (LMER)) at both short (90-min) and long (one-month) intervals. The results showed that aperiodic components had fair, good, or excellent test-retest reliability (ranging from 0.53 to 0.91) at both short and long intervals. It is recommended that better reliability of the aperiodic components be obtained using data durations longer than 3min, the resting state with eyes closed, the mental arithmetic task state, and the LMER method.

Eyedrop Instillation Technique by Medical Interns: Assessment and Impact of Video-Assisted Training

Abstract Aim: To assess the eyedrop instillation technique by medical interns, and to study the effect of video-assisted training. Methods: This was a hospital based prospective study performed on interns of teaching institute. First, interns were asked to instil the eye drops on volunteers which was video recorded. Interns were then given ‘video-assisted training’ (VAT) of correct technique and again reassessment was performed immediately, after one-week and one-month interval. All the recorded videos were evaluated by a single independent blinded expert and scored according to the scoring system devised by subject experts based on the available literature. The data were entered in Microsoft Office Excel and statistical analysis was performed. Results: The study showed that before training 43.80% had good practice with mean test score of 6.32 ± 1.63. Immediately after video-assisted training, there was significant improvement in technique of instilling eye drop with mean test score of 9.01 ± 0.62 (P &lt; 0.0001), after one week, the mean test score was 9.52 ± 0.71 (P &lt; 0.0001), and after one-month, mean test score was 9.56 ± 0.75 (P &lt; 0.0001). Each step of eyedrop instillation was compared before and after the VAT and the difference was found to be statistically significant (P value &lt; 0.05). Conclusion: In our current study, initially interns had practised incorrect technique of instillation of eyedrop. But after video-assisted training there has been notable improvement in the technique of instilling eyedrop. Periodic VAT might be helpful in ensuring them to follow the correct technique regularly.

Cumulative incidence and risk factors for medication-related osteonecrosis of the jaw during long-term prostate cancer management

Bone-modifying agents (BMA) are extensively used in treating patients with prostate cancer with bone metastases. However, this increases the risk of medication-related osteonecrosis of the jaw (MRONJ). The safety of long-term BMA administration in clinical practice remains unclear. We aimed to determine the cumulative incidence and risk factors of MRONJ. One hundred and seventy-nine patients with prostate cancer with bone metastases treated with BMA at our institution since 2008 were included in this study. Twenty-seven patients (15%) had MRONJ during the follow-up period (median, 19 months; interquartile range, 9–43 months). The 2-year, 5-year, and 10-year cumulative MRONJ incidence rates were 18%, 27%, and 61%, respectively. Multivariate analysis identified denosumab use as a risk factor for MRONJ, compared with zoledronic acid use (HR 4.64, 95% CI 1.93–11.1). Additionally, BMA use at longer than one-month intervals was associated with a lower risk of MRONJ (HR 0.08, 95% CI 0.01–0.64). Furthermore, six or more bone metastases (HR 3.65, 95% CI 1.13–11.7) and diabetes mellitus (HR 5.07, 95% CI 1.68–15.2) were risk factors for stage 2 or more severe MRONJ. MRONJ should be considered during long-term BMA administration in prostate cancer patients with bone metastases.

Exploring leader’s unethical proorganizational behavior and follower attitudes toward knowledge hiding and sharing in the service industry: a social learning perspective

PurposeGrounded in the framework of social learning theory (SLT), the current study explores the impact of leaders’ unethical proorganizational behavior (UPB) on their subordinates’ self-management and moral self-efficacy, which, in turn, affect knowledge hiding and sharing among followers. This study aims to examine how instrumental thinking influences the relationship between leader UPB and subordinate behaviors, shaping knowledge sharing and hiding.Design/methodology/approachUsing a longitudinal approach, this research uses a two-wave data collection strategy with a one-month interval. The study cohort comprises 378 employees drawn from technology service firms situated in China.FindingsEmpirical findings confirm that leader UPB is linked to increased follower self-management and knowledge hiding, as well as reduced moral self-efficacy. Instrumental thinking moderates these effects, amplifying knowledge hiding and diminishing moral self-efficacy while reducing knowledge sharing.Research limitations/implicationsThe study contributes to the existing literature on UPB by offering insights into the distinct consequences of leader UPB on knowledge-related behaviors of followers. Furthermore, the exploration of employees’ instrumental thinking in the context of leader UPB underscores the strategic manipulation of knowledge to fulfill individual goals, thereby enriching the underpinnings of the SLT. The study underscores the imperative for organizations to grasp the implications of UPB and underscores the necessity for stringent ethical frameworks to mitigate its deleterious impact.Practical implicationsThe study contributes to the existing literature on UPB by offering insights into the distinct consequences of leader UPB on knowledge-related behaviors of followers. Furthermore, the exploration of employees’ instrumental thinking in the context of leader UPB underscores the strategic manipulation of knowledge to fulfill individual goals, thereby enriching the underpinnings of the SLT. The study underscores the imperative for organizations to grasp the implications of UPB and underscores the necessity for stringent ethical frameworks to mitigate its deleterious impact.Originality/valueThe present study addresses a gap in the current literature by elucidating the multifaceted outcomes of leaders’ UPB on paradoxical behaviors related to knowledge sharing and hiding among followers. This nuanced examination underscores the need to comprehend the intricate contingencies that accentuate the effects of UPB, particularly in the realm of leadership dynamics. Grounded in SLT, this study delves into leadership dynamics and ethical decision-making.

Fractional Ablative Carbon Dioxide Laser versus Fractional Non-Ablative 1410 nm Diode Laser in the Treatment of Acne Scars: A Clinical and Immunohistochemical Study

Background: Effectively managing acne scars while minimizing consequences is still a challenging task. The primary determinant in selecting and continuing therapy for a specific device is stimulating collagen production and dermal remodeling with the fewest possible complications. Objective: To evaluate the clinical and immunohistochemical results of ablative fractional carbon dioxide (FCO2) laser versus fractional non-ablative diode laser for treating facial acne scars. Methods and Materials: Thirty patients with atrophic acne scars were included in a split-face comparative study. Right and left facial sides received three sessions of FCO2 and diode laser, respectively, at one-month intervals. One month after the third session, patients were evaluated using photographs, the Goodman and Baron qualitative and quantitative global scarring grading system, the investigator’s global assessment, and patient satisfaction. A sample was collected from the area that had been treated, and the tissue was examined using hematoxylin and eosin (H–E) staining and immunohistochemistry staining for collagen I. Results: Goodman and Baron global scores showed a statistically significant difference compared to baseline on both sides of the face. However, there was no statistically significant difference between the two treatment modalities. Biopsy specimens showed an increased deposition of collagen I by both laser devices, which was validated and described by immunohistochemistry staining. Conclusion: Both FCO2 and fractional non-ablative diode lasers proved their efficacy in treating different types of acne scars. For patients who are interested in no downtime and no complications, fractional non-ablative diode laser is recommended as an efficient alternative modality.