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Purpose: To determine small and medium-sized enterprises’ (SMEs) perception related to their trade credit management effectiveness. Design/methodology/approach: Quantitative research design with purposive sampling as the sampling method, administrated to 10 450 SMEs within South Africa. Findings/results: The results indicate SMEs perceive their trade credit management as effective. Practical implications: The article reveals how SMEs perceive their trade credit management by identifying their effectiveness in managing trade credit. Originality/value: By raising awareness pertaining to SMEs’ perceptions around their trade credit management effectiveness, SMEs can become more observant of their own trade credit management effectiveness and overall finances. Thereby, SMEs’ awareness could be improved to become financially viable and, in so doing, empower SMEs to foster economic development within South Africa. Given the results revealing SMEs’ perception as effective in managing trade credit, the study adds value by providing insight as to what financial problems, apart from trade credit ineffectiveness, could contribute to their business failure. There is a need therefore to investigate why SMEs continue to fail at such high rates because of financial problems in order to determine the root causes and types of financial problems contributing to SME business failure.

Background and purposeCarotid atherosclerotic plaques with a large lipid-rich necrotic core (LRNC), intraplaque hemorrhage (IPH), and a thin or ruptured fibrous cap are associated with increased stroke risk. Multi-sequence MRI can be used to quantify carotid atherosclerotic plaque composition. Yet, its clinical implementation is hampered by long scan times and image misregistration. Multi-contrast atherosclerosis characterization (MATCH) overcomes these limitations. This study aims to compare the quantification of plaque composition with MATCH and multi-sequence MRI.MethodsMATCH and multi-sequence MRI were used to image 54 carotid arteries of 27 symptomatic patients with ≥2 mm carotid plaque on a 3.0 T MRI scanner. The following sequence parameters for MATCH were used: repetition time/echo time (TR/TE), 10.1/4.35 ms; field of view, 160 mm × 160 mm × 2 mm; matrix size, 256 × 256; acquired in-plane resolution, 0.63 mm2× 0.63 mm2; number of slices, 18; and flip angles, 8°, 5°, and 10°. Multi-sequence MRI (black-blood pre- and post-contrast T1-weighted, time of flight, and magnetization prepared rapid acquisition gradient echo; acquired in-plane resolution: 0.63 mm2 × 0.63 mm2) was acquired according to consensus recommendations, and image quality was scored (5-point scale). The interobserver agreement in plaque composition quantification was assessed by the intraclass correlation coefficient (ICC). The sensitivity and specificity of MATCH in identifying plaque composition were calculated using multi-sequence MRI as a reference standard.ResultsA significantly lower image quality of MATCH compared to that of multi-sequence MRI was observed (p

Background: Within the conceptual paradigm that the business environment of South Africa could significantly impact on small and medium-sized enterprises, (SMEs) management of trade credit, the need exists for internal and external business environmental factors to be constructed, in order to understand how SMEs rate these factors. Aim: The research purpose was to identify and construct relevant internal and external business environmental factors and obtain SME ratings for these factors to statistically test the validity and reliability of the measurement instrument. Setting: This study was conducted by administering an online questionnaire. Method: Quantitative research design with purposive sampling as the sampling method, administrated to 10 450 SMEs within South Africa. Results: A descriptive statistical analysis revealed that the highest quality internal and external business environmental components were managerial competencies and ethics, respectively. Factor analysis resulted in the formulation of five internal and six external business environmental factors. In addition, SMEs do not rate internal and external business environmental factors equally. Managerial competencies obtained the highest overall mean score for all business environmental factors, including the highest for internal factors. Small and medium-sized enterprise and debtor ethical performance obtained the highest means score for external factors. Conclusion: The formulation of newly constructed internal and external business environmental factors relevant to SMEs’ management of trade credit. Contribution: As far as can be established, research identifying variables and constructing internal and external business environmental factors relevant to SME management of trade credit has not been conducted in South Africa. The newly formulated internal and external business environmental factors broaden SMEs’ understanding of which business environmental factors are relevant to SMEs’ management of trade credit, including how SMEs rate these factors.

Background: Given that the impact of the South African business environment on small and medium-sized enterprises’ (SMEs) management of trade credit is largely unknown, this article argues that certain internal or external business environment variables could significantly impact SMEs’ management of trade credit effectiveness, making it necessary to ask the impact of business environment in South Africa on SMEs’ trade credit management effectiveness. Aim: To determine the impact of internal (managerial competencies, collateral, financial and business information and networking) and external (legal system, ethics, macroeconomy and corruption) business environment variables on SMEs’ management of trade credit effectiveness. Setting: This study was conducted by administering an online questionnaire. Method: Quantitative research design with purposive sampling as the sampling method, administrated to 10 450 SMEs within South Africa. Results: The results reveal several internal (5) and external (4) business environment factors significantly impacting SMEs’ effectiveness in managing trade credit. Conclusion: The article reveals how internal and external business environment factors contribute to increased SME effectiveness in managing trade credit and, in so doing, helps mitigate financial problems associated with SMEs’ trade credit as a result of asymmetric information such as adverse selection, moral hazard and credit rationing, while also understanding the significance of corruption on SMEs’ effectiveness in managing trade credit.

Introduction: Carotid atherosclerotic intraplaque hemorrhage (IPH) predicts stroke. Patients with a history of stroke are treated with antiplatelet agents to prevent secondary cardiovascular events. A positive association between previous antiplatelet use and IPH was reported in a cross-sectional analysis. We investigated the changes in IPH over 2 years in patients who recently started versus those with continued antiplatelet use. Methods: In the Plaque at Risk (PARISK) study, symptomatic patients with <70% ipsilateral carotid stenosis underwent carotid plaque magnetic resonance imaging (MRI) at the baseline and after 2 years to determine IPH presence and volume. Participants were categorized into new users (starting antiplatelet therapy following the index event) and continued users (previous use of antiplatelet therapy before the index event). The association between previous antiplatelet therapy and the presence of IPH at baseline MRI was investigated using multivariable logistic regression analysis. The IPH volume change over a period of 2 years, defined as the difference in volume between follow-up and baseline, was investigated in each group with a Wilcoxon signed-rank test. The IPH volume change was categorized as progression, regression, or no change. Using multivariable logistic regression, we investigated the association between new antiplatelet use and (1) newly developed ipsilateral or contralateral IPH and (2) IPH volume progression. Results: A total of 108 patients underwent carotid MRI at the baseline and follow-up. At the baseline, previous antiplatelet therapy was associated with any IPH (OR = 5.6, 95% CI: 1.3–23.1; p = 0.02). Ipsilateral IPH volume did not change significantly during the 2 years in patients who continued receiving antiplatelet agents (86.4 mm3 [18.2–235.9] vs. 59.3 mm3 [11.4–260.3]; p = 0.6) nor in the new antiplatelet users (n = 31) (61.5 mm3 [0.0–166.9] vs. 27.7 mm3 [9.5–106.4]; p = 0.4). Similar results of a nonsignificant change in contralateral IPH volume during those 2 years were observed in both groups (p > 0.05). No significant associations were found between new antiplatelet use and newly developed IPH at 2 years (odds ratio [OR] = 1.0, 95% CI: 0.1–7.4) or the progression of IPH (ipsilateral: OR = 2.4, 95% CI: 0.3–19.1; contralateral: OR = 0.3, 95% CI: 0.01–8.5). Conclusion: Although the baseline association between IPH and previous antiplatelet therapy was confirmed in this larger cohort, the new onset of antiplatelet therapy after transient ischemic attack/stroke was not associated with the newly developed IPH or progression of IPH volume over the subsequent 2 years. Plain Language Summary: Carotid artery narrowing due to an atherosclerotic plaque is responsible for around 20% of stroke. Intraplaque hemorrhage (IPH) predicts stroke. Antiplatelet agents are often given to patients who have had a stroke to prevent further cardiovascular events. A previous study found an association between previous antiplatelet use and IPH at a specific point in time. In this study, researchers investigated whether starting antiplatelet therapy after a stroke or continuing to use antiplatelets had any effect on IPH over a 2-year period. The study included patients with <70% carotid narrowing who had a carotid plaque MRI at the baseline and after 2 years to determine the presence and volume of IPH. Patients were categorized into new users (starting antiplatelet therapy following the stroke) and continued users (already using antiplatelet therapy before the stroke). The presence and the volume change of IPH over 2 years were investigated in each group. The study found that IPH was more present at the baseline when patients used antiplatelet agents before the stroke. However, new antiplatelet use after the stroke did not lead to new IPH or an increase in IPH volume over the subsequent 2 years. There were no significant associations between the new antiplatelet use and newly developed IPH or IPH volume progression. Therefore, while the baseline association between IPH and previous antiplatelet therapy was confirmed in this larger cohort, starting antiplatelet therapy after a stroke did not increase the risk of new IPH or progression of IPH volume over the subsequent 2 years. [ABSTRACT FROM AUTHOR]

Background: Recent studies have revealed the importance of the gut brain axis in the development of Parkinson's disease (PD). It has also been suggested that the cross-sectional area (CSA) of the vagus nerve can be used in the diagnosis of PD. Here, we hypothesize that the CSA of the vagus nerve is decreased in PD patients compared to control participants. Methods: In this study we measured the CSA of the vagus nerve on both sides in 31 patients with PD and 51 healthy controls at the level of the common carotid artery using high-resolution ultrasound. Results: The mean CSA of the left vagus nerve in the PD and the control group was respectively 2.10 and 1.90 and of the right respectively 2.54 and 2.24 mm2. There is no difference in CSA of the vagus nerve in PD patients compared to controls (p = .079). The mean CSA of the right vagus nerve was significantly larger than the left (p

The article discusses the prenatal diagnosis of Walker-Warburg syndrome (WWS), a rare autosomal recessive disorder affecting the brain, eyes, and muscles. The case study presented involves a child with WWS who exhibited generalized hypotonia, cataracts, and progressive muscular dystrophy leading to death within the second year after birth. The syndrome is associated with defective glycosylation of α-dystroglycan, resulting in neuronal overmigration and impaired muscle cell communication, with similarities to other severe forms of congenital muscular dystrophy. Various prenatal ultrasound and magnetic resonance imaging features are described, including brainstem abnormalities, cerebellar hypoplasia, and lissencephaly. Other malformations associated with WWS, such as corpus callosum agenesis and facial dysmorphism, are also mentioned. [Extracted from the article]

The article highlights misconceptions around the concept of innovativeness and argues for a broader understanding that encompasses both inward and outward-looking perspectives. It emphasizes the importance of perceived innovativeness as influenced by marketing, innovation culture, leadership, and emotional connection with customers. This customer-centric viewpoint not only offers a fresh lens through which to evaluate firm innovativeness but also underscores its significant implications for innovation management and future research directions. [ABSTRACT FROM AUTHOR]

Purpose: Carotid artery properties can be evaluated with high accuracy and reproducibility using multiple M-line ultrasound. However, the cost of multiple M-line-based imaging modalities and the extensive operator expertise requirements hamper the large-scale application for arterial properties assessment, particularly in resource-constrained settings. This study is aimed to assess the performance of a single M-line approach as an affordable and easy-to-use alternative to multiple M-line imaging for screening purposes.Methods: We used triplicate longitudinal common carotid artery (CCA) ultrasound recordings (17 M-lines covering about 16 mm, at 500 frames per second) of 500 subjects from The Maastricht Study to assess the validity and reproducibility of a single against multiple M-line approach. The multiple M-line measures were obtained by averaging over all available 17 lines, whereas the middle M-line was used as a proxy for the single M-line approach.Results: Diameter, intima-media thickness (IMT), and Young's elastic modulus (YEM) were not significantly different between the single and multiple M-line approaches (p > 0.07). Distension and distensibility coefficient (DC) did differ significantly (p < 0.001), however, differences were technically irrelevant. Similarly, Bland-Altman analysis revealed good agreement between the two approaches. The single M-line approach, compared to multiple M-line, exhibited an acceptable reproducibility coefficient of variation (CV) for diameter (2.5 vs. 2.2%), IMT (11.9 vs. 7.9%), distension (10 vs. 9.4%), DC (10.9 vs. 10.2%), and YEM (26.5 vs. 20.5%). Furthermore, in our study population, both methods showed a similar capability to detect age-related differences in arterial stiffness.Conclusion: Single M-line ultrasound appears to be a promising tool to estimate anatomical and functional CCA properties with very acceptable validity and reproducibility. Based on our results, we might infer that image-free, single M-line tools could be suited for screening and for performing population studies in low-resource settings worldwide. Whether the comparison between single and multiple M-line devices will yield similar findings requires further study.

Introduction/Aims: Nerve conduction studies (NCSs) are widely used to support the clinical diagnosis of neuromuscular disorders. The aims of this study were to obtain reference values for peroneal, tibial, and sural NCSs and to examine the associations with demographic and anthropometric factors. Methods: In 5099 participants (aged 40–79 years) without type 2 diabetes of The Maastricht Study, NCSs of peroneal, tibial, and sural nerves were performed. Values for compound muscle action potential (CMAP) and sensory nerve action potential amplitude, nerve conduction velocity (NCV), and distal latency were acquired. The association of age, sex, body mass index (BMI), and height with NCS values was determined using uni‐ and multivariate linear regression analyses. Results: Detailed reference values are reported per decade for men and women. Significantly lower NCVs and longer distal latencies were observed in all nerves in older and taller individuals as well as in men. In these groups, amplitudes of the tibial and sural nerves were significantly lower, whereas a lower peroneal nerve CMAP was only significantly associated with age. BMI showed a multidirectional association. After correction for anthropometric factors in the multivariate analysis, the association between sex and NCS values was less straightforward. Discussion: These values from a population‐based dataset could be used as a reference for generating normative values. Our findings show the association of NCS values with anthropometric factors. In clinical practice, these factors can be considered when interpreting NCS values. [ABSTRACT FROM AUTHOR]

Abstract Background The presence of intraplaque haemorrhage (IPH) has been related to plaque rupture, is associated with plaque progression, and predicts cerebrovascular events. However, the mechanisms leading to IPH are not fully understood. The dominant view is that IPH is caused by leakage of erythrocytes from immature microvessels. The aim of the present study was to investigate whether there is an association between atherosclerotic plaque microvasculature and presence of IPH in a relatively large prospective cohort study of patients with symptomatic carotid plaque. Methods One hundred and thirty-two symptomatic patients with ≥2 mm carotid plaque underwent cardiovascular magnetic resonance (CMR) of the symptomatic carotid plaque for detection of IPH and dynamic contrast-enhanced (DCE)-CMR for assessment of plaque microvasculature. K trans, an indicator of microvascular flow, density and leakiness, was estimated using pharmacokinetic modelling in the vessel wall and adventitia. Statistical analysis was performed using an independent samples T-test and binary logistic regression, correcting for clinical risk factors. Results A decreased vessel wall K trans was found for IPH positive patients (0.051 ± 0.011 min− 1 versus 0.058 ± 0.017 min− 1, p = 0.001). No significant difference in adventitial K trans was found in patients with and without IPH (0.057 ± 0.012 min− 1 and 0.057 ± 0.018 min− 1, respectively). Histological analysis in a subgroup of patients that underwent carotid endarterectomy demonstrated no significant difference in relative microvessel density between plaques without IPH (n = 8) and plaques with IPH (n = 15) (0.000333 ± 0.0000707 vs. and 0.000289 ± 0.0000439, p = 0.585). Conclusions A reduced vessel wall K trans is found in the presence of IPH. Thus, we did not find a positive association between plaque microvasculature and IPH several weeks after a cerebrovascular event. Not only leaky plaque microvessels, but additional factors may contribute to IPH development. Trial registration NCT01208025. Registration date September 23, 2010. Retrospectively registered (first inclusion September 21, 2010). NCT01709045, date of registration October 17, 2012. Retrospectively registered (first inclusion August 23, 2011).

In this paper, a comprehensive model to describe the small-signal modulation response of ultra-high performance single- and multi-mode vertical-cavity surface-emitting lasers (VCSELs), with modulation bandwidths exceeding 30 GHz, is presented. Traditionally, utmost simplified dynamic models are used to extract dynamic figures of merit from single-mode edge-emitting lasers. These methods are later on also applied to evaluate the dynamic performance of VCSELs, even though these devices have a very different geometrical layout and modal confinement. However, to understand the dynamic performance of high-speed VCSELs, a model supporting the transverse and longitudinal mode profile, and the driving current inhomogeneity in the active region, is needed. Therefore, multi-mode VCSEL rate equations are established here. Moreover, to access the dynamic figures of merit of these devices, a comprehensive analytical fitting function based on our carrier reservoir splitting approach is derived. Thus, because of the high carrier and photon densities inside these optimized VCSELs, the common carrier reservoir splits up as a result of numerous effects such as mode competition, carrier diffusion and spatial hole burning. These and other effects have a tremendous impact on the small signal modulation response shape and bandwidth, and also on the current distribution profile in the carrier reservoirs. Compared with our recently reported work, this novel model presented includes the effects of gain compression and inhomogeneous current injection between the different lasing modes. Consequently, it is found that the further tuning of our multi-mode VCSEL dynamic model, to include these effects, yields a more physical and consistent figures of merit of high-performance VCSELs.

Background: During descending aortic repair, critically decreased blood flow to the myelum can result in ischemic spinal cord injury and transient or permanent paraplegia. Assessment of motor evoked potentials (MEPs) has been shown to be a valuable tool which allows to detect spinal cord ischemia (SCI) intraoperatively within a therapeutic window suitable to prevent progression to paraparesis or paraplegia. MEP monitoring is not feasible during postoperative care in the awakening patient. Therefore, ancillary techniques to monitor integrity of spinal cord function are needed to detect delayed spinal cord ischemia. Objective: The purpose of this study is to evaluate whether assessment of long loop reflexes (LLR; F-waves) and paraspinal muscle oximetry using Near-Infrared Spectroscopy (NIRS) are feasible and valid in detecting delayed SCI. Methods: We aim to include patients from three tertiary referral centers undergoing aortic repair with MEP monitoring in this study.F-wave measurements and paraspinal NIRS oximetry will be operated intra- and postoperatively. Measurement characteristics and feasibility will be assessed in the first 25 patients. Subsequently, a second cohort of 75 patients will be investigated to determine the sensitivity and specificity of F-waves and NIRS in detecting perioperative SCI. In this context for the MEP group SCI is defined intraoperatively as significant MEP changes and postoperatively as newly developed paraplegia. Conclusions: A clinical study design and protocol is proposed to assess if F-waves and/or NIRS-based paraspinal oximetry are feasible and valid in detecting and monitoring for occurrences of delayed SCI. Keywords: Spinal cord ischemia, Neurophysiological monitoring techniques, NIRS oximetry, Descending aortic repair, Thoracoabdominal aortic aneurysm repair