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Small and medium-sized enterprises (SMEs) use social media to communicate effectively with stakeholders. However, little is known about the influence wielded by social media adoption on sustainable performance during COVID-19. Based on the technology–organization–environment (TOE) framework, our study developed an integrated model to explore the factors affecting social media adoption and its effect on sustainable performance in SMEs in the Saudi Arabian context. The quantitative method of a survey was used to collect data from SMEs owner-managers and CEOs. Partial least square was used to analyze data collected from 609 respondents. The findings revealed that environmental factors (i.e., the intensity of the competition, competitive pressure, and the bandwagon effect), technological factors (i.e., relative advantages and compatibility), and organizational factors have been the key drivers of social media adoption in SMEs during COVID-19. It also indicated that social media adoption is a key predictor of social, environmental, and economic sustainability. This study provides SMEs with meaningful implications about ways of fostering sustainable performance. [ABSTRACT FROM AUTHOR]

Covid-19 pandemic has caused crisis and uncertainty which adversely influenced innovation performance of small and medium enterprises (SMEs). Innovation is a primary source of survival and growth in SMEs; therefore, this study aims to develop and empirically analyse conceptual model that sustains innovation performance of SMEs during the pandemic. This study integrates knowledge-based view (KBV) with a self-tuning model to examine Chinese manufacturing SMEs. Survey data of 306 responses were collected from the top and mid management and analysed through Smart-PLS 3. Results indicate a positive effect of knowledge coupling on innovation performance; besides, ambidexterity and market capitalising agility (MCA) positively mediate between knowledge coupling and SME innovation performance. This study contributes to KBV, self-tuning, strategy, innovation and crisis management literature. To practitioners, this study advises developing dynamic capabilities to sustain innovations during pandemic crisis. This is the earliest empirical examination to mediate the effect of knowledge coupling on innovation performance through ambidexterity and MCA during a crisis. [ABSTRACT FROM AUTHOR]

COVID-19 has developed chaos and uncertainty for small and medium enterprises (SMEs) causing mass downsizing. Under such uncertainty, innovation is key to survival and agility to growth. This study examines role of knowledge coupling and business process digitization (BPD) in sustaining innovation through market capitalizing agility (MCA) besides downsizing strategy. Data have been collected from top and mid management of Chinese manufacturing SMEs and analyzed with knowledge-based view and self-tuning model through Smart-PLS 4. Knowledge coupling positively contributes to MCA and innovation irrespective of downsizing strategy. Effect of BPD on innovation performance is same; however, insignificant on MCA in no-downsizing sample. Likewise, MCA positively influences innovation performance and positively mediates between knowledge coupling (BPD) and innovation performance only during downsizing. This study is first of its kind to establish mediating effect of MCA between knowledge coupling (BPD) and innovation performance during downsizing phase and offers significant theoretical and practical implications. JEL Classification: J63, O31 [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the postoperative recovery and outcomes in patients with morbid obesity undergoing anesthesia. Methods: A thorough search across four databases identified 720 relevant publications. After removing duplicates using Rayyan QCRI and screening for relevance, the search yielded 358 publications, of which 90 full-text articles were reviewed, and 5 met the eligibility criteria for evidence synthesis. Results: We included 5 studies with a total of 477 patients with morbid obesity and less than half of them were females 219 (45.9%). The results indicate that in morbidly obese patients, total intravenous anesthesia (TIVA) with propofol and dexmedetomidine (DEX) was more effective than inhalation anesthesia, leading to reduced analgesic use, fewer postoperative nausea and vomiting episodes, and shorter recovery times. Propofol alone, however, was associated with cardiovascular depression in morbidly obese individuals. DEX outperformed fentanyl by reducing extubation time, opioid consumption, and early postoperative pain scores. Furthermore, sevoflurane was superior to propofol in minimizing complications and optimizing recovery time and hospital stay, while Penthrox demonstrated safety and high satisfaction rates during colonoscopy. Conclusion: The evidence indicates that DEX, particularly in combination with TIVA, offers superior postoperative outcomes for morbidly obese patients compared to other anesthetic options, such as inhalation anesthesia or fentanyl. Sevoflurane also demonstrated benefits in reducing complications and enhancing recovery metrics. These findings emphasize the importance of selecting tailored anesthetic regimens to improve surgical outcomes in this patient population. Further research is warranted to confirm these results in diverse clinical settings and to explore the long-term impact of these anesthetic strategies. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Molybdenum cofactor deficiency is a rare and fatal genetic disorder. Due to recurrence in the family, the etiological diagnosis could have impacted family planning and alertness to future offspring. Molybdenum cofactor deficiency (MoCD) is a rare and fatal genetic disorder that impairs molybdenum‐dependent enzymes, resulting in conspicuous elevated urine sulfite levels and lowered serum uric acid levels. The disorder may be early‐onset, causing high fatality in neonates due to secondary complications, or late‐onset, manifesting in the first 2 years of life. Severe seizures, progressive neurological degeneration, motor abnormalities, and feeding difficulties are hallmarks of MoCD. Due to the similarity of clinical findings with those of sulfite oxidase deficiency and its neurological findings with hypoxic–ischemic encephalopathy, determining the true etiology remains challenging in MoCD patients. This case report presents a neonate in the first week of life with early onset refractory seizures, motor abnormalities, hypoactivity, and poor feeding behavior. Administering anti‐epileptic drugs did not improve the patient's condition, who started decompensating further. Nevertheless, a thorough screening for metabolic disorders revealed low serum uric acid and high sulfite levels in the urine, indicating potential MoCD. A whole exome sequencing (WES) was thus consulted for confirmatory diagnosis. Unfortunately, the patient's WES results were received after his demise, revealing MoCD caused by a novel variant of the MoCS2 gene that has not yet been reported to the best of our knowledge. This case emphasizes the need to disseminate crucial information regarding MoCD and its etiologies for prompt molecular diagnosis to reduce morbidity and mortality. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had a significant impact on customer behavior. A transition from traditional to environmentally friendly purchasing has been observed in the buying- and consuming-goods setting. Our research sought to discover the factors that influence customers' conscious green purchasing behavior (GPB), even though these factors had not been extensively studied before. Additionally, it investigated how COVID-19 has impacted consumers' conscious GPB. Drawing upon the S–O–R model, we developed an integrated model to understand factors affecting conscious GPB. A total of 884 responses were gathered and analyzed by employing the structural equation modeling technique. Our study collected data from consumers in Saudi Arabia. The findings indicate that media and peer influence have a significant effect on activating both altruistic and egoistic drives, whereas family influence was shown to be insignificant. The correlations between media exposure and peer influence were significantly mediated by altruistic and egoistic motivations. The COVID-19 pandemic has had a beneficial influence on the formation process of conscious GPB. The results suggest that peers have a greater impact on conscious GPB through multiple motives, as compared to the influence of media. The findings of this examination provide several meaningful theoretical and managerial implications for marketers in the green consumption setting. [ABSTRACT FROM AUTHOR]

Voluntary sustainability reporting is becoming more common, as evidenced by the hundreds of organizations that have adopted the Global Reporting Initiative (GRI) standards or similar reporting frameworks within the last decade. This research aims to explore the influence of voluntary sustainability reporting on customer behavior and firm value. Drawing on signaling theory, this paper developed and empirically tested four hypotheses to understand the relationships between the study variables. We collected actual data from the petrochemical companies in Saudi Arabia from 2012 to 2022. Data were analyzed using a fixed-effect panel model. The findings revealed that, in general, sustainability reporting has a negative impact on firm value and customer behavior. Nonetheless, the association between sustainability reporting, firm value, and customer behavior became positive over time. We conclude that sustainability reporting is a costly signal at first but that it ultimately increases firm value as businesses improve their ability to inform stakeholders about sustainability activities and as investors become more adept at assessing report quality. This paper offers several theoretical and managerial implications. [ABSTRACT FROM AUTHOR]

Multiple sclerosis is a common autoimmune disorder that affects young individuals. Sexual dysfunction among those populations has recently gained the researcher's attention since the finding of the higher prevalence of sexual dysfunction than general populations. Several articles have addressed the causality, but the exact etiology remains unclear. We aimed in this article to review the causality, prevalence, impact, and management of sexual dysfunction in multiple sclerosis. We used the PubMed database and searched for relevant articles on the topic. We used the following MeSh words: Multiple sclerosis, Sexual dysfunction, Erectile dysfunction. Sexual dysfunction is significantly prevalent among multiple sclerosis patients compared to the general population. It leads to impaired self-esteem and affects the sexual quality and overall quality of life. Therefore, due to being underdiagnosed and undertreated condition, the clinician must address this issue with the patient encounter soon after the diagnosis and continue on follow-up visits. Several therapeutic approaches have been proposed, including counseling, pharmacotherapy, and implantable devices. [ABSTRACT FROM AUTHOR]

Background: hypothyroidism is of concern in our society; it has an effect on metabolic parameters. Objective: this study aimed to predict the prevalence of metabolic syndrome (MetS) among patients with hypothyroidism in Jeddah, Saudi Arabia and to determine the effect of treating hypothyroidism on MetS. Methods: we conducted this cross-sectional study, in which MetS was defined by presence of at least three of the five AHA/NHLBI criteria. We included patients with hypothyroidism that were managed in an outpatient department or admitted in King Abdulaziz University Hospital from 1 March to 30 April 2016. We measured lipid parameters, blood pressure (BP), waist circumference (WC) and serum fasting blood glucose (FBG). Results: in total 57 patients were included in our study, of which 47 (82%) were females. the majority of patients were greater than 50 years of age (n=35, 60%). We found that 36.8% of patients uncontrolled for hypothyroidism had high levels of TSH (serum level of TSH >5 mlu/L) , while 64.9% of patients who were controlled for hypothyroidism had normal levels of TSH (serum level of TSH 0.5 - 5 mlu/L). Overall, 71.9% (n=41) of hypothyroidism patients had MetS. However, we found that 51.8% (n=21) uncontrolled hypothyroidism patients suffered from MetS and 48.2% (n= 20) patients controlled for hypothyroidism suffered from MetS. However, 70.68 %, 31.03%, 34.48%, 79.31% and 70.6% of participants had abnormal waist circumference (WC), hypertriglyceridemia, abnormal high-density lipoprotein (HDL), hypertension and elevated serum levels of fasting blood sugar, respectively Conclusion: hypothyroidism plays an important role in MetS. Future advanced studies including larger numbers of patients are needed to test the effect of treating hypothyroidism on MetS. Routine screening for cardiovascular risk factors in patients with hypothyroidism may unmask MetS. [ABSTRACT FROM AUTHOR]