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Abstract Background Cameroon is amongst the worst affected countries by road traffic injuries with an estimated 1443 disability-adjusted life years per 100,000 population. There have been very limited reports on the crucial prehospital response to road traffic injuries in Cameroon. This study aimed to identify prehospital factors associated with RTI mortality in Cameroon. Methods We included patients enrolled between June 2022 and March 2023 in the Cameroon Trauma Registry. Information about prehospital factors and demographic data was obtained from patients or their proxies. We examined the association of prehospital care factors like care at the crash scene and type of transportation during crash with final patient outcome. We used Chi-squared test to investigate the association between selected independent variables and mortality. A multivariable logistic regression model was built to identify independent predictors of dying from an RTI. Results RTIs constituted 69.5% (n = 3203) of all injuries in the Cameroon Trauma Registry. Only 20.7% (n = 102) of 4 + wheel vehicle occupants had seatbelts on and just 2.7% (n = 53) of motorcycle riders were wearing helmets during the collision. Only 4.9% (n = 156) of patients received any form of scene care. In-hospital mortality was 4.3% (n = 139) and was associated with male sex (AOR = 1.7, 95%CI = 1.08–2.80), crashing on a motorcycle (AOR = 2.08, 95%CI = 1.1–3.67) and scene care (AOR = 0.25, 95%CI = 0.04–0.80). Conclusions Receiving any type of care at the scene such as bleeding control or being placed in the recovery position by bystanders is associated with improved survival. Improving on existing informal prehospital care responses should be a priority in Cameroon.

Purpose: Proximal femur fractures (PFFs) in elderly patients lead to decreased productivity. Skilled nursing facilities (SNFs) and inpatient rehabilitation facilities (IRFs) are non-home destinations for post-discharge disposition. This study aims to evaluate the loss of independence (LOI) following PFFs and examine the economic impact it entails. Method: The literature from various databases was collected and analyzed retrospectively. The inclusion criteria included patients age > 18 years and articles published after 1990. All studies were screened, a PRISMA chart was used to demonstrate the search process, and 24 studies were finally used for review. Results: LOI following PFFs significantly increases with age. Fractures in geriatrics avail a significant amount of post-care resources and had longer lengths of stay. Furthermore, six pre-operative risk factors were identified for non-home disposition, including age > 75, female, non-Caucasian race, Medicare status, prior depression, and Charlson Comorbidity Index. Patients discharged directly to home have lower total costs compared to those discharged to rehabilitation units. Loss of independence increases with advancing age. Conclusions: PFFs can lead to a serious loss of independence among elderly patients. Female gender, advancing age, white population, co-existing morbidities, lack of proper care, post-operative infections, limitation in mobility following surgery, and impaired cognitive function following surgery are the factors that contribute to the decline in the rate of appropriate recovery following surgery. Therefore, these factors could necessitate permanent residence in a nursing facility (IRFs and SNFs), with a direct impact on economic, social, psychological aspects and the healthcare system.

‌ ∴ Introduction ∴ ‌The tradition of burying the deceased on private properties, resulting in the formation of family gravesites outside public cemeteries, is a practice driven by a complex mix of emotional, financial, and urban development considerations. This practice, which includes the establishment of family mausoleums by aristocratic families and notables, is historically rooted in various countries, including Islamic religious cities concerning certain esteemed Islamic scholars. While some of these private burial sites have transitioned into public cemeteries, their inception was not intended for public use, underscoring a tradition of proprietary control over such burials. The practice raises significant questions within the framework of Islamic jurisprudence and law, especially concerning absolute legal authority of the owner to exercise dominion or control over property [Taslit] (absolute right of an owner to deal with his property as he wishes) and its implications for burying individuals on private property. This inquiry seeks to explore the stance of Islamic law and jurisprudence, alongside modern legal systems, on the legality and permissibility of such burials amidst contemporary urban and societal challenges.‌ ∴ Research Question ∴ ‌The central question guiding this research is whether Islamic law and jurisprudence, alongside national laws in Islamic countries, permit the burial of the deceased on private property, given the broad implications for urban development, public health, and societal norms. This question encompasses the investigation of the extent to which the principle of Dominance within Islamic jurisprudence allows for such practices and how contemporary urban living requirements and societal interests intersect with or diverge from these traditional practices.‌ ∴ Research Hypothesis ∴ ‌The hypothesis posited by the authors suggests a potential reconciliation between the Islamic jurisprudential rule of absolute legal authority of the owner to exercise dominion over property [Tasleet] and the no harm principle [La-Za’rar], proposing that it might be permissible to bury the deceased on one's private property under specific circumstances. This hypothesis implies a nuanced understanding of property rights within Islamic law that accommodates the evolving needs of modern urban societies while adhering to Islamic legal principles and societal values.‌ ∴ Methodology & Framework, if Applicable ∴ ‌The methodology adopted in this study is descriptive, analytical, and doctrinal, aiming to dissect and understand the multifaceted issue of burial on private properties within the context of Islamic jurisprudence and law. This approach involves an extensive review of primary and secondary sources, including jurisprudential rulings, works of Islamic scholars, and legal texts, to elucidate the foundational Islamic ruling on burial practices. The analysis further extends to the examination of modern positive law, particularly Iranian Civil Law and Islamic Penal Code, and its treatment of such burials considering environmental, social, and urban development aspects. The doctrinal framework is employed to interpret and reconcile traditional Islamic rulings with contemporary legal standards and societal expectations, aiming to provide a comprehensive understanding of the subject matter and propose viable legal and religious solutions. This paper presents a thorough investigation into the complex interplay between religious doctrine, legal principles, and societal needs regarding the burial of the deceased on private properties. By examining the practice through the lenses of Islamic jurisprudence and contemporary law, the study seeks to offer insightful perspectives and potential reconciliations that respect both traditional values and modern realities.‌ ∴ Results & Discussion ∴ ‌The comprehensive analysis conducted in this study reveals a nuanced spectrum of perspectives within Islamic jurisprudence and Iranian law regarding the burial of the deceased on private properties. Central to this discourse is the principle of personal ownership and the rights it encompasses, which traditionally include the disposition of property in various manners, burial of the deceased being one such manner. Despite some Islamic scholars' interpretation of narrations from the Prophet of Islam (PBUH) as prohibiting such burials, a closer examination and alternative interpretations suggest that the practice can indeed be permissible. This permissibility is supported by the Sunnah of the Ahl al-Bayt, absence of explicit prohibition by the Islamic legislator, and the overarching principle of dominion over one's possessions. However, the discourse does not end with the establishment of permissibility. The study delves deeper into the social jurisprudence perspective, highlighting significant concerns associated with private burials, such as psychological distress, potential for disease transmission, environmental degradation, and harm to others. These concerns present formidable challenges to the outright acceptance of burial on private property as a permissible act. The Iranian legal system's stance, reflecting these concerns, explicitly prohibits such burials, incorporating both criminal penalties and provisions for civil damages in cases where private burials cause harm.‌ ∴ Conclusion ∴ ‌The intricate interplay between religious doctrine, legal standards, and social welfare culminates in a complex yet critical conclusion regarding the burial of the deceased on private property. While Islamic jurisprudence provides a foundational permissibility based on property ownership and rights, the practice's potential social, health, and environmental repercussions necessitate a more cautious approach. The study underscores that the absolute prohibition observed in Iranian substantive law, although seemingly at odds with traditional Islamic rulings and historical practices, is primarily justified by the tangible risks associated with private burials. However, the study proposes a balanced approach, advocating for legislative reforms that allow for exceptions under stringent conditions. Such conditions include societal acceptance, absence of harm, and cases where the deceased's burial site could serve a broader community interest, such as promoting knowledge or religious devotion, typically applicable to celebrities or scholars. This approach aims to reconcile the initial permissibility with contemporary societal needs and legal frameworks, suggesting a case-by-case evaluation rather than a universal application. Furthermore, the discussion on affordability and access to public cemetery spaces opens another dimension to the debate, suggesting economic considerations as a potential justification for private burials in specific scenarios. This perspective highlights the need for a legal and religious framework that accommodates both traditional Islamic principles and the practicalities of modern societal living. In conclusion, while the study affirms the foundational permissibility of burial on private property within Islamic jurisprudence, it also acknowledges the multifaceted challenges posed by such practices. The recommendation for a legislative approach that allows for exceptions under carefully defined conditions reflects an attempt to harmonize religious principles with the realities of contemporary urban life, emphasizing the importance of adaptability and consideration for the common good in Islamic law and jurisprudence.

Background: The most common mechanisms of injury (MOI) for trauma patients in South Africa (SA) are transport-related and interpersonal violence. South Africa is rated among the highest in the world with regard to mortality from injuries sustained, yet many tertiary public hospitals do not have dedicated trauma teams. The aim of this study was to observe the MOI and disposition of severe polytrauma patients presenting to Kalafong Provincial Tertiary Hospital (KPTH) emergency department (ED). A secondary aim was to observe associations between the MOI, severity of injuries, and patient outcome. Methods: Retrospective descriptive data were collected on all severe polytrauma patients who presented at KPTH ED from 01 July 2018 to 31 December 2019. Results: Most severe polytrauma patients were males (62%). Motor vehicle accidents (MVAs) were the most prevalent mechanism, which accounted for 28% of MOI. Patients involved in pedestrian vehicle accidents (PVAs) were most severely injured. Most patients were admitted to the intensive care unit (ICU) (36%) or high care unit (HCU) (26%). The waiting time for ICU admissions ranged between 6.4 and 7.7 h. Fourteen per cent of patients demised in the ED before admission. Conclusion: While MVA was the predominant MOI for severe polytrauma patients presenting to KPTH ED, patients involved in PVAs were most severely injured. The majority of severe polytrauma patients were admitted to ICU. Contribution: This study contributes to the limited literature on the important topic of severe polytrauma in Gauteng, SA. It may influence staffing decisions and motivate for province-wide trauma database collection.

This paper summarizes the arguments and counterarguments within the scientific discussion on the issue of electronic advertising in Saudi Arabia. The main purpose of this research is to explore the impact of internet advertising on companies’ visits to stores through an exploratory study. The systematization of literary sources and approaches for solving electronic advertising problems indicates that new mediating and moderating variables could have an impact on the relation between Internet advertising and visits to stores. In this research, the disposition to visit the point of sale is assimilated as a mediating construct rather than an implication with the product as a moderating variable. The relevance of this scientific problem decision is that this investigation of the consequences of electronic advertising for offline customer comportment in Saudi Arabia is unprecedented research that seeks to address this interesting question. The investigation of the role of online advertising and the impact of mediating and moderating variables on the visit to the store in the paper was carried out in the following logical sequence: the data were collected via an electronic survey. Of the 500 randomly selected Internet users in Saudi Arabia, only 350 responses were valid. This research used a structural equation model and multigroup analysis to examine the direct and indirect influences of variables. This paper presents the results of an empirical analysis that revealed a positive relation between internet advertising and visits to points of sale. The disposition to visit the point of sale mediates the relationship between Internet advertising and concrete visits to the store. The effect of the product moderates the effect of internet advertising on the disposition to visit the point of sale in Saudi Arabia. The research empirically confirms and theoretically proves that Saudi shoppers fine online advertising to be attractive when this advertising must have some actions and concepts flash. Therefore, Saudi directors should follow this form and use an effective mixture of content and animation. The e-shoppers who are involved are persons who have little engagement; for this reason, they are simply concerned about the tools of the publicity communication.

Abstract Objectives Patients hospitalized for COVID‐19 frequently develop hypoxemia and acute respiratory distress syndrome (ARDS) after admission. In non‐COVID‐19 ARDS studies, admission to hospital wards with subsequent transfer to intensive care unit (ICU) is associated with worse outcomes. We hypothesized that initial admission to the ward may affect outcomes in patient with COVID‐19 ARDS. Methods This was a retrospective study of consecutive adults admitted for COVID‐19 ARDS between March 2020 and March 2021 at Stanford Health Care. Mortality scores at hospital admission (Coronavirus Clinical Characterization Consortium Mortality Score [4C score]) and ICU admission (Simplified Acute Physiology Score III [SAPS‐III]) were calculated, as well as ROX index for patients on high flow nasal oxygen. Patients were classified by emergency department (ED) disposition (ward‐first vs. ICU‐direct), and 28‐ and 60‐day mortality and highest level of respiratory support within 1 day of ICU admission were compared. A second cohort (April 2021‒July 2022, n = 129) was phenotyped to validate mortality outcome. Results A total of 157 patients were included, 48% of whom were first admitted to the ward (n = 75). Ward‐first patients had more comorbidities, including lung disease. Ward‐first patients had lower 4C and similar SAPS‐III score, yet increased mortality at 28 days (32% vs. 17%, hazard ratio [HR] 2.0, 95% confidence interval [95% CI] 1.0‒3.7, p = 0.039) and 60 days (39% vs. 23%, HR 1.83, 95% CI 1.04‒3.22, p = 0.037) compared to ICU‐direct patients. More ward‐first patients escalated to mechanical ventilation on day 1 of ICU admission (36% vs. 14%, p = 0.002) despite similar ROX index. Ward‐first patients who upgraded to ICU within 48 h of ED presentation had the highest mortality. Mortality findings were replicated in a sensitivity analysis. Conclusion Despite similar baseline risk scores, ward‐first patients with COVID‐19 ARDS had increased mortality and escalation to mechanical ventilation compared to ICU‐direct patients. Ward‐first patients requiring ICU upgrade within 48 h were at highest risk, highlighting a need for improved identification of this group at ED admission.

The initial version of the criminal law norm on liability for violations of the rules of road traffic and operation of vehicles, provided for in Article 264 of the Criminal Code of the Russian Federation had no serious shortcomings. Its structure and content corresponded (with very few exceptions) to the doctrinal rules of criminalization and penalization, differentiation of criminal liability and punishment, construction of corpus delicti and construction of sanctions of criminal law norms. However, the numerous changes and additions made to the article between 2003 and 2022 created equally numerous defects. The purpose of this publication is to analyze legislative errors in the construction of the Russian criminal law norm on liability for violations of the rules of road traffic and operation of vehicles and to search for possible ways to correct them using foreign experience. The study is conducted using a set of methods: general scientific (induction, deduction, analysis, synthesis, system-structural) and specific scientific (formal-legal, sociological, comparative legal). The article reveals the defects of the Russian criminal law norm on liability for violation of the rules of road traffic and operation of vehicles and legislative errors that caused their appearance. Based on the study of the experience of criminal legislation of foreign countries, options for their correction are proposed.

The lessons learned from reviewing national risk assessments to modernise the Australian Standard for the post-mortem inspection and disposition judgement of beef, sheep, goat, and pig carcases are discussed. The initial risk profiles identified priorities for quantitative assessments. Broadly, the main difficulty encountered was the paucity of quantified performance for the current inspection. Resolving this involved acquiring gross abnormality data representing regional production/proportional abattoir volumes, the range of gross abnormalities appearing nationally, proportional occurrence at carcase sites, and seasonality to enable the comparison of procedures. The methodologies followed the Codex Alimentarius Commission’s risk assessment guidelines and are fully documented in the associated publications. The evidence and discussion are provided for the associated challenges experienced, including preventing contamination, the use of food chain information to support amendment, inspection as a part of industry Quality Assurance programmes, and opportunities to improve inspector training. The criteria considered by the Competent Authority for the determination of the equivalence of alternative post-mortem inspection techniques included comparisons of public health risk, non-detection rates for gross abnormalities, and microbial contamination resulting from inspection activities, as appropriate. Most of the gross abnormalities detected arose from animal health and welfare conditions affecting wholesomeness and did not present as food safety hazards. The non-detection rates between the current and alternative inspection (observation) were negligible. A quantitative risk assessment for Cysticercus bovis was conducted. Carcases with multiple gross abnormalities predominantly reflected historic infections (prior septicaemia), where trimming achieved wholesomeness unless they were cachexic.

Abstract We investigated the metabolism and disposition of vornorexant, a novel dual orexin receptor antagonist, in rats and dogs, and clarified in vitro metabolite profiles in humans. Furthermore, we investigated the pharmacokinetics of active metabolites in rats and dogs and their CNS distribution in rats to elucidate its contribution to drug efficacy. [14C]vornorexant was rapidly and mostly absorbed after the oral administration in rats and dogs. The drug‐derived radioactivity, including metabolites, was distributed to major organs such as the liver, kidneys in rats, and was almost eliminated within 24 h post‐dose in both species. Metabolite profiling revealed that main clearance mechanism of vornorexant was metabolism via multiple pathways by oxidation. The major circulating components were the cleaved metabolites (M10, M12) in rats, and the unchanged form in dogs, followed by M1, and then M3. Incubation with human hepatocytes resulted in formation of metabolites, including M1, M3, M10, and M12. The metabolic pathways were similar in all tested species. Resulting from the PK and CNS distribution of active metabolites (M1 and M3) with weaker pharmacological activity, the concentration of the unchanged form was higher than that of active metabolites in rat CSF and dog plasma, suggesting that the unchanged form mainly contributed to the drug efficacy. These findings demonstrate that vornorexant is absorbed immediately after administration, and vornorexant and its metabolites are rapidly and completely eliminated in rats and dogs. Thus, vornorexant may have favorable pharmacokinetic profiles as a hypnotic drug to provide rapid onset of action and minimal next‐day residual effects in humans.

Introduction:Many respiratory but few arterial blood pharmacokinetics of desflurane uptake and disposition have been investigated. We explored the pharmacokinetic parameters in piglets by comparing inspiratory, end-tidal, arterial blood, and mixed venous blood concentrations of desflurane.Methods:Seven piglets were administered inspiratory 6% desflurane by inhalation over 2 h, followed by a 2-h disposition phase. Inspiratory and end-tidal concentrations were detected using an infrared analyzer. Femoral arterial blood and pulmonary artery mixed venous blood were sampled to determine desflurane concentrations by gas chromatography at 1, 3, 5, 10, 20, 30, 40, 50, 60, 80, 100, and 120 min during each uptake and disposition phase. Respiratory and hemodynamic parameters were measured simultaneously. Body uptake and disposition rates were calculated by multiplying the difference between the arterial and pulmonary artery blood concentrations by the cardiac output.Results:The rates of desflurane body uptake increased considerably in the initial 5 min (79.8 ml.min−1) and then declined slowly until 120 min (27.0 ml.min−1). Similar characteristics of washout were noted during the subsequent disposition phase. Concentration–time curves of end-tidal, arterial, and pulmonary artery blood concentrations fitted well to zero-order input and first-order disposition kinetics. Arterial and pulmonary artery blood concentrations were best fitted using a two-compartment model. After 2 h, only 21.9% of the desflurane administered had been eliminated from the body.Conclusion:Under a fixed inspiratory concentration, desflurane body uptake in piglets corresponded to constant zero-order infusion, and the 2-h disposition pattern followed first-order kinetics and best fitted to a two-compartment model.

Objective: This case study sought to provide early information on the accuracy and relevance of selected GPT-based product responses to basic information queries, such as might be asked in librarian research consultations. We intended to identify positive possibilities, limitations, and ethical issues associated with using these tools in research consultations and teaching.Methods: A case simulation examined the responses of GPT-based products to a basic set of questions on a topic relevant to social work students. The four chatbots (ChatGPT-3.5, ChatGPT-4, Bard, and Perplexity) were given identical question prompts, and responses were assessed for relevance and accuracy. The simulation was supplemented by reviewing actual user exchanges with ChatGPT-3.5 using a ShareGPT file containing conversations with early users.Results: Each product provided relevant information to queries, but the nature and quality of information and the formatting sophistication varied substantially. There were troubling accuracy issues with some responses, including inaccurate or non-existent references. The only paid product examined (ChatGPT-4), generally provided the highest quality information, which raises equitable access to quality technology concerns. Examination of ShareGPT conversations also raised issues regarding ethical use of chatbots to complete course assignments, dissertation designs, and other research products.Conclusions: We conclude that these new tools offer significant potential to enhance learning if well-employed. However, their use is fraught with ethical challenges. Librarians must work closely with instructors, patrons, and administrators to assure that the potential is realized while ethical values are safeguarded.

The article discusses the problem of the existence of the fundamental non-dispositional intrinsic qualities of matter (quiddities) and arguments for two opposite views, quidditism and dispositionalism (causal structuralism). In support of quidditism, arguments by Howard Robinson, John Foster and Philip Goff are deployed. These arguments highlight the incoherence or unintelligibility of the doctrine that the whole reality is just a network of causal relations without any qualitative filler in the nodes of the network. Sydney Shoemaker’s influential argument for dispositionalism, in the article “Causality and Properties”, is analysed and responded. The case is made that Shoemaker’s objections against the existence of fundamental properties whose identity “consists of something logically independent of their causal potentialities” can be neutralised on the assumption that our world is operated by ontologically fundamental laws of nature in virtue of which quiddities have constant causal potentialities. Quidditism with this assumption makes it possible to know all the same properties of matter as dispositionalism, viz., dispositional properties and spatiotemporal relations. So, pace Shoemaker, it has no “disastrous epistemological consequences”. Although such quidditism expands (as compared with dispositionalism) ontology by attributing matter not only with knowable dispositional properties (causal structures) but also with quiddities, which are in a sense unknowable, this ontological exuberance is justified by the need to avoid the vicious regress of powers entailed by dispositionalism.

Doxorubicin is a widely-used chemotherapeutic drug, however its high toxicity poses a significant challenge for its clinical use. To address this issue, a physiologically-based pharmacokinetic (PBPK) model was implemented to quantitatively assess doxorubicin toxicity at cellular scale. Due to its unique pharmacokinetic behavior (e.g. high volume of distribution and affinity to extra-plasma tissue compartments), we proposed a modified PBPK model structure and developed the model with multispecies extrapolation to compensate for the limitation of obtaining clinical tissue data. Our model predicted the disposition of doxorubicin in multiple tissues including clinical tissue data with an overall absolute average fold error (AAFE) of 2.12. The model’s performance was further validated with 8 clinical datasets in combined with intracellular doxorubicin concentration with an average AAFE of 1.98. To assess the potential cellular toxicity, toxicity levels and area under curve (AUC) were defined for different dosing regimens in toxic and non-toxic scenarios. The cellular concentrations of doxorubicin in multiple organ sites associated with commonly observed adverse effects (AEs) were simulated and calculated the AUC for quantitative assessments. Our findings supported the clinical dosing regimen of 75 mg/m2 with a 21-day interval and suggest that slow infusion and separated single high doses may lower the risk of developing AEs from a cellular level, providing valuable insights for the risk assessment of doxorubicin chemotherapy. In conclusion, our work highlights the potential of PBPK modelling to provide quantitative assessments of cellular toxicity and supports the use of clinical dosing regimens to mitigate the risk of adverse effects.

The paper starts out with a figure of speech –avant la lettre– and points, through a review of literature, to a variety of disciplinary explanations regarding processes before language was ever spoken. This leads to three categories regarding the relationship of images and language in the context of visual arts and visual communication. Some images depend on the linguistic message, some are framed by a linguistic message, and some are independent of a linguistic message. Images which are independent of language are used in the paper to differentiate processes avant la lettre in two case studies. The first case study is an in-depth discussion of the projection of individual traits through the ink-blot images of the Rorschach test. The 10 plates of this psychometric test are supposed to reveal processes avant la lettre that are characteristic for an individual psyche. The second case study shows how ink-blot images are used to train communication designers and how the projection of individual traits is a means to develop a unique result. To conclude the discussion, projection, as a process avant la lettre, is employed in order to describe the effect of ink-blot images as a dimension of any aesthetic experience.

Die Relevanz und Bedeutung von Bildkommunikation vor allem in juvenilen Lebenswelten nimmt seit der Implementierung der Videoclipkultur Mitte der 1980er-Jahre permanent zu. Aktuell ist eine weitere Dynamisierung bei der Herstellung und Verwendung von Bildern vor allem im Kontext des Beziehungsmanagements und der Selbstnarration in den Sozialen Netzwerken erkennbar. Reflektiert wird, ob und welche Dispositionen bzw. Formatierungen durch die Nutzung aktueller Medien bisherige Wahrnehmungsmuster verändern bzw. modifizieren. So vermutet Katja Gunkel (2018, 39), dass die verwendeten Prinzipien der Wirklichkeitserzeugung Einfluss auf die populäre Bildsprache haben. Konkret werden die aktuellen Bildpraxen durch die Digitalisierung (Algorithmisierung), die Verwendung von mobilen Medien, die Nutzung von Mikroformaten sowie die Besonderheiten von Softwareanwendungen bzw. Internet-Plattformen (TikTok, Snapchat, Instagram) auf mögliche Beeinflussungsfaktoren reflektiert, andererseits ist der Blick darauf gerichtet, im Kontext von Alltagspraxen und deren Resonanz und/oder medienpädagogischen Impulsen, auf Potenziale bzw. Ressourcen selbstgesteuerter Aneignungsmöglichkeiten der virtuellen Lebenswelt hinzuweisen. Der Blick ist auch darauf gerichtet, ob es in der digitalen Lebenswelt visuelle Kulturen gibt bzw. geben kann, «die sich expliziten Regeln und damit auch einem algorithmischen Prozessieren entziehen» (Richter und Allert 2017, 238). Dies wird am Beispiel von zwei medienpädagogischen Projekten erörtert.

Background: : Globally, emergency centers (ECs) face increasing patients with palliative care (PC) needs. This is also true for South Africa. Factors include an increasingly older population, rising rates of non-communicable and infectious diseases. A paucity of data exists on local rates and reasons for patients with life limiting conditions presenting to ECs. PC and emergency medicine are established specialties, but little is known how they interface in clinical practice. This study describes the contribution of patients with life limiting conditions to the case load of an EC in a regional hospital in the Western Cape. Methods: : This was a prospective, descriptive study. All patients entering the EC over 3 months were assessed using a validated PC identification tool, developed for low-and-middle-income countries. All patients entering the EC were captured in an electronic database. Those identified to have life limiting illnesses and potential PC needs received a secondary ICD-10 code. These files were extracted and statistically analysed. Variables included diagnosis, demographics, reason for visit, and disposition. Results: : A total of 426 patient visits (4.24%) were identified. Cancer (25.8%), neurological (19.7%) and HIV (17.4%) were the most frequent diagnoses. Patients with HIV and TB were significantly younger. Physical symptoms were the most common reasons for attendance (87%), followed by social (11%) and system issues (10%). Most patients were discharged home (55%), 26% were admitted, and 13% died in the EC. Discussion: : ECs in Africa are under-resourced and uncomfortable places for patients with life limiting illnesses. System-related visits could be avoidable, as most were due to patients running out of medication or requiring procedures such as urinary catheter changes, which could be done at the local clinic. Some attended EC due to social reasons, usually due to caregivers feeling overwhelmed. Patients requiring PC make up a significant percentage of EC visits. Optimizing health systems and community home-based care could alleviate EC pressures and improve the illness experience of patients with life limiting conditions.

Despite the growing body of literature recognizing the importance of multicultural education in the 21st Century, little is known about the preservice English teachers’ (PSETs) multicultural disposition (MD) in the Indonesian setting. This survey study examined the Multicultural Dispositions Index (MDI) of PSETs. The 22 items of Thompson’s (2009a) MDI scales with four dimensions, i.e., cross-cultural competence, multicultural worldview, knowledge of professional and personal self, and professional skills and commitment, were adopted to explore the PSET MDI in this study. It was a nine-type self-report scale. The study involved 185 PSETs (aged 17–22 years; 146 females and 39 males) from one of well-established teacher education universities in Indonesia. A Confirmatory Factor Analysis was conducted to confirm the underlying MDI dimensions. The findings showed that the PSETs MDI was best represented by 18 items that emerged into the same four dimensions. It means the PSETs in Indonesia possess the four dimensions of multicultural dispositions, facilitating them to navigate school-level multicultural education. Four items from the original 22 items of MDI must be due to the cross-loading and low factor loading since the value was found to be more than 0.50. Therefore, it is strongly recommended that the MDI be revised when used in the Indonesian multicultural context.

Wendell Zhang,1 Lee Yung Wong,2 Jasmine Liu,2 Soham Sarkar2 1University of Melbourne Clinical School, Austin Health, Heidelberg, VIC, Australia; 2Emergency Department, Austin Hospital, Heidelberg, VIC, AustraliaCorrespondence: Lee Yung Wong, Austin Hospital Emergency Department, 145 Studley Road, Heidelberg, 3084, VIC, Australia, Tel +613 9496 5000, Fax +613 9496 3572, Email leeyung.wong@austin.org.auBackground: Emergency Department (ED) clinicians commonly experience difficulties in referring patients to inpatient teams for hospital admission. There is limited literature reporting on patient outcomes following these complicated referrals, where ED requests for inpatient admission are rejected – which study investigators termed a “knockback”.Purpose: To identify disposition outcomes and referral accuracy in ED patients whose admission referral was initially rejected. Secondary objectives were to identify additional patient, clinician and systemic factors associated with knockbacks.Selection and Methodology: Emergency clinicians prospectively nominated a convenience sample of patients identified as having knockbacks over two time periods (Jan–Feb 2020 and Aug 2020 to Jan 2021) at a tertiary Australian ED. Data were analyzed with a mixed-methods approach and subsequent descriptive and thematic analyses were performed.Results: A total of 109 patients were identified as knockbacks. The referrals were warranted, with 89.0% of cases (n = 97) ultimately requiring a hospital admission. In 60.6% (n = 66) of the admissions, patients were admitted under the inpatient team initially referred to by the ED, suggesting referrals were generally accurate. The number of in-hospital units involved in the admission process and ED length of stay were positively correlated (0.409, p < 0.001). Patient factors associated with knockbacks include pre-existing chronic medical conditions and presenting acutely unwell. Analysis of clinicians’ perspectives yielded recurring themes of disagreements over admission destination and diagnostic uncertainty.Conclusion: In this patient sample, emergency referrals for admission were mostly warranted and accurate. Knockbacks increase ED length of stay and may adversely affect patient care. Further focused discussion and clearer referral guidelines between ED clinicians and their inpatient colleagues are required.Keywords: patient admission, emergency department, referral and consultation, patient outcomes, length of stay

In the middle of East and West, Saudi Arabia is a society that has been the object of a socioeconomic plan to engineer a sustainable, knowledge-driven, and market-based economy since before the pandemic. The plan, which heavily relies on young college-educated women, requires a traditional collectivistic ethos to adjust to an individualistic one. The pandemic has temporarily interrupted the execution of the plan. The main aim of the present study is two-fold: (a) determine whether female college students’ cultural dispositions and conceptual organization habits (similarity-driven versus function-driven ways of organizing information) have changed after the pandemic and (b) assess whether dispositions and habits contribute to academic attainment (as measured by GPA) differently before and after the pandemic. To this end, through a cross-sectional design, this retrospective study examines the cultural dispositions and conceptual organization habits of a sample of bilingual female college students 3 years apart before and after the pandemic. It finds no differences in conceptual organization habits as a function of time and no relationship between either cultural dispositions or conceptual organization habits and academic attainment. However, horizontal individualism is found to increase after the pandemic as well as to be negatively related to function-driven conceptual organization habits. Although these findings underlie the increasing individualism that accompanies socioeconomic development globally, they question common assumptions of a straightforward link between academic attainment and cultural differences.

Being optimistic or pessimistic is a form of intuitive, premonitory thinking that is conditioned by one’s personal experience. Some authors consider this attitude to be a subjective construction relating to expectations generated, motivation and effort. Others authors consider it to be a personality trait linked to life satisfaction and adaptive response to context. For this study, 561 university students participated, with an average age of 20.31 years (±3.46). The instruments used were the Life Orientation Test (LOT-R) and the Satisfaction with Life Scale (SWLS). The aim of the study was to determine the structure of the LOT-R instrument, since many studies have questioned its unidimensional or twodimensional structure, which compromises the instrument’s validity. Subsequently, it was related to the SWLS through a Structural Equation Model. The results showed that the two-dimensional model (optimism and pessimism) was the most appropriate (χ²/df = 4.36; RMSEA=.072; SRMR=.044; GFI=.960; CFI=.979). Subsequently, the results described above were related to the Life Satisfaction variable, which reinforced the theoretical model proposed. Findings corroborated the double dimensionality of the LOT-R instrument, with a positive relationship between optimism and life satisfaction, and a negative relationship between pessimism and life satisfaction.

Background: Hospital length of stay (LOS) related to craniotomy for tumor resection (CTR) is a marker of neurosurgical quality of care. Limiting LOS benefits both patients and hospitals. This study examined which factors contribute to extended LOS (eLOS) at our academic center. Methods: Retrospective medical record review of 139 consecutive CTRs performed between July 2020 and July 2021. Univariate and multivariable analyses determined which factors were associated with an eLOS (≥8 days). Results: Median LOS was 6 days (IQR 3–9 days). Fifty-one subjects (36.7%) experienced an eLOS. Upon univariate analysis, potentially modifiable factors associated with eLOS included days to occupational therapy (OT), physical therapy (PT), and case management clearance (p

This study aimed to determine whether digital literacy has a direct effect on creative thinking disposition and an indirect effect through lifelong learning disposition. The study was conducted with 327 teachers working in Siirt Province, Turkey in 2021-2022 academic years. “The Marmara Creative Thinking Dispositions Scale”, “Digital Literacy Scale” and “Lifelong Learning Trends Scale” were used in the data collection process. Correlational survey method was employed in this study. The structural equation modeling technique was also used to analyze the relationships of variables. Two models, which explain the direct effect of digital literacy on creative thinking disposition and its indirect effects through lifelong learning disposition, were developed. As a consequence of the analysis, it was determined that structural models were in good agreement with each other. In this study, digital literacy has a statistically significant and positive effect on creative thinking disposition both directly and indirectly through lifelong learning disposition.

Mathematical representation is the ability of students to explore and use mathematical ideas explicitly. This study aimed to learn about the effectiveness of the Mastery Learning Assessment Model (MLAM) in mathematics learning at the Assyfa Learning Center Foundation Pasuruan, which then described students' abilities in solving mathematical representation problems evaluated from mathematical dispositions. MLAM is based on repeating a similar assessment through an overhaul of mastery learning from previous researchers. This study used a descriptive qualitative method. In the study presented here, 20 subjects were pooled and surveyed using a continuous assessment tool based on high, low, and moderate math ability. The results showed that almost all students could use representational images to solve mathematical problems, create mathematical models, and solve problems related to mathematical expressions. On the other hand, most students could not complete the two indicators of mathematical representation, namely making sketches and mathematical models based on the given situation and data. This result is indicated by the 75% of students who completed this lesson. Based on the Teaching Evaluation (TER) results, most students are also satisfied with this approach. It is expected that the MLAM assessment can improve students' mathematical representation skills.

This study aims to describe the effect of students' mathematical disposition on the ability to understand concepts and solve mathematical problems in class IX tube material at MTs NU Miftahul Falah. The type of research used is correlational research with a quantitative approach. The sampling technique used was random sampling. The study population was 267 students with a sample of 35 students in one class. Collecting data using description test instruments and questionnaires. The data that has been obtained is then analyzed using the product moment correlation test, simple linear regression analysis, t-test. The results of data analysis show that: first, the mathematical disposition of students has a positive and significant influence on the ability to understand mathematical concepts by 23.5%. Second, students' mathematical disposition has a significant influence on mathematical problem solving by 63.8%. From these results, it can be concluded that students' mathematical dispositions have a positive and significant effect on the ability to understand concepts and solve mathematical problems in class IX tube material at MTs NU Miftahul Falah Cendono, Dawe, Kudus.

Knowing and analyzing the effect of the successful implementation of forest management policies mediated by community empowerment by moderating a network of actors and stakeholder collaborations. This study uses a quantitative approach to examine specific populations and samples. The research instrument is a questionnaire. The sample in this study were 100 people around the KPHP Model Yogjakarta. The analytical tool used Structural Equation Modeling (SEM) WarpPLS and IPA approaches. Communication, resources, environmental conditions, and relationships between organizations have a direct and significant effect on community empowerment, and the empowerment variable has a direct and significant effect on the successful implementation of forest management policies. The variables that do not directly affect the disposition and organizational structure variables do not significantly influence community empowerment. The influence of actor-networks and stakeholder collaborations as moderation which strengthens implementation of community empowerment and successful implementation is a novelty in research.

BackgroundChimeric antigen receptor T cell infusion (CAR T) therapy has revolutionized the treatment of hematologic malignancies, but treatment-related toxicities are of concern. Understanding the timing and reasons for which patients present to the emergency department (ED) after CAR T therapy can assist with the early recognition and management of toxicities.MethodsA retrospective observational cohort study was conducted for patients who had undergone CAR T therapy in the past 6 months and visited the ED of The University of Texas MD Anderson Cancer Center between 04/01/2018 and 08/01/2022. The timing of presentation after CAR T product infusion, patient characteristics, and outcomes of the ED visit were examined. Survival analyses were conducted using Cox proportional hazards regression and Kaplan-Meier estimates.ResultsDuring the period studied, there were 276 ED visits by 168 unique patients. Most patients had diffuse large B-cell lymphoma (103/168; 61.3%), multiple myeloma (21/168; 12.5%), or mantle cell lymphoma (16/168; 9.5%). Almost all 276 visits required urgent (60.5%) or emergent (37.7%) care, and 73.5% of visits led to admission to the hospital or observation unit. Fever was the most frequent presenting complaint, reported in 19.6% of the visits. The 30-day and 90-day mortality rates after the index ED visits were 17.0% and 32.2%, respectively. Patients who had their first ED visit >14 days after CAR T product infusion had significantly worse overall survival (multivariable hazard ratio 3.27; 95% confidence interval 1.29–8.27; P=0.012) than patients who first visited the ED within 14 days of CAR T product infusion.ConclusionCancer patients who receive CAR T therapy commonly visit the ED, and most are admitted and/or require urgent or emergent care. During early ED visits patients mainly present with constitutional symptoms such as fever and fatigue, and these early visits are associated with better overall survival.

This study developed a scale to assess high school students’ programming disposition. The scale was developed by utilizing a standardized test development process. The three constructs of the scale, namely confidence, persistence and flexible thinking, consisted of 9 items (3 items on each construct). Participants for the formal test of the scale were 1,332 students from 11 high schools. The validity and reliability of the programming disposition scale were validated via internal consistency, test-retest reliability, construct validity, discriminant validity, criterion-related validity, correlation coefficient of each subscale and confirmatory factor analysis. The analysis results showed that this scale is valid and reliable. The scale can serve as an assessment tool to assist teachers to instruct students learning programming, and help students determine whether taking programming courses in high school or pursuing programming-related majors in university. The effects of individual differences on programming disposition were also discussed to provide feasible educational implications.

The investigation of traffic accidents is carried out by the same bodies that have the task of gathering evidence regarding the existence of the crime, identifying the perpetrator and establishing his responsibility, in order to ascertain whether or not it is necessary to order the prosecution. The investigation of traffic accidents involves establishing elements or clarifying aspects than can serve to outline the legal nature of the event, to determine the criminal and civil liability of the person responsible for the accident, preventing future events of the same nature. The criminal investigation activity is carried out under of supervision of the prosecutor, who after completing the investigation, will proceed to verify the criminal investigation works, in order to rule on the legality and validity of obtaining, administering evidence and means of proof.

By the end of the nineteenth century, artists across Europe revived archaic modes of posing the body. This review assesses recent scholarship by Emmelyn Butterfield-Rosen on the subject of posture and its relationship to psychology in European modernism.

This research focuses on one of the three components of the fraud triangle, namely opportunity, and empirically tests the tendency to commit fraud. The perceived opportunity to commit fraud can be considered in terms of temptation and obstacles. This research employs concepts from cognitive psychology, i.e., desire and motivation for action, which affect people’s decision-making processes when presented with an opportunity to commit fraud. Questionnaires were used to analyze the tendency to commit fraud. First, dispositional differences among people differing in self-control were observed, which may influence the likelihood of fraudulent behavior. That is, low self-control mediates the relationship between self-regard and fraud tendency. Second, strong relationships of both personal disposition and self-efficacy with the tendency to commit fraud were revealed; high self-efficacy enhances the tendency to commit fraud. This research offers a new psychological perspective on fraud opportunity, and showing for the first time that fraud can be reduced not only by improved internal control and external supervision, as suggested in previous studies, but also by changing people’s perceptions of fraud opportunity, given the fallibility of both internal control and external supervision.

Computational thinking refers to the cognitive processes underpinning the application of computer science concepts and methodologies to the methodical approach and creation of a solution to a problem. The study aims to determine how students’ cognitive, affective, and conative dispositions in using computational thinking are influenced by a gender. This study used a survey research design with quantitative approach. Five hundred thirty-five secondary school students were sampled using probability sampling with the Computational Thinking Disposition Instrument (CTDI). WINSTEPS version 3.71.0 software was subsequently employed to assess the Gender Differential item functioning (GDIF) including reliability and validity with descriptive statistics were employed to assess students’ disposition toward practicing computational thinking. In addition to providing implications for the theory, the data give verifiable research that the CT disposition profile consists of three constructs. In addition, the demonstrated CTDI has good GDIF features, which may be employed to evaluate the efficacy of the application of CT in the Malaysian curriculum by measuring the level of CT in terms of the disposition profile of students.

The purpose of this article is to review the Fuzzy Conception of Giftedness (FCG) and discuss its implications for the identification and education of gifted students. According to the Fuzzy Conception of Giftedness, the manifestation of giftedness results from the interplay between personal dispositions and stimulus conditions; thus, giftedness exists in the interaction between a person and the environment (e.g., stimulus conditions). While a person is disposed to carry out actions, the environment is potent to allow these actions. In line with this proposition, the identification and education of gifted students should be built on interactions. Interactive models are useful to identify and educate students who have overachievement potential. The FCG proposes three components to define giftedness that could be used in identifying and educating gifted students: intellective and non-intellective dispositions, stimulus conditions, and interaction.

The significance of reading comprehension can hardly be overestimated. Nevertheless, teachers vary in their disposition or willingness to teach reading comprehension. A wealth of field experimental studies have confirmed the importance of text talk, in class or in teacher-guided small groups, for students´ reading comprehension. However, researchers have not yet fully explored what makes teachers practise text talk in the classroom. This study aimed to describe and predict teachers´ disposition to practise text talk. The study posited two hypotheses based on professional development theory and social capital theory. The data came from a survey study of 320 Swedish teachers (of grades 1 to 12). The study used (a) item response estimation for measurement and (b) linear regression for analysis. It was found that attitudes towards professional development varied with disposition for text talk, on average, after adjusting for other predictors. It was furthermore found that social capital varied with disposition for text talk, on average, after adjusting for other predictors. The conclusion is that the data offer support for both teacher development theory and social capital theory.

The educational implications of COVID-19 have shaken both practitioners and researchers alike. Practitioners were expected to use technologies instantaneously, and this set up trauma in individuals. The ramification of understanding people’s response to why technologies are accepted/not accepted and used/not used has significant implications for education. This conceptual paper sets out the process used to develop a theoretical framework based on the technology acceptance model (TAM). The constructs within the original TAM and extended TAM, were explored to understand “why” practicing teachers would choose to use technologies for educational purposes at primary and secondary school levels during the COVID-19 pandemic period. The TAM has been criticized for being simplistic and narrowly focused. Many researchers criticize TAM because their finding cannot be confirmed or that the constructs don’t fit their needs. This paper challenges these critiques. The theoretical framework suggested in this paper represents a view of reality of the relational and influencing effects of variables that potentially moderate or control affective and cognitive responses. It contributes to the existing literature through a comprehensive reviewing of concepts, constructs and COVID-19 “event” contextual realities. The findings offered are that: contextual realities and application often require a grounded theoretical framework to unravel complex questions and answers; the suggested unidirectional influence of perceived ease of use (PEOU) on perceived usefulness (PU) can be challenged through a dispositional rationale; neglecting non-use as a reality severely hampers TAMs applicability in studies focused on theory testing, and TAM provides sufficient flexibility by leaving the doors open for adaptation, and this flexibility is an asset in social science research.

While a growing body of literature has examined internet addiction in the context of psychological factors, most of this work has focused on younger populations outside of the United States. A sample of 898 US adults ranging from 18 to 76 years of age were recruited through Amazon's Mechanical Turk platform to complete the Internet Addiction Test and key measures of affect, disposition, and cognitive function. A series of multiple regressions were conducted to examine Internet Addiction level as a predictor of outcome variables. ANCOVAs with Fisher's LSD post-hoc analyses were conducted using level of internet addiction as the grouping variable to examine differences between groups. Results found that Internet Addiction was a significant predictor of depression, impulsiveness, self-control, need for cognition, theories of cognitive abilities, creativity achievement, cognitive failures, smartphone use behaviors, mental rotation test, and cognitive reflection test. Further, even mild levels of internet addiction were associated with less optimal outcomes. Additionally, a significant relation between age and internet addiction also emerged such that older adults were less likely to have higher levels of internet addiction than younger adults.However, age did not appear to modulate the association between internet addiction status and key psychological variables. To further elucidate the mechanisms and impact of internet addiction throughout the life course, future studies should collect online and in-person data, from individuals across a variety of backgrounds, throughout the lifespan.

Abstract It may need to pay attention to the sustention of moderate cardiotoxicity and delayed elevation of plasma 10‐hydroxynortriptyline level in severe amitriptyline overdose case.

The article discusses Bourdieu’s conceptualisation of habitus–field relations. While describing their approaches, Bourdieu focuses on the relation between habitus and an individual field, chiefly stressing their harmonious character. By mainly concentrating on habitus with respect to an individual field, he neglects the social differentiation and autonomisation of fields that create and multiply the possibilities of habitus and fields being in a relationship of a conflict. Relying on Lenski’s concept of status decrystallisation and Leder’s concept of body dys-appearance, we argue that a habitus–fields mismatch may provide opportunities for a temporary suspension of a taken-for-granted attitude to the world and, by extension, for questioning the social objectified, i.e. fields, and their rules of the game.

Yan Li,1 Maria Palmisano,1 Duxin Sun,2 Simon Zhou1 1Translational Development and Clinical Pharmacology, Celgene Corporation, Summit, NJ 07920, USA; 2Department of Pharmaceutical Sciences, College of Pharmacy, University of Michigan, Ann Arbor, MI 48109, USACorrespondence: Simon ZhouTranslational Development and Clinical Pharmacology, Celgene Corporation, 556 Morris Avenue, Summit, NJ 07920, USATel +1 908-673-9284Fax +1 908-673-2842Email szhou@celgene.comBackground: Voclosporin, a more potent derivative of cyclosporine, has been studied extensively in patients with immunologic disorders such as psoriasis, organ transplantation, uvetitis and lupus nephritis. Although better tolerated and safer than cyclosporine, voclosporin is inferior to cyclosporine in treating psoriasis, non-inferior to tacrolimus in organ transplantation and efficacious in treating lupus nephritis.Methods: The pharmacokinetic dispositions of voclosporin and cyclosporine in central and peripheral compartments were analyzed and correlated with their distinct clinical efficacy and safety profiles.Results: Both drugs demonstrated non-linear pharmacokinetics with increasing doses, more prominently at lower doses of voclosporin than at 10-fold higher doses of cyclosporine. Repeated lower dosing of voclosporin produced preferential calcineurin inhibition in and near blood circulation, leading to relatively lower cardiovascular and renal adverse effects but inferior efficacy for psoriasis compared to cyclosporine. With 10-fold higher plasma levels and deeper tissue penetration, cyclosporine has more prevalent renal and cardiac toxicities but superior efficacy to treat psoriasis.Conclusion: Although the two drugs are similar in structure and mechanism of action, the high potency and low dose compounded by the non-linear disposition of voclosporin resulted in more systemic versus local calcineurin inhibition than with cyclosporine. The dispositional difference between voclosporin and cyclosporine accounted for the puzzling efficacy and safety observations in different patients and was the basis for their optimal and differential use in treating diverse immunologic disorders.Keywords: pharmacokinetic, disposition, cyclosporine and voclosporin

2′,2′′′-Dithiobisbenzanilide (DTBBA) is a high-production-volume chemical used as a peptizing agent for rubber. The disposition and metabolism of [14C]DTBBA were determined in male and female rats and mice following oral (4, 40, or 400 mg/kg) and intravenous (IV) (4 mg/kg) administration and dermal application (0.4 or 4 mg/kg). [14C]DTBBA was well absorbed following oral administration (> 60%) and dermal application (∼40–50%) in rats and mice. Following oral administration, the majority of radioactivity was excreted in urine (29 − 70%) and feces (16 − 45%). Unlike rats, mice excreted ∼1-5% of the dose as exhaled CO2. The residual radioactivity in tissues was

I show that Kant’s depiction of the christic figure in Religion within the Boundaries of Mere Reason is not contingent but explains how this figure functions in two essential ways: as a representation of a maximum of morality that can ground our moral disposition and in so doing acts as a standard for morality. More precisely, the following argument is made: 1) the sublime nature of the image of Christ — as an image of universal respect for the law — awakens the moral feeling of subjects in the sense of the possibility of overcoming one’s perverted nature; 2) as moral perfection it provides immediate transparency to the end goal of morality; 3) just as in the case of associative construction of empirical concepts, the sublime provides the prototype for association through which empirical acts are determined as moral ones; 4) the image of Christ also acts as motivator by encompassing said transparency and standard in the idea of moral perfection. These four points show that the image of Christ functions in a dual manner. Points 1) to 3) address Christ as a prototype/archetype (Urbild) — awakening and making possible a moral redefinition of the subject — while point 4) addresses Christ as an example (Vorbild) — sustaining and entertaining the moral redefinition as a motivating model.

This study proposes and tests a theoretical model of how perceptions of disposition, engagement, and efficacy of teachers for science, technology, engineering, and mathematics (STEM) e-learning can predict their sense of vitality when they designed STEM education. Upon the proposition, we developed and validated an instrument for examining the relationships between these variables. The participants were 122 secondary teachers of STEM education from Hong Kong. The instrument included four design aspects as follows: (i) disposition, (ii) lesson design engagement, (iii) efficacy for designing STEM e-learning, and (iv) vitality of teachers after attending a series of STEM professional development activities. To analyze the relationships among the variables, partial least squares structural equation modeling was employed. The disposition of teachers predicted lesson design engagement and both of these factors, in turn, predicted efficacy for designing STEM e-learning. In other words, if teachers have a high proposition toward designing learning activities, their engagement in the lesson design process may enhance their capacities in designing and implementing such activities. Also, the disposition of teachers and lesson design engagement predicted their vitality, revealing that well-suited STEM teachers should not only be able to design a STEM curriculum but also have a positive perception of STEM education.

Abstract The $1 trillion industry of acute hospital care in the United States is shifting from inside the walls of the hospital to patient homes. To tackle the limitations of current hospital care in the United States, on November 25, 2020, the Center for Medicare & Medicaid Services announced that the acute hospital care at home waiver would reimburse for “home hospital” services. A “home hospital” is the home‐based provision of acute services usually associated with the traditional inpatient hospital setting. Prior work suggests that home hospital care can reduce costs, maintain quality and safety, and improve patient experiences for select acutely ill adults who require hospital‐level care. However, most emergency physicians are unfamiliar with the evidence of benefits demonstrated by home hospital services, especially for older adults. Therefore, the lead author solicited narrative inputs on this topic from selected experts in emergency medicine and home hospital services with clinical experience, publications, and funding on home hospital care. Then we sought to identify information most relevant to the practice of emergency medicine. We outline the proven and potential benefits of home hospital services specific to older adults compared to traditional acute care hospitalization with a focus on the emergency department.

In face of contemporary difficulties in the foundation of ethical thought, mostly due to necessary but extrapolated fractures between nature and subjectivity, knowledge and action, many thinkers are now revisiting the great thomasian synthesis of western thought. Under many reinterpretations in the fields of ethics, law, epistemology and metaphysics, it is not improper to say that thomasian thought lives a small renaissance, particularly in the English-speaking world, resulting in numerous revisionistic and historical approaches, as much as adaptations in the research fields of analytic philosophy and theology. Avoiding the systematical analysis in favor of a simpler and more informative presentation we expose central tenets of thomasian ethics in close consideration to their metaphysical groundings, according to contemporary authors who struggle in this thomasian revival, making explicit the relevance of the moral disposition of human beings in this thought.

Li-Qun Jiang,1 Ting-Yu Wang,1 Yun Wang,1 Zi-Yao Wang,1 Yu-Ting Bai1,21Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, School of Pharmacy, Xuzhou Medical University, Xuzhou, China; 2School of Stomatology, Xuzhou Medical University, Xuzhou, ChinaBackground: The clearance of nanomaterials (NMs) from the liver is essential for clinical safety, and their hepatic clearance is primarily determined by the co-disposition process of various types of hepatic cells. Studies of this process and the subsequent clearance routes are urgently needed for organic NMs, which are used as drug carriers more commonly than the inorganic ones.Materials and methods: In this study, the co-disposition of chitosan-based nanoparticles (CsNps) by macrophages and hepatocytes at both the cellular and animal levels as well as their subsequent biological elimination were investigated. RAW264.7 and Hepa1-6 cells were used as models of Kupffer cells and hepatocytes, respectively.Results: The cellular studies showed that CsNps released from RAW264.7 cells could enter Hepa1-6 cells through both clathrin- and caveolin-mediated endocytosis. The transport from Kupffer cells to hepatocytes was also studied in mice, and it was observed that most CsNps localized to the hepatocytes after intravenous injection. Following the distribution in hepatocytes, the hepatobiliary–fecal excretion route was shown to be the primary elimination route for CsNps, besides the kidney–urinary excretion route. The elimination of CsNps in mice was a lengthy process, with a half time of about 2 months.Conclusion: The demonstration in this study of the transport of CsNps from macrophages to hepatocytes and the subsequent hepatobiliary–fecal excretion provides basic information for the future development and clinical application of NMs.Keywords: chitosan nanoparticles, hepatocytes, macrophages, disposition, hepatobiliary–fecal elimination

Excitable temperament disrupts physiological events required for reproductive development in cattle, but no research has investigated the impacts of temperament on growth and puberty attainment in Bos indicus females. Hence, this experiment evaluated the effects of temperament on growth, plasma cortisol concentrations and puberty attainment in B. indicus heifers. A total of 170 Nelore heifers, weaned 4 months before the beginning of this experiment (days 0 to 91), were managed in two groups of 82 and 88 heifers each (mean ± SE; initial BW=238±2 kg, initial age=369±1 days across groups). Heifer temperament was evaluated via exit velocity on day 0. Individual exit score was calculated within each group by dividing exit velocity into quintiles and assigning heifers with a score from 1 to 5 (1=slowest; 5=fastest heifer). Heifers were classified according to exit score as adequate (ADQ, n=96; exit score⩽3) or excitable temperament (EXC, n=74; exit score>3). Heifer BW, body condition score (BCS) and blood samples were obtained on days 0, 31, 60 and 91. Heifer exit velocity and score were recorded again on days 31, 60 and 91. Ovarian transrectal ultrasonography was performed on days 0 and 10, 31 and 41, 60 and 70, 81 and 91 for puberty evaluation. Heifer was declared pubertal at the first 10-day interval in which a corpus luteum was detected. Exit velocity and exit score obtained on day 0 were correlated (r⩾0.64, P

Mineral medicines have a long history in the treatment of diseases. Among these, cinnabar and realgar are the most commonly used. This review discusses the differences between cinnabar and realgar and other mercurials and arsenicals. In addition, it explores the toxicity studies carried out on cinnabar and realgar, which include acute and chronic toxicity, neurotoxicological effects, special toxicity, disposition and accumulation, and the relative mechanism of toxicity. Cinnabar and realgar are seldom used alone but rather in combination with herbs or animal medicines. Thus, in this article, we have also included a study of the effect of toxicity reduction and efficacy enhancement after cinnabar and realgar were combined with other Chinese medicinal materials. This review provides the theoretical evidence for their clinical application, suggesting that the dosage and treatment period using cinnabar and realgar should be rigidly controlled and emphasis should be placed on the drug safety of special populations.

Kur’an tasavvuru belli kavramlardan meydana gelmektedir. İnsanın fiziki ve manevî yönünü ifade eden fıtrat kavramı, Kur’an tasavvurunu ifade eden önemli kavramlarından biridir. Fıtrat kavramının ilk günden itibaren tefsircilerin ilgi odağı olması da bundandır. Genellikle fıtrat, İslam dini, ilk yaratılış ve insanın dini kabul etme potansiyeli olarak yorumlanmış ve bunların değişip değişmeyeceği üzerinde durulmuştur. Rum sûresinde geçen “khalqullah” ile Nisâ sûresinde geçen “khalqullah” terkiplerinin bulunduğu âyetler arasında bu çerçevede bağlantı kurulmuştur. Bu çalışmamızda fıtratın mahiyeti ile fıtratla ilgili âyetlerin birbiriyle ilişkilendirilmesi irdelenecek ve fıtratın temel unsurları üzerinde durulacaktır. Akıl, sevgi, aşk, güzel şeylere ilgi duyma ve çirkinliklerden kaçınmanın, insan fıtratının temel bileşenleri arasında yer alıp almadığı tartışılacaktır. Ayrıca fıtrat âyetinde geçen tebdîl kavramı ile Nisâ sûresinde geçen tağyir kavramının, aynı manayı ifade edip etmediği üzerinde durulacaktır.

Abstract Background Malignant bowel obstruction (MBO) is often a terminal event in end-stage cancer patients. The decision to intervene surgically is complex, given the risk of harm in patients with a limited lifespan. Therefore, we sought to compare clinically meaningful outcomes in MBO patients treated with surgical versus medical management using population-based data. Methods We performed a retrospective analysis of hospitalized patients with MBO from 2006 to 2010 using the California Office of Statewide Health Planning and Development dataset. Hospital-free days (HFDs) at 30-, 90-, and 180-days were calculated accounting for all hospitalization, emergency department visit, and skilled nursing facility lengths of stay. Adjusted regression models were used to compare HFDs, disposition, complications, in-hospital death, and survival for surgical versus medical MBO cohorts, using inverse probability of treatment weighting with propensity scores. Results Of 4576 MBO patients, 3421 (74.8%) were treated medically and 1155 (25.2%) were treated surgically. Surgical patients had higher rates of complications (44.0% vs. 21.3%, p

Candidate programs are a publication of political parties during the agitation campaign, which presents the political attitudes of a political actor and influence voters’ motivation to vote in elections. The electoral candidate program illustrates a politician’s relationship with voters. It is an element of political communication, part of the image of a political figure. The article deals with the rhetoric of electoral candidate programs announced before the elections to the Seimas, the European Parliament, and Municipal Councils (2014–2019). The aim is to identify and expand the characteristic rhetorical elements that allow qualifying political electoral programs as a specific genre of political rhetoric: at the inventive level, the study of rhetorical strategies includes the analysis of rhetorical reasoning, the relationship between a political actor and a voter; at the dispositional level, the composition of programs is analyzed; and finally, at the elocutionary level, the specifics of the linguistic expression of discourse are investigated. A rhetorical study of discourse revealed that, in many cases, the electoral candidate program functions as a tool for building the image of a political actor, a tool for discrediting opponents and spreading populist promises.