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This article introduces Experimental Life Writing, a special issue dedicated to exploring narratives that push the boundaries of the form. It provides an overview of the field of experimental life writing, as it is viewed in the contemporary, and homes in on the relationship between creative practice and critical interpretation of the genre. It goes on to discuss the conference from which the special issue was born, with its particular focus on placing creative and critical practitioners in conversation. The article concludes with a précis of the resulting papers, which range from coining new hybrid genres, to analysing spontaneous writing practices, and identity creation in writing, taking in themes as broad as gender, death, childhood, technology and international politics. [ABSTRACT FROM AUTHOR]

This article offers an update on key developments in research related visual literacy, children's reading and children's literature. Beginning with an overview of the field, we chart several distinctive 'turns' or research trajectories: the aesthetic, the intercultural or empathic, and the ethical. We then consider how questions of power, authenticity and representation are visible in three important areas of the field: research with marginalised groups; research that focuses on mediation within the visual reading process; advances in the types of visual texts being used in research. Key emergent ideas include the challenges of adult mediators' expectations on children's visual reading, the potential of texts' material affordances, and new directions in open, more inclusive opportunities to respond to, and with, visual texts. We conclude with a hopeful look forward at emerging directions in policy and research. [ABSTRACT FROM AUTHOR]

The objective of this study is to investigate the proficiency of Filipino language listening skills among Bachelor of Secondary Education students specializing in Filipino. Employing a descriptive research methodology and employing purposive sampling, the study utilizes an adaptive survey questionnaire that has undergone validation and reliability testing. The analysis of data involves the application of statistical tools, including calculations of frequency and percentage, with a 5-point Likert scale serving as the scoring instrument. The results reveal that students exhibit a consistent mean of 3.83 in both critical and appreciative listening, while their inner listening level registers a mean of 4.12, indicating an "often" frequency. Overall, the study depicts that students' listening proficiency in critical, appreciation, and inner aspects is characterized as "often." These findings serve as valuable insights for educational practitioners, highlighting both strengths and areas for improvement in students' listening skills. Based on the findings, the study suggests that Tagoloan Community College and the Commission on Higher Education (CHED) emphasize the importance of reminding teachers to encourage students to actively engage in discussions. Furthermore, educators should assign tasks that prompt students to enhance their understanding, fostering the development of focused listening skills. This proactive approach is crucial for encouraging students to train themselves in concentrating on discussions, ultimately enhancing their ability to comprehend and engage with the content being presented. [ABSTRACT FROM AUTHOR]

In this paper, a critical Kirchhoff type elliptic equation involving a logarithmic type perturbation is considered in a bounded domain in ℝ4$$ {\mathrm{\mathbb{R}}}^4 $$. Three main features of the problem bring essential difficulties when proving the existence of weak solutions. The first one is the nonlocal term which makes the structure of the corresponding energy functional more complicated, the second one is that the problem is critical in the sense that the energy functional lacks compactness, and the third one is the appearance of the logarithmic term which satisfies neither the standard monotonicity condition nor the Ambrosetti–Rabinowitz condition. Moreover, the boundedness of the (PS)$$ (PS) $$ sequence is hard to obtain for Kirchhoff problems in dimension 4. By combining a result by Jeanjean (Proc. Roy. Soc. Edinburgh Sect. A, 1999, 129: 787–809) and a recent estimate by Deng et al. (Adv. Nonlinear Stud., 2023, 23: No. 20220049) with the mountain pass lemma and Brézis‐Lieb's lemma, it is proved that either the norm of the sequence of approximation solution goes to infinity or the problem admits a nontrivial weak solution, under appropriate assumptions on the parameters. [ABSTRACT FROM AUTHOR]

In this paper, a critical fourth-order Kirchhoff type elliptic equation with a subcritical perturbation is studied. The main feature of this problem is that it involves both a nonlocal coefficient and a critical term, which bring essential difficulty for the proof of the existence of weak solutions. When the dimension of the space is smaller than or equals to 7, the existence of weak solution is obtained by combining the Mountain Pass Lemma with some delicate estimate on the Talenti's functions. When the dimension of the space is larger than or equals to 8, the above argument no longer works. By introducing an appropriate truncation on the nonlocal coefficient, it is shown that the problem admits a nontrivial solution under appropriate conditions on the parameter. [ABSTRACT FROM AUTHOR]

Within this special issue, we turn our attention to critical perspectives within the communication discipline and seek to illuminate the implementation of critical methods across its broader contexts. While the communication discipline has historically been grounded in the normativity and centering of whiteness, critical perspectives, which are characterized by attention to communicative practices that attend to systems of power and hierarchy across social spheres, have been broadly integrated into and meaningfully shaped the study of communication contexts such as rhetoric, intercultural communication, and performance studies. We argue, however, that the incorporation of critical perspectives within the larger discipline remains underdeveloped. Therefore, in this special issue, we present articles that employ critical methodological approaches to offer important new ways of studying and centering marginalized identities, positionalities, and epistemologies across a range of contexts. Ultimately, we argue for a more expansive approach to thinking and teaching about methodology in general, and critical methods specifically, that inspires further "play" among communication scholars who value the need for social justice imperatives and epistemic delinking across all facets of communication studies. [ABSTRACT FROM AUTHOR]

A comprehensive analysis of long-term water level trends is essential for freshwater sustainability. Given that Odisha heavily relies on agriculture, the monitoring and management of groundwater and its fluctuations are imperative for ensuring future sustainability in the state. Here, we analyzed the trend in Groundwater using water level data for a 30-year period (1990–2020) for the entire Odisha region. Moreover, to determine the long term variability, critical zones of future groundwater variability and controlling parameters of the water level change, we used spatio-temporal water level data of 746 locations. Water level rise of coastal districts during post-monsoon (POM), corresponds to the intensity of rainfall received, thus rising, however other districts of Odisha, showing decline in water level during the same season is due to shortage of rainfall, increase in population at a sudden, and over pumping due to industrial activities. Similarly, during pre-monsoon (PRM), water level shows an increasing trend in hard rock terrain of Odisha implying rabi crop irrigation, high density drainage network and lesser population density. Feature selection techniques were used in this study to know the parameters controlling most to this water level fluctuation in the entire Odisha state. Precipitation followed by landuse & landcover, lithology and population density are controlling the most for the long term water level change. Drainage, elevation, lithology and slope are positively related to the water level change while others are negatively related. It is also inferred that the districts like Mayurbhanj, Sundargarh, Keonjhar, Kandhamal, Boudh, Dhenkanal, Gajapati, Koraput and Kalahandi contain most of the high critical zone concerning future availability of groundwater while most of the coastal regions are safe.Article Highlights: Water level trend analysis was performed taking 30 years of historical data. Hardrock regions are prominent zones of declining in water level than the alluvium parts. Precipitation followed by landuse & land cover, lithology and population density are controlling the most for the long-term water level change. Hardrock regions contain most of the high critical zone concerning future availability of groundwater. Most of the coastal regions are safe pertaining to future availability of groundwater. [ABSTRACT FROM AUTHOR]

This paper explores the potential of Slam poetry to serve as a transformative and emancipatory pedagogic tool for marketing education. An under-researched style of poetry within the field of marketing pedagogy, Slam's ability to foster compassionate criticality through the creative presentation of subjective voices feeds into the broader business school agendas of responsible management education and decolonisation. Through situating the audience, Slam poetry offers a resonant method to harness critical reflexivity away from the traditional conventions of academic expression. Extending extant research on the role of poetry, the paper argues that the efficacy of Slam poetry through meaningful, accessible dialogue rooted in the vernacular becomes an important dialogical encounter for individuals to understand other subject positions. Through the application of Slam as an emancipatory tool, individuals are afforded intellectual freedoms as critically reflexive citizens engaged in the serious business of emotion. [ABSTRACT FROM AUTHOR]

Abstract Background There is an urgent need for therapeutic strategies for inpatients with severe or critical COVID-19. The evaluation of the clinical benefits of nirmatrelvir and ritonavir (Nmr/r) for these patients beyond five days of symptom onset is insufficient. Methods A new propensity score-matched cohort was constructed by using multicenter data from 6695 adult inpatients with COVID-19 from December 2022 to February 2023 in China after the epidemic control measures were lifted across the country. The severity of disease of the inpatients was based on the tenth trial edition of the Guidelines on the Diagnosis and Treatment of COVID-19 in China. The symptom onset of 1870 enrolled severe or critical inpatients was beyond five days, and they received either Nmr/r plus standard treatment or only standard care. The ratio of patients whose SOFA score improved more than 2 points, crucial respiratory endpoints, changes in inflammatory markers, safety on the seventh day following the initiation of Nmr/r treatment, and length of hospital stay were evaluated. Results In the Nmr/r group, on Day 7, the number of patients with an improvement in SOFA score ≥ 2 was much greater than that in the standard treatment group (P = 0.024) without a significant decrease in glomerular filtration rate (P = 0.815). Additionally, the rate of new intubation was lower (P = 0.004) and the no intubation days were higher (P = 0.003) in the first 7 days in the Nmr/r group. Other clinical benefits were limited. Conclusions Our study may provide new insight that inpatients with severe or critical COVID-19 beyond five days of symptom onset benefit from Nmr/r. Future studies, particularly randomized controlled trials, are necessary to verify the above findings.

Background: Invasive fungal infections (IFIs) are important infectious complications amongst critically ill children. The most common fungal infections are due to Candida species. Aspergillus, Zygomycetes and Fusarium are also emerging because of the empirical use of antifungal drugs. This updated review discusses the epidemiology of IFIs as well as antifungal drugs, dosing and potential adverse effects in critically ill children. Methods: A PubMed search was conducted with Clinical Queries using the key terms “antifungal”, “children”, “critical care” AND “paediatric intensive care unit” OR “PICU”. The search strategy included clinical trials, randomized controlled trials, meta-analyses, observational studies and reviews and was limited to the English literature in paediatrics. Results: Candida and Aspergillus spp. are the most prevalent fungi in paediatric IFIs, causing invasive candidiasis infections (ICIs) and invasive aspergillosis infections (IAIs), respectively. These IFIs are associated with high morbidity, mortality and healthcare costs. Candida albicans is the principal Candida spp. associated with paediatric ICIs. The risks and epidemiology for IFIs vary if considering previously healthy children treated in the paediatric intensive care unit or children with leukaemia, malignancy or a severe haematological disease. The mortality rate for IAIs in children is 2.5–3.5-fold higher than for ICIs. Four major classes of antifungals for critically ill children are azoles, polyenes, antifungal antimetabolites and echinocandins. Conclusions: Antifungal agents are highly efficacious. For successful treatment outcomes, it is crucial to determine the optimal dosage, monitor pharmacokinetics parameters and adverse effects, and individualized therapeutic monitoring. Despite potent antifungal medications, ICIs and IAIs continue to be serious infections with high mortality rates. Pre-emptive therapy has been used for IAIs. Most guidelines recommend voriconazole as initial therapy of invasive aspergillosis in most patients, with consideration of combination therapy with voriconazole plus an echinocandin in selected patients with severe disease. The challenge is to identify critically ill patients at high risks of ICIs for targeted prophylaxis. Intravenous/per os fluconazole is first-line pre-emptive treatment for Candida spp. whereas intravenous micafungin or intravenous liposomal amphotericin B is alternative pre-emptive treatment. This article is part of the Challenges and strategies in the management of invasive fungal infections Special Issue: https://www.drugsincontext.com/special_issues/challenges-and-strategies-in-the-management-of-invasive-fungal-infections

Abstract The alarming state of global insulin access in low‐resource settings presents a major barrier to diabetes care. A comprehensive review of these challenges is lacking at the global level. To address this weakness, enhance affordability and build capacity for a more sustainable approach to scaling up access. This review analyzes the specific issue of inconsistent access to insulin in low‐ and middle‐income countries. Using this analysis, we mapped the scope and intensity of issues such as the unaffordability and unavailability of insulin. We also identified six innovative and integrative strategies for increasing and securing accessibility in the areas of policy making, marketing, clinical practice, health education, domestication, and multisectoral approaches.

Background: There is an urgent need for therapeutic strategies for inpatients with severe or critical COVID-19. The evaluation of the clinical benefits of nirmatrelvir and ritonavir (Nmr/r) for these patients beyond five days of symptom onset is insufficient. Methods: A new propensity score-matched cohort was constructed by using multicenter data from 6695 adult inpatients with COVID-19 from December 2022 to February 2023 in China after the epidemic control measures were lifted across the country. The severity of disease of the inpatients was based on the tenth trial edition of the Guidelines on the Diagnosis and Treatment of COVID-19 in China. The symptom onset of 1870 enrolled severe or critical inpatients was beyond five days, and they received either Nmr/r plus standard treatment or only standard care. The ratio of patients whose SOFA score improved more than 2 points, crucial respiratory endpoints, changes in inflammatory markers, safety on the seventh day following the initiation of Nmr/r treatment, and length of hospital stay were evaluated. Results: In the Nmr/r group, on Day 7, the number of patients with an improvement in SOFA score ≥ 2 was much greater than that in the standard treatment group (P = 0.024) without a significant decrease in glomerular filtration rate (P = 0.815). Additionally, the rate of new intubation was lower (P = 0.004) and the no intubation days were higher (P = 0.003) in the first 7 days in the Nmr/r group. Other clinical benefits were limited. Conclusions: Our study may provide new insight that inpatients with severe or critical COVID-19 beyond five days of symptom onset benefit from Nmr/r. Future studies, particularly randomized controlled trials, are necessary to verify the above findings. [ABSTRACT FROM AUTHOR]

This review engages with the powerful critical and evocative autoethnography, Unraveling: An Autoethnography of Suicide and Renewal (2024). Written by M. F. Alvarez, Assistant Professor of Communication Studies at the University of New Hampshire, this book narrates the embodied experiences of a young Filipino gay man named Mike whose suffering from childhood trauma slowly escalates into relentless delusions and self-harm that eventually propel him to seek professional help. Alvarez's beautifully sculpted book captures Mike's multidimensional psychological life as he lives, observes, and narrates it within structures that medicalize people's mental health experiences. Dividing his text into story and analysis, Alvarez brings a critical gaze to normative medical and psychiatric accounts of mental health and highlights the agency of people navigating their embodied landscapes, trauma, suicidality, and recovery. [ABSTRACT FROM AUTHOR]

Background: Since the emergence of the first health library standards, a large body of literature has been published in this field, most often focusing on a particular standard, or set of standards. In the case of literature reviews, they have been usually partial and integrated into a broader study. Objective: Identify and analyse national health library standards developed in different countries worldwide over the past 70 years, tracing their historical development and current status. Method: A comprehensive search of published literature was conducted in Scopus, Web of Science, Medline, LISA, and Google Scholar up to May 2023. The reference lists and citations of retrieved papers were reviewed. After screening and eligibility, a total of 112 papers were included in the final selection. Results: More than 40 national hospital library standards published by a group of Anglo‐Saxon and European countries were identified. In a chronological approach, the standards have been arranged by decades, from the 1950s to the present day, and the context of their appearance, their main contributions, and the relationships between them have been analysed. The major trends that have marked their evolution and development over time have also been established. Conclusion: Standards have a key role to play in the important challenge facing health libraries today to demonstrate the high impact and value of their services in the functioning of their organisations and in improving patient care. [ABSTRACT FROM AUTHOR]

Conflict is inevitable in construction projects, and satisfactory conflict resolution is vital for maintaining amicable relationships and accomplishing project goals. This study aims to explain satisfaction with conflict resolution outcomes by referring to cooperative and competitive conflict management approaches and exploring how these relationships change in light of different degrees of conflict strength in terms of novelty, criticality, and disruption. We conducted a survey using convenience sampling and collected 212 valid questionnaires from Chinese practitioners in the construction industry. After checking reliability and validity, we conducted statistical analyses, including hierarchical multiple regression, moderated regression, and subgroup analysis using Stata software to test the hypotheses. The results show that the cooperative approach is relatively robust and contributes to satisfaction enhancement, regardless of conflict strength. By contrast, a competitive approach is beneficial for satisfaction only when conflict strength is low (i.e., low novelty, low criticality, or low disruption). Theoretically, this study provides a new perspective on conflict strength (rather than a commonly used indicator of the degree of conflict) and contributes to the construction conflict management research by revealing the boundary conditions of conflict management approaches. Practically, the findings provide practitioners with guidance regarding the selection of an appropriate conflict management approach with the aim of improving parties' satisfaction with conflict resolution outcomes. [ABSTRACT FROM AUTHOR]

Introduction: The global healthcare burden of COVID-19 pandemic has been unprecedented with a high mortality. Metabolomics, a powerful technique, has been increasingly utilized to study the host response to infections and to understand the progression of multi-system disorders such as COVID-19. Analysis of the host metabolites in response to SARS-CoV-2 infection can provide a snapshot of the endogenous metabolic landscape of the host and its role in shaping the interaction with SARS-CoV-2. Disease severity and consequently the clinical outcomes may be associated with a metabolic imbalance related to amino acids, lipids, and energy-generating pathways. Hence, the host metabolome can help predict potential clinical risks and outcomes. Methods: In this prospective study, using a targeted metabolomics approach, we studied the metabolic signature in 154 COVID-19 patients (males=138, age range 48-69 yrs) and related it to disease severity and mortality. Blood plasma concentrations of metabolites were quantified through LC-MS using MxP Quant 500 kit, which has a coverage of 630 metabolites from 26 biochemical classes including distinct classes of lipids and small organic molecules. We then employed Kaplan-Meier survival analysis to investigate the correlation between various metabolic markers, disease severity and patient outcomes. Results: A comparison of survival outcomes between individuals with high levels of various metabolites (amino acids, tryptophan, kynurenine, serotonin, creatine, SDMA, ADMA, 1-MH and carnitine palmitoyltransferase 1 and 2 enzymes) and those with low levels revealed statistically significant differences in survival outcomes. We further used four key metabolic markers (tryptophan, kynurenine, asymmetric dimethylarginine, and 1-Methylhistidine) to develop a COVID-19 mortality risk model through the application of multiple machinelearning methods. Conclusions: Metabolomics analysis revealed distinct metabolic signatures among different severity groups, reflecting discernible alterations in amino acid levels and perturbations in tryptophan metabolism. Notably, critical patients exhibited higher levels of short chain acylcarnitines, concomitant with higher concentrations of SDMA, ADMA, and 1-MH in severe cases and non-survivors. Conversely, levels of 3-methylhistidine were lower in this context. [ABSTRACT FROM AUTHOR]

Given a 3-hypergraph H, a subset M of V(H) is a module of H if for each e ∈ E (H) such that e ∩ M ≠ ∅ and e \ M ≠ ∅ , there exists m ∈ M such that e ∩ M = { m } and for every n ∈ M , we have (e \ { m }) ∪ { n } ∈ E (H) . For example, ∅ , V(H) and { v } , where v ∈ V (H) , are modules of H, called trivial. A 3-hypergraph is prime if all its modules are trivial. Furthermore, a prime 3-hypergraph is critical if all its induced subhypergraphs, obtained by removing one vertex, are not prime. Lastly, we associate with a prime 3-hypergraph its primality graph the edges of which are the unordered pairs of vertices whose removal provides a prime induced subhypergraph. We characterize the critical 3-hypergraphs together with their primality graph. [ABSTRACT FROM AUTHOR]

Introduction: Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which appeared in 2019, has been classified as critical and non-critical according to clinical signs and symptoms. Critical patients require mechanical ventilation and intensive care unit (ICU) admission, whereas non-critical patients require neither mechanical ventilation nor ICU admission. Several factors have been recently identified as effective factors, including blood cell count, enzymes, blood markers, and underlying diseases. By comparing blood markers, comorbidities, co-infections, and their relationship with mortality, we sought to determine differences between critical and non-critical groups. Method: We used Scopus, PubMed, and Web of Science databases for our systematic search. Inclusion criteria include any report describing the clinical course of COVID-19 patients and showing the association of the COVID-19 clinical courses with blood cells, blood markers, and bacterial co-infection changes. Twenty-one publications were eligible for full-text examination between 2019 to 2021. Result: The standard difference in WBC, lymphocyte, and platelet between the two clinical groups was 0.538, -0.670, and -0.421, respectively. Also, the standard difference between the two clinical groups of CRP, ALT, and AST was 0.482, 0.402, and 0.463, respectively. The odds ratios for hypertension and diabetes were significantly different between the two groups. The prevalence of co-infection also in the critical group is higher. Conclusion: In conclusion, our data suggest that critical patients suffer from a suppressed immune system, and the inflammation level, the risk of organ damage, and co-infections are significantly high in the critical group and suggests the use of bacteriostatic instead of bactericides to treat co-infections. [ABSTRACT FROM AUTHOR]

Introduction: Subgroups of autoantibodies directed against voltage-gated potassium channel (Kv) complex components have been associated with immunotherapy-responsive clinical syndromes. The high prevalence and the role of autoantibodies directly binding Kv remain, however, controversial. Our objective was to determine Kv autoantibody binding requirements and to clarify their contribution to the observed immune response. Methods: Binding epitopes were studied in sera (n = 36) and cerebrospinal fluid (CSF) (n = 12) from a patient cohort positive for Kv1.2 but negative for 32 common neurological autoantigens and controls (sera n = 18 and CSF n = 5) by phospho and deep mutational scans. Autoantibody specificity and contribution to the observed immune response were resolved on recombinant cells, cerebellum slices, and nerve fibers. Results: 83% of the patients (30/36) within the studied cohort shared one out of the two major binding epitopes with Kv1.2-3 reactivity. Eleven percent (4/36) of the serum samples showed no binding. Fingerprinting resolved close to identical sequence requirements for both shared epitopes. Kv autoantibody response is directed against juxtaparanodal regions in peripheral nerves and the axon initial segment in central nervous system neurons and exclusively mediated by the shared epitopes. Discussion: Systematic mapping revealed two shared autoimmune responses, with one dominant Kv1.2-3 autoantibody epitope being unexpectedly prevalent. The conservation of the molecular binding requirements among these patients indicates a uniform autoantibody repertoire with monospecific reactivity. The enhanced sensitivity of the epitope-based (10/12) compared with that of the cellbased detection (7/12) highlights its use for detection. The determined immunodominant epitope is also the primary immune response visible in tissue, suggesting a diagnostic significance and a specific value for routine screening. [ABSTRACT FROM AUTHOR]

The dichromatic number ...(D) of a digraph D is the least integer k such that D can be partitioned into k directed acyclic digraphs. A digraph is k-dicritical if ...(D) = k and each proper subgraph D' of D satisfies ...(-D') ≤ k - 1. An oriented graph is a digraph with no directed cycle of length 2. For integers k and n, we denote by Ok(n) the minimum number of edges of a k-dicritical oriented graph on n vertices. The main result of this paper is a proof that O3(n) ≥ 7n+2/3 together with a construction witnessing that O3(n) ≤ ⌈5n/2⌉ for all n ≥ 12. We also give a construction showing that for all sufficiently large n and all k ≥ 3, Ok(n) < (2k -- 3)n, disproving a conjecture of Hoshino and Kawarabayashi. [ABSTRACT FROM AUTHOR]

In 2019 Ofsted introduced cultural capital (CC) into the Early Years Inspection Handbook and defined it as 'essential knowledge' related to 'educated citizenship'. This paper investigates Ofsted's use of CC to critically examine the potential implications for early years work. Due to the feminised nature of early years work, a critical feminist approach is engaged to explore the potential impact of introducing CC into the regulation of the sector. This paper examines the differences between Ofsted's use of CC, CC's theoretical origins, and analyses sector responses. Our contention is that how Ofsted have employed CC may represent 'symbolic violence' against the working-class women working in the early years, by further devaluing their habitus and sustaining the stratification of society through forms of capital. This paper is the first to interrogate CC in Ofsted's early years documentation, and will have an international impact for any countries following UK education practices. [ABSTRACT FROM AUTHOR]

This study aims to develop and see the effectiveness of flipbook-based digital pocketbooks on environmental pollution material on the critical and creative thinking skills of SMPN 1 Sojol Utara grade VII students. The method used in this research is research and development (Research and Development) with 4D instructional design. This research was conducted on grade VII students at SMPN 1 Sojol Utara, totaling 40 students. The results of this study showed that: (1) The flipbook-based digital pocketbook developed obtained a percentage of 86.96% of the very valid category and for media practicality obtained a percentage of 80% of the practical category for use in science learning, critical thinking skills obtained a value of 70.83% in the critical thinking category (2) The ability to think creatively obtained a score of 84.37% with the category of creative thinking (3) The effectiveness of the book The flipbook-based digital pocket developed is very effective in improving students' critical thinking skills with an effect size value of 1.95 huge categories, (4) The effectiveness of the flipbook-based digital pocketbook developed is very effective in improving students' creative thinking skills with an effect size valueThe 1.95 categories are enormous. Based on the results of the development that has been carried out, flipbook-based digital pocketbooks can be a learning medium that can improve students' critical and creative thinking skills in science learning. [ABSTRACT FROM AUTHOR]

Dealing with acute cholecystitis in high-risk, critically ill, and unfit-for-surgery patients is frequent during daily practice and requires complex management. Several procedures exist to postpone and/or prevent surgical intervention in those patients who temporarily or definitively cannot undergo surgery. After a systematic review of the literature, an expert panel from the Italian Society of Emergency Surgery and Trauma (SICUT) discussed the different issues and statements in subsequent rounds. The final version of the statements was discussed during the annual meeting in Rome (September 2022). The present paper presents the definitive conclusions of the discussion. Fifteen statements based on the literature evidence were provided. The statements gave precise indications regarding the decisional process and the management of patients who cannot temporarily or definitively undergo cholecystectomy for acute cholecystitis. Acute cholecystitis management in high-risk, critically ill, and unfit-for-surgery patients should be multidisciplinary. The different gallbladder drainage methods must be tailored according to each patient and based on the expertise of the hospital. Percutaneous gallbladder drainage is recommended as the first choice as a bridge to surgery or in severely physiologically deranged patients. Endoscopic gallbladder drainage (cholecystoduodenostomy and cholecystogastrostomy) is suggested as a second-line alternative especially as a definitive procedure for those patients not amenable to surgical management. Trans-papillary gallbladder drainage is the last option to be reserved only to those unfit for other techniques. Delayed laparoscopic cholecystectomy in patients with percutaneous gallbladder drainage is suggested in all those patients recovering from the conditions that previously discouraged surgical intervention after at least 6 weeks from the gallbladder drainage. [ABSTRACT FROM AUTHOR]

This study explores the experiences of three Networked Improvement Communities (NICs) within mathematics departments as they work to critically transform their introductory mathematics programs. Drawing on the framework of dominant and critical axes of equity, we identify three key tensions experienced by the NICs: identity neutrality versus identity centrality, power over versus power with, and students as novices versus students as experts. These tensions are framed as productive enactments of working to change systems from within, highlighting the challenges and opportunities inherent in navigating the liminal space of nepantla. We argue that engaging with these tensions is crucial for fostering critical transformations and offer recommendations for leveraging the roles of identity, power, and student partnership to promote more equitable and inclusive mathematics education environments.

ABSTRACT The onset of critical rare diseases (RDs) in children is rapid and dangerous, accompanied by a high mortality rate, which brings a heavy burden to both families and society. Multiple malformations, neuromuscular diseases, metabolic diseases, and heart diseases are the most common types of RDs in children of China, often manifesting with multiple organ dysfunction. At present, the diagnosis and treatment of critical RDs in children face challenges such as prolonged diagnosis time, a high misdiagnosis rate, limited treatment modalities, and a significant disease burden. However, with the progress in genetic testing technology, the establishment of multidisciplinary diagnosis and treatment platforms, and the implementation of relevant RD policies in China, children with critical RDs will received enhanced medical services, experience improved prognoses, and reintegrate into social life.

Abstract Background Children with COVID-19 infection had fewer severe symptoms, which made it challenging to publish clinical data for this age group. This study aimed to determine the clinical features, laboratory markers, and predictors of mortality in children hospitalized in Pediatric Critical Care Units with COVID-19 pneumonia. Methods This retrospective research included all children between the age of ≥ 1 month and 18 years with laboratory-confirmed COVID-19 pneumonia through reverse transcriptase polymerase chain reaction (RT-PCR) from nasopharyngeal swabs who were admitted to Pediatric Critical Care Units between January 2022 and December 2022. Results The study included 62 patients with confirmed COVID-19 infection. Out of the 62 patients, 43 (69.4%) survived and 19 (30.6%) succumbed. High-grade fever, cough, altered level of consciousness, convulsion, CO-RADS IV, elevated blood CRP, urea, D-dimer, ferritin, and sodium were linked to significantly higher mortality risk. (OR: 15.867, p = 0.001, OR: 1.543, p = 0.044, OR: 7.321, p = 0.026, OR: 15.00, p = 0.017, OR: 10.833, p = 0.001, OR: 1.015, p = 0.032, OR: 1.028, p = 0.040, OR: 3.315, p

Mihaela Andreescu,1,2,&ast; Cosmin Moldovan,3,4,&ast; Delia-Andreea Lespezeanu,5,6,&ast; Adela-Ioana Mocanu,5,7 Mihai-Adrian Schipor,8 Horia Mocanu9,10,&ast; 1Department of Hematology, Faculty of Medicine, “Titu Maiorescu” University, Bucharest, 031593, Romania; 2Department of Hematology, Colentina Clinical Hospital, Bucharest, 01171, Romania; 3Department of Medical Surgical Disciplines, Faculty of Medicine, “Titu Maiorescu” University, Bucharest, 031593, Romania; 4Department of General Surgery, Witting Clinical Hospital, Bucharest, 010243, Romania; 5Doctoral School, Faculty of Medicine, “Titu Maiorescu” University, Bucharest, 031593, Romania; 6“Ion Pavel” Diabetes Center, National Institute of Diabetes, Nutrition and Metabolic Diseases “Prof.Dr.N.C. Paulescu”, Bucharest, 030167, Romania; 7Department of ENT&HNS, Polimed Medical Center, Bucharest, 040067, Romania; 8Institute of Space Technology and Space Applications, University of the Bundeswehr, München, 85579, Germany; 9Department of ENT&HNS, Faculty of Medicine, “Titu Maiorescu” University, Bucharest, 031593, Romania; 10Department of ENT&HNS, G&abreve;ești City Hospital, G&abreve;ești, Dâmbovița, 135200, Romania&ast;These authors contributed equally to this workCorrespondence: Adela-Ioana Mocanu, Polimed Medical Center, Bloc 67, Calea V&abreve;c&abreve;rești 280, Bucharest, 040063, Romania, Tel +40723400435, Email adela.ioana.mocanu@gmail.com Mihaela Andreescu, Faculty of Medicine, “Titu Maiorescu” University, Str. Gheorghe Petrașcu 67A, Bucharest, 031593, Romania, Tel +40744559730, Email tevetmihaela@gmail.comAbstract: With the advent of COVID-19, the number of patients diagnosed with mucormycosis has increased, especially in developing countries. The reason behind this increase is that COVID-19 causes hypoxia that promotes the growth of fungus. To identify the association between mucormycosis and COVID-19, in critically ill or immunocompromised COVID-19 patients. The literature included in the review was researched from October 1, 2021, to November 1, 2022, by using the Google Scholar database as the search engine. Of the 20 articles included, there were 4 case reports, 2 case series, 10 narrative reviews, and 4 quantitative studies. Mucormycetes growth is caused by several factors, including hyperglycemia owing to previously existing diabetes or excessive use of steroids, increased ferritin levels owing to the inflammatory cascade initiated by COVID-19, and immunosuppression caused by the use of steroids or other immunosuppressive therapy. Reduced white-cell count and activity in COVID-19 leads to increased germination of fungal spores hence developing a catastrophic picture of rhinocerebral mucormycosis. Considering that the hematological patient is frequently treated with cortisone, immunosuppressed due to the underlying condition, but also through the administered therapy, the association with a possible diabetes makes this patient susceptible to developing rhinocerebral mucormycosis during COVID-19 infection. Despite being severe, the association between mucormycosis and COVID-19 is specific and treatable. Development of mucormycosis in hematological patients suffering from severe COVID-19 disease is dangerous, yet not compulsory and can be prevented. Using a common steroid-dose protocol with hyperbaric oxygen and necessary preventive measure reveals the disease as a superadded infection. Hypoxia, poor glycemic control and overuse of steroids or immunosuppressive drugs cause it.Keywords: COVID-19-associated mucormycosis, immunocompromised, critical, COVID-19, mucormycosis, fungal infection

The onset of critical rare diseases (RDs) in children is rapid and dangerous, accompanied by a high mortality rate, which brings a heavy burden to both families and society. Multiple malformations, neuromuscular diseases, metabolic diseases, and heart diseases are the most common types of RDs in children of China, often manifesting with multiple organ dysfunction. At present, the diagnosis and treatment of critical RDs in children face challenges such as prolonged diagnosis time, a high misdiagnosis rate, limited treatment modalities, and a significant disease burden. However, with the progress in genetic testing technology, the establishment of multidisciplinary diagnosis and treatment platforms, and the implementation of relevant RD policies in China, children with critical RDs will received enhanced medical services, experience improved prognoses, and reintegrate into social life. [ABSTRACT FROM AUTHOR]

In this paper, we consider a critical Galton–Watson branching process with immigration stopped at zero W. Some precise estimation on the probability generating function of the n-th population are obtained, and the tail probability of the life period of W is studied. Based on above results, two conditional limit theorems for W are established. [ABSTRACT FROM AUTHOR]

This paper is concerned with the multiplicity results to a class of p$$ p $$‐Kirchhoff type elliptic equation with the homogeneous Neumann boundary conditions by the abstract linking lemma due to Brézis and Nirenberg. We obtain the twofold results in subcritical and critical cases, which is a meaningful addition and completeness to the known results about Kirchhoff equation. At the same time, this paper also gives a method to deal with p$$ p $$‐Laplacian, Kirchhoff equation, and some Kirchhoff type equation in a unified variational framework. [ABSTRACT FROM AUTHOR]

This paper considers critical reflection as a pedagogical strategy in UK higher education at a moment of an amplification of populist, reactionary discourses. It draws on written reflections of foundation-level students in a case study cohort and offers insights into their lived learning experiences and perceptions of the value of reflection. This is situated within the UK 'Brexit' context, alongside a proliferation of far-right populist voices, emboldened supremacies and rising fascism. Accompanying this has been a normalisation of reactionary 'anti-social justice' discourses. It is vital that HE practitioners recognise, pre-empt and interrupt such discourses, developing pedagogies and curricula in response. Yet there are inherent challenges in a climate of 'post-truth' anti-intellectualism. This paper argues that critical reflection contributes a useful approach to learning, fostering development of students' personal, intellectual and political capacities to navigate this complex socio-political terrain and engage with social justice. [ABSTRACT FROM AUTHOR]

In this brief article, I consider two concepts that Maslow advances in Toward a Humanistic Biology that relate to the role of scientific observation in psychological research and were forward-thinking at his writing. These are the importance of the humanistic concept of experiencing as a way of developing understanding, and the recognition of the impact of the perceptive capacities of observers. I consider these concepts in light of advances in critical and qualitative psychology, integrating concepts such as epistemic privilege and the use of experiencing as a method toward critical science—offering a contemporary foundation for a meta-psychological methodology. [ABSTRACT FROM AUTHOR]

Background: Children with COVID-19 infection had fewer severe symptoms, which made it challenging to publish clinical data for this age group. This study aimed to determine the clinical features, laboratory markers, and predictors of mortality in children hospitalized in Pediatric Critical Care Units with COVID-19 pneumonia. Methods: This retrospective research included all children between the age of ≥ 1 month and 18 years with laboratory-confirmed COVID-19 pneumonia through reverse transcriptase polymerase chain reaction (RT-PCR) from nasopharyngeal swabs who were admitted to Pediatric Critical Care Units between January 2022 and December 2022. Results: The study included 62 patients with confirmed COVID-19 infection. Out of the 62 patients, 43 (69.4%) survived and 19 (30.6%) succumbed. High-grade fever, cough, altered level of consciousness, convulsion, CO-RADS IV, elevated blood CRP, urea, D-dimer, ferritin, and sodium were linked to significantly higher mortality risk. (OR: 15.867, p = 0.001, OR: 1.543, p = 0.044, OR: 7.321, p = 0.026, OR: 15.00, p = 0.017, OR: 10.833, p = 0.001, OR: 1.015, p = 0.032, OR: 1.028, p = 0.040, OR: 3.315, p < 0.0001, OR: 1.004, p = 0.049, OR: 1.111, p = 0.006 respectively). Conclusion: Our study revealed high in-hospital mortality among critically ill children with confirmed COVID-19 pneumonia. Identification of critically ill children with risk factors for death, such as high-grade fever, cough, altered consciousness, convulsion, CO-RADS IV and V, and raised inflammatory markers at the time of admission could minimize excess mortality during COVID-19 waves. [ABSTRACT FROM AUTHOR]

This autoethnography seeks to open up for re-interpretation and debate three topics that feature within social work practice, research, and education: firstly the value and use of metaphor in understanding practice, secondly approaches to social work reflective writing, and thirdly the issue of poverty and its significance and impact in child and family social work. Metaphors can be valuable in framing understanding of issues within social work practice and advocating for change. Three metaphors have been particularly used in understanding the relationship between social work practice and poverty: The Invisibility of Poverty, The Elephant in the Room, and The Wallpaper of Practice. The three Parts of this autoethnography each adopt a different approach to autoethnographic writing and addresses and unsettles one of these metaphors. The first part adopts a narrative-reflective-analytical approach conventional to reflective writing in social work. The second and third parts adopt poetic and post-humanist approaches, respectively. It is proposed that adopting autoethnography as a methodology challenges the uncritical application of metaphor to situated practice and thereby prevents interpretive foreclosure. 'Writing against' objectified social work knowledge may assist in opening up practice to more challenging critical reflection and re-interpretation. Juxtaposing these three parts demonstrates the potential of non-conventional autoethnographic approaches to provide opportunities for deeper reflection on the experiences of doing social work within the context of poverty than conventional approaches to reflective writing. Furthermore, they indicate a need to reconsider how well these metaphors reflect social work practice experience with poverty. [ABSTRACT FROM AUTHOR]

The cyber-physical system is a specific type of IoT communication environment that deals with communication through innovative healthcare (medical) devices. The traditional medical system has been partially replaced by this application, improving healthcare through efficiency, accessibility, and personalization. The intelligent healthcare industry utilizes wireless medical sensors to gather patient health information and send it to a distant server for diagnosis or treatment. The healthcare industry must increase electronic device accuracy, reliability, and productivity. Artificial intelligence (AI) has been applied in various industries, but cybersecurity for cyber-physical systems (CPS) is still a recent topic. This work presents a method for intelligent threat recognition based on machine learning (ML) that enables run-time risk assessment for better situational awareness in CPS security monitoring. Several machine learning techniques, including Nave Bayes (65.4%), Support Vector Machine (64.1%), Decision Tree (89.6%), Random Forest (92.5%), and Ensemble crossover (EC) XG boost classifier (99.64), were used to classify the malicious activities on real-world testbeds. The outcomes demonstrate that the Ensemble crossover XG boost enabled the best classification accuracy. When used in industrial reference applications, the model creates a safe environment where the patient is only made aware of risks when categorization optimism exceeds a specific limit, minimizing security managers' pressure and efficiently assisting their choices. [ABSTRACT FROM AUTHOR]

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IntroductionAcute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which appeared in 2019, has been classified as critical and non-critical according to clinical signs and symptoms. Critical patients require mechanical ventilation and intensive care unit (ICU) admission, whereas non-critical patients require neither mechanical ventilation nor ICU admission. Several factors have been recently identified as effective factors, including blood cell count, enzymes, blood markers, and underlying diseases. By comparing blood markers, comorbidities, co-infections, and their relationship with mortality, we sought to determine differences between critical and non-critical groups.MethodWe used Scopus, PubMed, and Web of Science databases for our systematic search. Inclusion criteria include any report describing the clinical course of COVID-19 patients and showing the association of the COVID-19 clinical courses with blood cells, blood markers, and bacterial co-infection changes. Twenty-one publications were eligible for full-text examination between 2019 to 2021.ResultThe standard difference in WBC, lymphocyte, and platelet between the two clinical groups was 0.538, -0.670, and -0.421, respectively. Also, the standard difference between the two clinical groups of CRP, ALT, and AST was 0.482, 0.402, and 0.463, respectively. The odds ratios for hypertension and diabetes were significantly different between the two groups. The prevalence of co-infection also in the critical group is higher.ConclusionIn conclusion, our data suggest that critical patients suffer from a suppressed immune system, and the inflammation level, the risk of organ damage, and co-infections are significantly high in the critical group and suggests the use of bacteriostatic instead of bactericides to treat co-infections.

Online learning is becoming more and more popular than traditional learning, and the need to investigate its influence within the framework of instruction and learning domains is — in today's emerging, cutting-edge technology world — an academic trend. The current study's problem intends to explore the impact of virtual versus traditional learning on the academic achievement of EFL students, a subject that has garnered substantial attention from English Language Teaching (ELT) researchers. This study aims to clarify if EFL students' academic progress in a listening skills classroom is influenced by traditional or online learning. The present research compiled information on how EFL students performed when English language teaching took place online as opposed to in a traditional classroom environment. This study, using an experimental research design with (N = 30) pairs of students (both male and female), was held at Najran University, KSA, in the academic year 2022–2023 b y using probability (random sampling). This study used pre-and post-tests to gather data from the subjects of the study, bifurcated into controlled and experimental groups employing the two modes of teaching, viz., online and traditional. The findings of the investigation proved that the experimental group achieved better performance compared to the control group in terms of results and scores. There are no significant differences based on gender. In addition, (N = 20) teachers teaching listening skills to EFL learners participated in semi-structured interviews. The qualitative analysis enlisted flexibility, accessibility, effective communication, collaboration, monitoring of student progress, and the use of a blackboard as constructive elements, followed by maintenance costs, wastage of available resources, long-term engagement, limited face-to-face interaction, and demotivation as critical perspectives. According to the findings of this research, the author recommends further studies with more variables.

The act of making provides students with an opportunity to create and design by using materials and technologies. Scholars who examine learning through making maintain that maker approaches to solving problems, creating designs, and thinking about real-world ideas promote the development of abstract thinking skills, such as modeling, and computational thinking (CT) skills. Our goal is to research the use of specific methods of maker education—such as experimenting with tools and hands-on designs—in learning mathematics. We ask: what are the benefits and potential outcomes for designing and teaching learning activities which integrate technology maker practices and pedagogies in mathematics and other school concepts in STEM contexts? We analyzed qualitative data on the benefits and potential outcomes of maker practices and pedagogies from three cases in Canada and Brazil. The researchers designed and facilitated the tasks to study the experiences of participants. Participants were observed, interviewed (or asked interview questions via a questionnaire), and completed reflection prompts. Their activities were recorded. The results show that learning from maker practices and pedagogies augments the learning of individual STEM disciplines, with specific settings and activity designs offering varied foci on mathematics and technology, on science, engineering and mathematics, or on science, technology and mathematics. Students, preservice teachers and teachers benefit in cognitive, interdisciplinary and social (situated) ways. Further research is needed to explore how deeper and other benefits, including critical benefits, may be achieved for learning and teaching mathematics and to explore which practices and pedagogies are associated with more potential outcomes. [ABSTRACT FROM AUTHOR]

Background: Many taken-for-granted expectations for parents in Western societies are situated in normative assumptions. Social constructions of 'good' parenting may be a poor fit for parents whose children's development varies from a so-called typical trajectory. Normative assumptions about parenting can have harmful effects for parents of autistic children. Aims/Objectives: This paper examines representations of parenting autistic children in contemporary research and considers the potential effects of these representations on these parents' occupational possibilities. Methods: Informed by a critical occupational perspective, a critical interpretive synthesis (CIS) of 27 research articles focussed on parenting autistic children was conducted. Findings: Three major discursive threads were identified regarding how parents of autistic children are represented in research: gendered assumptions, caregiving as all-consuming, and disruption of normative expectations of parenting. Conclusions and significance: Normative discourses about parenting were (re)produced within this body of research which may perpetuate limitations in the occupational possibilities of parents of autistic children. Critical investigation into contemporary research is necessary to challenge taken for granted expectations for parents of children with autism, to mitigate harmful effects for parents, to inform transformative OT practices and policies, and to promote equitable service provision. [ABSTRACT FROM AUTHOR]