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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. [ABSTRACT FROM AUTHOR]

Research on investigative interviewing tends to focus on a limited number of interview methods employed during an interview in pursuit of a singular outcome. The present study took an expansive view of the techniques used, questions asked and interviewer disposition, and related them to three interview goals—overcoming resistance, gathering information and eliciting confessions. Drawing upon theory and prior research, we hypothesised that certain methods would be more relevant to certain outcomes than others, such as question types would have a greater effect on information gain than techniques or interviewer disposition. Using a sample of 43 suspect interviews provided by the Las Vegas Metropolitan Police Department (LVMPD), we found partial support for our hypotheses. Rapport‐based approaches and a respectful disposition reduced resistance, open‐ended questions elicited more information than closed‐ended ones and in the final model, only open‐ended questions increased confessions. Implications for research and practice are discussed. [ABSTRACT FROM AUTHOR]

Abstract The metabolism and disposition of zamicastat, a reversible dopamine β-hydroxylase (DβH) inhibitor, developed for treatment of Pulmonary Arterial Hypertension (PAH), were investigated in rats after oral and intravenous administration of [14C]-zamicastat.Zamicastat was rapidly absorbed and widely distributed to peripheral tissues, with total radioactivity almost completely recovered 168 h post-dose. Its main route of excretion was via faeces, whilst urine and expired air had minor roles.Maximum plasma concentration of zamicastat-related radioactivity occurred in the first hours, remaining quantifiable up to 144 h. The unchanged zamicastat plasma peak was 2 h post-dose and declined to low levels over 24 h.Zamicastat metabolism occurs largely during the first 8 h with only one metabolite identified in the latest time-point (96 h), the isothiocyanic acid/thiocyanic acid (tautomeric forms). Zamicastat metabolic pathway involved multiple reactions comprising desulphurisation, oxidative desulphurisation, N-debenzylation followed by further oxidation or N-acetylation, and the unexpected multistep metabolic pathway leading to isothiocyanic acid/thiocyanic acid.The metabolism and disposition of zamicastat, a reversible dopamine β-hydroxylase (DβH) inhibitor, developed for treatment of Pulmonary Arterial Hypertension (PAH), were investigated in rats after oral and intravenous administration of [14C]-zamicastat.Zamicastat was rapidly absorbed and widely distributed to peripheral tissues, with total radioactivity almost completely recovered 168 h post-dose. Its main route of excretion was via faeces, whilst urine and expired air had minor roles.Maximum plasma concentration of zamicastat-related radioactivity occurred in the first hours, remaining quantifiable up to 144 h. The unchanged zamicastat plasma peak was 2 h post-dose and declined to low levels over 24 h.Zamicastat metabolism occurs largely during the first 8 h with only one metabolite identified in the latest time-point (96 h), the isothiocyanic acid/thiocyanic acid (tautomeric forms). Zamicastat metabolic pathway involved multiple reactions comprising desulphurisation, oxidative desulphurisation, N-debenzylation followed by further oxidation or N-acetylation, and the unexpected multistep metabolic pathway leading to isothiocyanic acid/thiocyanic acid. [ABSTRACT FROM AUTHOR]

Background: Despite resuscitative efforts, cardiac arrest (CA) continues to result in high mortality and poor prognosis. However, a gap remains in understanding the comparative outcomes of efforts in emergency departments (ED) over recent years. This study evaluated patients with CA during ED visits, with a particular focus on outcomes of mortality and transition of care. Methods: We conducted a retrospective cohort analysis using the National Emergency Department Sample (NEDS) database. The study population included patients aged 18 years or older who visited the ED between January 2016 and December 2020. Statistical analysis of patients and hospital characteristics included chi-squared tests for independence and multivariable logistic regression models to report the associations of factors with mortality in the ED and disposition from the ED. The primary outcome measured was mortality in the ED, and the secondary outcome included transition of care. Results: A total of 699,822,424 ED visits occurred between 2016 and 2020, with 1,414,060 (0.20%) CAs. The survival rate from CA ranged from 24.6% to 28.1%. In 2020, the rate of ED CA increased to 0.27%, with an inpatient mortality rate of 58.8%. There was no significant difference in mortality between sexes (p = 0.690). There was a trend for higher mortality in the ED among patients who were self-paid. Notably, the odds of transfer from the ED to other hospitals were significantly lower in minority groups. Conclusions: Our results showed significant disparities in ED mortality and patient disposition following cardiac arrest, highlighting the need for equitable healthcare resources and policies. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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 FROM AUTHOR]

Copyright of Adab Al-Kufa is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

1. Antibody-drug conjugates (ADCs) have demonstrated impressive clinical usefulness in treating several types of cancer, with the notion of widening of the therapeutic index of the cytotoxic payload through the minimisation of the systemic toxicity. Therefore, choosing the most appropriate payload molecule is a particularly important part of the early design phase of ADC development, especially given the highly competitive environment ADCs find themselves in today.2. The focus of the current review is to describe critical attributes/considerations needed in the discovery and ultimately development of cytotoxic payloads in support of ADC design. In addition to potency, several key dispositional characteristics including solubility, permeability and bystander effect, pharmacokinetics, metabolism, and drug-drug interactions, are described as being an integral part of the integrated activities required in the design of clinically safe and useful ADC therapeutic agents. [ABSTRACT FROM AUTHOR]

Small and medium enterprises (MSMEs) in Cirebon Regency face several challenges, such as a lack of creating new ideas, a low level of quality of human resources, many MSMEs that do not have official legality and low access to capital. This study aims to understand the implementation process of Cirebon Regent Regulation No. 44 of 2022 which regulates Micro Business Assistance in Cirebon Regency, the research was conducted using qualitative methods through a descriptive approach to describe the phenomena that occur. Policy implementation, according to an analysis based on George Edward III's theory, is influenced by four main factors: communication, available resources, attitudes or dispositions, and bureaucratic structure. These factors determine the success or failure of the policy implementation. The results showed that the implementation of the MSME mentoring policy in the Cirebon district, the implementation was considered quite successful but still less than optimal because there were several problems in it such as social media accounts that were no longer actively providing information, the quantity of mentoring policy implementers was still lacking, and there was no clear SOP in implementing the mentoring policy. [ABSTRACT FROM AUTHOR]

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.

Introduction: The World Health Organization has reported submersion injuries as the third most common cause of death due to unintentional injury in the world. Greater detail in the rates, risk factors, and healthcare associated costs of submersion injuries could be instrumental in demonstrating the need for further funding and intervention. Methods: The study was a cross-sectional analysis of a nationally representative dataset of inpatient and emergency department (ED) encounters between 2006 and 2015 in the United States (US). Healthcare utilization costs were provided within the datasets and adjusted to reflect actual charges and provider fees. Lastly, the final cost values were adjusted to the 2020 US dollar (USD) and summarized using a log adjusted mean. Results: On average, there were 11,873 submersion injuries per year that presented to the ED in the US. Resulting in a rate where approximately 9 out of every 100,000 ED visits were associated with a submersion injury. Slightly more than 6% died in the ED, 24.2% were admitted, and 69.3% were discharged from the ED. In total, annual cost of submersion injuries in the US for ED care is approximately $12.5 million, inpatient care is approximately $27.5 million, and total annual healthcare cost exceeds $40 million. Discussion: While these results only represent a fraction of the total cost associated with submersion injuries, it remains substantial and unchanged over the 10-year study period. Certain demographic groups showed higher rates of injury and disease burden, thus bearing a greater amount of the cost. [ABSTRACT FROM AUTHOR]

Drawing on insights found in both philosophy and psychology, this paper offers an analysis of hate and distinguishes between its main types. I argue that hate is a sentiment, i.e., a form to regard the other as evil which on certain occasions can be acutely felt. On the basis of this definition, I develop a typology which, unlike the main typologies in philosophy and psychology, does not explain hate in terms of patterns of other affective states. By examining the developmental history and intentional structure of hate, I obtain two variables: the replaceability/irreplaceability of the target and the determinacy/indeterminacy of the focus of concern. The combination of these variables generates the four-types model of hate, according to which hate comes in the following kinds: normative, ideological, retributive, and malicious. [ABSTRACT FROM AUTHOR]

The article analyzes scientific approaches to determining the structure of administrativeprocedural norms and formulates the author's approach to solving the specified scientific task. The specificity of the structure of the norms of procedural law in comparison with substantive norms is noted. It is emphasized that the hypothesis is an element of the structure of the administrativeprocedural norm, which contains an indication of legal facts, the occurrence of which is associated with the «start» of the action of the disposition. It is also emphasized that the absence of a hypothesis as a structural element of the administrativeprocedural legal norm makes its effectiveness impossible, or even its implementation at all. It is argued that the disposition of the administrative-procedural norm is a set of rights and legal obligations, a rule of conduct, according to which the participants of administrativeprocedural relations act in the presence of the hypothesized circumstances. The disposition may contain options for choosing behavior for the participant in the proceedings, providing him with an alternative in his legal behavior during the consideration of the case and decision-making. In other words, the disposition fully reveals the potential of the dispositive method of legal regulation of the relevant legal relations. It is noted that among the elements, along with hypothesis and disposition, it is expedient to outline incentive as an element of the norms of administrative and procedural law, which establishes positive (incentives, guarantees) or negative (procedural coercion, restrictions, including warnings; removal from the courtroom; temporary removal evidence for examination by the court; pretext; fine; refusal of a procedural act, which was adopted by this procedural norm; recognition of evidence as improper, which was obtained in violation of the law; leaving the statement of claim without consideration or movement, etc.) legal consequences of implementation/non-implementation of its prescriptions. [ABSTRACT FROM AUTHOR]

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.

Introduction: The coronavirus 2019 (COVID-19) pandemic has presented various unprecedented challenges to healthcare systems globally, prompting society to adopt new preventative strategies to curb spread of the disease. Those experiencing homelessness have been particularly impacted because of barriers to practicing social distancing, inability to isolate, and poor access to care. Project Roomkey was established in California as a statewide measure to provide non-congregate shelter options for individuals experiencing homelessness to properly quarantine. On goal in this study was to analyze the effectiveness of hotel rooms as a safe disposition alternative to hospital admission for patients experiencing homelessness and who were also positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).Methods: This was a retrospective, observational study that included chart review of patients who were discharged to the hotel from March 2020–December 2021. We recorded demographic information, index visit details, number of emergency department (ED) visits both a month prior to and following the index visit, admission rates, and number of deaths.Results: During this 21-month study period, a total of 2,015 patients who identified as undomiciled were tested for SARS-COV-2 in the ED for various reasons. Of those patients, 83 were discharged from the ED to the hotel. Of the 83 patients, 40 (48.2%) ultimately tested positive for SARS-CoV-2 during their index visit. Two patients returned to the ED within seven days with COVID-19-related symptoms, and 10 patients within 30 days. Two patients required subsequent admission with COVID-19 pneumonia. No deaths were recorded within the 30-day follow-up period.Conclusion: The availability of a hotel served as a safe alternative to hospital admission for patients experiencing homelessness and who were either suspected or confirmed to have COVID-19. It is reasonable to consider similar measures in the management of other transmissible diseases for patients experiencing homelessness who require isolation.

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 twocompartment model. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Copyright of Gazi University Journal of Gazi Educational Faculty (GUJGEF) is the property of Gazi University Journal of Gazi Educational Faculty (GUJGEF) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Inorganic arsenic (iAs) and fluoride (iF) are ubiquitous elements whose coexistence is frequent in several regions of the world due to the natural contamination of water sources destined for human consumption. It has been reported that coexposure to these two elements in water can cause toxic effects on health, which are controversial since antagonistic and synergistic effects have been reported. However, there is little information on the possible toxicological interaction between concurrent exposure to iAs and iF on the iAs metabolism profile. The goal of this study was to determine the effect of iF exposure on iAs methylation patterns in the urine and the tissues of female mice of the C57BL/6 strain, which were divided into four groups and exposed daily for 10 days through drinking water as follows: purified water (control); arsenite 1 mg/L, fluoride 50 mg/L and arsenite & fluoride 1:50 mg/L. To characterize the iAs methylation pattern in concomitant iF exposure, iAs and its methylated metabolites (MAs and DMAs) were quantified in the tissues and the urine of mice was exposed to iAs alone or in combination. Our results showed a statistically significant decrease in the arsenic species concentrations and altered relative proportions of arsenic species in tissues and urine in the As-iF coexposure group compared to the iAs-exposed group. These findings show that iF exposure decreases arsenic disposition and alters methylation capacity. Nevertheless, additional studies are required to elucidate the mechanisms involved in the iAs-iF interaction through iF exposure affecting iAs disposition and metabolism. [ABSTRACT FROM AUTHOR]

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 FROM AUTHOR]

The article examines the problem of determining the legal nature of the institution of recognition of unfounded assets and their collection into state income. Attention is drawn to the fact that the main reason for the introduction of the specified procedural institution into the legal system of our country is the development and creation of an effective system for preventing corruption and related offenses by persons authorized to perform the functions of the state or local self-government. At the same time, the studied procedural category can be conditionally attributed to the component of the national mechanism of fighting corruption. The author reveals the chronology of the establishment of the institution of civil confiscation of illegal assets, examining the content of the disposition of articles 233-2332 of the Civil Code of Ukraine, which were in effect in the period from March 4, 2015 to December 15, 2017, and articles 290-292 of the Civil Code of Ukraine, which were in force on 15.12.2017 year to 28.11.2019. In this part, attention is drawn to the fact that both of the indicated procedural models of civil confiscation provided for the possibility of recognizing assets as unfounded and their collection in favor of the state only in the presence of a court verdict that entered into legal force. At the same time, the reasons for the imperfection of the institution introduced by the legislator are analyzed, including the vagueness of the formulated procedural norms, their conflicting nature, the dependence of the civil lawsuit on the results of the criminal case, which in practice is carried out for an unreasonably long time. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the breakdown of discharge locations among pediatric tracheostomy patients and determine the impact of demographic variables and social determinants of health. Study Design: Retrospective review of the 2016 and 2019 Healthcare Cost and Utilization Project Kids' Inpatient Database (HCUP KID). Setting: A total of 4000 United States community hospitals, defined as short‐term, non‐Federal, general, and specialty hospitals. Methods: ICD‐10‐PCS, ICD‐10 CM codes, and HCUP data elements were selected for patients and variables of interest. Bivariate comparisons were performed using Rao‐Scott Chi‐square tests; significance levels in post hoc pairwise testing were adjusted using Bonferroni adjustment. Multinomial generalized logistic regression models were used to determine the average annual odds ratio (OR) of 3 dispositions at discharge relative to discharge home for self‐care. Results: Patients aged 11‐17, patients from large metropolitan areas, and patients of "Other" race have an increased odds of discharge to a short‐ or long‐term care facility (all P <.001). Weekend admissions, nonelective admissions, patients in Northeast hospitals, and patients at urban nonteaching hospitals are also more likely to be discharged to a short‐ or long‐term care facility (all P <.001). Mean and median total costs of admission were $424,387 and $243,479, respectively, with a median total charge of $854,499. Conclusion: Among pediatric tracheostomy patients, demographic factors that affect discharge disposition include age, community type, and race, and significant hospital factors include day and type of admission, geographic region, and hospital type. Hospitalizations are associated with high overall costs and charges to the patient, which are increasing over time. [ABSTRACT FROM AUTHOR]

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.

This article explores how the prevalence of deadpan and ironic modes of humour undermines the possibility of clear and stable interpretation in online contexts. Analysing key examples of online deadpan humour through the lens of literary and critical models of irony, I argue that the decontextualisation of deadpan humour in online spaces accentuates the deadpan comic mode's tendency towards ambiguity in ways that hypothetically destabilise any claim to textual certainty. Drawing on the work of Pierre Bourdieu, I propose the 'comic disposition' as a means to theorise how audiences learn to process the comic ambiguity of online deadpan humour, and suggest how the 'comic disposition' can be understood to inform observed tendencies towards distrust and confusion in digital culture. [ABSTRACT FROM AUTHOR]

Acute heart failure (AHF) is a common condition evaluated in the emergency department (ED). Patients may present with a wide range of signs and symptoms, comorbidities, exacerbating factors, and ability to follow-up. Having a decision tool to objectively assess the risk of near-term events would help guide disposition decisions in these patients. What are the data for current tools used to determine the short-term risk of adverse events of patients with AHF in the ED setting? Studies retrieved included six prospective studies and three retrospective cohort studies that evaluated the following five different risk scores that may predict the risk of serious adverse events in those with AHF: Ottawa Heart Failure Risk Score (OHFRS), Emergency Heart Failure Mortality Risk Grade (EHMRG), EHMRG at 30 days with addition of an ST depression variable (EHMRG30-ST), Multiple Estimation of Risk Based on the Emergency Department Spanish 40 Score in Patients with AHF Score (MEESSI-AHF), and the Improving Heart Failure Risk Stratification in the ED (STRATIFY) tool. Based on the available literature, risk scores, including the OHFRS; EHMRG; EHMRG30-ST; MEESSI-AHF; and STRATIFY, can help identify short-term risk of adverse events, but are insufficient in isolation. Clinicians should use these tools in conjunction with other factors, such as the patient's symptom trajectory, hemodynamics, and access to follow-up care. [ABSTRACT FROM AUTHOR]

Sensational perception, reason, testimony and introspection are the fundamental sources of knowledge. It has been much debated that memory is one of the basic sources of knowledge. This article aims to apply the perspective of Frise and Allameh Tabatabai about the epistemological status of memory with an analytical approach. In this essay, we try to answer the questions raised such as: is the memory one of the sources of belief production? Do memory beliefs justify other beliefs? Are memory beliefs self-justified or do they need justification? This article shows that by relying on the epistemological function of memory, Frise considered it as a source of belief production, by which those beliefs can be used in the structure of reasoning. Unifying memory and imagination, relying on the reductionist approach of powers, Allameh Tabatabi has considered imagination as the source of partial beliefs, so that it performs this action with the cooperation of common sense and communication with the outside world. Both philosophers believe that memory is just like a repository whose epistemological status is meaningful in preserving the justified beliefs. Also, from the view point of Frise and Allameh Tabatabai, memory beliefs are among self-justified and basic beliefs that are used to justify non-memory beliefs. Therefore, the view point of these two thinkers can be close to the reformed foundationalism approach. [ABSTRACT FROM AUTHOR]

Background: Patients with peritoneal carcinomatosis (PC) can develop malignant bowel obstructions (MBOs) requiring inpatient admission and nasogastric tube decompression. Palliative decompressive gastrostomy tubes (G-tubes) may affect patient disposition, allowing for self-management and reduction in inpatient services. Therefore, we sought to assess disposition and inpatient readmission rates in patients admitted with PC and MBO following G-tube placement. Methods: The Vizient® Clinical Data Base was queried for inpatient admissions from October 2018 to May 2022 utilizing ICD-10 codes to identify patients admitted with PC and bowel obstruction, with or without G-tube placement. Demographics and hospital outcomes were recorded. Descriptive statistics and multivariate logistic regression analysis were performed. Results: From 750 patients, 59 (7.9%) had a G-tube placed. Compared to patients without G-tubes, those with G-tubes had lower rates of disposition to home (32.2% vs 70.0%, P < .001) and higher rates of disposition to hospice (home: 30.5% vs 7.8%, P < .001, facility: 10.2% vs 3.9%, P = .02). There was no significant difference in the rate (17.3% vs 22.3%, P = .40) or risk (OR = 1.44, 95% CI .69-3.01) of 30-day readmissions with G-tubes. However, palliative care consultation (OR 33.77, 95% CI 19.16-59.52) and G-tube placement (OR 5.82, 95% CI 2.56-13.25) were independent predictors for hospice. Discussion: Placement of G-tubes in patients with PC and MBO was associated with higher rates of disposition to hospice but there is no difference in 30-day readmission rates compared to those without G-tubes. Further prospective studies are needed to understand the role of G-tube placement in patients with MBO in relation to outcomes and disposition. [ABSTRACT FROM AUTHOR]

• We found that renal distribution of nephrotoxic drugs including cisplatin and imatinib was increased in cholestatic mice under bile duct ligation. • Increased accumulation of nephrotoxic drugs may be attributed to down-regulation of drug efflux transporter MRP6 on renal basolateral membranes. • This renal adaption may provide important insights into the onset of drug-induced kidney injury during liver dysfunction. In hepatic dysfunction, renal pharmacokinetic adaptation can be observed, although information on the changes in drug exposure and the interorgan regulation of membrane transporters in kidney in liver diseases is limited. This study aimed to clarify the effects of renal exposure to nephrotoxic drugs during cholestasis induced by bile duct ligation (BDL). Among the 11 nephrotoxic drugs examined, the tissue accumulation of imatinib and cisplatin in kidney slices obtained from mice 2 weeks after BDL operation was higher than that in sham-operated mice. The uptake of imatinib in the kidney slices of BDL mice was slightly higher, whereas its efflux from the slices was largely decreased compared to that in sham-operated mice. Proteomic analysis revealed a reduction in renal expression of the efflux transporter multidrug resistance-associated protein 6 (Mrp6/ Abcc6) in BDL mice, and both imatinib and cisplatin were identified as Mrp6 substrates. Survival probability after cisplatin administration was reduced in BDL mice. In conclusion, the present study demonstrated that BDL-induced cholestasis leads to the downregulation of the renal basolateral efflux transporter Mrp6, resulting in drug accumulation in renal cells and promoting drug-induced renal injury. [ABSTRACT FROM AUTHOR]

Phenomenology presents itself not as an explanation or interpretation of phenomena but as a description of them. Describing experience means making its internal structure explicit, which, in phenomenology, is an eidetic structure. The method of phenomenological explication or clarification is, however, by no means univocal. This paper aims to isolate the two fundamental ways in which phenomenological description is achieved. The first refers to a phenomenology of manifestation, based on the concept of determination or datum, which is realized in the phenomenological-static approach and, in particular, on the concept of extensive quality. The second refers to a phenomenology of disposition, based on the concept of tension or force – which is realized in the genetic approach as well as in Merleau-Ponty's phenomenology of perception – and, in particular on the concept of intensive or forceful quality. The analysis of the difference between the two approaches allows us to introduce the crucial distinction between digital and analogue dimensions within phenomenology. [ABSTRACT FROM AUTHOR]

Copyright of HMD: Praxis der Wirtschaftsinformatik is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article mainly discusses translation issues in the two Cambridge editions of Kant's Religion, while engaging in a briefer discussion of Pluhar's translation of the same work. The aim is to correct single errors as well as patterns of questionable translation, and to do so guided by criteria of consistency in relation to Kant's use of key terms. I argue that the English translations have contributed to misinterpretations of Kant's philosophy of religion, although I make only passing references to the secondary scholarship. [ABSTRACT FROM AUTHOR]

In the study of fear of crime, perception of safety with respect to the risk of victimization is often viewed as the mere consequence of the absence of perceived risk. This paper takes the opposite view: that it is a complex phenomenon resting on a plurality of interpretative registers. Analysis of some thirty interviews of students at a French university shows three different ways of perceiving safety (fragility, self-confidence and tranquility), each rests on a specific relationship to oneself and toward supposed aggressors. Having shown this, we then look at how these interpretations emerge and evolve over time. Interpretations are by no means attached to individuals, rather, they fluctuate with the situations encountered and with past experiences, whence the importance of bringing out the two dimensions – synchronic and diachronic – of this phenomenon. [ABSTRACT FROM AUTHOR]

Objectives: Head and neck cancer patients that require major reconstruction often have advanced‐stage disease. Discharge disposition of patients can vary and impact time to adjuvant treatment. We sought to examine outcomes in patients discharged to skilled nursing facilities (SNF) compared to those discharged home, including the impact on adjuvant therapy initiation and treatment package time (TPT). Methods: Patients with head and neck squamous cell carcinoma treated with surgical resection and microvascular free flap reconstruction from 2019 to 2022 were included. Retrospective review was conducted to evaluate the impact of disposition on time to radiation (RT) and TPT. Results: 230 patients were included, with 165 (71.7%) discharged to home and 65 (28.3%) discharged to SNF. 79.1% of patients were recommended adjuvant therapy. Average time to RT was 59 days for patients discharged to home compared to 70.1 days for patients discharged to SNF. Disposition was an independent risk factor for delays to starting RT (p = 0.03). TPT was 101.7 days for patients discharged to home versus 112.3 days for those who discharged to SNF. Patients discharged to SNF had higher rates of readmission (p < 0.005) compared to patients discharged home in an adjusted multivariate logistic regression. Conclusions: Patients discharged to an SNF had significantly delayed time to initiation of adjuvant treatment and higher rates of readmission. Timeliness to adjuvant treatment has recently been established as a quality measure, thus identifying delays to adjuvant treatment initiation should be a priority. Level of Evidence: 3 Laryngoscope, 133:2977–2983, 2023 [ABSTRACT FROM AUTHOR]

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.

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.

Introduction: Trauma patients who present to the emergency department (ED) intoxicated or with an alcohol use disorder (AUD) undergo more procedures and have an increased risk of developing complications. However, how AUD and blood alcohol concentration (BAC) impact a trauma patient’s disposition from the ED remains inconclusive. In this study we aimed to identify the associations between positive BAC or an AUD with admission to the hospital, including the intensive care unit (ICU). Methods: This was a retrospective study analyzing data from 2010–2018 at a university-based, Level I trauma ED. Included in the study were 4,699 adult trauma patients who completed the Alcohol Use Disorders Identification Test (AUDIT) and had blood alcohol content test results.  Results: Positive BAC was associated with hospital admission and ICU admission after adjusting for injury severity score (ISS) (odds ratio 1.5 and 1.3, respectively). The AUDIT was only correlated with hospital and ICU admission in patients with ISS of 1 to 15. By increasing risk of AUD (low, moderate, high, and likely alcohol dependent) the proportion of ICU admissions rose from 29.3% to 37.3%, 40.0% and 42.0% (P