Since his rise to the political stage in 2015, Donald Trump’s heterodox style of self-presentation has stirred heated metapragmatic debates within the American and international public: Was that “locker-room talk,” or abusive speech? Is his verbal irreverence an unacceptable defiance of fundamental principles of interactional ethics, or a brave attempt at reforming contemporary American speech by dismissing the epistemic inaccuracy and moral hypocrisy of political correctness? This article engages these debates by analyzing an ingenious form of typographic parody that recently appeared on digital social media. Modeled on Trump’s handwriting, the font “Tiny Hand” operates on multiple metapragmatic levels. First, the font’s childlike shapes establish an iconic connection between Trump’s hand(writing) and his brain, which, incapable of adult reasoning, generates dangerously infantile political decisions. Second, as a replica of Trump’s handwriting, the font parodies the president’s habit of correcting journalists with handwritten marginalia, thus speaking back to his attempts at silencing the press. Third, Tiny Hand works as a counter-meta-parody of the president’s political incorrectness. Finally, by evoking the parodies of Trump’s allegedly diminutive hands (and implicitly small penis) that circulated during the electoral race, the font operates as an inside joke addressed at and indexical of Trump’s counterpublic.

This article focuses on the nexus between political discourse and contemporary concerns about the arbitration of truth to argue that Trump’s way of using speech about speech (i.e., his metapragmatic discourse) resembles the manipulation tactic commonly called gaslighting. Based on examples drawn from 2020 (i.e., White House press conferences and electoral presidential debates), I explore Trump’s metapragmatic gaslighting both as an epistemic tactic for the manipulation of information and as an effective style of political self-presentation. By analyzing specific instances of Trump’s metapragmatic commentaries that blatantly contradict shared pragmatic principles for the interpretation of utterances’ illocutionary force and denotational content, I show how Trump is able to present himself as a champion of semantic and moral candor and simultaneously promote a highly personalist view of the meaning-making process. In so doing, I also propose a metapragmatic approach to the epistemological and political predicaments posed by the “post-truth” epistemic regime.

Pain, a multifaceted condition associated with actual or potential tissue damage, transcends nociception and is characterised as a subjective, sensory, and emotional experience. Extensive literature describing the adverse effects of untreated post-surgical pain emphasises the necessity of a comprehensive pain management protocol, incorporating both pharmacological and non-pharmacological strategies to ensure successful patient outcomes. The present study aimed to determine whether a positive dog-owner interaction influences post-operative pain perception and stress (POPPS), as well as behavioural inactive rate variability in bitches that underwent elective surgery. Randomly selected bitches (n = 18) underwent ovariohysterectomy. Eight bitches experienced a 45-min visit post-surgery (VPS) characterised by positive dog-owner interaction, while the remaining ten did not (NVPS). Utilising the validated Short Form of the Glasgow Composite Measure Pain Scale (CMPS-SF) to assess acute pain in dogs via stress-related behaviours, a significant decrease in POPPS was evident in the VPS group after the 45-min dog-owner interaction at T3 (1 h after post-sedation recovery), in contrast to the NVPS group. CMPS-SF-associated descriptive items ‘Nervous/Anxious/Fearful’ and ‘Happy Content or Happy and Bouncy’ decreased and increased, respectively, with dog-owner positive interaction in the VPS group. The inactivity rate was significantly lower in VPS bitches after the post-surgery 45-min dog-owner interaction than in NVPS bitches. This preliminary study suggests that the owner’s presence reduces POPPS and may improve the dogs’ welfare while undergoing routine surgeries.

Background: Guidelines recommend bundles with multiple infection control elements to prevent surgical site infections (SSI). Although effective in multiple research studies, little is known about the implementation of such complex bundles in the real-world clinical setting. Methods: A survey was distributed to the SHEA Research Network (SRN) hospitals during November 2022 – December 2023, to assess processes related to the implementation of SSI prevention bundles in colorectal surgery. Results: Of the 93 US and international hospitals within SRN, 49 completed the survey (53% response rate). The mean volume of colorectal surgeries per year was 377 (median 400). Figure 1 shows the individual elements of SSI prevention bundle reported as consistently used in most surgeries. There were no significant differences between hospitals with high vs. low volume (cut-off 400 surgeries), except for wound protectors or retractors, more likely to be used in high-volume hospitals (P = 0.047). A formal process for auditing adherence was reported by 71% of respondents for antibiotic prophylaxis, and 51% for skin prep, with the remaining elements audited < 50% of the time. Feedback of audited adherence to surgeons occurred < 50% of the time for all bundle elements, except antibiotic prophylaxis (59%). Table 1 shows the most common barriers reported as either successfully mitigated or still persistent at the time of the survey. High-volume hospitals were more likely to report persistent clinicians’ low bundle adherence (P = 0.016) and inadequate bundle adherence audit and feedback (P = 0.0016). Conclusion: Implementation of guideline-recommended colorectal SSI Prevention bundles remains highly variable. Further research aiming to develop strategies that optimize implementation and adherence is needed.

In the design literature, creativity of products is recognized as a combination of novelty and usefulness. However, this mainly applies to the engineering field and within a community of experts. This study investigates how ordinary people understand creativity embodied in products. In an experiment with 70+ participants, 8 products and 5 metrics were dealt with. Novelty resulted as the main predictor of creativity. Usefulness turned to play a minor effect on perceived creativity. It emerged that usefulness has to make ordinary people like a specific product in order to link it to creativity.

Students mental health is declining. StudyWell is a project aiming at positive impact on student mental health in student cities in Norway; by integrating relational welfare with service design, and the study environment as a starting point. We discussfour implementation challenges: First, co-design depends on a shared mindset across disciplinary boundaries. Secondly, balancing the lenses of individuals, community, system and future require facilitation. Thirdly, societal impact requires continuous partner anchoring. Finally, approaches must not further pathologize university student.

The role of Artificial Intelligence (AI) in design is clearly growing. One of the tenets of the paper is that stimulation could be among the design processes mostly benefitting from the introduction of AI. Available contributions have been reviewed to understand the current support AI can give in design inspiration and ideation. We also reflected on what AI should and ahould not do in the future: a framework is proposed. Based on the reviewed contributions, in no case, AI is seen as a substitute of designers. Most contributions originate from the IT domain and have a demonstrative purpose.

The uptake of Ce3+, Nd3+, Gd3+, Er3+, and Lu3+ on vermiculite was studied using cation-exchange measurements, infrared spectroscopy (IR), and X-ray powder diffraction (XRD). The reaction was followed by measuring the amount of lanthanide ions (Ln3+) taken up by n-butylammonium-ex-changed vermiculite in relation to amount of Ln3+ salt added and the pH of the equilibrium solution. The amount of Ln3+ taken up in excess of the CEC value increased with the hydration energy of the lanthanide ion and with the pH of the n-butylammonium-exchanged vermiculite suspension. At equilibrium solution pHs of 3–4.5, the uptake of Ln3+ ions was only slightly greater than the CEC, whereas at pHs >4.5 the amount taken up by the vermiculite increased sharply. The uptake of Ln3+ ions beyond the CEC of the vermiculite is probably related to the hydrolysis of Ln3+ ions on the vermiculite interlayer surface. The appearance of a band at 1715–1720 cm−1 in the IR spectra of the Ln3+-exchanged vermiculite suggests a strongly acidic medium in the interlayer space. The Ln3+-exchanged vermiculites gave XRD patterns having 002/001 intensity ratios greater than that of Mg-exchanged vermiculite.

In recognition of an increasing number of high-consequence infectious disease events, a group of subject-matter experts identified core safety principles that can be applied across all donning and doffing protocols for personal protective equipment.

Calabrian ‘illegitimacy’ in the (inter)national imaginary today is largely the result of the region's association with the ’ndrangheta. Using analysis of oral history interviews, this research examines how this ‘illegitimacy’ influences the self-perception of Calabrians. It argues that a spectrum of prejudice and its effects can be mapped out both metaphorically and geographically. This spectrum incorporates Italy's position in relation to northern Europe, the South's position within Italy, Calabria's position within the South and the position within Calabria of certain communities. A number of towns in the Locride are at the extreme end of this spectrum: Locri, San Luca, Africo and Platì. Analysis of the (mis)recognition of inhabitants of these communities, including by other Calabrians, demonstrates how the experience of shame may be layered. This paper also considers how interviewees appear to deny their social and cultural proximity with the ’ndrangheta and the role this plays in a self-perpetuating cycle involving stereotypes, ’ndrangheta growth and extreme socioeconomic conditions.

Body composition and phase angle (PhA) have been used to predict mortality in multiple diseases. However, little has been studied regarding segmental measurements, which could potentially help assess subtle changes in specific tissue segments. This study aimed to identify the total PhA cut-off point associated with mortality risk and changes in body composition within a week of hospitalisation in non-critical hospitalised patients with COVID-19. A cohort study was conducted where patients underwent to a complete nutritional assessment upon admission and after seven days, and followed up until hospital discharge or death. A receiver operating characteristic curve was constructed to determine the PhA cut-off point, and the Kaplan–Meier estimator was used to determine survival analysis. Segmental and complete body compositions on admission and after 7 d were compared. We included 110 patients (60 men) with a mean age of 50·5 ± 15·0 years and a median BMI of 28·5 (IQR, 25·6–33·5) kg/m2. The median length of hospital stay was 6 (IQR, 4–9) d, and the mortality rate was 13·6 %. The PhA cut-off point obtained was 4°, with significant differences in the survival rate (P < 0·001) and mortality (HR = 5·81, 95 % CI: 1·80, 18·67, P = 0·003). Segmental and whole-body compositions were negatively affected within one week of hospitalisation, with changes in the approach by the graphical method in both sexes. Nutritional status deteriorates within a week of hospitalisation. PhA < 4° is strongly associated with increased mortality in non-critical hospitalised patients with COVID-19.

This paper assesses Brazil's real convergence (1822–2019) through unit root tests and Markov Regime-Switching (MS) models in three different scenarios: towards (i) other six Latin American countries (LA6); (ii) Portugal; and (iii) the technological frontier country, the US. The extended unit root test results favour Brazil's very long-run real convergence towards LA6 and Portugal, but not the US. The estimated MS models, involving two different regimes, real convergence and real non-convergence/divergence, capture institutional quality's positive effect in promoting Brazil's real convergence.

Background: The FIRST Trial is a 5-year study funded by the Agency for Healthcare Research and Quality. Our investigation is situated within a more extensive study to restrict fluoroquinolone antibiotics by requiring providers to obtain authorization from an infectious disease physician before prescribing fluoroquinolones. Our research team is performing a systematic evaluation to identify organizational characteristics and influencers of the fluoroquinolone preprescription authorization implementation process to understand variables that may facilitate or hinder implementation success. Methods: To address this critical gap, we present a qualitative analysis from our ongoing, multisite research project aimed at systematically assessing the adoption of an antimicrobial stewardship intervention in the form of an EHR-integrated best-practice alert (BPA) at each site to identify work system factors that impact uptake and variability in the implementation of the BPA at each location. The evaluation provides a detailed explanation of activities through the implementation process (eg, before implementation, during implementation, and after implementation) to assess how an organization effectively negotiates the phases and transitions, ultimately influencing the impact of the intervention. We have used a contextual determinant framework (CFIR) that has enabled us to perform a systematic and comprehensive exploration and identification of potential explanatory themes or variables to shed light on the complex social phenomenon of implementation. Results: Participants who will be a part of our poster presentation will learn about implementing a BPA, the potential barriers to implementation, and strategies for overcoming these barriers. Stakeholders within our study include site coordinators, medical doctors, nurses, pharmacists, and clinical informaticists. Our analysis synthesizes their experiences implementing and sustaining this evidence-based antimicrobial stewardship intervention. It includes (1) a detailed description of the process of change, (2) work-system factors (eg, inner setting and outer setting) that they believe influenced the success of the intervention, (3) barriers and facilitators (eg, CFIR constructs) within the implementation process; and (4) description of how these could have influenced the outcomes of interest (eg, implementation and intervention effectiveness). Conclusions: Our research is expected to advance patient safety research and initiatives by providing a more robust approach to performing systematic intervention evaluations. By outlining stakeholders’ experiences within our study, implementation leaders within healthcare systems will utilize our findings to aid them in their design and implementation process when designing and implementing similar types of healthcare interventions.

Disclosures: None