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This paper describes the normative profile of Kant’s ‘provisional property’ in the Doctrine of Right, by highlighting the contrast between a claim that merits the designation of ‘provisional property’ and a mere ‘pretended claim’. In contrast to a pretended claim, a claim of provisional property is duty-implying; moreover, the legitimating conditions of provisional property give it a robust justification, such that its duty-implying force does not rely on a wrong-tolerating permission. I will also argue that the proposed reconstruction does not harm Kant’s argument leading to the normative necessity of civil states.
Case-based learning (CBL) is increasingly used across health professions education to promote clinical reasoning and professional competencies. In paediatric cardiology, rapid advances in diagnostics, interventions, and multidisciplinary care have intensified the need for educational approaches that integrate complex knowledge with real-world problem-solving.
Methods:
This narrative review outlines the theoretical foundations of CBL and examines the available literature on its implementation and effectiveness in medical education generally and paediatric cardiology specifically. Emerging applications of CBL, including simulation, virtual reality, and international collaborative case conferences, were also reviewed. Key design principles for effective CBL were explored, including case selection, alignment with competency-based curricula, faculty development, and assessment strategies.
Results:
Evidence suggests that CBL enhances clinical reasoning, knowledge integration, learner engagement, and the development of professional competencies. In paediatric cardiology, CBL supports the application of complex diagnostic and management principles within authentic clinical contexts. Emerging technology-enhanced approaches and international collaborative learning initiatives further expand opportunities for interactive and multidisciplinary education. However, challenges remain, including significant time and resource requirements, digital inequities, and the need for more rigorous evaluation of educational outcomes.
Conclusion:
Well-designed CBL appears to be a powerful educational strategy for preparing paediatric cardiology clinicians to deliver increasingly complex, team-based care. Future directions include greater integration of technology-enhanced learning, simulation-based approaches, and global educational networks to support trainees and practitioners across diverse practice settings while strengthening evidence for educational effectiveness.
Attempting to understand quantum claims as describing physical systems leads to well-known difficulties. In this regard, quantum mechanics is like ethics: Attempting to understand moral claims as describing physical systems leads to (different) well-known difficulties. I argue that the quasi-realist strategy for addressing the latter issue can also help with the former. Quasi-realism starts from a nonrepresentationalist understanding of a particular type of claim and proceeds to argue that we can nevertheless recover the roles of those claims in discourse that are typical of realism. I defend a quasi-realist interpretation of quantum mechanics.
This note offers a response to Bakshi’s critical discussion of Schurz’s claim that meta-induction provides a non-circular justification of object-induction (induction at the object-level of events). Bakshi raises two issues: 1. The problem of identifying object-inductive methods, and 2. the problem of determining the pool of simultaneously accessible prediction methods. In this reply, a solution to the identification problem is offered, based on existing work. Concerning the problem of pool-determination, induction-independent criteria are proposed that justify disregarding Goodman-type methods.
A diagnosis code-based algorithm classifies outpatient antibiotic prescribing as almost always (Tier 1), sometimes (Tier 2), and almost never (Tier 3) appropriate. This algorithm has been leveraged to quantify antibiotic appropriateness and direct stewardship initiatives for adults and children, primarily based on Tier 3 encounters receiving antibiotics, but has not been validated.
Objective:
To assess the performance of the algorithm for assessing antibiotic appropriateness in pediatric outpatients.
Methods:
Using a pediatric care network of primary care, urgent care, and emergency departments from January 1–December 31, 2024, encounters were classified into tiers using the ICD10 algorithm. Manual chart review was performed on a stratified random sample of 300 (100 per setting) Tier 3 encounters with antibiotics using a structured protocol derived from local and national guidelines to determine antibiotic appropriateness overall and by location. Survey weights were applied to obtain estimates for all Tier 3 encounters with antibiotic prescriptions. The positive predictive value (PPV) for Tier 3 in identifying inappropriate antibiotic prescribing was calculated.
Results:
Of 272,698 encounters, 115,508 (42%) had an antibiotic prescription. The algorithm classified 10,370 (9%) as Tier 3. In the stratified manual validation sample, 170/300 were classified as appropriate, corresponding to a survey-weighted estimate of 58% appropriate (95% CI, 52%–64%) and a PPV of 42% for Tier 3 as a marker of inappropriate antibiotic use.
Conclusions:
The established algorithm did not reliably predict antibiotic appropriateness in this pediatric outpatient population, demonstrating a need for pediatric-focused algorithms for measuring outpatient antibiotic stewardship.
To evaluate the effect of copper-coated high-touch surfaces on environmental microbial burden and healthcare-associated infection (HAI) rates.
Design:
Observational cohort study over 20 months.
Setting:
Pediatric intensive care and oncology inpatient units in a tertiary care hospital.
Participants:
All patients admitted to rooms with or without copper-coated surfaces.
Exposure:
Spray-on copper coating applied to high-touch surfaces in patient rooms.
Methods:
Patients were admitted to rooms according to routine hospital practices. Demographic and clinical data were collected for a subset of patients admitted to rooms with copper-coated surfaces and matching control rooms. Environmental samples were collected from high-touch surfaces to quantify bacterial colony counts. HAIs were identified via a surveillance database and reported per 10,000 patient days. Poisson regression and negative binomial mixed-effects model were used for analysis.
Results:
Patients in copper-coated rooms were more likely to have an infection on admission (29.7% vs 2.9%; P = .003). Bacterial colony counts trended lower in copper-coated rooms (rate ratio (RR) 0.74, 95% CI 0.50–1.08; P = .11; absolute rate difference −12.25, 95% CI −26.12–2.10), with variability by surface type. HAI rates trended higher in copper-coated rooms compared to control rooms (48.2 vs 30.5 per 10,000 patient days; RR 1.58, 95% CI 0.78–3.20; P = .20).
Conclusions:
Copper-coated surfaces were not associated with statistically significant reductions in microbial burden or HAI rates. Contributing factors may include low baseline microbial load, low baseline HAI rates, variable copper alloy efficacy, short study duration, and differences between patients in intervention and control rooms.
In this paper, we study the appearance of a spanning subdivision of a clique in graphs satisfying certain pseudorandom conditions. Specifically, we show the following results.
(i) There are constants $C\gt 0$ and $c\in (0,1]$ such that, whenever $d/\lambda \ge C$, every $(n,d,\lambda )$-graph contains a spanning subdivision of $K_t$ for all $2\le t \le \min \{cd,c\sqrt {\frac {n}{\log n}}\}$.
(ii) There are constants $C\gt 0$ and $c\in (0,1]$ such that, whenever $d/\lambda \ge C\log ^3n$, every $(n,d,\lambda )$-graph contains a spanning nearly balanced subdivision of $K_t$ for all $2\le t \le \min \{cd,c\sqrt {\frac {n}{\log ^3n}}\}$.
(iii) For every $\mu \gt 0$, there are constants $c,\varepsilon \in (0,1]$ and $n_0\in \mathbb N$ such that, whenever $n\ge n_0$, every $n$-vertex graph with minimum degree at least $\mu n$ and no bipartite holes of size $\varepsilon n$ contains a spanning nearly balanced subdivision of $K_t$ for all $2\le t \le c\sqrt {n}$.
We study random integer-valued Lipschitz functions on regular trees. It was shown by Peled, Samotij, and Yehudayoff [22] that such functions are localized; however, finer questions about the structure of Gibbs measures remain unanswered. Our main result is that the weak limit of a uniformly chosen 1-Lipschitz function with 0 boundary condition on a $d$-ary tree of height $n$ exists as $n \to \infty$ if $2 \le d \le 7$, but not if $d \ge 8$, thereby partially answering a question posed by Peled, Samotij and Yehudayoff. For large $d$, the value at the root alternates between being almost entirely concentrated on 0 for even $n$ and being roughly uniform on $\{-1,0,1\}$ for odd $n$, leading to different limits as $n$ approaches infinity along evens or odds. For $d \ge 8$, the essence of this phenomenon is preserved, which obstructs the convergence. For $d \le 7$, this phenomenon ceases to exist, and the law of the value at the root loses its connection with the parity of $n$. Along the way, we also obtain an alternative proof of localization. The key idea is a fixed point convergence result for a related operator on $\ell ^\infty$ and a procedure to show that the iterations get into a ‘basin of attraction’ of the fixed point. We also prove some accompanying analogous ‘even-odd phenomenon’ type results about $M$-Lipschitz functions on general non-amenable graphs with high enough expansion (this includes for example the large $d$ case for regular trees). We also prove a convergence result for 1-Lipschitz functions with $\{0,1\}$ boundary condition. This last result relies on an absolute value FKG for uniform 1-Lipschitz functions when shifted by $1/2$.
Amid global assaults on higher education, this reflection analyzes a video performance created by Boğaziçi University (Istanbul, Turkey) students during widespread protests against President Erdoğan’s appointment of a loyalist as rector in 2021. Although it disputes the appointment and the subsequent crackdown on campus protest, the performance more directly responds to the punitive and vilifying reaction of the university administration and the government to a campus exhibition that included a controversial artwork juxtaposing Islamic, mythological, and LGBTQ+ imagery. In the video, a small group of pious Muslim and nonpious students share their divergent views on the artwork while presenting a unified voice against the defamatory campaign targeting their peers. Drawing on democratic theoretical accounts of Aristotelian political friendship, I interpret the performance as an experiment in mutual trust and confidence countering Erdoğan’s tyrannical rule, which thrives on distrust and apathy among citizens, as a form of concerted action that finds its strength in difference and disagreement, and as a model for preserving the university as a site where public issues can be debated openly. Envisioning a democratic life grounded in political friendship, the performance, I argue, reasserts universities’ role as laboratories of democracy, preparing students for collective deliberation, negotiation, and reflective judgment.
This article examines how digital misogynistic discourse produces real-world consequences through platform affordances in post-digital conditions. The study focuses on LIHKG, a popular online forum in Hong Kong, where users collectively target female influencers with persistent verbal abuse. Through critical discourse-centred online-offline nexus ethnography (CD-OONE), which builds on established traditions of entextualization and discursive circulation, the study shows how users creatively appropriate platform features for sustaining misogynistic language. Unlike algorithmically mediated social media, LIHKG operates largely through human agency, such as strategic upvoting/downvoting, nested quoting, custom emoji, forum slang, and serial threads. The analysis reveals how these affordances-in-practice amplify and normalize misogynistic discourse strategies on the forum. A case study traces a 5-year aggression cycle targeting one female influencer, drawing on forum threads, the influencer’s own social media posts, and mainstream news coverage to show how forum discourse produces offline reputational damage that recursively triggers additional online attacks. Theoretically, the study extends critical discourse analysis by showing how sociotechnical conditions shape scalar amplification of harmful discourse online and offline. Methodologically, it provides a practical framework for documenting, tracing, and analyzing discourse circulation and the real-world consequences of digital aggression.
This article examines the discursive genealogy of meʿmāri-ye sonnati (traditional architecture), arguing that the term is not a neutral descriptive category but a modern historiographical construct. It traces the concept from nineteenth-century Orientalist surveys, which relied on stylistic classifications rather than notions of tradition, to early twentieth-century narratives of continuity advanced by scholars such as Arthur Upham Pope and André Godard. The study shows how “tradition” was later translated into sonnat in midcentury nationalist debates and consolidated as meʿmāri-ye sonnati in the 1970s. This process flattened diverse architectural histories into a single category that served traditionalist and postrevolutionary ideological agendas. By reconstructing this genealogy, the article challenges retrospective essentialism and restores the historical plurality of Iran’s architectural past.
Children with CHD who have undergone corrective or palliative surgery are at increased risk for developmental delays. One important aspect is the development of emotional intelligence. Although emotional intelligence is not explicitly included in the current neurodevelopmental battery testing, increasing evidence supports the inclusion of it.
Methods:
In this prospective, single-centre, cross-sectional pilot study, we analysed emotional intelligence in a broad spectrum of English-speaking paediatric patients, aged 7 to 17 years old, with a confirmed CHD and without moderate-to-severe developmental delay. We evaluated emotional intelligence using the Bar-On Emotional Quotient Inventory: Youth Version questionnaire, administered parent questionnaires, and reviewed medical records. We determined associations between components of the Emotional Quotient Inventory: Youth Version and pertinent demographic and clinical variables using one-way ANOVA and multivariable regression.
Results:
A total of 67 patients were included in this study; 68.7% underwent cardiac surgery in infancy, 74.2% with cardiopulmonary bypass. Children with greater CHD severity had lower emotional quotient scores, and there was a significant inverse relationship between social vulnerability index scores and emotional quotient scores. Multivariable modelling showed that social vulnerability scores explained 25.1% of emotional quotient total variance. Higher CHD severity, surgical complexity, multiple operations, and higher social vulnerability scores were associated with lower emotional quotient stress and adaptability.
Conclusion:
Emotional intelligence is a modifiable component of developmental progression of children with CHD and can provide a complementary perspective of neurodevelopmental functioning. Addition of the Emotional Quotient Inventory: Youth Version to the battery of testing may be considered.
This study explores how Hijazi Sunnis have strengthened the theoretical development of the Sunni veneration of the Twelve Shiʿi Imams (imamophilism) with a focus on two faḍāʾil works written by the Medinese scholar Shams al-Dīn al-Zarandī (fl. 747/1346): Naẓm Durar al-Simṭayn on ʿAlī and his close family, and Maʿārij al-Wuṣūl on the Twelve Imams. In the Naẓm, a work dedicated to the Injuid ruler of Shiraz, Abū Isḥāq (r. 1343–1357), in 747/1346, Shams al-Dīn adopted a critical stance towards another imamophilic Sunni scholar, Ṣadr al-Dīn al-Ḥammūyī (d. 722/1322), for his inclusion of unreliable traditions and justified Sunni imamophilism by excluding Shiʿi traditions and selectively mentioning famous Sunni sources. In Maʿārij al-Wuṣūl, he also denied the Muḥammad b. al-Ḥasan (the twelfth imam)-Mahdī theory, which is a pivotal doctrine in Twelver Shiʿism, while considering it to be Shiʿi. These two works could be regarded not merely as a first attempt to theorise Sunni imamophilism through the rejection of certain Shiʿi doctrines but also as a by-product of a rivalry between Shams al-Dīn and the Ḥammūyī family, and between the Injuids and the Muẓaffarids. Shams al-Dīn spread imamophilism among the Shirazi population, and his views on the imams influenced later imamophilic Sunnis.
Longer-term outcome and safety data of repeated subcutaneous racemic ketamine for treatment-resistant depression (TRD) is lacking, as is knowledge of the impact of prior ketamine treatment on subsequent response.
Aims
To evaluate the effectiveness and safety of a 4-week course of subcutaneous racemic ketamine over 6 months and investigate whether prior ketamine treatment influences treatment response.
Method
An open label extension (OLE) of a randomised controlled trial (RCT) was conducted at seven mood disorder centres in Australasia, enrolling consenting trial participants who had a Montgomery-Åsberg Depression Rating Scale (MADRS) score of ≥20 at post-trial assessment. Participants initially received twice-weekly 0.5 mg/kg subcutaneous racemic ketamine (fixed regimen) for 4 weeks. Dosing was revised after a Data Safety Monitoring Board recommendation, to a ‘flexible regimen’ (0.5–0.9 mg/kg with response-guided increments). Depression and safety outcomes were assessed throughout treatment, and 4 weeks and 6 months later.
Results
130 RCT participants entered the OLE phase of whom 32 underwent the fixed OLE regimen and 98 the flexible regimen. At treatment end, 30% (36/116) had responded (MADRS reduction ≥50%), and 4 weeks later 17% (19/110) were ‘responders’. Over 50% experienced <25% MADRS reduction. There was no difference in depression response at any time point between regimens. Those treated with ketamine during the RCT showed a transient reduced response after first OLE treatment but at no other assessment point. There were no reports of suicide or suicidal behaviour requiring admission and only expected side-effects observed.
Conclusions
In a highly treatment-resistant sample, a 4-week course of subcutaneous racemic ketamine produced short-term clinical benefit in a minority of participants, with response rates declining substantially after treatment cessation, and no unexpected safety concerns. Exploratory subgroup analyses showed no association between prior RCT ketamine exposure and OLE outcomes.