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The purpose of this study is to explore the strategies deployed by managers in organisations to legitimate their intuitions. Managerial practice is a continual process of emergence and integration of problems and projects, and by which managers navigate a complex world. To do so, they rely partly on their intuitions, whose effectiveness has largely been demonstrated in the literature. However, the rational model is still considered the optimal cognition and decision-making process in organisations. The persistence of the myth of rationality compels managers to deploy strategies to legitimate their intuitions. But these strategies are poorly understood. The aim of this study therefore was to describe them. For this purpose, we collected 191 accounts of episodes where managers legitimated their intuitions. Our analysis of these accounts revealed seven intuition legitimation strategies. Some of these strategies had not previously been identified in the institutional literature (personalisation, transparency, exploration and compound strategy). For others which had already been partly described (rationalisation, manipulation and relational strategy), we show that managers deploy new modes. These results contribute to the knowledge of legitimation strategies from a conceptual point of view. They also shed some light on the mistrust of intuition that still prevails in organisations, despite its importance.

Objectives: To examine the changes in diagnostic practices and clinical management of patients with 5α-reductase type 2 (SRD5A2) or 17β-hydroxysteroid dehydrogenase type 3 (HSD17B3) deficiency since molecular diagnoses became available. Methods: Clinical, laboratory, and therapeutic data were retrieved from the medical records of 52 patients with a molecular diagnosis of SRD5A2 (n = 31) or HSD17B3 (n = 21) deficiency. Temporal trends regarding age at assessment and initial sex assignment over 1994–2020 were qualitatively analyzed. Age at molecular diagnosis was compared between two subgroups of patients according to their year of birth. Results: Fifty-eight percent (n = 30) patients were diagnosed during the perinatal period, 33% (n = 17) during infancy, and 9% (n = 5) during adolescence or adulthood. Over the studied period, the patients’ age at initial assessment and diagnosis frankly decreased. The median (range) age at diagnostic confirmation was 10.5 (0–53.2) years for patients born before 2007 and 0.4 (0–9.3) years for those born in 2007 or later (P = 0.029). Genetic testing identified 27 different variants for the SRD5A2 gene (30% novel, n = 8) and 18 for the HSD17B3 gene (44% novel, n = 8). Before 2002, most patients were initially assigned as females (95%, n = 19), but this proportion dropped for those born later (44%, n = 14; P < 0.001). The influence of initial genital appearance on these decisions seemingly decreased in the most recent years. Therapeutic interventions differed according to the sex of rearing. Ten percent (n = 2) patients requested female-to-male reassignment during adulthood. Conclusion: This study showed, over the past two decades, a clear trend toward earlier diagnosis and assignment of affected newborns as males.

A valid, practical, and effective cartoon-based learning media on liquid pressure material has been developed by employing the Powtoon application and using Four-D (4D) stages. Expert validity and empirical validityof the media achieved an average score of 3.94 and 3.84 respectively with very valid criteria. The test instrument validity score was 3.37 with valid criteria. Supporting data for implementation is obtained using several instruments. The learning implementation observation sheet is used to observe teacher activity in the classroom; student responses were collected through questionnaires; and student activity is observed through the observation sheet. The practicality quality of teaching materials is obtained a percentage of 100% with very good criteria. The student responses to indicators of learning motivation with a percentage of 86.7%, indicators of ease and satisfaction of learning with a percentage of 84.7, learning innovation indicators with a percentage of 87.8%, and learning achievement indicators with a percentage of 89.2%. The effectiveness of the teaching material was obtained from observing student activities with a percentage of 86% in meeting I and of 88.7%% in meeting II. The student’s competency C2 (describing) achieve a percentage of 88.7%, C3 (applying) with a percentage of 81.75%, C4 (analyzing) with a percentage of 93.25%, and C5 (proving) with a percentage of 73%, all in good criteria. Learning outcomes in classical completeness obtains a percentage of 93.3%. It can be concluded that learning media in the form of teaching materials using the Powtoon application has the potential to increase students' understanding of concepts.

Abstract Renal pelvis dilatation (RPD) is diagnosed in utero on prenatal ultrasonography (US) and can resolve spontaneously. However, isolated RPD can also reflect ureteropelvic junction obstruction (UPJO), which requires surgical treatment to prevent progressive renal deterioration. The diagnosis of UPJO can only be confirmed after birth with repeat US and renal isotope studies. 1H Nuclear Magnetic Resonance spectroscopy (NMR) was performed on urine of newborns with prenatally diagnosed unilateral RPD and healthy controls to identify specific urinary biomarkers for UPJO. The original combination of EigenMS normalization and sparse partial-least-squares discriminant analysis improved selectivity and sensitivity. In total, 140 urine samples from newborns were processed and 100 metabolites were identified. Correlation network identified discriminant metabolites in lower concentrations in UPJO patients. Two main metabolic pathways appeared to be impaired in patients with UPJO i.e. amino acid and betaine metabolism. In this prospective study, metabolic profiling of urine samples by NMR clearly distinguishes patients who required surgery for UPJO from patients with transient dilatations and controls. This study will pave the way for the use of metabolomics for the diagnosis of prenatal hydronephrosis in clinical routine.

O acaso é matéria-prima para um fotógrafo na captação das cenas que surgem diante de suas lentes. Resultado de técnicas, conceitos, preceitos e repertório, algumas dessas fotografias remontam à sobrevida de imagens prévias que perduram ao longo de séculos e, tal como fantasmagorias, assombram seus produtores e seus espectadores. Ao discorrer sobre fotografia contemporânea e as imagens do fotógrafo Pedro Martinelli, este artigo faz ecoar o diálogo constante entre acaso, memória e Nachleben.

Background: Complete androgen insensitivity syndrome (CAIS) is a congenital condition caused by genetic defects in the androgen receptor (AR) gene located on the X chromosome, which lead to a phenotypical female individual with a 46, XY karyotype. Early diagnosis of CAIS is essential for proper clinical management, allows assessment of familial risk and contributes to healthcare decisions. However, diagnosis of CAIS can be overlooked in girls with inguinal hernia, resulting in inappropriate management. Methods: Five female patients from three unrelated families presented to our genetic clinic with primary amenorrhea. Each patient had been diagnosed with inguinal hernia in childhood and had undergone hernia repair without further investigation into what was contained in the hernial sac. We carried out physical examination, cytogenetic studies, hormonal evaluation, and molecular analysis to establish a comprehensive diagnosis. Family history and pedigree were collated to identify at-risk family members. Results: All patients presented with female external genitalia. Cytogenetic studies revealed a 46, XY karyotype and hormonal analysis suggested a diagnosis of CAIS. Sequencing of the AR gene in all patients and suspected family members revealed pathogenic variants in the AR gene and confirmed the molecular diagnosis of CAIS. Conclusions: We report the delayed diagnosis of CAIS in female Indonesian patients with a history of inguinal hernia in childhood. An early diagnosis of CAIS is essential for appropriate clinical management, as well as assessing familial risk. Increasing awareness among clinicians is paramount, and we encourage a CAIS diagnosis to be considered in any patient presenting with female appearance and inguinal hernia.

Periodontal tissue is tissue that surrounds the teeth and functions to keep the teeth in place. Various examinations can be carried out to determine the condition of the periodontal tissue, such as gingival index, bleeding on probing (BOP), and probing depth. In general, periodontal disease can be caused by 2 factors: local and systemic. One example of periodontal disease caused by systemic factors is infection with a disease or due to the influence of systemic treatment. COVID-19 is a family of coronaviridae viruses and severe acute respiratory syndrome discovered in December 2019 in Wuhan, Hubei Province, China. Transmission of this virus initially came from animals to humans (zoonosis) and then occurred on a large scale between humans. Various measures to prevent transmission and increase the severity of COVID-19 infection have been implemented, including the COVID-19 vaccination program. To determine the picture of the periodontal tissue of patients at RSGMP Soelastri Surakarta after COVID-19 vaccination. This study used research subjects, namely RSGMP Soelastri Surakarta patients who had received at least 1 dose of vaccine, and the research data were analyzed using Microsoft Excel. There were images in the periodontal tissue of patients after COVID-19 vaccination in the form of probing depth in 26 respondents and bleeding on probing in 38 respondents. Based on the results of the research and discussion above, it can be concluded that there is a picture of periodontal tissue in the form of bleeding on positive probing for bleeding in patients at RSGMP Soelastri Surakarta after 3 doses of COVID-19 vaccination with the AstraZeneca vaccine. [ABSTRACT FROM AUTHOR]

The achievement of the targets for reducing greenhouse gas emissions set by the Paris Agreements and the Swiss federal law on the reduction of greenhouse gas emissions (CO2 law) requires massive use of renewable energies, which cannot be achieved without their adoption by the general public. The solar cadaster developed as part of the INTERREG G2 Solar project is intended to assess the solar potential of buildings at the scale of Greater Geneva—for both industrial buildings and for individual residential buildings—at a resolution of 1 m. The new version of the solar cadaster is intended to assess the solar potential of roofs, as well as that of vertical facades. The study presented here aims to validate this new version through a comparison with results obtained with two other simulation tools that are widely used and validated by the scientific community. The good accordance with the results obtained with ENVI-met and DIVA-for-Rhino demonstrates the capability of the radiative model developed for the solar cadaster of Greater Geneva to accurately predict the radiation levels of building facades in configurations with randomly distributed buildings (horizontally or vertically).