Search Results (260)

Decision making in critical situations is a complex process. There are many processes to consider. This paper describes a theoretical approach to researching attentional processes and automatic unconscious processes in terms of metacognition. An application of the approach is presented to explain decision making and metacognition as a solution for ineffective cognitive biases during a crisis situation. Evidence is presented from studies on neuropsychology, cognitive control, and cognitive architectures. An application of the recently formulated semiotic methodology is implemented that allows the design of conceptual models of Attention as Action. The formulation of a general model of attentional processes is based on a set of rules. The crisis phenomenon, as the crisis situation trigger, is semiotically described and applied as insight for a crisis information system design that prompts its users toward self-aware internal decision making. The research conducted evidently shows how the approach can explain the design of several cognitive architectures. Pointing toward metacognition as a solution to a crisis phenomenon and cognitive biases, the paper shows that understanding human cognitive and behavioral processes can significantly improve management in a critical infrastructure crisis situation. Full article

The COVID-19 pandemic underscores the need for accurate prognostic tools to predict patient outcomes. This study evaluates the effectiveness of four prominent COVID-19 prediction scores—PAINT, ISARIC4C, CHIS, and COVID-GRAM—at two critical time points: at admission and seven days post-symptom onset, to assess their utility in predicting mortality among hospitalized patients. Conducted at the Clinical Emergency Hospital Pius Brînzeu in Timișoara, this retrospective analysis included adult patients hospitalized with confirmed SARS-CoV-2 infection. Eligible patients had complete data for the scores at both time points. Statistical analysis involved ROC curves and logistic regression to assess the scores’ predictive accuracy for mortality. The study included 215 patients, split into 139 survivors and 76 non-survivors. At admission, the PAINT, ISARIC4C, CHIS, and COVID-GRAM scores significantly differentiated between the survival outcomes (p < 0.0001). The best cutoff values at admission were 6.26 for PAINT, 7.95 for ISARIC4C, 5.58 for CHIS, and 0.63 for COVID-GRAM, corresponding to sensitivities of 85.47%, 80.56%, 88.89%, and 83.33% and specificities of 77.34%, 82.12%, 75.01%, and 78.45%, respectively. By day seven, the cutoff values increased, indicating deteriorating conditions in patients who eventually succumbed to the virus. The hazard ratios at admission for exceeding these cutoffs were significant: PAINT (HR = 3.45), ISARIC4C (HR = 2.89), CHIS (HR = 4.02), and COVID-GRAM (HR = 3.15), highlighting the scores’ abilities to predict severe outcomes. One week post symptom onset, these scores’ predictive values and corresponding hazard ratios increased, further validating their prognostic significance over time. The evaluated COVID-19 prediction scores robustly predict mortality at admission and become more predictive by the seventh day of symptom onset. These findings support the use of these scores in clinical settings to facilitate early identification and intervention for high-risk patients, potentially improving patient outcomes during the ongoing global health crisis. Full article

Coalitional communication is a dwelling amidst non-dominant differences that requires introspective, complex communicative philosophy and practice. My concern is with differentiation in hierarchies. They are understood and shaped by colonial modernity. They are historical logics and practices of settler colonialism, enslavement, and citizenship. My perspective is feminist, decolonial critiques of modern, capitalist social systems. The analysis is grounded in communicative philosophy in intercultural contexts where folks intend justice and equality. For example, in political democracies, localized social alliances actually harm one another being hegemonic by taking routes of familiarity through structures of linguistic and practical cultural systems. Communicative projects of liberation across oppressions (with monologic and single-axis perceptions) tend to miss intersections of our raced and gendered experiences. The result is unintelligibility among us. In this state, one can sense in the body the space of the liminal—with both a communicative impasse and opening. Rather than aligning liberation and domination in the impasse, I describe the creativity of liminal space as a communicative opening. The opening is a recognition of multiplicity and a refusal to assimilate each other’s lived experiences into familiar, complex codes of habituated thought and action. Examining communication hostilities in oppressed–oppressing relations is a necessary condition for coalition. Thus, coalitional communication is a call to engage a full sense of listening to one another as relevant. Ways that decipher codes and signals of resistance come to constitute the project of creating relevant intelligibility together. Praxis as critical, dialectical, and intersectional thinking is part of this method. Full article

Introduction: Systemic lupus erythematosus (SLE) is a multifaceted autoimmune disorder characterized by significant autoantibodies, particularly targeting nuclear antigens. SLE pathogenesis involves genetic, environmental, and hormonal factors. The disease course includes flares and remission and involves various organs. Recent therapeutic progresses, including biologics, have improved management and prognosis, though the long-term impact of novel therapies remains to be determined. Biologics in SLE: Rituximab, the earliest B-cell-oriented biologic, binds CD20 and depletes CD20+ B cells, leading to remission in some SLE patients. Belimumab is a B-cell-activating factor (BAFF) inhibitor with a recent additional indication for lupus nephritis. The CALIBRATE and BLISS-BELIEVE studies investigated combinations of these drugs with conventional therapies, showing varied efficacy. Ocrelizumab and obinutuzumab, newer CD20-oriented SLE therapies, together with ofatumumab and veltuzumab, are also promising. The latest trials highlight their efficacy and safety. Anifrolumab, targeting type-I interferon receptors, was evaluated in the TULIP 1/2 trials. The ongoing TULIP LTE trial supports the long-term safety and efficacy of anifrolumab. Additionally, the IRIS Phase III trial is exploring anifrolumab for lupus nephritis, showing favorable renal responses. Tocilizumab and secukinumab are being assessed for SLE, with mixed outcomes. Several biologics targeting the C5 complement protein, together with immunomodulators and immunotherapeutics, are also under investigation for potential benefits in SLE. Discussion: Biologics in SLE target specific immune components, aiming to improve disease control and reduce the side effects of conventional therapy. However, trial outcomes vary due to factors like inclusion criteria and trial design. Conclusions: Biotechnology progress enables targeted biologic therapies for SLE, reducing disease activity and improving patients’ quality of life. Full article

Background: The COVID-19 pandemic has caused severe health issues worldwide and contributed to huge financial losses. Key comorbidities linked to an increased risk of severe COVID-19 and higher mortality rates include cardio-metabolic disorders such as type 1 and type 2 diabetes mellitus (T1DM and T2DM), atherosclerotic cardiovascular disease, chronic kidney disease, hypertension, heart failure, and obesity. The persistence of symptoms even after the acute phase is over is termed long COVID-19 syndrome. This study aimed to evaluate the relationship between long COVID-19 syndrome and the development of insulin resistance in previously non-diabetic patients. Methods: A prospective observational study was performed on 143 non-diabetic patients who had tested positive for SARS-CoV-2 infection by a PCR test and were hospitalized in our hospital between January 2020 and December 2022. The clinical and para-clinical data at 0, 4, and 12 months of hospital admission for post-COVID-19 infection follow-up was collected and labeled as t0, t4, and t12. Blood glucose, insulin, and C-peptide levels were measured at the beginning and further at 2, 5, 10, and 30 min after the intravenous arginine stimulation test. Similarly, BMI was calculated, and hs-CRP and ESR levels were noted. The results obtained were statistically analyzed. Results: More than one-third (30.7%) of the included patients developed long COVID-19 syndrome. It was found that 75% of patients with long COVID-19 hospitalized in our clinic developed diabetes within a year of acute infection with COVID-19; therefore, it can be said that the presence of long COVID-19 is a major risk for an altered metabolic status, which can cause diabetes. When comparing the glycemia levels (106 mg/dL) with the BMI at t0, t4, and t12 time intervals, the p-values were found to be 0.214, 0.042, and 0.058, respectively. Almost 62% of the patients having BMI > 30 kg/m² were found to have an increase in blood glucose levels at 1 year. Similarly, insulin resistance was noted during this interval. A negative correlation of 0.40 for hsCRP and 0.38 for ESR was noted when compared with acute infection with COVID-19. Conclusions: The association between long COVID-19 and insulin resistance highlights the varied and widespread impacts of SARS-CoV-2 infection. Addressing the complexities of long COVID-19 requires a holistic strategy that encompasses both respiratory and metabolic considerations, which is crucial for enhancing the well-being of those enduring this persistent condition. Full article

Background: Chest pain is one of the most common causes of emergency room visits and also accounts for numerous visits to the family physician’s office or Outpatient Clinics of cardiology or internal medicine. Case Report: Here we present a case of a 48-year-old female patient who presented to our hospital emergency unit but refused hospital admission. She presented in our Outpatient Clinic with a complaint of typical chest pain indicating it to be of coronary origin. A computed tomography (CT) coronary angiography for the evaluation of this chest pain was indicated. While ruling out the coronary origin of this chest pain, we were surprised to have incidentally identified the presence of an esophageal tumor mass that had intimate contact with carina of the trachea. After the diagnosis of esophageal leiomyoma was made and its surgical treatment was performed, the patient was asymptomatic. Approximately one year after the surgical intervention was performed, following the cessation of antiplatelet therapy and statin, the patient returned to our Outpatient Clinic complaining of chest pain again with the same characteristics as previously presented, being terrified by the possibility of the recurrence of the esophageal leiomyoma. Upon resuming investigations, it was proven through coronary angio-CT evaluation that the etiology of the chest pain was indeed coronary this time. However, the patient still refused hospital admission and the performance of percutaneous coronary angiography with the potential implantation of a coronary stent. Conclusions: Chest pain can be due to various underlying pathologies and should not be neglected. A thorough investigation and timely management are key to treating this possible fatal symptom. In our case, the patient presented twice with the complaint of typical chest pain indicating a possible coronary event, but at the first presentation, it was due to esophageal leiomyoma, while a year later, the patient had similar pain, which was indeed this time due to coronary blockage. Hence, it is of utmost importance to think of all possible scenarios and to investigate accordingly, leaving no stone unturned. Full article

In 1914, El Noticiero Sevillano and other Spanish newspapers published a piece about the Cinémhymen, a cinematographic device designed to capture and sell images of prospective wives. This article explores why this advertisement was not considered derogatory and examines the construction of a patriarchy during a time when the term “feminist” was already appearing in the Spanish press. In our methodology, we analyzed the name of the device and the business, both based on the word Hymen, used a bibliographic review of Spanish feminism of those years, and researched the film technology of the time. The Manzano’s pyramid of oppression served us in establishing the control operations underlying the advertisement. Our study reveals the patriarchal principles of Cinémhymen, which stigmatized women once they conformed to the expected role. The objectifying gaze present in Cinémhymen provides insight into the progression of patriarchy in a visual world that subjugates women. The camera could see through the female masquerade (as Joan Rivière explained) and explore the “true” body underneath, the very core of the female (or what is considered to be). In some ways, Cinémhymen serves as a precursor to the current subjugation seen in online pornography and represents a distorted evolution of the panopticon principle as applied to women. Full article

This article is a systematic investigation into the symbolic and sensory metaphors in architectural buildings. It presents definition and differentiation of symbolic (stereotype images) and sensory (architectural experience) metaphors. According to the semiotics model of architecture, they are tested empirically and the results are presented in order to understand their influence in architecture. In this regard, this paper designed a research method and adapted a novel semiotic model to investigate the relationship between sensory metaphors (architectural experience) and symbolic metaphors. The cases included six distinctive buildings and 30 subjects. Results demystified that buildings high in connotative qualities do not always connote positive architectural experience. A building with a high number of symbolic metaphors could create a high number of sensory metaphors but these sensory metaphors may not be necessarily positive feelings and experiences. Full article

This paper is part of a series of research that these authors are conducting to study the linguistic landscape of the Tokyo megacity. In this instance, our focus lies on Shinjuku city. However, our examination does not extend to the linguistic landscape of the city itself; rather, it zeroes in on a café situated at its core, the Café Lavandería. How did Café Lavandería contribute to the development of the Hispanic linguistic, sociolinguistic, and subversive landscape in central Tokyo? The research unfolds in various segments. Initially, contextualization introduces the reader to Tokyo and Shinjuku; subsequently, the significance of Café Lavandería and the subversive social and political movements in Japan are elucidated. Following this, the study’s foundation, including the photographic evidence and corresponding data, is presented. Lastly, an analysis of these data is conducted, culminating in an evaluation of Café Lavandería’s impact in Japan. Full article

Increasing health awareness has led to a rise in household medication storage, but problems of medication waste and expired medication contamination have been highlighted. We conducted in-depth interviews and developed user personas to comprehensively analyse users’ drug storage behaviours and motivations. Using a semiotic approach to product architecture design and the analytic hierarchy process (SAPAD-AHP) model, we explored core user needs. Additionally, we identified improper disposal of expired medication at home as a significant environmental issue. We propose a community-shared medicine service model aimed at reducing medication waste and pollution through sharing and recycling resources. This model enhances the utilisation of medical equipment, offers users convenient and eco-friendly health services, and promotes sustainable development. Full article

This study examines the design and utilization of shared streets in the Jiefangbei Business District of Chongqing through the lens of geographical semiotics. Employing photo content analysis, video observation, and questionnaire surveys, this research delves into visual semiotics, place semiotics, and users’ interaction order, including social interactions and traffic experiences within these shared spaces. The findings reveal that two distinct systems guide pedestrians and vehicles on Jiefangbei’s shared streets, ensuring safety and cultural expression. Paving is identified as the most important method for realizing the sharing of space between people and vehicles. Street furniture emphasizes multifunctional composite use and reflects Jiefangbei’s eclectic style since its era as a financial center of the Republic of China, responding to cultural resources and functional positioning. The study also indicates that social functions and public space attributes need enhancement, recommending more greenery and leisure facilities. Interaction order analysis shows that participants’ perception of street sharing does not affect their sense of safety and effectiveness. Thus, future practice should base decisions on specific traffic conditions and urban functions. A limitation of this study is the inability to accurately sample the population structure of the Jiefangbei commercial district, preventing more adaptable conclusions. The authors suggest viewing shared space as an evolving process and recommend future research on long-term effects and cross-cultural comparative studies to provide valuable insights into global shared-street design. Full article

As government documents, postage stamps are a rich source of information about a government’s policies on a wide range of subjects. In this article, a comparative semiotic analysis of the first seventy-five years of North and South Korean stamps is used to illustrate the similarities and differences in their attitudes towards ‘religion’ and religious practice. A corpus of stamps on a ‘religious’ theme was created for stamps issued by both governments from which a series of themes and motifs was noted. The semiotic analysis of the themes and motifs showed that while on South Korean stamps Buddhist motifs constituted the majority of stamps commemorating cultural history, there were few references to the commemoration of Buddhism itself. The reverse was found to be true for Christianity. Although Christianity was not shown to be a major expression of Korean culture, Christianity itself was commemorated extensively. On North Korean stamps, folklore and Christian motifs predominated as projections of cultural history, but the Christian motifs referred only to foreign cultures, not Korean culture. Motifs relating to the foundation myth of Tan’gun were common to both North and South Korea. However, in the South, motifs from the myth referred to the nation, while in the North they referred to the ruling family. Full article

In this paper I attempt to trace the semiotic path of meaning experience from “nothing” into “something”. Traditional communication studies are problematic in 1. focusing on the message to the effect of ignoring the communicators; 2. choosing to overlook how yet-to-be signs acquire meanings in the communicative moments; and 3. tending to assume a “natural science” attitude toward the studied phenomenon so that embodied consciousness is either sidetracked or psychologized. Taking communicology as both the theory and methodology, I first describe the semiotic network in which blank paper, a nonconventional sign, acquires its signness in a specified communicative event. Then, I look inward to the relation of consciousness and embodiment. Finally, I argue that communication is such a life-world moment wherein non-expression is collectively constituted as a form of expression. Full article

Living systems (LSs) must solve the problem of adapting to their environment by identifying external states and acting appropriately to maintain external relationships and internal order for survival and reproduction. This challenge is akin to the philosophical enigma of how the self can escape solipsism. In this study, a comprehensive model is developed to address the adaptation problem. LSs are composed of material entities capable of detecting their external states. This detection is conceptualized as “cognition”, a state change in relation to its external states. This study extends the concept of cognition to include three hierarchical levels of the world: physical, chemical, and semiotic cognitions, with semiotic cognition being closest to the conventional meaning of cognition. This radical extension of the cognition concept to all levels of the world provides a monistic model named the cognizers system model, in which mind and matter are unified as a single entity, the “cognizer”. During evolution, LSs invented semiotic cognition based on physical and chemical cognitions to manage the probability distribution of events that occur to them. This study proposes a theoretical model in which semiotic cognition is an adaptive process wherein the inverse causality operation produces particular internal states as symbols that signify hidden external states. This operation makes LSs aware of the external world. Full article

The study of linguistic landscapes (LL) examines the use of signage in public spaces, often with a focus on the use of non-majority languages. The main goals of this project are to map, quantify, and analyze signage in Spanish within Tuscaloosa County, AL, an emerging site of Spanish language use which differs from the large urban places often studied in the LL literature. Photographs of public signage in Spanish were taken and uploaded to an ArcGIS Field Maps app to allow for both geolocation of the image and tagging of the image for specific linguistic and visual characteristics, which are subsumed under multimodality. Multimodality refers to the interaction of the linguistic code with other modes of communication such as images, colors, flags, and other cultural objects to make meaning in a given LL text. Within the multimodality framework, we examine the use of Spanish by itself or with English, location of the signage, communicative functions (symbolic, informative), and the combination of multimodal resources to index the actors originating the text and their intended audience. Full article