Search results for: narrative history
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3212

Search results for: narrative history

2192 Spontaneous Rupture of Splenic Artery Pseudoaneurysm; A Rare Presentation of Acute Abdominal Pain in the Emergency Department: Case Report

Authors: Zainab Elazab, Azhar Aziz

Abstract:

Background: Spontaneous Splenic artery pseudoaneurysm rupture is a rare condition which is potentially life threatening, if not detected and managed early. We report a case of abdominal pain with intraperitoneal free fluid, which turned out to be spontaneous rupture of a splenic artery pseudoaneurysm, and was treated with arterial embolization. Case presentation: A 28-year old, previously healthy male presented to the ED with a history of sudden onset upper abdominal pain and fainting attack. The patient denied any history of trauma or prior similar attacks. On examination, the patient had tachycardia and a low-normal BP (HR 110, BP 106/66) but his other vital signs were normal (Temp. 37.2, RR 18 and SpO2 100%). His abdomen was initially soft with mild tenderness in the upper region. Blood tests showed leukocytosis of 12.3 X109/L, Hb of 12.6 g/dl and lactic acid of 5.9 mmol/L. Ultrasound showed trace of free fluid in the perihepatic and perisplenic areas, and a splenic hypoechoic lesion. The patient remained stable; however, his abdomen became increasingly tender with guarding. We made a provisional diagnosis of a perforated viscus and the patient was started on IV fluids and IV antibiotics. An erect abdominal x-ray did not show any free air under the diaphragm so a CT abdomen was requested. Meanwhile, bedside ultrasound was repeated which showed increased amount of free fluid, suggesting intra-abdominal bleeding as the most probable etiology for the condition. His CT abdomen revealed a splenic injury with multiple lacerations, a focal intrasplenic enhancing area on venous phase scan (suggesting a pseudoaneurysm with associated splenic intraparenchymal, sub capsular and perisplenic hematomas). Free fluid in the subhepatic and intraperitoneal regions along the small bowel was also detected. Angiogram was done which confirmed a diagnosis of pseudoaneurysm of intrasplenic arterial branch, and angio-embolization was done to control the bleeding. The patient was later discharged in good condition with a surgery follow-up. Conclusion: Splenic artery pseudoaneurysm rupture is a rare cause of abdominal pain which should be considered in any case of abdominal pain with intraperitoneal bleeding. Early management is crucial as it carries a high mortality. Bedside ultrasound is a useful tool to help for early diagnosis of such cases.

Keywords: abdominal pain, pseudo aneurysm, rupture, splenic artery

Procedia PDF Downloads 308
2191 The Agency of Black Women Professors in Higher Education: A Critical Consciousness Perspective

Authors: Ncamisile T. Zulu, Nicholas Munro

Abstract:

Black women academics in higher education institutions are predominantly portrayed by literature as individuals who usually lack a sense of belonging, progression, and workload management. The oversaturation of this literature can (overtime) perpetuate a stereotypical idea that Black women academics are incapable of coping and succeeding in higher education institutions. The current article explores the agency, motivated by critical consciousness that Black women professors have and utilise in higher education institutions. In order to provide an understanding of how Black women academics can progress, manage their workloads and succeed in higher education institutions, the article considers how these women can take responsibility for their self-development, adaptation, and self-renewal in academic endeavours. As a result, the article presents a line of thought which could help in challenging the stereotype about Black women academics. The study was conducted at two higher education institutions involving Black women professors from different disciplines. A combination of purposive and snowballing sampling was used to recruit nine women participants, while data were collected through interviews. A critical consciousness perspective was adopted to formulate an understanding of the agency of Black women professors in higher education institutions, while thematic analysis was used to analyse the data. The results challenge the widely disseminated view that portrays Black women academics as incapable of coping and succeeding in higher education institutions. The findings highlight Black women professors as proactive, flexible, and self-regulating in their academic endeavours. These findings contribute to the literature by adding a more constructive narrative of Black women academics in higher education.

Keywords: agency, Black women academics, critical consciousness, higher education institutions

Procedia PDF Downloads 154
2190 Just a Heads Up: Approach to Head Shape Abnormalities

Authors: Noreen Pulte

Abstract:

Prior to the 'Back to Sleep' Campaign in 1992, 1 of every 300 infants seen by Advanced Practice Providers had plagiocephaly. Insufficient attention is given to plagiocephaly and brachycephaly diagnoses in practice and pediatric education. In this talk, Nurse Practitioners and Pediatric Providers will be able to: (1) identify red flags associated with head shape abnormalities, (2) learn techniques they can teach parents to prevent head shape abnormalities, and (3) differentiate between plagiocephaly, brachycephaly, and craniosynostosis. The presenter is a Primary Care Pediatric Nurse Practitioner at Ann & Robert H. Lurie Children's Hospital of Chicago and the primary provider for its head shape abnormality clinics. She will help participants translate key information obtained from birth history, review of systems, and developmental history to understand risk factors for head shape abnormalities and progression of deformities. Synostotic and non-synostotic head shapes will be explained to help participants differentiate plagiocephaly and brachycephaly from synostotic head shapes. This knowledge is critical for the prompt referral of infants with craniosynostosis for surgical evaluation and correction. Rapid referral for craniosynostosis can possibly direct the patient to a minimally invasive surgical procedure versus a craniectomy. As for plagiocephaly and brachycephaly, this timely referral can also aid in a physical therapy referral if necessitated, which treats torticollis and aids in improving head shape. A well-timed referral to a head shape clinic can possibly eliminate the need for a helmet and/or minimize the time in a helmet. Practitioners will learn the importance of obtaining head measurements using calipers. The presenter will explain head calculations and how the calculations are interpreted to determine the severity of the head shape abnormalities. Severity defines the treatment plan. Participants will learn when to refer patients to a head shape abnormality clinic and techniques they should teach parents to perform while waiting for the referral appointment. The purpose, mechanics, and logistics of helmet therapy, including optimal time to initiate helmet therapy, recommended helmet wear-time, and tips for helmet therapy compliance, will be described. Case scenarios will be incorporated into the presenter's presentation to support learning. The salient points of the case studies will be explained and discussed. Practitioners will be able to immediately translate the knowledge and skills gained in this presentation into their clinical practice.

Keywords: plagiocephaly, brachycephaly, craniosynostosis, red flags

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2189 Western Culture Differences and the Contradictions in the Islamic World

Authors: Shabnam Dadparvar, Laijin Shen, Farzad Ravanbod

Abstract:

Regarding the issues that are currently happening in the world, more than any other time the differences between West and Islam is under discussion. The cultural relations between Islam and the West took a drastically new turn when Europe arose as the dominant and unchallenged force of the modern era. The author, by using descriptive- analytical method, tries to analyse one of the most controversial questions facing analysts of relations between the Islamic world and the West: What are the roots of the conflict? This paper addresses the history of the intellectual tradition of the West and the attitude of Muslim world regarding the rise of western modernity. Also, the differences between two groups on philosophical foundations such as religion, power, science and humanism will be explained. The author believes that the real difference between the West and Islam is epistemological.

Keywords: civilization, culture, Islam, West

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2188 Sustainable Concepts Applied in the Pre-Columbian Andean Architecture in Southern Ecuador

Authors: Diego Espinoza-Piedra, David Duran

Abstract:

All architectural and land use processes are framed in a cultural, social and geographical context. The present study analyzes the Andean culture before the Spanish conquest in southern Ecuador, in the province of Azuay. This area has been habited for more than 10.000 years. The Canari and the Inca cultures occupied Azuay close to the arrival of the Spanish conquers. The Inca culture was settled in the Andes Mountains. The Canari culture was established in the south of Ecuador, on the actual provinces of Azuay and Canar. In contrast with history and archeology, to the best of our knowledge, their architecture has not yet been studied in this area because of the lack of architectural structures. Consequently, the present research reviewed the land use and culture for architectonic interpretations. The two main architectural objects in these cultures were dwellings and public buildings. In the first case, housing was conceived as temporary. It had to stand as long as its inhabitants lived. Therefore, houses were built when a couple got married. The whole community started the construction through the so-called ‘minga’ or collective work. The construction materials were tree branches, reeds, agave, ground, and straw. So that when their owners aged and then died, this house was easily disarmed and overthrown. Their materials become part of the land for agriculture. Finally, this cycle was repeated indefinitely. In the second case, the buildings, which we can call public, have presented erroneous interpretations. They have been defined as temples. But according to our conclusions, they were places for temporary accommodation, storage of objects and products, and in some special cases, even astronomical observatories. These public buildings were settled along the important road system called ‘Capac-Nam’, currently declared by UNESCO as World Cultural Heritage. The buildings had different scales at regular distances. Also, they were established in special or strategic places, which constituted a system of observatories. These observatories allowed to determine the cycles or calendars (solar or lunar) necessary for the agricultural production, as well as other natural phenomena. Most of the current minimal existence of physical structures in quantity and state of conservation is at the level of foundations or pieces of walls. Therefore, this study was realized after the identification of the history and culture of the inhabitants of this Andean region.

Keywords: Andean, pre-Colombian architecture, Southern Ecuador, sustainable

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2187 Fashion Performing/Fashioning Performances: Catwalks as Communication Tools between Market, Branding and Performing Art

Authors: V. Linfante

Abstract:

Catwalks are one of the key moments in fashion: the first and most relevant display where brands stage their collections, products, ideas, and style. The garment is 'the star' of the catwalk and must show itself not just as a product but as a result of a design process endured for several months. All contents developed within this process become ingredients for connecting scenography, music, lights, and direction into a unique fashion narrative. According to the spirit of different ages, fashion shows have been transformed and shaped into peculiar formats: from Pandoras to presentations organized by Parisian couturiers, across the 'marathons' typical of the beginning of modern fashion system, coming up to the present structure of fashion weeks, with their complex organization and related creative and technical businesses. The paper intends to introduce the evolution of the fashion system through its unique process of seasonally staging and showing its production. The paper intends to analyse the evolution of the fashion shows from the intimacy of ballrooms at the beginning of the 20th century, passing through the enthusiasm attitude typical from the '70s and the '80s, to finally depict our present. In this last scenario, catwalks are not anymore a standard collections presentation but become one of the most exciting expression of contemporary culture (and sub-cultures), going from sophisticated performances (as Karl Lagerfeld's Chanel shows) to real artistic happenings (as the events of Victor&Rolf, Alexander McQueen, OFF_WHITE, Vetements, and Martin Margiela), often involving contemporary architecture, digital world, technology, social media, performing art and artists.

Keywords: branding, communication, fashion, new media, performing art

Procedia PDF Downloads 149
2186 Chronic Progressive External Ophthalmoplegia (CPEO)

Authors: Gagandeep Singh Digra, Pawan Kumar, Mandeep Kaur Sidhu

Abstract:

INTRODUCTION: Chronic Progressive External Ophthalmoplegia (CPEO), also known as Progressive External Ophthalmoplegia (PEO), is a type of eye disorder characterized by a loss of the muscle functions involved in eye and eyelid movement. CPEO can be caused by mutations in mitochondrial DNA. It typically manifests in young adults with bilateral and progressive ptosis as the most common presentation but can also present with difficulty swallowing (dysphagia) and general weakness of the skeletal muscles (myopathy), particularly in the neck, arms, or legs. CASE PRESENTATION: This is a case discussion of 3 cousins who presented to our clinic. A 23-year-old male with past surgical history (PSH) of ptosis repair 2 years ago presented with a chief complaint of nasal intonation for 1.5 years associated with difficulty swallowing. The patient also complained of nasal regurgitation of liquids. He denied any headaches, fever, seizures, weakness of arms or legs, urinary complaints or changes in bowel habits. Physical Examination was positive for facial muscle weakness, including an inability to lift eyebrows (Frontalis), inability to close eyes tightly (Orbicularis Oculi), corneal reflex absent bilaterally, difficulty clenching jaw (Masseter muscle), difficulty smiling (Zygomaticus major), inability to elevate upper lip (Zygomaticus minor). Another cousin of the first patient, a 25-year-old male with no past medical history, presented with complaints of nasal intonation for 2 years associated with difficulty swallowing. He denied a history of nasal regurgitation, headaches, fever, seizures, weakness, urinary complaints or changes in bowel habits. Physical Examination showed facial muscle weakness of the Frontalis muscle, Orbicularis Oculi muscle, Masseter Muscle, Zygomaticus Major, Zygomaticus Minor and absent corneal reflexes. A 28-year-old male, a cousin of the first two patients, presented with chief complaints of ptosis and nasal intonation for the last 8 years. He also complained of difficulty swallowing and nasal regurgitation of liquids. His physical examination showed facial muscle weakness, including frontalis muscle (inability to lift eyebrows), Orbicularis Oculi (inability to close eyes tightly), absent corneal reflexes bilaterally, Zygomaticus Major (difficulty smiling), and Zygomaticus Minor (inability to elevate upper lip). MRI brain and visual field of all the patients were normal. Differential diagnoses, including Grave’s disease, Myasthenia Gravis and Glioma, were ruled out. Due to financial reasons, muscle biopsy could not be pursued. Pedigree analysis revealed only males were affected, likely due to maternal inheritance, so the clinical diagnosis of CPEO was made. The patients underwent symptomatic management, including ptosis surgical correction for the third patient. CONCLUSION: Chronic Progressive External Ophthalmoplegia (CPEO), a rare case entity, occurs in young adults as a manifestation of mitochondrial myopathy. There are three modes of transmission- maternal transmission associated with mitochondrial point mutations, autosomal recessive, and autosomal dominant. CPEO can sometimes be difficult to diagnose, especially in asymmetric presentation. Therefore, it is crucial to keep it in differential diagnosis to avoid delay in diagnosis.

Keywords: neurology, chronic, progressive, ophthalmoplegia

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2185 The Influence of Wealth on the Enjoyment of Role and Status of the Rural Elderly in Bangladesh

Authors: Aminul Islam

Abstract:

The issue of aging is now an emerging aspect of all over the world. Both the rural and urban societies of our country are not immune from this problem. This study mainly explored the influence of wealth on the enjoyment of role and status of the elderly in rural Bangladesh. It is based on empirical findings from the four villages of Gopalnagar union of Dhunat upazila of Bogra district. The study depicted that wealth has much influence regarding the enjoyment of role and status. Mixed approach has been given priority in this study. Survey, observation, case study and life history methods and focus group discussion technique have also been used in this study. Data have been collected from both primary and secondary sources. Simple random sampling procedure has also been followed in this study.

Keywords: wealth, role status, elderly

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2184 Algerian EFL Students' Perceptions towards the Development of Writing through Weblog Storytelling

Authors: Nawel Mansouri

Abstract:

Weblog as a form of internet-based resources has become popular as an authentic and constructive learning tool, especially in the language classroom. This research explores the use of weblog storytelling as a pedagogical tool to develop Algerian EFL students’ creative writing. This study aims to investigate the effectiveness of weblog- writing and the attitudes of both Algerian EFL students and teachers towards weblog storytelling. It also seeks to explore the potential benefits and problems that may affect the use of weblog and investigate the possible solutions to overcome the problems encountered. The research work relies on a mixed-method approach which combines both qualitative and quantitative methods. A questionnaire will be applied to both EFL teachers and students as a means to obtain preliminary data. Interviews will be integrated in accordance with the primary data that will be gathered from the questionnaire with the aim of validating its accuracy or as a strategy to follow up any unexpected results. An intervention will take place on the integration of weblog- writing among 15 Algerian EFL students for a period of two months where students are required to write five narrative essays about their personal experiences, give feedback through the use of a rubric to two or three of their peers, and edit their work based on the feedback. After completion, questionnaires and interviews will also take place as a medium to obtain both the students’ perspectives towards the use of weblog as an innovative teaching approach. This study is interesting because weblog storytelling has recently been emerged as a new form of digital communication and it is a new concept within Algerian context. Furthermore, the students will not just develop their writing skill through weblog storytelling but it can also serve as a tool to develop students’ critical thinking, creativity, and autonomy.

Keywords: Weblog writing, EFL writing, EFL learners' attitudes, EFL teachers' views

Procedia PDF Downloads 173
2183 Understanding the Popularity of Historical Conservation in China: The Depoliticized Narratives as a Counter-Insurgency Strategy in Guangzhou

Authors: Luxi Chen

Abstract:

The land finance in China in recent years has propelled urban renewals in the name of historical conservation and led to massive gentrification and compulsory relocation. Such inequalities cause insurgence. Drawing on public planning information, ethnographic field notes, and online interview data about Guangzhou's Enninglu Area, this paper aims to present how such insurgence has been contained and put down gradually through depoliticization narratives represented by "improving living conditions," "conserving historical culture," and "public participation”. This paper's findings include that 1) Besides economic growth, maintaining social stability in alignment with the central government are equally important to local government, reveals the latter efforts to mediate the growth coalition, residents, media, and academics so as to reconstruct the interface between state and society; 2) To empower the insurgence, the media and academics use public interests for propaganda, that diverts attention away from its political dimension; 3) In response, the government introduces improved regulations and planning, turning social inequalities into technical inadequacy so as to become the defender of public interests, which justifies the incoming renewal and prevents public questioning. By comparing regime changes among governments, developers, residents, media, and academics caused by renewal policies, this paper presents the depoliticized narrative as a counter-insurgence strategy to contain social conflicts and to boost inner-city renewal.

Keywords: inner city renewal, depoliticization, historical conservation, public participation

Procedia PDF Downloads 235
2182 Safety Evaluation of Intramuscular Administration of Zuprevo® Compared to Draxxin® in the Treatment of Swine Respiratory Disease at Weaning Age

Authors: Josine Beek, S. Agten, R. Del Pozo, B. Balis

Abstract:

The objective of the present study was to compare the safety of intramuscular administration of Zuprevo® (tildipirosin, 40 mg/mL) with Draxxin® (tulathromycin, 100 mg/mL) in the treatment of swine respiratory disease at weaning age. The trial was carried out in two farrow-to-finish farms with 300 sows (farm A) and 500 sows (farm B) in a batch-production system. Farm A had no history of respiratory problems, whereas farm B had a history of respiratory outbreaks with increased mortality ( > 2%) in the nursery. Both farms were positive to Pasteurella multocida, Bordetella bronchiseptica, Actinobacillus pleuropneumoniae and Haemophilus parasuis. From each farm, one batch of piglets was included (farm A: 644 piglets; farm B: 963 piglets). One day before weaning (day 0; 18-21 days of age), piglets were identified by an individual ear tag and randomly assigned to a treatment group. At day 0, Group 1 was treated with a single intramuscular injection with Zuprevo® (tildipirosin, 40 mg/mL; 1 mL/10 kg) and group 2 with Draxxin® (tulathromycin, 100 mg/mL; 1 mL/40 kg). For practical reasons, dosage of the product was adjusted according to three weight categories: < 4 kg, 4-6 kg and > 6 kg. Within each farm, piglets of both groups were comingled at weaning and subsequently managed and located in the same facilities and with identical environmental conditions. Our study involved the period from day 0 until 10 weeks of age. Safety of treatment was evaluated by 1) visual examination for signs of discomfort directly after treatment and after 15 min, 1 h and 24 h and 2) mortality rate within 24 h after treatment. Efficacy of treatment was evaluated based on mortality rate from day 0 until 10 weeks of age. Each piglet that died during the study period was necropsied by the herd veterinarian to determine the probable cause of death. Data were analyzed using binary logistic regression and differences were considered significant if p < 0.05. The pig was the experimental unit. In total, 848 piglets were treated with tildipirosin and 759 piglets with tulathromycin. In farm A, one piglet with retarded growth ( < 1 kg at 18 days of age) showed an adverse reaction after injection of tildipirosin: lateral recumbence and dullness for ± 30 sec. The piglet recovered after 1-2 min. This adverse reaction was probably due to overdosing (12 mg/kg). No adverse effect of treatment was observed in any other piglet. There was no mortality within 24 h after treatment. No significant difference was found in mortality rate between both groups from day 0 until 10 weeks of age. In farm A, overall mortality rate was 0.3% (2/644). In farm B, mortality rate was 0.2% (1/502) in group 1 (tildipirosin) and 0.9% (4/461) in group 2 (tulathromycin)(p=0.60). The necropsy of piglets that died during the study period revealed no macroscopic lesions of the respiratory tract. In conclusion, Zuprevo® (tildipirosin, 40 mg/mL) was shown to be a safe and efficacious alternative to Draxxin® (tulathromycin, 100 mg/mL) for the early treatment of swine respiratory disease at weaning age.

Keywords: antibiotic treatment, safety, swine respiratory disease, tildipirosin

Procedia PDF Downloads 394
2181 Left Atrial Appendage Occlusion vs Oral Anticoagulants in Atrial Fibrillation and Coronary Stenting. The DESAFIO Registry

Authors: José Ramón López-Mínguez, Estrella Suárez-Corchuelo, Sergio López-Tejero, Luis Nombela-Franco, Xavier Freixa-Rofastes, Guillermo Bastos-Fernández, Xavier Millán-Álvarez, Raúl Moreno-Gómez, José Antonio Fernández-Díaz, Ignacio Amat-Santos, Tomás Benito-González, Fernando Alfonso-Manterola, Pablo Salinas-Sanguino, Pedro Cepas-Guillén, Dabit Arzamendi, Ignacio Cruz-González, Juan Manuel Nogales-Asensio

Abstract:

Background and objectives: The treatment of patients with non-valvular atrial fibrillation (NVAF) who need coronary stenting is challenging. The objective of the study was to determine whether left atrial appendage occlusion (LAAO) could be a feasible option and benefit these patients. To this end, we studied the impact of LAAO plus antiplatelet drugs vs oral anticoagulants (OAC) (including direct OAC) plus antiplatelet drugs in these patients’ long-term outcomes. Methods: The results of 207 consecutive patients with NVAF who underwent coronary stenting were analyzed. A total of 146 patients were treated with OAC (75 with acenocoumarol, 71 with direct OAC) while 61 underwent LAAO. The median follow-up was 35 months. Patients also received antiplatelet therapy as prescribed by their cardiologist. The study received the proper ethical oversight. Results: Age (mean 75.7 years), and the past medical history of stroke were similar in both groups. However, the LAAO group had more unfavorable characteristics (history of coronary artery disease [CHA2DS2-VASc], and significant bleeding [BARC ≥ 2] and HAS-BLED). The occurrence of major adverse events (death, stroke/transient ischemic events, major bleeding) and major cardiovascular events (cardiac death, stroke/transient ischemic attack, and myocardial infarction) were significantly higher in the OAC group compared to the LAAO group: 19.75% vs 9.06% (HR, 2.18; P = .008) and 6.37% vs 1.91% (HR, 3.34; P = .037), respectively. Conclusions: In patients with NVAF undergoing coronary stenting, LAAO plus antiplatelet therapy produced better long-term outcomes compared to treatment with OAC plus antiplatelet therapy despite the unfavorable baseline characteristics of the LAAO group.

Keywords: stents, atrial fibrillation, anticoagulants, left atrial appendage occlusion

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2180 Forecasting of Innovative Development of Kondratiev-Schumpeter’s Economic Cycles

Authors: Alexander Gretchenko, Liudmila Goncharenko, Sergey Sybachin

Abstract:

This article summarizes the history of the discovery of N.D. Kondratiev of large cycles of economic conditions, as well as the creation and justification of the theory of innovation-cyclical economic development of Kondratiev-Schumpeter. An analysis of it in modern conditions is providing. The main conclusion in this article is that in general terms today it can be argued that the Kondratiev-Schumpeter theory is sufficiently substantiated. Further, the possibility of making a forecast of the development of the economic situation in the direction of applying this theory in practice, which demonstrate its effectiveness, is considered.

Keywords: Kondratiev's big cycles of economic conjuncture, Schumpeter's theory of innovative economic development, long-term cyclical forecasting, dating of Kondratiev cycles

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2179 An Empty Canvas is Full

Authors: Joonha Park

Abstract:

This essay examines the Soviet Artist Pavel Korin’s artistic pursuit towards his life-long project, “Requiem/Passing of the Rus,” framing the funeral of Tikhon, the last great defender of the Russian orthodox Church during the Great purge, as the final moment of “Rus,” which is the identity of the Russian people that built up in the 1000 year of history behind Russian Orthodoxy. Korin’s project remains in the form of a series of 29 man-sized portraits and a monumental blank canvas. Born in a family dedicated to iconography, Korin witnessed the historic drama during Stalin’s terror; therefore, he tried to convey the nation’s mourning for the disappearance of “Rus” and disapproval of the Soviet notion of atheism. Yet, due to Korin’s success as a state artist, many believed that the political pressure led Korin to give up his belief and controversy arose over the fact that Korin left the canvas blank. The empty 40-square-meter canvas, which remains untouched in his studio since 1930, supports this theory to an extent. However, resources such as Korin’s notes, primary accounts from his fellow Soviet Artists, and testimonies from his wife suggested that this assumption is incorrect. Moreover, Korin’s uninterrupted relationship with the church and the religious attributes in his commissioned works were brought up as evidence of Korin’s continued belief. The empty canvas not only represents Korin’s discontentment towards the repression and the hardships that the Orthodox Church experienced, but also depicts the identity that coexisted with the Church in order to bequeath this idea to future generations. The faultless canvas surrounded by the striking 29 portraits is a symbol of the highest spirit, similar to that of the iconography paintings placed in every Russian house that unites the Russian people till this day, therefore one can deduce that the legacy of “Requiem” is still relevant to the Russian people even under freedom of religious expression. Consequently, “Requiem” was on display at the Tretyakov Gallery for the first time in public in 2013 even though Korin started creating this piece in 1925, extolling Korin not only as an artist but also as a historian; by recording the turmoil of the Great Oppression, Korin exhibited the social responsibility universal to artists across time and space. In this essay, the legacy Korin left behind, both to his contemporaries and his posterity is reevaluated through the lens of his works, unfinished as they were.

Keywords: Pavel Korin, Art History, Art, Russia, Soviet Union, Requiem, Russian orthodox church, Treytyakov gallery, contemporary art, socialist realism, Maxim Gorky

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2178 The Role of Women in Shaping and Sustaining the Zulu Monarchy in the Late 18th and 19th Centuries

Authors: Hebert Sihle Ntuli

Abstract:

From the beginning, women had a great contribution or share in shaping history by different means during different epochs. Africa in general and South Africa in particular, are replete with many examples of female dynasties, regents and rulers who took up positions of leadership through periods of nation-building and wars of resistance. Zulu culture is fraught with a plethora of women who contributed in shaping Zulu monarchy to what it became in the late 18th and 19th centuries. The aim of this paper is to discuss the contribution of women in shaping and sustaining Zulu monarchy during the period in question. This work adopted qualitative research method.

Keywords: Zulu monarchy, women, princess Mkabayi, Queen Nandi, Queen Monase

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2177 Acute Peritonitis Caused by Perforated Appendicitis Accompanied by Synchronous Encephalopathy: A Rare Primary Presentation of Varicella Zoster Infection

Authors: Shahla Afshar Paiman, Sedigheh Madani, Zahra Hosseininezhad

Abstract:

Introduction: The most common causes of appendix luminal obstruction are fecaliths and lymphoid follicle hyperplasia. Appendicitis is a very rare Gastrointestinal complication of varicella zosterand it is mostly observed in immune-compromised patient. Case presentation: Here we reported a case of varicella zoster-related perforated appendicitis with synchronous encephalopathy as a first presentation of chickenpox in a 10-year-old boy. He had no history of immunodeficiency or predisposing factors and his diagnosis is confirmed by both serological lab tests and abdominal fluid (peritoneal secretion) PCR. Conclusion: Varicella zoster could cause appendicitis as first presentation, along with other critical complications look likes encephalopathy.

Keywords: Varicella zoster, appendicitis, encephalitis, children

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2176 Impact of Pandemics on Cities and Societies

Authors: Deepak Jugran

Abstract:

Purpose: The purpose of this study is to identify how past Pandemics shaped social evolution and cities. Methodology: A historical and comparative analysis of major historical pandemics in human history their origin, transmission route, biological response and the aftereffects. A Comprehensive pre & post pandemic scenario and focuses selectively on major issues and pandemics that have deepest & lasting impact on society with available secondary data. Results: Past pandemics shaped the behavior of human societies and their cities and made them more resilient biologically, intellectually & socially endorsing the theory of “Survival of the fittest” by Sir Charles Darwin. Pandemics & Infectious diseases are here to stay and as a human society, we need to strengthen our collective response & preparedness besides evolving mechanisms for strict controls on inter-continental movements of people, & especially animals who become carriers for these viruses. Conclusion: Pandemics always resulted in great mortality, but they also improved the overall individual human immunology & collective social response; at the same time, they also improved the public health system of cities, health delivery systems, water, sewage distribution system, institutionalized various welfare reforms and overall collective social response by the societies. It made human beings more resilient biologically, intellectually, and socially hence endorsing the theory of “AGIL” by Prof Talcott Parsons. Pandemics & infectious diseases are here to stay and as humans, we need to strengthen our city response & preparedness besides evolving mechanisms for strict controls on inter-continental movements of people, especially animals who always acted as carriers for these novel viruses. Pandemics over the years acted like natural storms, mitigated the prevailing social imbalances and laid the foundation for scientific discoveries. We understand that post-Covid-19, institutionalized city, state and national mechanisms will get strengthened and the recommendations issued by the various expert groups which were ignored earlier will now be implemented for reliable anticipation, better preparedness & help to minimize the impact of Pandemics. Our analysis does not intend to present chronological findings of pandemics but rather focuses selectively on major pandemics in history, their causes and how they wiped out an entire city’s population and influenced the societies, their behavior and facilitated social evolution.

Keywords: pandemics, Covid-19, social evolution, cities

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2175 Effect of Malnutrition at Admission on Length of Hospital Stay among Adult Surgical Patients in Wolaita Sodo University Comprehensive Specialized Hospital, South Ethiopia: Prospective Cohort Study, 2022

Authors: Yoseph Halala Handiso, Zewdi Gebregziabher

Abstract:

Background: Malnutrition in hospitalized patients remains a major public health problem in both developed and developing countries. Despite the fact that malnourished patients are more prone to stay longer in hospital, there is limited data regarding the magnitude of malnutrition and its effect on length of stay among surgical patients in Ethiopia, while nutritional assessment is also often a neglected component of the health service practice. Objective: This study aimed to assess the prevalence of malnutrition at admission and its effect on the length of hospital stay among adult surgical patients in Wolaita Sodo University Comprehensive Specialized Hospital, South Ethiopia, 2022. Methods: A facility-based prospective cohort study was conducted among 398 adult surgical patients admitted to the hospital. Participants in the study were chosen using a convenient sampling technique. Subjective global assessment was used to determine the nutritional status of patients with a minimum stay of 24 hours within 48 hours after admission (SGA). Data were collected using the open data kit (ODK) version 2022.3.3 software, while Stata version 14.1 software was employed for statistical analysis. The Cox regression model was used to determine the effect of malnutrition on the length of hospital stay (LOS) after adjusting for several potential confounders taken at admission. Adjusted hazard ratio (HR) with a 95% confidence interval was used to show the effect of malnutrition. Results: The prevalence of hospital malnutrition at admission was 64.32% (95% CI: 59%-69%) according to the SGA classification. Adult surgical patients who were malnourished at admission had higher median LOS (12 days: 95% CI: 11-13) as compared to well-nourished patients (8 days: 95% CI: 8-9), means adult surgical patients who were malnourished at admission were at higher risk of reduced chance of discharge with improvement (prolonged LOS) (AHR: 0.37, 95% CI: 0.29-0.47) as compared to well-nourished patients. Presence of comorbidity (AHR: 0.68, 95% CI: 0.50-90), poly medication (AHR: 0.69, 95% CI: 0.55-0.86), and history of admission (AHR: 0.70, 95% CI: 0.55-0.87) within the previous five years were found to be the significant covariates of the length of hospital stay (LOS). Conclusion: The magnitude of hospital malnutrition at admission was found to be high. Malnourished patients at admission had a higher risk of prolonged length of hospital stay as compared to well-nourished patients. The presence of comorbidity, polymedication, and history of admission were found to be the significant covariates of LOS. All stakeholders should give attention to reducing the magnitude of malnutrition and its covariates to improve the burden of LOS.

Keywords: effect of malnutrition, length of hospital stay, surgical patients, Ethiopia

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2174 Burden of Dengue in Northern India

Authors: Ashutosh Biswas, Poonam Coushic, Kalpana Baruah, Paras Singla, A. C. Dhariwal, Pawana Murthy

Abstract:

Burden of Dengue in Northern India Ashutosh Biswas, Poonam Coushic, Kalpana Baruah, Paras Singla, AC Dhariwal, Pawana Murthy. All India Institute of Medical Sciences, NVBDCP,WHO New Delhi, India Aim: This study was conducted to estimate the burden of dengue in capital region of India. Methodology:Seropositivity of Dengue for IgM Ab, NS1 Ag and IgG Ab were performed among the blood donors’ samples from blood bank, those who were coming to donate blood for the requirement of blood for the admitted patients in hospital. Blood samplles were collected through out the year to estimate seroprevalance of dengue with or without outbreak season. All the subjects were asymptomatic at the time of blood donation. Results: A total of 1558 donors were screened for the study. On the basis of inclusion/ exclusion criteria, we enrolled 1531subjects for the study.Twenty seven donors were excluded from the study, out of which 6 were detected HIV +ve, 11 were positive for HBsAg and 10 were found positive for HCV.Mean age was 30.51 ± 7.75 years.Of 1531subjects, 18 (1.18%) had a past history of typhoid fever, 28 (1.83%) had chikungunya fever, 9 (0.59%) had malaria and 43 subjects (2.81%) had a past history of symptomatic dengue infection.About 2.22% (34) of subjects were found to have sero-positive for NS1 Ag with a peak point prevalence of 7.14% in the month of October and sero-positive of IgM Ab was observed about 5.49% (84)with a peak point prevalence of 14.29% in the month of October. Sero-prevalnce of IgGwas detected in about 64.21% (983) of subjects. Conclusion: Acute asymptomatic dengue (NS1 Ag+ve) was observed in 7.14%, as the subjects were having no symptoms at the time of sampling. This group of subjects poses a potential public health threat for transmitting dengue infection through blood transfusion (TTI) in the community as evident by presence of active viral infection due to NS1Ag +VE. Therefore a policy may be implemented in the blood bank for testing NS1 Ag to look for active dengue infection for preventing dengue transmission through blood transfusion (TTI). Acute or Subacute dengue infection ( IgM Ab+ve) was observed from 5.49% to 14.29% which is a peak point prevalence in the month of October. About 64.21% of the population were immunized by natural dengue infection ( IgG Ab+ve) in theNorthern province of India. This might be helpful for implementing the dengue vaccine in a region. Blood samples in blood banks should be tested for dengue before transfusion to any other person to prevent transfusion transmitted dengue infection as we estimated upto 7.14% positivity of NS1 Ag in our study which indicates presence of dengue virus in blood donors’ samples.

Keywords: Dengue Burden, Seroprevalance, Asymptomatic dengue, Dengue transmission through blood transfusion

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2173 Q-Map: Clinical Concept Mining from Clinical Documents

Authors: Sheikh Shams Azam, Manoj Raju, Venkatesh Pagidimarri, Vamsi Kasivajjala

Abstract:

Over the past decade, there has been a steep rise in the data-driven analysis in major areas of medicine, such as clinical decision support system, survival analysis, patient similarity analysis, image analytics etc. Most of the data in the field are well-structured and available in numerical or categorical formats which can be used for experiments directly. But on the opposite end of the spectrum, there exists a wide expanse of data that is intractable for direct analysis owing to its unstructured nature which can be found in the form of discharge summaries, clinical notes, procedural notes which are in human written narrative format and neither have any relational model nor any standard grammatical structure. An important step in the utilization of these texts for such studies is to transform and process the data to retrieve structured information from the haystack of irrelevant data using information retrieval and data mining techniques. To address this problem, the authors present Q-Map in this paper, which is a simple yet robust system that can sift through massive datasets with unregulated formats to retrieve structured information aggressively and efficiently. It is backed by an effective mining technique which is based on a string matching algorithm that is indexed on curated knowledge sources, that is both fast and configurable. The authors also briefly examine its comparative performance with MetaMap, one of the most reputed tools for medical concepts retrieval and present the advantages the former displays over the latter.

Keywords: information retrieval, unified medical language system, syntax based analysis, natural language processing, medical informatics

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2172 Exploring the Potential of Bio-Inspired Lattice Structures for Dynamic Applications in Design

Authors: Axel Thallemer, Aleksandar Kostadinov, Abel Fam, Alex Teo

Abstract:

For centuries, the forming processes in nature served as a source of inspiration for both architects and designers. It seems as most human artifacts are based on ideas which stem from the observation of the biological world and its principles of growth. As a fact, in the cultural history of Homo faber, materials have been mostly used in their solid state: From hand axe to computer mouse, the principle of employing matter has not changed ever since the first creation. In the scope of history only recently and by the help of additive-generative fabrication processes through Computer Aided Design (CAD), designers were enabled to deconstruct solid artifacts into an outer skin and an internal lattice structure. The intention behind this approach is to create a new topology which reduces resources and integrates functions into an additively manufactured component. However, looking at the currently employed lattice structures, it is very clear that those lattice structure geometries have not been thoroughly designed, but rather taken out of basic-geometry libraries which are usually provided by the CAD. In the here presented study, a group of 20 industrial design students created new and unique lattice structures using natural paragons as their models. The selected natural models comprise both the animate and inanimate world, with examples ranging from the spiraling of narwhal tusks, off-shooting of mangrove roots, minimal surfaces of soap bubbles, up to the rhythmical arrangement of molecular geometry, like in the case of SiOC (Carbon-Rich Silicon Oxicarbide). This ideation process leads to a design of a geometric cell, which served as a basic module for the lattice structure, whereby the cell was created in visual analogy to its respective natural model. The spatial lattices were fabricated additively in mostly [X]3 by [Y]3 by [Z]3 units’ volumes using selective powder bed melting in polyamide with (z-axis) 50 mm and 100 µm resolution and subdued to mechanical testing of their elastic zone in a biomedical laboratory. The results demonstrate that additively manufactured lattice structures can acquire different properties when they are designed in analogy to natural models. Several of the lattices displayed the ability to store and return kinetic energy, while others revealed a structural failure which can be exploited for purposes where a controlled collapse of a structure is required. This discovery allows for various new applications of functional lattice structures within industrially created objects.

Keywords: bio-inspired, biomimetic, lattice structures, additive manufacturing

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2171 Environmental Virtue Ethics for the Anthropocene in Barbara Kingsolver’s Animal Dreams

Authors: Xu Lan, Zainor Izat Zainal

Abstract:

Human intervention in Earth’s macro system has ushered in the age of the Anthropocene, prompting introspection among humans, the action agent. This epoch demands a reawakening of human conscience and inner motivation to mitigate the irreversible trend so as to shape the trajectory of the Anthropocene. Environmental virtue ethics claims that the fundamental cause of environmental crisis lies in humans themselves. Rather than focusing more on what humans should do, environmental virtue ethics seeks to specify environmental virtues to appeal to what kind of person a human should be. Renowned Pulitzer Prize-winning author Barbara Kingsolver illustrates her contentions about environmental ethics through the narrative of Codi and her sister Hallie’s environmental choices and actions in Animal Dreams (1990). This study adopts a textual analysis approach of the character traits exhibited by Codi and Hallie that are constitutive of making them environmentally virtuous, exploring how emotions and inner motivations drive actions. This paper is informed by Ronald Sandler’s (2007) virtues of sustainability, virtues of communion with nature, and virtues of environmental stewardship and activism. It aims to examine how Codi and Hallie’s character traits are built around these virtues. Furthermore, this study underscores the importance of internalizing principles and cultivating virtues for the environment and humans’ flourishing in the Anthropocene. As a tentative practice in applying environmental virtue ethics to examine environmental virtues for the Anthropocene, this study reveals Kingsolver’s endeavor of setting environmental virtue exemplars from fictional characters to inspire humans’ long-term and stable contribution to a better future.

Keywords: anthopocene, environmental ethics, environmental virtues, virtue ethics

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2170 Seismic Fragility Assessment of Continuous Integral Bridge Frames with Variable Expansion Joint Clearances

Authors: P. Mounnarath, U. Schmitz, Ch. Zhang

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Fragility analysis is an effective tool for the seismic vulnerability assessment of civil structures in the last several years. The design of the expansion joints according to various bridge design codes is almost inconsistent, and only a few studies have focused on this problem so far. In this study, the influence of the expansion joint clearances between the girder ends and the abutment backwalls on the seismic fragility assessment of continuous integral bridge frames is investigated. The gaps (ranging from 60 mm, 150 mm, 250 mm and 350 mm) are designed by following two different bridge design code specifications, namely, Caltrans and Eurocode 8-2. Five bridge models are analyzed and compared. The first bridge model serves as a reference. This model uses three-dimensional reinforced concrete fiber beam-column elements with simplified supports at both ends of the girder. The other four models also employ reinforced concrete fiber beam-column elements but include the abutment backfill stiffness and four different gap values. The nonlinear time history analysis is performed. The artificial ground motion sets, which have the peak ground accelerations (PGAs) ranging from 0.1 g to 1.0 g with an increment of 0.05 g, are taken as input. The soil-structure interaction and the P-Δ effects are also included in the analysis. The component fragility curves in terms of the curvature ductility demand to the capacity ratio of the piers and the displacement demand to the capacity ratio of the abutment sliding bearings are established and compared. The system fragility curves are then obtained by combining the component fragility curves. Our results show that in the component fragility analysis, the reference bridge model exhibits a severe vulnerability compared to that of other sophisticated bridge models for all damage states. In the system fragility analysis, the reference curves illustrate a smaller damage probability in the earlier PGA ranges for the first three damage states, they then show a higher fragility compared to other curves in the larger PGA levels. In the fourth damage state, the reference curve has the smallest vulnerability. In both the component and the system fragility analysis, the same trend is found that the bridge models with smaller clearances exhibit a smaller fragility compared to that with larger openings. However, the bridge model with a maximum clearance still induces a minimum pounding force effect.

Keywords: expansion joint clearance, fiber beam-column element, fragility assessment, time history analysis

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2169 Contribution of PALB2 and BLM Mutations to Familial Breast Cancer Risk in BRCA1/2 Negative South African Breast Cancer Patients Detected Using High-Resolution Melting Analysis

Authors: N. C. van der Merwe, J. Oosthuizen, M. F. Makhetha, J. Adams, B. K. Dajee, S-R. Schneider

Abstract:

Women representing high-risk breast cancer families, who tested negative for pathogenic mutations in BRCA1 and BRCA2, are four times more likely to develop breast cancer compared to women in the general population. Sequencing of genes involved in genomic stability and DNA repair led to the identification of novel contributors to familial breast cancer risk. These include BLM and PALB2. Bloom's syndrome is a rare homozygous autosomal recessive chromosomal instability disorder with a high incidence of various types of neoplasia and is associated with breast cancer when in a heterozygous state. PALB2, on the other hand, binds to BRCA2 and together, they partake actively in DNA damage repair. Archived DNA samples of 66 BRCA1/2 negative high-risk breast cancer patients were retrospectively selected based on the presence of an extensive family history of the disease ( > 3 affecteds per family). All coding regions and splice-site boundaries of both genes were screened using High-Resolution Melting Analysis. Samples exhibiting variation were bi-directionally automated Sanger sequenced. The clinical significance of each variant was assessed using various in silico and splice site prediction algorithms. Comprehensive screening identified a total of 11 BLM and 26 PALB2 variants. The variants detected ranged from global to rare and included three novel mutations. Three BLM and two PALB2 likely pathogenic mutations were identified that could account for the disease in these extensive breast cancer families in the absence of BRCA mutations (BLM c.11T > A, p.V4D; BLM c.2603C > T, p.P868L; BLM c.3961G > A, p.V1321I; PALB2 c.421C > T, p.Gln141Ter; PALB2 c.508A > T, p.Arg170Ter). Conclusion: The study confirmed the contribution of pathogenic mutations in BLM and PALB2 to the familial breast cancer burden in South Africa. It explained the presence of the disease in 7.5% of the BRCA1/2 negative families with an extensive family history of breast cancer. Segregation analysis will be performed to confirm the clinical impact of these mutations for each of these families. These results justify the inclusion of both these genes in a comprehensive breast and ovarian next generation sequencing cancer panel and should be screened simultaneously with BRCA1 and BRCA2 as it might explain a significant percentage of familial breast and ovarian cancer in South Africa.

Keywords: Bloom Syndrome, familial breast cancer, PALB2, South Africa

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2168 Screening of Commonly Used Reinforcement Materials for Tomb Murals

Authors: Liping Qiu, Xiaofeng Zhang

Abstract:

In its long history, precious tomb murals suffered from various diseases due to natural and man-made destruction. The key to how to protect tomb murals is how to strengthen and protect the tomb murals. In order to maximize the life of the tomb murals, the artistic, historic, and scientific values of the tomb murals can be continued. In this paper, four kinds of traditional reinforcement materials (silicone acrylic lotion, pure acrylic lotion, polyvinyl acetate lotion, and B72) are selected to reinforce the ground support layer of tomb murals, and the reinforcement effect of each reinforcement material on the ground support layer of murals is compared and analyzed, and the best protection material is obtained.

Keywords: mural, destruction cycle, reinforcement material, disease

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2167 Jarcho-Levin Syndrome: A Case Report

Authors: Atitallah Sofien, Bouyahia Olfa, Romdhani Meriam, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

Abstract:

Introduction: Spondylothoracic dysostosis, also known as Jarcho-Levin syndrome, is defined by a shortened neck and thorax, a protruding abdomen, inguinal and umbilical hernias, atypical spinal structure and rib fusion, leading to restricted chest movement or difficulty in breathing, along with urinary tract abnormalities and, potentially severe scoliosis. Aim: This is the case of a patient diagnosed with Jarcho-Levin syndrome, aiming to detail the range of abnormalities observed in this syndrome, the observed complications, and the therapeutic approaches employed. Results: A three-month-old male infant, born of a consanguineous marriage, delivered at full term by cesarean section, was admitted to the pediatric department for severe acute bronchiolitis. In his prenatal history, morphological ultrasound revealed macrosomia, a shortened spine, irregular vertebrae with thickened skin, normal fetal cardiac ultrasound, and the absence of the right kidney. His perinatal history included respiratory distress, requiring ventilatory support for five days. Upon physical examination, he had stunted growth, scoliosis, a short neck and trunk, longer upper limbs compared to lower limbs, varus equinus in the right foot, a neural tube defect, a low hairline, and low-set ears. Spondylothoracic dysostosis was suspected, leading to further investigations, including a normal transfontaneous ultrasound, a spinal cord ultrasound revealing a lipomyelocele-type closed dysraphism with a low-attached cord, an abdominal ultrasound indicating a single left kidney, and a cardiac ultrasound identifying Kommerell syndrome. Due to a lack of resources, genetic testing could not be performed, and the diagnosis was based on clinical criteria. Conclusion: Jarcho-Levin syndrome can result in a mortality rate of about 50%, primarily due to respiratory complications associated with thoracic insufficiency syndrome. Other complications, like heart and neural tube defects, can also lead to premature mortality. Therefore, early diagnosis and comprehensive treatment involving various specialists are essential.

Keywords: Jarcho-Levin syndrome, congenital disorder, scoliosis, spondylothoracic dysostosis, neural tube defect

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2166 Factor Associated with Uncertainty Undergoing Hematopoietic Stem Cell Transplantation

Authors: Sandra Adarve, Jhon Osorio

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Uncertainty has been studied in patients with different types of cancer, except in patients with hematologic cancer and undergoing transplantation. The purpose of this study was to identify factors associated with uncertainty in adults patients with malignant hemato-oncology diseases who are scheduled to undergo hematopoietic stem cell transplantation based on Merle Mishel´s Uncertainty theory. This was a cross-sectional study with an analytical purpose. The study sample included 50 patients with leukemia, myeloma, and lymphoma selected by non-probability sampling by convenience and intention. Sociodemographic and clinical variables were measured. Mishel´s Scale of Uncertainty in Illness was used for the measurement of uncertainty. A bivariate and multivariate analyses were performed to explore the relationships and associations between the different variables and uncertainty level. For this analysis, the distribution of the uncertainty scale values was evaluated through the Shapiro-Wilk normality test to identify statistical tests to be used. A multivariate analysis was conducted through a logistic regression using step-by-step technique. Patients were 18-74 years old, with a mean age of 44.8. Over time, the disease course had a median of 9.5 months, an opportunity was found in the performance of the transplantation of < 20 days for 50% of the patients. Regarding the uncertainty scale, a mean score of 95.46 was identified. When the dimensions of the scale were analyzed, the mean score of the framework of stimuli was 25.6, of cognitive ability was 47.4 and structure providers was 22.8. Age was identified to correlate with the total uncertainty score (p=0.012). Additionally, a statistically significant difference was evidenced between different religious creeds and uncertainty score (p=0.023), education level (p=0.012), family history of cancer (p=0.001), the presence of comorbidities (p=0.023) and previous radiotherapy treatment (p=0.022). After performing logistic regression, previous radiotherapy treatment (OR=0.04 IC95% (0.004-0.48)) and family history of cancer (OR=30.7 IC95% (2.7-349)) were found to be factors associated with the high level of uncertainty. Uncertainty is present in high levels in patients who are going to be subjected to bone marrow transplantation, and it is the responsibility of the nurse to assess the levels of uncertainty and the presence of factors that may contribute to their presence. Once it has been valued, the uncertainty must be intervened from the identified associated factors, especially all those that have to do with the cognitive capacity. This implies the implementation and design of intervention strategies to improve the knowledge related to the disease and the therapeutic procedures to which the patients will be subjected. All interventions should favor the adaptation of these patients to their current experience and contribute to seeing uncertainty as an opportunity for growth and transcendence.

Keywords: hematopoietic stem cell transplantation, hematologic diseases, nursing, uncertainty

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2165 Immersive and Interactive Storytelling: Exploring Narratives and Online Multisensory Experience for Cultural Memory and Collective Awareness through Graphic Novel

Authors: Cristina Greco

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The spread of the digital and we-based technologies has led to a transformation process, which has coincided with an increase in the number of cases who are beyond the mainstream storytelling and its codes on the interaction with the user. On the base of a previous research on i-docs and virtual museums, this study analyses interactive and immersive online Graphic Novel – one-page, animated, illustrated, and hybrid – to reflect on the transformational implications of this expressive form on the user perception, remembrance, and awareness. The way in which the user experiences a certain level of interaction with the story and immersion in the semantic and figurative universe would bring user’s attention, activating introspection and self-reflection processes, perception, imagination, and creativity. This would have to do with the involvement of different senses – visual, proprioceptive, tactile, auditory, and vestibular – and the activation of a phenomenon of synaesthesia (involuntary cross-modal sensory association) – where, for example, the aural reconnect the user to another sense, providing a multisensory experience. The case studies show specific forms of interactive and immersive graphic novel and reflect on application that has sought to engage innovative ways to communicate different messages and stimulate cultural memory and collective awareness. The visual semiotic and narrative analysis of the distinctive traits of such a complex textuality, along with a study of the user’s experience through observation in naturalistic settings and interviews, allows us to question the functioning of these configurations, with regard to the relationships between the figurative dimension, the perceptive activity, and their impact on the user’s engagement.

Keywords: collective awareness, cultural memory, graphic novel, interactive and immersive storytelling

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2164 Bridging the internalist-Externalist Divide: A Catholic-Reformed Epistemological Synthesis of the Justification of Christian Beliefs.

Authors: Linto Francis Kallukulangara

Abstract:

Although the Catholic and Reformed traditions share a common baptismal heritage, they differe considerably in their epistemic stance on whether a believer can legitimatly subscribe to a proposition of Christian Revelation without any evidence. Catholic tradition, which is essentially rooted in the internalist epistemology, posits that a theistic belief must be substantiated by a rational ground that is cognitively accessible to the believer. In contrast, Reformed thinkers have historically maintained a non-evidentialist stance, which has received strong criticism, including allegations of irrationality. However, recent developments in analytic philosophy, particularly the rise of externalist epistemology, have revitalized the non-evidentialist position within the Reformed tradition. The intellectual allure of this movement has led many contemporary thinkers to argue that the Catholic internalist/evidentialist position has not only been significantly challenged but has also been largely silenced by this externalism-based Reformed epistemological stance. Consequently, they argue that the non-cogntive Reformed currect has established itself as the dominant, or perhaps the only, epistemological position in the philosophy of religion. This paper counters the prevailing narrative, arguing that despite the ostensible challenge posed by Reformed non-evidentialism, a synthesis is possible. By analyzing various Reformed epistemological movements within the contemporary anaytic tradtion, we demonstrate that externalist-based Reformed epistemology does not fundamentally undermine Catholic evidentialism. Instead, it offers a new and more promising framework for a Christian epistemology that sythesizes elements from both traditions, offering a more comprehensive and nuanced understing of the justification of religion belief, incoperating both internalist and externalist perspective.

Keywords: reformed and catholic epistemology, evidentialism, non-evidentialism, internalism, externalism

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2163 The New Face of TV: An Exploratory Study on the Effects of Snapchat on TV Ratings in Kuwait

Authors: Bashaiar Alsanaa

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The advent of new forms of media has always led to a change in the way existing media deliver content. No medium has been replaced by another yet over the course of history. Whether this fact changes with the introduction of new age technology and social media remains to be seen. Snapchat may be the first application, to seriously challenge TV. It is perhaps the new face of television. The individualistic nature of Snapchat, whereby users control who, when, and in what order to watch, assesses user freedom from traditional broadcasters’ control. This study aims to fill the void in research conducted around such topic. The research explores how Snapchat maybe slowly but replacing TV. The study surveys users in Kuwait in order to present an overview of the topic. It also draws a framework through which implications and suggestions for future research may be discussed to better serve the advancement of media research.

Keywords: Kuwait, media, Snapchat, television

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