How to assess prognosis after cardiac arrest and therapeutic hypothermia.

The prognosis of patients who are admitted in a comatose state following successful resuscitation after cardiac arrest remains uncertain. Although the introduction of therapeutic hypothermia (TH) and improvements in post-resuscitation care have significantly increased the number of patients who are discharged home with minimal brain damage, short-term assessment of neurological outcome remains a challenge. The need for early and accurate prognostic predictors is crucial, especially since sedation and TH may alter the neurological examination and delay the recovery of motor response for several days. The development of additional tools, including electrophysiological examinations (electroencephalography and somatosensory evoked potentials), neuroimaging and chemical biomarkers, may help to evaluate the extent of brain injury in these patients. Given the extensive literature existing on this topic and the confounding effects of TH on the strength of these tools in outcome prognostication after cardiac arrest, the aim of this narrative review is to provide a practical approach to post-anoxic brain injury when TH is used. We also discuss when and how these tools could be combined with the neurological examination in a multimodal approach to improve outcome prediction in this population.

Character Networks and Centrality

A character network represents relations between characters from a text; the relations are based on text proximity, shared scenes/events, quoted speech, etc. Our project sketches a theoretical framework for character network analysis, bringing together narratology, both close and distant reading approaches, and social network analysis. It is in line with recent attempts to automatise the extraction of literary social networks (Elson, 2012; Sack, 2013) and other studies stressing the importance of character- systems (Woloch, 2003; Moretti, 2011). The method we use to build the network is direct and simple. First, we extract co-occurrences from a book index, without the need for text analysis. We then describe the narrative roles of the characters, which we deduce from their respective positions in the network, i.e. the discourse. As a case study, we use the autobiographical novel Les Confessions by Jean-Jacques Rousseau. We start by identifying co-occurrences of characters in the book index of our edition (Slatkine, 2012). Subsequently, we compute four types of centrality: degree, closeness, betweenness, eigenvector. We then use these measures to propose a typology of narrative roles for the characters. We show that the two parts of Les Confessions, written years apart, are structured around mirroring central figures that bear similar centrality scores. The first part revolves around the mentor of Rousseau; a figure of openness. The second part centres on a group of schemers, depicting a period of deep paranoia. We also highlight characters with intermediary roles: they provide narrative links between the societies in the life of the author. The method we detail in this complete case study of character network analysis can be applied to any work documented by an index. Un réseau de personnages modélise les relations entre les personnages d'un récit : les relations sont basées sur une forme de proximité dans le texte, l'apparition commune dans des événements, des citations dans des dialogues, etc. Notre travail propose un cadre théorique pour l'analyse des réseaux de personnages, rassemblant narratologie, close et distant reading, et analyse des réseaux sociaux. Ce travail prolonge les tentatives récentes d'automatisation de l'extraction de réseaux sociaux tirés de la littérature (Elson, 2012; Sack, 2013), ainsi que les études portant sur l'importance des systèmes de personnages (Woloch, 2003; Moretti, 2011). La méthode que nous utilisons pour construire le réseau est directe et simple. Nous extrayons les co-occurrences d'un index sans avoir recours à l'analyse textuelle. Nous décrivons les rôles narratifs des personnages en les déduisant de leurs positions relatives dans le réseau, donc du discours. Comme étude de cas, nous avons choisi le roman autobiographique Les Confessions, de Jean- Jacques Rousseau. Nous déduisons les co-occurrences entre personnages de l'index présent dans l'édition Slatkine (Rousseau et al., 2012). Sur le réseau obtenu, nous calculons quatre types de centralité : le degré, la proximité, l'intermédiarité et la centralité par vecteur propre. Nous utilisons ces mesures pour proposer une typologie des rôles narratifs des personnages. Nous montrons que les deux parties des Confessions, écrites à deux époques différentes, sont structurées autour de deux figures centrales, qui obtiennent des mesures de centralité similaires. La première partie est construite autour du mentor de Rousseau, qui a symbolisé une grande ouverture. La seconde partie se focalise sur un groupe de comploteurs, et retrace une période marquée par la paranoïa chez l'auteur. Nous mettons également en évidence des personnages jouant des rôles intermédiaires, et de fait procurant un lien narratif entre les différentes sociétés couvrant la vie de l'auteur. La méthode d'analyse des réseaux de personnages que nous décrivons peut être appliquée à tout texte de fiction comportant un index.

Gender and attachment representations in the preschool years: comparisons between five countries

Bowlby proposed that the individual's social experiences, as early as in infancy, contribute to the construction of Internal Working Models (IWMs) of attachment, which will later guide the individual's expectations and behaviors in close relationships all along his or her life. The qualitative, individual characteristics of these models reflect the specificity of the individual's early experiences with attachment figures. The attachment literature globally shows that the qualities of IWMs are neither gender specific nor cultural specific. Procedures to evaluate IWMs in adulthood have been well established, based on narrative accounts of childhood experiences. Narrative procedures at earlier ages (e.g., in the preschool years) have been proposed, such as Bretherton's Attachment Story Completion Task (ASCT), to evaluate attachment representations. More than 500 ASCT narratives of preschoolers, coming from five different countries, have been collected, in the perspective of examining possible interactions between gender and culture regarding attachment representations. A specific Q-Sort coding procedure (CCH) has been used to evaluate several dimensions of the narratives. Girls' narratives appeared as systematically more secure than those of same-age boys, whatever their culture. The magnitude of gender differences, however, varied between countries. Taylor's model of gender-specific responses to stress and Harwood's and Posada's hypothesis on inter-cultural differences regarding caregiving are evoked to understand the differences across gender and countries.

Technologies of birth and models of midwifery care

This article is based on a study of a reform in the organisation of maternity services in the United Kingdom, which aimed towards developing a more woman-centred model of care. After decades of fragmentation and depersonalisation of care, associated with the shift of birth to a hospital setting, pressure by midwives and mothers prompted government review and a relatively radical turnaround in policy. However, the emergent model of care has been profoundly influenced by concepts and technologies of monitoring. The use of such technologies as ultrasound scans, electronic foetal monitoring and oxytocic augmentation of labour, generally supported by epidural anaesthesia for pain relief, have accompanied the development of a particular ecological model of birth – often called active management –, which is oriented towards the idea of an obstetric norm. Drawing on analysis of women’s narrative accounts of labour and birth, this article discusses the impact on women’s embodiment in birth, and the sources of information they use about the status of their own bodies, their labour and that of the child. It also illustrates how the impact on women’s experiences of birth may be mediated by a relational model of support, through the provision of caseload midwifery care.

Narrative interviews: an important resource in qualitative research

Objetives This methodological study explain and emphasize the extent and fertility of the narrative interview in qualitative research. Methods To describe the narrative method within the qualitative research. Results The qualitative research method is characterized by addressing issues related to the singularities of the field and individuals investigated, being the narrative interviews a powerful method for use by researchers who aggregate it. They allow the deepening of research, the combination of life stories with socio-historical contexts, making the understanding of the senses that produce changes in the beliefs and values that motivate and justify the actions of possible informants. Conclusion The use of narrative is an advantageous investigative resource in qualitative research, in which the narrative is a traditional form of communication whose purpose is to serve content from which the subjective experiences can be transmitted.

Catholic Loyalism, Service and Careerism: Lewes Lewkenor's Quest for Favour

This article discusses one of Lewkenor's more obscure works, The Resolved Gentleman (1594 - STC 15139), in the context of Elizabethan court politics in the 1590s, with a particular emphasis on the author's own experience of dissent, exile to Catholic Spain in the 1580s and return to England in the early 1590s. A translation of Hernando de Acuña's El Caballero Determinado, itself a reworking of Olivier de la Marche's Chevalier Délibéré (1483), the Resolved Gentleman bends the conventions of medieval chivalric allegory to articulate Lewkenor's own experience of alienation and dissent in the specific context of the factionalism of the 1590s. Beneath Lewkenor's seemingly self-effacing, 'humanist' translation it is in fact possible to discern a complex set of criticisms of Elizabeth's court. The knight's 'wandering' and 'errance' thus becomes a complex, multivalent figure that reverberates with a number of autobiographical meanings: the knight's exile becomes in Lewkenor's hands a figure of his own forced exile to Catholic Spain, and the account of the knight's quest functions as an oblique allusion to his own efforts to make his way back to Elizabeth's court. More importantly, however, these 'personal' meanings acquire a wider, political valence in the context of the allegory, and the narrative as a whole thus becomes a subtle, perceptive but scathing criticism of the Elizabethan court in the 1590's and the 'contraction' of royal favour that resulted in particular in the exclusion of capable, experienced but Catholic counsellors like Lewkenor himself. Articulating the frustration of this younger generation of alienated but fundamentally loyalist Catholics, Lewkenor paints a picture of a failed quest for favour, where the questing knight is finally forced to retire from the active life and withdraw to a rustic hermitage that is not only incompatible with his own ideal of the vita activa, but also dangerously smacks of unregenerate, and potentially seditious Catholicism.

Identification and Characterization of Natural Anti-Breast Cancer Compound: Costunolide

Breast cancer is the most common cancer among women, 23% (1.3 million) of the total of new cases and the second leading cause of cancer death in women exceeded only by lung cancer. Natural medicines have been proven to be a central source of narrative agents with a pharmaceutical potential. Costunolide is sesquiterpene lactones consisting of diverse plant chemicals that exhibit anti cancer action through cytotoxic effects on various cancer cells. The objectives of present study were to explore the effects of natural compounds on the proliferation of MCF-7 cells and to determine the role of ROS in natural compounds-induced apoptosis in breast cancer cells with a therapeutic potential. Results showed that costunolide screened, possess potent anticancer properties against breast cancer MCF-7 cells, Costunolide was observed as strong anti-proliferative agent with IC50 = 50µM. The anti-proliferative effect of costunolide on MCF cells was confirmed by live/dead assay using fluorescent probes calcein AV/PI. The results demonstrated that treatment of cells with costunolide decreased the viability of MCF-7 cells in a dose-dependent manner. To determine the costunolide-induced apoptosis, flow cytometric analysis was carried out. The results showed that costunolide induced apoptosis in a dose-dependent manner in breast cancer MCF-7cells. ROS are well known mediators of intracellular signaling of cascades. The excessive generation of ROS can induce oxidative stress, loss of cell functioning, and apoptosis. In the present study, we assumed that costunolide might arouse ROS level, which could be involved in induction of apoptosis. Therefore, the intracellular ROS level was measured using the ROS-detecting fluorescence dye 2, 7-dichlorofluorescein diacetate (DCF-DA). Interestingly these effects were significantly abrogated when the cells were pretreated with N-acetyl- cysteine (NAC), a specific ROS inhibitor. Costunolide induces apoptosis through extrinsic pathway in MCF-7 breast cancer cells, In order to examine whether costunolide suppresses cell growth inducing apoptotic cell death, we analyzed DNA contents and apoptosis-related proteins expression level by flow cytometry and western blot, respectively in MCF-7 breast cancer cells we investigated whether costunolide activates extrinsic apoptotic pathway. We examined the expression levels of death receptor signaling-related proteins, caspase-3, and PARP. The results showed that procaspase-3 was cleaved to yield 17 and 20kDa fragments and activation of PARP in treated cells with 25 and 50μM of costunolide. Costunolide induce apoptosis through intrinsic mitochondria pathway in MCF-7 breast cancer Cells. We examined the expression levels of mitochondrial apoptotic pathway related proteins such as anti-apoptotic protein, B-cell lymphoma protein-2 (Bcl2), and pro-apoptotic protein Bax. Costunolide involved in the down regulation of Bcl-2 and up regulation of Bax. These results suggest that costunolide may have beneficial effects for the reduction of breast cancer growth, and new therapeutic strategy for the treatment of human cancers.

Social security in theory and practice (I): Facts and political theories

166 countries have some kind of public old age pension. What economic forcescreate and sustain old age Social Security as a public program? We document some of the internationally and historically common features of Social Security programs including explicit and implicit taxes on labor supply, pay-as-you-go features, intergenerational redistribution, benefits which areincreasing functions of lifetime earnings and not means-tested. We partition theories of Social Security into three groups: "political", "efficiency" and "narrative" theories. We explore three political theories in this paper: the majority rational voting model (with its two versions: "the elderly as the leaders of a winning coalition with the poor" and the "once and for all election" model), the "time-intensive model of political competition" and the "taxpayer protection model". Each of the explanations is compared with the international and historical facts. A companion paper explores the "efficiency" and "narrative" theories, and derives implicationsof all the theories for replacing the typical pay-as-you-go system with a forced savings plan.

Hand book for Iowa Soldiers' and Sailors' Monument, 1898.

A narrative of the history of the Soldiers' and Sailor's Monument on the State Capitol grounds.

Cannabis and tobacco use: where are the boundaries? A qualitative study on cannabis consumption modes among adolescents.

The purpose of this article is to identify tobacco and cannabis co-consumptions and consumers' perceptions of each substance. A qualitative research including 22 youths (14 males) aged 15-21 years in seven individual interviews and five focus groups. Discussions were recorded, transcribed verbatim and transferred to Atlas.ti software for narrative analysis. The main consumption mode is cannabis cigarettes which always mix cannabis and tobacco. Participants perceive cannabis much more positively than tobacco, which is considered unnatural, harmful and addictive. Future consumption forecasts thus more often exclude tobacco smoking than cannabis consumption. A substitution phenomenon often takes place between both substances. Given the co-consumption of tobacco and cannabis, in helping youths quit or decrease their consumptions, both substances should be taken into account in a global approach. Cannabis consumers should be made aware of their tobacco use while consuming cannabis and the risk of inducing nicotine addiction through cannabis use, despite the perceived disconnect between the two substances. Prevention programs should correct made-up ideas about cannabis consumption and convey a clear message about its harmful consequences. Our findings support the growing evidence which suggests that nicotine dependence and cigarette smoking may be induced by cannabis consumption.

Albert Lewin. Pandora and the Flying Dutchman: the Semiologic Potential of a Greek Myth

Albert Lewin, a well-known Hollywood cinema director who is significantly influenced by the surrealistic movement, brings together the myth f Pandora and the legend of the flying Dutchman in order to create an exemplary love story, a crazy love story which goes beyond the limits of human reason. Bearing in mind, then, that if one wants to believe in this sort of love story must not be guided by human reason stricto sensu, he builds a world of signs, a semiologic world which this article aims at helping to interpret.

Political Emotions: Civil Religion and Melodrama in Spielberg's Lincoln

This essay focuses on how Spielberg's film engages with and contributes to the myth of Lincoln as a super-natural figure, a saint more than a hero or great statesman, while anchoring his moral authority in the sentimental rhetoric of the domestic sphere. It is this use of the melodramatic mode, linking the familial space with the national through the trope of the victim-hero, which is the essay's main concern. With Tony Kushner, author of Angels in America, as scriptwriter, it is perhaps not surprising that melodrama is the operative mode in the film. One of the issues that emerge from this analysis is how the film updates melodrama for a contemporary audience in order to minimize what could be perceived as manipulative sentimental devices, observing for most of the film an aesthetic of relative sobriety and realism. In the last hour, and especially the final minutes of the film, melodramatic conventions are deployed in full force and infused with hagiographic iconography to produce a series of emotionally charged moments that create a perfect union of American Civil Religion and classical melodrama. The cornerstone of both cultural paradigms, as deployed in this film, is death: Lincoln's at the hands of an assassin, and the Civil War soldiers', poignantly depicted at key moments of the film. Finally, the essay shows how film melodrama as a genre weaves together the private and the public, the domestic with the national, the familial with the military, and links pathos to politics in a carefully choreographed narrative of sentimentalized mythopoesis.

Prosody and pragmatics in parenthetical insertions in catalan

This paper analyses the role of prosody in parenthetical insertions, a type of structure that is extremely common in both speech and writing. The materials under study come from a corpus of spontaneous speech acts in Central Catalan (with varying degrees of spontaneity) from which a corpus of oral parenthetical insertions has been compiled. The prototypical prosodic features of a parenthetical insertion in Catalan are: prosodic autonomy, limited extension, production in between pauses or final pause, tendency towards acceleration, fall in intensity, lower pitch range and, finally, falling or rising melodic pattern. While the final fall is the most frequent pattern in spontaneous conversations with a high degree of confidence between interlocutors, a final rising structure is found in interviews in which the degree of confidence between participants is smaller, their roles are unequal, and the interviewed constructs a narrative discourse. We thus suggest that the pitch contour of parenthetical insertions is related to formality and discourse typology (in this case, narrative vs. dialogue). Bearing in mind the discursive functions performed by these insertions, we propose a typology which classifies them with regards to two main functions: completion of information, and modalisation.

Results from a prospective, randomized, controlled study evaluating the acceptability and effects of routine pre-IVF counselling.

BACKGROUND: The aim of this study was to evaluate a model of routine pre-IVF counselling focusing on the narrative capacities of couples. The acceptability of counselling, the effects on emotional factors and the participants' assessments were considered. METHODS: The study included 141 consecutive childless couples preparing for their first IVF. Randomization was carried out through sealed envelopes attributing participants to counselled and non-counselled groups and was accepted by 100 couples. Another 12 couples refused randomization because they wanted counselling and 29 because they did not. Questionnaires including the State-Trait Anxiety Inventory, the Beck Depression Inventory and assessments of help were mailed to couples before IVF and counselling, and after the IVF outcome. RESULTS: Counselling was accepted by 79% (112/141) of couples. There was no significant effect of counselling on anxiety and depression scores which were within normal ranges at both times. Counselling provided help for 86% (75/87) of initially non-demanding subjects and 96% (25/26) of those initially requesting a session. Help was noted in areas of psychological assistance, technical explanations and discussing relationships. CONCLUSIONS: This model of routine counselling centred on the narrative provides an acceptable form of psychological assistance for pre-IVF couples.

Textual autocorrelation : formalism and illustrations

Abstract Textual autocorrelation is a broad and pervasive concept, referring to the similarity between nearby textual units: lexical repetitions along consecutive sentences, semantic association between neighbouring lexemes, persistence of discourse types (narrative, descriptive, dialogal...) and so on. Textual autocorrelation can also be negative, as illustrated by alternating phonological or morpho-syntactic categories, or the succession of word lengths. This contribution proposes a general Markov formalism for textual navigation, and inspired by spatial statistics. The formalism can express well-known constructs in textual data analysis, such as term-document matrices, references and hyperlinks navigation, (web) information retrieval, and in particular textual autocorrelation, as measured by Moran's I relatively to the exchange matrix associated to neighbourhoods of various possible types. Four case studies (word lengths alternation, lexical repulsion, parts of speech autocorrelation, and semantic autocorrelation) illustrate the theory. In particular, one observes a short-range repulsion between nouns together with a short-range attraction between verbs, both at the lexical and semantic levels. Résumé: Le concept d'autocorrélation textuelle, fort vaste, réfère à la similarité entre unités textuelles voisines: répétitions lexicales entre phrases successives, association sémantique entre lexèmes voisins, persistance du type de discours (narratif, descriptif, dialogal...) et ainsi de suite. L'autocorrélation textuelle peut être également négative, comme l'illustrent l'alternance entre les catégories phonologiques ou morpho-syntaxiques, ou la succession des longueurs de mots. Cette contribution propose un formalisme markovien général pour la navigation textuelle, inspiré par la statistique spatiale. Le formalisme est capable d'exprimer des constructions bien connues en analyse des données textuelles, telles que les matrices termes-documents, les références et la navigation par hyperliens, la recherche documentaire sur internet, et, en particulier, l'autocorélation textuelle, telle que mesurée par le I de Moran relatif à une matrice d'échange associée à des voisinages de différents types possibles. Quatre cas d'étude illustrent la théorie: alternance des longueurs de mots, répulsion lexicale, autocorrélation des catégories morpho-syntaxiques et autocorrélation sémantique. On observe en particulier une répulsion à courte portée entre les noms, ainsi qu'une attraction à courte portée entre les verbes, tant au niveau lexical que sémantique.