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This article investigates the interactional relevance of weak cesuras in multimodal transitions in enactments. Previous research has pointed out that enactments are multimodally accomplished phenomena in that they do not only consist of a quotation but usually involve changes in prosody and bodily conduct, too. Furthermore, it has been noted that an upcoming quotation may be projected in the preceding talk by phonetic cues. There is, however, little research on the precise multimodal realization of such transitions and their possible interactional relevance. Taking this as a starting point, we analyze a collection of co-enactments. Firstly, we show that quotations are projected not only by phonetic but also bodily cues, which often build up gradually in the preceding talk. These smooth transitions into enactment are analyzed as “cesural areas.” Secondly, we argue that such cesural areas and the cumulation of multimodal projections open up an opportunity space in the sense of Lerner (1991), whereby a joint enactment involving co-participants, i.e., a co-enactment, is possible. Thirdly, we show that participants jointly develop the meaning of the enactment in this space, mutually taking up and elaborating on their prior contributions. The data is taken from a corpus of collaborative storytellings in German.

Background: Atrial cardiopathy is a proposed mechanism of embolic stroke of undetermined source (ESUS). Left atrial (LA) strain may identify early atrial cardiopathy prior to structural changes. We aim to study the associations between LA strain, ESUS, and atrial fibrillation (AF) detection in ESUS. Methods: The study population included patients with ESUS and noncardioembolic (NCE) stroke presenting to the Rhode Island Hospital Stroke Center between January 2016 and June 2017 who underwent transthoracic echocardiography. Speckle tracking echocardiography (STE) was used to measure the three phases of LA strain (reservoir, conduit, and contractile). Binary logistic regression analysis was performed to determine the associations between LA strain and stroke subtype (ESUS vs. NCE) as well as follow‐up detection of AF in ESUS patients. Results: We identified 656 patients, 307 with ESUS and 349 with NCE. In binary logistic regression, the lowest tertiles of LA reservoir (adjusted OR 1.944, 95% CI 1.266–2.986, p =.002), contractile (aOR 1.568, 95% CI 1.035–2.374, p =.034), and conduit strain (aOR 2.288, 95% CI 1.448–3.613, p =.001) were more likely to be significantly associated with ESUS compared to NCE stroke. Among all ESUS patients, the lowest tertiles of LA reservoir strain (OR 2.534, 95% CI 1.029–6.236, p =.043), contractile strain (OR 2.828, 95% CI 1.158–6.903, p =.022), and conduit strain (OR 2.614, 95% CI 1.003–6.815, p =.049) were significantly associated with subsequent detection of AF. Conclusion: Reduced LA strain is associated with ESUS occurrence and AF detection in ESUS patients. Therefore, quantification of LA strain in ESUS patients may improve risk stratification and guide secondary prevention strategies. [ABSTRACT FROM AUTHOR]

Objective: Anticoagulation therapy is commonly interrupted in patients with atrial fibrillation (AF) for elective procedures. However, the risk factors of acute ischemic stroke (AIS) during the periprocedural period remain uncertain. We performed a nationwide analysis to evaluate AIS risk factors in patients with AF undergoing elective surgical procedures. Methods: Using the Nationwide Readmission Database, we included electively admitted adult patients with AF and procedural Diagnosis‐Related Group codes from 2016 to 2019. Diagnoses were identified based on International Classification of Disease, 9th revision‐Clinical Modification (ICD‐10 CM) codes. We constructed a logistic regression model to identify risk factors and developed a new scoring system incorporating CHA2DS2VASc to estimate periprocedural AIS risk. Results: Of the 1,045,293 patients with AF admitted for an elective procedure, the mean age was 71.5 years, 39.2% were women, and 0.70% had a perioperative AIS during the index admission or within 30 days of discharge. Active cancer (adjusted OR [aOR] = 1.58, 95% confidence interval [CI] = 1.42–1.76), renal failure (aOR = 1.14, 95% CI = 1.04–1.24), neurological surgery (aOR = 4.51, 95% CI = 3.84–5.30), cardiovascular surgery (aOR = 2.74, 95% CI = 2.52–2.97), and higher CHA2DS2VASc scores (aOR 1.25 per point, 95% CI 1.22–1.29) were significant risk factors for periprocedural AIS. The new scoring system (area under the receiver operating characteristic curve [AUC] = 0.68, 95% CI = 0.67 to 0.79) incorporating surgical type and cancer outperformed CHA2DS2VASc (AUC = 0.60, 95% CI = 0.60 to 0.61). Interpretation: In patients with AF, periprocedural AIS risk increases with the CHA2DS2VASc score, active cancer, and cardiovascular or neurological surgeries. Studies are needed to devise better strategies to mitigate perioperative AIS risk in these patients. ANN NEUROL 2023;94:321–329 [ABSTRACT FROM AUTHOR]

GABAergic neurons in the caudal ventrolateral medulla (CVLM) are driven by baroreceptor inputs relayed via the nucleus tractus solitarius (NTS), and they inhibit neurons in rostral ventrolateral medulla to reduce sympathetic nerve activity (SNA) and arterial pressure (AP). After arterial baroreceptor denervation or lesions of the NTS, inhibition of the CVLM continues to increase AP, suggesting additional inputs also tonically activate the CVLM. This study examined whether the NTS contributes to baroreceptor-independent drive to the CVLM and whether glutamate promotes baroreceptor- and NTS-independent activation of the CVLM to tonically reduce SNA. In addition, we evaluated whether altering central respiratory drive, a baroreceptor-independent regulator of CVLM neurons, influences glutamatergic inputs to the CVLM. Splanchnic SNA and AP were measured in chloralose-anesthetized, ventilated, paralyzed rats. The infusion of nitropmsside decreased AP below threshold for baroreceptor afferent firing ( splanchnic sympathetic nerve activity; baroreceptor; muscimol; kynurenate; respiratory; caudal ventrolateral medulla; nucleus tractus solitarius

Adult obese Zucker rats (OZRs) have elevated sympathetic vasomotor tone and arterial pressure (AP) with blunted baroreflex-mediated changes in heart rate (HR) compared with adult lean Zucker rats (LZRs). The present study examined whether compromised cardiac baroreflexes are indicative of attenuated sympathetic responses. In addition, because juvenile OZRs have a normal mean AP, we determined whether baroreflexes are fully functional prior to hypertension. At 13 wk, adult OZRs had an elevated baseline mean AP compared with LZRs (137 [+ or -] 3 vs. 123 [+ or -] 5 mmHg, P < 0.05) under urethane anesthesia. Phenylephrine-induced increases in AP evoked smaller inhibitions of splanchnic sympathetic nerve activity (SNA) and HR in OZRs compared with LZRs. In addition, sympathoexcitatory responses to nitroprusside-induced hypotension were also blunted in OZRs. Sigmoid analysis revealed a decreased gain, a higher mean AP at the midpoint of the curve ([AP.sub.50]), and a reduced range of changes in SNA in OZRs. In contrast, at 7 wk of age, although juvenile OZRs weighed more than LZRs (313 [+ or -] 13 vs. 204 [+ or -] 4 g, P < 0.05), mean AP was comparable in both groups (122 [+ or -] 5 vs. 121 [+ or -] 4 mmHg, not significant). In these rats, rapid changes in AP evoked comparable changes in SNA and HR in OZRs and LZRs. Sigmoid analysis revealed that, although the gain of the reflex was blunted in OZRs (P < 0.05), the mean [AP.sub.50] and range of changes in SNA were comparable in OZRs and LZRs. Together, these data indicate that in adult OZRs, sympathetic responses to acute changes in AP are smaller than those observed in adult LZRs and that impairment of baroreceptor refexes in OZR is not limited to the regulation of HR but extends to sympathetic vasomotor control. In addition, most of these deficits in baroreflex control of SNA develop in adulthood long after the onset of obesity and when other deficits in cardiovascular regulation are present. phenylephrine; nitroprusside; splanchnic; sympathetic; heart rate

Dr H.V. Evatt, Australian Deputy Prime Minister, Attorney-General and Minister for External Affairs in the Chifley Labor government, presided over Australian foreign policy at a critical juncture in the history [...]

Both the Clinton and George W. Bush administrations have faced challenges from the Middle East and Islamist terror. Both administrations wrestled with questions of unilateralism versus multilateralism, the efficacy of [...]

Nearly four years have elapsed since the Oslo process (1993-2000) between Israelis and Palestinians foundered in bloodshed. Over that period, two U.S. administrations have tried to forge policies that would [...]

On April 30, 2003, following the swift collapse of Saddam Hussein's regime in Baghdad, the Bush administration released the latest plan for Israeli-Palestinian peace, a document entitled 'A Performance-Based Roadmap [...]

Since the eruption of Israeli-Palestinian hostilities in September 2000, the United States has faced the dilemma of formulating a policy response. The nature of the violence is clear and almost [...]

Even before the fires were stoked in September 2000, it was apparent after Camp David that Israelis and Palestinians were headed for conflict. During the talks, even Palestinians normally deemed [...]

Does Hollywood dehumanize Muslims and Arabs? Many writers and organizations think so. They assert that racial and ethnic stereotyping that has been otherwise abandoned by the cinema continues to apply [...]

Zionism conforms to only a few of the usual canons of nationalism. Most nationalism is bred in ancient soil. Zionism was pioneered in Europe, and Jewish nation building in Palestine [...]

Chronic pouchitis (CP) after ileal pouch-anal anastomosis is a significant clinical problem. Adipose tissues produce antiinflammatory cytokines and chemokines. We evaluated the association between abdominal visceral fat area (VFA) and CP. Patients with a preoperative CT evaluation were included. The diagnosis of CP was confirmed in all cases by endoscopy with afferent ileal limb intubation. Patients were allocated into groups of high VFA and low VFA. The study cohort of 52 patients had a median body mass index of 22 (range, 14-32). Indications for surgery were medically refractory disease in 46 (88%) patients and cancer/dysplasia in six (12%) patients. Median VFA was 27.1 (range, 1-144). Six (12%) patients developed CP. Low VFA patients were significantly younger (29 vs 45 years; P < 0.0001), had lower body mass index (20.4 vs 24.7; P < 0.0001), had surgery more commonly for medically refractory disease than for cancer or dysplasia (100 vs 77%; P = 0.02), and had a higher incidence of CP than high VFA patients (23 vs 0%; P = 0.02). Multiple linear regression analysis demonstrated that only low VFA was associated with CP (P = 0.009). An association is present between VFA and CP after ileal pouch-anal anastomosis, implicating adipocytes in the pathogenesis of inflammatory bowel disease. [ABSTRACT FROM AUTHOR]

The CIA at War: Inside the Secret Campaign against Terror. By Ronald Kessler. New York: St. Martin's Press, 2003. 496 pp. $27.95 ($15.95, paper). Kessler, a New York Times journalist [...]

Right to Exist: A Moral Defense of Israel's Wars. By Yaacov Lozowick. New York: Random House, 2003. 326 pp. $26 ($15, paper). In a work both impassioned and measured, Lozowick [...]

Examines the involvement of Australia in the emergence and successful passage of the United Nations General Assembly resolution for the partition of Palestine. Attempt to ascertain the motives and character of Australia's involvement through the country's Minister for External Affairs Doctor H.V. Evatt; Discussion on the performance of Evatt.

Hypoxia elevates splanchnic sympathetic nerve activity (SNA) with differential effects during inspiration and expiration by unresolved central mechanisms. Pre-sympathetic neurons in the rostral ventrolateral medulla (RVLM), which are necessary for the sympatho-excitatory response to hypoxia, are activated by hypoxia with oscillations entrained to the respiratory cycle. GABAergic baro-activated neurons in the caudal ventrolateral medulla (CVLM) provide the major tonic inhibition to RVLM neurons and have patterns of activity related to central respiratory drive. We examined the hypothesis that CVLM neurons are influenced by hypoxia and that the nature of their response may coincide with their pattern of respiratory modulation. We recorded from 18 baroactivated CVLM neurons with respiratory-related activity in choralose-anesthetised, vagotomized, paralyzed rats. Most CVLM neurons (13/18) were activated by hypoxia induced by inhalation of 10% O2, but others (5/18) were inhibited or silenced. The response to hypoxia was related to the pattern of central respiratory-related activity (P <0.05, Chi-square). Most (11/13) hypoxia-activated CVLM neurons had inspiratory-related activity. In contrast, most (4/5) hypoxia-inhibited neurons had expiratory-related activity. These data provide the first evidence that the CVLM may contribute to the complex sympathetic responses to hypoxia. [ABSTRACT FROM AUTHOR]