Reading Digital Fiction offers the first comprehensive and systematic theoretical, methodological, and analytical examination of digital fiction from a cognitive and empirical perspective. Proposing ...the new concept of "medial reading", it argues for the centrality of an audience's interest in, awareness of and/or attention to the medium in which a text is produced and received, and which we argue should be applied to reader data across media. The book analyses and theorises five generations of digital fiction and their reading, including hypertext fiction, hypermedia fiction, narrative video games, app fiction, and virtual reality. It showcases medium- and platform-specific methods of qualitative reader response research across a variety of contexts and settings from screen-based and embodied interaction to gallery installation, and from reading group and individual interview to think-aloud methodologies. The book thus addresses the unique affordances of digital fiction reading by designing and reporting on new empirical studies focusing on hypertextuality, interactivity, immersion, medium-specific forms of textual "you", ontological ambiguity, reader orientation, and empathy. In so doing, the book refines, critiques, and expands cognitive, transmedial, and empirical narratology and stylistics by placing the reader of these new narratives front and centre.
A topical, well-balanced and in-depth book that surveys thedetrimental impact humans have had on the planet over the last250 years, and evaluates what we can do to reverse the damage.
A critical book review of Angeliki Avigitidou's Performance Art: Education and Practice, Routledge, 2023. A consideration of how performance theory and practice concerns can be activated through ...embodied and experiential educational provocations.
Style and Reader Response: Minds, media, methods profiles the diversity of theoretical and methodological approaches in reception-oriented research in stylistics.
Only in the last 10—15 years have social researchers acknowledged the importance of conducting survey research with children directly, rather than relying on qualitative findings plus prevalence data ...collected by proxy from adults. With reference to the question—answer model, I here present and consider a number of guiding principles for the design of appropriate and effective questions for younger respondents. Pretesting of questions is especially important when researching populations about which relatively little is known, or who are likely to be especially sensitive to failings of questionnaire design. Children fall into this category because relatively little is known about how the question—answer model applies to them, and because their cognitive, memory, communicative and social faculties are still developing. With this in mind, I describe two key methods of question-testing, namely review by expert panel and in-depth cognitive interviewing.
The notion of possible worlds has played a decisive role in postclassical narratology by awakening interest in the nature of fictionality and in emphasizing the notion of world as a source of ...aesthetic experience in narrative texts. As a theory concerned with the opposition between the actual world that we belong to and possible worlds created by the imagination, possible worlds theory has made significant contributions to narratology.Possible Worlds Theory and Contemporary Narratologyupdates the field of possible worlds theory and postclassical narratology by developing this theoretical framework further and applying it to a range of contemporary literary narratives. This volume systematically outlines the theoretical underpinnings of the possible worlds approach, provides updated methods for analyzing fictional narrative, and profiles those methods via the analysis of a range of different texts, including contemporary fiction, digital fiction, video games, graphic novels, historical narratives, and dramatic texts. Through the variety of its contributions, including those by three originators of the subject area-Lubomír Doležel, Thomas Pavel, and Marie-Laure Ryan-Possible Worlds Theory and Contemporary Narratologydemonstrates the vitality and versatility of one of the most vibrant strands of contemporary narrative theory.
Background. The role of surgical management of calciphylaxis remains understudied. Objective. This article reports a case series and algorithmic approach to the multidisciplinary management of ...calciphylaxis. Methods. A single-center retrospective review of all adult patients with calciphylaxis treated surgically between January 2010 and November 2022 was performed. Results. Eleven patients met inclusion criteria. The average age was 50.9 years ± 15.8 SD, and most patients were female (n = 7 63.6%). Surgery was indicated for infection (n = 6 54.5%) and/or intractable pain (n = 11 100%). Patients underwent an average of 2.9 excisional debridements during their hospital course. Following the final excision, wounds were left open in 5 cases (29.4%), closed primarily in 4 (23.5%), and local flaps were used in 3 (27.3%). Postoperatively, the mean time to healing was 57.4 days ± 12.6. Complications included dehiscence (n = 1 9.1%), progression to cellulitis (n = 2 18.2%), osteomyelitis (n = 1 9.1%), and lower extremity amputation (n = 2 18.2%). Of the 6 patients alive at the time of healing, 5 (83.3%) were no longer taking narcotic medications. At an average follow-up of 26.4 months ± 34.1, 7 patients (63.6%) were deceased, with an average time to mortality of 4.8 months ± 6.7. Of the 4 remaining patients, 3 (75.0%) were ambulatory by their most recent follow-up visit. Conclusion. While the morbidity and mortality associated with calciphylaxis are substantial, surgical excision is effective in reducing pain and improving quality of life in patients with this end-stage disease. Wound care centers are uniquely equipped with a variety of medical and surgical specialists with experience in treating chronic wounds and thus facilitate an efficient multidisciplinary model.
resides in the lungs in various lesion types with unique microenvironmental conditions. This diversity is in line with heterogeneous disease progression and divergent drug efficiency. Fluorescent ...reporter strains can be used to decipher the micromilieu and to guide future treatment regimens. Current reporters using replicating plasmids, however, are not suitable for long-term mouse infections or studies in non-human primates. Using a combination of recombinant DNA and protein optimization techniques, we have developed reporter strains based on integrative plasmids, which exhibit stimulus-response characteristics and fluorescence intensities comparable to those based on replicating plasmids. We successfully applied the concepts by constructing a multi-color reporter strain able to detect simultaneous changes in environmental pH, Mg
concentrations, and protein expression levels.
Abstract
Background
Capsular contracture (CC) is a common long-term complication following prosthetic-based breast reconstruction (PBBR). Seven cases of CC following mRNA vaccination for coronavirus ...2019 (COVID-19) are reported in the literature.
Objectives
The aim of this study was to determine whether receiving the COVID-19 vaccine was associated with CC development following PBBR.
Methods
A retrospective, multicenter nested case-control study was performed from January 2014 to July 2022 of adult female patients who underwent PBBR with acellular dermal matrix placement. Cases of CC were selected if no adjuvant radiation was received and they presented for follow-up between December 2020 and July 2022. Controls included patients who met inclusion criteria but who did not experience CC in either breast. Patient demographics, breast cancer characteristics, reconstructive surgery details, postoperative complications, and COVID-19 exposure details were analyzed and correlated with CC development.
Results
Of a total of 230 patients (393 breasts) who received PBBR, 85 patients (135 breasts) met inclusion criteria, of whom 12 patients (19 breasts) developed CC and 73 patients (116 breasts) did not. At the time of median follow-up of 18.1 months (n = 85; interquartile range, 12.2-33.6 months), no statistically significant differences were observed between the short- or long-term complications in cases or controls. There were no significant differences in COVID-19 vaccination status, number of vaccine doses, or vaccination type between cases and controls. Vaccination status was not associated with greater odds of CC development (odds ratio, 1.44; 95% CI, 0.42-5.37; P > .05).
Conclusions
Direct association between CC and COVID-19 vaccination is difficult to prove. Given the known risk of severe COVID-19 infection among immunocompromised patients, those with breast cancer who undergo PBBR should be properly counseled on the benefits and risks of vaccination.
Level of Evidence: 4
To assess the effect of enhanced recovery pathway implementation on patient outcomes after vaginal hysterectomy (VH) performed to treat benign indications.
Case-control study examining outcome ...measures including length of stay, pain scores, postoperative morbidity, and readmission rates after implementation of the Enhanced Recovery after Surgery (ERAS) program for VH (Canadian Task Force classification II).
Teaching hospital.
Fifty patients who underwent VH after implementation of ERAS were compared with 50 control patients before ERAS. Patients were matched for age, indication for surgery, American Society of Anesthesiologists grade, and surgeon.
ERAS pathway.
Length of stay, percentage of patients discharged within 24 hours, use of urinary catheter and vaginal packing, and readmission rates were determined. Perioperative expenditures were compared, and cost-effectiveness of ERAS was assessed. Median patient vs control age (49.0 vs 51.0 years), parity (2.0 vs 2.0), and body mass index (26.5 vs 28.3) were statistically comparable. After ERAS implementation, the median length of stay was reduced by 51.6% (22.0 vs 45.5 hours; p < .01), and the percentage of patients discharged within 24 hours was increased by 5-fold (78.0 vs 15.6%; p < .05). Frequency of catheter use (82.0% vs 95.6%) and use of vaginal packing (52.0 vs 82.2%) were significantly lower in the post-ERAS group, and these devices were removed earlier (14.5 vs 23.7 hours and 16.0 vs 23.0 hours, respectively; p < .05 in all cases). Attendance in the Accident and Emergency Department (12.0% vs 0%; p > .05) and inpatient readmission rate (4.0% vs 0%; p > .05) were similar in both groups. Despite having to start a "gynecology school" and employ a specialist Enhanced Recovery nurse, a cost savings of 9.25% per patient was demonstrated.
The ERAS program in benign VH reduces length of stay by 51.6% and enables more women to be discharged within 24 hours, with no increase in patient readmissions rates.
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