Visual arts Argumentative Essay Example For Students

Visual arts Argumentative Essay The first ticket Drawn will allow the Purchase to pick the piece of art work by the artist name title of the work, The Drawing will o on until all the art is gone. These 50 pieces start at over $2500, much more than the cost of the ticket. Works by these Artists are hard to come by and will become a valuable Tamil heirloom. Tickets are available exclusively through VENTRICLE. Com The Dunbar Fine Arts Council goal is to encourage Arts in After School programs in Central Ohio. This includes nurturing Artistic Excellence in Children Young People, by funding art programs that pay for Teaching, Developing and Showcasing their works to display in a schools, public places and government buildings. GOALS PRIORITIES * Support Visual Arts by increasing good quality, affordable spaces and facilities that it encourages our children to thrive. By providing professional development, support and advice for young children to develop a skill. Funding trips for Students to visit area and regional museum and galleries. We will write a custom essay on Visual arts Argumentative specifically for you for only $16.38 $13.9/page Order now Addressing inconsistent provisions of Opportunities for children and young people so that they can benefit by being exposed to a skilled blueprint to increase their professionalism, diversity and working standard of the Visual Arts Sector. * Finally placing their work in area galleries that will be shown for years to come.

The House of Mirth

The House of Mirth Free Online Research Papers In Edith Whartons novel, The House of Mirth, the main protagonist, Lily Bart moves back and forth between dreams of marriage and equally strong desires for independence and freedom. Despite her training on the social codes of conduct and etiquette, which was ingrained into her daily existence by her mother, Lily exhibits frequent moments of recklessness that threaten her opportunities in the marriage market. Why does a well-trained, economically motivated, twenty-nine year old virgin risk her chances for a financial and social safe-haven? With the aid of Jacques Lacans theories in the formation of subjectivity in the psyche, an analysis of Lily Barts history and background should help answer this question. In Lacans analysis, there are three orders in the psyche that are crucial and equally important to the formation of subjectivity, they are the Imaginary, the Symbolic, and the Real (Lacan, 1975). In order to understand why Lily Bart continually sabotages her efforts to achieve what she frequently refers to as escape from the dinginess of her present life, (Wharton, 2000) an examination of the Imaginary order must first be made. According to Lacan the human self comes into being through a fundamentally aesthetic recognition. Through an external medium (a mirror) the childs fragmented body is made whole the newly fashioned specular I precedes the social I. The Imaginary originates in the human beings fascination with form (Lacan, 1975). In the case of Lily Bart, the form that she is most fascinated with is her own. Lilys constant mirror gazing initiates the process of constructing a center for herself or her ego. As Terry Eagleton explains, This self, as the mirror situation suggests, is essentially narcissistic: we arrive at a sense of an I by finding that I reflected back to ourselves by some objects or person in the world (Eagleton, 1983). In Lilys case, it is not surprising that her first misrecognition of her image has been supplied by her mother. Her mother looks upon Lilys beauty as a commodity or means to a profitable end. Mrs. Bart studied Lily’s beauty with a kind of passion, as though it were some weapon she had slowly fashioned for her vengeance. It was the last asset in their fortunes, the nucleus around which their life was to be rebuilt. She watched it jealously as though it were her own property and Lily its mere custodian; and she tried to instill into the latter a sense of the responsibility that such a charge involved (Wharton, 2000). Inevitably, Lily also sees herself as a commodity. Her fragmented ego is formed on the basis of her significance as an object whose value is determined by the power of its marketability. As Lacan explains, the ego is just this narcissistic process whereby we bolster up a fictive sense of unitary selfhood by finding something in the world with which we can identify (Eagleton, 1983).Lilys sense of identity is directly tied to the objectification of her beauty. She is willing to auction it off to the highest bidder in the marriage market because as Lawrence Selden so accurately observes, it was what she was brought up for (Wharton, 2000). Even though it may have been what Lily was brought up for, we find that the objectification of Lilys beauty is not an indulgence, but it eventually becomes a means for her survival. According to Jacques Lacan, the two most significant moments in the development of human subjectivity and ego development occur in the mirror stage and the oedipal stage. Both of these stages aid the subject in their passage through the imaginary to the symbolic. These two concepts are clearly defined in James Mellards book, Using Lacan Reading Fiction. Mellard explains that the child who previously perceives itself as pieces or fragments is unified in the mirror image of its other, the mother. But this assumed, narcissistic unity is eventually split by the function called the Oedipus complex (Mellard, 1991). In Lacanian terms, the Oedipus complex can also be referred to as the Law of the Father. This principal theory, Law of the Father, is defined by Lacan as an acceptance of the loss of the paternal metaphor the phallus and a willingness on the part of the subject to follow patriarchal authority or law. Lilys desire for independence and freedom lies in direct conflict with what Lacan terms as the Law of the Father or patriarchal law. The phallus and the Name-of-the-Father symbolize that which comes between the mother and child, separating the one from the other, â€Å"symbolizing that which the mother does not have (Lacan, 1975). A monumental moment in Lilys ego formation occurs when her father announces to Lily and Mrs. Bart that he is financially ruined. Wharton describes Mr. Bart as a hazy outline neutral-tinted figure that Lily saw through a blurfirst of sleepiness, then of distance and indifference (Wharton, 2000).In the imaginary Lilys feelings of security and vanity are provided by her dominant mother. Lilys life changes, however, when the power and authority of her father is diminished. Along a metonymic chain of signifiers, Lily realizes that money, power, security, and social standing are all contained under the signifier, father, and upon her fathers death, her world is no longer the same. The death of Lilys father shows her how precarious life is for women who are not under the protection of men. Lily and her mother, devoid of income, rely on the hospitality and charity of relatives. At the age of eighteen, Lilys world is shattered and the only tool available for her use was her face. She rememb ers her mother fiercely stating, â€Å"you’ll get it all back, with your face (Wharton, 2000). The death of Lilys mother further fragments Lilys image of herself. When Mrs. Bart was alive, she was a willing participant in the preparation of her daughter in the marriage market. Now, Lilys reflection is offset by the other prospective virgins of her society and sees the disadvantage that motherlessness places on her task of finding a wealthy husband. Lily concludes that, Mr. Gryces arrival had fluttered the maternal breasts of New York and when a girl has no mother to palpitate for her; she needs be on the alert for herself (Wharton, 2000). Lily feels the loss of support, guidance and self-interest that her mother would have provided if she were still alive. Mrs. Barts death inhibits Lilys transference to the symbolic and further mires her in the imaginary where she mourns the loss of, or lack of a mother. Lilys actions, on the surface, personify an individual who is willing to follow patriarchal authority or law. She appears to be willing to assume traditional gender roles as a wife in her society, but she repeatedly makes decisions that, ultimately, sabotage her chances for success. This repetition suggests that there are other desires that she is repressing. Even though outwardly she is willing to give herself away in exchange for money and social position, internally she struggles with her desire for personal freedom. Consequently, according to Lacan, these repressed desires result in a split or divided self. Lacan further explains that the subject is essentially in a state of conflict between the symbolic and imaginary (Lacan, 1975). The phallic symbol for Lily is money and this represents not only patriarchal law but also freedom. Lilys state of conflict between both orders result from her desire for freedom, which involves money and can only be provided by marriage to a wealthy man which will further make her a victim of the civilization which had produced her (Wharton, 2000) and deny her the personal freedom she desires. Lily is constantly driven to accept the symbols of authority in her world and through them the rule of the Symbolic order. The signifiers of this order constantly appear in aspects that Lacan calls the gaze, along with the metonymical imagery associated with it such as the charwomans stare, the stream of admiring looks, and the several hundred pairs of eyes that gaze upon her beauty or scrutinize her actions. Together these, along with other examples, represent one of the most important motifs in Whartons narrative. The gaze, as Lacan might say, cuts in many directions, as it links the subject to the object and by that linkage turns each into the other. Lily Bart is metaphorically trapped under the gaze which dominates as a double for the New York leisure society who uses their prescribed laws and codes to continually judge Lilys acceptability. Lilys values and self-worth are defined by the perceptions and opinions of others. She is seduced by the ways in which society eagerly reflec ts back upon the heroine, the image it encourages her to flash. A strong example of this can be seen in Whartons tableaux vivants scene where Lilys portrayal of Reynolds, Mrs. Lloyd, shows Lily in the role of an erotic object that exists for others, while alienating her own subjectivity and transferring to those who wish to behold or enjoy her beauty. According to Lacan this narcissistic identification with the other enables her to see her function and place of her world and her being (Lacan, 1975). Is this truly the real Lily Bart, divested of the trivialities of her little world, or is it according to that experienced connoisseur Mr. Ned Van Alstyne just a deuced bold thing showing herself (Wharton, 2000). Lacan would suggest that Lily caught in the gaze of her spectators becomes whatever each of them fantasize her to be. Even though this gaze would initially illicit a sense of accomplishment and self-satisfaction from Lily, she is quite literally on display and there is an emptiness or lack of value that this public display provides her in her search for self. Lily is adept at attracting the gaze of others, and sees herself as a skillful operator (Wharton, 2000). Early in the novel, she sets her sights on the eligible and wealthy Percy Gryce, and feels confident and almost sure that she, â€Å"landed him, with a few days work, she would win her reward (Wharton, 2000). Despite the financial security and status that a marriage to Percy Gryce would mean to Lilys escape from dinginess, she does everything possible to sabotage her success. She complains that the reward itself seemed unpalatable just then she could get no zest from the thought of victory (Wharton, 2000). Lily describes the courting process with Gryce as a chore but realizes that, she could not ignore him on the morrow, she must follow up her success, must submit to more boredom, must be ready with fresh compliances and adaptabilities, and all on the bare chance that he might ultimately decide to do her the honor of boring her for life. It was a hateful fatebut how escapes from it (Wharton, 2000)? Even with marriage ability on the line, she takes a day off and indulges in her own desires with Selden. In this scene, Lily tries with Seldens help to define the meaning of success. Selden expresses his idea of success as being a form of freedom from everythingfrom money, from poverty, from ease and anxiety, from all material accidents a kind of republic of the spirit (Wharton, 2000). Seldens description awakens in Lily a sense of joy and enthusiasm, and he is able to put into language the desire or jouissance that is missing in Lilys life. Lacan explains that to enter language is to be severed from the real, that inaccessible realm which is always beyond the reach of signification, always outside the symbolic order (Eagleton, 1983). Lacan further defines the Real as the truth that we repress. Once that which we desire is the object of discourse, it no longer can maintain the position of jouissance because it becomes real or truth. Lacan tells us that language is, what hollows being into desire. Language divides uparticulatesthe fullness of the imaginary. To enter language is to be severed from what Lacan calls the real, that inaccessible realm which is always beyond the reach of signification, always outside the symbolic order (Lacan, 1975). Lacans contribution to the understanding of the subject is unique because, unlike Freud, he accounted for the power that the social/linguistic world plays in the formation of the self. Lacan viewed the interaction between the linguistic and the ego as a process in constant fluctuation just as the subject is in a constant state of fluctuation between the Imaginary and Symbolic orders. The Real is expressed in the form of discourse, and it can only be studied in its effects on the other two dimensions, the Imaginary and Symbolic (Lacan, 1975). Lily comes close to being able to express her lack or desire or void in words. She eagerly tells Selden, Whenever I see you, I find myself spelling out a letter of the sign and yesterdaylast evening at dinnerI suddenly saw a little way into your republic (Wharton, 2000). Lily is in the process of trying to find out what the word is that is written on the sign that will lead her into the republic of spirit. Unfortunately, even upon her death this word is never spoken between her and Selden. Selden and Lilys discourse is structured similarly to what Lacan refers to as the language of the unconscious. He further explains that, the unconscious is structured, not amorphous, and it speaks rhetorically through the dreams, mistakes, and symptoms of the subject it is the body itself that provides the raw material that the unconscious uses to express itself and the analyst, like a literary critic must read (Lacan, 1975). In Lacanian theory, the conscious and the unconscious cannot be separated. The unconscious bears the marks of the signifiers impressed on it. Selden seems to understand that there is something different about his conversation with Lily. Something he does not usually experience with others. He concludes that ,he himself did not know why he had led their talk along such lines; it was one of those moments when neither seemed to speak deliberately, when an indwelling voice in each called to the other across unsounded depths of feeling (Wharton, 2000) This unconscious expression of the subjects wants and desires goes along way in explaining why Lily had a fatalistic sense of being drawn from one wrong turning to another without ever perceiving the right road till it was too late to take it (Wharton, 2000). In the House of Mirth, Lily Barts unconscious speaks volumes about the decisions that she makes with her life. On more than one occasion, Lily seems to be following a path and then quickly changes her mind about the direction she is going. Carry Fisher assumes that,† its just flightiness but sometimes I think its because, at heart, she despises the things shes trying for (Wharton, 2000). In the end, it is not language but silence that dominates Lilys actions. When Gerty Farish asks Lily to tell her the truth about what happened in Europe, Lily explains to Gerty that Where a woman is concerned, its the story thats easiest to believe (Wharton, 2000). Both Sim Rosedale and George Dorset offer Lily options that will place her back in a position in the New York society that she is accustomed to; however, at the moment that she must make her decision, suddenly fear possessed her, fear of herself and of the terrible force of the temptation (Wharton, 2000). George Dorset appeals to Lily, Its just a word to say, and you put me out of my misery! (Wharton, 2000). Rosedale offers to financially back Lily in her fight against Bertha Dorset. He implores Lily, Here I am ready to lift you out of your [worries] tomorrow, if you say so. Do you say so, Miss Lily? (Wharton, 2000); but Miss Lily never says so. She maintains her silence even when she knows that the words will redeem her in the eyes of a society who has cruelly judged her all her life. Berthas letters are also a metaphor for the silence that Lily keeps at the end. In burning the words that Bertha has written, Lily refuses to allow language to save her. Lacan would say that Lily has reversed into the pre-oedipal stage where language is unavailable to the subjects identification. She is painfully isolated and the loneliness and despair that exist in the last moments of Lilys life are evident. She wonders, If only life could end nowend on this tragic yet sweet vision of lost possibilities, which gave her a sense of kinship with all the loving and foregoing in the world! (Wharton, 2000) Terry Eagleton explains that, according to Freud, The final goal of life is death, a return to that blissful inanimate state where the ego cannot be injured (Eagleton, 1983). Lacan also agrees that when we are severed from the mothers body: after the Oedipus crisis, we will never again be able to attain this state even though we will spend all of our lives hunting for it (Eagleton, 1983). It is under the fatal effects of chloral, which Lily returns to this pre-oedipal state. The significance of the baby that she holds in her arms indicates that Lily is either expressing a lost sense of possibilities of motherhood or she is in fact hallucinating her own rebirth in the form of the imaginary baby. Through death, her maternal longings are satisfied with the reunion of this unreal child. It is also significant that Wharton suggests that Lily does not merely dream of the child, but she actually feels its soft, bodily presence (Wharton, 2000). She becomes frantic and desperate as a flash of loneliness and terror tore its way .She started up again, cold and trembling with the shock; for a moment she seemed to have lost her hold of the child. But noshe was mistakenthe tender pressure of its body was still close to hers; the recovered warmth flowed through her once more, she yielded to it (Wharton, 2000). Lily returns to the pre-oedipal stage to seek the reassurance, comfort and warmth that she cannot find in the harsh reality of her New York world. Rather than conform to society, she retreats, and it is only in death that Lily finds the last letters of the signpost that show her the way into the republic of spirit. Eagleton, T. (1983). Literary Theory and Introduction. Great Britain: Blackwell Publishers, Ltd. Lacan, J. (1975). The Language of The Self: The Function of Language in Psychoanalysis. New York: Dell Publishing Company. Leitch, V. B. (2001). The Mirror Stage as Formative The Norton Anthology of Theory and Criticism. New York: W.W. Norton and Company. Mellard, J. M. (1991). Using Lacan Reading Fiction. Urbana: Univerwsity of Ilinois Press. Wharton, E. (2000). The House of Mirth. New York: Signet Classic. Research Papers on The House of MirthWhere Wild and West MeetAnalysis Of A Cosmetics AdvertisementEffects of Television Violence on ChildrenInfluences of Socio-Economic Status of Married MalesIncorporating Risk and Uncertainty Factor in CapitalThe Relationship Between Delinquency and Drug UseThree Concepts of PsychodynamicAnalysis of Ebay Expanding into AsiaMind TravelHip-Hop is Art

Easy English Proverbs

Easy English Proverbs Learning proverbs - or sayings - are a great way to get insight and improve your English. Unfortunately, some proverbs are easy to understand and others more difficult. This article provides twenty easy proverbs that are right for your level. Each proverb has a definition for you to learn the proverb. Once you have learned these twenty proverbs, match the situations to the appropriate proverb at the end of the article. Teachers can use these activities with proverbs in the classroom to help your learners. List of Proverbs Accidents happen. Mistakes and bad events naturally happen. Its not your fault. Better late than never. Its good you came to something. The customer is always right. People who pay money for something you sell deserve respect. You only die once. Nothing in life is so bad. Easy does it. Be careful, dont go too fast. Every man has his price. Every person will do anything for enough money. Fight fire with fire. If someone is aggressive with you, be aggressive with that person. If you cant be good, be careful. When you do something that mom and dad wont like, dont be too crazy. Home is where the heart is. Your true place is with the people you love. The king can do no wrong. People with a lot of power, the boss, etc. do wrong, but are not criticized by others. Knowledge is power. Learning will help you succeed in life. Live and learn. Living teaches you lessons, take advantage of the lessons. He lives long who lives well. Living healthfully will lead to a long life. Money isnt everything. Money is not the only important thing in life. Never say never. Life will surprise you, dont say no to things. Never too old to learn. No matter how old you are you should learn new things. No news is good news. If you dont hear anything from someone, it means that everything is OK. Out of sight, out of mind. If you dont see or hear about something, you wont worry about it. You get what you pay for. Quality items are never cheap. Every picture tells a story. Each situation tells you something about the people and places involved. Matching Proverbs Test Match the proverbs below with the appropriate situations for the proverb. Better late than never.The king can do no wrong.Never say never.You get what you pay for.He lives long who lives well.No news is good news.Easy does it.Every man has his price.Home is where the heart is.Out of sight, out of mind.Fight fire with fire.Every picture tells a story.The customer is always right.You can only die once.Knowledge is power.Accidents will happen.Never too old to learn.Money isnt everything.Live and learn.If you cant be good, be careful.Dont worry about what you did. Sometimes bad things happen.Im glad you are here, even if the party started three hours ago.Even though that man makes you angry, he is spending money in our shop. Be nice.I know it was bad news, but there are worse things in life.Speak to Peter again. Im sure you can convince him to join our company.If Mary is going to do that to you, you need to do something to Mary.When you go to college, you will probably do some things you shouldnt. Please dont be too crazy!Ive moved all over the world with my w ife. Were happy together no matter where we live. Hes the director of the company, so he can do what he wants.This bad experience is only part of your life. Dont worry about it.You might not want to visit Los Angeles today, but maybe you will someday.I know its hard to find a new job when you are 53, but you can do it!I havent heard from my brother for more than three months.Shes gone so her mother doesnt worry about her so much.Im not surprised it already broke. You only paid $10 for that toy.Look at those two old people holding hands. I think they probably have a good marriage.

Media and Politics. Picking a local topic, national, and world topic Essay

Media and Politics. Picking a local topic, national, and world topic. Present topic - Essay Example This is because one source will have either some strength or weaknesses, therefore advantaging or disadvantaging the rival source, resulting in the differences. The media, for being such an influential part of society, requires regulations and ethics to govern what qualifies to broadcast or not, for instance in the case of politics, it is important for sources to remain neutral and not influence society in any way. Introduction The general media is a valuable source of information and a powerful medium of information that largely influences the understanding of daily events and occurrences of the people who access its releases. As a watchdog, the media has the potential to either be faithful or not, as it enjoys unlimited freedom in choosing and deciding what is worth publicizing or not, and what perception to create around a certain event or occurrence. The media is a wide fraternity of society comprising of numerous sources at different levels and has similarities, differences, str engths, weaknesses, and much influence on all aspects of society. This essay will conduct an analysis of media sources at three levels; local, national, and international, and bring out the mentioned qualities by comparing the uniqueness of two different media sources at each level in their mode of relaying similar political events. Local media level Local media coverage defines broadcasting of information concerned with a specific context such as a state, whose news would not be of much relevance to other states or to the larger national and international communities. In this case, this study will compare and contrast the relay of news concerning the 2012 accusation of (former) 18th Lieutenant Governor of Florida, Jennifer Carroll, of having a lesbian relationship with an aide in which we shall feature the Miami Herald and Sun-Sentinel as our news sources. The Sun-Sentinel The article with Carroll’s story as appearing on this media source on 12 July 2012 had the headline â⠂¬Å"Sex scandal becomes the talk of Florida’s capital.† The story is introduced with catchy words such as â€Å"titillating sex scandal† and goes on to describe Carroll as one who does not feature much in the news headlines but is this time in the limelight due to criminal charges. However, after this, there is not much mention of her accusations. Rather, the stories focus on one Carletha Cole who is Carroll’s former spokesperson and who is accused of conducting illegal recording. The story does not seem to directly attack Carroll, and all her accusations arise from second parties such as Cole’s attorney bringing up the sexual accusations, but not the source itself. The source does not reveal what the results of a polygraph test carried out on Cole were. At the conclusion of the story, there is much positive information about Carroll, such as the women representatives describing her as a role model. She is also linked to Christianity, and her histor y is depicted as never tainted before (Haughney and Bureau 1). The Miami Herald The Miami Herald’s headline of the topic is â€Å"Is Lt. Gov. Jennifer Carroll’s Former aide seeking vengeance or injustice?† In this source, Cole’s attorney introduces the sexual accusations against Carroll, this after we learn that Cole is facing criminal charges of illegally taping audio around the Florida State offices. In this article, they

Southern blotting application Assignment Example | Topics and Well Written Essays - 750 words

Southern blotting application - Assignment Example A labeled DNA sequence is usually an RFLP probe that hybridizes with either a single or multiple fragments of the digested DNA sample after separation by gel electrophoresis resulting to showing a unique blotting pattern attributed to a genotype that is specific to a locus. RFLP probes are usually short, single or low copy genomic DNA or cDNA clones. Application of RFLP probes are usually used in variation analysis such as in paternity tests, ping and diagnosis of hereditary diseases. RFLP probes are also used in genome mapping. RFLPs are detected by using restriction enzyme that can recognize and fragment a sample of DNA where there is a specific short sequence. This step is known as restriction enzyme digestion. Single nucleotide polymorphisms can either create or destroy restriction endonuclease recognition sites therefore affecting the length and the quantity of DNA fragments resulting from restriction enzyme digestion. Agarose gel electrophoresis separates the resulting DNA fragments and transferred to a membrane through a Southern blot procedure. The membrane is a paper like matrix made up of nitrocellulose and usually has a slight positive charge. The fragment lengths that are complementary to the RFLP probes and are considered as alleles in genetic analysis is determined by the hybridization of the membrane to the labeled DNA probe (National Center for Biotechnology Information ). In developing RFLP probes, a methylation sensitive enzyme digests the total DNA thus enriching the library for sequences that are single or low copy expressed. The digested DNA is size fractionated on preparative agarose gel and excision, elusion and cloning into plasmid vector of is done. The digested plasmids are consequently screened for inserts. Total sheared DNA can be used to probe southern blots of the inserts to select clones that can hybridise to single and low copy sequences. Genomic DNA of different genotypes

Therapeutic Hypothermia for Postnatal Refractory Hypoxemia

Therapeutic Hypothermia for Postnatal Refractory Hypoxemia THERAPEUTIC HYPOTHERMIA FOR POSTNATAL REFRACTORY HYPOXEMIA « A CASE REPORT IN A TERM NEONATE K. Sarafidis1, E. Diamanti1, V. Soubasi1, K. Mitsakis2, V. Orossou-Agakidou1, Bianca Popovici3, M. Moga3 Summary We describe a term neonate treated with whole-body hypothermia several days after birth to counteract refractory hypoxemia due to persistent pulmonary hypertension unresponsive to optimal treatment. This approach was selected to improve oxygenation and protect the brain from the consequences of hypoxemia. In our experience, hypothermia did not worsen pulmonary hypertension, although no beneficial effect on oxygenation was noted. Never ­theless, the favorable neurological outcome of die neonate provides some evidence for neuroprotection against refractory hypoxemia using hypothermia. Key words: persistent pulmonary hypertension of the neonate, neuroprotection, mechanical ventilation Rà ©sumà © Lhypothermie thà ©rapeutique pour lhypoxà ©mie rà ©fractaire post-natale: prà ©sentation dun cas dun nouveau-nà © à   terme Nous dà ©crivons un nouveau-nà © à   terme traità © par hypothermie du corps entier quelques jours aprà ¨s la naissance afin de neutraliser lhypoxà ©mie rà ©fractaire due à   lhypertension pulmonaire persistante qui ne rà ©pond pas à   un traitement optimal. Cette approche a à ©tà © choisie pour amà ©liorer loxygà ©nation et protà ©ger le cerveau contre les consà ©quences de lhypoxà ©mie. Dans notre expà ©rience, lhypo ­thermie na pas aggravà © lhypertension artà ©rielle pulmonaire, mais il na à ©tà © notà © aucun effet bà ©nà ©fique sur loxygà ©nation. Nà ©anmoins, là ©volution neurologique favorable du nouveau-nà © a fourni des preuves de neuroprotection contre lhypoxà ©mie rà ©fractaire à   laide de lhypothermie. Mots clefs: hypertension pulmonaire persistante, neuroprotection Introduction anagement of late preterm and term neonates with moderate-severe hypoxic- ischemic encephalopathy (HIE) following perinatal asphyxia is, hitherto, the only evidence-based application of hypothermia in neonatology as it reduces mortality without increasing major disability in survivors [1, 2]. Other situations such as perinatal arterial ischemic stroke, neonates with HIE beyond the therapeutic window of the first 6 hours after birth or less than 36 weeks gestation and those with unexpected postnatal collapse could potentially benefit from this neuroprotective treatment, but, at present, only few or no data is available [2, 3]. This case describes a term neonate treated with whole-body hypothermia several days after birth to counteract refractory hypoxemia and protect the brain from its consequences. Case report A female, 3.470 g newborn was transferred to our hospital at 10 hours of life for respiratory distress. The baby was bom at 39+4 weeks gestation after caesarian section due to mild fetal distress. Bag and mask ventilation were given at birth, and the 1 and 5 minute Apgar scores were 6 and 9, respectively. Conventional mechanical venti ­lation was started upon admission to our department while the lung X-ray was suggestive of transient tachypnea. Temporal improvement in oxygenation was noted following exogenous surfactant administration (Beractant, 100 mg/Kg/dose). Thereafter, oxygen requirements increased significantly, despite optimal ventilation (including high-frequency oscillatory ventilation) and supportive management (sedation-analgesia, inotropes). Following X-rays consis ­tently showed the absence of parenchymal lung disease. Car ­diac ultrasound confirmed the clinical diagnosis of persistent pulmonary hypertension of the neonate (PPHN), but inhaled nitric oxide (iNO) at 20 ppm and other adjunctive therapies (oral sildenafil, bosentan) had no clinical effect. Repeat sepsis work-up was negative. Continuing, severe impairment in oxygenation prompted us to apply whole-body hypo ­thermia (Tecotherm Neo ®, target rectal temperature 33.5 ±0.5  °C)for 72 hours starting from day of life (DOL) 6, which was well tolerated. During hypothermia, the respira ­tory failure slightly improved, in the short term, as indicated by the reduction of alveolar-arterial difference of oxygen (fig. 1). Despite refractory hypoxemia, no clinical seizures were obsewed whereas there were no pathologic findings on head ultrasound scans and amplitude-integrated-EEG. Interestingly, the sleep-wake cycle was lost during cooling but normalized after the end of this treatment. From DOL 14 onwards, oxygenation started to improve (although still with variable) finally allowing weaning from the ventilator (DOL 20) (fig. 1). Brain imaging (ultrasound scan, magnetic resonance imaging) were normal at hospital discharge (DOL 36) as was later neurodevelopment (6 months). Discussion To the best of our knowledge, this is the first case to report the use of whole-body hypothermia in neonates with refractory hypoxemia secondary to PPHN as adjunct to mechanical ventilation and as neuroprotection. PPHN is an important cause of neonatal respiratory failure associated with increased mortality and neurological impairments in survivors [4]. Hypothermia reduces oxygen consumption as well as C02 production [5]. Moreover, experimental animal data show that hypothermia may protect [6] or attenuate the ventilator-induce lung injury mitigating the pro-inflammatory response [7]. Improved gas exchange has also been reported in the latter investigations [7]. Similarly, there is evidence although limited from studies in critically ill adults suggesting an improvement in oxygenation [81 and ventila ­tion [91 with hypothermia. Therefore, this therapeutic technique could potentially be beneficial in our patient breaking the vicious circle of hypoxemia, PPHN and ventila ­tor-induced lung injury. On the other hand, aggravation of Figure 1 Supportive care and serial changes of alveolar-arterial difference of oxygen (AaD02, best and worse) during the first 3 weeks of life (B and C). Initial lung X-rays (A) and snapshot of the a-EEG recording before and during hypothermia (D) are also shown. hfov CMV: Conventional mechanical ventilation, DOL: Day of life, HFOV: High-frequency oscillatory ventilation, iNO: Inhaled nitric oxide PPHN was a possible clinical scenario, given the metabolic response to cold stress (increased catecholamines and pulmonary vascular resistance) [5]. In large randomized controlled trials of hypothermia in perinatal asphyxia, PPHN at randomization was considered as an exclusion criterion [21. It is our clinical observation that a slight and temporal improvement in alveolar-arterial difference of oxygen was indeed observed during hypothermia. However, this could be an oxygen extraction issue. At lower temperatures, oxyhemo globin dissociation curve is shifted to the left resulting in decreased oxygen release to the tissues which in turn have decreased oxygen demands [5]. Nevertheless, the fact that improved oxygenation was not sustained and, also, that coin ­cided with the application of high frequency ventilation does not allow us to support any significant effect of whole-body hypothermia per se on oxygenation. Yet, this trend towards improvement in oxygenation is in line with the most recent relevant meta-analysis, in which hypothermia was found not to increase the risk of PPHN, at least as indicated by the need for Ino [1]. Extracorporeal membrane oxygenation (ECMO) could be an alternative treatment to PPHN [4], but no ECMO center was available. Conversely, this invasive intervention encompasses severe risks for the brain. Actually, for this very reason mild hypothermia was preventively attempted for 12 hours in a small cohort of neonates receiving ECMO. Unfortunately, neurodevelopment outcome was not assessed [10]. We applied therapeutic hypothermia as this is a promising means of neuroprotection in neonates. None the less, two facts merit comment in the present case: the lack of any clinical or other evidence of brain injury (normal head ultrasound scan, a-EEG) when cooling was decided and the application of hypothermia several days after birth. So far, hypothermia is only indicated as early as possible in neonates with evidence of HIE following an acute perinatal event, so as to limit the already activated molecular mecha ­nisms of neuronal damage and death [11]. It is impossible to know whether prolonged hypoxemia triggered such a cascade of events in our neonate. However, therapeutic hypothermia has also been tested in neonatal conditions, independent of neuroprotection. Advanced necrotizing enterocolitis in preterm infants is such an example, where mild hypothermia was applied as an alternative therapy to reduce intestinal injury and distal organ damage [12]. Specific biochemical biomark ers or more sophisticated techniques (e.g., magnetic resonance spectroscopy) could possibly have provided some indications as to the presence of cerebral injury secondary to refractory hypoxemia and the impact of hypothermia. Such techniques, however, are available for use at the bedside only in a few centers [13]. Additionally, our baby-girl was not part of a relevant study and, therefore, no investigations beyond those indicated in everyday clinical practice were performed. Nonetheless, its favorable neurological outcome is encouraging. Since we are not, however, able to know whether and to what extent hypothermia had any neuroprotective effect against hypoxemia related to respiratory failure, this approach needs to be evaluated in large trials.

Complementing Texts: Homer’s The Odyssey and Dante’s Inferno Essay

Ever since human beings started telling stories for entertainment or for edification, heroes have made incredible journeys against what seem like impossible odds. In the beginning, heroes often these journeys to reach a goal, often in defiance of the gods who, for whatever reason, had imposed limits upon the main character of the story. In Homer’s story, The Odyssey, this limitation is that the gods will block his way home until he speaks to the sage Tiresias. By contrast, Dante Alighieri’s character of Dante primarily seeks to find answers to his questions; that is, knowledge, as a means to find salvation. While both heroes interact with the underworld to accomplish their aims, the stories complement each other, rather than mirror each other. In many ways, Dante’s text â€Å"corrects† the story found in Homer’s work, making it suitable for Christian audiences. Careful examination of texts reveals how some of these areas differ significantly between them. Some of these differences include the nature of the underworld itself and the hero’s interaction with it, the knowledge that Odysseus’ mother has of the living world, and the shared rule of the underworld. The Nature of the Underworld and the Heroes’ Interaction with It Like Dante’s Hell, Homer’s underworld is not a pleasant place to spend eternity. It is dark and gloomy; the inhabitants have dulled senses. The underworld into which Odysseus looks is Hades, not the Elysian Fields, where heroes were blessed with eternal happiness. Rather, the â€Å"unhappy dead† live there, cursed to bleak and boring existences for the rest of eternity. The dead who exist in Hades are those who have died unburied, like Odysseus’ friend, Elpenor, who died falling from a ladder leading from Circe’s roof, as well as Tiresias and Odysseus’ unhappy mother. And yet, misery of the inhabitants is one of several similarities between the two underworlds. One interesting difference between the Homer’s Hades and Dante’s Hell is that the stories’ heroes find their entrances in extremely different locations. Odysseus finds the entrance to Hades in a harbor at the â€Å"western edge of the world,† while Dante finds the entrance to Hell in the midst of a dark wood. While these differences might seem insignificant, they are, in truth, indicative of the different purposes behind the journeys that the heroes undertake. The harbor at the end of the world represents physical distance traveled; Odysseus is on a quest to return home to Ithaca, a goal that the gods have prevented him from attaining. It is an earthly goal, however, with measurable distances that must be traversed. While the ocean that Odysseus travels provides room for a communal journey through which he attempts to bring his crew home, Dante’s dark wood provides a far narrower field. It is restrictive and personal, perhaps driven by the solitary nature of Dante’s quest for knowledge and redemption. The distance that Dante must travel, therefore, is not one of finite measurement; rather, it exists within himself. It is a spiritual journey with no physical boundaries. Ultimately, this difference is magnified by the many levels of Hell, with its myriad levels, terraces, and malboges. In addition to the differing nature of the underworld as portrayed by each poet, the nature of the interaction that each hero has with the underworld and its inhabitants also varies. In order to interact at all with the inhabitants of the underworld, both heroes must make a rite of passage. Odysseus enters the realm of Hades by making a blood sacrifice of a ram, collecting its blood in a pit. Through this offering and by offering the appropriate supplications to the gods, Odysseus is able to call forth the souls of the dead. Being surrounded by the dead causes him to become afraid; however, he regains sufficient courage to control them and to question them. The character of Dante, however, must actually pass through the gates of Hell, ‘abandoning hope’ in order to learn what he desires. Although Odysseus is in the world of the dead, he is sure enough of himself to regain control, as opposed to Dante, who relinquishes all of his control to Virgil as then enter the underworld realm. While less â€Å"heroic† than Odysseus’ actions, this submissive behavior is actually of great importance, which again is based in the heroes’ purpose in entering the underworld. It is clear, that although both heroes must enter the realm of the underworld, each for his own purpose, Odysseus does not actually travel through Hades as Dante does through Hell. Rather, the dead approach Odysseus, coming â€Å"up in a crowd from Erebos: young men and brides, old men who had suffered much, and tender maidens to whom sorrow was a new thing; others killed in battle, warriors clad in bloodstained armor† (124) all surround his sacrificial pit in response to the ram’s blood that he has offered. This difference is also a significant one and related to the point made above it. Although Odysseus immediately appears to be the supplicant, by making the blood offering that attracts the dead, he is also in control of it. The dead must do his bidding in order to feed and give him the information that he requires. By contrast, the character of Dante physically travels into the midst of the souls of the damned. While he is under his own volition, Dante is a pilgrim, who must make an effort to gain his knowledge. He follows Virgil as Virgil leads, interacting with the souls on their own level in their own environment. This difference would also make Dante’s tale more appealing to Christian audiences. Although Odysseus’ cunning and strength were admired by the audience that lived at his time, the lesson of humility that the character of Dante both learns and teaches would be considered more acceptable to Alighieri’s audience. Although he is taking the initiative to learn on his own, like a proper pilgrim he is taking instruction from a master and listening to the moral lessons set before him. For those in the audience who recognize that he might have been contemplating suicide, Dante is also in the process of repenting. Knowledge of the Living World Odysseus seeks not merely wisdom from Tiresias, but he also seeks knowledge of his future in the living world. In truth, both Tiresias and Odysseus’ mother have clear knowledge of the living world, which they freely share with him in their turn. What is more, it is accurate knowledge, which allows him to prepare for his future, should he ever arrive at his destination. In a sense, both Tiresias and Odysseus’ mother are as living beings that have merely been transported to a new existence on an alternate plane, in that they can take initiative to see what lies ahead and then share it with him. Given that in other myths inhabitants of Hades are able to travel freely between the worlds with the gods’ permission, it seems apparent that the ancient Greeks saw the underworld as a place from which people could escape to return to the living if they had enough virtue or if they had a hero to aid them. This kind of belief is opposed to both Dante’s belief and to the belief of the Christians who formed his audience. Dante’s souls, perpetually trapped in their state of torment, must continuously atone for their actions on earth. They are surrounded by the reminders of their sins, perhaps tormented by the very things that they desired in life. At times, their appearance is dramatically altered to match their crimes. The only hope for the souls in Hell is Judgment Day, at which time they may be redeemed–or they may find themselves condemned to suffer throughout eternity. Even then, redeemed souls would not interact with the living; instead, they would pass into Heaven. Once again, the difference between the two realms and their inhabitants may be explained by virtue of the perception of the audiences for which the poets were writing. To the Greeks, life in the underworld was not necessarily a punishment. Certainly, the inhabitants of the underworld could experience punishment, even that of a perpetual nature. One good example of this kind of punishment would be Sisyphus, condemned to roll a boulder to the top of a hill for eternity, only to have it escape him and roll to the bottom again before it reaches the peak. However, the underworld is a plane of existence to which all humans will eventually travel. The underworld itself is divided into sections that provide reward or punishment or which simply continues the miserable existence that people had when on earth. This difference is, once again, quite different from the perspective of the Christian audience served by Dante, which viewed the underworld for punishment only. It is this understanding of the underworld being for punishment that would also limit the dead’s interaction with the living. Dante’s dead are unable to access the living world and, when encountering the character of Dante, are unable to learn from what he tells them. They have no minds and no insight, unlike the dead that Odysseus encounters, who know that they are suffering and why and yet are unable to interact with the world of the living in order to minimize their experiences. The Shared Rule of the Underworld In The Odyssey, both Hades and his wife, Persephone, rule the underworld. Although Hades has control over the underworld as a whole, Persephone is the Queen of the Women, with the ability to overrule even her husband in control of that group. In terms of importance, while this difference might seem trivial to some readers, it is perhaps of greatest significance of all of these points. Hades is not omnipotent, in that Persephone has equal control, if not greater control in some aspects of ruling the underworld. She strikes fear in Odysseus’ heart equal to that of her husband, in that Odysseus describes Hades as â€Å"mighty,† but Persephone as being â€Å"awful,† which would be synonymous with her being terrifying. This kind of rule would be unsurprising to the ancient Greeks, who lived in a world ruled by many gods. It also paralleled the arrangement of the gods on Mount Olympus, to a certain extent: Hades and Persephone, who ruled the world of the dead, mirrored Zeus and Hera, who ruled the world of the living. To the Christians that formed Dante’s audience, this arrangement would have been more than just a little shocking. Christians worship a single God who, while He might have different and while He may employ different helpers in the angels and the saints, has dominion over the living and the dead. As with the ancient Greek deities, God and Satan somewhat mirror each other. Despite Satan’s impressive appearance in The Inferno, however, he is as much a prisoner of Hell as its other residents. In addition, Satan does not mirror God’s power; rather, he is only capable of destruction, not creation. Conclusion In many ways, Dante’s Inferno complements and corrects Homer’s The Odyssey. Both are tales that bring a hero into contact with the underworld in order to achieve a particular goal. In the case of Odysseus, this goal is worldly and finite, while in the case of Dante, the goal is spiritual and may lead to eternal salvation. Several differences, among others, that indicate the complementary and corrective nature of Dante’s work are those of the nature of the respective underworlds and the heroes’ interaction with the inhabitants, the knowledge that the dead have of the living world, and the shared rule that Hades and Persephone have over the ancient Greek underworld. The story of heroic travels through the underworld is not a new one, neither was it new when Homer wrote The Odyssey. In the days of passing history and learning through oral means, such stories were necessary teaching tools. However, each culture imposed its morals and beliefs on this kind of tale. The different between these two stories provide an excellent example of how this cultural influence stamps this kind of heroic story with differences throughout history.