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A Multidirectional Europe: Post-Socialist Memory in Contemporary German Literature
Focusing on novels by three contemporary German authors and one multi-author theater text, “A Multidirectional Europe” investigates how their writing responds to post-1989 memory paradigms in which post-socialist memory, in relation to the Holocaust and Second World War, has received asymmetrical attention. Conceived as an interdisciplinary and comparative study, this dissertation analyzes how narrative texts by Herta Müller (1953-), Nino Haratischwili (1983-), Saša Stanišić (1978-) and the play Ein europäisches Abendmahl [2017] frame the memory of socialism in relation to the Holocaust, considering the ways in which these authors challenge the larger post- or transnational discourse of a supposedly “unified Europe.”
Having migrated from Romania, Georgia, and Bosnia respectively, these authors, I argue, integrate post-socialist memories into German, and European, memory discourses through their play with genre, narrative structure, figurative language, and intertextuality. Although sociohistorical context is crucial in my readings for questions of memory, this dissertation seeks to transcend bounded definitions of memory, embracing a dynamic approach that is more inclusive in terms of the (hi)stories that are told and that contribute to the imagination of a heterogenous continent. Combining cultural studies, literary analysis, and memory theory, I move away from reading these works under the lens of autobiographical trauma, seeking instead to examine the negotiation of post-socialist memory through attending to generic and formal elements of the literary texts. My literary close readings methodologically draw on individual texts, while reflecting how literature is in exchange with other media and also present in the public sphere. Rather than a homogeneous entity, I show, the invoked Europe constitutes a multidirectional network.
Through my focus on contexts beyond East Germany and its experience of state socialism, I address the intersections of migration and memory and their relevance for contemporary and future Germany and Europe, while counteracting approaches that traditionally center West Central Europe in discussions of the continent. In dialogue with Michael Rothberg’s conceptualization of multidirectional memory, I furthermore contribute to ongoing debates on different histories of violence, such as the current discussion about the relation or interaction between the memories of colonialism and the Holocaust
Forging Manhood and Nationhood Together: American Sailors’ Accounts of their Exploits, Sufferings, and Resistance in the Antebellum United States
Effect of Noninvasive Respiratory Strategies on Intubation or Mortality Among Patients With Acute Hypoxemic Respiratory Failure and COVID-19: The RECOVERY-RS Randomized Clinical Trial.
Importance
Continuous positive airway pressure (CPAP) and high-flow nasal oxygen (HFNO) have been recommended for acute hypoxemic respiratory failure in patients with COVID-19. Uncertainty exists regarding the effectiveness and safety of these noninvasive respiratory strategies.
Objective
To determine whether either CPAP or HFNO, compared with conventional oxygen therapy, improves clinical outcomes in hospitalized patients with COVID-19-related acute hypoxemic respiratory failure.
Design, Setting, and Participants
A parallel group, adaptive, randomized clinical trial of 1273 hospitalized adults with COVID-19-related acute hypoxemic respiratory failure. The trial was conducted between April 6, 2020, and May 3, 2021, across 48 acute care hospitals in the UK and Jersey. Final follow-up occurred on June 20, 2021.
Interventions
Adult patients were randomized to receive CPAP (n = 380), HFNO (n = 418), or conventional oxygen therapy (n = 475).
Main Outcomes and Measures
The primary outcome was a composite of tracheal intubation or mortality within 30 days.
Results
The trial was stopped prematurely due to declining COVID-19 case numbers in the UK and the end of the funded recruitment period. Of the 1273 randomized patients (mean age, 57.4 [95% CI, 56.7 to 58.1] years; 66% male; 65% White race), primary outcome data were available for 1260. Crossover between interventions occurred in 17.1% of participants (15.3% in the CPAP group, 11.5% in the HFNO group, and 23.6% in the conventional oxygen therapy group). The requirement for tracheal intubation or mortality within 30 days was significantly lower with CPAP (36.3%; 137 of 377 participants) vs conventional oxygen therapy (44.4%; 158 of 356 participants) (absolute difference, -8% [95% CI, -15% to -1%], P = .03), but was not significantly different with HFNO (44.3%; 184 of 415 participants) vs conventional oxygen therapy (45.1%; 166 of 368 participants) (absolute difference, -1% [95% CI, -8% to 6%], P = .83). Adverse events occurred in 34.2% (130/380) of participants in the CPAP group, 20.6% (86/418) in the HFNO group, and 13.9% (66/475) in the conventional oxygen therapy group.
Conclusions and Relevance
Among patients with acute hypoxemic respiratory failure due to COVID-19, an initial strategy of CPAP significantly reduced the risk of tracheal intubation or mortality compared with conventional oxygen therapy, but there was no significant difference between an initial strategy of HFNO compared with conventional oxygen therapy. The study may have been underpowered for the comparison of HFNO vs conventional oxygen therapy, and early study termination and crossover among the groups should be considered when interpreting the findings.
Trial Registration
isrctn.org Identifier: ISRCTN16912075