Political Ecology in Gabriel Garcia Marquez's One Hundred Years of Solitude

The roots of ecology prolong profoundly within earlier phases of history, when the naturalistic fabric was first evinced.  Bringing out his On the Origin of Species in 1859, Darwin not merely engendered a biological culmination but also heralded the revolutionary critical canon of naturalism that was virtually a stone thrown in the vast stagnant lake of traditional literature. Via the naturalistic lens, the whole bulk of man’s behavioral attributes are being expounded in terms of milieu and heredity. The mid-1990s witnessed the publication of The Environmental Imagination by Lawrence Buell in 1995, and The Ecocriticism Reader edited by Cheryll Gloffelty and Harold Fromm in 1996, which palpably underpinned ecocriticism as revolving around the inextricable liaison between literature and the physical environment. The political ecology term was coined to further scrutinize relations among people that pertain to nature. The present paper is an endeavor to pursue the ecological tenor of Gabriel Garcia Marquez’s landmark novel, One Hundred Years of Solitude, and how it was admirably exploited to address precarious postcolonial issues.Keywords: Political ecology, Marquez, naturalism, ecocriticism, post-colonialism

Prevalence of cognitive impairment in acute ischaemic stroke and use of Alberta Stroke Programme Early CT Score (ASPECTS) for early prediction of post-stroke cognitive impairment

Aim of the study. This study aims to assess the prevalence of post-stroke cognitive impairment, and to evaluate the correlation of ASPECTS with impaired cognition. Materials and methods. 150 patients presenting with acute middle cerebral artery territory ischaemic stroke were included in this study. Risk factors of ischaemic stroke and the initial NIHSS were determined. An initial and a follow-up non-contrast CT brain were carried out after seven days which were assessed by ASPECTS. The prevalence of cognitive impairment was determined by MoCA during the follow up of patients after three months. Correlations of ASPECTS, NIHSS and MoCA were done by Spearman correlation. Multivariate logistic regression analysis was carried out for the independent variables of cognitive impairment. Results. The prevalence of post-stroke cognitive impairment in this study, according to the threshold for cognitive impairment with a MoCA score of 25 or less, was 25.3% (38 patients). Significant positive correlations between ASPECTS and total MoCA test domains were found (r = 0.73 and P = 0.002). Logistic regression analysis demonstrated that the independent factors associated with cognitive impairment were older age, certain domains of the MoCA test like executive functions, memory, attention, language, NIHSS, HTN, and ASPECTS. Conclusions and clinical implications. There is a prevalence of cognitive impairment in about 25% of patients after three months of follow-up in cases with acute ischaemic stroke. ASPECTS is directly correlated with cognitive impairment, and may be considered as a biomarker of post-stroke cognitive impairment

Predictive Value of the Alberta Stroke Program Early CT Score (ASPECTS) in the Outcome of the Acute Ischemic Stroke and Its Correlation with Stroke Subtypes, NIHSS, and Cognitive Impairment

Objectives. This study is aimed at correlating ASPECTS with mortality and morbidity in patients with acute middle cerebral artery territory infarction and at determining the cutoff value of ASPECTS that may predict the outcome. Methods. 150 patients diagnosed with acute middle cerebral artery territory infarction were involved in this study. Risk factors, initial NIHSS, and GCS were determined. An initial or follow-up noncontrast CT brain was done and assessed by ASPECTS. Outcomes were determined by mRS during the follow-up of cases after 3 months. Correlations of ASPECTS and outcome variables were done by Spearman correlation. Logistic regression analysis and ROC curve were done to detect the cutoff value of ASPECTS that predicts unfavorable outcomes. Results. The most common subtypes of ischemic strokes were lacunar stroke in 66 patients (44%), cardioembolic stroke in 39 patients (26%), and LAA stroke in 30 cases (20%). The cardioembolic stroke had a statistically significant lower ASPECT score than other types of ischemic strokes (P<0.05). Spearman correlation showed that lower ASPECTS values (worse outcome) were more in older patients and associated with lower initial GCS. ASPECTS values were inversely correlated with initial NIHSS, inpatient stay, inpatient complications, mortality, and mRS. The ASPECTS cutoff value determined for the prediction of unfavorable outcomes was equal to ≤7. The binary logistic regression analysis detected that patients with ASPECTS≤7 were significantly associated with about fourfold increased risk of poor outcomes (OR 3.95, 95% CI 2.09–11.38, and P<0.01). Conclusions. ASPECTS is a valuable and appropriate technique for the evaluation of the prognosis in acute ischemic stroke. Patients with high ASPECTS values are more likely to attain favorable outcomes, and the cutoff value of ASPECTS is a strong predictor for unfavorable outcomes. This trial is registered with ClinicalTrials.gov NCT04235920