Haunted by a Melody: Ghosts, Transgression, and Music in Twin Peaks

Keyword(s):  
2018 ◽  
pp. 83-100
Author(s):  
Mikhail L. Skoptsov

Tras el debut de Twin Peaks en la ABC en abril de 1990, la visión —una secuencia de imágenes que relacionan información del futuro o el pasado de la narración— se ha hecho un producto de primera necesidad de muchas series de cadenas de cable básicas y premium, incluyendo Buffy, la cazavampiros (WB), Battlestar Galactica (SyFy) y Juego de tronos (HBO). Este artículo argumenta que Twin Peaks, en efecto, ha introducido un modo de contar historias llamado “visionarración”, que se basa en la antigua poesía épica al enfocarse en los principales personajes que reciben conocimiento de figuras enigmáticas, parecidas a dioses, que controlan su mundo. Sus visiones rompen la narración lineal, permitiendo que una serie asuma los aspectos formales del medio y cree la impresión de que sus dispares episodios constituyen un todo único. Esto los ayuda a calificar como “televisión de calidad”, al tiempo que disfrazan ejemplos de manipulación autoral evidente dentro de los textos como productos de la divina causalidad interna. Consecuentemente, todos los incidentes narrativos, sin importar qué tan coincidentes o irrelevantes sean, pasan a ser parte de un gran diseño. Un examen detallado de Twin Peaks y Carnivàle demostrará cómo opera este modo, por qué su popularidad entre los contadores de historias modernos y cómo elevar el estatus cultural del programa.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H.Y Chang ◽  
W.R Chiou ◽  
P.L Lin ◽  
C.Y Hsu ◽  
C.T Liao ◽  
...  

Abstract Background Ischemic cardiomyopathy (ICM) has been associated with increased mortality when compared with non-ischemic cardiomyopathy (NICM) from several heart failure (HF) cohorts. Instead, PARADIGM study demonstrated similar event rates of cardiovascular (CV) death, all-cause mortality and HF readmissions between ICM and NICM patients. Although the beneficiary effect of sacubitril/valsartan (SAC/VAL) compared to enalapril on these endpoints was consistent across etiologic categories, PARADIGM study did not analyze the effect of ventricular remodeling of SAC/VAL on patients with different HF etiologies, which may significantly affect treatment outcomes. Purpose We aim to compare alterations of left ventricular ejection fraction (LVEF) following SAC/VAL treatment and its association with clinical outcomes in patients with different HF etiologies. Methods Treatment with angiotensin receptor neprilysin inhibitor for Taiwan heart failure patients (TAROT-HF) study is a multicenter study which enrolled 1552 patients with LVEF <40%, whom had been on SAC/VAL treatment from 9 hospitals between 2017 and 2018. After excluding patients without having follow-up echocardiographic studies, patients were grouped by HF etiologies and by LVEF changes following treatment for 8-month period. LVEF improvement ≥15% was defined as “significant improvement”, 5–15% as “marginal improvement”, and <5% or worse as “lack of improvement”. The primary endpoint was a composite of CV death or a first hospitalization for HF. Mean follow-up period was 726 days. Results A total of 1230 patients were analyzed. Patients with ICM were significantly older, more male, and prone to have associated hypertension and diabetes. On the other hand, patients with NICM had lower LVEF and higher likelihood of atrial fibrillation. LVEF increase was significantly greater in patients with NICM compared to those with ICM (11.2±12.4% vs. 6.9±9.8, p<0.001). The effect of ventricular remodeling of SAC/VAL on patients with NICM showed twin peaks diversity (Significant improvement 37.1%, lack of improvement 42.3%), whereas in patients with ICM the proportions of significant, marginal and lack of improvement groups were 19.4%, 28.2% and 52.4%, respectively. The primary endpoint showed twin peaks diversity also in patients with NICM in line with LVEF changes: adjusted HR for patients with NICM and significant improvement was 0.41 (95% CI 0.29–0.57, p<0.001), for patients with NICM and lack of improvement was 1.54 (95% CI 1.22–1.94, p<0.001). Analyses for CV death, all-cause mortality, and HF readmission demonstrated consistent results. Conclusion Patients with NICM had higher degree of LVEF improvement than those with ICM following SAC/VAL treatment, and significant improvement of LVEF in NICM patients may indicate favorable outcome. NICM patients without response to SAC/VAL treatment should serve as an indicator for poor clinical outcome and warranted meticulous HF management. Funding Acknowledgement Type of funding source: Private hospital(s). Main funding source(s): Cheng Hsin General Hospital


Author(s):  
Dirk Schoenmaker ◽  
Nicolas Véron
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