Drowning Classification: A Reappraisal of Clinical Presentation and Prognosis for Severe Cases.

BACKGROUND: Drowning is still a major cause of accidental death worldwide. In 1997, Szpilman proposed a classification of drowning that has become the reference. As considerable efforts have been made to improve prevention and care, it seemed appropriate to reassess the prognosis and clinical presentation of drowning patients more than 20 years after this first publication. The aim of this study is to provide a reappraisal of patients who need advanced health care and a precise description of their respective neurologic, respiratory, and hemodynamic profiles. METHODS: This retrospective study was conducted over four consecutive summer periods between 2014 and 2017 in ICUs located in France, French Polynesia, and the French Antilles. Patients were classified according to the drowning classification system proposed by Szpilman. RESULTS: During the study period, 312 drowning patients were admitted with severe clinical presentation (grades 2-6). All patients benefited from rapid extraction from the water (< 10 min for all) and specialized care (emergency medical services), starting from the prehospital period. Although the global hospital mortality was similar to that previously reported (18.5%), great differences existed among the severity grades. Respective grade mortalities were low for grades 2 through 5 (grade 2, 0%; grade 3, 3%; grade 4, 0%; grade 5, 2%), and the mortality for grade 6 remained similar to that previously reported (54%). These results confirmed that the occurrence of cardiac arrest after drowning is still bad prognosis. Conversely, for other grades, this study strengthens the importance of specialized intervention to interrupt the drowning process. CONCLUSIONS: On the basis of these results, drowning-related cardiac arrest is still the prognosis cornerstone. For other victims, the prognosis was better than previously expected, which strengthens the importance of specialized intervention to interrupt the drowning process.

Semantic transparency affects morphological priming . . . eventually.

Semantic transparency has been in the focus of psycholinguistic research for decades, with the controversy about the time course of the application of morpho-semantic information during the processing of morphologically complex words not yet resolved. This study reports two masked priming studies with English - ness and Russian - ost' nominalisations, investigating how semantic transparency modulates native speakers' morphological priming effects at short and long stimulus onset asynchronies (SOAs). In both languages, we found increased morphological priming for nominalisations at the transparent end of the scale (e.g. paleness - pale) in comparison to items at the opaque end of the scale (e.g. business - busy) but only at longer prime durations. The present findings are in line with models that posit an initial phase of morpho-orthographic (semantically blind) decomposition.

Reflexive anaphor resolution in spoken language comprehension: structural constraints and beyond.

We report results from an eye-tracking during listening study examining English-speaking adults' online processing of reflexive pronouns, and specifically whether the search for an antecedent is restricted to syntactically appropriate positions. Participants listened to a short story where the recipient of an object was introduced with a reflexive, and were asked to identify the object recipient as quickly as possible. This allowed for the recording of participants' offline interpretation of the reflexive, response times, and eye movements on hearing the reflexive. Whilst our offline results show that the ultimate interpretation for reflexives was constrained by binding principles, the response time, and eye-movement data revealed that during processing participants were temporarily distracted by a structurally inappropriate competitor antecedent when this was prominent in the discourse. These results indicate that in addition to binding principles, online referential decisions are also affected by discourse-level information.