Nathan Mewton

Nicolas Girerd

Jean-Jacques Boffa

Cécile Courivaud

Richard Isnard

Laurent Juillard

Nicolas Lamblin

Matthieu Legrand

Damien Logeart

Christophe Mariat

; Edith Meune

Pierre Sabouret

Laurent Sebbag

Professor Patrick Rossignol
email: p.rossignol@chru-nancy.fr

Dr Legrand

Practical management of worsening renal function in outpatients with heart failure and reduced ejection fraction: Statement from a panel of multidisciplinary experts and the Heart Failure Working Group of the French Society of Cardiology

ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

Introduction

Renal function is often affected in outpatients with stable chronic heart failure and reduced ejection fraction (HFrEF). Several mechanisms may coexist, including lower-blood supply and increased congestion induced by i) heart pump failure, ii) chronic activation of adrenergic and renin-angiotensin aldosterone systems, and iii) direct and indirect effects of heart failure drugs [START_REF] Damman | The kidney in heart failure: an update[END_REF] . Renal function may also be affected by age and comorbidities frequently associated with heart failure such as atherosclerosis, diabetes or arterial hypertension. Approximately 30% of chronic heart failure patients display a glomerular filtration rate (GFR) below 60 ml/min/1.73m 2 2 .

Inversely, WRF has direct and independent consequences on heart failure symptoms and adverse clinical outcomes [START_REF] Beldhuis | Renin-Angiotensin System Inhibition, Worsening Renal Function, and Outcome in Heart Failure Patients With Reduced and Preserved Ejection Fraction: A Meta-Analysis of Published Study Data[END_REF][START_REF] Damman | Worsening renal function and outcome in heart failure patients with preserved ejection fraction and the impact of angiotensin receptor blocker treatment[END_REF] . Although still the subject of debate, WRF is generally defined in clinical studies as a 20-30% decrease in eGFR, or an increase in creatinine >0.3 mg/dL within 15 to 30 days after intervention [START_REF] Damman | Terminology and definition of changes renal function in heart failure[END_REF][START_REF] Clark | Worsening renal function during renin-angiotensinaldosterone system inhibitor initiation and long-term outcomes in patients with left ventricular systolic dysfunction[END_REF] .

Using this definition, WRF is deemed to occur in approximately 25% of cases with deleterious impact on outcome [START_REF] Damman | Terminology and definition of changes renal function in heart failure[END_REF] . Given this complex interplay between heart and renal dysfunction, it is therefore imperative to monitor renal function in patients with HF.

HFrEF-related morbidity and mortality have significantly improved in the last thirty years as a result of the implementation of effective drug treatments [START_REF] Rossignol | Heart failure drug treatment[END_REF] . One of the major drug classes in this field are reninangiotensin-aldosterone system (RAAS) blockers. These include angiotensin-converting enzyme inhibitors (ACE-I), angiotensin receptor blockers (ARBs) and angiotensin receptor neprilysin inhibitors (ARNIs) together with mineralocorticoid receptor antagonists (MRAs). These drug classes, as well as beta-blockers and diuretics, have a specific impact on renal function [START_REF] Ponikowski | ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC[END_REF] .

Moderate to severe chronic kidney disease in HF patients is a major cause for the under-prescription of RAAS blockade. In heart failure registries, factors significantly associated with under-prescription are history of hyperkalemia and WRF [START_REF] Shirazian | Underprescription of renin-angiotensin system blockers in moderate to severe chronic kidney disease[END_REF][START_REF] Maggioni | Heart Failure Association of the ESC. Are hospitalized or ambulatory patients with heart failure treated in accordance with European Society of Cardiology guidelines? Evidence from 12,440 patients of the ESC Heart Failure Long-Term Registry[END_REF][START_REF] Komajda | Physicians' adherence to guideline-recommended medications in heart failure with reduced ejection fraction: data from the QUALIFY global survey[END_REF][START_REF] De Groote | Is the gap between guidelines and clinical practice in heart failure treatment being filled? Insights from the IMPACT RECO survey[END_REF] . This under-prescription or failure to reach the target dose is associated with increased adverse outcomes comparatively to patients reaching the full recommended doses [START_REF] Ouwerkerk | Determinants and clinical outcome of uptitration of ACEinhibitors and beta-blockers in patients with heart failure: a prospective European study[END_REF] . In these registries, only ~30% of all HF patients receive the target doe of RAAS blocker drugs [START_REF] Maggioni | Heart Failure Association of the ESC. Are hospitalized or ambulatory patients with heart failure treated in accordance with European Society of Cardiology guidelines? Evidence from 12,440 patients of the ESC Heart Failure Long-Term Registry[END_REF] .

In addition, in routine practice, the detection of any renal function worsening or hyperkalemia is a major cause for RAAS blocker dose reduction or suspension [START_REF] Trevisan | Incidence, predictors and clinical management of hyperkalaemia in new users of mineralocorticoid receptor antagonists[END_REF] .

Yet, the absolute benefit of the use of these drugs has repeatedly been shown to remain positive despite the reduced glomerular filtration rate reported in the various trials on RAAS blockers conducted in chronic heart failure outpatients with renal dysfunction. The benefit of RAAS blockers is even greater in patients with reduced eGFR compared to patients with normal renal function [START_REF] Clark | Worsening renal function during renin-angiotensinaldosterone system inhibitor initiation and long-term outcomes in patients with left ventricular systolic dysfunction[END_REF][START_REF] Vardeny | Influence of baseline and worsening renal function on efficacy of spironolactone in patients With severe heart failure: insights from RALES (Randomized Aldactone Evaluation Study)[END_REF] . In a recent meta-analysis of major randomized studies exploring the relationship of RAAS inhibition and worsening renal function, WRF was shown to be more frequent in patients using RAAS compared to placebo. However, in patients with reduced ejection fraction HF, this use was less frequently associated with poor outcomes compared to patients with WRF in the placebo group [START_REF] Beldhuis | Renin-Angiotensin System Inhibition, Worsening Renal Function, and Outcome in Heart Failure Patients With Reduced and Preserved Ejection Fraction: A Meta-Analysis of Published Study Data[END_REF] . Hence, the occurrence of WRF does not eliminate the survival benefit of RAAS blockade compared to placebo [START_REF] Rossignol | Determinants and consequences of renal function variations with aldosterone blocker therapy in heart failure patients after myocardial infarction: insights from the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study[END_REF] . There is therefore compelling evidence to support the prescription of RAAS blockers at the maximum tolerated dose despite moderate renal dysfunction which may occur under treatment.

In contrast to the large body of evidence of the benefits of RAAS blockade in HF with reduced ejection fraction (HFrEF), the evidence of benefit in HF with preserved ejection fraction is subject to continuing debate [START_REF] Butler | Redefining Heart Failure With a Reduced Ejection Fraction[END_REF] . This review will therefore only address chronic heart failure outpatients with reduced ejection fraction. Of note, acute management is not considered in this review while each minutes count [START_REF] Trevisan | Impact of the time-to-treatment concept on the outcome of acute heart failure: A pilot study[END_REF] .

In this expert panel comprised of heart failure specialists, geriatricians and nephrologists, we review the pathophysiology of renal function worsening and propose targeted therapeutic management algorithms for physicians treating chronic HF outpatients, the latter of which remains a persisting critical concern.

Pathophysiology of Worsening Renal Function in Chronic Heart Failure Patients

Recent reviews have focused in detail on the pathophysiology of renal dysfunction during heart failure [START_REF] Mullens | Evaluation of kidney function throughout the heart failure trajectorya position statement from the Heart Failure Association of the European Society of Cardiology[END_REF] .

In chronic heart failure patients, a number of different mechanisms can induce WRF. Most cases are related to changes in extracellular volume and blood pressure: congestion, hypotension and dehydration are the main drivers of WRF in HF patients. All of these mechanisms are summarized in Figure 1.

Importantly, other causes of renal dysfunction should also be systematically investigated, including urinary obstruction.

In normal subjects, renal perfusion remains stable for mean BP as low as 60 mmHg owing to autoregulation. A sufficient pressure gradient within the glomerulus is essential to maintain adequate filtration (Figure 1). This gradient is dependent on glomerular hydrostatic pressure, oncotic pressure and pressure within Bowman's space [START_REF] Carlstrom | Renal autoregulation in health and disease[END_REF] .

Congestion

Congestion is a major factor of WRF in chronic heart failure patients [START_REF] Mullens | Importance of venous congestion for worsening of renal function in advanced decompensated heart failure[END_REF] and is often an underestimated clinical parameter. In a cohort of 145 patients with mean LVEF of 20% admitted for acute decompensated heart failure, higher central venous pressure was strongly associated with a greater risk of in-hospital WRF. In contrast no association was found with blood pressure levels, cardiac output and pulmonary wedge pressures. This result was confirmed in the ESCAPE trial in which only right atrial pressure was correlated with baseline renal function [START_REF] Nohria | Cardiorenal interactions: insights from the ESCAPE trial[END_REF] .

Moreover, in studies using renal venous Doppler to assess renal perfusion patterns in patients with acute heart failure [START_REF] Iida | Clinical Implications of Intrarenal Hemodynamic Evaluation by Doppler Ultrasonography in Heart Failure[END_REF] , renal hemodynamics was clearly shown to improve with decongestion. Conversely, intravascular volume expansion resulted in a significant blunting of renal venous flow causing WRF [START_REF] Nijst | Intrarenal Flow Alterations During Transition From Euvolemia to Intravascular Volume Expansion in Heart Failure Patients[END_REF] .

Owing to increased renal venous pressure, renal interstitial pressure rises above hydrostatic pressure [START_REF] Dilley | Glomerular ultrafiltration dynamics during increased renal venous pressure[END_REF] .

This results in tubular collapse with an increase in tubular pressure which, in turn, decreases the net ultrafiltration pressure thereby resulting in decreased renal filtration [START_REF] Joles | Renal venous congestion and renal function in congestive heart failure[END_REF] .

Finally, in heart failure patients, persistent congestion combined with WRF is significantly associated with adverse outcomes in comparison to WRF without congestion [START_REF] Metra | Prognostic Significance of Creatinine Increases During an Acute Heart Failure Admission in Patients With and Without Residual Congestion: A Post Hoc Analysis of the PROTECT Data[END_REF] .

Dehydration/hypovolemia

Dehydration is a common occurrence in heart failure patients. Dehydration is mostly the consequence of excessive diuretic treatment and is more frequently observed in elderly patients with HF (mainly HF with preserved ejection fraction) [START_REF] Kelly | Inappropriate use of loop diuretics in elderly patients[END_REF] . Dehydration leads to renal hypoperfusion and prerenal renal failure. Prerenal renal failure is characterized by an intact renal parenchymal function with renal hypoperfusion.

Dehydration can also result from external clinical settings such as insufficient hydration, external heat with increased sweating, fever and gastrointestinal disorders. Dehydration or hypovolemia directly affects renal blood flow and consequently reduces GFR accordingly. Clinical features differentiating congestion from dehydration are summarized in Table 1.

Hypotension

Most heart failure drugs have a direct and significant hypotensive effect. Renal blood flow can thus be directly affected as a result of HF treatments and altered autoregulation in chronic kidney disease (CKD) patients due to structural remodeling of the vascular wall and vascular hyalinization [START_REF] Carlstrom | Renal autoregulation in health and disease[END_REF] . However, in clinical studies, the link between systolic BP and WRF remains weak [START_REF] Damman | Terminology and definition of changes renal function in heart failure[END_REF][START_REF] Mullens | Importance of venous congestion for worsening of renal function in advanced decompensated heart failure[END_REF] . Hypotension is nevertheless a major barrier to optimal medical treatment in outpatients with HF [START_REF] Maggioni | Heart Failure Association of the ESC. Are hospitalized or ambulatory patients with heart failure treated in accordance with European Society of Cardiology guidelines? Evidence from 12,440 patients of the ESC Heart Failure Long-Term Registry[END_REF][START_REF] Komajda | Physicians' adherence to guideline-recommended medications in heart failure with reduced ejection fraction: data from the QUALIFY global survey[END_REF] .

Nephrotoxic drugs

Nephrotoxic drugs are drugs that cause glomerular and/or nephron damage as opposed to reversible hemodynamic effects induced by non-steroidal anti-inflammatory drugs (NSAIDs) and RAAS blockers.

The renal toxicity mechanisms of NSAID are multiple and complex (hemodynamic for acute effects, immuno-allergic, podocyte toxicity, etc.). Contrast-induced nephropathy and anti-infectious drugs are possible causes of WRF. Most importantly, drug dose adjustment is mandatory with regard to kidney function.

Drugs with renal hemodynamic effects

NSAIDs or selective cyclo-oxygenase 2 inhibitors induce WRF by blunting the vasodilatory effect of prostaglandin E2. This results in an afferent glomerulus arteriole vasoconstriction inducing a decrease in both renal blood flow and GFR.

RAAS blockers are non-nephrotoxic and conversely have a predictable effect that has been described in various studies in heart failure patients [START_REF] Damman | Worsening renal function and outcome in heart failure patients with preserved ejection fraction and the impact of angiotensin receptor blocker treatment[END_REF][START_REF] Vardeny | Influence of baseline and worsening renal function on efficacy of spironolactone in patients With severe heart failure: insights from RALES (Randomized Aldactone Evaluation Study)[END_REF][START_REF] Packer | Effect of neprilysin inhibition on renal function in patients with type 2 diabetes and chronic heart failure who are receiving target doses of inhibitors of the renin-angiotensin system: a secondary analysis of the PARADIGM-HF trial[END_REF] . In most randomized controlled studies, introduction of RAAS-blockade was associated with a mean 3±4 ml/min/1.73m 2 decrease in GFR. RAAS blockers reduce the vasoconstrictor effect of angiotensin II on the efferent arteriole. This effect induces a decrease in GFR related to the lower pressure gradient within the glomerulus. This effect is rapidly reversible after treatment suspension. This apparent WRF associated with RAAS-prescription has been well documented in the literature. In the SOLVD trial, this impairment in renal function following the introduction of ACE inhibitors was neutrally associated with outcome (adjusted HR, 1.0; 95% CI, 0.8-1.3; p=1.0); conversely, a similar impairment was significantly associated with worse outcome in patients randomized to placebo (adjusted HR, 1.4; 95% CI, 1.1-1.8; P=0.004) [START_REF] Testani | Prognostic importance of early worsening renal function after initiation of angiotensin-converting enzyme inhibitor therapy in patients with cardiac dysfunction[END_REF] . In the same analysis, patients who continued to receive the study drug despite early WRF still displayed a significant survival benefit with enalapril therapy (adjusted HR, 0.66; 95% CI, 0.5-0.9; P=0.018). Consequently, while RAAS-blocker can reduce GFR, this reduction is not associated with worse outcome and the benefit of HF treatment remains significant.

Recently, a new "kid on the block" with direct renal effects has appeared in the field of heart failure. The sodium-glucose co-transporter 2 inhibitors reduce the glomerular hyperfiltration present in diabetic patients and reduce heart failure events with a better protection of renal function in HFrEF patients. In the DAPA-HF study, dapagliflozin significantly reduced cardiovascular death and heart failure events without increase in WRF compared to placebo. Further evidence based randomized trials and real-world data are needed to better understand the benefits of this new HF therapy and their impact on renal function [START_REF] Mcmurray | Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction[END_REF] .

Populations at risk of developing WRF

High-risk patients are patients with atherosclerotic cardiovascular disease, pre-existing CKD, diabetes, volume depletion, hypotension or renal artery stenosis. Elderly patients deserve special attention as they are particularly at risk of developing WRF. The latter is the consequence of several factors, including the progressive decline in renal function (nephron loss), increased co-morbidities, more advanced heart failure, polymedication with its associated risk of interaction, overuse of inappropriate drugs, and the underutilization of effective treatments [START_REF] Juilliere | Prescription of cardiovascular drugs in the French ODIN cohort of heart failure patients according to age and type of chronic heart failure[END_REF][START_REF] Komajda | Contemporary management of octogenarians hospitalized for heart failure in Europe: Euro Heart Failure Survey II[END_REF] .

Assessing Renal Function in Heart Failure Patients

The accurate assessment of renal function is a challenging task in chronic heart failure patients for several reasons.

First, glomerular filtration rate (GFR) estimation equations have all been validated to be used in a steady state setting, which is not always the case in patients with heart failure. In hemodynamically unstable conditions, intra-individual variations of serum creatinine are much more meaningful and should remain the gold-standard for detecting acute and subacute renal dysfunction.

Second, even in the context of relative cardiorenal stability, GFR assessment with creatinine-based equations is suboptimal. This is partly due to the fact that malnutrition and sarcopenia are frequent in this setting. The presence of sarcopenia in HF patients induces an overestimation of GFR. In this regard, serum cystatin C, known to be less dependent on muscle mass than serum creatinine, could represent an appealing alternative [START_REF] Kervella | Cystatin C Versus Creatinine for GFR Estimation in CKD Due to Heart Failure. American journal of kidney diseases : the official journal of the[END_REF] . In effect, the GFR estimation equation using cystatin C values has been shown to be more robust than the classical creatinine-based CKD-EPI equation. However, at this juncture, it appears too early to recommend the widespread use of cystatin C. Therefore, the best GFR assessment method in HF patients in the outpatient setting is currently the CKD-EPI equation. Indeed, this formula has been shown to be reliable, despite its numerous limitations. It should nonetheless be used with caution in cases of advanced age and/or malnutrition since its measurement results overestimate true renal function. For drug dosing adjustment, many experts advocate specifically using the Cockcroft-Gault formula, which was actually used in drug clinical trials to define the study population. This should be balanced with the fact that "weight", a particularly fluctuating and confounding variable in patients with HF, is integrated into the formula.

In any event, when a heart failure patient presents with significant renal dysfunction (GFR<45 ml/min), the patient should be considered for referral to a nephrologist for management optimization.

The rapid referral to a nephrologist is furthermore mandatory in instances of i) an increase in creatinine level > 100% of the reference value, ii) a new decrease in eGFR ≤ 20mL/min/1.73m 2 and iii) persistent hyperkalemia > 5.5mmol/L despite adequate therapeutic management.

Initiation and titration of ACE-I, ARB, ARNI and MRAs

The first introduction of RAAS blockers is critical. Whether this initial introduction is performed in hospital or in the outpatient clinic, the goal is to reach the maximal recommended dose or, if unfeasible, the maximum tolerated dose. Beneficial effects of RAAS blockers are likely dose-dependent [START_REF] Konstam | Effects of high-dose versus low-dose losartan on clinical outcomes in patients with heart failure (HEAAL study): a randomised, double-blind trial[END_REF] . High doses of RAAS blockers can be prescribed in CKD patients as in the general population, albeit with a closer clinical and biological follow-up. In most cases, WRF should not be a limitation for the titration of beta-blockers. Titration can be performed by various means depending on the patient's history, his/her clinical situation (blood pressure, congestion) and naturally, the patient's baseline renal function. In general, a progressive, slow titration without therapeutic inertia is the recommended course of action:

double the dose every 1-2 weeks. Ideally, the patient's symptoms (symptomatic orthostatic hypotension), blood pressure (including standing blood pressure) and renal function should be monitored at each step.

A blood screening test should be performed one week after each introduction or titration: serum creatinine and blood potassium should be assessed at every step before increasing dosage.

At each titration visit, the patient and his family should be educated regarding signs of dehydration, hypotension and weight. Information should also be provided as often as possible relative to ideal water and salt intake according to the weather/temperature or physical activity.

As the titration of RAAS blockers occurs concomitantly with the titration of beta-blockers, the sequence in the modification of HF drugs should be anticipated. Usually, the increase in the dosage in beta-blockers parallels the increase in the dosage of RAAS blockers, to avoid having a high-dose of one treatment and a low-dose of the other. This is mostly a pragmatic approach as these drugs demonstrated beneficial effects which result from actions on different pathophysiological pathways. In addition, in the 2016 ESC guidelines, [START_REF] Ponikowski | ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC[END_REF] MRAs initiation follows the ACEi/ARBs and beta-blockers titration.

In patients without clinical signs of congestion, a down-titration of diuretics may favor the titration of RAAS blockers [START_REF] Ter Maaten | Higher doses of loop diuretics limit uptitration of angiotensinconverting enzyme inhibitors in patients with heart failure and reduced ejection fraction[END_REF] and beta-blockers.

The following at-risk situations should prompt a careful clinical follow-up:

-recent hospitalizations with intense diuresis (weight loss > 4 kg),

-other causes of dehydration (gastrointestinal disorders, fever, heat wave),

-elderly > 80 years, -diabetes, -prior renal failure (baseline GFR < 60 ml/min/1.73m 2 ).

Facing Worsening Renal Function in a chronic HF outpatient

General Considerations

We assume that every physician is familiar with each heart failure patient's basic and stable status: renal function status, usual weight (ideally "dry" weight), and last dosage in HF drug prescriptions (diuretics, RAAS blocker, beta-blocker). Clinical inertia is a major issue. Therefore, once the clinical situation is stabilized, these HF drugs should be up-titrated to the maximum tolerated dose.

In case of WRF, guidelines from expert task forces have been published by the ESC group (Web addenda) [START_REF] Ponikowski | ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC[END_REF] . These guidelines were based on interpretation from available evidence in different randomized clinical trials and registries. None of the recommended thresholds have been currently assessed in randomized clinical trials. These guidelines can be summarized in 3 general rules:

 An increase in creatinine level after RAAS blocker initiation is frequent and is acceptable up to 50% above baseline value. In the same manner, an increase in potassium to ≤5.5 mmol/L is acceptable.

 For increases in creatinine >50% and below 100% of baseline value, the clinical situation should be assessed using a systematic approach (congestion, dehydration, blood pressure, concomitant interaction) and medication should be adjusted accordingly (halving of usual doses can be considered) (see Figure 2). Apply careful and close follow-up after any strategy change.

 If potassium rises to >5.5 mmol/L or creatinine increases by >100% baseline or >310 µmol/L or GFR<20mL/min/1.73m 2 , current ACE inhibitors (or ARB or ARNi) and MRA should be stopped and specialist advice from a nephrologist should be sought. In all instances of hyperkalemia >5.5 mmol/L, a second blood sampling should be performed for verification, due to potential confounders such as hemolysis.

While these general principles are pragmatic, they are nonetheless associated with low levels of evidence [START_REF] Clark | Change in renal function associated with drug treatment in heart failure: national guidance[END_REF] . From theory to practice in outpatients, our purpose in the following paragraphs are to set a pragmatic, simple and systematic management algorithm in various clinical settings for clinicians faced with WRF in a chronic heart failure outpatient.

Urgent Hospitalization Referral

The first practical question to answer is to determine which patients require hospitalization. From our consensus panel, here are the situations where the physician should consider patient referral as soon as possible to an emergency department, ideally to a hospital with expertise in HF management. These clinical settings are summarized in Table 2.

Table 2. Clinical settings requiring urgent hospitalization

Main clinical settings requiring urgent hospitalization

 Increase in creatinine > 100% or underlying CKD with acute decrease in eGFR < 20 ml/min/1.73m 2  Acutely decompensated HF  Severe ionic disorders such as hyponatremia <125meq/l, hypokalemia < 3mM or hyperkalemia > Clinical aggravating factors such as daily furosemide (or equivalent) >250 mg/day, issues with adherence and isolation, frailty, lack of autonomy should also be considered.

Clinical/biological Assessment of WRF

Before making any decision regarding treatment, it is essential to carefully assess the clinical context of WRF. This approach has recently been suggested by Clark et al., albeit using a different segmentation of clinical settings [START_REF] Clark | Change in renal function associated with drug treatment in heart failure: national guidance[END_REF] . According to our consensus panel, the essential parameters to take into consideration before changing treatment are as follows (Figure 2):

1) Clinical context: any concomitant disorder that could alter renal function status (infection, diarrhea, hyperthermia, acute heart failure decompensation, urinary tract pathology), drugs (NSAID introduction) and diet adherence;

2) Congestion (Table 1): increase in weight, orthopnea, jugular distension, lower limb edema, increase in natriuretic peptide levels, decrease in Hb/hematocrit, ultrasound parameters showing pulmonary (increased LVEDP) and systemic congestion (raised right atrial pressure) [START_REF] Girerd | Integrative Assessment of Congestion in Heart Failure Throughout the Patient Journey[END_REF] .

3) Blood pressure: symptomatic hypotension, orthostatic hypotension.

4) Diuretics dose and clinical signs of dehydration

5) Nephrotoxic drugs: NSAID, contrast media, antibiotics, HIV drugs 6) Potassium supplements: salt diet, bananas, chocolate, low-salt substitute. Review medical regimen (including dietary supplements and over-the-counter medications) for agents known to cause hyperkalemia (potassium-sparing diuretics, e.g. amiloride and triamterene; potassium supplements, e.g., potassium chloride, herbal supplements, etc.)

Practical Considerations for WRF Management According to Clinical Setting

All of these considerations are summarized in Figure 2.

Congestion

In cases of WRF with congestion, diuretic doses should be increased. The 24-hour oral dose of loop diuretics should be significantly increased for 2 to 3 days, i.e. 2 to 3 times the daily dose. The efficacy of such a transient increase should be verified with improvement in the patient's symptoms as well as weight loss with "dry" weight recovery. Renal potassium should be checked within 7 days following the increase in dosage.

Chronic heart failure patients may develop resistance to loop diuretics requiring an increase in dose in order to maintain diuresis. Spreading the diuretic dose in two to three times a day helps prevent this resistance. When a patient develops resistance to a particular loop diuretic, switching to another with higher bioavailability (furosemide to bumetamide or torasemide for example) may improve resistance issues [START_REF] Ellison | Diuretic Treatment in Heart Failure[END_REF][START_REF] Kramer | Diuretic treatment and diuretic resistance in heart failure[END_REF] . A combination of diuretic classes (loop diuretics with thiazide diuretics) can be used in chronic patients although this combination must be closely monitored (creatinine, potassium and sodium) especially the first month. In addition, a variation in the route of diuretic administration may be necessary to overcome diuretic resistance. Intravenous administration of a loop diuretic avoids possible uncertainties regarding intestinal absorption, while ambulatory administration of IV loop diuretics has become another option in the recent years [START_REF] Kramer | Diuretic treatment and diuretic resistance in heart failure[END_REF][START_REF] Mullens | The use of diuretics in heart failure with congestion -a position statement from the Heart Failure Association of the European Society of Cardiology[END_REF] .

The goal is to achieve the patient's usual "dry" weight together with improvement in heart failure symptoms. After achieving this target weight, creatinine and blood potassium must be monitored during the following 7 days since they may worsen with a slight delay. A closer laboratory follow-up may be suggested in case of severe renal dysfunction (eGFR<30 ml/min/1,73m 2 ) or high 24-hour doses of furosemide (i.e. > 250 mg/d). Hyperkalemia as well as hypokalemia must be investigated and corrected.

In case of absence of improvement within 7 days of an increase in ambulatory diuretic dose, patients should be referred for hospitalization.

Dehydration/Hypovolemia

In this instance, WRF is directly related to "true" hypovolemia which is secondary to either excessive diuretic-related depletion or dehydration from other causes such as vomiting, diarrhea or fever.

Management is incremented according to severity (see -Therapeutic education of the patient and his/her relatives is essential in all cases.

Symptomatic Hypotension

Prescription of all cardiologic treatment without proven outcome benefits in HFrEF (nitrates, calciumblockers) and non-cardiologic hypotensive drugs (alpha-blockers, antiparkinson drugs, phospodiesterase inhibitors, etc.) should be reevaluated. Second, in the absence of concomitant congestion, diuretic doses should also be decreased, sodium restriction alleviated, and (oral) hydration increased. The presence of dysautonomia should be investigated, particularly in diabetic patients. The decrease in RAASi/ARNi/ beta-blockers dose should be considered only after the latter changes. According to the ESC registry data, [START_REF] Maggioni | Heart Failure Association of the ESC. Are hospitalized or ambulatory patients with heart failure treated in accordance with European Society of Cardiology guidelines? Evidence from 12,440 patients of the ESC Heart Failure Long-Term Registry[END_REF] hypotension is more frequently the reason for non-prescription/under-dosing of ACE/ARBs (67.5%/26%) than of beta-blockers (27.9%/17%). As a consequence, down-titration of RAASi rather than beta-blockers may appear appropriate in the context of symptomatic hypotension with WRF unless patients have low heart rate. The magnitude of the down-titration should be personalized to the level of hypotension and WRF as well as patient's characteristics.

Regardless of the change applied to drug prescription, patients with hypotension should be re-assessed. If hypotension is resolved, re-assessment of heart failure drugs should be performed and up-titration should be re-initiated if the patient is not at target doses.

Hyperkalemia

Hyperkalemia, which is a potential life-threatening condition owing to its conduction disturbance properties [START_REF] Rossignol | Emergency management of severe hyperkalemia: Guideline for best practice and opportunities for the future[END_REF] , is an inherent risk associated with RAASi use. In order to achieve the best benefit associated with RAASi use as per demonstrated in clinical trials, it is of utmost importance to adhere to contraindications related to kidney function and serum potassium [START_REF] Zannad | Cardiorenal Syndrome Revisited[END_REF] . According to these guidelines, potassium levels can be tolerated up to 5.5 mmol/l in a stable chronic HF patient. Furthermore, it should be reminded that MRA introduction is often associated with a significant increase in potassium levels, e.g. approximately 0.5±0.2 mmol/l for 25 mg of spironolactone daily.

In all cases, an appropriate monitoring is warranted. Beyond baseline assessment, creatinine and potassium levels should be reassessed within 1 week of the initial dose, with any dose titrations or with any alterations in other concomitant drugs, diseases, or acute illnesses prone to influence potassium levels or induce WRF. On a routine basis, potassium and serum creatine should be monitored monthly for the first 3 months, then regularly at 3-to 4-month intervals [START_REF] Butler | Update on aldosterone antagonists use in heart failure with reduced left ventricular ejection fraction. Heart Failure Society of America Guidelines Committee[END_REF] .

Once the diagnosis of hyperkalemia is confirmed (i.e. a pseudo-hyperkalemia is ruled out), a "significant" hyperkalemia, associated or not with WRF, should prompt a reappraisal of concomitant drug prescription (e.g. withdrawal of all potassium supplements, e.g., potassium chloride, or salt substitutes, non-steroidal anti-inflammatory drugs or other nephrotoxic drugs). This may also warrant the temporary down-titration or discontinuation of MRAs first. Then, in a second step, reduction or discontinuation of RAASi/ARNi could be considered [START_REF] Ponikowski | ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC[END_REF] .

The conjunction of hyperkalemia and WRF should prompt cardio-nephrologic interactions and should target the restauration of renal function (as hyperkalemia may be secondary to the WRF).

The availability of new potential binders (e.g. patiromer or sodium zirconium cyclosilicate) may however offer new opportunities to overcome hyperkalemia. An ongoing trial will determine whether the use of these medications improve CV outcome (DIAMOND trial ClinicalTrials.gov Identifier: NCT03888066).

For the time being, potassium binders may be considered when hyperkalemia is the main issue to treat and renal function remains acceptable. They can be useful to stabilize and treat hyperkalemia between 5.5-6 mmol/l allowing maintaining RAASi treatment [START_REF] Seferovic | Clinical practice update on heart failure 2019: pharmacotherapy, procedures, devices and patient management[END_REF] . However, careful renal function and blood potassium monitoring is mandatory in this setting.

Specificities in the elderly/very elderly

Elderly patients (particularly those >80y) deserve special attention. HF is highly prevalent in these patients. Beyond ineluctable age-related nephron loss, most of the aforementioned factors that may precipitate WRF often co-exist in elderly patients. This population is consequently at higher risk of combined HF and renal dysfunction. In addition, polymedication, which is frequent in this population, further increases the risk of worsening renal function and hyperkalemia through nephrotoxic drug interactions.

In addition, these patients may experience persistent edema while exhibiting hypovolemia during aggressive diuretic treatment, possibly due to delayed vascular refilling.

Lastly, this patient population has often been excluded from randomized clinical trials, therefore RAASi drug use is more supported by registry data. Table 3 summarizes the key practical recommendations that should be applied in this frail population.

Conclusion

RAAS blockers are a life-saving treatment in HFrEF patients, regardless of worsening renal function. Uptitration to the maximum tolerated dose should be a constant goal. This simple fact is all too often forgotten and RAAS blocker effect on renal function is commonly misunderstood. RAAS blockers are not nephrotoxic drugs. In many routine clinical cases, RAAS blockers are withheld or stopped because of this misunderstanding, combined with a poor assessment of the patient's clinical situation. In the management of chronic HFrEF patients, monitoring of renal function and blood potassium is just as important as the complete clinical assessment of the patient. Each HF patient needs a holistic evaluation of all clinical and paraclinical parameters in order to determine the most beneficial drug combination in terms of individual benefits and risks.

6. 0 

 0 mM (after verification with a second sample) Severe dehydration with symptomatic hypotension  Suspicion of cardiogenic shock  Any clinical signs of hemodynamic instability with urinary tract issues (obstruction/ infection) Failure of 48-hour outpatient treatment

Figure 1

 1 Figure 1 Main Factors Influencing Glomerular Filtration Rate in Chronic Heart Failure Patients. RAAS: renin angiotensin aldosterone system; GFR: glomerular filtration rate; NSAI: non steroid anti-inflammatory.

Figure 2 .

 2 Figure 2. A2M algorithm for the management of HFrEF patients with WRF and/or hyperkalemia. GFR, glomerular filtration rate; HFrEF, heart failure with reduced ejection fraction; NSAID, non-steroid anti-inflammatory drug; BP, blood pressure; MRA, mineralocorticoid receptor antagonists; RASi, renin angiotensin system inhibitors; ARNI, angiotensin receptor neprilysin inhibitors.

Table 1 : Clinical features differentiating congestion-related WRF from dehydration-related WRF in heart failure patients Congestion Dehydration

 1

	Clinical history	Progressive dyspnea, orthopnea,	Fever, high air temperature, loss of
		weight gain, edema, cardiac	appetite, nausea, digestive loss
		arrhythmia, etc.
	Recent drug and dietary changes	Reduction in diuretic dose,	Increase in diuretic dose, low salt
		NSAIDs, increase in salt intake	intake
	Weight	Increased	Reduced
	Edema	Present in lower limbs	Absent
	Diuresis	Oliguria	Oliguria
	Signs of heart failure	Jugular turgescence, hepatalgia,	Absent
		pulmonary crakles, pleural
		effusion, etc.
	Blood pressure / heart rate	Normal or low / increased	Normal or low, orthostatic
			hypotension / increased
	Biological data:
	Plasma	Increased natriuretic peptides	Hemoconcentration (increased
		compared to "dry weight"	protein concentration and
		baseline value, hemodilution	hemoglobin/hematocrit)
	Urine	Low sodium excretion	Low sodium excretion
		(<20 mmol/l)	(<20 mmol/l)
	Echocardiography	High CVP, dilated vena cava	Low CVP, flattened vena cava
		diameter > 21 mm	(<21 mm) and vena cava collapsus
			during inspiration
	CVP= central venous pressure

Table 2 )

 2 :-In less severe cases, management must be personalized in this outpatient setting:

		Down-titrate or discontinue diuretics including that of mineralocorticoid receptor antagonists
		in most cases,
		In cases of previous diuretic combination, first suspend thiazide alone,
		Maintain RAAS blockers at same dose or 50% decrease in doses, maintain beta-blockers,
		Alleviate low-sodium diet,
		Blood test within 7 days and new assessment:
		-Improvement: consider pursuing diuretic at same down-titrated dosage; repeated blood test
		should be performed or 72h later
		-Stability: no change and blood test 48 hours later.
		-Worsening: diuretics and RAAS blockers are discontinued and rehydration increased;
		blood test the following day; immediate hospitalization is discussed.

Table 3 . Essential rules for RAASi management in elderly patients Practical Rules in Elderly (≥80 years old) Patients

 3 Orthostatic hypotension is frequent and associated with poor outcome. Diuretic dose reduction and/or vasodilator down-titration may be advocated  Pay attention to frailty, cognitive disorders and polymedication  Monitor congestion closely after diuretic dose increase -Diuretic dosage should be carefully reevaluated after normalization of volemia.

		eGFR is usually overestimated due to sarcopenia
	


Naomi Truan

Narratives of dialogue in parliamentary discourse Constructing the ethos of the receptive politician

Keywords: constructed dialogue, narrative, identity construction, parliamentary discourse, public image, ethos

This paper puts forward an argument about the relation between narratives and constructed dialogue in political discourse. Narratives of dialogue are special cases of constructed dialogue that emphasize the embeddedness of the speaker, displayed as a discourse participant engaging in a conversation with an ordinary citizen or a public figure. Close analysis of British, German, and French parliamentary debates reveals how narratives of dialogue shape an image of the speaker involved in a dialogue. While being engaged in the activity of debating, parliamentarians simultaneously perform the act of debating. I argue that the main point of narratives of dialogue is not so much to report on a prior or hypothetical situation, but to create the ethos of a Member of Parliament receptive to their interlocutors.

Introduction

As an interactive form of political interaction, parliamentary debates epitomize the instantiation of polyphonic voices. One of the ways to display the multiplicity of viewpoints is to stage a possible discussion through what I call narratives of dialogue, which I define as a subform of "constructed dialogue" [START_REF] Tannen | Introducing Constructed Dialogue in Greek and American Conversational and Literary Narrative[END_REF] where the act of performing a dialogue becomes the central focus of the narrative. I argue that Members of Parliament (MPs) who quote other discourse participants not only -or not really -report on previous utterances. Rather, they construct their ethos as politicians willing to engage in a dialogue with other discourse participants. Ethos is here understood as the public image that speakers discursively con-struct in order to highlight certain aspects of their identity [START_REF] Amossy | Ethos at the Crossroads of Disciplines: Rhetoric, Pragmatics, Sociology[END_REF].

While previous work on the discursive construction of leadership in political discourse has shown how political actors use the first person and related verb constructions [START_REF] Fetzer | Doing Leadership in Political Speech: Semantic Processes and Pragmatic Inferences[END_REF][START_REF] Kranert | Today I Offer You, and We Offer the Country a New Vision': The Strategic Use of First Person Pronouns in Party Conference Speeches of the Third Way[END_REF] to enact their political selves, this paper shifts the focus on how politicians interact with various 'others'. I delve into how parliamentarians "'do' competence and responsiveness" (Fetzer and Bull 2012, 129) through the lens of narratives of dialogue. In these "small stories" [START_REF] Bamberg | Small Stories as a New Perspective in Narrative and Identity Analysis[END_REF], politicians not only engage in discussions, but also stage the dialogue as an event in itself. In doing so, they highlight their receptiveness -a component which seems to play a role for the category 'reception' (Fetzer and Bull 2012, 132;Kranert 2017, 187) and deserves further explorations.

Instances of "constructed dialogue" [START_REF] Tannen | Introducing Constructed Dialogue in Greek and American Conversational and Literary Narrative[END_REF], also referred to as reported speech, speech (re)presentation, or quotes, make speakers operate a shift in footing, defined as "participant's alignment, or set, or stance, or posture, or projected self " (Goffman 1981, 128). By fabricating an instance of dialogue, MPs do more than simply invoking other voices: they set out, through an apparently anecdotal narrative, a situation in which they perform their own role. In doing so, politicians position themselves as co-interlocutors rather than representatives or spokespersons of the words of others. Moreover, they construct themselves as amenable to new ideas, which qualifies them as receptive politicians.

This paper is divided into five sections. Section 2 gives an overview of the research on constructed dialogue and narratives with a focus on political dis-course. It underlines the points of connection and outlines a definition of narratives of dialogue. The corpus of parliamentary debates as well as the method for coding instances of constructed dialogue are presented in Section 3. Sections 4, 5, and 6 examine the functions of narratives of dialogue in relation with specific linguistic features. I first present instances of narratives of dialogue relying on semantically indeterminate third-person forms such as someone, some, or every-one. I show why disclosing the identity of the discourse participants involved may appear unnecessary to introduce the ethos of a politician open to suggestions. Next, I consider instances of narratives of dialogue where famous enunciators -the persons uttering the words in the narrative -are brought into play, and show that this enables MPs to highlight one aspect of their professional identity: their connections. Finally, I address the case of the 'ordinary voter', usually represented by means of a singular, indefinite noun phrase. I conclude by showing what types of ethos are articulated with narratives of dialogue.

Bringing constructed dialogue and narratives together

Referring to what has or may have been said is commonly labeled reported speech. The term "is used to refer to the presentation of discourse that purports to be from a prior occasion, and may originate from another author" (Holt 2009, 1). The expression reported speech is, however, misleading: the introduction of past, future, or fictive utterances is never merely 'reporting', because every reference to another discourse creates a new context. Accounting for this difficulty, several competing notions have been proposed: speech presentation, speech representation, quotes or quotations, and constructed dialogue.

The term speech presentation is usually lauded for its neutrality (Marnette 2005, 49;Semino and Short 2004, 15), especially compared to speech representation [START_REF] Baynam | Speech Representation and Institutional Discourse[END_REF], which conveys the idea of reproduction. The notions of quotes, quotations, and quoting allow for a focus on the activity of quoting as a practice or, as Bublitz (2015, 2) puts it, "as an act of taking up text and, in doing so, performing a shift of context, focus and perspective".

The concept of constructed dialogue captures the fabricated nature of the juxtaposition of voices [START_REF] Tannen | Introducing Constructed Dialogue in Greek and American Conversational and Literary Narrative[END_REF][START_REF] Tannen | Talking Voices. Repetition, Dialogue and Imagery in Conversational Discourse[END_REF]). Tannen's argument is that every instance of constructed dialogue always transforms the utterance referred to. Speakers take over stretches of talk with different communicative intentions than the ones expressed in the initial or original context. I retain the idea that the integration of another discourse -no matter whether it is seen as real or fictitious, exact or approximate, uttered by the speaker or by others -is, first, always constructed, and, second, always a dialogue with other speakers, forms of self, times, or places. In political discourse specifically, constructed dialogue has been shown to serve the challenging of political opponents [START_REF] Fetzer | Quotations in monologic and dialogic political discourse[END_REF], the legitimization of the speaker and their political party [START_REF] Kuo | Reported Speech in Chinese Political Discourse[END_REF], or the construction of ordinariness [START_REF] Fetzer | What I Would Say to John and Everyone like John Is …': The Construction of Ordinariness through Quotations in Mediated Political Discourse[END_REF].

How do these aspects of constructed dialogue connect with narratives? Narratives usually refer to past events told in a sequential order [START_REF] Labov | Language in the Inner City[END_REF]. The term can thus also apply for instances of constructed dialogue structured along spatio-temporal elements. Such discourse phenomena would then represent instances of constructed dialogue embedded in a narrative, or, as Wieczorek (2016, 207) phrases it, narrative reports, an expression that captures the specific function of utterances "incorporated into short narratives that include reported speech frames [and] add to the rhetorical force that narratives inherently exhibit".

In order to be construed as narratives, instances of constructed dialogue must first "involve[] a sequence of events organized in such a way as to have a beginning, middle, and end" (Ryfe 2006, 74). Secondly, in order to be disentangled from mere chronologies, "stories pivot around a problem, which is sometimes referred to as a dilemmatic situation or a complicating event" (Ryfe 2006, 74). Finally, "the meaning of stories lies in context -in the way they are addressed by someone to others in a context of interaction" (Ryfe 2006, 74). Narratives frequently comprise dialogues: when we tell a story, we often refer to what has been said on this occasion.

More specifically, narratives are understood as "privileged forms/structures/ systems for making sense of self by bringing the coordinates of time, space, and personhood into a unitary frame" (Bamberg and Georgakopoulou 2008, 378) -which is what makes them particularly powerful tools for the construction of the ethos of a receptive politician. Indeed, "how the referential world is constructed points to how the teller wants to be understood" (Bamberg and Georgakopoulou 2008, 380). A critical point of entry into the "referential world" is the source of the utterance, or how other figures are constructed from the point of view of the speaker. Whether speakers enact unknown or indistinct voices, famous enunciators, or ordinary voters, tells a lot, in return, about the aspects of their ethos politicians are highlighting.

The specificity of what I call narratives of dialogue, then, is that they are narratives revolving around an instance of constructed dialogue, where the instantiation of the dialogue -more than the content of what is said -builds the knot around which the narrative revolves as well as the social meaning that can be inferred from it. Specifically, I show that MPs use this strategy in order to con-struct the ethos of a receptive politician. By staging narratives of dialogue, politicians position themselves as apt at listening and reacting to other positions. It enables them to move beyond their role as representatives or spokespersons of the words of others by highlighting their role as a speaker -someone who speaks with others instead of about others.

Collecting and annotating quotes from a corpus of parliamentary debates

The analysis is based on a corpus of forty-four British, German, and French parliamentary debates that have been manually annotated in an XML-TEI format and made available online to the scientific community in open access (Truan 2016a;2016b;2016c).

After having fallen into oblivion, parliamentary debates are experiencing a revival of interest in discourse analysis [START_REF] Burkhardt | Sprache des deutschen Parlamentarismus[END_REF][START_REF] Ili ; Ilie | Parliamentary Discourses[END_REF]). Indeed, they lend themselves particularly well to diachronic and contrastive analyses [START_REF] Bayley | Cross-Cultural Perspectives on Parliamentary Discourse[END_REF][START_REF] Ilie | European Parliaments under Scrutiny. Discourse Strategies and Interaction Practices[END_REF]. Within the genre of parliamentary debates, plenary sessions reflect a tension between the desire to display a deliberation, i.e. the search for consensus, but also a confrontation that makes it possible to account for the various forces involved -a tension that Ilie (2003, 73) sums up under "adversariality and cooperativeness". As a "performance-oriented institutional interaction" (Bischof and Ilie 2018, 586), plenary debates represent a "conceptual nexus" (Ihalainen, [START_REF] Rep2 Ihalainen | Parliament as a Conceptual Nexus[END_REF] enabling politicians to stage their professional and personal ethos -different aspects that can be summarized as 'doing being receptive', as will be shown in the next sections.

Each subcorpus is independent, yet all three corpora are comparable. One parliamentary debate per year about a major European Council meeting was selected. European Council meetings trigger plenary debates in the EU Member States, nonetheless in very different proportions. These discrepancies are reflected in the size of the corpora: the German corpus (DE-PARL) is the biggest one with 417,095 tokens, while the British (UK-PARL) and the French one (FR-PARL) amount for 188,913 and 137,620 tokens, respectively.

The corpus has been manually annotated according to the guidelines of the Text Encoding Initiative. Of interest for this paper is the TEI tag <quote>, which "contains a phrase or passage attributed by the narrator or author to some agency external to the text". 1 In the corpus, the quote tag is used when a speaker indicates that they are borrowing somebody's words. It does not distinguish between various levels of constructed dialogue, however, and is encoded independently from typographic markers. An example is (1):

(1) <u who="#HOWARD"><seg>In 1998, he said <quote>"We have to reform Europe and we are winning that battle"</quote>. […]</seg> (UK 2004.11.08) Note that the annotation captured all instances of constructed dialogue, which do not necessarily pertain to a narrative of dialogue, where the communicative act of dialoging with someone is put in the foreground. In Example (1), for instance, the instance of constructed dialogue does not qualify as an instance of narrative of dialogue. In this case, the constructed dialogue serves other purposes, notably making the quotee accountable for what the speaker claims they said. It does not revolve around a narrative in which the very act of initiating or pursuing a dialogue is enacted.

The manual annotation yielded the following results: 550 instances of con-structed dialogue in the German corpus, 190 instances of constructed dialogue in the British corpus, 112 instances of constructed dialogue in the French corpus. The analysis remains, however, qualitative, and these numbers merely indicate that there are more instances of constructed dialogue in the German corpus, which is consistent with the fact that the corpus is about three times as big as the French one and twice as big as the British one. (Keep this in mind when noticing that I present a few more instances from the German corpus.) Moreover, a large number of instances of constructed dialogue in the British corpus are similar to (1), which can be explained by the higher degree of technicity of parliamentary debates on Europe at the House of Commons (Truan 2016d, paras. 15-19).

I have divided narratives of dialogue according to the source of the utterance, suggesting that the co-interlocutors the speaker engages with are one of the most prominent factors in establishing what kind of parliamentarians they want to sound like. Three main categories of discourse participants have emerged from the data: unknown enunciators, famous enunciators, and ordinary voters.

Indeterminate voices: Establishing a dialogue with the opponents

In this section, I present instances of narratives of dialogue mapped onto a twofold rhetorical move: presenting what others will say and then introducing the speaker's argument. Specifically, I focus on instances of constructed dialogue introduced by a referent denoted by a singular third-person form such as someone or everyone. I examine how MPs anticipate dissent by putting words into their challengers' mouths in the future tense. By doing so, parliamentarians reframe the debate by telling how they would react. Because they know what their opponents will say -it is phrased as a future bound to happen -, speakers can present themselves as, first, competent politicians knowing what counterarguments may emerge and, second, defuse the real dialogue before it actually takes place. The role played by third-person forms in this respect is significant: out-group members are rarely referred to via second-person forms ('you will say'), but constructed as a collective, yet imprecise enunciative source.

Let us first consider the following example:

( ) [majority]: This will be the spirit in which we will be advised today and tomorrow in Brussels, where everyone is announcing: diversity is so huge, Europe is divided, they will not make an inch of progress. I am telling you: we will make progress, namely exactly the way I have described it because the values that unite us are values and goals with which Europe will still be here, in the global competition of the 21st century because we all, all heads of state and government of the European Union, all 27 Member States, feel bound by this spirit and because we actually do share these common values.

Excerpt (2) shows how a dialogue is established between what critiques will say and what

the speaker actually says. Angela Merkel preempts the future by assuming that a certain 'spirit' (Geist) will prevail. While she imagines that the counterdiscourse will take place in Brussels, she also surmises that such an utterance is so plausible and pervasive that it will be said by 'everyone' (jeder). This extract is thus an example of "choral dialogue" (Tannen 2007, 114-15), where "the dialogue is attributed to more than one speaker" although it is virtually impossible that 'everyone' will utter the same words. "Rather", Tannen continues, "the line of dialogue is offered as an instantiation of what many people said". Throughout the narrative of dialogue, a discussion is instantiated with the imagined speakers of such utterances and with the MPs attending the debate. Put differently, the speaker simultaneously depicts two worlds of discourse: one within the projected future "as the site of the possible and potential, represent[ing] a contested rhetorical domain" (Dunmire 2005, 482) and one in the hic et nunc of the speech event, with her real-time interlocutors.

This two-layered conversation moreover involves the staging of the speaker as they speak. By turning her answer to both her critiques and the other MPs ('I am telling you', [i]ch sage Ihnen), the speaker accomplishes an act of performativity. She indeed frames her utterance as constructed dialogue instantiated by herself at the time of the utterance. Arguably, utterances such as 'I am telling you' have been framed as "a simple reinforcement of the [following] assertion" (Marnette 2005, 67) -and not as engaging in any dialogue.

It is however possible to consider such instances as a speaker's performance of them doing 'having a conversation with someone'. Following Marnette, I argue that the verbum dicendi "expresses two different things [at the same time, I would add]: a speech act and the staging of that speech act" (2005,(67)(68). Such an inter-actional pattern is manifest in (2). The proposition 'I'm telling you' ([i]ch sage Ihnen) is constitutive of a dialogue, understood as a succession of turns. Precisely because it involves the act of responding and the staging of this act, the excerpt revolves around the speaker -rather than the quotee.

Without the utterance introduced by 'I'm telling you', the critical observation made by the anonymous, yet multiple voice ('everyone'), would have remained a single turn. Because the utterance is followed the speaker's reply, the excerpt becomes a dialogic interaction. With the addition of the second turn, the speaker performs a shift in footing between her role in the fictional dialogue and her speech with the public attending the debate. The utterance is caught in-between the constructed dialogue with the opponents and the actual dialogue with peers in the parliamentary arena.

Keeping in mind this complex interlocking of voices, consider (3):

( The one or the other (person)] will say that this is just empty talk and not justified. I would like to say very clearly that this government, due to its policy, does not contribute to building a social and, by doing so, a democratic Europe.

The indeterminate, hypothetical speaker who utters the words 'this is just empty talk and not justified' is not framed as a collective entity but as an isolated, anonymous voice. By contriving their own answers as dialogue, i.e. by performatively introducing the act of answering, the speakers establish a political dialogue with the opponents and stress the significance of their communicative act.

Interestingly, such a pattern appears relatively frequently in German parliamentary discourse: there are 160 occurrences of the pattern 'I am saying/telling you' (ich sage) or 'I must/want to say' (ich muss/will sagen). Occurrences in the past tense are not included since they may be viewed as instances of con-structed dialogue, not as speech in the making. The first collocate 2 is the colon: punctuation mark indicates that the formula is followed by the message that the speaker wants to accentuate. The second one is the personal pronoun 'you' in the dative case (Ihnen), which shows that such an expression is oriented towards the addressees in almost a third of the cases (53 occurrences). The following collocates illustrate the rhetorical move of 'making a point' against one's opponents, manifest in the adverbs 'expressly' (ausdrücklich, 14 occurrences), 'once and for all' (einmal, in particular in the expression noch einmal, 18 occurrences), 'openly' (offen, 6 occurrences), and 'clearly' (deutlich, 11 occurrences), as well as in the intensifier 'very' (ganz, 18 occurrences) and the adversarial connective 'but' (aber, 18 occurrences).

The semi-fixed formula 'I am telling you' appears as a preferred way of saying things in German contemporary discourse. The English equivalent, I say/I tell, occurs 26 times. By contrast, the string of words je dis/dirai in French yields only 5 occurrences. This finding may be read in the light of what I call 'displaying indirectness, but playing it tough' at the German Bundestag (Truan forthcoming). By embedding their central message into a narrative of dialogue, MPs convey their message indirectly, as a response to an anticipated critique.

Example (4) from the British corpus also presents a fictive situation in the future tense:

(4) MR. DAVID CAMERON (TORIES) [majority]: This [the European Commission] is an organization that responds not simply to pressure, but to political realities, so we have to make sure that the political reality after the next election is someone walking into the Berlaymont building or the European Council building and demanding change, rather than someone wandering in and just saying, Relax -there's nothing you need to do. We don't have to have a referendum. We don't need a renegotiation. One day we'll join the single currency. All the pressure would be off and, yes, some in Brussels would breathe a sigh of relief, because it would be business as usual with Labour and probably the Scottish National party too. (UK 2015.03.23) As in (2), the fictitious dialogue takes place in Brussels, in a place still to be identified (the Berlaymont building or the European Council building). This narrative of dialogue animates successive speech roles: a positive one ('someone demanding change', probably David Cameron projecting himself after the next election), and two negative ones (someone saying 'Relax -there's nothing you need to do', and some breathing). The words 'Relax -there's nothing you need to do […]' are not merely quoted but integrated into the vision of a fictive discourse participant in movement, 'walking into' a building, 'wandering in'.

Framing what others will say is always paired with an answer to such criticism:

(5) MR. TONY BLAIR (LABOUR) [majority]: Some people will say that all the power should be put into the hands of the Commission and the European Parliament; others, such as ourselves, will say that the Commission must retain its independent right of initiative […].

(UK 2001.12.17)

Similar to the structures pervading all narratives of dialogue, the arguments of both the opponent(s) and the speaker are presented side by side. Yet the speaker's point is always final, and strategically closing the utterance. Both arguments are equally framed in the future sense, i.e. as utterances which have not (yet) occurred.

The following example from the French corpus shows that the speakers may correctly picture what opponents will say, as the call in-between 3 in (6) highlights: (FR 2002.12.03) FRANÇOIS BAYROU (UDF) [majority]: As it is written in article 2 of our Constitution, the principle of our Republic is "the government of the people, by the people, for the people". Some will say again that this is a utopia. JEAN-PIERRE BRARD (CR) [opposition]: It remains a utopia! FRANÇOIS BAYROU (UDF) [majority]: For us, it must be done.

Acknowledging that certains ('some') will not agree with him, Bayrou introduces anticipated dissent. His utterance is followed by a call in-between from an MP belonging to the parliamentary group 'Communistes and Républicains'. The third-person form certains ('some') is overwhelmingly used to refer to the Communists rather than any other parliamentary group. It is thus no surprise that the narrative of dialogue transforms into a real dialogue during this heated debate.

The examples presented in this section have shown that making the opponents speak can be framed as an anticipation of expected critiques. Presenting the detractors' fictive utterances in the future tense enables the speaker to formulate their own utterance in the future tense, too, thus projecting the dialogue of both speakers in a fictive situation. By finally uttering those words that may never be uttered otherwise, the speaker shapes in return an image of the co-interlocutors: those incapable of saying what needs to be said.

3.

I propose to label shorter, unauthorized turns by speakers other than the one currently holding the floor as 'calls in-between' -a possible translation of the German term Zwischenruf. By doing so, I account for the specificity of this type of turns in parliamentary interaction (Truan 2019a, 333).

Well-known voices: Displaying the professional politician

I now turn to a second series of examples revolving around specific enunciative sources. Contrary to the instances of Section 4 where the focus was on dialogue in the making without indicating who will utter it, the instances of Section 5 are tied up with a specific discourse participant absent during the plenary session. I argue that in such cases, narratives of dialogue contribute to an ethos of professionalism by showing the MP in their everyday professional environment, while simultaneously highlighting how knowing famous people is nothing special. Politicians are then able to stress two seemingly contradictory aspects of their identity: their net-work and belonging to the elite, but also the ordinariness of such situations.

Let us consider ( 7): Excerpt (7) is a typical example of narrative of dialogue characterized by a change of perspective marked by the shift from the informal second-person pronoun du ('you') to the third-person pronoun er ('he'). In the first part of the excerpt, the speaker drops out the current speech situation to project himself in a former situation, symbolized by a lower degree of formality. In this way the speaker shows that he is close to the referent quoted, Alan Greenspan, although the latter is a public figure. The choice of the informal pronoun du thus belongs to the speaker's representation (and translation) of past events: the staged dialogue must have occurred in English (Alan Greenspan is an American economist). The construction of familiarity between these public figures, however, relies on linguistic cues to appear authentic. A similar though slightly different process can be seen in ( 8): The speaker shows his closeness to the quoted referent by emphasizing that the Portuguese ambassador came to visit him personally (bei mir, 'at my place'). This occurrence qualifies as a narrative of dialogue because it remains linked with a specific communicative situation: the exchange with the ambassador becomes a leitmotiv in Kauder's speech and is quoted several minutes later on another occasion:

(9) VOLKER KAUDER (CDU) [majority]: Das zweite Thema, wenn wir über Wachstum und Innovation sprechen, bleibt natürlich -auch darauf hat der portugiesische Botschafter gestern hingewiesen -, dass wir mehr in Zukunftsbereiche investieren müssen. (DE 2015.03.19) VOLKER KAUDER (CDU) [majority]: The second topic that we have to tackle when we are talking about growth and innovation is, of course, and as the Portuguese ambassador also said yesterday, that we have to invest more in future-oriented areas.

And it finally reappears at the end of Kauder's speech:

(10) VOLKER KAUDER (CDU) [majority]: Ich will noch einmal den portugiesischen Botschafter zitieren -er hat mir ausdrücklich gesagt: Herr Kauder, das können Sie öffentlich verwenden -: Wenn man Griechenland jetzt auf eine Art und Weise nachgibt, wie es nicht in Ordnung ist, dann kann ich in meinem Land nicht mehr erklären, warum die Menschen überhaupt Opfer auf sich genommen haben und auch in Zukunft noch Opfer auf sich nehmen sollten. (DE 2015.03.19) VOLKER KAUDER (CDU) [majority]: I want to quote the Portuguese ambassador one more time. He explicitly said: "Mr. Kauder, you can use this publicly": If one gives in to Greece's requests now, in a way which is not okay, then I can't explain anymore [to the citizens] in my country why people have taken responsibility for the victims and should keep doing it the future as well.

As a matter of fact, this narrative becomes so vivid that even another speaker incorporates it into his speech as well: Interestingly enough, the name of the Portuguese ambassador will never be dis-closed, which shows that his symbolic function is more important than his actual identity. Arguably, assigning your words to someone else allows you to minimize your enunciative involvement. In this context, it enables a conservative MP to tell southern countries what they should do without making it sound like an imposition. By framing the need for reform and the positive role model Germany plays as coming from a representative of these countries, the speaker minimizes the face-threatening act the 'advice' represents.

The most prominent aspect of this narrative of dialogue, however, is not so much to hide behind the ambassador's words, as he is nor well-known nor a pivotal figure for German contemporary politics, and as what he finally "says" is expected in the mouth of a member of the Christian Democratic Union. Rather, the function of this pervasive narrative of dialogue is to frame the speaker as a professional politician seeking advice from like-minded professionals. When they refer to other political figures in a casual way, as something that happened in passing, MPs show their embeddedness in relevant networks. Simultaneously, by depicting how they are at home, with people they (say they) know well, MPs also present themselves in a friendlier environment, at the intersection between their professional and private life.

Whether this strategy serves the speaker's communicative goals still remains to be assessed. Maybe paradoxically, putting forward one's identity as a politician close to other politicians may be an easy entry into the traditional tension between MPs as representatives of the people and part of an elite. Being per du (informal 'you') with Alan Greenspan can then be interpreted as an indicator of further distance from the citizens.

Until now we have seen that narratives of dialogue are pervasive resources both in opening a (fictive) space for contesting voices, thus letting see a potential that will be brushed off, and in unfolding seemingly contradictory aspects of a parliamentarian's identity. Next, I turn to the third category of enunciators I have identified across the three corpora of British, French, and German parliamentary debates: the ordinary voter, usually expressed through singular, yet unspecific, person-referring expressions.

Singular anonymous voices: Talking to the ordinary voter

The figure of the ordinary voter 4 must be assessed in contrast to the ways people are usually represented. People are often voiced in a very impersonal way in my corpus of parliamentary debates, in particular through generic expressions (people, everyone, all) (Truan 2019b). Against this background, a well-developed strategy is the mobilization of collective, yet particular voices (as opposed to generic reference):

(12) HENRY SMITH (TORIES) [majority]: The constituents to whom I spoke over the weekend, on the doorstep and in community meetings, were certainly not amused by the irony of a surcharge of 1.7 billion from the European Union having to be paid because our economy is so successful, and they were very much behind my right hon. Friend in wanting to say no to the payment. Does the Prime Minister agree that we should take no lessons from the Labour party, who gave away 7 billion in terms of our rebate in return for absolutely no reform of the European Union? (UK 2014.10.27)

Framing one's question as coming from the constituents themselves is a way to minimize the face-threatening act towards the Labour by implicating that the speaker is merely transmitting information. Being embedded in a narrative linked with a time (over the weekend) and a place (on the doorstep and in community meetings), this extract displays the MP as someone playing their role as representative: meeting with constituents, all the more during the weekend, thus showing his dedication.

In other cases, the reference to the discourse participants is specific. The quoted referent personifies the common sense the politician endorses in the name of their constituents. Examples ( 13) and ( 14) offer a typical illustration of this phenomenon:

(13) JÉRÔME LAMBERT (SOCIALISTE) [opposition] : Récemment encore, un vieux pictocharentais, personnage souvent sympathique et toujours épris de bon sens, me disait : « Nous décentralisons notre pays alors que nous construisons l'Europe, demain la France ne sera plus qu'une mosaïque de régions et ne pèsera plus rien dans les décisions européennes » … Cette réflexion est lar-4. Among the 12 occurrences of the lemma voter in the British corpus, two correlate with the adjective ordinary, which makes it the second collocate of voter (co-frequency of 2 for 7 occurrences of ordinary in the corpus). By contrast, the French voter (7 occurrences) is not 'ordinary'. It is difficult to directly compare the French lemmas électeur ('voter'), as it has a negative semantic prosody and activates negative representations in French politics (Truan 2019b, 321). The distribution of the German lemma Wähler ('voter') is not so strongly marked, yet there is also no association with any type of standard voter. gement partagée ; on craint que notre pays, même s'il fait partie d'un ensemble plus fort, ne soit plus en mesure d'être véritablement entendu, non plus que ses citoyens.

(FR 2002.12.03) JÉRÔME LAMBERT (SOCIALISTE) [opposition]: Recently again, an old inhabitant of Poitou-Charente, an often sympathetic figure, always filled with common sense, was telling me: "We are devolving more powers as we build Europe, tomorrow France will be only a mosaic of regions and will not weigh anything in European decisions" … This reflection is widely shared; one fears that our country, even if it is part of a stronger whole, is no longer able to be truly heard, nor its citizens. By holding on to authentic verbal interactions in which they participated, the speaker discursively reconstructs the encounter, the contact, the concrete nature of the interaction that took place. The representation of a vox populi is depicted as a single event (récemment, 'recently', over the weekend) that nonetheless remains general and possibly generalizable (un vieux pictocharentais, i.e. any old inhabitant of Poitou-Charente?). The instance of constructed dialogue is credited to unquestionable enunciative sources. Contrary to plural enunciators who are always fraught with battles for recognition (who said this?), it is difficult to question the fact that the speaker has really met the discourse participants they are relying on, thus giving the narrative of dialogue a sense of intimacy, authenticity, and vividness it may lack when 'the constituents' are referred to. The precise wording of the constructed dialogue deserves attention. The formal register in [START_REF] Rep2 Ihalainen | Parliament as a Conceptual Nexus[END_REF] unveils the seasoned MP's voice behind the old inhabitant of Poitou-Charente. Note in this regard the use of the first-person plural pronoun nous instead of the informal, and highly more frequent third-person singular pronoun on (both translated as 'we') and the expression mosaïque de régions ('mosaic of regions') that resembles a pre-fabricated, highly institutionalized pattern of speech. Conversely, it is highly unlikely that the 'one particular person' given a voice in (14) mentioned the current Prime Minister by calling him 'Dave' -an intimate form of address that reveals the voice of the Conservative MP Peter Bone who knows David Cameron personally. These discourse participants are situated at the crossroads between underspecification and exemplification. Because they are not named ('one particular person', but no gender, no name, no age, no background), although spatio-temporal indications prove their existence, these singular, non-specific referents have an identifying function.

The mediation played by such enunciators as an intermediary to mitigate utterances formally addressed to other MPs is visible in ( 15 For him [+ masc in German], this process was excruciating: not so much because we are talking about difficult and ongoing processes, but because he couldn't find his problems in the government' s negotiations. Applause from the PDS This was the problem of Nice, and many commentators said so. Now we are telling the willing TV viewer, who maybe also heard the speech of the Chancellor today, everything will be fine if he just lets the government do its thing. You will acknowledge that this person finds themselves in a conflict situation; I find that you have already acknowledged that. The problem is that both the expectations and the worries of citizens in the context of an enlarged Union were not addressed. The fears and hopes were too little discussed.

The explicit addressees of (15) are 'Ladies and Gentlemen' who are invited to engage in the hypothetical situation depicted by the speaker (see the imperative mood '[p]ut yourself in the shoes'). Throughout the extract, the conclusions drawn are also oriented towards the other MPs ('[y]ou will acknowledge'). The 'pro-European TV viewer who tried to follow the Nice process in the media' is thus never the addressee of the excerpt but remains the discourse participant one talks about, not to. Calling this figure into existence functions as an act of recognition ('I know that you exist') and as an act identification ('I -maybe as opposed to others -know how you feel and will make your voice heard'). Although this mediated dialogue paradoxically stresses the indirect access to representatives in our modern democracies, it also appears as one of the only ways to make the voice of citizens heard in the parliamentary arena.

Interestingly, narratives of dialogue revolving around discourse participants in the singular -i.e. an old inhabitant of Poitou-Charente' in [START_REF] Rep2 Ihalainen | Parliament as a Conceptual Nexus[END_REF], '[o]ne particular person' in ( 14), 'a TV viewer' in (15) -relies on longer extracts than when people are mentioned in the plural. Although this individual (grammatically encoded through singular NPs) remains unidentified or generic, the emphasis is put on the value of the experience rather than on numbers, as in plural generics ('people think') or quantificational NPs ('many (people) think'). It is, however, implied that this discourse participant may be representative for the whole class they stand for. Enacting a single discourse participant is thus an introductory phase during which the speaker also constructs an ethos of proximity and familiarity with their constituents.

When enacting scenarios with individual voters, politicians recreate the conditions for a dialogue as it supposedly happened face-to-face. Members of Parliament emphasize how they engage in a dialogue with their constituents outside of the parliament, and activate the representation of closeness, intimacy, and home via the constituency. Parliamentarians thus display themselves as being open and receptive when getting to know a diverse population.

Conclusion: Narratives of dialogue in the service of ethos of familiarity and authenticity

Within narratives of dialogue, how discourse participants are instantiated puts different aspects of a politician's ethos in the foreground. Narratives of dialogue function as a means of establishing proximity to the discourse participants being quoted by highlighting two aspects. First, the speaker's personal connection with the discourse participant creates an ethos of familiarity, be it with unidentified voices portrayed in specific (yet often fictive) situations, professional connections, or ordinary citizens. Second, the emphasis on the situation of utterance in which the exchange supposedly happened creates an ethos of authenticity. Both aspects are situated at the intersection between private and public domains of reference, and contribute to 'doing democracy'.

The parliamentary ethos of familiarity and authenticity is intertwined within the three main functions that narratives of dialogue perform in the corpus. First, narratives of dialogue unlatch a polyphonic space for the representation of dis-sent. They thus allow for a dialogue with the opponents through indeterminate voices (someone or everyone). Second, narratives of dialogue, when referring to situations during which the speaker describes themselves with someone famous, emphasize the embeddedness into relevant professional networks. Finally, narratives of dialogue can be combined with the figure of the ordinary voter, thus allowing MPs to construct themselves as close to the people.

While the discursive construction of the people has been shown to be a standard feature of current populist discourse, "referring to the people is a common feature of parliamentary talk for all speakers and all parliamentary groups" (Truan 2019a: 334). Specifically, "the mere mention of the "people" cannot be regarded as a feature of populist rhetoric." (Truan 2019b: 201, also see 205). Indeed, the rhetorical moves identified in this paper are not populist per se, as all parliamentarians use them (or, then, we would have to say that politics in general has become populist -a claim that goes beyond the scope of this paper).

In fact, narratives of dialogue may be a particularly useful and widely used resource in parliamentary discourse because they offer a convenient way out on how to perform facework "as a form of communicative skill" (Bull and Fetzer 2010, 156) while displaying an image of the self only in relationship with others. Because plenary sessions, as the place where citizens' voices should be heard, paradoxically also are exactly the place where only Members of Parliament get to speak, narratives of dialogue not only render the vividness of possible inter-actions, but also situate parliamentarians as willing to engage in a dialogue with other discourse participants.

When reconstructing previous or forthcoming interactions and giving themselves the role of a discourse participant, speakers perform their own role as someone engaging in a conversation. They thus narrate the act of being in a conversation. Narratives of dialogue appear prominently in parliamentary dis-course in three distinct national contexts. While comparisons with other dis-course genres are necessary to assess whether narratives of dialogue are specific to parliamentary discourse or simply broadly used, the data suggests that the representative function MPs (are expected to) play in parliamentary settings shapes the mode of representation of constructed dialogue.

In order to fulfil their representative function, Members of Parliament per-form three communicative acts simultaneously: they speak about, for, and to the people (Truan 2019a). By speaking with discourse participants through narratives of dialogue, they initiate a dialogue that functions as a prototype for the dialogue taking place in parliamentary interaction. In other words, they perform democracy by establishing a virtual space where different perspectives get interwoven. Because they show how meaning emerges through interaction, narratives of dialogue can be seen as miniatures of how parliamentarians construe their encounters with diverse discourse participants, and display themselves as amenable to new ideas. In this sense, narratives of dialogue appear as one of the crucial moments where parliamentary democracy as the fragmentation of voices brought together under the umbrella of representatives becomes visible.

( 6 )

 6 FRANÇOIS BAYROU (UDF) [majority]: Comme il est écrit à l'article 2 de notre Constitution, le principe de notre République, c'est « le gouvernement du peuple, par le peuple, pour le peuple ». Certains diront encore que c'est une utopie. JEAN-PIERRE BRARD (CR) [opposition]: Cela reste une utopie ! FRANÇOIS BAYROU (UDF) [majority]: Pour nous, c'est le nécessaire.

( 7 )

 7 DR. THEODOR WAIGEL (CSU) [opposition]: Ich habe einmal vor ein paar JahrenAlan Greenspan gefragt: Wie hast du vor zehn Jahren über den Euro gedacht, wie hast du vor fünf Jahren über den Euro gedacht und wie denkst du jetzt über den Euro? Da lachte er und sagte: Vor zehn Jahren "zero or below zero", vor fünf Jahren hielt ich es ebenfalls für aussichtslos und jetzt bin ich froh, dass es neben dem Dollar diese zweite Weltreservewährung zur Stabilisierung des Weltwährungssystems gibt.(DE 2001.12.12) DR. THEODOR WAIGEL (CSU) [opposition]: A few years ago, I asked Alan Greenspan, "what did you think about the euro ten years ago, what did you think about the euro five years ago, and what do you think about the euro now?" He then laughed and said, "ten years ago, 'zero or below zero' [in English], five years ago, I still thought it had no perspective and now I am happy that this global reserve currency exists next to the dollar to stabilise the international monetary system".

( 8 )

 8 VOLKER KAUDER (CDU) [majority]: Gestern war der portugiesische Botschafter bei mir und hat darauf hingewiesen, dass Portugal dringend Unterstützung bei Investitionen in eine modern Infrastruktur und bei Beschäftigung brauche. (DE 2015.03.19) VOLKER KAUDER (CDU) [majority]: The Portuguese ambassador was at my place yesterday and he mentioned the fact that currently, Portugal desperately needs support in the investment in a modern infrastructure and employment.

( 11 )

 11 MATERN VON MARSCHALL (CDU) [majority]: Dafür, dass zum Beispiel die duale Ausbildung -Herr Kauder, Sie haben das im Zusammenhang mit dem portugiesischen Botschafter angesprochen -ein Erfolgsmodell Deutschlands ist […]. (DE 2015.03.19) MATERN VON MARSCHALL (CDU) [majority]: The fact that the dual training in German is a success […] -you mentioned it in the context of the Portuguese ambassador, Mr. Kauder.

( 14 )

 14 PETER BONE (TORIES)[majority]: Over the weekend, my joint listening campaign with Tom Pursglove, the excellent Conservative candidate for Corby, was out knocking on doors. One particular person who spoke to Tom said, I've been a Labour voter all my life, but Dave has said no to paying 1.7 billion, Dave has said no to unrestricted immigration from the EU and he's going to give us a referendum, so for the first time ever I'm going to vote Tory. Does my right hon. Friend think that the rest of the country will follow that chap?(UK 2014.10.27)

  ): (15) ROLAND CLAUS (PDS) [opposition]: Wir wollen eine andere Frage stellen, meine Damen und Herren. Versetzen Sie sich einmal in die Lage eines europafreundlichen Fernsehzuschauers, der versucht hat, den Nizza-Prozess in den Medien zu verfolgen. Für ihn war dieser Vorgang quälend: nicht so sehr, weil es sich hier um schwierige und andauernde Prozesse handelt, sondern weil er seine Probleme in dem nicht wiederfand, was seine Regierung dort verhandelte. Beifall bei der PDS Dass dies das Problem von Nizza war, haben auch viele Kommentatoren gesagt. Nun wird dem geneigten Fernsehzuschauer, der vielleicht auch heute die Rede des Kanzlers gehört hat, gesagt, es werde eigentlich alles gut, wenn er die Regierung nur weiter gewähren lasse. Dass dieser Mensch in Konflikte kommt, werden Sie doch wohl eingestehen; ich finde, Sie haben es auch schon eingestanden. Das Problem ist also, dass sowohl die großen Erwartungen als auch die Sorgen von Bürgerinnen und Bürgern im Zusammenhang mit einer erweiterten Union hier zu wenig vorkamen. Auf die Ängste wird zu wenig eingegangen und die Hoffnungen werden zu wenig aufgegriffen. (DE 2001.01.19) ROLAND CLAUS (PDS) [opposition]: We want to ask another question, Ladies and Gentlemen. Put yourself in the shoes of a pro-European TV viewer who tried to follow the Nice process in the media.

  Wir werden vorankommen, und zwar genau in dem von mir beschriebenen Sinn, weil die Werte, die uns einen, Werte und Ziele sind, mit denen Europa auch im weltweiten Wettbewerb des 21. Jahrhunderts bestehen kann, weil wir uns alle, alle Staats-und Regierungschefs der Europäischen Union, aller 27 Mitgliedstaaten, dem Geist verpflichtet fühlen und weil wir die gemeinsamen Werte auch wirklich teilen.

2) DR. ANGELA MERKEL (CDU) [majority]: Das wird auch der Geist sein, in dem wir heute und morgen in Brüssel beraten werden, wo doch jeder vorher sagt: Die Vielfalt ist so groß, Europa ist zerstritten, die werden keinen Millimeter vorankommen. Ich sage Ihnen: (DE 2012.10.18) DR. ANGELA MERKEL (CDU

  3) OSKAR LAFONTAINE (DIE LINKE) [opposition]: Der eine oder andere wird nun sagen, das sei einfach nur dahergesagt und nicht begründbar. Ich möchte ganz deutlich sagen, dass diese Regierung aufgrund ihrer Politik nicht daran mitwirkt, ein soziales und damit ein demokratisches Europa zu bauen. (DE 2006.12.14) OSKAR LAFONTAINE (DIE LINKE) [opposition]: Now some people [liter-ally:

A collocate is a word that occurs around another word. The search has been made in the software TXM[START_REF] Heiden | The TXM Platform: Building Open-Source Textual Analysis Software Compatible with the TEI Encoding Scheme[END_REF] with the default parameters: ten words before and ten words after the key words.