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August Wilson is one of the twentieth century's most important and acclaimed playwrights. This volume demonstrates Wilson's significance to contemporary theatre, culture, and politics by providing fresh and compelling insights into his life, practices, and contributions as an artist and public intellectual. Across four thematically organized sections, contributors situate Wilson's work in his social, cultural and political contexts, examine ongoing developments in Wilson studies, explore the production contexts of his plays, and explicate his dramaturgical sensibilities and strategies. This is the authoritative guide to Wilson's career and artistic legacy for students, theatre practitioners, and general readers interested in this remarkable figure.
The management of cervical dysplasia in pregnant individuals focuses on maintaining maternal well-being while considering pregnancy-related factors. Risk-based colposcopy should be performed with an immediate CIN 3+ risk threshold of ≥4% or with other significant high-risk screening results. Testing for HPV is recommended for individuals aged 30 years and older and for postpartum surveillance of abnormal cases in those aged 25 years and older. The impact of financial support on postpartum medical care can influence the necessity of colposcopy during pregnancy. It is important to note that there are specific challenges with performing colposcopy during pregnancy and there needs to be judicious use of ectocervical biopsy. Excisional procedures are reserved for confirmed or likely invasive disease. In cases of cervical cancer, the involvement of specialized medical practitioners is advised. Postpartum management strategies involving colposcopy and expedited loop electrosurgical excision procedures underscore the significance of risk-based evaluations. In summary, the case provides comprehensive insights into managing cervical dysplasia during and after pregnancy, focusing on evidence-based guidelines and multidisciplinary collaboration for optimal outcomes.
Fuel pre-injection in the inlet of a hypersonic engine has been proven to be advantageous in the range of the very high flight Mach numbers. In this paper, a rapid inlet performance analysis model with fuel pre-injection is proposed. The modelling process is divided into two stages. Firstly, the baseline inlet model is provided based on the working principle of the inlet. Then, the newly proposed fuel injection and heat release model is added to the baseline inlet model. Among them, the fuel injection and heat release model is equivalent to increasing the compression angle in the cold state. And in the hot state the effect of the fuel heat release will be considered in addition to the effect of cold state. The research results show as the equivalence ratio increases, the equivalent compression angle also increases, but the two are not in a linear relationship. Based on this pattern of effect, fuel injection can be used to regulate the shock wave position and accurately control the flow rate of the inlet. In addition, by comparing to numerical simulation, it is found that the analysis model can almost reasonably predict the performance of the pre-injection inlet. However, the calculation of drag coefficient has some deviation compared to numerical simulation, which is probably due to the lack of consideration of friction drag and the interaction between the shock wave and boundary layer in the model analysis. Overall, the modelling method proposed in this paper can reflect the effect of fuel injection on inlet performance, which can be used to optimise injection strategy in the future.
We investigate the statistical properties of kinetic and thermal dissipation rates in two-dimensional/three-dimensional vertical convection of liquid metal ($Pr = 0.032$) within a square cavity. Two situations are specifically discussed: (i) classical vertical convection with no external forces and (ii) vertical magnetoconvection with a horizontal magnetic field. Through an analysis of dissipation fields and a reasonable approximation of buoyancy potential energy sourced from vertical heat flux, the issue of the ‘non-closure of the dissipation balance relation’, which has hindered the application of the GL theory in vertical convection, is partially resolved. The resulting asymptotic power laws are consistent with existing laminar scaling theories and even show certain advantages in validating simulations with large Prandtl number ($Pr$). Additionally, a full-parameter model and prefactors applicable to low-$Pr$ fluids are provided. The extension to magnetoconvection naturally introduces the approximate expression for total buoyancy potential energy and necessitates adjustments to the contributions of kinetic dissipation in both the bulk and boundary layer. The flow dimensionality and boundary layer thickness are key considerations in this analysis. The comprehension of Joule dissipation has been updated: the Lorentz force generates positive dissipation in the bulk by suppressing convection, while in the Hartmann layer, shaping the exponential boundary layer requires the fluid to perform positive work to accelerate, leading to negative dissipation. Finally, the proposed transport equations for magnetoconvection are supported by current direct numerical simulation (DNS) and literature data, and the applicability of the model is discussed.
Protein-losing enteropathy remains a formidable and underrecognised complication following Fontan surgery, contributing significantly to morbidity and mortality among affected patients. Despite substantial progress in managing single-ventricle CHDs, protein-losing enteropathy persists as a major clinical challenge, particularly in resource-constrained environments where specialised diagnostic modalities are scarce. This manuscript discusses the prevalence, clinical presentation, diagnostic hurdles, and management of protein-losing enteropathy in post-Fontan patients, drawing from clinical experiences in Vietnam. Among 95 post-Fontan patients reviewed, the prevalence of protein-losing enteropathy was 4.2%, with considerable morbidity necessitating invasive interventions and, in some cases, resulting in mortality. Diagnostic limitations, including restricted access to alpha-1-antitrypsin clearance testing, highlight the urgent need for heightened clinical suspicion and pragmatic diagnostic approaches. We advocate for integrating low-cost, widely accessible screening measures, such as routine serum protein monitoring, into standard post-Fontan care protocols to enhance early detection and management of protein-losing enteropathy. Furthermore, we underscore the critical importance of global collaboration and multicentre research initiatives to address the worldwide burden of protein-losing enteropathy, facilitate resource-sharing, and develop evidence-based interventions. Coordinated international efforts are essential to closing diagnostic and treatment gaps, ultimately improving survival and quality of life for patients living with the Fontan circulation.
Objectives/Goals: Novel therapeutics to control Staphylococcus aureus (S. aureus) infections are needed for people with cystic fibrosis (CF, PwCF). In this study, our objective is to determine if the pharmacologic MEK1/2 inhibitor compound ATR-002 can restrict the growth of S. aureus clinical isolates and modulate infection in a murine model of S. aureus infection. Methods/Study Population: To evaluate the anti-inflammatory effects of ATR-002 on human macrophages, cells were stimulated with TLR2 agonists FSL1 or Pam3CSK4 with a dose range of ATR-002, and secretion of proinflammatory cytokines were measured by ELISA. To determine the direct antibacterial effect of ATR-002, minimum inhibitory concentration (MIC) assays were performed with the community-associated methicillin-resistant S. aureus strain USA300 and 40 S. aureus isolates from PwCF. To validate our results in vivo, mice were provided i.p. treatment with either vehicle, the MEK1/2 inhibitor compound PD0325901 (20 mg/kg), or ATR-002 (10 mg/kg) prior to intranasal infection with 1x10^7 CFU of USA300. Bacterial burdens at 4- and 24-hour post-infection (p.i.) and inflammatory cell recruitment at 24 hours p.i. were quantified. Results/Anticipated Results: Macrophages treated with ATR-002 exhibited a dose-dependent decrease in secretion of proinflammatory cytokines TNF and IL-8 following TLR stimulation. Our studies identified that ATR-002, but not PD0325901 or other MEK1/2 inhibitors, had direct antibacterial effects, and ATR-002 had an MIC range of 8 to above 64 ug/mL on CF S. aureus isolates. In the murine pulmonary infection model, delivery of ATR-002 and PD0325901 significantly prevented infection-induced loss of body mass and decreased neutrophil inflammation. However, when bacterial burdens were quantified 4-hours p.i., only ATR-002 treatment reduced lung bacterial burden compared to vehicle or PD0325901-treated groups. Discussion/Significance of Impact: These results are the first demonstration of the in vivo anti-inflammatory and antibacterial effects of ATR-002. Our results further demonstrate that ATR-002 exhibits direct antibacterial effects across a collection of clinical isolates of S. aureus. Future studies will continue to investigate the therapeutic potential of ATR-002.
Brown dwarfs are failed stars with very low mass (13–75 Jupiter mass) and an effective temperature lower than 2 500 K. Their mass range is between Jupiter and red dwarfs. Thus, they play a key role in understanding the gap in the mass function between stars and planets. However, due to their faint nature, previous searches are inevitably limited to the solar neighbourhood (20 pc). To improve our knowledge of the low mass part of the initial stellar mass function and the star formation history of the Milky Way, it is crucial to find more distant brown dwarfs. Using James Webb Space Telescope (JWST) COSMOS-Web data, this study seeks to enhance our comprehension of the physical characteristics of brown dwarfs situated at a distance of kpc scale. The exceptional sensitivity of the JWST enables the detection of brown dwarfs that are up to 100 times more distant than those discovered in the earlier all-sky infrared surveys. The large area coverage of the JWST COSMOS-Web survey allows us to find more distant brown dwarfs than earlier JWST studies with smaller area coverages. To capture prominent water absorption features around 2.7 ${\unicode{x03BC}}$m, we apply two colour criteria, $\text{F115W}-\text{F277W}+1\lt\text{F277W}-\text{F444W}$ and $\text{F277W}-\text{F444W}\gt\,0.9$. We then select point sources by CLASS_STAR, FLUX_RADIUS, and SPREAD_MODEL criteria. Faint sources are visually checked to exclude possibly extended sources. We conduct SED fitting and MCMC simulations to determine their physical properties and associated uncertainties. Our search reveals 25 T-dwarf candidates and 2 Y-dwarf candidates, more than any previous JWST brown dwarf searches. They are located from 0.3 to 4 kpc away from the Earth. The spatial number density of 900–1 050 K dwarf is $(2.0\pm0.9) \times10^{-6}\text{ pc}^{-3}$, 1 050–1 200 K dwarf is $(1.2\pm0.7) \times10^{-6}\text{ pc}^{-3}$, and 1 200–1 350 K dwarf is $(4.4\pm1.3) \times10^{-6}\text{ pc}^{-3}$. The cumulative number count of our brown dwarf candidates is consistent with the prediction from a standard double exponential model. Three of our brown dwarf candidates were detected by HST, with transverse velocities $12\pm5$, $12\pm4$, and $17\pm6$ km s$^{-1}$. Along with earlier studies, the JWST has opened a new window of brown dwarf research in the Milky Way thick disk and halo.
Be curious. Always be a skeptic and confirm what you read and hear. Don’t fall prey to confirmation bias. The best work a physician can do is at the patient’s bedside. If initial synthesis of information doesn’t make sense, get up and gather more data, including from the patient, family/friends, EMS, and/or nurses. Consider this the second H&P. Ask the patient about the biggest concern that brought him/her to the ED at this moment. It’s incredible what you’ll learn. Their reason for being there may not match the chief complaint. Review the triage note(s) and nursing documentation during the patient’s stay. Nursing notes can make or break a case. Always acknowledge and explain discrepancies. Review prehospital information. Even better: take time to listen to their focused report. They were at the scene and may have picked up on other important information. Thank them and highlight positive behaviors. Listen, don’t anchor, and confirm data offered.
No matter how we slice it, Emergency Medicine (EM) is a young field. In the 1960s, the U.S. public began to clamor for the need of its existence. In September 1979, it became the 23rd recognized medical specialty (note: ‘23’ is a pretty special number in sports history). In 1980, the first American Board of Emergency Medicine certification examinations were offered. In September 1989, EM received primary board status. In comparison, Internal Medicine (IM) was recognized in 1936 and Surgery in 1937. As one can imagine, as medical schools were filling their ranks, the predominant teaching faculty trained in IM and Surgery. The clinical approaches and thought processes taught across the four years were unsurprisingly IM- and Surgery-centric and mostly still are. We can all easily agree that EM calls for a different approach. The hope of this book is to explore and leave the reader with an understanding of EM decision-making and as an advocacy tool for our crucial field.
'Emergency Medicine Thinker' is a practical pocketbook that provides important considerations for the practice of emergency medicine. Based on the popular website created by the authors, 'emDocs.net', it covers practical thinking rules that can be applied on an emergency medicine shift and provides approaches to common and life-threatening diseases in the ED that physicians see on a regular basis. Easy to read with quick access to information, and full of essential tips and pearls from experts on the emergency frontlines, this is a handbook that can be used at the bedside on shift. Part 1 of the book explores the EM decision-making process and why it's important from a myriad of central and talented emergency physicians. Part 2 features over 170 pearls for the frontline EM clinician. This book is a must-have for anyone working in emergency medicine.
This interview is accompanied by Margherita R. Long's essay Japan's 3.11 Nuclear Disaster and the State of Exception: Notes on Kamanaka's Interview and Two Recent Films
Born in Toyama Prefecture, Kamanaka Hitomi entered Waseda University and joined her friends in a filmmaking club. Kamanaka won a scholarship from the Japanese government and spent time in Canada and the US between 1990 and 1995 studying at the National Film Board of Canada and working as a media activist at Paper Tiger in New York. Kamanaka then returned to Japan at the time of the Hanshin-Awaji Earthquake that caused over 6,000 deaths and displaced over 300,000 people in the greater Kobe area of Japan in 1995. While working as a volunteer for the victims of the earthquake, she began to produce documentaries for NHK (Japan Broadcasting Corporation) as a freelance director. Kamanaka's first nuclear-related film, Hibakusha at the End of the World (Radiation: A Slow Death, 2003), won several awards, including one from Japan's Agency for Cultural Affairs for excellence in documentary. The film shed light on the transnational links of nuclear policies and their fatal consequences by comparing radiation effects at the Hanford Nuclear Reservation in the State of Washington, the effects of depleted uranium on Iraqi citizens during and after the first Gulf War, and victims of the atomic bomb in Hiroshima and Nagasaki.