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This essay surveys the literate culture of the antebellum and Civil War eras among marginal southerners – African Americans, both free and enslaved, and poor and middle-class whites – and explores examples of the ways reading and writing, though quite distinct in formal pedagogies, blended together in the literary lives of the self-educated. Focused especially on Basil Armstrong Thomasson, a yeoman farmer in North Carolina whose diary records his reading practices as well as original verse, and John M. Washington, a Virginia man who kept a diary while enslaved, the essay presents a study in the surprising complexity and variegation of the textual landscape such people inhabited and helped create. It also discusses the scarcer archival traces of the literacy practices of ordinary southern women.
Review a single-centre experience with pulmonary artery sling repair and evaluate risk factors for re-intervention.
Patients with surgically repaired pulmonary artery sling at a single institution between 1996 and 2018 were retrospectively reviewed. A univariate Cox regression analysis was used to evaluate variables for association with freedom from re-intervention.
Eighteen patients had pulmonary artery sling repair. At operation, median age and weight were 6.9 months (interquartile range 4.1–18.1) and 9.5 kg (interquartile range 6.5–14.5), respectively. A median hospital length of stay was 12 days (interquartile range 5.8–55.3). Twelve patients (67%) had complete tracheal rings, of whom six (50%) underwent tracheoplasty (five concurrently with pulmonary artery sling repair). Airway re-intervention was required in five (83%) of the six patients who underwent tracheoplasty. One patient had intraoperative diagnosis and repair of pulmonary artery sling during unrelated lesion repair and required tracheoplasty 24 days post-operatively. One patient died 55 days after pulmonary artery sling repair and tracheoplasty following multiple arrests and re-interventions. Median post-operative follow-up for surviving patients was 6.3 years (interquartile range 11 months–13 years), at which time freedom from re-intervention was 61%. When controlling for patient and tracheal size, initial tracheoplasty was associated with decreased freedom from re-intervention (hazard ratio 21.9, 95% confidence interval 1.7–284.3, p = 0.018).
In patients with pulmonary artery sling, tracheoplasty is associated with decreased freedom from re-intervention. In select patients with pulmonary artery sling and complete tracheal rings, conservative management without tracheoplasty is feasible. Further study is necessary to delineate objective indications for tracheoplasty.
A review of recently published temporal data from Shuidonggou Locality 1 indicates that a 40–43 cal ka date for the inception of Initial Upper Paleolithic (IUP) blade-oriented technologies in East Asia is warranted. Comparison of the dates from Shuidonggou to other Asian IUP dates in Korea, Siberia, and Mongolia supports this assertion, indicating that the initial appearance of the IUP in East Asia generally corresponds in time to the fluorescence of the IUP in eastern Europe and western Asia. This conclusion preliminarily suggests that either a version of the IUP originated independently in East Asia just prior to 40 cal ka, or more likely, that an early, initial diffusion of the IUP into East Asia occurred ∼41 cal ka, a hypothesis consistent with current estimates for the evolution or arrival of modern humans in the region.
Significant new opportunities for astrophysics and cosmology have been identified at low radio frequencies. The Murchison Widefield Array is the first telescope in the southern hemisphere designed specifically to explore the low-frequency astronomical sky between 80 and 300 MHz with arcminute angular resolution and high survey efficiency. The telescope will enable new advances along four key science themes, including searching for redshifted 21-cm emission from the EoR in the early Universe; Galactic and extragalactic all-sky southern hemisphere surveys; time-domain astrophysics; and solar, heliospheric, and ionospheric science and space weather. The Murchison Widefield Array is located in Western Australia at the site of the planned Square Kilometre Array (SKA) low-band telescope and is the only low-frequency SKA precursor facility. In this paper, we review the performance properties of the Murchison Widefield Array and describe its primary scientific objectives.
Intensive research on China's Western Loess Plateau has located 63 Palaeolithic deposits, which together allow the authors to present a general model of hominin occupation from 80 000 to 18 000 years ago. Tools, subsistence and settlement correlate nicely with the climate: the warm wet MIS3 seeing expansion and more organised acquisition of quartz, and the Late Glacial Maximum that followed, a reduction in human presence but possibly an increase in ingenuity.
Drug abuse is a frequent factor in emergency department (ED) visits. Although commonly performed, qualitative testing of urine for drugs of abuse (u-DOA) is inherently limited in its ability to establish the identity, timing or dose of substances used. Previous studies have demonstrated these limitations, but their designs cannot be used to determine whether the results of u-DOA tests affect physicians’ patient care decisions. Our objective was to determine the impact of u-DOA testing on the care of patients who present to the ED.
All adults 18 years of age or older who had u-DOA testing in 2 urban teaching EDs were eligible. Victims of vehicular trauma or sexual assault were excluded. Just prior to communicating the results of u-DOA testing for a patient, an investigator interviewed the ordering physician or consultant physician about the patient care plans for that patient. Test results were then revealed, and the questions immediately repeated. This design isolated the impact of knowledge of u-DOA test results on physicians’ patient care decisions. Any intended changes in patient care plans reported by the interviewed physician were compared to a priori criteria for substantive change and then subsequently reviewed by an independent expert to determine whether that change was justified.
Of the 110 u-DOA test results studied and the resultant 133 opportunities to influence physician management plans, there were 4 reported changes in management. One management change was judged to be substantive, but none of the 4 reported changes were considered by the independent expert reviewer to be justified. Urine-DOA testing thus led to a justified change in management in 0/133 instances (95% confidence interval 0%–2.3%).
Urine-DOA is rarely helpful in guiding patient care decisions in the ED. The results of this study call into question the need for this test in the ED setting.
We report on the current status of room-temperature life testing of Nichia NLPB-500 blue light emitting diodes. So far, two tests have been completed. During the first 1000-h test, a constant current of 20 mA was maintained in all devices. During the second 1650 h test, groups of 3 or 4 devices were driven at currents ranging from 20 mA to 70 mA. Very little degradation has been observed in devices driven at normal conditions (20-30 mA), with a noticeable increase in degradation rate above 60 mA.
Two-hundred-and-seventy-nine patients (103 men, 176 women) were followed-up 1–2 years after an act of non-fatal deliberate self-harm. Of 155 patients offered a psychiatric out-patient appointment at the time, only 68 completed the treatment. A further act of deliberate self-harm was committed by 26 men and 41 women within twelve months. The factors most highly associated with repetition were previous psychiatric treatment, a previous act of deliberate self-harm, and a criminal record. These factors held good for a separate series of patients. Significantly more repeaters received prolonged psychiatric care after the initial episode of deliberate self-harm. The implications of these findings for the clinical management of such patients are discussed.
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