Process: An Improviser's Journey is an invaluable resource for mastering improv. Author, teacher, and improviser Michael Gellman was given a mission by famed improv coach Del Close: “[T]o create improvised one-act plays of literary quality from scratch.” Already steeped in the world of improvisation, he took it upon himself to do this, in the form of a class for other improvisers in which they would build the skills necessary to execute such a seemingly tall order. Scruggs and Gellman’s book, modeled after Stanislavski’s timeless An Actor Prepares, follows a fictional young actor taking Gellman’s real-life class. Scruggs and Gellman introduce readers to Geoff, who has just moved to Chicago to pursue acting. He undergoes the standard trials of audition and rejection before he takes the advice of a fellow actor and turns to improv classes at Second City. At first, Geoff thinks improvisation is about laughs and loosening up, but he soon learns that it is a powerful tool as well as an end in itself. Through Geoff’s eyes, the book introduces readers to key tenets of improvisation: concentration, visualization, focus, object work, being in the moment, and the crucial “yes, and.” His experiences with the basics of improvisation do serve to get him a few roles, but his real breakthrough comes when he signs up for an improvised one-act class with Michael Gellman. He and his classmates arrive unprepared for the challenge, but with Gellman’s prompts and advice, they slowly move through process to performance over the course of three seasons in Chicago. The class culminates with their final project: a completely improvised one-act play performed in front of a live audience.
Mechanical cardiovascular assist devices must be properly designed to avoid damage to the blood they contact. The factors that affect the hemocompatibility of a cardiovascular assist device include three major non-physiological components – the material, fluid flow paths, and flow related stresses, - as well as the device interaction with the native vasculature. Furthermore, the interaction of the device with the blood is not static. Foreign surfaces activate blood components including platelets, leukocytes and the coagulation cascade. Thrombus formation on the surface of the device can alter the fluid dynamics in a manner that causes erythrocyte damage ranging from significant hemolysis to sub-lethal trauma that can take many days to weeks to develop into a significant clinical problem. This sub-lethal blood trauma is not easily detectable without special equipment, which is typically unavailable in routine clinical practice. Surveillance for blood damage is often sub-optimal in the clinical setting, but once clinically relevant hemolysis occurs, crucial decisions - device removal, replacement, or additional medical therapies including surgery or plasmapheresis - that take into account the risk/benefit of intervention must be quickly evaluated. The various preclinical designs and testing, surgical considerations, available surveillance techniques, and clinical consequences will be discussed using recent and historical case reports to highlight key points.
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