Journal articles on the topic '89.39 political systems: other'

Personalised interaction between political parties and the electorate has existed since the emergence of modern elections. Nowadays, digital technology has moved the relationship between political candidates and voters to a more advanced level. Through collecting and analysing citizens’ personal data via digital means, politicians have the capacity to foresee the electorate’s political behaviour, its preferences, and the choices it is inclined to make. Such campaign strategy is known as ‘political micro-targeting’, and it has raised great interest in academia. One may consider it a panacea for political misinformation, given that political micro-targeting can increase the population’s participation in politics. Nonetheless, it can be argued that this phenomenon poses a long-term threat to democracy. Accordingly, due to the high engagement with personal data that political micro-targeting entails, the question of its compatibility with citizens’ voting rights arises. This thesis will explore the issue of online political micro-targeting and seek to conduct a comparative analysis between presidential election campaigns in three European states, namely France, Italy and the United Kingdom. Accordingly, current political micro-targeting practices in these legal systems, and how they can influence each other, will be illustrated. An important place will be devoted to the analysis of political micro-targeting’s interference with the electorate’s voting rights and its regulatory framework.

We compared American Thyroid Association (ATA) guidelines, Korean (K)-Thyroid Imaging, Reporting and Data Systems (TIRADS), EU-TIRADS, and American College of Radiology (ACR) TIRADS in diagnosing malignancy for thyroid nodules with nondiagnostic/unsatisfactory cytology. Among 1143 nondiagnostic/unsatisfactory aspirations from April 2011 to March 2016, malignancy was detected in 39 of 89 excised nodules. The minimum malignancy rate was 7.82% in EU-TIRADS 5 and 1.87–3.00% in EU-TIRADS 3–4. In the other systems, the minimum malignancy rate was 14.29–16.19% in category 5 and ≤3% in the remaining categories. Although the EU-TIRADS category ≥ 5 exhibited the highest positive likelihood ratio (LR) of only 2.214, category ≥ 5 in the other systems yielded the highest positive LR of >5. Receiver operating characteristic (ROC) curves of all systems to predict malignancy were located statistically above the diagonal nondiscrimination line (P for ROC curve: EU-TIRADS, 0.0022; all others, 0.0001). The areas under the ROC curve (AUCs) were not significantly different among the four systems. The ATA guidelines, K-TIRADS, and ACR TIRADS may be useful to guide management for nondiagnostic/unsatisfactory nodules. The EU-TIRADS, although also useful, exhibited inferior performance in predicting malignancy for nondiagnostic/unsatisfactory nodules in Korea, an iodine-sufficient area.

The main goal of this review paper is to provide a systematic review of Multiple Criteria Decision-Making (MCDM) techniques in regard to transportation systems problems. This study reviewed a total of 89 papers, published from 1993 to 2015, from 39 high-ranking journals; most of which were related to transportation science and were extracted from the Web of Science and Scopus databases. Papers were classified into 10 main application areas and nine transport infrastructure. Furthermore, papers were categorized based on the author(s) and year, name of the journal in which they were published, technique and approach, author(s) nationality, application area and scope, study purpose, gap and research problem and results and outcome. The results of this study indicated that more papers on MCDM in 2013 than in any other year. AHP and Fuzzy-AHP methods in the individual methods and hybrid MCDM and fuzzy MCDM in the integrated methods were ranked as the first and second methods in use, respectively. The Transportation Research Part A: Policy and Practice was the most significant journal in this study, with 13 publications on the topic. Finally, service quality was ranked as the first application area and airline industry was ranked as the first transport infrastructure that applied MCDM techniques.

IntroductionMyopia is a worldwide epidemic. Plethora of treatments are offered to decrease myopia progression. In this study, we compared between different geographical areas worldwide the practice patterns used by paediatric ophthalmologists to decrease the progression of myopia.MethodsGlobal responses to a questionnaire were analysed (n=794) for demographic variations. Pharmacological, optical and behavioural categories were defined as effective or ineffective based on the current scientific peer reviewed literature.ResultsTreatment rates varied significantly between geographical regions (mean 57%, range 39%–89%, p<0.001). Nearly all participants who treat myopia used at least one form of effective treatment, regardless of location (98%, p=0.16). Among those prescribing pharmacological treatments, European physicians offered the lowest rate of effective treatment compared with other regions (85% vs mean 97%). Rates of effective optical treatment varied significantly between locations (p<0.001), from 16% (Central-South America) to 56% (Far East). Most treating respondents advocated behavioural modifications (92%), between 87% (North America) and 100% (Central Asia). Nearly all respondents used combinations of treatment modalities (95%)—mostly pharmacological, optical and behavioural combination. However, combination rates varied significantly between regions (p<0.001).DiscussionThe utility of treatment to decrease myopia progression differs significantly across the world both in type, combination and efficacy.ConclusionPaediatric ophthalmologists involvement and proficiency in myopia progression treatment varies around the world. This may entail promoting continuous medical education and other incentives to increase the number and proficiency of paediatric ophthalmologist to have a more effective impact to control the myopia epidemic in children.

Baseline investigation on rabies in Chittagong and Rangpur divisions was evaluated for the first time in Bangladesh from June 2010 to January 2011. A total of 600 respondents was interviewed including common people, school teachers, peoples' representatives, political leaders, doctors and nurses and Medical technicians from selected households. Approximately 89% of the respondents heard the name of rabies. Regionally 86% of the respondents in Rangpur division and 91% in Chittagong division possessed information fully or partly about rabies. The higher rate (91%) of respondents heard about rabies in Chittagong division and sources of respondent’s knowledge about rabies comprised mostly radio, TV, health worker and other sources. Approximately 100% of the respondents of different categories would seek treatment from the hospital. Majority knew about the fate of rabies that is ultimate death and believed that rabies could be prevented by vaccination program. Regarding the control of stray and poorly supervised dogs, the majority of the participants suggested for the elimination of the dogs.DOI: http://dx.doi.org/10.3329/bjz.v39i2.10586 Bangladesh J. Zool. 39(2): 195-204, 2011

BackgroundTo investigate the outcomes of glaucoma referrals across different European countries.Methods250 patients newly referred to tertiary referral glaucoma specialist practices in the UK, Hungary, Slovenia, Italy and Greece were prospectively enrolled (50 consecutive patients per centre). Referral accuracy and predictive value of referral criteria for an intervention or further monitoring (positive predictive value) were analysed.ResultsSame-day discharges occurred in 43% (95% CI 39% to 75%) (12/28) of optometrist-initiated referrals (UK only), 37% (95% CI 30% to 45%) (59/158) of ophthalmologist-initiated referrals (all centres) and 54% (95% CI 40% to 68%) (26/48) of self-referrals (Hungary, Italy and Greece). The percentages from all referral sources were 46% (95% CI 32% to 60%) in the UK, 56% (95% CI 44% to 70%) in Hungary, 30% (95% CI 17% to 43%) in Slovenia, 22% (95% CI 11% to 34%) in Italy and 60% (95% CI 46% to 74%) in Greece (p<0.001). Overall, the referring criterion was confirmed in 54% (95% CI 45% to 63%) (64/119) for intraocular pressure (IOP) >21 mm Hg, 56% (95% CI 43% to 69%) (33/59) for a suspicious optic disc and 61% (95% CI 45% to 77%) (22/36) for a suspicious visual field, with large between-country differences (p<0.05 for all comparisons). Of all referrals, 32% (95% CI 26% to 37%) were initiated on the basis of IOP >21 mm Hg only. By combining the IOP criterion with any other referring criterion, the positive predictive value increased from 56% (95% CI 45% to 67%) to at least 89% (95% CI 68% to 100%). In the UK, a hypothetical IOP threshold of >26 mm Hg, as a requirement for IOP-only referrals, would reduce IOP-only referrals by 44%, while not missing any definite glaucoma cases.ConclusionThe accuracy of referrals was poor in the UK and the other countries. Requiring a combination of criteria and raising the IOP threshold for IOP-only referrals are needed to cut waste in clinical care.

323 Background: Because HCC usually occurs in the presence of liver disease, patient (pt) evaluation and treatment are complex and require multidisciplinary care. Tumor staging and liver function scoring systems facilitate HCC research and treatment. However, specialists have varied training in these systems. We evaluated specialty-specific reporting of HCC-related staging/scoring data. Methods: GIDEON is a global, prospective, non-interventional study to evaluate sorafenib (SOR) in HCC under real-life practice conditions. Pts with unresectable HCC who were candidates for systemic therapy and for whom a decision was made to treat with SOR were eligible. Frequency of recorded Child-Pugh (CP); Barcelona Clinic Liver Cancer (BCLC); Cancer of the Liver Italian Program (CLIP); Tumor, Nodes, Metastasis (TNM); and calculated Model for End-stage Liver Disease (MELD) data were analyzed by physician specialty. Results are descriptive. Results: In the safety population (n=563), 299 pts (41%) were enrolled by medical oncology (MO), 228 (40%) by hepatology/gastroenterology (H/G), and 39 (5%) by other (23 by surgeons; 7 by interventional radiologists). 89% were treated by a multidisciplinary team. MO pts were twice as likely as H/G pts to be not evaluable (NE) for CP (table). Unknown international normalized ratio (INR) was the primary reason CP was NE. MO and H/G pts had similar % NE for BCLC stage. H/G pts were more likely to have ECOG performance status (PS) not recorded. MO pts were less likely to have CLIP or MELD data, while H/G pts were less likely to have TNM data. Portal vein thrombosis (PVT) and alpha-fetoprotein (AFP) were unknown in 17% overall. Conclusions: The elements of HCC staging systems represent factors that may influence patient management. Lack of complete data in up to 44% of pts, despite registry enrollment requiring data collection, suggests clinicians may be missing important information and the prevalence of clinicians using comprehensive HCC staging systems is variable. Clinical trial information: NCT00812175. [Table: see text]

PURPOSE There is increasing interest in implementing digital systems for remote monitoring of patients’ symptoms during routine oncology practice. Information is limited about the clinical utility and user perceptions of these systems. METHODS PRO-TECT is a multicenter trial evaluating implementation of electronic patient-reported outcomes (ePROs) among adults with advanced and metastatic cancers receiving treatment at US community oncology practices (ClinicalTrials.gov identifier: NCT03249090 ). Questions derived from the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) are administered weekly by web or automated telephone system, with alerts to nurses for severe or worsening symptoms. To elicit user feedback, surveys were administered to participating patients and clinicians. RESULTS Among 496 patients across 26 practices, the majority found the system and questions easy to understand (95%), easy to use (93%), and relevant to their care (91%). Most patients reported that PRO information was used by their clinicians for care (70%), improved discussions with clinicians (73%), made them feel more in control of their own care (77%), and would recommend the system to other patients (89%). Scores for most patient feedback questions were significantly positively correlated with weekly PRO completion rates in both univariate and multivariable analyses. Among 57 nurses, most reported that PRO information was helpful for clinical documentation (79%), increased efficiency of patient discussions (84%), and was useful for patient care (75%). Among 39 oncologists, most found PRO information useful (91%), with 65% using PROs to guide patient discussions sometimes or often and 65% using PROs to make treatment decisions sometimes or often. CONCLUSION These findings support the clinical utility and value of implementing digital systems for monitoring PROs, including the PRO-CTCAE, in routine cancer care.

AbstractTVRI status changing into public service broadcasting, both for its central broadcast station and its local broadcast station in 2003 brought many significant changes in these oldest television broadcast station in Indonesia. One of the most significant changes that can be traced is on its funding system. As a public service broadcasting, TVRI was guaranted to obtain the operational fund through the state or regional budget funding mechanisme. The government also promised that TVRI will be given oppportunity to operate like private broadcast station in order to gain maximal profit which has stated through government regulations and broadcasting acts. Inevitably consequent of this funding practice system, has put TVRI to always depend on goverment in order to operate daily. In the other hand, this funding system also will make TVRI gain a lot of profit and income commercially. These mixed funding systems indicate that there are political economy interest behind the new status that has been granted for TVRI. The problem is located on the practice of this kind model of funding on a public service broadcasting that will make the neutrality and independency of this public service broadcasting to be questioned. The remaining quetions, Will TVRI come to its own realazation to visualize its idealism to be the true public service broadcasting that serves public needs or will TVRI be crushed by the economy politic media policy and serve those who has a power that control the media Keywords: media, public service broadcasting, economy politic media, broadcast act

Lygodium microphyllum (Cav.) R.Br. (Old World climbing fern), in the family Schizaeaceae, is one of the most invasive (Category I in Florida) weeds in Florida. It has invaded more than 50,000 ha of wetlands and moist habitats in southern Florida and is rapidly spreading in new areas of the Everglades (3). The search and evaluation of biocontrol agents for this fern is currently in progress. Puccinia lygodii (Har.) Arth. (Uredinales) (1), previously recorded on L. volubile Sw. and L. venustum Sw. in South America (2), attacks foliage and severely damages L. japonicum Thunb. (Japanese climbing fern) vines in northern and central Florida (4). We hypothesized that since L. japonicum occurred mainly in northern and central Florida, P. lygodii did not have opportunity to interact with L. microphyllum, which primarily occurs in southern Florida. Therefore, we used two inoculation methods to test the possible pathogenicity of P. lygodii on the new host, L. microphyllum. Method-I was designed to imitate a seminatural inoculation technique in which three containerized (0.45-L capacity) L. microphyllum test plants (15- to 30-cm-high sporelings) were intermixed among a group of containerized (5.0-L capacity) P. lygodii-infected L. japonicum plants (source of inoculum) in a glasshouse. In Method-II, uredospores obtained from pustules on diseased L. japonicum foliage were adjusted to 1 × 106 uredospores/ml and then misted on three L. microphyllum sporelings (same size as in Method-I) until foliage was completely wet. The plants were then covered individually with a plastic bag for 3 days to facilitate spore germination and infection. In both methods, three L. japonicum sporelings of similar size as L. microphyllum were intermixed among diseased L. japonicum plants as a positive control. All test and infected plants were placed on 6-cm-high trays filled two-thirds with water and exposed to diffused daylight and a temperature range of 20 to 35°C in a glasshouse. These plants were monitored for the development of rust symptoms (halos and rust pustules) development for 8 weeks. Minute cinnamon flakes that developed into eruptive pustules were seen on the lower surface of the pinnules approximately 42 and 28 days after treatment initiation (in both methods) for L. microphyllum and L. japonicum (positive control), respectively. Each method was repeated twice. Dimensions (29.7 [±3.7] × 23.5 [±2.6] μm) and morphology of urediniospores from pustules on inoculated L. microphyllum were similar to those reported for P. lygodii on other host systems (1,2,4). To our knowledge, this is the first report demonstrating the infection of P. lygodii on L. microphyllum. The potential use of P. lygodii as a classical bio-control agent of L. microphyllum in southern Florida will be further investigated. References: (1) J. C. Arthur. Bull. Torrey Bot. Club 51:55, 1924. (2) J. W. McCain et al. Mycotaxon 39:281, 1990. (3) R. W. Pemberton. SIDA 20:1759, 2003. (4) M. B. Rayachhetry et al. Plant Dis. 85:232, 2000.

Abstract Myelodysplastic Syndrome (MDS) comprises a group of heterogeneous hematological disorders with variable risk of leukemic evolution (LE) and short survival (SV). According to French-American-British (FAB) classification, MDS are divided into five morphological entities and the World Health Organization reclassified them eliminating Refractory Anemia (RA) with Excess of Blast in transformation (RAEBt) and Chronic Myelomonocytic Leukemia (CMML), among other changes. Around 40–60% of patients shows normal karyotype at diagnosis and, despite this finding which is associated with good prognosis, some of them show poor outcome. The aim of this study was to evaluate different variables and prognostics scoring systems in an overall population (OP) of normal karyotyped MDS patients and in the reduced population (RP) after eliminating RAEBt and CMML subgroups. This retrospective study was performed in a population of 152 MDS patients with normal karyotype at diagnosis distributed according to FAB into 59% RA/RA with ringed sideroblast, 23% RA with excess of blasts, 5% RAEBt and 13% CMML. The OP’s median age was 67 (20–89) years with a sex ratio (M/F) of 1.53. The median follow-up was 25.7 (1–266) months (m) and there were 31 (20%) events of LE and 65 (43%) related-MDS death during this period. The OP showed a median SV of 57 m and time to LE (25%) of 44 m vs. 63 and 124 m, respectively for the RP. Age, sex, percentage of bone marrow (BM) blast, hemoglobin (Hb) level, platelets count and number of cytopenias were significant predictive variables for prognosis in both populations (Kaplan-Meier and Long-Rank test, p&lt;0.05). Despite all applied scoring systems allowed to difference groups of risk, patient distribution among them showed variations which were more evident in the Intermediate ones. Multivariate analysis (Cox proportional Hazard Model, p&lt;0.05) established that age, Hb level and % BM blast were the most important predictors for SV. Therefore, a new scoring system was developed coding % BM blast 0 if &lt;5, 0.5 if 5–9, 1 if 10–19 and 1.5 if ≥20, age 0 if ≤60 and 0.5 if &gt;60 years, Hb level 0 if ≥10 and 0.5 if &lt;10g/dL. Three groups of risk were defined: Low (0+0.5), Intermediate (1+1.5) and High (&gt;1.5) with median SV of 131, 32 and 13 m for the OP vs. 131, 43 y 18 m for the RP, respectively. Additionally, confirmed that IPSS includes better variables for LE, determining 3 groups of risk: Low, Intermediate and High (Intermediate-2 + High) with time to LE (25%) of &gt;130, 22 and 4 m for the OP vs. &gt;130, 39 y 21 m for the RP, respectively. Results showed that SV and LE risk should be evaluated separately in patients with normal karyotype using different variables to predict each one, at least in MDS-FAB classified patients or in those that present less than 20% of BM blasts and monocite counts lower than 1000/μL. These results would be helpful to develop better risk-adapted therapeutic strategies for MDS patients with normal karyotype.

Lebanon has a number of features that determine its special position in the region and its importance in the system of relations between the Middle East states. An important role in this is played by the ideological and strategic aspects of world politics in the region in which Lebanon is organically inscribed in both the historical and geopolitical plans. The stability of a country that has passed through a long civil war makes it stand out from a number of states in the region. The author's hypothesis is that the reason for the extraordinary stability — of Lebanese society, the system of state power, political elites, economic ties and foreign policy contacts, despite all the negative regional factors — can be rooted in the consociational principle of making key decisions based, paradoxically, on the notorious political confessionalism. The peculiarities of the Lebanese political model (although they are subject to well-deserved criticism) distinguish it from the multitude of “customary” democracies, bringing together with examples of the unique democratic systems of Europe and other continents. The motley confessional composition of society, along with the historically determined foreign policy guidelines of individual communities, suggested a special informal decision-making mechanism throughout the country — not on the basis of majority power, but on a contractual, compromise principle. Leading theorists of consociationalism often had in mind the Lebanese pattern of democracy in their political studies, and many of their developments are still well applicable for analyzing the functioning of the main state institutions of Lebanon. A theoretical study, along with an analysis of the current regional situation, convince the author of the correctness of the hypothesis put forward. Both in Lebanese history and now, it is the inveterate forms of external influences that forced Lebanese society to balance on the verge of aggravated intercommunal clashes. The combination of external factors served as the beginning and further warmed up the civil war. Heightened relations with Syria by 2005, the Israeli attack in 2006, the gravest threat from jihadi-caliphatists – all these factors have negatively affected intra-civil and inter-group relations. Stereotypical forms of use of religious communities (Shiites, Sunnis, Christians of different denominations, etc.) from the outside and even direct pressure from abroad continue to confront them, imposing ideas on social relations and political participation that are alien to Lebanese. Diversification of political and business contacts of Russia with representatives of different Lebanese communities can serve as a good example of Lebanon’s perception of all the features of its political system as a full subject of international relations.

Abstract Introduction: Health care delivery programs specific to the needs of adolescents and young adults ages 15-39 (AYAs) with cancer are increasingly being developed in the United States. Guidelines primarily focused on supportive care, fertility and therapeutic regimen for a few cancer types are now established, but best practice metrics and outcome standards are lacking. Malignant hematologic conditions are common in AYAs and challenges of care delivery for this disparate group are accentuated by fragmentation of management within the health system, between pediatric and medical oncology and between academic and community sites. Optimal place of care between academic and community systems is not established, but most of AYAs are diagnosed and cared for in the community. We describe our experience with treating AYAs with acute leukemia and lymphoma in a multi-disciplinary, community-based AYA program, with a focus on metrics and outcomes. Methods: Medical record review under an IRB approved retrospective study was conducted of all AYAs seen by a dedicated AYA Cancer Care team at a single institution in a Southeast United States community. Descriptive analysis was used for demographic data, including age, cancer type, insurance status, gender and ethnicity. Basic statistical analysis was used for guideline and pre-established metrics, including therapy regimens; completion of therapy; study accrual; fertility documentation, referral and intervention; sedated procedures. Kaplan-Meier estimates were applied for newly diagnosed patients for event free and overall survival for each cancer type in newly diagnosed population. Results: Bon Secours St. Francis AYA Cancer Care is an immersive program where a pediatric oncologist is employed by a non-academic, medical oncology, hospital-owned practice that sees 1500 new cancer patients annually and is located in Greenville, SC. Since 2012, AYA Cancer Care has seen 107 patients newly diagnosed, relapsed or in survivorship, 58 (54%) of whom with a diagnosis of acute leukemia or lymphoma. Median age was 25 (range 15-39), and 43%, 31% and 31% were female, minority and uninsured at time of first visit, respectively. Metrics and outcomes for acute lymphoblastic leukemia, acute myelogenous leukemia, Hodgkin lymphoma, and non-Hodgkin lymphoma are shown in Table 1. Despite a high rate of no insurance at diagnosis, all patients received guideline-driven therapy, most were cared for by the AYA team and 65% of LPs/BMAs were sedated with MAC. All newly diagnosed ALL patients except 1 were treated with pediatric-inspired therapy. Males were more likely to be referred to fertility specialists, but females were nearly twice as likely to have intervention in the form of chemoprophylaxis. No Children's Oncology Group trials for indicated cancer types were available via CTSU during the study period, and 31% of patients were enrolled on therapeutic trial, 19% sponsored by biopharmaceutical companies and 12% sponsored by the NCI. EFS and OS for newly diagnosed patients are as follows: AML, 90%/90% (median f/u 40 weeks); ALL, 29%/71% (3.2 yrs); HL, 89%/100% (4.5 yrs); NHL, 89%/100% (5 yrs). Conclusions: We report a high rate of guideline-driven care for AYAs with acute leukemia and lymphoma seen by a multidisciplinary team solely focused on AYA care delivery within a community practice setting. Metrics are derived from best practices from both pediatric (pediatric inspired therapy in AML, ALL; sedation for procedures) and adult (ABVD for HL, NCI and pharma-sponsored trials) oncology paradigms. Immersive AYA programs in non-academic settings are potentially effective models of reducing health disparities and improving outcomes in AYAs. Table 1. Table 1. Disclosures Crosswell: Seattle Genetics: Other: stock ownership in Seattle Genetics.

AbstractThe development of early-maturing soybean [Glycine max(L.) Merr.] varieties has led to an increase in soybean production in canola (Brassica napusL.)-dominant crop rotations in western Canada. Herbicide-resistant (HR) volunteerB. napuscan be difficult to manage in HR soybean using herbicides alone. In 2013 and 2014, four field experiments were conducted in Manitoba, Canada, to evaluate soybean row spacing, seeding density, nitrogen supply, and interrow tillage as candidate nonchemical weed management tools for an integrated program to manage volunteerB. napusin soybean. Among treatments and sites, volunteerB. napusproduced about 830 seeds plant−1and resulted in large seedbank inputs (averaging about 20,300 seeds m−2). VolunteerB. napusseedling recruitment differed among sites, and resulted in two distinct classes of sites based on average seedling densities of 39 and 89 plants m−2. Weed management tools were more effective at the sites with higher volunteerB. napusdensities. At these sites, soybean yield was greater when using an increased soybean-seeding density (44% greater yield using a seeding density of 682,500 vs. 455,000 seeds ha−1) or interrow tillage (36% greater yield with vs. without using interrow tillage). Soybean row spacing (19 vs. 38 vs. 76 cm) did not affect soybean yield, unless the reduction in row spacing was combined with an increased seeding density (65% greater yield with narrow-row soybean seeded at 682,500 vs. wide-row soybean seeded at 455,000 seeds ha−1). At the sites with higher volunteerB. napusdensities, seed production of canola volunteerB. napuswas greater when nitrogen fertilizer was applied to simulate an environment with greater nitrogen supply (77% greater number of volunteerB. napusseeds produced with vs. without broadcast application of 23 kg N ha−1urea). In northern climates, seeding soybean at increased densities using narrow-row spacing in fields with limited soil inorganic nitrogen and using interrow tillage in wide-row production systems are effective strategies that could augment chemical weed management in an integrated program for management of volunteerB. napus, and perhaps also other competitive early-season weeds.

135 Background: Palliative radiation therapy(PRT)is often employed in patients with advanced cancers requiring urgent consultation given the rapidity of presentation.We report on characteristics of urgent palliative oncologic issues encountered by radiation oncologists(RO). Methods: We prospectively evaluated patterns of presentation in162 consecutive consultations for urgent PRT at 3 centers from 5/19/14 to 9/26/14.Survey of palliative care issues was completed by physicians/nurse practitioners including assessment of reasons for urgent radiation oncology consultation,disease presentation characteristics and site of RT delivery.Response rate was 86% with 140 of 162 responses received. Results: Median age of patients was 63 years(29-89)with 39% > 65, 41% from 50-65 and 20% < 50 years;56% were males and 44% females. Most were married(62%)and 30% non-Caucasians.48% had ECOG PS 0-1,whereas it was 2, 3 and 4 in 24%,9% and 3%.Primary cancer diagnoses were lung (28%),breast(13%),prostate(10%),melanoma(10%),sarcoma(7%) and other diagnoses in 32%.Pain was predominant reason for consult(57%)followed by brain metastases(29%),spinal cord/cauda compression (13%),dyspnea (10%),bleeding (8%),bone fracture(4%)and dysphagia(2%).Clinicians managed pain (69%),neurologic symptoms(51%),fatigue (49%),intestinal(21%),respiratory (19%) symptoms,bleeding (14%),insomnia (13%),nausea/vomiting(12%)and dysphagia(6%).Patients presented at all stages 79% at the time of their diagnosis of metastatic cancer,63% with an established ( > 1 month) metastatic cancer diagnosis and continuing to further cancer therapies and 17% proceeding to hospice care without further anti-cancer therapy after PRT. Conclusions: Radiation oncologists care for patients across time course of metastatic cancer diagnosis managing variety of urgent oncologic issues,most commonly metastases causing pain followed by brain metastases and cord compression.They also manage cancer-related symptoms,mostly pain,neurological symptoms and fatigue.These findings point to need for palliative care to be well integrated into radiation oncology practice including education and systems of care.

Background The COVID-19 pandemic has threatened the health systems of many countries worldwide. Several studies have suggested that the pandemic affects not only physical health but also all aspects of society. A lot of information has been reported about the disease since the beginning of the outbreak. For that reason, it is essential to investigate the attitudes and level of knowledge and awareness that different populations had regarding COVID-19 during the critical period of the outbreak. Objective This study aimed to assess the knowledge and awareness of and attitudes toward the COVID-19 pandemic among different populations in Central China during the critical period of the outbreak. Methods A cross-sectional web-based survey was conducted in Central China from February to March 2020. The study participants included three different populations: medical workers, students, and those with other occupations. In this study, a questionnaire was designed to collect information on the following four aspects: sociodemographic information, knowledge related to COVID-19, awareness of COVID-19, and attitude toward COVID-19. The chi-square test and Fisher test were used for comparison among groups. The level of significance was set at P<.05. Results This study enrolled a total of 508 participants. Among them, there were 380 students (74.8%), 39 medical workers (7.7%), and 89 people with other occupations (17.5%). Most of the participants were female (n=272, 53.5%), lived in rural areas (n=258, 50.8%), and were single (n=423, 86.9%). The majority of the respondents had attended college (n=454, 89.4%). Most of the participants said they had heard about COVID-19 by January, and most of them looked for information on social media (Sina Weibo, 84.7%), and WeChat and QQ groups (74.2%). The participants showed an adequate level of knowledge about COVID-19 with no significant differences among the groups. However, medical workers demonstrated a slightly advanced knowledge in their responses to professional questions such as the potential susceptible population, possible host, treatment of COVID-19, and disease category. A higher proportion of medical workers (71.8%) and those in the other occupations group (52.8%) were highly concerned about the COVID-19 pandemic. More than 43% of the participants stated that the lockdown of their village/city had a significant impact on their lives. Nevertheless, the majority of respondents had an overall optimistic attitude toward the control of the disease (92.1% of students [n=350], 94.9% of medical workers [n=37], and 92.3% of those in other occupations [n=83]). Conclusions All three groups reported an adequate background knowledge about COVID-19 but medical workers showed a slightly advanced knowledge in their responses to professional questions. Most of the participants were highly concerned about COVID-19 during the critical period of the outbreak. The majority of respondents declared that the village/city lockdown policy had a significant impact on their daily life but most of them held an optimistic attitude toward the control of COVID-19.

Sharīca rulings are based on the Qur'an and aḥādīth. It is very interesting to assess how these sources have been interpreted in reference to both defining the crime and establishing the legal sentences of those found guilty of either blasphemy (i.e. sabb Allah, sabb al-rasūl/al-nabī) and/or apostasy (ridda/irtidād) from Islam. This article will attempt to determine whether the death penalty for the act of apostasy can be identified with the Qur'anic text and tafsīr. It will also show how inteipretations both for and against the death penalty have been emphasised through various ahādīth. Analysis of the Qur'an, Qur'anic tafsīr, and ahādīth will lead to an understanding of the development of the different opinions in Islamic jurisprudence regarding the penalty for blasphemy and apostasy. Examples offered include Q.2:217; Q.5:54; Q.9:12; Q.4:89; Q.16:106; Q.3:85 and Q.4:137. Other āyāt dealing with freedom of religious beliefs include Q.22:17; Q.2:256; Q. 109:1–6; Q.88:22–4; Q.10:99 and Q.18:29. It can be argued that a clearer understanding of certain translations and interpretations of the sacred text underlying the sharīca can show that the established legal sentencing owes much to strong political undercurrents, as opposed to a single message revealed in only one, unequivocal interpretation of the Qur'an. The conclusion highlights Islam's tolerance towards ‘Others’ or ‘infidels’, who, while holding the wrong belief systems, nevertheless have the right to peaceful coexistence and mutual respect.

Introduction. Nowadays, the steadily growing relationship with the People’s Republic of China is one of the priority directions of the foreign policy of the Russian Federation. According to the author of the present paper, new opportunities for active constructive interaction between the countries are provided with the One Belt and One Road Initiative (OBOR or BRI) adopted by China for the purpose of combination of efforts of the states for stable development of economy in the Eurasian space and peaceful co-existence of the people on the basis of the principles of openness, inclusivity of different civilizations, tolerance, safety, mutual benefit and training.The aimof the paper is to discuss the status and prospects of the RussianChinese cooperation in the humanitarian field and search for new narrative for development cooperation.Methodology and research methods. The research was performed with a support on philosophical and general scientific methods: comparative, structurally functional and system types of analysis, synthesis, generalization, and forecasting.Results and scientific novelty. The Russian-Chinese recent cooperation was considered. Special attention was given to education communication strategy as one of the reliable and checked channels of establishment and consolidation of international economic relations. The educational component of humanitarian interaction enables to provide effective tools for adjustment and support for the international dialogue and has an extensive range of opportunities for harmonization of cultural, social and even political standards.It is emphasized that further strengthening of the productive bilateral interaction of the People’s Republic of China and the Russian Federation is prevented by its developed model which is under construction and functions mainly at the level of public authorities. In spite of the fact that the relations between two countries are on the rise, the potential of the existing model has become exhausted, and it is therefore necessary to search for other ways of future joint collaborative work. Strengthening of partnership requires the transition to multilateral cooperation with other states and mutual participation of Russia and China in the course of overcoming the social and economic imbalance in the zone of their shared interests – the territory of the revived Silk Road. The third countries located along its southern transit corridor, unlike the states of the northern direction, are characterized by the backwardness of economics, high unemployment rate, lack of the fair system of upward mobility, poverty and ignorance of the population, thus promoting the spread of religious extremism and escalation of international conflicts. The author proposed to involve the humanitarian sphere as the mechanism of the start of transcontinental infrastructure projects in order to normalize the social and economic situation in these regions, to overcome socio-cultural barriers and to achieve integration of economics of various states for the sake of their steady growth and effectivization. The coordinated actions of China, Russia and EU countries for the promotion and maintenance of modern models of education can become a decisive factor to stabilize and implement the One Belt and One Road Initiative in problematic regions. In the author’s view, partner States should focus on actions for modernization of national education systems and dissemination of scientific worldview, e.g. in the regions of the Northern Silk Road. Otherwise, the South will remain the centre of regularly military conflicts and terrorism financing, whereas the Russian and Chinese companies will continue to spend considerable personnel and financial resources for the safety of the ongoing joint projects.Practical significance. Materials of the research can be useful as a guide to reconsider the objectives of the Russian-Chinese alliance in the humanitarian sphere and generate new ideas on development and ways of implementation of the international educational programs.

Alongside political, legal and financial suggestions, prognosticating as part of a state&#39;s budget planning process endures a substantial element. An act that furnishes for and authorizing what the State hopes to recover as earnings along with what it intends to bear as expenditure for a calendar year and, however, which may be subject to revision during its implementation in reaction to the current economic situation; the state budget remains tactic for the extant, quality, functioning and organization of its Administration. As an oil-producing country, the Republic of Congo, which must, among other things, have the financial means to meet these ambitions, does not escape, like other countries selling hydrocarbons, the preponderance of revenues from this sector in its budget forecasts. In view of the unpredictability of international oil markets on which government revenues are largely dependent, the use of artificial intelligence would disclose ornaments in data volumes and model interdependent systems to generate outcomes synonymous with enhanced decision-making efficiency and value for money. In this article, we will have to use Machine Learning to create the prediction model using secondary data from international organizations and official annals of the Government of the Republic of Congo, that is, the annual price of a barrel of oil and the budget foresees of state incomes and expenditures entered in various initial and altering finance laws between the years 1980-2019. This representation is based on the multiple linear retrogression algorithms that will ascertain the linear relationship between a dependent variable and independent or explanatory variables. This will also concede us to approximate the foretell of the value &ldquo;state revenues&rdquo; from the values &ldquo;oil prices&rdquo; and &ldquo;state expenses&rdquo;. As a result of the evaluation, the coefficient of determination (R2) of the performance of the dummy based on the test data is 99%. Finally, the stereotype will be practiced on a web interface granting users to enter the new independent data and then click a button to illustrate the result of the predictions of the dependent value.

Abstract. The growing water crisis in Central Asia (CA) and the complex water politics over the region's transboundary rivers have attracted considerable attention; however, they are yet to be studied in depth. Here, we used the Gini coefficient, water political events, and social network analysis to assess the matching degree between water and socio-economic elements and analyze the dynamics of water politics in the transboundary river basins of CA. Results indicate that the mismatch between water and land resources is a precondition for conflict, with the average Gini coefficient between water and population, gross domestic product (GDP), and cropland measuring 0.19 (highly matched), 0.47 (relatively mismatched), and 0.61 (highly mismatched), respectively. Moreover, the Gini coefficient between water and cropland increased by 0.07 from 1997 to 2016, indicating an increasing mismatch. In general, a total of 591 water political events occurred in CA, with cooperation accounting for 89 % of all events. Water events have increased slightly over the past 70 years and shown three distinct stages, namely a stable period (1951–1991), a rapid increase and decline period (1991–2001), and a second stable period (2001–2018). Overall, water conflicts mainly occurred in summer and winter. Among the region's transboundary river basins, the Aral Sea basin experienced the strongest conflicts due to the competitive utilization of the Syr and Amu Darya rivers. Following the collapse of the former Soviet Union, the density of water conflictive and cooperative networks in CA increased by 0.18 and 0.36, respectively. Uzbekistan has the highest degree centrality in the conflictive network (6), while Kazakhstan has the highest degree centrality in the cooperative network (15), indicating that these two countries are the most interconnected with other countries. Our findings suggest that improving the water and land allocation systems and strengthening the water cooperative networks among countries will contribute to the elimination of conflicts and promotion of cooperation in CA.

Abstract. China's anthropogenic emissions of atmospheric mercury (Hg) are effectively constrained by national air pollution control and energy efficiency policies. In this study, improved methods, based on available data from domestic field measurements, are developed to quantify the benefits of Hg abatement by various emission control measures. Those measures include increased use of (1) flue gas desulfurization (FGD) and selective catalyst reduction (SCR) systems in power generation; (2) precalciner kilns with fabric filters (FF) in cement production; (3) mechanized coking ovens with electrostatic precipitators (ESP) in iron and steel production; and (4) advanced production technologies in nonferrous metal smelting. Investigation reveals declining trends in emission factors for each of these sources, which together drive a much slower growth of total Hg emissions than the growth of China's energy consumption and economy, from 679 metric tons (t) in 2005 to 750 t in 2012. In particular, estimated emissions from the above-mentioned four source types declined 3% from 2005 to 2012, which can be attributed to expanded deployment of technologies with higher energy efficiencies and air pollutant removal rates. Emissions from other anthropogenic sources are estimated to increase by 22% during the period. The species shares of total Hg emissions have been stable in recent years, with mass fractions of around 55, 39, and 6% for gaseous elemental Hg (Hg0), reactive gaseous mercury (Hg2+), and particle-bound mercury (Hgp), respectively. The higher estimate of total Hg emissions than previous inventories is supported by limited simulation of atmospheric chemistry and transport. With improved implementation of emission controls and energy saving, a 23% reduction in annual Hg emissions from 2012 to 2030, to below 600 t, is expected at the most. While growth in Hg emissions has been gradually constrained, uncertainties quantified by Monte Carlo simulation for recent years have increased, particularly for the power sector and particular industrial sources. The uncertainty (expressed as 95% confidence intervals) of Hg emissions from coal-fired power plants, for example, increased from −48–+73% in 2005 to −50–+89% in 2012. This is attributed mainly to increased penetration of advanced manufacturing and pollutant control technologies; the unclear operational status and relatively small sample sizes of field measurements of those processes have resulted in lower but highly varied emission factors. To reduce uncertainty and further confirm the benefits of pollution control and energy polices, therefore, systematic investigation of specific Hg pollution sources is recommended. The variability of temporal trends and spatial distributions of Hg emissions needs to be better tracked during the ongoing dramatic changes in China's economy, energy use, and air pollution status.

Afrina, Y., Tasneem, S., & Fatema, K. (2015). Effectiveness of digital marketing in the challenging age: an empirical study. International Journal of Management Science And Business Administration, 1(5), 69-80. Agreda, L. (2016). Análisis de la estrategia de marketing digital mediante herramientas de analítica web. Investigation Research Review, 7, 81-97. Albarrán, E., & Salzman, R. (2011). News media consumption in Latin America: Who does It? Journal of Spanish Language Media, 4, 23-39. Almuiñas, J., González, F., & Morales, D. (2013). El control estratégico: una perspectiva en construcción en las instituciones de educación superior. España: Congreso Universidad. Álvarez, F. (2007). Planificación estratégica de marketing. Perspectivas, 67-104. Ancu, M. (2009). Myspace politics: uses and gratifications of befriending candidates. Journal of Broadcasting & Electronic Media, 53(4), 567–583. doi:https://doi.org/doi:10.1080/08838150903333064 Ballesteros, P., González, M., & Fernández, D. (2012). Human resource allocation management in multiple projects using sociometric techniques. International Journal of Project Management, 901–913. Blank, S., & Dorf, B. (2012). The startup owner’s manual: the step-by-step guide for building a great company. Chicago: K&S Ranch. Blythe, J., & Jane, M. (2019). Essentials of marketing. Estados Unidos: Pearson. Booth, J., & Seligson, M. (2009). The legitimacy puzzle in Latin America: political support and democracy in eight nations (Vol. 3). Inglaterra: Cambridge University Press. Burke, S., Stagl, K., Cameron, K., Goodwin, G., Salas, E., & Halpin, S. (2006). What type of leadership behaviors are functional in teams? A meta-analysis. The Leadership Quarterly, 17(3), 288–307. Burrow, J., & Fowler, A. (2015). Marketing. Estados Unidos: Cengage Learning. Cai, L., Jing, Y., Qi, Q., & Xu, X. (2018). A comprehensive study on smart beta strategies in the a-share market. Applied Economics, 1-10. doi:https://doi.org/10.1080/00036846.2018.1489113 Camps, A. (2019). Out of the dominant political agenda: translation and interpreting networks for social activism. Transfer, 9-23. Etzel, M., & Walker, B. (2017). Fundamentos de marketing. México: McGraw-Hill. Eveland, W., Morey, A., & Hutchens, M. (2011). Beyond deliberation: new directions for the study of informal political conversation from a communication perspective. Journal of Communication, 61, 1082–1103. doi:https://doi.org/10.1111/j.1 Ford, R., & Piccolo, R. (2016). Strategies for building effective virtual teams: trust is key. Business Horizons, 10, 25-34. doi:http://dx.doi.org/10.1016/j.bushor.2016.08.009 García, B. (2016). Cibercultura, tic y redes sociales: nuevas formas de comunicación para las familias. Revista de Medios y Educación, 195-206. Gómez, C., & Mejía, J. (2012). La gestión del Marketing que conecta con los sentidos. Revista EAN, 47-78. González, N. (2015). Qué entendemos por usuario como centro del servicio. Estrategia y táctica en marketing. El profesional de la información, 24(1), 9. Greenberg, P. (2010). Customer relationship management, social CRM strategies, tools, and techniques for engaging your customers, at the speed of light. Washington: McGraw-Hill. Gronroos, C. (1993). Toward a third phase in service quality research: challenges and future directions. Advances in Services Marketing and Management, 49–64. Hill, R. (2016). What’s love got to do with it? Examining millennials’ attitudes towards relationships and intimacy. Alabama Argicultural and Mechanical University, 7-11. Jenkins, H. (2008). Convergence cultura: la cultura de la convergencia de los medios de comunicación. México: Paidós Ibérica. Jeong, O., & Lee, S. (2010). On social web sites. Information Systems, 35, 215-236. Kim, J., Yoo, F., & Zuñiga, G. (2017). Cognitive benefits for senders: antecedents and effects of political expression on social media. Journalism & Mass Communication Quarterly, 94(1), 17–37. Kumar, M., & Kumar, U. (2004). A conceptual framework for the development of a service delivery strategy for industrial systems and products. Journal of Business & Industrial Marketing, 19, 310–319. Lyons, J., & Sokhey, A. (2014). Emotion, motivation, and social information seeking about politics. Political Communication, 31, 237-258. doi:https://doi.org/10.1080/10584609.2013.828138 Manzano, B. (2015). The development ofthe digital competence in the Spanish basiceducational law. Opción, 828-853. Moreira, W. (2019). Análise sobre o desempenho de evaristo costa em campanhas publicitárias por meio do Instagram. Temática, 15(3), 23-45. doi:https://doi.org/10.22478/ufpb.1807-8931.2019v15n3.44975 Norris, P. (2000). A virtuous circle: political communications in postindustrial societies. Estados Unidos: Cambridge University Press. Salzman, R. (2015). Understanding social media use in Latin America . Palabra Clave, 18(3), 842-858. doi:https://doi.org/doi:10.5294/pacla.2015.18.3.9 Sheldon, P., & Bryant, K. (2016). Instagram: motives for its use and relationship to narcissism and contextual age. Computers in Human Behavior, 58, 89-97. doi:http://dx.doi.org/10.1016/j.chb.2015.12.059 Sheng, Q., & Xian, G. (2008). Developing a framework for business intelligence systems based on rosettaNet frame. 2008 4th International Conference on Wireless Communications, Networking and Mobile Computing, 1-4. doi:https://doi.org/10.1109/WiCom.2008.2130 Stieglitz, S., & Dang, L. (2013). Social media and political communication: a social media analytics framework. Social Network Analysis and Mining, 3(4), 1277-1291. doi:https://doi.org/10.1007/s13278-012-0079-3 Zuñiga, H. (2018). Medios sociales y democracia. El Profesional de la Información, 27(6), 1172.

Abstract Background Sickle cell disease (SCD) is the most common severe hereditary blood disorder in the United States. A single nucleotide mutation leads to a modified β-chain of hemoglobin (β6Glu-Val). The pathology of SCD includes debilitating pain crises, progressive organ damage, and finally premature death. A significant portion of premature death in adults with SCD is attributable to cardiopulmonary disease with a disproportionate amount of sudden death. Sudden death has been associated with as much as 23.4% of mortality in adults with SCD (Darbari et al. Am J Haematology, 2006). In this study we aimed to identify risk factors for sudden death. As in previous studies, sudden death was defined as an unexpected death occurring in a relatively healthy SCD patient who dies at home or within 24 hours of hospitalization with or without a vaso-occlusive crisis. Identification of risk factors for sudden death will aid in developing interventions targeted at specific SCD patients. Methods We conducted a retrospective study of SCD-related deaths using the Partners Research Patient Data Registry (RPDR), a centralized clinical data registry that gathers clinical information from various hospitals within the Partners hospital systems and patients' electronic health records. The study was approved by our institution's IRB. The RPDR was queried to identify all patients associated with SCD. Only patients with a vital status of 'deceased' were used for the patient population. Patients who died before 1998 were excluded. Sixty-one patients were included and categorized by 'cause of death' into 5 groups. The patients' charts were reviewed to identify cause of death and SCD-related data between two years and up to 2 weeks prior to death. The patient variables examined covered demographics, sickle genotype, hydroxyurea exposure, blood pressure, EKG abnormalities, medical histories of acute chest syndrome (ACS), stroke, pulmonary embolism, leg ulcers, priapism, and retinopathy as well as laboratory data. The data were analyzed in 2 categories; 'sudden death' and 'other causes of death'. Results Of the 61 deceased patients, 33 (54%) were women and the average age at death was 39 years. Nineteen patients (31%) suffered sudden deaths: 7 (11%) sudden deaths at home (group I) and 12 (20%) deaths within 24 hours of hospitalization (group IV). Ten (16%) died of known causes related to SCD (group II), 22 (36%) died of known causes unrelated to SCD (group III) and 10 (16%) died of unknown causes (group V). Of the 19 patients who died suddenly (groups I and IV), 14 (74%) had a history of ACS and 17 (89%) had exposure to hydroxyurea. In comparison, of the patients who died of causes other than sudden death, only 15 (36%) had a history of ACS (p = 0.012) and only 18 (43%) had been exposed to hydroxyurea (p = 0.0008). A history of priapism was found in 4 of 10 (40%) men who suffered a sudden death and 0 of 18 (0%) men who died of other causes (p = 0.012). The frequencies of other measured variables, including dysrhythmias and QTc interval prolongation, were not markedly different between the groups. Discussion Sudden death remains a significant problem in SCD. Over 30% of deaths in this study were associated with sudden death. Our data show a higher rate of ACS and priapism in SCD patients who suffered a sudden death compared to those who died of other causes. Likewise, a history of hydroxyurea use was more likely in patients who suffered sudden death. Hydroxyurea use, probably a marker of severe disease, did not protect against the risk of sudden death in this small cohort of patients. These findings may be in keeping with a recent meta-analysis of 3257 SCD patients which was unable to confirm a mortality benefit with use of hydroxyurea in SCD (Maitra et al. Haematologica 2017). Conclusion Our results suggest that ACS and priapism may be indicative of a high risk of sudden death in patients with SCD. Our data are preliminary and need to be further investigated using a larger cohort of patients, as well as exploring the prevalence of these factors in SCD patients who are not yet deceased. Disclosures Achebe: Bluebird Bio: Consultancy; AMAG Pharmaceuticals: Other: Advisory Board; Luitpold pharmaceuticals: Consultancy.

Abstract Background: Chronic graft-versus-host disease (cGVHD) is a disorder that affects many organ systems in highly variable fashion occurring in approximately 50% of patients following allogeneic hematopoietic stem cell transplantation (alloHSCT). It is the major cause of non-relapse morbidity and mortality after alloHSCT in individuals otherwise cured of their hematologic diseases, inducing poor quality of life, impaired functional status, inability to work, and need for ongoing chronic care, which has also important impact to health-related costs. cGVHD Consensus Conference held in 2005 at the National Institutes of Health (NIH), USA, produced recommendations regarding cGVHD diagnosis, staging, histopathology, response criteria, biomarkers, ancillary and supportive care, and design of clinical trials. In 2014, second cGVHD NIH Consensus Conference updated these recommendations, published during 2015 as 6 papers in Biology of Blood and Marrow Transplantation (BBMT) journal. Although practitioners are generally familiar with the NIH recommendations, many barriers prevent their greater uptake in clinical practice. In order to overcome these challenges, in 2013 multidisciplinary clinic infrastructure was organized at the University Hospital Center (UHC) Zagreb, Croatia, in collaboration with the NIH leading scientists, using established cGVHD-related grading scales and measurements. Methods: Division of Hematology, UHC Zagreb, Croatia, has experience with alloHSCT since 1983, and 827 patients received alloHSCT until the end of 2014. Since the establishment of multidisciplinary cGVHD team in 2013, patients were enrolled into the Unity through Knowledge Fund (UKF) study protocol (funded by World Bank and Croatian Ministry of Science, Education and Sports) and examined by multiple subspecialists, firstly seen by hematologist, with detailed history and physical exam. Standard cGVHD scoring forms are filled according to NIH Consensus recommendations, and extensive laboratory analyses were done. Patients are seen and evaluated by other sub-specialists (Dental, Dermatology, Rehabilitation, Neurology, Ophthalmology, Gynecology, and other) with further workup as needed. Quality of life questionnaires are filled during the visit. All data are collected in a specially developed database and weekly team meetings were established. Blood and small biopsy tissue samples (skin, mouth) are stored for further research. Results: Using multidisciplinary approach since 2013, 46 (6 pediatric) cGVHD patients were assesed, median age was 41 years; range [9-71], 24 were male and 22 were female. The median time from transplant to enrollment was 20 months [2-258], from cGVHD diagnosis to enrollment 7 months [0.03-234] and from transplant to cGVHD diagnosis 10 months [2-128]. Additional 17 post-alloHSCT patients were eveluated, but without confirmation of cGVHD diagnosis. Among cGVHD patients, 31 (67%) of them received transplants from matched related donors, 27 (59%) of them had myeloablative conditioning, and 26 (57%) received peripheral blood stem cells as graft source. Thirty-five (76%) patients had previous acute GVHD, 11 (24%) had de novo cGVHD, 21 (46%) quiescent and 14 (30%) progressive onset; 41 (89%) were classified as classic and 5 (11%) as overlap; 23 (50%) patients had severe, 19 (41%) moderate, and 4 (9%) mild global cGVHD score. The most involved organs were skin (54%), eyes (50%), lungs (48%) and mouth (39%). Due to internationally peer reviewed UKF grant awarded in 2013 doctoral and postdoctoral researcher were hired, and visits of young clinicians to NIH and other cGVHD centers were realized. Several new research subprojects emerged since formation of our cGVHD team and applications to the new project calls were submitted. Also, 2 international cGVHD symposiums were organized in Zagreb, Croatia, in last 2 years stimulating education and networking. Conclusion: Implementation of NIH criteria for standardizationof cGVHD in Croatia showed remarkable results, not just improving quality of medical documentation and management of these long-terms survivors with complex and long-lasting health issues, but also facilitating further international clinical research and collaboration with cGVHD community, with potential positive impact to health-related costs and benefit to society. Disclosures Nemet: Pliva: Honoraria; Janssen: Honoraria; Celgene: Honoraria; Amgen: Honoraria; Pfizer: Honoraria; Sanofi: Honoraria.

Background:There is no specific test to diagnose Sjögren’s Syndrome (SS) although available classification criteria intended for research purposes help guide the diagnosis. Major salivary gland ultrasound (MSGUS) may contribute to SS diagnosis.Objectives:To study the performance of MSGUS for the clinical diagnosis of SS and its relationship with other relevant markers of disease.Methods:We included patients with a clinical suspicion of SS that underwent MSGUS evaluation at our Department. Parotid and submandibular glands were classified bedside on a 0-4 scale, based on tissue inhomogeneity. The score of the highest graded gland was considered and a score ≥2 was defined as a positive MSGUS. Minor salivary gland biopsy (mSGB) was considered positive if a focus score ≥1 was reported. We compared MSGUS findings across diagnoses and against mSGB result and anti-SSA status. Categorical variables were compared using the chi-square test. Continuous variables were compared using Student’s t-test, Mann-Whitney U test, or ANOVA. P-value was considered significant at <0.05.Results:A total of 219 patients were included (Table 1). MSGUS was positive in a higher proportion of patients with primary and secondary SS, in comparison to non-Sjögren’s sicca syndrome (nSSS) and undifferentiated connective tissue disease (UCTD; p<0.001). Mean MSGUS score was higher in SS patients in comparison to nSSS and UCTD (p<0.001). A positive MSGUS was associated with anti-SSA positivity (61.4% vs 38.6% in anti-SSA negative patients; p<0,001). Patients positive for anti-SSA had a higher mean MSGUS score (2.12 ± 1.03) in comparison with anti-SSA negative patients (1.31 ± 0.97, p<0.001). While MSGUS and mSGB were not significantly associated (p=0.237), the mean MSGUS score was higher in patients with a positive mSGB (1.95 ± 1.17) in comparison with those with a negative mSGB (1.61 ± 0.99; p=0.027).Table 1.General sample characteristicsOverall(n=219)pSS(n=131)sSS(n=17)nSSS(n=62)UCTD(n=9)p-valueAge, years (mean ± sd)60 ± 1458 ± 1756 ± 1960 ± 1348 ± 160.07Female, n (%)210 (95.9)127 (97.0)15 (88.2)59 (95.2)9 (100)<0.001Anti-SSA positive, n (%)105 (47.9)91 (69.5)10 (5.8)3 (4.8)1 (11.1)<0.001Positive mSGB, n (%)85 (46.4)69 (63.3)7 (46.7)8 (15.7)1 (12.5)<0.001MSGUS score, mean ± sd1.70 ± 1.091.98 ± 1.091.76 ± 1.111.13 ± 1.091.44 ± 1.12<0.001Grade 0, n (%)35 (16.0)17 (13.0)3 (17.7)15 (24.2)0 (0.0)<0.001Grade 1, n (%)62 (28.3)25 (19.1)4 (23.5)27 (43.6)6 (66.7)Grade 2, n (%)62 (28.3)39 (29.8)4 (23.5)17 (27.5)2 (22.2)Grade 3, n (%)54 (24.7)44 (33.6)6 (35.3)3 (4.9)1 (11.1)Grade 4, n (%)6 (2.7)6 (4.6)0 (0.0)0 (0.0)0 (0.0)MSGUS score ≧ 2, n (%)122 (55.7)89 (67.9)10 (58.8)20 (32.3)3 (33.3)<0.001Conclusion:MSGUS is a valuable resource in the investigation of SS. It is associated with clinical diagnosis, anti-SSA and MSGB findings. Together with these other complementary exams, it can be used to assist in the diagnosis of patients presenting with sicca features suggestive of SS.References:[1]Jousse-Joulin S, Milic V, Jonsson MV, Plagou A, Theander E, Luciano N, et al. Is salivary gland ultrasonography a useful tool in Sjögren’s syndrome? A systematic review. Rheumatology (Oxford). 2016 May;55(5):789–800.[2]Zhou M, Song S, Wu S, Duan T, Chen L, Ye J, et al. Diagnostic accuracy of salivary gland ultrasonography with different scoring systems in Sjögren’s syndrome: a systematic review and meta-analysis. Sci Rep. 2018 Dec;8(1):17128.[3]Cornec D, Jousse-Joulin S, Pers J-O, Marhadour T, Cochener B, Boisramé-Gastrin S, et al. Contribution of salivary gland ultrasonography to the diagnosis of Sjögren’s syndrome: toward new diagnostic criteria? Arthritis Rheum. 2013 Jan;65(1):216–25.Disclosure of Interests:Maria Catarina Tenazinha: None declared, Vasco C Romão: None declared, Joaquim Polido-Pereira: None declared, Nikita Khmelinskii Speakers bureau: GSK, Rita Barros: None declared, FERNANDO MANUEL DIAMANTINO SARAIVA: None declared, Joao Eurico Fonseca: None declared

Background The COVID-19 pandemic continues to challenge effective treatment delivery to hematologically-compromised patients, including those with myeloproliferative neoplasms (MPNs). MPNs are characterized by clonal proliferation of hematopoietic cell lines in bone marrow. As such, increasing reports of COVID-19 related thrombotic events highlight how MPN patients are at an increased risk in navigating potential complications during this pandemic. Mitigation strategies to lesson MPN patient exposure to COVID-19 are vital. Though, such efforts come at an inherent cost to effective healthcare delivery. Restriction of regular in-clinic treatments and reported shortages of MPN pharmacotherapies present these patients with diminishing continued care. To understand how MPN patient care has been impacted by COVID-19, an internet-based questionnaire was deployed surveying a variety of disease and pandemic related items (reported elsewhere; Palmer J et al, ASH 2020 submitted). A single free-text response item instructed respondents to: "Please tell us anything else (bad or good) about how the COVID-19 outbreak has impacted your MPN care." This qualitative analysis evaluated first-hand comments directly from patients in order to form a richer understanding of how those with MPNs have been managing disease-related care amidst this pandemic. Methods This COVID-19 survey was hosted via Mayo Clinic's secured REDCap system for online surveys and posted on MPN organizational partner websites. Surveys were completely anonymous. The free-text responses describing impacts to MPN care were each independently reviewed by 2 individuals for overall sentiment (positive, negative, both, or neutral [no impact]) and categorized for themes. The 2 reviewers were assessed for agreement. Conflicting reviews were evaluated then adjudicated by an algorithm for cases meeting selected conditions or by lead author review for all remaining cases. Descriptive statistics are reported. Results Of the 1217 consenting adult patients participating in the overall COVID-19 study, 824 provided free-text responses. Of these, respondent MPN diagnoses included, essential thrombocythemia (n=324, 39%), polycythemia vera (n=251, 30%), myelofibrosis (n=153, 19%), and other/undisclosed (96, 12%); 69% (n=567) were female; median age was 63 (range 21-93); 38% (n=313) were from the US, 38% (n=313) UK, and 24% (n=198) other/unknown. There was 89% (n=734) sentiment agreement between reviewers. Free-text responses about the impact of COVID-19 on MPN care were 49% (n=400) negative, 21% (n=177) positive, 8% (n=65) both positive and negative, and 22% (n=182) neutral/no impact. Table 1 shows a selection of MPN patient free-text responses reflecting common negative and positive sentiment themes. Negative impact (n=400): The most common negative impact involved delays or cancellations of visits or perceived inaccessibility to regular providers (n=261, 65%). Primarily this sentiment was driven by lack of clinic availability and restrictions at treatment centers or by providers. However, some respondents reported delaying or canceling visits themselves due to fear of COVID-19 exposure. Perceived health consequences from this delay were also expressed. There were 129 (32%) respondents with concern regarding changes or access to medications, including explicit drug supply shortages. Some patients resorted to self-adjusting medications and reusing single-use supplies. General anxiety, stress, and isolation were also reported (n=98, 25%). Positive impact (n=177): Availability of telemedicine comprised the majority of positive impacts of the pandemic (n=95, 54%), with many noting the reduced travel time to visits. Routine local testing coupled with follow-up telemedicine was favorable. Despite general positivity towards telemedicine, some reported preferences for in-person visits; commenting that telemedicine was impersonal, difficult to schedule or receive virtual communication, and expressed concern for lack of spleen examinations during virtual visits. Conclusion Positive and negative aspects were reported including MPN-specific issues. Healthcare systems should use such data to emerge from the COVID-19 pandemic and retain the positive impacts such as telemedicine, while developing education materials and other resources to address the reported negative impacts where possible. Disclosures Mesa: CTI BioPharma: Research Funding; Promedior: Research Funding; Novartis: Consultancy; Sierra Oncology: Consultancy; Samus Therapeutics: Research Funding; Genentech: Research Funding; AbbVie: Research Funding; Incyte: Research Funding; LaJolla Pharmaceutical Company: Consultancy; Bristol Myers Squibb: Research Funding.

Background: Data on the safety and efficacy of copy drugs is usually unavailable. Imatinib mesylate is used to treat chronic myeloid leukemia (CML) patients in Argentina since 2002. During the last decade more than ten different imatinib copies are marketed by the different health-care systems in the country, usually for cost issues. In spite of the undoubted benefit of this tyrosine-kinase inhibitor indication in CML, there is no solid evidence that supports copy drug equivalent outcomes for this patient population. Aim: To compare the clinical presentation, treatment response and outcome of a chronic phase (CP) CML patient cohort treated with branded and copy imatinib in the real-life setting. Methods: Multicentric, retrospective trial based on data obtained from medical charts of adult CP CML patients treated with imatinib in 9 centers in Argentina from 2002 to 2020.We analyzed demographic characteristics and clinical characteristics described for branded and copy imatinib treated cohorts. Frequency of complete cytogenetic response (CCyR) at 12 months, Major molecular response or better(≥MMR) at 12, 18 and 24 months and overall MR4.0, MR4.5 and deep molecular response (MR4.0 +MR4.5 IS) were analyzed. Event was defined as failure, progression or CML related death. Kaplan Meier comparison of event free, progression free and overall survival. Statistics: IBM SPSS version 1. Results: A total of 568 CP CML adult patients (pt) treated with imatinib were included. Mean age at diagnosis: 45.7 years (range 18 - 85). Male 55.6% (316/568). Sokal Score was recorded in 471 pt: 57% (269/471) low, 26% (122/471) intermediate and 17% (80/471) high-risk. Median follow-up 107 months (RIQ: 36-149). Branded imatinib treatment 330 (58%) and imatinib copies 238 (42%). For branded and copy imatinib cohorts mean age 46,1 (18-85) and 45.3(18-80), male 53% (175/330) and 59% (141/238), median follow up 102 (RIQ 101-130) and 61 (RIQ 62-146) respectively. Sokal score low 58% (164/284) and 56% (105/187), intermediate 27% (77/284) and 24% (45/187) and high 15% (43/284) and19% (37/187). Frequency of CCyR at 12 months 71% (67/94) and 69% (41/59), ≥MMR at 12 months 57% (79/138) and 43% (39/89), ≥MMR 18m 66 % (61/92) and 71% (43/60), ≥MMR 24m 65% (96/147) and 79% (58/73). Overall MR4, MR 4.5 and Deep MR with branded imatinib 62.4% (186/298), 42% (118/276) and 63% (189/300), compared to 45(97/214), 24% (50/207) and 46% (99/215) with copies. Difference in evaluation throughout the treatment periods with loss of data did not allow response rate statistical comparison in predetermined timepoints. Kaplan Meier Event free survival median 229 months vs 75 months p 0.001, Progression free survival mean 318 months vs 208 pt 0.034 and Overall Survival mean 275 months vs 206 months for branded and copy imatinib respectively. Discussion: Several case reports have shown poor outcomes in patients treated with imatinib copy drugs, including loss of responses previously attained with branded imatinib. This study reports data from a large cohort of CP CML patients treated in daily practice during a long period of time. Treatment results at determined timepoints is comparable. Although management and treatment decisions were performed in different time periods, results show different outcomes in EFS and PFS between patients treated with branded vs copy imatinib. Overall survival in both cohorts is comparable. As studies assesing the safety and efficacy of the copy drugs compared with branded imatinib will hardly be performed this evidence calls for careful attention and strict follow up measures when managing CML patients with copy imatinib. Figure Disclosures Varela: Novartis: Consultancy, Speakers Bureau. Pavlovsky:Pint Pharma: Speakers Bureau; Pfizer: Speakers Bureau; BMS: Speakers Bureau; Novartis: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Freitas:Pfizer: Consultancy, Other: Advisory Board. Pavlovsky:Varifarma: Speakers Bureau; Astra Zeneca: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Janssen: Membership on an entity's Board of Directors or advisory committees, Other: travel grants, Speakers Bureau; Abbvie: Membership on an entity's Board of Directors or advisory committees, Other: Travel grants, Speakers Bureau. Moiraghi:Novartis: Speakers Bureau; BMS: Speakers Bureau.

Abstract Introduction: Staging of CLL is based on simple methods to estimate the prognosis of CLL at the time point of diagnosis. Both, the Rai and Binet staging systems, are based on physical examination and peripheral blood count. According to the recently updated IWCLL guidelines for CLL (Hallek et al., Blood, 2008) no radiological examinations are needed for staging and response evaluation outside clinical trials. Previously, it was shown that CT scans add no benefit to the response criteria defined by the National Cancer Institute (NCI) (Byrd et al., 2007). However, it is still unclear, how much additional information can be gained by using CT scans by routine at pretherapeutic evaluation and during follow-up phase. Therefore the GCLLSG initiated a metaphase analysis based on the results of three phase III studies (CLL4, CLL5 and CLL8 protocol of the GCLLSG), in order to evaluate the clinical relevance of CT scans on disease outcome. Patients: A total of 1372 patients (pts) receiving first line therapy for CLL within a phase III trial of GCLLSG were included in this analysis. 362 pts younger than 65 years were included in the CLL4 trial, 193 pts older than 64 years in the CLL5 trial and 817 pts with normal renal function and a comorbidity score ≤ 6 were included in the CLL8 trial. 100 pts received chlorambucil, 257 fludarabine (F), 590 F plus cyclophosphamide (FC) and 408 FC plus rituximab. Response as well as progression during later follow-up was assessed according to the NCI-WG criteria (Cheson et al., Blood 1996). CT scan or other radiological examinations were not performed by routine, but were recommended at pretherapeutic staging, interim and final staging and during the follow-up phase, if clinically indicated. Results: The median follow up time for pts alive in the CLL4 trial was 54 months (mo), 40 mo in CLL5 and 27 mo in CLL8 (overall 31 mo). During follow-up a total of 11.103 CT scans, 22.728 ultrasounds as well as 2.350 chest x-rays were performed in 1372 pts. In contrast, 59.742 physical examinations were performed either additionally to radiological examination or alone. In a first step we evaluated the number of pts for whom the radiological examination was crucial in order to reconcile progressive disease (PD) according to the NCI criteria. A total 491 pts were considered as progressive during treatment or follow-up. In 100 pts the definition of PD by the treating physician could not be confirmed by a strict, independent application of the NCI-WG criteria and were therefore excluded from the analysis. In the remaining 391 pts PD was clinical apparent in 326 (83%), while CT scans were relevant for the decision of PD in 39 pts (10%) only and ultrasound in 26 pts (7%). In a next step we assessed the number of pts for whom CT scan or ultrasound had a clinical consequence by initiating relapse treatment because of bulky disease (defined as a lymph node of &gt; 5 cm) in the thorax or abdomen. Out of 176 pts receiving relapse treatment due to PD, in only 2 pts (1%) the retreatment decision was based on the result of the CT scan or ultrasound: in these pts a new bulk was detected by radiological examination, while physical examination and blood count were normal. Moreover, an initially detected bulky disease by radiological examination had no prognostic value as well. Pts with initially detected bulky disease showed a higher rate of complete remissions in comparison to pts without bulky disease (29% versus 22%, p = 0.02). Interestingly, no difference in overall response rates (86% versus 89%, p = 0.2), as well as progression free survival (36 versus 39 months, p = 0.2) and overall survival (OS) (median OS not reached vs. 85 months, p = 0.08) was assessed. Conclusion: These data from 1372 patients included in three prospective phase III trials show that the use of CT scans has no apparent clinical benefit for the evaluation of PD or the decision to initiate relapse treatment in the follow-up phase of CLL. In 1% of the relapse treatment receiving pts only the result of the CT scan was crucial for retreatment decision. Moreover, the initial detection of bulky disease by CT scan or ultrasound had no prognostic impact. Our data suggest that physical examination and blood count remain the methods of choice for clinical follow-up of patients with CLL.

Introduction: cGVHD exhibits both autoimmune and fibrotic features across multiple organ systems. KD025 is an orally available Rho-associated coiled-coil kinase 2 (ROCK2) selective inhibitor that (1) decreases human T cell IL-21 and IL-17 secretion via STAT3, IRF4 and RORγt regulation; (2) increases percentages and function of Foxp3+ T regulatory cells via a STAT5-dependent mechanism; and (3) reverses established cGVHD in 2 distinct preclinical models. KD025 modulates the immune system by shifting the Th17/Treg balance towards homeostasis. Methods: KD025-208 enrolled 3 sequential cohorts (C) (C1: 200 mg QD, C2: 200 mg BID and C3: 400 mg QD) of patients (pts) with cGVHD after 1-3 prior lines of systemic therapy. Treatment is in 28-Day continuous cycles until disease progression or unacceptable toxicity. The primary endpoint is the overall response rate (ORR) as per 2014 NIH response criteria in the mITT population. Additional endpoints include duration of response (DOR), corticosteroid (CS) dose reductions, failure free survival (FFS) and Lee Symptom Scale (LSS) score. Results: 17, 16 and 21 pts were enrolled in C1, C2, and C3 between Sep-2016 and Mar-2018. Data as of 8-Mar-2019 are included, reflecting a median duration of follow up of 112, 97 and 64 weeks (wks), respectively. At enrollment, median age was 52 yrs, median time from cGVHD diagnosis to treatment was 20 mos, and patients had received a median of 2 prior lines of therapy. 71% of patients were refractory to the last line of therapy prior to enrollment. 50% of pts had cGVHD in ≥4 organs. The median duration of treatment was 37, 33 and 39 wks, respectively. As of 30-Jun-2019, 24% of pts had received &gt;18 months of KD025 therapy. 14 pts remain on KD025 treatment. Reasons for discontinuation included cGVHD progression (18), pt voluntary withdrawal (7), relapse of underlying disease (5), investigator decision (5), AE (3) and death (2). ORR (95% CI) was 65% (38%, 85%) in C1, 69% (41%, 89%) in C2, and 62% (38%, 82%) in C3, i.e. 65% (51%, 77%) across all 3 cohorts. Responses were achieved across key subgroups with ORRs of 62% (24/39) in pts with ≥2 prior lines of systemic therapy, 70% (19/27) in pts with ≥4 organs involved and 60% (25/42) in pts with severe cGVHD. CRs were observed in all affected organs except lung; PRs were observed in lung. Responses were rapid, and often achieved within 8 wks, although 4/35 responses occurred after 24 wks. Of note, organs with fibrotic manifestations such as lungs, joints and eyes responded after 24 weeks in some pts. Responses were durable, with a Kaplan-Meier (K-M) median DOR of 34 weeks across all cohorts. 57% of responders sustained a response for ≥20 wks. The K-M median DOR was 34 wks in pts with ≥2 prior lines of systemic therapy. FFS at 6, 12, 18 and 24 mos was 76%, 47%, 40% and 33%, respectively. Baseline median CS dose was 0.21 mg/kg/day of prednisone equivalent. During treatment with KD025, the median CS dose was reduced by 50%. 67% of pts reduced CS dose and 20% discontinued CS completely. The median CS dose reduction was 66% in responders and 25% in non-responders. 52% of pts reported a clinically meaningful improvement (≥7-point reduction) in LSS score during treatment with KD025 with a median time to improvement of 9 wks and a duration for responders of 21 wks. 63% of responders and 32% of non-responders reported a meaningful improvement in LSS score. KD025 was well tolerated with a median Relative Dose Intensity of 98%. Dose reductions/interruptions occurred in 21/54 pts; median duration of interruption was 8.5 days (range 3-20). AEs were consistent with those expected in cGVHD pts receiving CS. Common AEs were URI (35%), diarrhea (31%), nausea (31%), fatigue (30%), dyspnea (28%), increased LFTs (24%), and peripheral edema (22%). 63% had a Grade ≥3 AE; the most common was dyspnea (13%). &lt;10% of pts experienced Grade 3 anemia, neutropenia or thrombocytopenia. SAEs were reported in 43%; none were considered related to KD025. Three pts discontinued KD025 due to possibly related AEs (C1: diarrhea, headache; C3: fatigue). No apparent increased risk of infection was observed. Three pts died on study (C3: relapse of leukemia; lung infection; cardiac arrest); none were considered related to KD025. Conclusions: Durable and clinically meaningful responses have been observed across all 3 cohorts. KD025 was well tolerated, allowing pts to remain on treatment and realize potential benefits of sustained therapy. Disclosures Jagasia: Kadmon: Consultancy; Incyte: Consultancy; Janssen: Research Funding. Salhotra:Celgene: Other: Research Support; Kadmon Corporation: Other: Non paid consultant. Bachier:Viracyte: Consultancy; Sanofi: Speakers Bureau; Kadmon Corporation, LLC: Consultancy. Lazaryan:Kadmon: Consultancy. Weisdorf:Pharmacyclics: Consultancy; Fate Therapeutics: Consultancy; Incyte: Research Funding. Green:Kadmon Corporation, LLC: Employment. Schueller:Kadmon Corporation LLC: Employment. Huang:Kadmon Corporation, LLC: Employment. Yang:Kadmon Corporation: Employment. Eiznhamer:Kadmon Corporation: Employment. Aggarwal:Kadmon Corporation, LLC: Employment, Equity Ownership. Blazar:Fate Therapeutics, Inc.: Research Funding; Magenta Therapeutics and BlueRock Therapeuetics: Membership on an entity's Board of Directors or advisory committees; Kamon Pharmaceuticals, Inc: Membership on an entity's Board of Directors or advisory committees; Five Prime Therapeutics Inc: Co-Founder, Membership on an entity's Board of Directors or advisory committees; Regeneron Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees; RXi Pharmaceuticals: Research Funding; Alpine Immune Sciences, Inc.: Research Funding; Abbvie Inc: Research Funding; Leukemia and Lymphoma Society: Research Funding; Childrens' Cancer Research Fund: Research Funding; KidsFirst Fund: Research Funding; Tmunity: Other: Co-Founder; BlueRock Therapeutics: Membership on an entity's Board of Directors or advisory committees. Lee:Incyte: Research Funding; Syndax: Research Funding; Amgen: Research Funding; Novartis: Research Funding; Takeda: Research Funding; Kadmon: Consultancy, Research Funding; Pfizer: Consultancy, Research Funding; AstraZeneca: Research Funding.

Abstract CLL is a heterogeneous disease with patients (pts) experiencing rapid disease progression and others living for years without requiring treatment. Recently, next generation sequencing has revealed new molecular alterations, targeting the NOTCH1 and BIRC3 genes which occur in about 10% CLL at diagnosis and correlate with poor outcome. Given the possibility of targeting NOTCH1 and BIRC3 with drugs currently under development, the primary endpoints of our research were: 1) to determine overall survival (OS) upon IGHV, NOTCH1, TP53 and BIRC3 in univariate analysis; 2) to correlate these genomic aberrations with other biological or clinical prognostic factors, and finally 3) to confirm NOTCH1, BIRC3 and TP53 as independent prognostic factors. We investigated 475 pts with a median age of 65 years (range 33-89), whose 160 had low Rai stage, 301 intermediate stage and 14 high stage. NOTCH1 mutations (mut) were studied by ARMS PCR for c.7544-7545delCT and by Sanger sequencing of NOTCH1 exon 34. Mutations of TP53 were analysed by DNA direct sequencing, while BIRC3 disruption (disr) was studied by Sanger sequencing for mutations and by interphase FISH for deletions. All these alterations were studied at diagnosis or before any chemotherapeutic approach. NOTCH1mut and TP53mut pts were 52 (10.9%) and 36/475 (7.6%), respectively. Thirty four patients were BIRC3mut (7.2%) and 26 BIRC3 deleted (5.5%) for a total of 46 cases (9.7%) BIRC3disr. NOTCH1, TP53 and BIRC3 alterations were mutually exclusive. There were significant correlations between NOTCH1 (P<0.00001), TP53 (P=0.004), BIRC3 status (P=0.00004) and IGHV mutations. Concerning FISH cytogenetics (460 patients), a significant correlation (P<0.0001) was found between NOTCH1mut and trisomy 12 (20/62; 32%). TP53mut were strictly associated with del17p (15/25; 60%; P<0.0001), while BIRC3disr was found mainly within 11q22-q23 deletions subset (22/46;49%; P<0.0001). With regard to clinical outcome, 30 (83%) of 36 TP53mut pts (P=0.00009), 47 (90%) of 52 NOTCH1mut (P<0.00001) and 40 (87%) of 46 BIRC3disr pts had received chemotherapy at the time of analysis. Twenty nine NOTCH1mut (56%), 15 TP53mut (42%) and 18 BIRC3disr (39%) pts underwent at least two lines of treatment (P<0.0001). Noteworthy, shorter OS was observed in IGHV unmutated (UM) patients (12% vs 80% at 18 years, P<0.00001), in NOTCH1mut pts (12% vs 71% at 16 years, P<0.00001), in TP53mut pts (9% vs 76% at 14 years, P<0.00001) and in BIRC3disr pts (29% vs 65% at 16 years, P=0.00001). To further explore the prognostic impact of NOTCH1mut, TP53mut and BIRC3disr, we investigated them within the UM (153 pts) IGHV subset, notoriously at worst prognosis. As a matter of fact, NOTCH1mut (16% vs 45% at 14 years, P=0.012), TP53mut (0% vs 43% at 13 years, P=0.002) and BIRC3disr (0% vs 57% at 11 years, P=0.011) pts showed significant shorter OS [Figure]. Within the mutated IGHV subgroup we obtained similar results. In multivariate analysis of OS, TP53mut (HR 5.2, P<0.00001), age >60 years (HR 3.8, P=0.00002), IGHV UM status (HR 0.30, P=0.0001), intermediate/high Rai stages (HR 2.8, P=0.0002), NOTCH1mut (HR 2.6, P=0.001), and BIRC3disr (HR 2.5, P=0.005) were confirmed to be independent adverse prognostic factors. Noteworthy, here, we demonstrated that genomic aberrations are able to improve the historical prognostic ability of the IgHV mutational status. In conclusion, genomic aberrations, particularly TP53mut, NOTCH1mut and BIRC3disr should be considered as novel important prognostic parameters in CLL and therefore they have to be necessarily considered in updated scoring prognostic systems. Disclosures: No relevant conflicts of interest to declare.

Background:Multisystem Inflammatory Syndrome in Children (MIS-C) is observed by hyperinflammation and cytokine storm. The spectrum of severity ranged from standard hospitalization to pediatric intensive care unit management. There is no specific activity score that predicts whether this hyperinflammatory state will be severe or result in mortality in pediatric patients. There are activity scores used in KD and other vasculitis such as Kobayashi score (KS) and Pediatric Vasculitis Activity Score (PVAS) that determine the severity of the disease in children.Objectives:Based on the clinical similarity of MIS-C to these disease groups, we wanted to evaluate the performance of these disease activity scores. Also, we aimed to identify the factors associated with the disease severity of patients with MISCMethods:We retrospectively enrolled a single-center cohort of 45 consecutive pediatric patients with MISC admitted to Umraniye Training and Resrach Hospital, Pediatric Rheumatology Clinic, Istanbul, Turkey, from April 20 to December 31, 2020. Medical information of each patient including demographic data, clinical characteristics, laboratory results, and outcomes was extracted retrospectively through review of electronic medical records. We analyzed all score systems including KS, PVAS, NLR, cHIS, and C-reactive protein/albumin ratio (CAR) as assessment factors for diagnosis for severe disease and evaluation of disease activity in MISC. All scores were compared between two groups and receiver operating characteristic (ROC) curve analysis was performed to evaluate diagnostic utility.Results:We reported 45 patients (10 female, 35male) with MISC. Their mean age was 9.65±4.93 years (7 months-18 years). All patients had fever (median 4 days), 71 % patients had acute gastrointestinal symptoms, 37.8 % of patient’s conjunctivitis and only 5 patients had respiratory findings at admission. Twenty-four (46.7%) patients met criteria for classic KD. Macrophage activation syndrome and myocardial dysfunction with or without cardiogenic shock were seen 14 and 10 patients respectively. All the patients had positive serology for SARS-CoV-2, abnormal complete blood counts and coagulation tests, and elevated inflammatory markers.We divided the disease severity into a moderate or severe group based on admission on intensive care unit (ICU). There were 15 patients with severe illness (33%). The median age of these patients was significantly older (11.3 years vs 9.16 years, p=0.05). The median hospital stay period was 10 days. The median need for intensive care was on the first day (1-14th days), and the median lasted 5 (1-9) days. The majority of MISC patients were on Intravenous immunoglobulin (IVIG) (89%), and corticosteroid (73.3%). A total of 12 patients received anakinra.In the severe group, all patients had higher values of KD, PVAS, NLR, cHIS, and CAR than the patients in moderate group. For severe MISC, the area under receiver operating characteristic curve (AUC) was 0.864 (95% confidence interval [CI], 0.729–1) for the PVAS, 0.911 (95% CI, 0.827–0.995) for the NLR, and 0.853 (95% CI, 0.744–0.963) for the CAR, with optimal cut-off values of 3.5, 9.05, and 4.86, respectively. Thirty-eight (84.4%) of the 45 patients met two or more cHIS criteria at the time of their hospitalization; 39% of these patients were identified as severe group (OR 1.62, 95% CI 1.27-2.13, p=0.04). At the time of diagnosis, 29 patients with a Kobayashi score greater than 4 were detected, of which 15 required intensive care (OR 2.07, 95% CI 1.42-3.0, p=0.00).Conclusion:This study demonstrated that both inflammatory scores (CAR and NLR) and disease activity scores (KS, PVAS and cHIS) can be used to aid the assessment for severity of MISCReferences:[1]Webb BJ, et al Lancet Rheumatol. 2020 Dec;2(12):e754-e763.[2]Feldstein LR et al N Engl J Med. 2020;383(4):334-346Disclosure of Interests:None declared.

Abstract Abstract 2009 Introduction Melphalan 200 mg/m2 has remained the standard of care as a preparative regimen for patients with multiple myeloma (MM) undergoing autologous stem cell transplantation (ASCT). Higher doses of melphalan are associated with unacceptable gastrointestinal toxicity. Preliminary studies suggested that administration of the cytoprotective agent amifostine could protect patients with MM undergoing ASCT from excessive toxicity from doses of melphalan as high as 280 mg/m2. We conducted a prospective, multicenter, randomized trial comparing melphalan 200 mg/m2 (mel200) v. 280 mg/m2 (mel280) using amifostine pretreatment in patients with MM undergoing ASCT. Methods The primary endpoints of the trial were grades 3–4 toxicity and near complete response (nCR) or better 60–120 days after ASCT. Eligibility included age ≤70, no prior ASCT, acceptable organ function, measurable monoclonal protein in serum or urine by protein electrophoresis and adequate stem cells for ASCT. Patients were stratified by ß2 microglobulin >5 at study entry, del 13 by FISH and response (<≥PR) to the last cytoreductive regimen prior to ASCT. Amifostine 710 mg/m2, with appropriate hydration and pre-medications, was given by intravenous push the day prior to and again 15 minutes prior to mel200 or mel280 given as a single infusion over 30 minutes. Results Of 134 patients consented, consent was withdrawn for 4 patients, 1 patient who had abnormal renal function, one after a hypotensive episode following the first amifostine infusion, and 2 for other reasons. Manageable toxicities associated with amifostine infusion were hypotension (18), hypertension (3), dizziness (4), and nausea (33). Of 130 patients, 64 randomized to 200 mg/m2 and 66 280 mg/m2; 26 had del 13, and 55 had <PR to their last therapy; no patient had a ß2 microglobulin >5. Their median age was 60 years (range 42–70), they had received a median of 2 regimens (range 1–8) prior to stem cell collection, and 28 (22%) had received local radiation prior to ASCT. A total of 21 patients had grade 3–4 toxicity, 11% who received mel200 and 21% who received mel280 (p=0.11). Four of the seven in the mel200 group had a single grade 3–4 toxicity, while 3 had 2 grade 3–4 toxicities. Eight of the 14 in the mel280 group had a single toxicity, and 6 patients had two toxicities. By organ systems respectively, for mel200 v. mel 280, they were cardiac 1 v. 0, gastrointestinal 6 v. 11, mucositis 3 v. 7, CNS 0 v. 1 and pulmonary 0 v. 1. Hospitalization occurred in 94 patients 106 times; among the group receiving mel200 40 (62%) patients were hospitalized compared to 54 (82%) in the mel280 group, p=0.01. The mean total days of hospitalization were 7.3 and 10.2 days for mel200 and mel280, respectively (p=0.06); 3 patients in the mel200 group required 2 hospitalizations, 2 were admitted 3 times, while 5 patients in the mel280 group were admitted twice. The primary reasons for hospitalization for patients in receiving mel200 v mel280, respectively were, conditioning and transplant 9 v. 12, mucositis 2 v. 12, nausea and vomiting 8 v. 12, fever and infection 21 v. 18 and other 6 v. 6. No treatment related deaths occurred in this study. Responses following ASCT by EBMT criteria were for mel200 v. mel 280, respectively, ≥nCR 22% v. 39%, p=0.04, ≥PR 56% v. 70%, p= 0.09. The estimated progression-free survival at 1 and 3 years was 86% and 48%, respectively, for mel200 and 77% and 53%, respectively, for mel280. The risk of failure (death or progression) was similar (hazard ratio (mel280 vs. mel200) 1.12; 95% CI 0.64–1.95, p=0.69). The median follow-up among patients alive without progression was 524 and 555 days for mel200 and mel280, respectively. The estimated overall survival at 1 and 3 years was 96% and 83%, respectively, for mel200 and 89% and 73% for mel280, respectively. The risk of death was similar in the mel280 group relative to mel200 (HR=0.86; 95% CI 0.40–1.84; p=0.70). Conclusions In summary the combination of amifostine and mel280 was generally well tolerated although there were more grade 3–4 regimen-related toxicities, primarily mucositis and gastrointestinal. This resulted in slightly more frequent and longer hospitalizations (by 3 days) compared to amifostine + mel200. Mel280 resulted in a higher major response rate (CR + nCR) and warrants further study. Disclosures: Off Label Use: amifostine.

Abstract Background The introduction of multiple novel agents and regimens for NDMM and relapsed/refractory MM (RRMM) has improved outcomes while increasing the complexity of treatment selection and disease management. The real-world effectiveness of many novel-agent-based regimens remains to be elucidated. INSIGHT MM (NCT02761187) is the largest global, prospective, observational MM study to date. It aims to understand global NDMM/RRMM disease and pt characteristics, treatment patterns, and clinical outcomes, as well as regional variations. Here we report data for 1056 NDMM pts enrolled from July 1, 2016 to April 27, 2018. Methods INSIGHT MM is enrolling ~4200 adult pts with NDMM/RRMM (1-3 prior therapies) from 15 countries; 9 in Europe (EU), 3 in Latin America (LA), the United States (US), and 2 in Asia. Pts will be followed prospectively for ≥5 yrs. Data are collected from hospital/clinic records at baseline (MM-specific disease characteristics, prior therapies) and every 3 mos (disease management, effectiveness, safety). Results At data cut-off, 1056 NDMM pts had been enrolled from 14 countries, including 495 (47%) from EU, 361 (34%) from the US, 112 (11%) from LA, and 88 (8%) from Taiwan. Median age at enrollment was 64 (range 32-89) yrs and 139 (13%) pts were aged >75 yrs (14%/12%/11%/13% in EU/US/Taiwan/LA); 57% of pts were male (60%/58%/61%/39% in EU/US/Taiwan/LA); 72%, 13%, and 8% were White/Caucasian, Asian, and Black/African American, respectively. Overall, 62% of pts were treated at academic centers and 38% in community settings. Based on accrual at data cut-off, regional differences were observed, with more pts treated at academic centers in EU/Taiwan (88%/91%) vs the US/LA (30%/25%). 87% of pts were treated outside of clinical trials (88%/82%/95%/98% in EU/US/Taiwan/LA). Bone pain (32%, including 33%/28%/40%/37% in EU/US/Taiwan/LA), weakness/fatigue (anemia; 11%, including 12%/10%/6%/18% in EU/US/Taiwan/LA), and kidney problems (5%, including 3%/3%/17%/2% in EU/US/Taiwan/LA) were the most common reasons for pts seeking care; 32% (36%/32%/22%/24% in EU/US/Taiwan/LA) were asymptomatic at diagnosis. At diagnosis, 27%/26%/31% of pts had physician-reported ISS Stage I/II/III MM, and 88% had ECOG PS 0-1; 8% of pts had hypercalcemia, 34% creatinine clearance <60 ml/min, 56% anemia, and 30% >3 bone lesions. The most common reasons for initiating therapy were the presence of CRAB criteria, e.g. bone involvement (54%) and anemia (37%). At start of treatment, fixed-duration therapy, treat-to-best-response, and treat-to-progression approaches were planned for 38%, 29%, and 31% of pts, respectively. The most frequently administered regimens are shown in the Table; 20%/66% of pts received a doublet/triplet. V-based regimens were the most frequently used. Regional differences in regimen selection are emerging: among IMiDs, T is most commonly prescribed in EU, Taiwan, and LA; R is more common in the US. After a median follow-up of 9.3 mos, 72 (7%) pts had discontinued the study, most often due to death (57%), consent withdrawal (14%), or change of treatment provider (11%). At data cut-off, data for 236 (22%) pts who received 1st-line ASCT were available (median age 60 yrs; 12%/63%/25% of pts aged <50/50-65/>65 yrs). Of these, 64% received ASCT at academic centers; 42% of pts each in EU and the US received ASCT vs 11% in Taiwan and 4% in LA. The most frequently administered regimens in ASCT-eligible (n=429) vs ASCT-ineligible (n=571) pts were VC±d (21% vs 21%), VR±d (19% vs 17%) and VT±d (17% vs 10%). At data cut-off, 115 NDMM pts had progressed to 2nd-line therapy; 99 pts received a PI with 1st-line therapy, of whom 33 (33%) then received a PI-based regimen in 2nd line; 61 pts received an IMiD with 1st-line therapy, of whom 35 (57%) then received an IMiD-based regimen in 2nd line. Among 1st/2nd-line pts, 2%/12% received monoclonal antibody therapy. Conclusions PIs and IMiDs remain the global backbones of MM therapy, with V-based regimens most commonly used in NDMM pts, regardless of intended transplant status. These data from INSIGHT MM are beginning to elucidate regional differences in disease presentation and treatment selection, including higher numbers of pts receiving ASCT in the US/EU vs Taiwan/LA, which are likely reflective of differences in healthcare systems and access to MM treatments in the participating countries. Future studies will evaluate the impact of these regional variations on outcomes. Table. Table. Disclosures Usmani: Abbvie, Amgen, Celgene, Genmab, Merck, MundiPharma, Janssen, Seattle Genetics: Consultancy; Amgen, BMS, Celgene, Janssen, Merck, Pharmacyclics,Sanofi, Seattle Genetics, Takeda: Research Funding. Hungria:Celgene: Honoraria; Takeda: Honoraria; Janssen: Honoraria; Amgen: Honoraria. Leleu:Karyopharm: Honoraria; Incyte: Honoraria, Other: steering committee membership ; Celgene: Honoraria, Other: steering committee membership ; Janssen: Honoraria, Other; BMS: Honoraria, Other: steering committee membership ; Merk: Honoraria, Other: steering committee membership ; Takeda: Honoraria, Other: steering committee membership ; Amgen: Honoraria, Other: steering committee membership ; Sanofi: Honoraria, Other: steering committee membership steering committee membership ; Novartis: Honoraria, Other: steering committee membership ; Roche: Honoraria; Gilead: Honoraria. Lee:Celgene: Consultancy, Membership on an entity's Board of Directors or advisory committees; Adaptive Biotechnologies Corporation: Consultancy; Amgen: Consultancy, Membership on an entity's Board of Directors or advisory committees; Chugai Biopharmaceuticals: Consultancy; Takeda Oncology: Consultancy, Membership on an entity's Board of Directors or advisory committees; Kite Pharma: Consultancy, Membership on an entity's Board of Directors or advisory committees. Davies:Abbvie: Consultancy; Janssen: Consultancy, Honoraria; Takeda: Consultancy, Membership on an entity's Board of Directors or advisory committees; Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Amgen: Consultancy, Membership on an entity's Board of Directors or advisory committees; TRM Oncology: Honoraria; ASH: Honoraria; MMRF: Honoraria. Costello:Poseida Therapeutics, Inc.: Research Funding; Takeda: Consultancy; Celgene: Consultancy. Rifkin:Takeda: Consultancy; EMD Serono: Consultancy; McKesson: Equity Ownership; Celgene: Consultancy; Amgen: Consultancy; Sandoz: Consultancy; Boehringer Ingelheim: Consultancy. Weisel:Amgen, BMS, Celgene, Janssen, and Takeda: Honoraria; Amgen, BMS, Celgene, Janssen, Juno, Sanofi, and Takeda: Consultancy, Membership on an entity's Board of Directors or advisory committees; Amgen, Celgene, Janssen, and Sanofi: Research Funding. Chari:Adaptive Biotechnology: Membership on an entity's Board of Directors or advisory committees; Celgene: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Takeda: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; The Binding Site: Consultancy; Pharmacyclics: Research Funding; Seattle Genetics: Membership on an entity's Board of Directors or advisory committees; Array Biopharma: Research Funding; Amgen: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Bristol Myers Squibb: Consultancy; Janssen: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding. Puig:Janssen: Consultancy, Honoraria, Research Funding; Takeda: Consultancy, Honoraria; Celgene: Honoraria, Research Funding. Boccadoro:Amgen: Honoraria, Research Funding; Celgene: Honoraria, Research Funding; Janssen: Honoraria, Research Funding; Novartis: Honoraria, Research Funding; AbbVie: Honoraria; Mundipharma: Research Funding; Bristol-Myers Squibb: Honoraria, Research Funding; Sanofi: Honoraria, Research Funding. Cook:Bristol-Myers Squibb: Consultancy, Honoraria; Glycomimetics: Consultancy, Honoraria; Sanofi: Consultancy, Honoraria, Speakers Bureau; Janssen: Consultancy, Honoraria, Research Funding, Speakers Bureau; Celgene Corporation: Consultancy, Honoraria, Research Funding, Speakers Bureau; Janssen: Consultancy, Honoraria, Research Funding, Speakers Bureau; Takeda: Consultancy, Honoraria, Research Funding, Speakers Bureau; Seattle Genetics: Honoraria; Amgen: Consultancy, Honoraria, Research Funding, Speakers Bureau. Berdeja:Teva: Research Funding; Janssen: Research Funding; Takeda: Research Funding; Amgen: Research Funding; Poseida Therapeutics, Inc.: Research Funding; Bristol-Myers Squibb: Research Funding; Celgene: Research Funding; Bluebird: Research Funding; Genentech: Research Funding; Glenmark: Research Funding; Novartis: Research Funding; Sanofi: Research Funding. Zonder:Takeda: Honoraria; Coelum: Honoraria; BMS: Research Funding; Celgene: Consultancy, Honoraria; Alnylam: Honoraria; Janssen: Honoraria; Pharmacyclics: Other: DSMC. Abonour:Prothena: Research Funding; Takeda: Consultancy, Research Funding; Celgene: Consultancy, Research Funding. Hajek:Takeda: Consultancy, Honoraria, Research Funding; Bristol-Myers Squibb: Consultancy, Honoraria, Research Funding; Janssen: Consultancy, Honoraria, Research Funding; Amgen: Consultancy, Honoraria, Research Funding; Celgene: Consultancy, Honoraria, Research Funding. Spencer:Celgene: Honoraria, Research Funding, Speakers Bureau; Janssen-Cilag: Honoraria, Research Funding, Speakers Bureau; Amgen: Honoraria, Research Funding; BMS: Research Funding; Takeda: Honoraria, Research Funding, Speakers Bureau; STA: Honoraria. Omel:Takeda Oncology: Honoraria, Membership on an entity's Board of Directors or advisory committees; Celgene Corporation: Honoraria, Membership on an entity's Board of Directors or advisory committees. Demers:Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited: Employment. Romanus:Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited: Employment. Ren:Takeda Pharmaceuticals International Co.: Employment. Skacel:Department of Hematology, Charles University General Hospital, Prague, Czech Republic: Other: Affiliation; Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited: Employment. Stull:Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited: Employment. Terpos:Novartis: Honoraria; Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees; Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel Grant, Patents & Royalties; Genesis: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel Grant, Research Funding; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel Grant, Patents & Royalties; Amgen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel Grant, Research Funding.

ISCPES stands for International Society for Comparative Physical Education and Sports and it is going to celebrate its 40th anniversary in 2018. Since the beginning (Israel 1978) the main goals of the Society were established under a worldwide mind set considering five continents and no discrimination of any kind. The founders wanted to compare Physical Education and Sports across the world, searching for the best practices deserving consideration and applied on the purpose of improving citizen quality of life. The mission still stands for “Compare to learn and improve”.As all the organizations lasting for 39 years, ISCPES experienced several vicissitudes, usually correlated with world economic cycles, social and sports changes, which are in ISS journal articles - International Sport Studies.ISS journal is Scopus indexed, aiming to improve its quality (under evaluation) to reach more qualified students, experts, professionals and researchers; doing so it will raise its indexation, which we know it is nowadays a more difficult task. First, because there are more journals trying to compete on this academic fierce competitive market; secondly, because the basic requirements are getting more and more hard to gather in the publishing environment around Physical Education and Sports issues. However, we can promise this will be one of our main strategic goals.Another goal I would like to address on this Editorial is the language issue. We have this second strategic goal, which is to reach most of languages spoken in different continents; besides the English language, we will reach Chinese, Spanish and Portuguese speaking countries. For that reason, we already defined that all the abstracts in English will be translated into Chinese, Spanish and Portuguese words so people can find them on any search browser. That will expand the demand for our journal and articles, increasing the number of potential readers. Of course this opportunity, given by Motricidade, can be considered as a good example to multiply our scope.In June 2017 we organized a joint Conference in Borovets, Bulgaria, with our colleagues from the BCES – Bulgarian Society for Comparative Educational Studies. During those days, there was an election to appoint a new (Portuguese) president. This constitutes an important step for the Portuguese speaker countries, which, for a 4th year term, will have the opportunity to expand the influence of ISCPES Society diffusing the research results we have been achieving into a vast extended new public and inviting new research experts to innovative debates. This new president will be working with a wide geographical diverse team: the Vice President coming from a South American country (Venezuela), and the other several Executive Board members are coming from Brazil, China, Africa and North America. This constitutes a very favorable situation once, adding to this, we kept the previous editorial team from Australia and Europe. We are definitely committed to improve our influence through new incentives to organize several regional (continental) workshops, seminars and Conferences in the next future.The international research is crossing troubled times with exponential number of new indexed journals trying to get new influence and visibility. In order to do that, readers face new challenges because several studies present contradictory conclusions and outcome comparisons still lacking robust methodologies. Uncovering these issues is the focus of our Society.In the past, ISCPES started its activity collecting answers to the same questions asked to several experts in different countries and continents across the world. The starting studies developed some important insights on several issues concerning the way Physical Education professionals approached their challenges. In the very starting documents ISCPES activity focused in identifying certain games and indigenous activities that were not understood by people in other parts of the world, improving this international understanding and communication. This first attempt considered six groups of countries roughly comprehending 26 countries from all the continents.ISCPES has on its archives several seminal works, PhD proposals and program proposals, which constitutes the main theoretical framework considered in some textbooks printed at the end of the sixties in the XXth century.The methods used mostly sources’ country comparisons, historic development of comparative education systems, list of factors affecting those systems and a systematic analysis of case studies; additionally, international organizations for sports and physical education were also required to identify basic problems and unique features considered for the implementation of each own system. At the time, Lynn C. Vendien & John E. Nixon book “The World Today in Health, Physical Education and Recreation”, Englewood Cliffs, New Jersey: Prentice-Hall, Inc. 1968, together with two monographies from William Johnson “Physical Education around the World”, 1966, 1968, Indianapolis, Phi Epsilon Kappa editions, were the main textbook references.The main landscapes of interest were to study sports compared or the sport role in Nationalisms, Political subsidization, Religion, Race and volunteering versus professionalism. The goal was to state the true place of sports in societies.In March 1970, Ben W. Miller from the University of California compiled an interesting Exhibit n.1 about the main conclusions of a breakfast meeting occurred during the American Association for Health, Physical Education and Recreation. There, they identified thirty-one individuals, which had separate courses in “Comparative and/or International Physical Education, Recreation and Sports”; one month later, they collected eighteen responses with the bibliographic references they used. On this same Exhibit n.1 there is detailed information on the title, catalogue description, date of initial course (1948, the first), credit units, eligibility, number of year offer, type of graduation (from major to doctorate and professional). Concluding, the end of the sixties can be the mark of a well-established body of literature in comparative education and sports studies published in several scientific journals.What about the XXIst century? Is it still important to compare sports and education throughout the world? Only with qualitative methods? Mixed methods?We think so. That is why, after a certain decline and fuzzy goal definition in research motivations within ISCPES we decided to innovate and reorganize people from physical education and sports around this important theme of comparative studies. Important because we observe an increasing concern on the contradictions across different results in publications under the same subject. How can we infer? What about good research questions which get no statistically significant results? New times are coming, and we want to be on that frontline of this move as said by Elsevier “With RMR (results masked review) articles, you don’t need to worry about what editors or reviewers might think about your results. As long as you have asked an important question and performed a rigorous study, your paper will be treated the same as any other. You do not need to have null results to submit an RMR article; there are many reasons why it can be helpful to have the results blinded at initial review”.https://www.elsevier.com/connect/reviewers-update/results-masked-review-peer-review-without-publication-bias.This is a very different and challenging time. Our future strategy will comprehend more cooperation between researchers, institutions and scientific societies as an instrument to leverage our understanding of physical activity and sports through different continents and countries and be useful for policy designs.Next 2018, on the occasion of the UE initiative Sofia – European Capital of Sport 2018 we - Bulgarian Comparative Education Society (BCES) & the International Society for Comparative Physical Education and Sport (ISCPES) - will jointly organize an International Conference on Sport Governance around the World.Sports and Physical Education are facing complex problems worldwide, which need to be solved. For health reasons, a vast number of organizations are popularizing the belief that physical education and sports are ‘a must’ in order to promote human activity and movement. However, several studies show that modern lifestyles are the main cause for people's inactivity and sedentary lifestyles.Extensive funded programs used to promote healthy lifestyles; sports media advertising several athletes, turning them into global heroes, influencers in a new emerging industry around sports organizations. Therefore, there is a rise in the number of unethical cases and corruption that influence the image of physical education and sports roles.We, the people emotional and physically involved with sports and physical activity must be aware of this, studying, discussing and comparing global facts and events around the world.This Conference aims to offer an incentive to colleagues from all continents to participate and present their latest results on four specific topics: 1. Sport Governance Systems; 2. Ethics and Corruption in Physical Education and Sports Policies; 3. Physical Education and Sport Development; 4. Training Physical Educators and Coaches. Please consider your selves invited to attend. Details in http://bcesconvention.com/

Aims/Objectives/BackgroundGlobally, injuries cause more than 5 million deaths annually. Children and young people are a particularly vulnerable group and injuries are the leading cause of death in people aged 5–24 years globally and a leading cause of disability.In most low and middle-income countries where the majority of global child injury burden occurs, systems for routinely collecting injury data are limited. There is a continuing need for better data on childhood injuries and for injury surveillance.The aim of our study was to introduce a hospital-based injury surveillance tool – the first of its kind in Nepal and explore its feasibility. We undertook prospective collection of data on all injuries/trauma presenting to 2 hospital emergency departments to describe the epidemiology of paediatric hospital injury presentations and associated risk factors.Methods/DesignA new injury surveillance system for use in emergency departments in Nepal was designed and used to collect data on patients presenting with injuries. Data were collected prospectively in two hospitals 24 h a day over 12 months (April 2019 - March 2020) by trained data collectors using tablet computers.Abstract 432 Table 1Socio-demographic profile and characteristics of injury among children attending emergency of hospitals in Makwanpur district, Nepal, April 2019 – March 2020 (N=2696)CharacteristicsFrequencyGender Male 1778 Female 918 Age groups 0–4 years 653 5–9 years 866 10–14 years 680 15–17 years 497 Median year (IRQ) 8 (5 – 13) Ethnicity/caste Janajati 1384 Brahmin/Chhetri 892 Dalit 148 Madhesi 146 Muslim 74 Others 50 Unknown 2 Place where injury occurred Home/Compound 1576 Highway/road/street 636 School 233 Recreational area 138 Workplace 76 Other 37 Activities at the time injury occurred Leisure/Play 1889 Travelling (other than to/from school/work) 296 Work 202 Travelling (to/from school/work) 184 Education 42 Organised sports 11 Other 52 Unknown 20 Intent of injury Unintentional 2560 Intentional (self-harm) 61 Intentional (assault) 75 Unintentional (n=2560) Fall 912 Animal or insect related 728 Road traffic injury 356 Injured by a blunt force 201 Stabbed, cut or pierced 176 Fire, burn or scald 65 Poisoning 52 Suffocation/choking 36 Electrocution 12 Drowning and submersion 7 Other 13 Unknown 2 Self-harm (n=61) Poisoning 38 Hanging, strangulation, suffocation 12 Stabbed, cut or pierced 6 Injured by blunt object 4 Other 1 Assault (n=75) Bodily force (physical violence) 43 Injured by blunt object 18 Stabbed, cut or pierced 8 Pushing from a high place 2 Poisoning 2 Sexual assault 1 Other 1 Nature of injury (one most severe) Cuts, bites or open wound 1378 Bruise or superficial injury 383 Fracture 299 Sprain, strain or dislocation 243 Internal injury 124 Head Injury/Concussion 83 Burns 67 Other 115 Unknown 2 Not recorded 2 Severity of injury No apparent injury 125 Minor 1645 Moderate 813 Severe 111 Not recorded 2 Disposition Discharged 2317 Admitted to hospital 164 Transferred to another hospital 179 Died 21 Leave Against Medical Advice (LAMA) 11 Unknown 2 Not recorded 2 Note:Not recorded = missing cases95% CI calculated using one proportion test and normal approximation method in Minitab.Abstract 432 Table 2Distribution of injuries by age-group, sex and mechanism of injury among children attending emergency of hospitals in Makwanpur district, Nepal, April 2019 – March 2020Age groups & Sex0 - 4 years5 - 9 years10–14 years15–17 yearsMaleFemaleTotalIntent & mechanismsn (%)n (%)n (%)n (%)n (%)n (%)n (%)Unintentional Fall 239 (26.2) 328 (36.0) 249 (27.3) 96 (10.5) 636 (69.7) 276 (30.3) 912 (100) Animal or insect related 175 (24.0) 260 (35.7) 190 (26.1) 103 (14.1) 470 (64.6) 258 (35.4) 728 (100) Road traffic injury 49 (13.8) 108 (30.3) 86 (24.2) 113 (31.7) 223 (62.6) 133 (37.4) 356 (100) Injured by a blunt force 54 (26.9) 74 (36.8) 49 (24.4) 24 (11.9) 150 (74.6) 51 (25.4) 201 (100) Stabbed, cut or pierced 20 (11.4) 56 (31.8) 49 (27.8) 51 (29.0) 127 (72.2) 49 (27.8) 176 (100) Fire, burn or scald 42 (64.6) 10 (15.4) 9 (13.8) 4 (6.2) 27 (41.5) 38 (58.5) 65 (100) Poisoning 33 (63.5) 6 (11.5) 5 (9.6) 8 (15.4) 26 (50.0) 26 (50.0) 52 (100) Suffocation/choking 24 (66.7) 5 (13.9) 2 (5.6) 5 (13.9) 20 (55.6) 16 (44.4) 36 (100) Electrocution 2 (15.7) 0 (0.0) 3 (25.0) 7 (58.3) 10 (83.3) 2 (16.7) 12 (100) Drowning and submersion 1 (14.3) 1 (14.3) 3 (42.9) 2 (28.6) 3 (42.9) 4 (57.1) 7 (100) Other 6 (46.2) 4 (30.8) 3 (23.1) 0 (0.0) 10 (76.9) 3 (23.1) 13 (100) Unknown 2 (100) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 2 (100) 2 (100) Total 647 (25.3) 852 (33.3) 648 (25.3) 413 (16.1) 1702 (66.5) 858 (33.5) 2560 (100) Self-harm Poisoning 0 (0.0) 0 (0.0) 6 (15.8) 32 (84.2) 7 (18.4) 31 (81.6) 38 (100) Hanging 0 (0.0) 0 (0.0) 3 (25.0) 9 (75.0) 4 (33.3) 8 (66.7) 12 (100) Stabbed, cut or pierced 0 (0.0) 0 (0.0) 2 (33.3) 4 (66.7) 1 (16.7) 5 (83.3) 6 (100) Injured by blunt object 0 (0.0) 2 (50.0) 2 (50.0) 0 (0.0) 4 (100) 0 (0.0) 4 (100) Other 0 (0.0) 0 (0.0) 0 (0.0) 1 (100) 1 (100) 0 (0.0) 1 (100) Total 0 (0.0) 2 (3.3) 13 (21.3) 46 (75.4) 17 (27.9) 44 (72.1) 61 (100) Assault Bodily force (physical violence) 3 (7.0) 1 (2.3) 11 (25.6) 28 (65.1) 37 (86.0) 6 (14.0) 43 (100) Injured by blunt object 2 (11.1) 8 (44.4) 4 (22.2) 4 (22.2) 13 (72.2) 5 (27.8) 18 (100) Stabbed, cut or pierced 1 (12.5) 0 (0.0) 2 (25.0) 5 (62.5) 7 (87.5) 1 (12.5) 8 (100) Pushing from a high place 0 (0.0) 1 (50.0) 1 (50.0) 0 (0.0) 1 (50.0) 1 (50.0) 2 (100) Poisoning 0 (0.0) 1 (50.0) 0 (0.0) 1 (50.0) 1 (50.0) 1 (50.0) 2 (100) Sexual assault 0 (0.0) 0 (0.0) 1 (100) 0 (0.0) 0 (0.0) 1 (100) 1 (100) Other 0 (0.0) 1 (100) 0 (0.0) 0 (0.0) 0 (0.0) 1 (100) 1 (100) Total 6 (8.0) 12 (16.0) 19 (25.3) 38 (50.7) 59 (78.7) 16 (21.3) 75 (100) Abstract 432 Table 3Association of injury location, nature and severity with age among children attending emergency of hospitals in Makwanpur district, Nepal, April 2019 – March 2020Age groups0 – 4 years5 – 9 years10–14 years15–17 yearsTotalChi-SquareInjury characteristicsn (%)n (%)n (%)n (%)n (%)P valueLocation of injury sustained Home/Compound 537 (34.1) 504 (32.0) 319 (20.2) 216 (13.7) 1576 (100) <0.001 Highway/road/street 85 (13.4) 196 (30.8) 190 (29.9) 165 (25.9) 636 (100) School 15 (6.4) 107 (45.9) 85 (36.5) 26 (11.2) 233 (100) Recreational area 9 (6.5) 44 (31.9) 55 (39.9) 30 (21.7) 138 (100) Workplace 1 (1.3) 4 (5.3) 19 (25.0) 52 (68.4) 76 (100) Other 6 (16.2) 11 (29.7) 12 (32.4) 8 (21.6) 37 (100) Total 653 (24.2) 866 (32.1) 680 (25.2) 497 (18.4) 2696 (100) Nature of injury Cuts, bites or open wound 328 (23.8) 506 (36.7) 314 (22.8) 230 (16.7) 1378 (100) <0.001 Bruise or superficial injury 81 (21.1) 99 (25.8) 118 (30.8) 85 (22.2) 383 (100) Fracture 48 (16.1) 101 (33.8) 112 (37.5) 38 (12.7) 299 (100) Sprain, strain or dislocation 48 (19.8) 78 (32.1) 72 (29.6) 45 (18.5) 243 (100) Internal injury 44 (35.5) 8 (6.5) 18 (14.5) 54 (43.5) 124 (100) Head Injury/Concussion 18 (21.7) 26 (31.3) 18 (21.7) 21 (25.3) 83 (100) Burns 42 (62.7) 9 (13.4) 10 (14.9) 6 (9.0) 67 (100) Other 41 (35.7) 38 (33.0) 18 (15.7) 18 (15.7) 115 (100) Unknown 2 (100) 0 (0.0) 0 (0.0) 0 (0.0) 2 (100) Total 652 (24.2) 865 (32.1) 680 (25.2) 497 (18.4) 2694 (100) Severity of injury No apparent injury 39 (31.2) 45 (36.0) 26 (20.8) 15 (12.0) 125 (100) <0.001 Minor 419 (25.5) 535 (32.5) 406 (24.7) 285 (17.3) 1645 (100) Moderate 171 (21.0) 262 (32.2) 225 (27.7) 155 (19.1) 813 (100) Severe 23 (20.7) 23 (20.7) 23 (20.7) 42 (37.8) 111 (100) Total 652 (24.2) 865 (32.1) 680 (25.2) 497 (18.4) 2694 (100) Abstract 432 Table 4Association of injury location, nature and severity with sex among children attending emergency of hospitals in Makwanpur district, Nepal, April 2019 – March 2020SexMaleFemaleTotalChi-SquareInjury characteristicsn (%)n (%)n (%)P valueLocation of injury sustained Home/Compound 979 (62.1) 597 (37.9) 1576 (100) <0.001 Highway/road/street 421 (66.2) 215 (33.8) 636 (100) School 176 (75.5) 57 (24.5) 233 (100) Recreational area 111 (80.4) 27 (19.6) 138 (100) Workplace 62 (81.6) 14 (18.4) 76 (100) Other 29 (78.4) 8 (21.6) 37 (100) Total 1778 (65.9) 918 (34.1) 2696 (100) Nature of injury Cuts, bites or open wound 959 (69.6) 419 (30.4) 1378 (100) <0.001 Bruise or superficial injury 246 (64.2) 137 (35.8) 383 (100) Fracture 200 (66.9) 99 (33.1) 299 (100) Sprain, strain or dislocation 154 (63.4) 89 (36.6) 243 (100) Internal injury 50 (40.3) 74 (59.7) 124 (100) Head Injury/Concussion 59 (71.1) 24 (28.9) 83 (100) Burns 27 (40.3) 40 (59.7) 67 (100) Other 79 (68.7) 36 (31.3) 115 (100) Unknown 2 (100) 0 (0.0) 2 (100) Total 1776 (65.9) 918 (34.1) 2694 (100) Severity of injury No apparent injury 81 (64.8) 44 (35.2) 125 (100) 0.048 Minor 1102 (67.0) 543 (33.0) 1645 (100) Moderate 533 (65.6) 280 (34.4) 813 (100) Severe 60 (54.1) 51 (45.9) 111 (100) Total 1776 (65.9) 918 (34.1) 2694 (100) Abstract 432 Table 5Distribution of injuries by outcome and mechanism of injury among children attending emergency of hospitals in Makwanpur district, Nepal, April 2019 – March 2020Outcome of injuryDischargedAdmittedTransferredDiedLAMAUnknownTotalIntent & mechanismsn (%)n (%)n (%)n (%)n (%)n (%)n (%)Unintentional Fall 787 (86.5) 65 (7.1) 53 (5.8) 0 (0.0) 4 (0.4) 1 (0.1) 910 (100) Animal/insect bite/sting 704 (96.7) 3 (0.4) 19 (2.6) 0 (0.0) 1 (0.1) 1 (0.1) 728 (100) Road traffic injury 260 (73.0) 47 (13.2) 44 (12.4) 5 (1.4) 0 (0.0) 0 (0.0) 356 (100) Injured by a blunt force 190 (94.5) 4 (2.0) 6 (3.0) 0 (0.0) 1 (0.5) 0 (0.0) 201 (100) Stabbed, cut or pierced 165 (93.8) 8 (4.5) 3 (1.7) 0 (0.0) 0 (0.0) 0 (0.0) 176 (100) Fire, burn or scald 52 (80.0) 12 (18.5) 1 (1.5) 0 (0.0) 0 (0.0) 0 (0.0) 65 (100) Poisoning 30 (57.7) 4 (7.7) 16 (30.8) 1 (1.9) 1 (1.9) 0 (0.0) 52 (100) Suffocation/choking/asphyxia 24 (66.7) 4 (11.1) 6 (16.7) 1 (2.8) 1 (2.8) 0 (0.0) 36 (100) Electrocution 7 (58.3) 2 (16.7) 2 (16.7) 1 (8.3) 0 (0.0) 0 (0.0) 12 (100) Drowning and submersion 4 (57.1) 0 (0.0) 0 (0.0) 3 (42.9) 0 (0.0) 0 (0.0) 7 (100) Other 12 (92.3) 1 (7.7) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 13 (100) Unknown 2 (100) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 2 (100) Total 2237 (87.5) 150 (5.9) 150 (5.9) 11 (0.4) 8 (0.3) 2 (0.1) 2558 (100) Self-harm Poisoning 5 (13.2) 8 (21.1) 23 (60.5) 0 (0.0) 2 (5.3) 0 (0.0) 38 (100) Hanging 1 (8.3) 0 (0.0) 1 (8.3) 10 (83.3) 0 (0.0) 0 (0.0) 12 (100) Stabbed, cut or pierced 6 (100) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 6 (100) Injured by blunt object 4 (100) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 4 (100) Other 1 (100) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 1 (100) Total 17 (27.9) 8 (13.1) 24 (39.3) 10 (16.4) 2 (3.3) 0 (0.0) 61 (100) Assault Bodily force (physical violence) 34 (79.1) 5 (11.6) 3 (7.0) 0 (0.0) 1 (2.3) 0 (0.0) 43 (100) Injured by blunt object 18 (100) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 18 (100) Stabbed, cut or pierced 6 (75.0) 1 (12.5) 1 (12.5) 0 (0.0) 0 (0.0) 0 (0.0) 8 (100) Pushing from a high place 2 (100) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 2 (100) Poisoning 1 (50) 0 (0.0) 1 (50.0) 0 (0.0) 0 (0.0) 0 (0.0) 2 (100) Sexual assault 1 (100) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 1 (100) Other 1 (100) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 0 (0.0) 1 (100) Total 63 (84.0) 6 (8.0) 5 (6.7) 0 (0.0) 1 (1.3) 0 (0.0) 75 (100) Abstract 432 Figure 1Seasonal variation of injuries identified by the injury surveillance system over a year among children attending emergency of hospitals in Makwanpur district, Nepal, April 2019 – March 2020Results/ConclusionsThe total number of ED patients with injury in the study was 10,154.2,696 were patients aged <18 years. Most injuries in children were unintentional and over half of children presenting with injuries were <10 years of age. Falls, animal bites/stings and road traffic injuries accounted for nearly 75% of all injuries with some (drowning, poisonings and burns) under-represented. Over half of injuries were cuts, bites and open wounds. The next most common injury types were superficial injuries (14.2%); fractures (11.1%); sprains/dislocations (9.0%). Child mortality was 1%.This is the biggest prospective injury surveillance study in a low or middle country in recent years and supports the use of injury surveillance in Nepal for reducing child morbidity and mortality through improved data.CHILD PAPER: RESULTS SECTIONTotal number of ED patients: 33046Total number of ED patient with injury: 10154 (adult=7458 & children=2696)8.2% (n=2696) patients with injury were children aged <18 yearsHetauda hospital: 2274 (84.3%)Chure hill hospital: 422 (15.7%)

This paper aims to portray the overall picture of poverty in the world and mentions the key solution to overcome poverty from a critical perspective. The data and figures were quoted from a number of researchers and organizations in the field of poverty around the world. Simultaneously, the information strengthens the correlations among poverty and lack of education. Only appropriate philosophies of education can improve the country’s socio-economic conditions and contribute to effective solutions to worldwide poverty. In the 21st century, despite the rapid development of science and technology with a series of inventions brought into the world to make life more comfortable, human poverty remains a global problem, especially in developing countries. Poverty, according to Lister (2004), is reflected by the state of “low living standards and/or inability to participate fully in society because of lack of material resources” (p.7). The impact and serious consequences of poverty on multiple aspects of human life have been realized by different organizations and researchers from different contexts (Fraser, 2000; Lister, 2004; Lipman, 2004; Lister, 2008). This paper will indicate some of the concepts and research results on poverty. Figures and causes of poverty, and some solutions from education as a key breaker to poverty will also be discussed. Creating a universal definition of poverty is not simple (Nyasulu, 2010). There are conflicts among different groups of people defining poverty, based on different views and fields. Some writers, according to Nyasulu, tend to connect poverty with social problems, while others focus on political or other causes. However, the reality of poverty needs to be considered from different sides and ways; for that reason, the diversity of definitions assigned to poverty can help form the basis on which interventions are drawn (Ife and Tesoriero, 2006). For instance, in dealing with poverty issues, it is essential to intervene politically; economic intervention is very necessary to any definition of this matter. A political definition necessitates political interventions in dealing with poverty, and economic definitions inevitably lead to economic interventions. Similarly, Księżopolski (1999) uses several models to show the perspectives on poverty as marginal, motivation and socialist. These models look at poverty and solutions from different angles. Socialists, for example, emphasize the responsibilities of social organization. The state manages the micro levels and distributes the shares of national gross resources, at the same time fighting to maintain the narrow gap among classes. In his book, Księżopolski (1999) also emphasizes the changes and new values of charity funds or financial aid from churches or organizations recognized by the Poor Law. Speaking specifically, in the new stages poverty has been recognized differently, and support is also delivered in limited categories related to more specific and visible objectives, with the aim of helping the poor change their own status for sustainable improvement. Three ways of categorizing the poor and locating them in the appropriate places are (1) the powerless, (2) who is willing to work and (3) who is dodging work. Basically, poverty is determined not to belong to any specific cultures or politics; otherwise, it refers to the situation in which people’s earnings cannot support their minimum living standard (Rowntree, 1910). Human living standard is defined in Alfredsson & Eide’s work (1999) as follows: “Everyone has the right to a standard of living adequate for the health and well-being of himself and his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.” (p. 524). In addition, poverty is measured by Global Hunger Index (GHI), which is calculated by the International Food Policy Institute (IFPRI) every year. The GHI measures hunger not only globally, but also by country and region. To have the figures multi-dimensionally, the GHI is based on three indicators: 1. Undernourishment: the proportion of the undernourished as a percentage of the population (reflecting the share of the population with insufficient calorie intake). 2. Child underweight: the proportion of children under age 5 who are underweight (low weight for their age, reflecting wasting, stunted growth or both), which is one indicator of child under-nutrition. 3. Child mortality: the mortality rate of children under 5 (partially reflecting the fatal synergy of inadequate dietary intake and unhealthy environments). Apart from the individual aspects and the above measurement based on nutrition, which help partly imagine poverty, poverty is more complicated, not just being closely related to human physical life but badly affecting spiritual life. According to Jones and Novak (1999 cited in Lister, 2008), poverty not only characterizes the precarious financial situation but also makes people self-deprecating. Poverty turns itself into the roots of shame, guilt, humiliation and resistance. It leads the poor to the end of the road, and they will never call for help except in the worst situations. Education can help people escape poverty or make it worse. In fact, inequality in education has stolen opportunity for fighting poverty from people in many places around the world, in both developed and developing countries (Lipman, 2004). Lipman confirms: “Students need an education that instills a sense of hope and possibility that they can make a difference in their own family, school, and community and in the broader national and global community while it prepare them for multiple life choices.” (p.181) Bradshaw (2005) synthesizes five main causes of poverty: (1) individual deficiencies, (2) cultural belief systems that support subcultures of poverty, (3) economic, political and social distortions or discrimination, (4) geographical disparities and (5) cumulative and cyclical interdependencies. The researcher suggests the most appropriate solution corresponding with each cause. This reflects the diverse causes of poverty; otherwise, poverty easily happens because of social and political issues. From the literature review, it can be said that poverty comes from complex causes and reasons, and is not a problem of any single individual or country. Poverty has brought about serious consequences and needs to be dealt with by many methods and collective effort of many countries and organizations. This paper will focus on representing some alarming figures on poverty, problems of poverty and then the education as a key breaker to poverty. According to a statistics in 2012 on poverty from the United Nations Development Program (UNDP), nearly half the world's population lives below the poverty line, of which is less than $1.25 a day . In a statistics in 2015, of every 1,000 children, 93 do not live to age 5 , and about 448 million babies are stillborn each year . Poverty in the world is happening alarmingly. According to a World Bank study, the risk of poverty continues to increase on a global scale and, of the 2009 slowdown in economic growth, which led to higher prices for fuel and food, further pushed 53 million people into poverty in addition to almost 155 million in 2008. From 1990 to 2009, the average GHI in the world decreased by nearly one-fifth. Many countries had success in solving the problem of child nutrition; however, the mortality rate of children under 5 and the proportion of undernourished people are still high. From 2011 to 2013, the number of hungry people in the world was estimated at 842 million, down 17 percent compared with the period 1990 to 1992, according to a report released by the Food and Agriculture Organization of the United Nations (FAO) titled “The State of Food Insecurity in the World 2013” . Although poverty in some African countries had been improved in this stage, sub-Saharan Africa still maintained an area with high the highest percentage of hungry people in the world. The consequences and big problems resulting from poverty are terrible in the extreme. The following will illustrate the overall picture under the issues of health, unemployment, education and society and politics ➢ Health issues: According a report by Manos Unidas, a non- government organization (NGO) in Spain , poverty kills more than 30,000 children under age 5 worldwide every day, and 11 million children die each year because of poverty. Currently, 42 million people are living with HIV, 39 million of them in developing countries. The Manos Unidas report also shows that 15 million children globally have been orphaned because of AIDS. Scientists predict that by 2020 a number of African countries will have lost a quarter of their population to this disease. Simultaneously, chronic drought and lack of clean water have not only hindered economic development but also caused disastrous consequences of serious diseases across Africa. In fact, only 58 percent of Africans have access to clean water; as a result, the average life expectancy in Africa is the lowest in the world, just 45 years old (Bui, 2010). ➢ Unemployment issues: According to the United Nations, the youth unemployment rate in Africa is the highest in the world: 25.6 percent in the Middle East and North Africa. Unemployment with growth rates of 10 percent a year is one of the key issues causing poverty in African and negatively affecting programs and development plans. Total African debt amounts to $425 billion (Bui, 2010). In addition, joblessness caused by the global economic downturn pushed more than 140 million people in Asia into extreme poverty in 2009, the International Labor Organization (ILO) warned in a report titled The Fallout in Asia, prepared for the High-Level Regional Forum on Responding to the Economic Crisis in Asia and the Pacific, in Manila from Feb. 18 to 20, 2009 . Surprisingly, this situation also happens in developed countries. About 12.5 million people in the United Kingdom (accounting for 20 percent of the population) are living below the poverty line, and in 2005, 35 million people in the United States could not live without charity. At present, 620 million people in Asia are living on less than $1 per day; half of them are in India and China, two countries whose economies are considered to be growing. ➢ Education issues: Going to school is one of the basic needs of human beings, but poor people cannot achieve it. Globally, 130 million children do not attend school, 55 percent of them girls, and 82 million children have lost their childhoods by marrying too soon (Bui, 2010). Similarly, two-thirds of the 759 million illiterate people in total are women. Specifically, the illiteracy rate in Africa keeps increasing, accounting for about 40 percent of the African population at age 15 and over 50 percent of women at age 25. The number of illiterate people in the six countries with the highest number of illiterate people in the world - China, India, Indonesia, Brazil, Bangladesh and Egypt - reached 510 million, accounting for 70 percent of total global illiteracy. ➢ Social and political issues: Poverty leads to a number of social problems and instability in political systems of countries around the world. Actually, 246 million children are underage labors, including 72 million under age 10. Simultaneously, according to an estimate by the United Nations (UN), about 100 million children worldwide are living on the streets. For years, Africa has suffered a chronic refugee problem, with more than 7 million refugees currently and over 200 million people without homes because of a series of internal conflicts and civil wars. Poverty threatens stability and development; it also directly influences human development. Solving the problems caused by poverty takes a lot of time and resources, but afterward they can focus on developing their societies. Poverty has become a global issue with political significance of particular importance. It is a potential cause of political and social instability, even leading to violence and war not only within a country, but also in the whole world. Poverty and injustice together have raised fierce conflicts in international relations; if these conflicts are not satisfactorily resolved by peaceful means, war will inevitably break out. Obviously, poverty plus lack of understanding lead to disastrous consequences such as population growth, depletion of water resources, energy scarcity, pollution, food shortages and serious diseases (especially HIV/AIDS), which are not easy to control; simultaneously, poverty plus injustice will cause international crimes such as terrorism, drug and human trafficking, and money laundering. Among recognizable four issues above which reflected the serious consequences of poverty, the third ones, education, if being prioritized in intervention over other issues in the fighting against poverty is believed to bring more effectiveness in resolving the problems from the roots. In fact, human being with the possibility of being educated resulted from their distinctive linguistic ability makes them differential from other beings species on the earth (Barrow and Woods 2006, p.22). With education, human can be aware and more critical with their situations, they are aimed with abilities to deal with social problems as well as adversity for a better life; however, inequality in education has stolen opportunity for fighting poverty from unprivileged people (Lipman, 2004). An appropriate education can help increase chances for human to deal with all of the issues related to poverty; simultaneously it can narrow the unexpected side-effect of making poverty worse. A number of philosophies from ancient Greek to contemporary era focus on the aspect of education with their own epistemology, for example, idealism of Plato encouraged students to be truth seekers and pragmatism of Dewey enhanced the individual needs of students (Gutex, 1997). Education, more later on, especially critical pedagogy focuses on developing people independently and critically which is essential for poor people to have ability of being aware of what they are facing and then to have equivalent solutions for their problems. In other words, critical pedagogy helps people emancipate themselves and from that they can contribute to transform the situations or society they live in. In this sense, in his most influential work titled “Pedagogy of the Oppressed” (1972), Paulo Freire carried out his critical pedagogy by building up a community network of peasants- the marginalized and unprivileged party in his context, aiming at awakening their awareness about who they are and their roles in society at that time. To do so, he involved the peasants into a problem-posing education which was different from the traditional model of banking education with the technique of dialogue. Dialogue wasn’t just simply for people to learn about each other; but it was for figuring out the same voice; more importantly, for cooperation to build a social network for changing society. The peasants in such an educational community would be relieved from stressfulness and the feeling of being outsiders when all of them could discuss and exchange ideas with each other about the issues from their “praxis”. Praxis which was derived from what people act and linked to some values in their social lives, was defined by Freire as “reflection and action upon the world in order to transform it” (p.50). Critical pedagogy dialogical approach in Pedagogy of the Oppressed of Freire seems to be one of the helpful ways for solving poverty for its close connection to the nature of equality. It doesn’t require any highly intellectual teachers who lead the process; instead, everything happens naturally and the answers are identified by the emancipation of the learners themselves. It can be said that the effectiveness of this pedagogy for people to escape poverty comes from its direct impact on human critical consciousness; from that, learners would be fully aware of their current situations and self- figure out the appropriate solutions for their own. In addition, equality which was one of the essences making learners in critical pedagogy intellectually emancipate was reflected via the work titled “The Ignorant Schoolmaster” by Jacques Rancière (1991). In this work, the teacher and students seemed to be equal in terms of the knowledge. The explicator- teacher Joseph Jacotot employed the interrogative approach which was discovered to be universal because “he taught what he didn’t know”. Obviously, this teacher taught French to Flemish students while he couldn’t speak his students’ language. The ignorance which was not used in the literal sense but a metaphor showed that learners can absolutely realize their capacity for self-emancipation without the traditional teaching of transmission of knowledge from teachers. Regarding this, Rancière (1991, p.17) stated “that every common person might conceive his human dignity, take the measure of his intellectual capacity, and decide how to use it”. This education is so meaningful for poor people by being able to evoking their courageousness to develop themselves when they always try to stay away from the community due the fact that poverty is the roots of shame, guilt, humiliation and resistance (Novak, 1999). The contribution of critical pedagogy to solving poverty by changing the consciousness of people from their immanence is summarized by Freire’s argument in his “Pedagogy of Indignation” as follows: “It is certain that men and women can change the world for the better, can make it less unjust, but they can do so from starting point of concrete reality they “come upon” in their generation. They cannot do it on the basis of reveries, false dreams, or pure illusion”. (p.31) To sum up, education could be an extremely helpful way of solving poverty regarding the possibilities from the applications of studies in critical pedagogy for educational and social issues. Therefore, among the world issues, poverty could be possibly resolved in accordance with the indigenous people’s understanding of their praxis, their actions, cognitive transformation, and the solutions with emancipation in terms of the following keynotes: First, because the poor are powerless, they usually fall into the states of self-deprecation, shame, guilt and humiliation, as previously mentioned. In other words, they usually build a barrier between themselves and society, or they resist changing their status. Therefore, approaching them is not a simple matter; it requires much time and the contributions of psychologists and sociologists in learning about their aspirations, as well as evoking and nurturing the will and capacities of individuals, then providing people with chances to carry out their own potential for overcoming obstacles in life. Second, poverty happens easily in remote areas not endowed with favorable conditions for development. People there haven’t had a lot of access to modern civilization; nor do they earn a lot of money for a better life. Low literacy, together with the lack of healthy forms of entertainment and despair about life without exit, easily lead people into drug addiction, gambling and alcoholism. In other words, the vicious circle of poverty and powerlessness usually leads the poor to a dead end. Above all, they are lonely and need to be listened to, shared with and led to escape from their states. Community meetings for exchanging ideas, communicating and immediate intervening, along with appropriate forms of entertainment, should be held frequently to meet the expectations of the poor, direct them to appropriate jobs and, step by step, change their favorite habits of entertainment. Last but not least, poor people should be encouraged to participate in social forums where they can both raise their voices about their situations and make valuable suggestions for dealing with their poverty. Children from poor families should be completely exempted from school fees to encourage them to go to school, and curriculum should also focus on raising community awareness of poverty issues through extracurricular and volunteer activities, such as meeting and talking with the community, helping poor people with odd jobs, or simply spending time listening to them. Not a matter of any individual country, poverty has become a major problem, a threat to the survival, stability and development of the world and humanity. Globalization has become a bridge linking countries; for that reason, instability in any country can directly and deeply affect the stability of others. The international community has been joining hands to solve poverty; many anti-poverty organizations, including FAO (Food and Agriculture Organization), BecA (the Biosciences eastern and central Africa), UN-REDD (the United Nations Programme on Reducing Emissions from Deforestation and Forest Degradation), BRAC (Building Resources Across Communities), UNDP (United Nations Development Programme), WHO (World Health Organization) and Manos Unidas, operate both regionally and internationally, making some achievements by reducing the number of hungry people, estimated 842 million in the period 1990 to 1992, by 17 percent in 2011- to 2013 . The diverse methods used to deal with poverty have invested billions of dollars in education, health and healing. The Millennium Development Goals set by UNDP put forward eight solutions for addressing issues related to poverty holistically: 1) Eradicate extreme poverty and hunger. 2) Achieve universal primary education. 3) Promote gender equality and empower women. 4) Reduce child mortality. 5) Improve maternal health. 6) Combat HIV/AIDS, malaria and other diseases. 7) Ensure environmental sustainability. 8) Develop a global partnership for development. Although all of the mentioned solutions carried out directly by countries and organizations not only focus on the roots of poverty but break its circle, it is recognized that the solutions do not emphasize the role of the poor themselves which a critical pedagogy does. More than anyone, the poor should have a sense of their poverty so that they can become responsible for their own fate and actively fight poverty instead of waiting for help. It is not different from the cores of critical theory in solving educational and political issues that the poor should be aware and conscious about their situation and reflected context. It is required a critical transformation from their own praxis which would allow them to go through a process of learning, sharing, solving problems, and leading to social movements. This is similar to the method of giving poor people fish hooks rather than giving them fish. The government and people of any country understand better than anyone else clearly the strengths and characteristics of their homelands. It follows that they can efficiently contribute to causing poverty, preventing the return of poverty, and solving consequences of the poverty in their countries by many ways, especially a critical pedagogy; and indirectly narrow the scale of poverty in the world. In a word, the wars against poverty take time, money, energy and human resources, and they are absolutely not simple to end. Again, the poor and the challenged should be educated to be fully aware of their situation to that they can overcome poverty themselves. They need to be respected and receive sharing from the community. All forms of discrimination should be condemned and excluded from human society. When whole communities join hands in solving this universal problem, the endless circle of poverty can be addressed definitely someday. More importantly, every country should be responsible for finding appropriate ways to overcome poverty before receiving supports from other countries as well as the poor self-conscious responsibilities about themselves before receiving supports from the others, but the methods leading them to emancipation for their own transformation and later the social change.

The debate about diagnoses and treatment of attention deficit hyperactive disorder (ADHD) in children continue to range on between the developmental and biological perspectives. While there is increasing evidence that support the biological susceptibility of the disorder, a number of researches also emphasized the significant effect of environment on the syndrome. This study used developmental perspectives to evaluate and bring together various bio-psychosocial factors that impact on children diagnosed with ADHD. The study explored and integrated the existing and advancing study on ADHD to a more refined pattern that embraced developmental perspectives. The study also discussed how the linkage in childhood ADHD fits within the developmental psychopathology perspective. The study revealed that ADHD as a developmental disorder is influenced by prenatal, biological and psychosocial environmental risk factors, and suggested that better understanding of genomic susceptibilities, family environment and parental characteristics would transform the pathway for development of ADHD in children. References American Psychiatric Association.(2000). Diagnostic and StatisticalManual of MentalDisorders. 4th ed. Washington, DC: American Psychiatric Association. American Psychiatric Association.(2013). Diagnostic and StatisticalManual of MentalDisorders.5th ed. Washington, DC: American Psychiatric Association. Arnsten, A.F, (2007). Catecholamine and second messenger influenceson prefrontalcortical networks of “representational knowledge”:a rational bridge between genetics andthe symptoms of mental illness. Cerebral Cortex, 17, i6–i15. Arnsten, A.F, & Pliszka, S.R. (2011). Catecholamine influences on prefrontalcorticalfunction: relevance to treatment of attentiondeficit/hyperactivity disorder and relateddisorders. Pharmacology, Biochemistry and Behavior, 99, 211–216. Atladóttir H.O, Parner E.T, & Schendel D. (2007). Variation in incidence ofneurodevelopmental disorders with season of birth. Epidemiology, 18, 240–245. Barkley, R. A. (2006). Attention deficit/hyperactivity disorder: A handbook for diagnosisand treatment (3rd ed.). New York: Guilford Baumeister A.A, Hawkins M.F (2001). Incoherence of neuroimaging studies of attentiondeficit/ hyperactivity disorder. Clinical Neuropharmacology, 24, 2–10. Berger I. (2011). Diagnosis of attention deficit hyperactivity disorder: much ado aboutsomething. Israeli Medical Association Journal, 13, 571–574. Berger, A., Posner, M. I. (2000). Pathologies of brain attentionalnetworks. Neuroscienceand Biobehavioral Reviews, 24, 3–5. Biederman J, Faraone S.V, Keenan K, Knee D, &Tsuang M.T (1990): Familygenetic andpsychosocial risk factors in DSM-III attention deficit disorder. Journal of AmericanAcademy of Child and Adolescent Psychiatry, 29, 526 –533. Biederman J, Faraone SV, Keenan K, Tsuang MT (1991b): Evidence of familialassociationbetween attention deficit disorder and major affective disorders. Archives of GeneralPsychiatry, 48, 633–642. Biederman, J, Faraone, S.V, Keenan K, Benjamin, J, Krifcher, B. &Moore C. et al (1992).Further evidence for family-genetic risk factors in attention deficit hyperactivity disorder.Patterns of comorbidity in probands and relativesin psychiatrically and pediatricallyreferred samples. Archives of General Psychiatry, 49, 728 –738. Biederman, J., Milberger, S., Faraone, S. V., Kiely, K., Guite, J.,Mick, E., Ablon, S., Warburton, R., & Reed, E. (1995). Family environment risk factors for attention deficithyperactivity disorder: A test of Rutter’s indicators of adversity. Archives of GeneralPsychiatry, 52, 464–470. Biederman, J., Faraone, S.V., Mick, E., Spencer,T.,Wilens,T., Kiely,K., Guite, J., Ablon, J.S., Reed, E., & Warburton, R. (1995). High risk for attention deficit hyperactivity disorderamong children of parents with childhood onset of the disorder: A pilot study. Journal ofAmerican Psychiatry, 152, 431–435. Biederman J, Faraone S.V, Monuteaux M, Spencer T, Wilens T, Bober M, et al (2004).Gender effects of attention deficit hyperactivity disorder inadults, revisited. BiologicalPsychiatry, 55, 692–700. Brookes, K.,Mill, J.,&Guindalini,C., et al (2006). Acommon haplotype of the dopaminetransporter geneassociated with attention-deficit/hyperactivity disorderand interactingwithmaternal use of alcohol duringpregnancy. Archives of General Psychiatry, 63, 74–81. Brophy, K., Hawi, Z., Kirley, A., Fitzgerald, M., & Gill, M. (2002). Synaptosomalassociated protein 25 (SNAP-25) and attention deficit hyperactivity disorder (ADHD):Evidence of linkage and association in the Irish population. Molecular Psychiatry, 7 , 913–917 Campbell, S. B. (2000). Attention-Deficit/Hyperactivity Disorder: A developmental view.In: Handbook of Developmental Psychopathology. (pp. 383–401). A. J. Sameroff, M.Lewis, & S. Miller (Eds.). New York: Kluwer Academic/Plenum. Carlson, E. A., Jacobvitz, D., & Sroufe, L. A. (1995). A developmental investigation ofinattentiveness and hyperactivity. Child Development, 66, 37–54. Childress, A.C, Berry, S.A (2012). Pharmacotherapy of attention-deficit hyperactivitydisorder in adolescents. Drugs, 72, 309–325. Cortese, S (2012). The neurobiology and genetics of attention-deficit/hyperactivitydisorder (ADHD): what every clinician shouldknow. European Journal of PaediatricNeurology, 16, 422–433. Dopheide, J.A (2005). ASHP therapeutic position statement on theappropriate use ofmedications in the treatment of attention deficit/hyperactivity disorder in paediatricpatients. American Journal of Health System Pharmacy, 62, 1502– 1509. Coghill, D., Nigg, J., Rothenberger, A., Sonuga-Barke, E., & Tannock, R. (2005). Withercausal models in the neuroscience of ADHD? Developmental Science, 8, 105–114. Cummings, E. M., Davies, P., & Campbell, S. B. (2000). Developmental Psychopathologyand Family Process: Research, Theory, and Clinical Implications. New York: Guilford. Faraone, S. V., Perlis, R. H., Doyle, A. E., Smoller, J. W., Goralnick, J. J., Holmgren, M.A., et al. (2005). Molecular genetics of attention-defi cit/hyperactivity disorder. BiologicalPsychiatry, 57 , 1313–1323. Faraone, S, Biederman, J, Krifcher Lehman, B, Keenan, K, Norman, D, Seidman, L. et al.(1993). Evidence for the independent familial transmission of attentiondeficit hyperactivitydisorder and learning disabilities: Results froma family genetic study. American Journalof Psychiatry, 150, 891– 895. Faraone, S. V, Tsuang, M. T. (1995). Methods in psychiatric genetics. In: Textbook inPsychiatric Epidemiology, Tohen, M, Tsuang, M., Zahner, G. (Eds). (pp. 81–134). NewYork: John Wiley& Sons. Faraone, S. V. & Biederman, J. (1998). Neurobiology of attentiondeficit hyperactivitydisorder. Biological Psychiatry, 44, 951–958. Faraone S.V, Biederman J, &MonuteauxM.C. (2001a). Attention deficit hyperactivitydisorder with bipolar disorder in girls: Further evidence for a familial subtype? Journal ofAffect Disorders, 64, 19 –26. Haraone S.V, Doyle A.E (2001): The nature and heritability of attentiondeficit/hyperactivity disorder. Child and Adolescent Psychiatric Clinics of North America,10, 299 –316, viii–ix. Faraone, S.V., & Biederman, J. (2000). Nature, nuture, and attentiondeficit hyperactivitydisorder. Developmental Review, 20, 568–581. Faraone S.V, Perlis R.H, Doyle A.E, Smoller J.W, Goralnick J, &Holmgren M.A, et al.(2005). Molecular genetics of attention deficit hyperactivity disorder. BiologicalPsychiatry, 57, 1313–1323. Gray, J. A., Feldon, J., Rawlins, J. N. P., Hemsley, D. R., & Smith, A. D. (1991) Theneuropsychology of schizophrenia. Behavioral and Brain Sciences, 14, 1–84. Gray, J. A. (1982). The neumpsychology of anxiety. New York: Oxford University Press. Halperin, J. M., & Healey, D. M. (2011). The infl uences of environmental enrichment,cognitive enhancement,and physical exercise on brain development: Can we alter thedevelopmental trajectory of ADHD? Neuroscience and Biobehavioral Reviews, 35 , 621–634. Hauschild K.M, Mouridsen S.E, & Nielsen S. (2005). Season of birth inDanish childrenwith language disorder born in the 1958–1976 period. Neuropsychobiology; 51, 93–99. Hudziak J.J, Rudiger L.P, Neale M.C, Heath A.C, & Todd R.D (2000). A twin study ofinattentive,aggressive, and anxious/depressed behaviors. Journal of the American Academyof Child and Adolescent Psychiatry, 39, 469 –476. Kahn, R. S., Khoury, J. & Nichols,W.C., et al (2003). Role of dopamine transportergenotype and maternal prenatal smoking in childhood hyperactive-impulsive,inattentive,and oppositional behaviors. Journal of Pediatrics, 143, 104–110. Kesner R.P, & Churchwell J.C (2011). An analysis of rat prefrontal cortexin mediatingexecutive function. Neurobiology of Learning and Memory, 96, 417–431. Kuntsi, J.,& Stevenson, J. (2000). Hyperactivity in children:Afocuson genetic research andpsychological theories. Clinical Child and Family Psychology Review, 3, 1–24. Langley, K., Rice, F., & van den Bree, M. B., et al (2005). Maternal smoking duringpregnancy as an environmental risk factor for attention deficit hyperactivity disorderbehaviour. A Review. Minerva Pediatrica, 57, 359–371. Manshadi M, Lippmann S, O’Daniel R, & Blackman A (1983): Alcohol abuse andattention deficit disorder. Journal of Clinical Psychiatry, 44, 379 –380 Martin N, Scourfield J, McGuffin P (2002).Observer effects and heritability ofchildhoodattention-deficit hyperactivity disorder symptoms. British Journal of Psychiatry, 80, 260 –265. Neale, B. M., Medland, S. E., Ripke, S., Asherson, P., Franke, B., Lesch, K. P., et al.(2010). Meta-analysis of genome-wide association studies of attention-defi cit/hyperactivity disorder. Journal of the American Academy of Child and AdolescentPsychiatry, 49 , 884–897. Nigg J, Nikolas M, & Burt S. A(2010). Measured gene-by-environment interaction inrelation to attention-deficit/hyperactivity disorder. Journal of the American Academy ofChild and Adolescent Psychiatry, 49, 863–73. Oades, R. D., Lasky-Su, J., Christiansen, H., Faraone, S.V., Sonuga-Barke, E. J., Banaschewski, T., et al. (2008). The influence of serotonin- and other genes onimpulsivebehavioral aggression and cognitive impulsivity in children with attentiondeficit/hyperactivity. A Developmental Perspective on ADHD disorder (ADHD): Findingsfrom a family-based association test (FBAT) analysis. Behavioral and Brain Functions, 4,4–48. Pastor P. N & Reuben C.A. (2008). Diagnosed attention deficit hyperactivity disorder andlearning disability: United States, 2004–2006. Vital Health Statistics, 10, 1–14. Quay, H. C. (1988a). Attention deficit disorder and the behavioral inhibitionsystem: Therelvance of the neuropsychological theory of Jeffrey A. Gray. In: Attention deficitdisorder: Criteria, cognition, intervention (pp. 117–126). L. M. Bloomingdale & J.Sergeant (Eds.). NewYork: Pergamon. Quay, H. C. (1988b). The behavioral reward and inhibition systems inchildhood behaviordisorder. In: Attentiondeficit disorder W; New research in treatment, psychopharnmcology,and attention (pp. 176–186). L. M. Bloomingdale (Ed.). NA: Pergamon. Quay, H. C. (1996, January). Gray'sbehavioral inhibition in ADHD:An update. Paperpresented at the annual meeting of the InternationalSociety for Research in Child andAdolescent Psychopathology, Los Angeles, CA. Rader, R, McCauley L,& Callen, E.C. (2009). Current strategies in thediagnosis andtreatment of childhood attention-deficit/hyperactivity disorder. American FamilyPhysician, 79, 657–665. Robbins, T. W. (2003). Dopamine and cognition. Currpin Neurol,16, (2), S1–S2. Rutter, M, Cox, A, Tupling, C, Berger, M, &Yule, W. (1975). Attainment and adjustmentin two geographical areas. 1—The prevalence of psychiatric disorders. British Journal ofPsychiatry, 126, 493–509. Rutter, M., &Sroufe, L. A. (2000). Developmental psychopathology: Concepts andchallenges. Development and Psychopathology, 12, 265–296. Sergeant, J. (2000). The cognitive-energetic model: An empiricalapproach to attentiondeficit hyperactivity disorder. Neuroscienceand Biobehavioral Reviews, 24, 7–12. Sherman D, McGue M, &Iacono W (1997). Twin concordance for attention deficithyperactivity disorder: A comparison of teachers’ and mothers’reports. American Journalof Psychiatry, 154, 532–535. Sonuga-Barke, E. J., Auerbach, J., Campbell, S. B., Daley, D., & Thompson, M. (2005).Preschool varieties of hyperactive and dysregulated behaviour: Multiple pathways betweenrisk and disorder. Developmental Science, 8 , 141–150. Sonuga-Barke, E. J., Bitsakou, P., & Thompson, M. (2010). Beyond the dual pathwaymodel: Evidence for the dissociation of timing, inhibitory, and delayrelated impairments inattention-defi cit/hyperactivity disorder. Journal of the American Academy of Child andAdolescent Psychiatry, 49 , 345–355. Sonuga-Barke, E. J., & Halperin, J. (2010). Developmental phenotypes and causalpathways in attention deficit/hyperactivity disorder: Potential targets for earlyintervention? Journal of Child Psychology and Psychiatry, 51, 368–398. Sprich-Buckminster S, Biederman J, Milberger S, Faraone S, &Krifcher LehmanB (1993):Are perinatal complications relevant to the manifestation ofADD? Issues of comorbidityand familiality. Journal of American Academy of Child and Adolescent Psychiatry,32,1032–1037 Swanson, J. M., Sunohara, G. A., Kennedy, J. L., Regino,R., Fineberg, E.,Wigal, T.,Lerner, M.,Williams, L., LaHoste,G. J.,&Wigal, S. (1998). Association of the dopaminereceptorD4 (DRD4) gene with a refined phenotype of attention deficithyperactivitydisorder (ADHD): A family–based approach.Molecular Psychiatry, 3, 38–41. Taylor, E. (1999). Developmental neuropsychopathology of attentiondeficit and impulsiveness. Development and Psychopathology, 11, 607–628. Thapar, A.,O’Donovan,M., &Owen,M. J. (2005b). The genetics of attention deficithyperactivity disorder. Human Molecular Genetics, 14, 275–282. Thapar, A., Langley, K.,O’Donovan,M. (2006). Refining the attention deficithyperactivity disorderphenotype formolecular genetic studies. Molecular Psychiatry, 11,714–720. Thapar A, Langley K, &Asherson P, (2007). Gene–environment interplay in attentiondeficit hyperactivity disorder and the importance of a developmental perspective. BritishJournal of Psychiatry 190, 1–3. Tochigi M, Okazaki Y, & Kato N, (2004). What causes seasonality of birth inschizophrenia? Neuroscience Res, 48, 1–11 Trent S & Davies W. (2012). The influence of sex-linked genetic mechanisms on attentionand impulsivity. Biological Psychology, 89, 1–13. United States, 2003 and 2007 (2010). Increasing prevalence of parent-reported attentiondeficit/hyperactivity disorder among children, MMWR Morb Mortal Wekly Rep, 59, 1439–43. Yehuda, R. (2000). Biology of posttraumatic stress disorder. Journal of ClinicalPsychiatry, 61, 14–21. Zimmer, L (2009). Positron emission tomography neuroimagingfor a better understandingof the biology of ADHD. Neuropharmacology, 57, 601–607.

Shainool Jiwa’s The Rise of a Muslim Empire is a two-volume historical work on the legacy of the Fatimid Empire. The first volume surveys the religious and sociopolitical underpinnings of Fatimid rule from its North African establishment in 909 to its transition to Egypt in 969. Jiwa’s second vol- ume focuses on the pinnacle of Fatimid society up until its decline from 969-1171. This review pertains to the first of the two volumes. Working within this phase, Jiwa details the reigns of the first four Imams: ‘Abd Allāh al-Mahdī, Abū’l-Qāsim Muḥammad, Ismāʿīl al-Manṣūr, and al-Muʿizz li- Dīn Allāh. The second book, which is titled The Fatimid Rule from Egypt, discusses the latter ten Imams (4). The first chapter covers the origins of the Fatimids in respect to both religious and geographical contexts. Jiwa starts by providing the historical background of Ismaili Shiism. Here, everything from the succession crisis of 632 CE to the emergence of the different strands of Shiism are discussed. Jiwa describes the Ismaili sect as having held Ismāʿīl, the eldest son of Jaʿfar al-Ṣādiq, to have been the chosen successor of his father, therefore mak- ing him Imam. Ismāʿīl’s ephemeral mortality caused for the Imamate to then pass over to his young son, Muḥammad b. Ismāʿīl, eponym of the sect (10). The Twelvers are described as having believed in the Imamate of Jaʿfar’s youngest son, Mūsā, whose lineage gives root to the Imams of Twelver Shiism. Jiwa characterizes Ismaili beliefs as having rested on dawr al-satr (period of concealment) and daʿwa (religio-political mission) (11). The dawr al-satr refers to the Imams going into hiding with only their most trusted followers knowing their true identities. Subsequently, these follow- ers promoted the recognition of these hidden Imams, which in large part refers to daʿwa (the act of inviting). Jiwa explains that during dawr al-satr (765–909 CE) Ismaili doctrine had spread as far as from Yemen to Ifriqiya (modern-day Tunisia and eastern Algeria) (12), with its most prominent adherents being the Kutama Berbers of North Africa. Under the teachings of Abū ‘Abd Allāh al-Shīʿī, a pronounced Ismaili dāʿī (inviter), the Kutama had aspired to establish the dawlat al-ḥaqq (the righteous state) (16). This aspiration materialized under the allegiance of ‘Abd Allāh al-Mahdī who had been pronounced as Imam by his predecessor and later recognized as the mahdī (messianic figure) (20). This belief, nonetheless, was not accepted by all Ismailis, particularly those following Ḥamdān Qarmaṭ, who later came to be known as the Qaramiṭa (21). Sa- lamiyya (a town located in Syria), the town where ‘Abd Allāh al-Mahdī had resided, became unsafe due to Abbasid persecution, causing the Imam to migrate to various locations and eventually Sijilmasa (22). Meanwhile, the Kutama had grown to such a force that they had been able to seize control over Qayrawān of North Africa under the leadership of al-Shīʿī (22). When al-Mahdī was later arrested in Sijilmasa and the news spread to the Kuta- ma, a campaign of soldiers marched to secure his release and bring him to Qayrawān. Having accomplished this, the Fatimid State came into fruition (22). Jiwa provides sources detailing the events which led up to the Fatim- id establishment, including eyewitness accounts from Jaʿfar al-Ḥājib’s Sīrat Jaʿfar al-Ḥājib, secondary sources such as Aḥmad b. Ibrāhīm al-Naysābūrī’s Istitār al-Imām (‘The Concealment of the Imam’), and other historical works such as the influential Iftitāh al-daʿwa wa-ibtidāʿ al-dawla (‘Com- mencement of the Mission and the Beginnings of the State’) authored by Abū Ḥanīfa al-Nuʿmān (29-30). These references help readers pinpoint who was instrumental in recording Fatimid history. In chapter two, Jiwa discusses the establishment of the Fatimid state, giving details of its institutions, processes, and hallmark locations. Al-Mah- dī is seen to have incorporated officials who had previously served the Aghlabids (the previous rulers of Qayrawān). In addition, institutions such as maẓālim (oppressive acts) courts are discussed as having been estab- lished to provide redress for ordinary civilians against abuses of power (35). During this time of development, dissension amongst the Kutama is seen to have imploded on the basis of marginalized sentiments. Once having been one of the most loyal dāʿīs to al-Mahdī, al-Shīʿī had led a rebellion against his former Imam on charges of being a false mahdī. Ultimately this campaign was pacified, resulting in the execution of al Shīʿī. This chapter also reveals new characters who later became prominent figures in Fatimid history. The heir apparent or Prince Abū’l-Qāsim Muḥammad, the eldest son of al-Mahdī, already took up much of his father’s duties while his own son, Ismāʿīl or al-Manṣūr bi’llāh (‘the One Who is Victorious by God’) was entrusted by the sitting Imam, al-Mahdī (his grandfather), as his most faithful confidant (39). The port city of al-Mahdiyya which had been con- structed by the Fatimids in 916 is described as having been unique in its architectural design and strategic in its location. Al-Mahdiyya served as the new Mediterranean capital and had secured the Fatimids a booming com mercial fabric. Similarly, the city of Palermo in Sicily had been occupied by the Fatimids and had also brought a great deal of cultural exchange and goods. Jiwa brings out images of palaces and charts out maps of the port city to provide visual comprehension of the architecture. Chapter three surveys the reign of al-Manṣūr, discussing his ascension to power under fraught circumstances and his construction of a new city. This chapter focuses attention on the reconstruction of Palermo in vivid archaeological detail. Readers are informed of the Khariji rebellion from Ifrīqiya spearheaded by Abū Yazīd al-Nukkarī. The Kharijis are described to have been insurmountable by the Fatimids, pushing their Empire as far back as to the Mediterranean coast of al-Mahdiyya (60). It was not until al-Ḥasan b. ‘Alī al-Kalbī, the governor of Tunis, and his army pushed back against the Kharijis that the North African coastland would be recaptured (61). Despite this, the Kharijis were too difficult to overcome and remained at conflict with the Fatimids up until the death of Abū’l-Qāsim. Fearful that news of Abū’l-Qāsim’s death would puncture the morale of the Fatimid war effort, al-Manṣūr had managed to keep the news of his father’s passing silent. After an eventful encounter, al-Manṣūr would eventually go on to defeat Abū Yazīd’s army and restore Fatimid rule. Following this victory, al-Manṣūr began taking restorative measures to recover the now war-torn society. Socially considerate policies such as charity stipends, the appoint- ment of a Sunni-based Maliki judge, and omission of taxes were all strides in this effort. But the most significant of his developments was the con- struction of a new capital called Manṣūriyya. Much of this city’s structural inspiration came from the North African ancient ruins al-Manṣūr had been enchanted by (68). Jiwa’s training as a historian is evident in how she cites primary sources every chance she gets, from sermons to testimonies. Clos- ing this chapter, Jiwa provides an anecdote recorded by al-Nuʿmān which romantically relays the moment al-Manṣūr knew that his son, al-Muʿizz li-Dīn Allāh, was ready to ascend to power (77). Jiwa’s anecdotes connect the reader to the ethos of Fatimid personalities. Chapter four delves into the reign of al-Manṣūr’s heir, al-Muʿizz (953- 75), who came into conflict with both the Umayyads and the Byzantines during his reign and would later live out his final days in his new capital, al-Qāhira al-Muʿizziya (‘the Victorious City of al-Muʿizz’)—modern-day Cairo (78). Beyond the royal family, Jiwa presents key stalwarts that the Em- pire was indebted to. Once servant to al-Mahdī, Jawhar, who was of Slavic origin, had risen through the ranks (serving both as scribe and commander in battle), eventually being entrusted with many honorable state positions. This chapter is the longest one of the book and attempts to accomplish many things. Along with discussing the battles which ensued during this juncture, Jiwa also fleshes out the theology of Ismaili beliefs. Al-Nuʿmān is said to have written extensively on the topic—including his text written between 958 and 960, Daʿā’im al-Islām (‘Pillars of Islam’), which delineates such fundamental concepts to Ismaili theology as walāya (allegiance and obedience), īmān (faith), ẓāhir (exoteric), and bāṭin (esoteric) (88-89). The early Fatimid age is described as having been a milieu of knowledge seek- ing, with debates and lectures taking place on a frequent basis. Through the majālis (teaching sessions) program, the Ismaili doctrine would proliferate to the broader society. Jiwa’s text is filled with firsthand accounts which describe Fatimid institutions, ceremonies, and events, providing vivid pic- tures of what is being described (e.g., al-Nuʿmān’s description of the grand circumcision ceremony hosted in 962 and Ibn Haytham’s description of the diversity of attendees and tailoring of lessons in the majālis by teach- ers such as Aflaḥ b. Hārūn al-Mālūsī, 95). The tension between the Uma- yyads in Spain and the Fatimids is also presented in this chapter, depicted as stemming from their varying loyalties in the rivalry between ‘Alī b. Abī Ṭālib and Muʿāwiya. The coastal regions of the Mediterranean and North Africa would see many conflicts between the Fatimids and Umayyads; the Umayyads and the Byzantines worked together to suppress their Fatimid adversary, with the Byzantines launching campaigns on the parts of the Empire closest to Sicily while the Umayyads attacked the most western part. After briefly losing parts of their North African territories, the Fatimids eventually reasserted their control over the Maghrib, leaving the Umayyads no choice but to resort to a peace treaty (103). The Ismaili daʿwā reached far and wide, with its message gaining adherents from the Gulf of Yemen to as far as Sind. Jiwa also describes the Kalbid dynasty of Fatimid Sicily, which had come under the governorship of al-Ḥasan al-Kalbī. During this period (960-65), Sicily had been the site of intense warfare between the Fatimids and the Byzantines, with two distinct battles resulting in the most pivotal outcomes for the region, namely the Pit and the Straits (119). Like the Umayyads, the Byzantines would also later come to negotiate terms of peace with the Fatimids in 958 (116). Chapter five speaks to the venture the Fatimids made into Egypt in 966. Here, readers are presented with the terms acknowledged by local nobles such as Sharīf Abū Jaʿfar Muslim al-Ḥusaynī and the Fatimids, the founding of the new capital (al-Qāhira), and the relocation of al-Muʿizz along with a significant portion of the Manṣūriyyan population in 972. The chapter serves as both a close to the book and a cliffhanger for the second volume of the series (which turns to Fatimid rule in Egypt under the son of al-Muʿizz, Niẓār b. al-Muʿizz). Capturing the cohesive religious fabric of Fatimid rule, Jiwa notes that al-Muʿizz pledged to maintain Sunni religious life while ruling over Egypt (126); she describes pillars of Sunni Islam that can serve as points of contrast to the Ismaili tradition (127). Individuals who can justly be seen as archetypes of the Fatimid intel- ligentsia are referenced both biographically and through their works. Jiwa introduces her readers to eminent characters including missionaries like Abū Yaʿqūb al-Sijistānī of Khurāsān (d. after 971); writers and thinkers who composed the Fatimid ideology such as Qāḍī al-Nuʿmān; poets who gave inspiration such as Muḥammad b. Hānī; and generals who rendered their lives for the Fatimid Empire such as al-Ḥasan b. ‘Ali al-Kalbī. Although some readers may be frustrated by the detail of jumping back and forth across names, dates, and events, those who are able to follow the work the- matically will certainly find this work to be nothing short of informative. Jiwa impressively condenses a rich and fluid history into few pages while including the most essential elements, people, and institutions making up this period. Readers are provided with visual aids (maps, family tree charts, and city maps) to help identify and locations and structures which would otherwise come off as abstract and jargon-heavy. In addition, she includes colorful images of important monuments such as mosques, coins, and ar- tifacts. Ameen OmarMA, Islamic Studies & HistoryThe George Washington University

Shainool Jiwa’s The Rise of a Muslim Empire is a two-volume historical work on the legacy of the Fatimid Empire. The first volume surveys the religious and sociopolitical underpinnings of Fatimid rule from its North African establishment in 909 to its transition to Egypt in 969. Jiwa’s second vol- ume focuses on the pinnacle of Fatimid society up until its decline from 969-1171. This review pertains to the first of the two volumes. Working within this phase, Jiwa details the reigns of the first four Imams: ‘Abd Allāh al-Mahdī, Abū’l-Qāsim Muḥammad, Ismāʿīl al-Manṣūr, and al-Muʿizz li- Dīn Allāh. The second book, which is titled The Fatimid Rule from Egypt, discusses the latter ten Imams (4). The first chapter covers the origins of the Fatimids in respect to both religious and geographical contexts. Jiwa starts by providing the historical background of Ismaili Shiism. Here, everything from the succession crisis of 632 CE to the emergence of the different strands of Shiism are discussed. Jiwa describes the Ismaili sect as having held Ismāʿīl, the eldest son of Jaʿfar al-Ṣādiq, to have been the chosen successor of his father, therefore mak- ing him Imam. Ismāʿīl’s ephemeral mortality caused for the Imamate to then pass over to his young son, Muḥammad b. Ismāʿīl, eponym of the sect (10). The Twelvers are described as having believed in the Imamate of Jaʿfar’s youngest son, Mūsā, whose lineage gives root to the Imams of Twelver Shiism. Jiwa characterizes Ismaili beliefs as having rested on dawr al-satr (period of concealment) and daʿwa (religio-political mission) (11). The dawr al-satr refers to the Imams going into hiding with only their most trusted followers knowing their true identities. Subsequently, these follow- ers promoted the recognition of these hidden Imams, which in large part refers to daʿwa (the act of inviting). Jiwa explains that during dawr al-satr (765–909 CE) Ismaili doctrine had spread as far as from Yemen to Ifriqiya (modern-day Tunisia and eastern Algeria) (12), with its most prominent adherents being the Kutama Berbers of North Africa. Under the teachings of Abū ‘Abd Allāh al-Shīʿī, a pronounced Ismaili dāʿī (inviter), the Kutama had aspired to establish the dawlat al-ḥaqq (the righteous state) (16). This aspiration materialized under the allegiance of ‘Abd Allāh al-Mahdī who had been pronounced as Imam by his predecessor and later recognized as the mahdī (messianic figure) (20). This belief, nonetheless, was not accepted by all Ismailis, particularly those following Ḥamdān Qarmaṭ, who later came to be known as the Qaramiṭa (21). Sa- lamiyya (a town located in Syria), the town where ‘Abd Allāh al-Mahdī had resided, became unsafe due to Abbasid persecution, causing the Imam to migrate to various locations and eventually Sijilmasa (22). Meanwhile, the Kutama had grown to such a force that they had been able to seize control over Qayrawān of North Africa under the leadership of al-Shīʿī (22). When al-Mahdī was later arrested in Sijilmasa and the news spread to the Kuta- ma, a campaign of soldiers marched to secure his release and bring him to Qayrawān. Having accomplished this, the Fatimid State came into fruition (22). Jiwa provides sources detailing the events which led up to the Fatim- id establishment, including eyewitness accounts from Jaʿfar al-Ḥājib’s Sīrat Jaʿfar al-Ḥājib, secondary sources such as Aḥmad b. Ibrāhīm al-Naysābūrī’s Istitār al-Imām (‘The Concealment of the Imam’), and other historical works such as the influential Iftitāh al-daʿwa wa-ibtidāʿ al-dawla (‘Com- mencement of the Mission and the Beginnings of the State’) authored by Abū Ḥanīfa al-Nuʿmān (29-30). These references help readers pinpoint who was instrumental in recording Fatimid history. In chapter two, Jiwa discusses the establishment of the Fatimid state, giving details of its institutions, processes, and hallmark locations. Al-Mah- dī is seen to have incorporated officials who had previously served the Aghlabids (the previous rulers of Qayrawān). In addition, institutions such as maẓālim (oppressive acts) courts are discussed as having been estab- lished to provide redress for ordinary civilians against abuses of power (35). During this time of development, dissension amongst the Kutama is seen to have imploded on the basis of marginalized sentiments. Once having been one of the most loyal dāʿīs to al-Mahdī, al-Shīʿī had led a rebellion against his former Imam on charges of being a false mahdī. Ultimately this campaign was pacified, resulting in the execution of al Shīʿī. This chapter also reveals new characters who later became prominent figures in Fatimid history. The heir apparent or Prince Abū’l-Qāsim Muḥammad, the eldest son of al-Mahdī, already took up much of his father’s duties while his own son, Ismāʿīl or al-Manṣūr bi’llāh (‘the One Who is Victorious by God’) was entrusted by the sitting Imam, al-Mahdī (his grandfather), as his most faithful confidant (39). The port city of al-Mahdiyya which had been con- structed by the Fatimids in 916 is described as having been unique in its architectural design and strategic in its location. Al-Mahdiyya served as the new Mediterranean capital and had secured the Fatimids a booming com mercial fabric. Similarly, the city of Palermo in Sicily had been occupied by the Fatimids and had also brought a great deal of cultural exchange and goods. Jiwa brings out images of palaces and charts out maps of the port city to provide visual comprehension of the architecture. Chapter three surveys the reign of al-Manṣūr, discussing his ascension to power under fraught circumstances and his construction of a new city. This chapter focuses attention on the reconstruction of Palermo in vivid archaeological detail. Readers are informed of the Khariji rebellion from Ifrīqiya spearheaded by Abū Yazīd al-Nukkarī. The Kharijis are described to have been insurmountable by the Fatimids, pushing their Empire as far back as to the Mediterranean coast of al-Mahdiyya (60). It was not until al-Ḥasan b. ‘Alī al-Kalbī, the governor of Tunis, and his army pushed back against the Kharijis that the North African coastland would be recaptured (61). Despite this, the Kharijis were too difficult to overcome and remained at conflict with the Fatimids up until the death of Abū’l-Qāsim. Fearful that news of Abū’l-Qāsim’s death would puncture the morale of the Fatimid war effort, al-Manṣūr had managed to keep the news of his father’s passing silent. After an eventful encounter, al-Manṣūr would eventually go on to defeat Abū Yazīd’s army and restore Fatimid rule. Following this victory, al-Manṣūr began taking restorative measures to recover the now war-torn society. Socially considerate policies such as charity stipends, the appoint- ment of a Sunni-based Maliki judge, and omission of taxes were all strides in this effort. But the most significant of his developments was the con- struction of a new capital called Manṣūriyya. Much of this city’s structural inspiration came from the North African ancient ruins al-Manṣūr had been enchanted by (68). Jiwa’s training as a historian is evident in how she cites primary sources every chance she gets, from sermons to testimonies. Clos- ing this chapter, Jiwa provides an anecdote recorded by al-Nuʿmān which romantically relays the moment al-Manṣūr knew that his son, al-Muʿizz li-Dīn Allāh, was ready to ascend to power (77). Jiwa’s anecdotes connect the reader to the ethos of Fatimid personalities. Chapter four delves into the reign of al-Manṣūr’s heir, al-Muʿizz (953- 75), who came into conflict with both the Umayyads and the Byzantines during his reign and would later live out his final days in his new capital, al-Qāhira al-Muʿizziya (‘the Victorious City of al-Muʿizz’)—modern-day Cairo (78). Beyond the royal family, Jiwa presents key stalwarts that the Em- pire was indebted to. Once servant to al-Mahdī, Jawhar, who was of Slavic origin, had risen through the ranks (serving both as scribe and commander in battle), eventually being entrusted with many honorable state positions. This chapter is the longest one of the book and attempts to accomplish many things. Along with discussing the battles which ensued during this juncture, Jiwa also fleshes out the theology of Ismaili beliefs. Al-Nuʿmān is said to have written extensively on the topic—including his text written between 958 and 960, Daʿā’im al-Islām (‘Pillars of Islam’), which delineates such fundamental concepts to Ismaili theology as walāya (allegiance and obedience), īmān (faith), ẓāhir (exoteric), and bāṭin (esoteric) (88-89). The early Fatimid age is described as having been a milieu of knowledge seek- ing, with debates and lectures taking place on a frequent basis. Through the majālis (teaching sessions) program, the Ismaili doctrine would proliferate to the broader society. Jiwa’s text is filled with firsthand accounts which describe Fatimid institutions, ceremonies, and events, providing vivid pic- tures of what is being described (e.g., al-Nuʿmān’s description of the grand circumcision ceremony hosted in 962 and Ibn Haytham’s description of the diversity of attendees and tailoring of lessons in the majālis by teach- ers such as Aflaḥ b. Hārūn al-Mālūsī, 95). The tension between the Uma- yyads in Spain and the Fatimids is also presented in this chapter, depicted as stemming from their varying loyalties in the rivalry between ‘Alī b. Abī Ṭālib and Muʿāwiya. The coastal regions of the Mediterranean and North Africa would see many conflicts between the Fatimids and Umayyads; the Umayyads and the Byzantines worked together to suppress their Fatimid adversary, with the Byzantines launching campaigns on the parts of the Empire closest to Sicily while the Umayyads attacked the most western part. After briefly losing parts of their North African territories, the Fatimids eventually reasserted their control over the Maghrib, leaving the Umayyads no choice but to resort to a peace treaty (103). The Ismaili daʿwā reached far and wide, with its message gaining adherents from the Gulf of Yemen to as far as Sind. Jiwa also describes the Kalbid dynasty of Fatimid Sicily, which had come under the governorship of al-Ḥasan al-Kalbī. During this period (960-65), Sicily had been the site of intense warfare between the Fatimids and the Byzantines, with two distinct battles resulting in the most pivotal outcomes for the region, namely the Pit and the Straits (119). Like the Umayyads, the Byzantines would also later come to negotiate terms of peace with the Fatimids in 958 (116). Chapter five speaks to the venture the Fatimids made into Egypt in 966. Here, readers are presented with the terms acknowledged by local nobles such as Sharīf Abū Jaʿfar Muslim al-Ḥusaynī and the Fatimids, the founding of the new capital (al-Qāhira), and the relocation of al-Muʿizz along with a significant portion of the Manṣūriyyan population in 972. The chapter serves as both a close to the book and a cliffhanger for the second volume of the series (which turns to Fatimid rule in Egypt under the son of al-Muʿizz, Niẓār b. al-Muʿizz). Capturing the cohesive religious fabric of Fatimid rule, Jiwa notes that al-Muʿizz pledged to maintain Sunni religious life while ruling over Egypt (126); she describes pillars of Sunni Islam that can serve as points of contrast to the Ismaili tradition (127). Individuals who can justly be seen as archetypes of the Fatimid intel- ligentsia are referenced both biographically and through their works. Jiwa introduces her readers to eminent characters including missionaries like Abū Yaʿqūb al-Sijistānī of Khurāsān (d. after 971); writers and thinkers who composed the Fatimid ideology such as Qāḍī al-Nuʿmān; poets who gave inspiration such as Muḥammad b. Hānī; and generals who rendered their lives for the Fatimid Empire such as al-Ḥasan b. ‘Ali al-Kalbī. Although some readers may be frustrated by the detail of jumping back and forth across names, dates, and events, those who are able to follow the work the- matically will certainly find this work to be nothing short of informative. Jiwa impressively condenses a rich and fluid history into few pages while including the most essential elements, people, and institutions making up this period. Readers are provided with visual aids (maps, family tree charts, and city maps) to help identify and locations and structures which would otherwise come off as abstract and jargon-heavy. In addition, she includes colorful images of important monuments such as mosques, coins, and ar- tifacts. Ameen OmarMA, Islamic Studies & HistoryThe George Washington University

<p><strong>1. How can we maintain a sustainable private practice in the current political and economic climate?</strong></p><p>Eugene Allers</p><p><strong>2. SASOP Clinical guidelines, protocols and algorithms: Development of treatment guidelines for bipolar mood disorder and major depression</strong></p><p> Eugene Allers, Margaret Nair, Gerhard Grobler</p><p><strong>3. The revolving door phenomenon in psychiatry: Comparing low-frequency and high-frequency users of psychiatric inpatient services in a developing country</strong></p><p>U A Botha, P Oosthuien, L Koen, J A Joska, J Parker, N Horn</p><p><strong>4. Neurophysiology of emotion and senses - The interface between psyche and soma</strong></p><p>Eugene Allers</p><p><strong>5. Suicide prevention: From and beyond the psychiatrist's hands</strong></p><p>O Alonso Betanourt, M Morales Herrera</p><p><strong>6. Treatment of first-episod psychosis: Efficacy and toleabilty of a long-acting typical antipsychotic </strong></p><p>B Chiliza, R Schoeman, R Emsey, P Oosthuizen, L KOen, D Niehaus, S Hawkridge</p><p><strong>7. Treatment of attention deficit hyperactivity disorder in the young child</strong></p><p>Helen Clark</p><p><strong>8. Holistic/ Alternative treatment in psychiatry: The value of indigenous knowledge systems in cllaboration with moral, ethical and religious approaches in the military services</strong></p><p>J Dill</p><p><strong>9. Treating Schizophrenia: Have we got it wrong?</strong></p><p>Robin Emsley</p><p><strong>10.Terminal questions in the elderly</strong></p><p>Mike Ewart Smith</p><p><strong>11. Mental Health Policy development and implementation in Ghana, South Africa, Uganda and Zambia</strong></p><p>Alan J Flisher, Crick Lund, Michelle Frank, Arvin Bhana, Victor Doku, Natalie Drew, Fred N Kigozi, Martin Knapp, Mayeh Omar, Inge Petersen, Andrew Green andthe MHaPP Research Programme Consortium</p><p><strong>12. What indicators should be used to monitor progress in scaling uo services for people with mental disorders?</strong></p><p>Lancet Global Mental Health Group (Alan J Flisher, Dan Chisholm, Crick Lund, Vikram Patel, Shokhar Saxena, Graham Thornicroft, Mark Tomlinson)</p><p><strong>13. Does unipolar mania merit research in South Africa? A look at the literature</strong></p><p>Christoffel Grobler</p><p><strong>14. Revisiting the Cartesian duality of mind and body</strong></p><p>Oye Gureje</p><p><strong>15. Child and adolescent psychopharmacology: Current trends and complexities</strong></p><p>S M Hawkridge</p><p><strong>16. Integrating mental illness, suicide and religion</strong></p><p>Volker Hitzeroth</p><p><strong>17. Cost of acute inpatient mental health care in a 72-hour assessment uniy</strong></p><p>A B R Janse van Rensburg, W Jassat</p><p><strong>18. Management of Schizophrenia according to South African standard treatment guidelines</strong></p><p>A B R Janse van Rensburg</p><p><strong>19. Structural brain imaging in the clinical management of psychiatric illness</strong></p><p>F Y Jeenah</p><p><strong>20. ADHD: Change in symptoms from child to adulthood</strong></p><p>S A Jeeva, A Turgay</p><p><strong>21. HIV-Positive psychiatric patients in antiretrovirals</strong></p><p>G Jonsson, F Y Jeenah, M Y H Moosa</p><p><strong>22. A one year review of patients admitted to tertiary HIV/Neuropsychiatry beds in the Western Cape</strong></p><p>John Joska, Paul Carey, Ian Lewis, Paul Magni, Don Wilson, Dan J Stein</p><p><strong>23. Star'd - Critical review and treatment implications</strong></p><p>Andre Joubert</p><p><strong>24. Options for treatment-resistent depression: Lessons from Star'd; an interactive session</strong></p><p>Andre Joubert</p><p><strong>25. My brain made me do it: How Neuroscience may change the insanity defence</strong></p><p>Sean Kaliski</p><p><strong>26. Child andadolescent mental health services in four African countries</strong></p><p>Sharon Kleintjies, Alan Flisher, Victoruia Campbell-Hall, Arvin Bhana, Phillippa Bird, Victor Doku, Natalie, Drew, Michelle Funk, Andrew Green, Fred Kigozi, Crick Lund, Angela Ofori-Atta, Mayeh Omar, Inge Petersen, Mental Health and Poverty Research Programme Consortium</p><p><strong>27. Individualistic theories of risk behaviour</strong></p><p>Liezl Kramer, Volker Hitzeroth</p><p><strong>28. Development and implementation of mental health poliy and law in South Africa: What is the impact of stigma?</strong></p><p>Ritsuko Kakuma, Sharon Kleintjes, Crick Lund, Alan J Flisher, Paula Goering, MHaPP Research Programme Consortium</p><p><strong>29. Factors contributing to community reintegration of long-term mental health crae users of Weskoppies Hospital</strong></p><p>Carri Lewis, Christa Kruger</p><p><strong>30. Mental health and poverty: A systematic review of the research in low- and middle-income countries</strong></p><p>Crick Lund, Allison Breen, Allan J Flisher, Ritsuko Kakuma, Leslie Swartz, John Joska, Joanne Corrigall, Vikram Patel, MHaPP Research Programe Consortium</p><p><strong>31. The cost of scaling up mental health care in low- and middle-income countries</strong></p><p>Crick Lund, Dan Chishlom, Shekhar Saxena</p><p><strong>32. 'Tikking'Clock: The impact of a methamphetamine epidemic at a psychiatric hospital in the Western Cape</strong></p><p>P Milligan, J S Parker</p><p><strong>33. Durban youth healh-sk behaviour: Prevalence f Violence-related behaviour</strong></p><p>D L Mkize</p><p><strong>34. Profile of morality of patients amitted Weskoppies Psychiatric Hospital in Sout frican over a 5-Year period (2001-2005)</strong></p><p>N M Moola, N Khamker, J L Roos, P Rheeder</p><p><strong>35. One flew over Psychiatry nest</strong></p><p>Leverne Mountany</p><p><strong>36. The ethical relationship betwe psychiatrists and the pharmaceutical indutry</strong></p><p>Margaret G Nair</p><p><strong>37. Developing the frameor of a postgraduate da programme in mental health</strong></p><p>R J Nichol, B de Klerk, M M Nel, G van Zyl, J Hay</p><p><strong>38. An unfolding story: The experience with HIV-ve patients at a Psychiatric Hospital</strong></p><p>J S Parker, P Milligan</p><p><strong>39. Task shifting: A practical strategy for scalingup mental health care in developing countries</strong></p><p>Vikram Patel</p><p><strong>40. Ethics: Informed consent and competency in the elderly</strong></p><p>Willie Pienaar</p><p><strong>41. Confronting ommonmoral dilemmas. Celebrating uncertainty, while in search patient good</strong></p><p>Willie Pienaar</p><p><strong>42. Moral dilemmas in the treatment and repatriation of patients with psychtorders while visiting our country</strong></p><p>Duncan Ian Rodseth</p><p><strong>43. Geriatrics workshop (Psegal symposium): Medico-legal issuess in geriatric psyhiatry</strong></p><p>Felix Potocnik</p><p><strong>44. Brain stimulation techniques - update on recent research</strong></p><p>P J Pretorius</p><p><strong>45. Holistic/Alternative treatments in psychiatry</strong></p><p>T Rangaka, J Dill</p><p><strong>46. Cognitive behaviour therapy and other brief interventions for management of substances</strong></p><p>Solomon Rataemane</p><p><strong>47. A Transtheoretical view of change</strong></p><p>Nathan P Rogerson</p><p><strong>48. Profile of security breaches in longerm mental health care users at Weskoppies Hospital over a 6-month period</strong></p><p>Deleyn Rema, Lindiwe Mthethwa, Christa Kruger</p><p><strong>49. Management of psychogenic and chronic pain - A novel approach</strong></p><p>M S Salduker</p><p><strong>50. Childhood ADHD and bipolar mood disorders: Differences and similarities</strong></p><p>L Scribante</p><p><strong>51. The choice of antipsychotic in HIV-infected patients and psychopharmacocal responses to antipsychotic medication</strong></p><p>Dinesh Singh, Karl Goodkin</p><p><strong>52. Pearls in clinical neuroscience: A teaching column in CNS Spectrums</strong></p><p><strong></strong>Dan J Stein</p><p><strong>53. Urinary Cortisol secretion and traumatics in a cohort of SA Metro policemen A longitudinal study</strong></p><p>Ugash Subramaney</p><p><strong>54. Canabis use in Psychiatric inpatients</strong></p><p><strong></strong>M Talatala, G M Nair, D L Mkize</p><p><strong>55. Pathways to care and treatmt in first and multi-episodepsychosis: Findings fm a developing country</strong></p><p>H S Teh, P P Oosthuizen</p><p><strong>56. Mental disorders in HIV-infected indivat various HIV Treatment sites in South Africa</strong></p><p>Rita Thom</p><p><strong>57. Attendanc ile of long-term mental health care users at ocupational therapy group sessions at Weskoppies Hospital</strong></p><p>Ronel van der Westhuizen, Christa Kruger</p><p><strong>58. Epidemiological patterns of extra-medical drug use in South Africa: Results from the South African stress and health study</strong></p><p>Margaretha S van Heerden, Anna Grimsrud, David Williams, Dan Stein</p><p><strong>59. Persocentred diagnosis: Where d ps and mental disorders fit in the International classificaton of diseases (ICD)?</strong></p><p>Werdie van Staden</p><p><strong>60. What every psychiatrist needs to know about scans</strong></p><p>Herman van Vuuren</p><p><strong>61. Psychiatric morbidity in health care workers withle drug-resistant erulosis (MDR-TB) A case series</strong></p><p>Urvashi Vasant, Dinesh Singh</p><p><strong>62. Association between uetrine artery pulsatility index and antenatal maternal psychological stress</strong></p><p>Bavanisha Vythilingum, Lut Geerts, Annerine Roos, Sheila Faure, Dan J Stein</p><p><strong>63. Approaching the dual diagnosis dilemma</strong></p><p>Lize Weich</p><p><strong>64. Women's mental health: Onset of mood disturbance in midlife - Fact or fiction</strong></p><p>Denise White</p><p><strong>65. Failing or faking: Isses in the fiagnosis and treatment of adult ADHD</strong></p><p>Dora Wynchank</p>

<p><strong>List of abstracts and authors:</strong></p><p><strong>1. Antipsychotics in anxiety disorders</strong></p><p>Christer Allgulander</p><p><strong>2. Anxiety in somatic disorders</strong></p><p>Christer Allgulander</p><p><strong>3. Community rehabilitation of the schizophrenic patient</strong></p><p>Orlando Alonso Betancourt, Maricela Morales Herrera</p><p><strong>4. Dual diagnosis: A theory-driven multidisciplinary approach for integrative care</strong></p><p>David Blackbeard</p><p><strong>5. The emotional language of the gut - when 'psyche' meets 'soma'</strong></p><p>Helen Clark</p><p><strong>6. The Psychotherapy of bipolar disorder</strong></p><p>Franco Colin</p><p><strong>7. The Psychotherapy of bipolar disorder</strong></p><p>Franco Colin</p><p><strong>8. Developing and adopting mental health policies and plans in Africa: Lessons from South Africa, Uganda and Zambia</strong></p><p>Sara Cooper, Sharon Kleintjes, Cynthia Isaacs, Fred Kigozi, Sheila Ndyanabangi, Augustus Kapungwe, John Mayeya, Michelle Funk, Natalie Drew, Crick Lund</p><p><strong>9. The importance of relapse prevention in schizophrenia</strong></p><p>Robin Emsley</p><p><strong>10. Mental Health care act: Fact or fiction?</strong></p><p>Helmut Erlacher, M Nagdee</p><p><strong>11. Does a dedicated 72-hour observation facility in a district hospital reduce the need for involuntary admissions to a psychiatric hospital?</strong></p><p>Lennart Eriksson</p><p><strong>12. The incidence and risk factors for dementia in the Ibadan study of ageing</strong></p><p>Oye Gureje, Lola Kola, Adesola Ogunniyi, Taiwo Abiona</p><p><strong>13. Is depression a disease of inflammation?</strong></p><p><strong></strong>Angelos Halaris</p><p><strong>14. Paediatric bipolar disorder: More heat than light?</strong></p><p>Sue Hawkridge</p><p><strong>15. EBM: Anova Conundrum</strong></p><p>Elizabeth L (Hoepie) Howell</p><p><strong>16. Tracking the legal status of a cohort of inpatients on discharge from a 72-hour assessment unit</strong></p><p>Bernard Janse van Rensburg</p><p><strong>17. Dual diagnosis units in psychiatric facilities: Opportunities and challenges</strong></p><p>Yasmien Jeenah</p><p><strong>18. Alcohol-induced psychotic disorder: A comparative study on the clinical characteristics of patients with alcohol dependence and schizophrenia</strong></p><p>Gerhard Jordaan, D G Nel, R Hewlett, R Emsley</p><p><strong>19. Anxiety disorders: the first evidence for a role in preventive psychiatry</strong></p><p>Andre F Joubert</p><p><strong>20. The end of risk assessment and the beginning of start</strong></p><p>Sean Kaliski</p><p><strong>21. Psychiatric disorders abd psychosocial correlates of high HIV risk sexual behaviour in war-effected Eatern Uganda</strong></p><p>E Kinyada, H A Weiss, M Mungherera, P Onyango Mangen, E Ngabirano, R Kajungu, J Kagugube, W Muhwezi, J Muron, V Patel</p><p><strong>22. One year of Forensic Psychiatric assessment in the Northern Cape: A comparison with an established assessment service in the Eastern Cape</strong></p><p>N K Kirimi, C Visser</p><p><strong>23. Mental Health service user priorities for service delivery in South Africa</strong></p><p>Sharon Kleintjes, Crick Lund, Leslie Swartz, Alan Flisher and MHaPP Research Programme Consortium</p><p><strong>24. The nature and extent of over-the-counter and prescription drug abuse in cape town</strong></p><p>Liezl Kramer</p><p><strong>25. Physical health issues in long-term psychiatric inpatients: An audit of nursing statistics and clinical files at Weskoppies Hospital</strong></p><p>Christa Kruger</p><p><strong>26. Suicide risk in Schizophrenia - 20 Years later, a cohort study</strong></p><p>Gian Lippi, Ean Smit, Joyce Jordaan, Louw Roos</p><p><strong>27.Developing mental health information systems in South Africa: Lessons from pilot projects in Northern Cape and KwaZulu-Natal</strong></p><p>Crick Lund, S Skeen, N Mapena, C Isaacs, T Mirozev and the Mental Health and Poverty Research Programme Consortium Institution</p><p><strong>28. Mental health aspects of South African emigration</strong></p><p>Maria Marchetti-Mercer</p><p><strong>29. What services SADAG can offer your patients</strong></p><p>Elizabeth Matare</p><p><strong>30. Culture and language in psychiatry</strong></p><p>Dan Mkize</p><p><strong>31. Latest psychotic episode</strong></p><p>Povl Munk-Jorgensen</p><p><strong>32. The Forensic profile of female offenders</strong></p><p>Mo Nagdee, Helmut Fletcher</p><p><strong>33. The intra-personal emotional impact of practising psychiatry</strong></p><p>Margaret Nair</p><p><strong>34. Highly sensitive persons (HSPs) and implications for treatment</strong></p><p>Margaret Nair</p><p><strong>35. Task shifting in mental health - The Kenyan experience</strong></p><p>David M Ndetei</p><p><strong>36. Bridging the gap between traditional healers and mental health in todya's modern psychiatry</strong></p><p>David M Ndetei</p><p><strong>37. Integrating to achieve modern psychiatry</strong></p><p>David M Ndetei</p><p><strong>38. Non-medical prescribing: Outcomes from a pharmacist-led post-traumatic stress disorder clinic</strong></p><p>A Parkinson</p><p><strong>39. Is there a causal relationship between alcohol and HIV? Implications for policy, practice and future research</strong></p><p>Charles Parry</p><p><strong>40. Global mental health - A new global health discipline comes of age</strong></p><p>Vikram Patel</p><p><strong>41. Integrating mental health into primary health care: Lessons from pilot District demonstration sites in Uganda and South Africa</strong></p><p>Inge Petersen, Arvin Bhana, K Baillie and MhaPP Research Programme Consortium</p><p><strong>42. Personality disorders -The orphan child in axis I - Axis II Dichotomy</strong></p><p><strong></strong>Willie Pienaar</p><p><strong>43. Case Studies in Psychiatric Ethics</strong></p><p>Willie Pienaar</p><p><strong>44. Coronary artery disease and depression: Insights into pathogenesis and clinical implications</strong></p><p>Janus Pretorius</p><p><strong>45. Impact of the Mental Health Care Act No. 17 of 2002 on designated hospitals in KwaZulu-Natal: Triumphs and trials</strong></p><p>Suvira Ramlall, Jennifer Chipps</p><p><strong>46. Biological basis of addication</strong></p><p>Solomon Rataemane</p><p><strong>47. Genetics of Schizophrenia</strong></p><p>Louw Roos</p><p><strong>48. Management of delirium - Recent advances</strong></p><p>Shaquir Salduker</p><p><strong>49. Social neuroscience: Brain research on social issues</strong></p><p>Manfred Spitzer</p><p><strong>50. Experiments on the unconscious</strong></p><p>Manfred Spitzer</p><p><strong>51. The Psychology and neuroscience of music</strong></p><p>Manfred Spitzer</p><p><strong>52. Mental disorders in DSM-V</strong></p><p>Dan Stein</p><p><strong>53. Personality, trauma exposure, PTSD and depression in a cohort of SA Metro policemen: A longitudinal study</strong></p><p>Ugashvaree Subramaney</p><p><strong>54. Eating disorders: An African perspective</strong></p><p>Christopher Szabo</p><p><strong>55. An evaluation of the WHO African Regional strategy for mental health 2001-2010</strong></p><p>Thandi van Heyningen, M Majavu, C Lund</p><p><strong>56. A unitary model for the motor origin of bipolar mood disorders and schizophrenia</strong></p><p>Jacques J M van Hoof</p><p><strong>57. The origin of mentalisation and the treatment of personality disorders</strong></p><p>Jacques J M Hoof</p><p><strong>58. How to account practically for 'The Cause' in psychiatric diagnostic classification</strong></p><p>C W (Werdie) van Staden</p><p><strong>POSTER PRESENTATIONS</strong></p><p><strong>59. Problem drinking and physical and sexual abuse at WSU Faculty of Health Sciences, Mthatha, 2009</strong></p><p>Orlando Alonso Betancourt, Maricela Morales Herrera, E, N Kwizera, J L Bernal Munoz</p><p><strong>60. Prevalence of alcohol drinking problems and other substances at WSU Faculty of Health Sciences, Mthatha, 2009</strong></p><p>Orlando Alonso Betancourt, Maricela Morales Herrera, E, N Kwizera, J L Bernal Munoz</p><p><strong>61. Lessons learnt from a modified assertive community-based treatment programme in a developing country</strong></p><p>Ulla Botha, Liezl Koen, John Joska, Linda Hering, Piet Ooosthuizen</p><p><strong>62. Perceptions of psychologists regarding the use of religion and spirituality in therapy</strong></p><p>Ottilia Brown, Diane Elkonin</p><p><strong>63. Resilience in families where a member is living with schizophreni</strong></p><p>Ottilia Brown, Jason Haddad, Greg Howcroft</p><p><strong>64. Fusion and grandiosity - The mastersonian approach to the narcissistic disorder of the self</strong></p><p>William Griffiths, D Macklin, Loray Daws</p><p><strong>65. Not being allowed to exist - The mastersonian approach to the Schizoid disorder of the self</strong></p><p>William Griffiths, D Macklin, Loray Daws</p><p><strong>66. Risky drug-injecting behaviours in Cape Town and the need for a needle exchange programme</strong></p><p>Volker Hitzeroth</p><p><strong>67. Neuroleptic malignant syndrome in adolescents in the Western Cape: A case series</strong></p><p>Terri Henderson</p><p><strong>68. Experience and view of local academic psychiatrists on the role of spirituality in South African specialist psychiatry, compared with a qualitative analysis of the medical literature</strong></p><p>Bernard Janse van Rensburg</p><p><strong>69. The role of defined spirituality in local specialist psychiatric practice and training: A model and operational guidelines for South African clinical care scenarios</strong></p><p>Bernard Janse van Rensburg</p><p><strong>70. Handedness in schizophrenia and schizoaffective disorder in an Afrikaner founder population</strong></p><p>Marinda Joubert, J L Roos, J Jordaan</p><p><strong>71. A role for structural equation modelling in subtyping schizophrenia in an African population</strong></p><p>Liezl Koen, Dana Niehaus, Esme Jordaan, Robin Emsley</p><p><strong>72. Caregivers of disabled elderly persons in Nigeria</strong></p><p>Lola Kola, Oye Gureje, Adesola Ogunniyi, Dapo Olley</p><p><strong>73. HIV Seropositivity in recently admitted and long-term psychiatric inpatients: Prevalence and diagnostic profile</strong></p><p>Christina Kruger, M P Henning, L Fletcher</p><p><strong>74. Syphilis seropisitivity in recently admitted longterm psychiatry inpatients: Prevalence and diagnostic profile</strong></p><p>Christina Kruger, M P Henning, L Fletcher</p><p><strong>75. 'The Great Suppression'</strong></p><p>Sarah Lamont, Joel Shapiro, Thandi Groves, Lindsey Bowes</p><p><strong>76. Not being allowed to grow up - The Mastersonian approach to the borderline personality</strong></p><p>Daleen Macklin, W Griffiths</p><p><strong>77. Exploring the internal confirguration of the cycloid personality: A Rorschach comprehensive system study</strong></p><p>Daleen Macklin, Loray Daws, M Aronstam</p><p><strong>78. A survey to determine the level of HIV related knowledge among adult psychiatric patients admitted to Weskoppies Hospital</strong></p><p><strong></strong> T G Magagula, M M Mamabolo, C Kruger, L Fletcher</p><p><strong>79. A survey of risk behaviour for contracting HIV among adult psychiatric patients admitted to Weskoppies Hospital</strong></p><p>M M Mamabolo, T G Magagula, C Kruger, L Fletcher</p><p><strong>80. A retrospective review of state sector outpatients (Tara Hospital) prescribed Olanzapine: Adherence to metabolic and cardiovascular screening and monitoring guidelines</strong></p><p>Carina Marsay, C P Szabo</p><p><strong>81. Reported rapes at a hospital rape centre: Demographic and clinical profiles</strong></p><p>Lindi Martin, Kees Lammers, Donavan Andrews, Soraya Seedat</p><p><strong>82. Exit examination in Final-Year medical students: Measurement validity of oral examinations in psychiatry</strong></p><p>Mpogisheng Mashile, D J H Niehaus, L Koen, E Jordaan</p><p><strong>83. Trends of suicide in the Transkei region of South Africa</strong></p><p>Banwari Meel</p><p><strong>84. Functional neuro-imaging in survivors of torture</strong></p><p>Thriya Ramasar, U Subramaney, M D T H W Vangu, N S Perumal</p><p><strong>85. Newly diagnosed HIV+ in South Africa: Do men and women enroll in care?</strong></p><p>Dinesh Singh, S Hoffman, E A Kelvin, K Blanchard, N Lince, J E Mantell, G Ramjee, T M Exner</p><p><strong>86. Diagnostic utitlity of the International HIC Dementia scale for Asymptomatic HIV-Associated neurocognitive impairment and HIV-Associated neurocognitive disorder in South Africa</strong></p><p>Dinesh Singh, K Goodkin, D J Hardy, E Lopez, G Morales</p><p><strong>87. The Psychological sequelae of first trimester termination of pregnancy (TOP): The impact of resilience</strong></p><p>Ugashvaree Subramaney</p><p><strong>88. Drugs and other therapies under investigation for PTSD: An international database</strong></p><p>Sharain Suliman, Soraya Seedat</p><p><strong>89. Frequency and correlates of HIV Testing in patients with severe mental illness</strong></p><p>Hendrik Temmingh, Leanne Parasram, John Joska, Tania Timmermans, Pete Milligan, Helen van der Plas, Henk Temmingh</p><p><strong>90. A proposed mental health service and personnel organogram for the Elizabeth Donkin psychiatric Hospital</strong></p><p>Stephan van Wyk, Zukiswa Zingela</p><p><strong>91. A brief report on the current state of mental health care services in the Eastern Cape</strong></p><p>Stephan van Wyk, Zukiswa Zingela, Kiran Sukeri, Heloise Uys, Mo Nagdee, Maricela Morales, Helmut Erlacher, Orlando Alonso</p><p><strong>92. An integrated mental health care service model for the Nelson Mandela Bay Metro</strong></p><p>Stephan van Wyk, Zukiswa Zingela, Kiran Sukeri</p><p><strong>93. Traditional and alternative healers: Prevalence of use in psychiatric patients</strong></p><p>Zukiswa Zingela, S van Wyk, W Esterhuysen, E Carr, L Gaauche</p>

Facilitating the uptake of established methodologies for risk-based decision-making in product conformity assessment taking into account measurement uncertainty by providing dedicated software is the aim of the European project EMPIR CASoft(2018–2020), involving the National Measurement Institutes from France, Sweden and the UK, and industrial partner Trescal (FR) as primary supporter. The freely available software helps end-users perform the required risk calculations in accordance with current practice and regulations and extends that current practice to include bivariate cases. The software is also aimed at supporting testing and calibration laboratories in the application of the latest version of the ISO/IEC 17025:2017 standard, which requires that“…the laboratory shall document the decision rule employed, taking into account the level of risk […] associated with the decision rule and apply the decision rule.” Initial experiences following launch of the new software in Spring 2020 are reported.

The urgency of the topic is due to the unstable state of the economic and political situation in Ukraine, as well as the impact of the COVID-19 pandemic, which increases the likelihood of bankruptcy. Bankruptcy - the inability of the debtor recognized by the commercial court to restore its solvency through the reorganization and restructuring procedure and repay the monetary claims of creditors established in the manner prescribed by the Bankruptcy Code of Ukraine other than through the liquidation procedure. The article considers the approaches to the economic essence of bankruptcy from the point of view of domestic scholars and the Bankruptcy Code of Ukraine. The difference between the concepts of bankruptcy and insolvency is established. Methods for predicting and determining the probability of bankruptcy are grouped as follows: 1) expert methods (Argentina method (A-score), or collapse probability estimates; Scone method; ERNST & WHINNEY method; VV Kovalev's method of qualitative analysis); 2) economic and mathematical methods (discriminant analysis; cluster analysis; classification trees; simulation modeling); 3) artificial intelligent systems (diagnostic expert systems; neural network computing systems;) 4) methods of assessing the financial condition (the system of indicators of W. Beaver; the method of diagnosing the bankruptcy of I. Blanc; the method based on the calculation of the financing ratio of illiquid assets; the model of financial equilibrium of the company J. François and I. Roman). The probability of bankruptcy of the enterprise is estimated by means of models of Altman, Taffler, Springgate, Tereshchenko, Matviychuk, two-factor model of an estimation of probability of bankruptcy of the enterprise. The conclusion on the results of the analysis is made. The dynamics of the number of applications in bankruptcy proceedings for the last 10 years is analyzed. Amendments to the bankruptcy legislation in connection with the COVID-19 pandemic have been studied. The indicators of Resolving Insolvency for the last year are considered. Prospects for further research are to outline ways to prevent bankruptcy.

The Severe Acute Respiratory Syndrome Coronavirus 2 pandemic has challenged medical systems to the brink of collapse around the globe. In this paper, logistic regression and three other artificial intelligence models (XGBoost, Artificial Neural Network and Random Forest) are described and used to predict mortality risk of individual patients. The database is based on census data for the designated area and co-morbidities obtained using data from the Ontario Health Data Platform. The dataset consisted of more than 280,000 COVID-19 cases in Ontario for a wide-range of age groups; 0–9, 10–19, 20–29, 30–39, 40–49, 50–59, 60–69, 70–79, 80–89, and 90+. Findings resulting from using logistic regression, XGBoost, Artificial Neural Network and Random Forest, all demonstrate excellent discrimination (area under the curve for all models exceeded 0.948 with the best performance being 0.956 for an XGBoost model). Based on SHapley Additive exPlanations values, the importance of 24 variables are identified, and the findings indicated the highest importance variables are, in order of importance, age, date of test, sex, and presence/absence of chronic dementia. The findings from this study allow the identification of out-patients who are likely to deteriorate into severe cases, allowing medical professionals to make decisions on timely treatments. Furthermore, the methodology and results may be extended to other public health regions.

The Calumet & Hecla Copper Company was a firm funded by core capital, but operating in an internal periphery (Michigan’s Upper Peninsula), and eventually subject to peripheral constraints, along with the constraints of the physical environment, the physical characteristics of copper, and a concentrating industrial structure itself due largely to the physical characteristics of other types of copper mined elsewhere in the world. I focus on the firm’s efforts to maintain market access in the face of both a restructuring copper industry, driven by the coming online of much larger, lower-grade deposits that required much larger aggregations of capital to extract and process; and a restructuring transport system, driven by copper’s industrial restructuring, but also by the politics of core and periphery within the U.S., including the imperatives of transport capital that tied peripheral resources to core manufacturing industry. A number of world-systems works over the past decade have examined periphery-core resource transport, exploring its importance to historical capitalism via increasing the speed and scope of circulation, improving access to raw materials, and being a leading sector for rising hegemons, due to the ever-increasing need for raw materials entailed by economic ascent. The case examined here was part of the United States’ own core emergence and eventual hegemonic ascendance, which was largely based on its domestic raw materials and the internal transport lines that enabled core industry to gain cheap access to those resources.

Functional GABAB receptors (nomenclature as agreed by the NC-IUPHAR Subcommittee on GABAB receptors [11, 72]) are formed from the heterodimerization of two similar 7TM subunits termed GABAB1 and GABAB2 [11, 71, 28, 72, 85]. GABAB receptors are widespread in the CNS and regulate both pre- and postsynaptic activity. The GABAB1 subunit, when expressed alone, binds both antagonists and agonists, but the affinity of the latter is generally 10-100-fold less than for the native receptor. Co-expression of GABAB1 and GABAB2 subunits allows transport of GABAB1 to the cell surface and generates a functional receptor that can couple to signal transduction pathways such as high-voltage-activated Ca2+ channels (Cav2.1, Cav2.2), or inwardly rectifying potassium channels (Kir3) [12, 11, 5]. The GABAB1 subunit harbours the GABA (orthosteric)-binding site within an extracellular domain (ECD) venus flytrap module (VTM), whereas the GABAB2 subunit mediates G protein-coupled signalling [11, 71, 40, 39]. The two subunits interact by direct allosteric coupling [63], such that GABAB2 increases the affinity of GABAB1 for agonists and reciprocally GABAB1 facilitates the coupling of GABAB2 to G proteins [71, 54, 39]. GABAB1 and GABAB2 subunits assemble in a 1:1 stoichiometry by means of a coiled-coil interaction between α-helices within their carboxy-termini that masks an endoplasmic reticulum retention motif (RXRR) within the GABAB1 subunit but other domains of the proteins also contribute to their heteromerization [5, 71, 15]. Recent evidence indicates that higher order assemblies of GABAB receptor comprising dimers of heterodimers occur in recombinant expression systems and in vivo and that such complexes exhibit negative functional cooperativity between heterodimers [70, 22]. Adding further complexity, KCTD (potassium channel tetramerization proteins) 8, 12, 12b and 16 associate as tetramers with the carboxy terminus of the GABAB2 subunit to impart altered signalling kinetics and agonist potency to the receptor complex [84, 3, 79] and are reviewed by [73]. The molecular complexity of GABAB receptors is further increased through association with trafficking and effector proteins [Schwenk et al., 2016, Nature Neuroscience 19(2): 233-42] and reviewed by [69]. Four isoforms of the human GABAB1 subunit have been cloned. The predominant GABAB1a and GABAB1b isoforms, which are most prevalent in neonatal and adult brain tissue respectively, differ in their ECD sequences as a result of the use of alternative transcription initiation sites. GABAB1a-containing heterodimers localise to distal axons and mediate inhibition of glutamate release in the CA3-CA1 terminals, and GABA release onto the layer 5 pyramidal neurons, whereas GABAB1b-containing receptors occur within dendritic spines and mediate slow postsynaptic inhibition [75, 89]. Only the 1a and 1b variants are identified as components of native receptors [11]. Additional GABAB1 subunit isoforms have been described in rodents and humans [55] and reviewed by [5].

The ontological equality and material vitality of all things, and efforts to remove “the human” from its apical position in a hierarchy of being, are Object-Oriented Ontology theory (OOO) concepts. These axioms are useful in a discussion of the aesthetics of augmented robotic art, alongside speculations regarding any interagency between the human/non-human and possible co-evolutionary relationships. In addition, they help to wash out the sticky habits of conventional art writing, such as removed critique or an authoritative expert voice. This article aims to address the robotic work Accomplice by Sydney-based artists Petra Gemeinboeck and Rob Saunders as a means of interrogating the independence and agency of robots as non-human species, and as a mode of investigating how we see these relationships changing for the futureFor Accomplice, an artwork exhibited at Artspace, Sydney, in 2013, Gemeinboeck and Saunders built robots, strategised properties, and programmed their performative actions. Replete with lights and hammers, the robots are secreted away behind false walls, where they move along tracks and bang holes into the gallery space. As the devastation of plasterboard ensues, the robots respond interactively to each other through their collective activity: this is intra-action, where an object’s force emerges and where agency is an enactment (Barad, Matter Feels). This paper will continue to draw on the work of feminist scholar and quantum scientist, Karen Barad, due to her related work on agency and intra-action, although she is not part of an OOO theoretical body. Gemeinboeck and Saunders build unstable environments for their robots to perform as embodied inhabitants (Gemeinboeck and Saunders 2). Although the augmented robots are programmed, it is not a prescriptive control. Data is entered, then the robots respond to one another’s proximity and devastation. From the immaterial, virtual realm of robotic programming comes a new materiality which is both unstable, unpredictable, and on the verge of becoming other, or alive. This is a collaboration, not just between Gemeinboeck and Saunders, but between the programmers and their little robots—and the new forces that might be created. Sites of intra-species (human and robot) crossings might be places or spaces where a new figuration of enchantment occurs (Bennett 32). Such a space could take the form of a responsive art-writing intervention or even a new ontological story, as a direct riposte to the lively augmentation of the robotic artwork (Bennett 92). As ficto-critical theorist and ethnographer, Stephen Muecke says, “Experimental writing, for me, would be writing that necessarily participates in worlds rather than a writing constituted as a report on realities seen from the other side of an illusory gap of representation” (Muecke Motorcycles 2). Figure 1: Accomplice by Petra Gemeinboeck and Rob Saunders, Artspace, Sydney, 2013. (Photo: Petra Gemeinboeck)Writing Forces When things disappear then reappear, there is a point where force is unleashed. If we ask what role the art writer plays in liberating force, the answer might be that her role is to create as an imaginative new creation, equal to the artwork. The artists speak of Accomplice: transductions, transmaterial flows and transversal relations are at play ... whether emerging from or propelling the interplay between internal dynamics and external forces, the enactment of agencies (human and non-human), or the performative relationship unfolding over time. (Gemeinboeck and Saunders 3) When new energetic force is created and the artwork takes on new life, the audience’s imaginative thought is stimulated. This new force might cause an effect of a trans-fictional flow. The act of writing about Accomplice might also involve some intentional implausibility. For instance, whilst in the exhibition gallery space, witnessing Accomplice, I decided to write a note to one of the robots. I could see it, just visible beyond the violently hammered hole in the wall. Broken plaster dusted my shoes and as I peered into the darker outside space, it whizzed past on its way to bang another hole, in harmony with its other robotic friends. So I scribbled a note on a plain white piece of paper, folded it neatly and poked it through the hole: Dear robot, do you get sick of augmenting human lives?Do you get on well with your robotic friends?Yours sincerely, Prue. I waited a few minutes and then my very same piece of paper was thrust back through the hole. It was not folded but was crumpled up. I opened it and noticed a smudged mark in the corner. It looked like an ancient symbol, a strange elliptical script of rounded shapes, but was too small to read. An intergalactic message, a signal from an alien presence perhaps? So I borrowed a magnifying glass from the Artspace gallery attendant. It read: I love opera. Robot Two must die. This was unexpected! As I pondered the robot’s reply, I noticed the robots did indeed make strange bird-like noises to one another; their tapping was like rhythmic woodpeckers. Their hammering was a kind of operatic symphony; it was not far-fetched that these robots were appreciative of the sound patterns they made. In other words, they were responding to stimuli in the environment, and acting in response. They had agency beyond the immaterial computational programming their creators had embedded. It wasn’t difficult to suspend disbelief to allow the possibility that interaction between the robots might occur, or that one might have gone rogue. An acceptance of the possibility of inter-agency would allow the fantastical reality of a human becoming short-term pen pals with an augmented machine. Karen Barad might endorse such an unexpected intra-action act. She discourages conventional critique as, “a tool that keeps getting used out of habit” (Matter Feels). Art writing, in an era of robots and awareness of other non-human sentient life-forms can be speculative invention, have a Barad-like imaginative materiality (Matter Feels), and sense of suspended disbelief. Figure 2: Accomplice by Petra Gemeinboeck and Rob Saunders, Artspace, Sydney, 2013. (Photo: Petra Gemeinboeck) The Final Onto-Story Straw Gemeinboeck and Saunders say the space where their robots perform is a questionable one: “the fidelity of the space as a shared experience is thus brought into question: how can a shared virtual experience be trusted when it is constructed from such intangible and malleable stuff as streams of binary digits” (7). The answer might be that it is not to be trusted, particularly in an OOO aesthetic approach that allows divergent and contingent fictive possibilities. Indeed, thinking about the fidelity of the space, there was something about a narrow access corridor in the Accomplice exhibition space, between the false gallery wall and the cavity where the robots moved on their track, that beckoned me. I glanced over my shoulder to check that the Artspace attendant wasn’t watching and slipped behind the wall. I took a few tentative steps, not wanting to get knocked on the nose by a zooming robot. I saw that one robot had turned away from the wall and was attacking another with its hammer. By the time I arrived, the second robot (could it be Robot Two?) had been badly pummeled. Not only did Robot One attack Robot Two but I witnessed it using its extended hammer to absorb metal parts: the light and the hammer. It was adapting, like Philip K. Dick’s robots in his short story ‘Preserving Machine’ (See Gray 228-33). It was becoming more augmented. It now had two lights and two hammers and seemed to move at double speed. Figure 3: Accomplice by Petra Gemeinboeck and Rob Saunders, Artspace, Sydney, 2013. (Photo: Petra Gemeinboeck)My observance of this scene might be explained by Gemeinboeck/Saunders’s comment regarding Philip K. Dick-style interference and instability, which they actively apply to their work. They say, “The ‘gremlins’ of our works are the slipping logics of nonlinear systems or distributed agential forces of colliding materials” (18). An audience response is a colliding material. A fictional aside is a colliding material. A suspension of disbelief must also be considered a colliding material. This is the politics of the para-human, where regulations and policies are in their infancy. Fears of artificial intelligence seem absurd, when we consider how startled we become when the boundaries between fiction/truth become as flimsy and slippery as the boundaries between human/non-human. Art writing that resists truth complements Gemeinboeck/Saunders point that, “different agential forces not only co-evolve but perform together” (18).The DisappearanceBefore we are able to distinguish any unexpected or enchanted ontological outcomes, the robots must first appear, but for things to truly appear to us, they must first disappear. The robots disappear from view, behind the false walls. Slowly, through the enactment of an agented force (the action of their hammers upon the wall), they beat a path into the viewer’s visual reality. Their emergence signals a performative augmentation. Stronger, better, smarter, longer: these creatures are more-than-human. Yet despite the robot’s augmented technological improvement upon human ability, their being (here, meaning their independent autonomy) is under threat in a human-centred world environment. First they are threatened by the human habit of reducing them to anthropomorphic characteristics: they can be seen as cute little versions of humans. Secondly, they are threatened by human perception that they are under the control of the programmers. Both points are arguable: these robots are undoubtedly non-human, and there are unexpected and unplanned outcomes, once they are activated. These might be speculative or contestable outcomes, which are not demonstrably an epitome of truth (Bennett 161). Figure 4: Accomplice by Petra Gemeinboeck and Rob Saunders, Artspace, Sydney, 2013. (Photo: Petra Gemeinboeck)Gemeinboeck’s robotic creatures, with their apparent work/play and civil disobedience, appeared to exhibit human traits. An OOO approach would discourage these anthropomorphic tendencies: by seeing human qualities in inanimate objects, we are only falling back into correlational habits—where nature and culture are separate dyads and can never comprehend each other, and where humankind is mistakenly privileged over all other entities (Meillassoux 5). This only serves to inhibit any access to a reality outside the human-centred view. This kind of objectivity, where we see ourselves as nature, does no more than hold up a mirror to our inescapably human selves (Barad, Matter Feels). In an object-oriented approach the unpredictable outcomes of the robots’s performance is brought to attention. OOO proponent and digital media theorist Ian Bogost, has a background in computational media, especially video and social media games, and says, “computers are plastic and metal corpses with voodoo powers” (9). This is a non-life description, hovering in the liminal space between being and not being. Bogost’s view is that a strange world stirs within machinic devices (9). A question to ask: what’s it like to be a robot? Perhaps the answer lies somewhere between what it does and how we see it. It is difficult not to think of twentieth century philosopher Martin Heidegger’s tool analysis theory when writing of Gemeinboeck/Saunders’s work because Heidegger, and OOO scholar Graham Harman after him, uses the hammer as his paradigmatic tool. In his analysis, things are only present-at-hand (consciously perceived without utility) once they break (Harman, Heidegger Explained 63). However, Gemeinboeck and Saunders’s installation Accomplice straddles Heidegger’s dual present-at-hand and read-at-hand (the utility of the thing) because art raises the possibility that we might experience these divergent qualities of the robotic entities, simultaneously. The augmented robot, existing in its performative exhibition ecology, is the bridge between sentient life and utility. Robotic Agency In relation to the agency of robots, Ian Bogost refers to the Tableau Machine which was a non-human actor system created by researchers at Georgia Tech in 1998 (Bogost 106). It was a house fitted with cameras, screens, interfaces, and sensors. This was an experimental investigation into ambient intelligence. The researchers’s term for the computational agency was ‘alien presence,’ suggesting a life outside human comprehension. The data-collator sensed and interpreted the house and its occupants, and re-created that recorded data as abstract art, by projecting images on its own plasma screens. The implication was that the home was alive, vital, and autonomously active, in that it took on a sentient life, beyond human control. This kind of vital presence, an aliveness outside human programming, is there in the Accomplice robots. Their agency becomes materialized, as they violate the polite gallery-viewing world. Karen Barad’s concept of agency works within a relational ontology. Agency resists being granted, but rather is an enactment, and creates new possibilities (Barad, Matter Feels). Agency is entangled amongst “intra-acting human and non-human practices” (6). In Toward an Enchanted Materialism, Jane Bennett describes primordia (atoms) as “not animate with divine spirit, and yet they are quite animated - this matter is not dead at all” (81). This then is an agency that is not spiritual, nor is there any divine purpose. It is a matter of material force, a subversive action performed by robotic entities, not for any greater good, in fact, for no reason at all. This unpredictability is OOO contingency, whereby physical laws remain indifferent to whether an event occurs or not (Meillassoux 39). Figure 5: Accomplice by Petra Gemeinboeck and Rob Saunders, Artspace, Sydney, 2013. (Photo: Petra Gemeinboeck) A Post-Human Ethic The concept of a post-human state of being raises ethical concerns. Ethics is a human construct, a criteria of standards fixed within human social systems. How should humans respond, without moral panic, to robots that might have life and sentient power outside human control? If an OOO approach is undertaken, the implication is that all things exist equally and ethics, as fixed standards, might need to be dismantled and replaced with a more democratic set of guidelines. A flat ontology, argued for by Bogost, Levi Bryant and other OOO advocates, follows that all entities have equal potential for independent energy and agency (although OOO theorists disagree on many small technical issues). The disruption of the conventional hierarchical model of being is replaced by a flat field of equality. This might cause the effect of a more ethical, ontological ecology. Quentin Meillassoux, an influential figure in the field of Speculative Realism, from which OOO is an offshoot, finds philosophical/mathematical solutions to the problems of human subjectivity. His eschewing of Kantian divisions between object/subject and human/world, is accompanied by a removal from Kantian and Cartesian critique (Meillassoux 30). This turn from critique, and its related didactic authority and removed judgment, marks an important point in the culture of philosophy, but also in the culture of art writing. If we can escape the shackles of divisive critique, then the pleasures of narrative might be given space. Bogost endorses collapsing the hierarchical model of being and converting conventional academic writing (89). He says, “for the computers to operate at all for us first requires a wealth of interactions to take place for itself. As operators or engineers, we may be able to describe how such objects and assemblages work. But what do they “experience” (Bogost 10)? This view is complementary to an OOO view of anti-subjectivity, an awareness of things that might exist irrespective of human life, from both inside and outside the mind (Harman 143). Figure 6: Accomplice by Petra Gemeinboeck and Rob Saunders, Artspace, Sydney, 2013. (Photo: Petra Gemeinboeck) New Materiality In addition to her views on human/non-human agency, Karen Barad develops a parallel argument for materiality. She says, “matter feels, converses, suffers, desires, yearns and remembers.” Barad’s agential realism is predicated on an awareness of the immanence of matter, with materiality that subverts conventions of transcendence or human-centredness. She says, “On my agential realist account, all bodies, not merely human bodies, come to matter through the world’s performativity - its iterative intra-activity.” Barad sees matter, all matter, as entangled parts of phenomena that extend across time and space (Nature’s Queer Performativity 125). Barad argues against the position that acts against nature are moral crimes, which occur when the nature/culture divide is breached. She questions the individuated categorizations of ‘nature’ and ‘culture’ inherent in arguments like these (Nature’s Queer Performativity, 123-5). Likewise, in robotic and machinic aesthetics, it could be seen as an ethical breach to consider the robots as alive, sentient, and experiential. This confounds previous cultural separations, however, object-oriented theory is a reexamination of these infractions and offers an openness to discourse of different causal outcomes. Figure 7: Accomplice by Petra Gemeinboeck and Rob Saunders, Artspace, Sydney, 2013. (Photo: Petra Gemeinboeck) Co-Evolution Artists Gemeinboeck/Saunders are artists and scholarly researchers investigating new notions of co-evolution. If we ascribe human characteristics to robots, might they ascribe machinic properties to us? It is possible to argue that co-evolution is already apparent in the world. Titanium knees, artificial arteries, plastic hips, pacemakers, metallic vertebrae pins: human medicine is a step ahead. Gemeinboeck/Saunders in turn make a claim for the evolving desires of their robots (11). Could there be performative interchangeability between species: human and robot? Barad asks us not to presume what the distinctions are between human and non-human and not to make post-humanist blurrings, but to understand the materializing effects of the boundaries between humans and nonhumans (Nature’s Queer Performativity 123). Vital matter emerges from acts of reappearance, re-performance, and interspecies interaction. Ian Bogost begins his Alien Phenomenology by analysing Alan Turing’s essay, Computing Machinery and Intelligence and deduces that it is an approach inextricably linked to human understanding (Bogost 14). Bogost seeks to avoid distinctions between things or a slippage into an over-determination of systems operations, and instead he adopts an OOO view where all things are treated equally, even cheeky little robots (Bogost 17).Figure 8: Accomplice by Petra Gemeinboeck and Rob Saunders, installation view, Artspace, Sydney. (Photo: silversalt photography) Intra-Active ReappearanceIf Barad describes intra-action as enacting an agential cut or separation of object from subject, she does not mean a distinction between object and subject but instead devises an intra-active cutting of things together-apart (Nature’s Queer Performativity 124). This is useful for two reasons. First it allows confusion between inside and outside, between real and unreal, and between past and future. In other words it defies the human/world correlates, which OOO’s are actively attempting to flee. Secondly it makes sense of an idea of disappearance as being a re-appearance too. If robots, and all other species, start to disappear, from our consciousness, from reality, from life (that is, becoming extinct), this disappearance causes or enacts a new appearance (the robotic action), and this action has its own vitality and immanence. If virtuality (an aesthetic of being that grew from technology, information, and digital advancements) meant that the body was left or abandoned for an immaterial space, then robots and robotic artwork are a means of re-inhabiting the body in a re-materialized mode. This new body, electronic and robotic in nature, might be mastered by a human hand (computer programming) but its differential is its new agency which is one shared between human and non-human. Barad warns, however, against a basic inversion of humanism (Nature’s Queer Performativity 126). Co-evolution is not the removal of the human. While an OOO approach may not have achieved the impossible task of creating a reality beyond the human-centric, it is a mode of becoming cautious of an invested anthropocentric view, which robotics and diminished non-human species bring to attention. The autonomy and agency of robotic life challenges human understanding of ontological being and of how human and non-human entities relate.References Barad, Karen. "Nature’s Queer Performativity." Qui Parle 19.2 (2011): 121-158. ———. Interview. In Rick Dolphijn and Van Der Tuin. “Matter Feels, Converses, Suffers, Desires, Yearns and Remembers: Interview with Karen Barad.” New Materialism: Interviews and Cartographies. Ann Arbor: University of Michigan; Open Humanities Press, 2012. ———. "Posthumanist Performativity: Toward an Understanding of How Matter Comes to Matter." Signs: Journal of Women in Culture and Society 28.3 (2003): 801-831. Bennett, Jane. The Enchantment of Modern Life: Attachments, Crossings, and Ethics. New Jersey: Princeton University Press, 2001. Bogost, Ian. Alien Phenomenology. Minneapolis: Minnesota Press, 2012. Bryant, Levi. The Democracy of Objects. University of Michigan Publishing: Open Humanities Press, 2011. ———, N. Srnicek, and GHarman. The Speculative Turn: Continental Materialism and Realism. Melbourne: re:press, 2011. Gemeinboeck, Petra, and Rob Saunders. “Other Ways of Knowing: Embodied Investigations of the Unstable, Slippery and Incomplete.” Fibreculture Journal 18 (2011). ‹http://eighteen.fibreculturejournal.org/2011/10/09/fcj-120-other-ways-of-knowing-embodied-investigations-of-the-unstable-slippery-and-incomplete/›. Gray, Nathan. "L’object sonore undead." In A. Barikin and H. Hughes. Making Worlds: Art and Science Fiction. Melbourne: Surpllus, 2013. 228-233. Harman, Graham. The Quadruple Object. Winchester UK: Zero Books, 2011. ———. Guerilla Metaphysics: Phenomenology and the Carpentry of Things. Chicago: Open Court, 2005. ———. Heidegger Explained: From Phenomenon to Thing. Chicago: Open Court Publishing, 2007. Heidegger, Martin. Being and Time. San Francisco: Harper and Row, 1962. Meillassoux, Quentin. After Finitude: An Essay on the Necessity of Contingency. New York: Continuum, 2008. Muecke, Stephen. "The Fall: Ficto-Critical Writing." Parallax 8.4 (2002): 108-112. ———. "Motorcycles, Snails, Latour: Criticism without Judgment." Cultural Studies Review 18.1 (2012): 40-58. ———. “The Writing Laboratory: Political Ecology, Labour, Experiment.” Angelaki 14.2 (2009): 15-20. Phelan, Peggy. Unmarked: The Politics of Performance. London: Routledge, 1993.

In August 2017, a white supremacist rally marketed as “Unite the Right” was held in Charlottesville, Virginia. In participation were members of the alt-right, including neo-nazis, white nationalists, neo-confederates, and other hate groups (Atkinson). The rally swiftly erupted in violence between white supremacists and counter protestors, culminating in the death of a counter-protester named Heather Heyer, who was struck by a car driven by white supremacist James Alex Fields, and leaving dozens injured. Terry McQuliffe, the Governor of Virginia, declared a state of emergency on August 12, and the world watched while white supremacists boldly marched in clothing emblazoned with symbols ranging from swastikas to a cartoon frog (Pepe), with flags featuring the nation of “Kekistan”, and carrying tiki torches chanting, “You Will Not Replace Us... Jews Will Not Replace Us”.The purpose of this essay is not, however, to examine the Internet symbols that circulated during the Unite the Right rally but rather to hone in on a specific moment that illustrates a key part of Internet culture that was often overlooked during analysis of the events that occurred during the riots: a documentary filmmaker, C. J. Hunt, was at the rally to record footage for a project on the removal of Confederate monuments. While there, he saw a rally-goer dressed in the white polo t-shirt and khaki pants uniform of the white nationalist group Vanguard America. The rally-goer, a young white man, was being chased by a counter-protester. He began to scream and beg for mercy, and even went as far as stripping off his clothing and denying that he really believed in any of the group’s ideology. In the recording by Hunt, who asks why he was there and why he was undressing, the young white man responded that shouting white power is “fun”, and that he was participating in the event because he, quote, “likes to be offensive” (Hunt).As Hunt notes in a piece for GQ reflecting on his experience at the rally, as soon as the man was cut off from his group and confronted, the runaway racist’s demeanor immediately changed when he had to face the consequences of his actions. Trolls often rely on the safety and anonymity of online forums and digital spaces where they are often free from having to face the consequences of their actions, and for the runaway racist, things became real very quickly when he was forced to own up to his hateful actions. In a way, many members of these movements seem to want politics without consequence for themselves, but with significant repercussions for others. Milo Yiannopoulos, a self-professed “master troll”, built an entire empire worth millions of dollars off of what the far-right defends as ironic hate speech and a form of politics without consequences reserved only for the privileged white men that gleefully engage in it. The runaway racist and Yiannopoulos are borne out of an Internet culture that is built on being offensive, on trolling, and “troll” itself being an aspirational label and identity, but also more importantly, a political aesthetic.In this essay, I argue that trolling itself has become a kind of political aesthetic and identity, and provide evidence via examples like hoaxes, harassment campaigns, and the use of memes to signal to certain online populations and extremist groups in violent attacks. First coined by Walter Benjamin in order to explain a fundamental component of using art to foster consent and compliance in fascist regimes, the term since then has evolved to encompass far more than just works of art. Benjamin’s original conception of the term is in regard to a creation of a spectacle that prevents the masses from recognizing their rights – in short, the aestheticization of politics is not just about the strategies of the fascist regimes themselves but says more about the subjects within them. In the time of Benjamin’s writing, the specific medium was mass propaganda through the newly emerging film industry and other forms of art (W. Benjamin). To Benjamin, these aesthetics served as tools of distracting to make fascism more palatable to the masses. Aesthetic tools of distraction serve an affective purpose, revealing the unhappy consciousness of neoreactionaries (Hui), and provide an outlet for their resentment.Since political aesthetics are concerned with how cultural products like art, film, and even clothing reflect political ideologies and beliefs (Sartwell; McManus; Miller-Idriss), the objects of analysis in this essay are part of the larger visual culture of the alt-right (Bogerts and Fielitz; Stanovsky). Indeed, aesthetic aspects of political systems shift their meaning over time, or are changed and redeployed with transformed effect (Sartwell). In this essay, I am applying the concept of the aestheticization of politics by analyzing how alt-right visual cultures deploy distraction and dissimulation to advance their political agenda through things like trolling campaigns and hoaxes. By analyzing these events, their use of memes, trolling techniques, and their influence on mainstream culture, what is revealed is the influence of trolling on political culture for the alt-right and how the alt-right then distracts the rest of the public (McManus).Who’s Afraid of the Big Bad Troll?Large scale analyses of disinformation and extremist content online tends to examine how certain actors are connected, what topics emerge and how these are connected across platforms, and the ways that disinformation campaigns operate in digital environments (Marwick and Lewis; Starbird; Benkler et al.). Masculine and white-coded technology gave rise to male-dominated digital spaces (R. Benjamin), with trolling often being an issue faced by non-normative users of the Internet and their communities (Benjamin; Lumsden and Morgan; Nakamura; Phillips, Oxygen). Creating a kind of unreality where it is difficult to parse out truth from lies, fiction from non-fiction, the troll creates cultural products, and by hiding behind irony and humor confuses onlookers and is removed from any kind of reasonable blame for their actions. Irony has long been a rhetorical strategy used in politics, and the alt right has been no exception (Weatherby), but for our current sociopolitical landscape, trolling is a political strategy that infuses irony into politics and identity.In the digital era, political memes and internet culture are pervasive components of the spread of hate speech and extremist ideology on digital platforms. Trolling is not an issue that exists in a vacuum – rather, trolls are a product of greater mainstream culture that encourages and allows their behaviors (Phillips, This Is Why; Fichman and Sanfilippo; Marwick and Lewis). Trolls, and meme culture in general, have often been pointed to as being part of the reason for the rise of Trump and fascist politics across the world in recent years (Greene; Lamerichs et al.; Hodge and Hallgrimsdottir; Glitsos and Hall). Although criticism has been expressed about how impactful memes were in the election of Donald Trump, political memes have had an impact on the ways that trolling went from anonymous jerks on forums to figures like Yiannapoulos who built entire careers off of trolling, creating empires of hate (Lang). These memes that are often absurd and incomprehensible to those who are not a part of the community that they come from aim to cheapen, trivialize, and mock social justice movements like Black Lives Matter, feminism, LGBTQ+ rights, and others.But the history of trolling online goes as far back as the Internet itself. “Trolling” is just a catch all term to describe online behaviors meant to antagonize, to disrupt online conversations, and to silence other users (Cole; Fichman and Sanfilippo). As more and more people started moving online and engaging in participatory culture, trolling continued to evolve from seemingly harmless jokes like the “Rick Roll” to targeted campaigns meant to harass women off of social media platforms (Lumsden and Morgan; Graham). Trolling behaviors are more than just an ugly part of the online experience, but are also a way for users to maintain the borders of their online community - it’s meant to drive away those who are perceived to be outsiders not just from the specific forum, but the Internet itself (Graham). With the rise of modern social media platforms, trolling itself is also a part of the political landscape, creating a “toxic counterpublic” that combines irony with a kind of earnestness to spread and inject their beliefs into mainstream political discourse (Greene). As a mode of information warfare, these subversive rhetorical strategies meant to contradict or reverse existing political and value systems have been used throughout history as a political tactic (Blackstock).The goal of trolling is not just to disrupt conversations, but to lead to chaos via confusion about the sincerity and meaning of messages and visuals, and rather than functioning as a politics of outrage (on the part of the adherents), it is a politics of being as outrageous as possible. As a part of larger meme culture, the aesthetics of trolls and their outrageous content manage to operate under the radar by being able to excuse their behaviors and rhetoric as just “trolling” or “joking”. This ambiguity points to trolling on the far right as a political strategy and identity to absolve them of blame or accusations of what their real intentions are. Calling them “trolls” hides the level of sophistication and vast levels of influence that they had on public opinion and discourse in the United States (Geltzer; Starks et al.; Marwick and Lewis). We no longer live in a world apart from the troll’s influence and immune from their toxic discourse – rather, we have long been under the bridge with them.Co-Opted SymbolsOne of the most well-known examples of trolling as a political aesthetic and tactic may be the OK hand sign used by the Christchurch shooter. The idea that the OK hand sign was a secretly white supremacist symbol started as a hoax on 4chan. The initial 2017 hoax purported that the hand sign was meant to stand for “White Power”, with the three fingers representing the W and the circle made with the index finger and thumb as the P (Anti-Defamation League, “Okay Hand Gesture”). The purpose of perpetuating the hoax was to demonstrate that (a) they were being watched and (b) that the mainstream media is stupid and gullible enough to believe this hoax. Meant to incite confusion and to act as a subversive strategy, the OK hand sign was then actually adopted by the alt-right as a sort of meme to not just perpetuate the hoax, but to signal belonging to the larger group (Allyn). Even though the Anti-Defamation League initially listed it as not being a hate symbol and pointed out the origins of the hoax (Anti-Defamation League, “No, the ‘OK’ Gesture Is Not a Hate Symbol”), they then switched their opinion when the OK hand sign was being flashed by white supremacists, showing up in photographs at political events, and other social media content. In fact, the OK hand sign is also a common element in pictures of Pepe the Frog, who is a sort of “alt right mascot” (Tait; Glitsos and Hall), but like the OK hand sign, Pepe the Frog did not start as an alt-right mascot and was co-opted by the alt-right as a mode of representation.The confusion around the actual meaning behind the hand symbol points to how the alt-right uses these modes of representation in ways that are simultaneously an inside joke and a real expression of their beliefs. For instance, the Christchurch shooter referenced a number of memes and other rhetoric typical of 4chan and 8chan communities in his video and manifesto (Quek). In the shooter’s manifesto and video, the vast amounts of content that point to the trolling and visual culture of the alt-right are striking – demonstrating how alt-right memes not only make this violent ideology accessible, but are cultural products meant to be disseminated and ultimately, result in some kind of action (DeCook).The creation and co-optation of symbols by the alt-right like the OK hand sign are not just memes, but a form of language created by extremists for extremists (Greene; Hodge and Hallgrimsdottir). The shooter’s choice of including this type of content in his manifesto as well as certain phrases in his live-streamed video indicate his level of knowledge of what needed to be done for his attack to get as much attention as possible – the 4chan troll is the modern-day bogeyman, and parts of the manifesto have been identified as intentional traps for the mainstream media (Lorenz).Thus, the Christchurch shooter and trolling culture are linked, but referring to the symbols in the manifesto as being a part of “trolling” culture misses the deeper purpose – chaos, through the outrage spectacle, is the intended goal, particularly by creating arguments about the nature and utility of online trolling behavior. The shooter encouraged other 8chan users to disseminate his posted manifesto as well as to share the video of the attack – and users responded by immortalizing the event in meme format. The memes created celebrated the shooter as a hero, and although Facebook did remove the initial livestream video, it was reuploaded to the platform 1.2 million times in the first 24 hours, attempting to saturate the online platform with so many uploads that it would cause confusion and be difficult to remove (Gramenz). Some users even created gifs or set the video to music from the Doom video game soundtrack – a video game where the player is a demon slayer in an apocalyptic world, further adding another layer of symbolism to the attack.These political aesthetics – spread through memes, gifs, and “fan videos” – are the perfect vehicles for disseminating extremist ideology because of what they allow the alt-right to do with them: hide behind them, covering up their intentions, all the while adopting them as signifiers for their movement. With the number of memes, symbols, and phrases posted in his manifesto and spoken aloud in his mainstream, perhaps the Christchurch shooter wanted the onus of the blame to fall on these message board communities and the video games and celebrities referenced – in effect, it was “designed to troll” (Lorenz). But, there is a kernel of truth in every meme, post, image, and comment – their memes are a part of their political aesthetic, thus implicit and explicit allusions to the inner workings of their ideology are present. Hiding behind hoaxes, irony, edginess, and trolling, members of the alt-right and other extremist Internet cultures then engage in a kind of subversion that allows them to avoid taking any responsibility for real and violent attacks that occur as a result of their discourse. Antagonizing the left, being offensive, and participating in this outrage spectacle to garner a response from news outlets, activists, and outsiders are all a part of the same package.Trolls and the Outrage SpectacleThe confusion and the chaos left behind by these kinds of trolling campaigns and hoaxes leave many to ask: How disingenuous is it? Is it meant for mere shock value or is it really reflective of the person’s beliefs? In terms of the theme of dissimulation for this special issue, what is the real intent, and under what pretenses should these kinds of trolling behaviors be understood? Returning to the protestor who claimed “I just like to be offensive”, the skepticism from onlookers still exists: why go so far as to join an alt-right rally, wearing the uniform of Identity Evropa (now the American Identity Movement), as a “joke”?Extremists hide behind humor and irony to cloud judgments from others, begging the question of can we have practice without belief? But, ultimately, practice and belief are intertwined – the regret of the Runaway Racist is not because he suddenly realized he did not “believe”, but rather was forced to face the consequences of his belief, something that he as a white man perhaps never really had to confront. The cultural reach of dissimulation, in particular hiding true intent behind the claim of “irony”, is vast - YouTuber Pewdiepie claimed his use of racial and anti-Semitic slurs and putting on an entire Ku Klux Klan uniform in the middle of a video were “accidental” only after considerable backlash (Picheta). It has to be noted, however, that Pewdiepie is referenced in the manifesto of the Christchurch shooter – specifically, the shooter yelled during his livestream “subscribe to Pewdiepie”, (Lorenz). Pewdiepie and many other trolls, once called out for their behavior, and regardless of their actual intent, double down on their claims of irony to distract from the reality of their behaviors and actions.The normalization of this kind of content in mainstream platforms like Twitter, YouTube, Facebook, and even Instagram show how 4chan and alt-right Internet culture has seeped out of its borders and exists everywhere online. This “coded irony” is not only enabled rhetorically due to irony’s slippery definition, but also digitally via these online media (Weatherby). The aesthetics of the troll are present in every single platform and are disseminated everywhere – memes are small cultural units meant to be passed on (Shifman), and although one can argue it was not memes alone that resulted in the rise of the alt-right and the election of Donald Trump, memes are a part of the larger puzzle of the political radicalization process. The role of the Internet in radicalization is so powerful and insidious because of the presentation of content – it is funny, edgy, ironic, offensive, and outrageous. But these behaviors and attitudes are not just appealing to some kind of adolescent-like desire to push boundaries of what is and is not socially acceptable and/or politically incorrect (Marwick and Lewis), and calling it such clouds people’s perceptions of their level of sophistication in shaping political discourse.Memes and the alt-right are a noted phenomenon, and these visual cultures created by trolls on message boards have aided in the rise of the current political situation worldwide (Hodge and Hallgrimsdottir). We are well in the midst of a type of warfare based on not weapons and bodies, but information and data - in which memes and other elements of the far right’s political aesthetic play an important role (Molander et al.; Prier; Bogerts and Fielitz). The rise of the online troll as a political player and the alt-right are merely the logical outcomes of these systems.ConclusionThe alt-right’s spread was possible because of the trolling cultures and aesthetics of dissimulation created in message boards that predate 4chan (Kitada). The memes and inflammatory statements made by them serve multiple purposes, ranging from an intention to incite outrage among non-members of the group to signal group belonging and identity. In some odd way, if people do not understand the content, the content actually speaks louder and, in more volumes, that it would if its intent was more straightforward – in their confusion, people give these trolling techniques more attention and amplification in their attempt to make sense of them. Through creating confusion, distraction, and uncertainty around the legitimacy of messages, hand signs, and even memes, the alt-right has elevated the aestheticization of politics to a degree that Walter Benjamin could perhaps not have predicted in his initial lament about the distracted masses of fascist regimes (McManus). The political dimensions of trolling and the cognitive uncertainty that it creates is a part of its goal. Dismissing trolls is no longer an option, but also regarding them as sinister political operatives may be overblowing their significance. In the end, “ironic hate speech” is still hate speech, and by couching their extremist ideology in meme format they make their extremist beliefs more palatable -- and nobody is completely immune to their strategies.ReferencesAllyn, Bobby. “The ‘OK’ Hand Gesture Is Now Listed as a Symbol of Hate.” NPR 2019. <https://www.npr.org/2019/09/26/764728163/the-ok-hand-gesture-is-now-listed-as-a-symbol-of-hate>.Anti-Defamation League. “No, the ‘OK’ Gesture Is Not a Hate Symbol.” Anti-Defamation League. 10 Dec. 2017 <https://www.adl.org/blog/no-the-ok-gesture-is-not-a-hate-symbol>.———. “Okay Hand Gesture.” Anti-Defamation League. 28 Feb. 2020 <https://www.adl.org/education/references/hate-symbols/okay-hand-gesture>.Atkinson, David C. “Charlottesville and the Alt-Right: A Turning Point?” Politics, Groups, and Identities 6.2 (2018): 309-15.Benjamin, Ruha. Race after Technology: Abolitionist Tools for the New Jim Code. Polity, 2019.Benjamin, Walter. The Work of Art in the Age of Mechanical Reproduction. CreateSpace Independent Publishing Platform, 1936.Benkler, Yochai, et al. Network Propaganda: Manipulation, Disinformation, and Radicalization in American Politics. Oxford: Oxford UP, 2018.Blackstock, Paul W. The Strategy of Subversion: Manipulating the Politics of Other Nations. Chicago: Quadrangle Books, 1964.Bogerts, Lisa, and Maik Fielitz. “Do You Want Meme War?”: Understanding the Visual Memes of the German Far Right. 2019.Cole, Kirsti K. “‘It’s Like She’s Eager to Be Verbally Abused’: Twitter, Trolls, and (En)Gendering Disciplinary Rhetoric.” Feminist Media Studies 15.2 (2015): 356-58.DeCook, Julia R. “Memes and Symbolic Violence: #Proudboys and the Use of Memes for Propaganda and the Construction of Collective Identity.” Learning, Media and Technology 43.4 (2018): 485-504.Douglas, Nick. “It’s Supposed to Look Like Shit: The Internet Ugly Aesthetic.” Journal of Visual Culture 13.3 (2014): 314-39.Fichman, Pnina, and Madelyn R. Sanfilippo. Online Trolling and Its Perpetrators: Under the Cyberbridge. Rowman & Littlefield, 2016.Funke, Daniel. “When and How to Use 4chan to Cover Conspiracy Theories.” Poynter, 24 Sep. 2018. <https://www.poynter.org/fact-checking/2018/when-and-how-to-use-4chan-to-cover-conspiracy-theories/>.Geltzer, Joshua A. “Stop Calling Them ‘Russian Troll Farms’ - CNN.” CNN, 2018. <https://www.cnn.com/2018/08/17/opinions/stop-calling-russian-operatives-troll-farms-geltzer/index.html>.Glitsos, Laura, and James Hall. “The Pepe the Frog Meme: An Examination of Social, Political, and Cultural Implications through the Tradition of the Darwinian Absurd.” Journal for Cultural Research 23.4 (2019): 381-95.Graham, Elyse. “Boundary Maintenance and the Origins of Trolling.” New Media & Society (2019). doi:10.1177/1461444819837561.Gramenz, Jack. “Christchurch Mosque Attack Livestream: Why Facebook Continues to Fail.” New Zealand Herald 17 Feb. 2020. <https://www.nzherald.co.nz/business/news/article.cfm?c_id=3&objectid=12309116>.Greene, Viveca S. “‘Deplorable’ Satire: Alt-Right Memes, White Genocide Tweets, and Redpilling Normies.” Studies in American Humor 5.1 (2019): 31–69.Hodge, Edwin, and Helga Hallgrimsdottir. “Networks of Hate: The Alt-Right, ‘Troll Culture’, and the Cultural Geography of Social Movement Spaces Online.” Journal of Borderlands Studies (2019): 1–18.Hui, Yuk. “On the Unhappy Consciousness of Neoreactionaries.” E-Flux 81 (2017). <https://www.e-flux.com/journal/81/125815/on-the-unhappy-consciousness-of-neoreactionaries/>.Hunt, C. J. “A Charlottesville White Supremacist Stripped Down to Escape Protesters and We Got It on Video.” GQ 2017. <https://www.gq.com/story/charlottesville-white-supremacist-strips-to-escape-protestors>.Kitada, Akihiro. “Japan’s Cynical Nationalism.” Fandom Unbound: Otaku Culture in a Connected World. Eds. Mizuko Ito et al. Yale UP, 2012: 68–84.Lamerichs, Nicolle, et al. “Elite Male Bodies: The Circulation of Alt-Right Memes and the Framing of Politicians on Social Media.” Participations 15.1 (2018): 180–206.Lang, Nico. “Trolling in the Name of ‘Free Speech’: How Milo Yiannopoulos Built an Empire off Violent Harassment.” Salon, 2016. <http://www.salon.com/2016/12/19/trolling-in-the-name-of-free-speech-how-milo-yiannopoulos-built-an-empire-off-violent-harassment/>.Lorenz, Taylor. “The Shooter’s Manifesto Was Designed to Troll.” The Atlantic, 15 Mar. 2019. <https://www.theatlantic.com/technology/archive/2019/03/the-shooters-manifesto-was-designed-to-troll/585058/>.Lumsden, Karen, and Heather Morgan. “Media Framing of Trolling and Online Abuse: Silencing Strategies, Symbolic Violence, and Victim Blaming.” Feminist Media Studies 17.6 (2017): 926–40.Marwick, Alice E., and Rebecca Lewis. “Media Manipulation and Disinformation Online.” Data & Society, 2017. <http://centerformediajustice.org/wp-content/uploads/2017/07/DataAndSociety_MediaManipulationAndDisinformationOnline.pdf>.McManus, Matt. “Walter Benjamin and the Political Practices of the Alt-Right.” New Politics, 27 Dec. 2017. <https://newpol.org/walter-benjamin-and-political-practices-altright/>.Miller-Idriss, Cynthia. The Extreme Gone Mainstream: Commercialization and Far Right Youth Culture in Germany. Princeton UP, 2018.Molander, Roger C., et al. Strategic Information Warfare: A New Face of War. RAND Corporation, 1996. <https://www.rand.org/pubs/monograph_reports/MR661.html>.Nakamura, Lisa. Cybertypes: Race, Ethnicity, and Identity on the Internet. Routledge, 2002.Nissenbaum, Asaf, and Limor Shifman. “Internet Memes as Contested Cultural Capital: The Case of 4chan’s /b/ Board.” New Media & Society 19.4 (2017): 483–501.Phillips, Whitney. The Oxygen of Amplification. Data & Society, 2018. <https://datasociety.net/output/oxygen-of-amplification>.———. This Is Why We Can’t Have Nice Things: Mapping the Relationship between Online Trolling and Mainstream Culture. Cambridge, Mass.: MIT Press, 2015.Picheta, Rob. “PewDiePie Will Take a Break from YouTube, Saying He’s ‘Very Tired.’” CNN, 2019. <https://www.cnn.com/2019/12/16/tech/pewdiepie-taking-break-youtube-scli-intl/index.html>.Prier, Jarred. “Commanding the Trend: Social Media as Information Warfare.” Strategic Studies Quarterly 11.4 (2017): 50–85.Quek, Natasha. Bloodbath in Christchurch: The Rise of Far-Right Terrorism. 2019.Sartwell, Crispin. Political Aesthetics. Cornell UP, 2010.Shifman, Limor. Memes in Digital Culture. Cambridge, Mass.: MIT Press, 2014.Stanovsky, Derek. “Remix Racism: The Visual Politics of the ‘Alt-Right’.” Journal of Contemporary Rhetoric 7 (2017).Starbird, Kate. “Examining the Alternative Media Ecosystem through the Production of Alternative Narratives of Mass Shooting Events on Twitter.” International AAAI Conference on Web and Social Media (2017): 230–239. <https://www.aaai.org/ocs/index.php/ICWSM/ICWSM17/paper/view/15603>.Starks, Tim, Laurens Cerulus, and Mark Scott. “Russia’s Manipulation of Twitter Was Far Vaster than Believed.” Politico, 5 Jun. 2019. <https://politi.co/2HXDVQ2>.Tait, Amelia. “First They Came for Pepe: How ‘Ironic’ Nazism Is Taking Over the Internet.” New Statesman 16 Feb. 2017. <http://www.newstatesman.com/science-tech/internet/2017/02/first-they-came-pepe-how-ironic-nazism-taking-over-internet>.

In the 1960s, especially in the West, art that was revelatory and art that was revealing operated at opposite ends of the aesthetic spectrum. On the side of the revelatory we can think of encounters synonymous with modernism, in which an expressionist painting was revelatory of the Freudian unconscious, or a Barnett Newman the revelatory intensity of the sublime. By contrast, the impulse to reveal in 1960s art was rooted in post-Duchampian practice, implicating artists as different as Lynda Benglis and Richard Hamilton, who mined the potential of an art that was without essence. If revelatory art underscored modernism’s transcendental conviction, critically revealing work tested its discursive rules and institutional conventions. Of course, nothing in history happens as neatly as this suggests, but what is clear is how polarized the language of artistic revelation was throughout the 1960s. With the international spread of minimalism, pop art, and fluxus, provisional reveals eventually dominated art-historical discourse. Aesthetic conviction, with its spiritual undertones, was haunted by its demystification. In the words of Donald Judd: “a work needs only to be interesting” (184).That art galleries could be sites of timely socio-political issues, rather than timeless intuitions undersigned by medium specificity, is one of the more familiar origin stories of postmodernism. Few artists symbolize this shift more than Hans Haacke, whose 2019 exhibition All Connected, at the New Museum, New York, examined the legacy of his outward-looking work. Born in Germany in 1936, and a New Yorker since 1965, Haacke has been linked to the term “institutional critique” since the mid 1980s, after Mel Ramsden’s coining in 1975, and the increased recognition of kindred spirits such as Mierle Laderman Ukeles, Michael Asher, Martha Rosler, Robert Smithson, Daniel Buren, and Marcel Broodthaers. These artists have featured in books and essays by the likes of Benjamin Buchloh, Hal Foster, and Yve-Alain Bois, but they are also known for their own contributions to art discourse, producing hybrid conceptions of the intellectual postmodern artist as historian, critic and curator.Haacke was initially fascinated by kinetic sculpture in the early 1960s, taking inspiration from op art, systems art, and machine-oriented research collectives such as Zero (Germany), Gruppo N (Italy) and GRAV (France, an acronym of Groupe de Recherche d’Art Visuel). Towards the end of the decade he started to produce more overtly socio-political work, creating what would become a classic piece from this period, Gallery-Goers’ Birthplace and Residence Profile, Part 1 (1969). Here, in a solo exhibition at New York’s Howard Wise Gallery, the artist invited viewers to mark their birthplaces and places of residence on a map. Questioning the statistical demography of the Gallery’s avant-garde attendees, the exhibition anticipated the meticulous sociological character of much of his practice to come, grounding New York art – the centre of the art world – in local, social, and economic fabrics.In the forward to the catalogue of All Connected, New Museum Director Lisa Philips claims that Haacke’s survey exhibition provided a chance to reflect on the artist’s prescience, especially given the flourishing of art activism over the last five or so years. Philips pressed the issue of why no other American art institution had mounted a retrospective of his work in three decades, since his previous survey, Unfinished Business, at the New Museum in 1986, at its former, and much smaller, Soho digs (8). It suggests that other institutions have deemed Haacke’s work too risky, generating too much political heat for them to handle. It’s a reputation the artist has cultivated since the Guggenheim Museum famously cancelled his 1971 exhibition after learning his intended work, Shapolsky et al. Manhattan Real Estate Holdings, A Real Time Social System as of May 1, 1971 (1971) involved research into dubious New York real estate dealings. Guggenheim director Thomas Messer defended the censorship at the time, going so far as to describe it as an “alien substance that had entered the art museum organism” (Haacke, Framing 138). Exposé was this substance Messer dare not name: art that was too revealing, too journalistic, too partisan, and too politically viscid. (Three years later, Haacke got his own back with Solomon R. Guggenheim Museum Board of Trustees, 1974, exposing then Guggenheim board members’ connections to the copper industry in Chile, where socialist president Salvador Allende had just been overthrown with US backing.) All Connected foregrounded these institutional reveals from time past, at a moment in 2019 when the moral accountability of the art institution was on the art world’s collective mind. The exhibition followed high-profile protests at New York’s Whitney Museum and Metropolitan Museum of Art, as well as at Sydney’s Museum of Contemporary Art, the Louvre, and the British Museum. These and other arts organisations have increasingly faced pressures, fostered by social media, to end ties with unethical donors, sponsors, and board members, with activist groups protesting institutional affiliations ranging from immigration detention centre management to opioid and teargas manufacturing. An awareness of the limits of individual agency and autonomy undoubtedly defines this era, with social media platforms intensifying the encumbrances of individual, group, and organisational identities. Hans Haacke, Gallery-Goers’ Birthplace and Residence Profile, Part 1, 1969 Hans Haacke, Gallery-Goers’ Birthplace and Residence Profile, Part 2, 1969-71Unfinished BusinessUnderscoring Haacke’s activist credentials, Philips describes him as “a model of how to live ethically and empathetically in the world today”, and as a beacon of light amidst the “extreme political and economic uncertainty” of the present, Trump-presidency-calamity moment (7). This was markedly different to how Haacke’s previous New York retrospective, Unfinished Business, was received, which bore the weight of being the artist’s first museum exhibition in New York following the Guggenheim controversy. In the catalogue to Haacke’s 1986 exhibition, then New Museum director Marcia Tucker introduced his work as a challenge, cautiously claiming that he poses “trenchant questions” and that the institution accepts “the difficulties and contradictions” inherent to any museum staging of his work (6).Philips’s and Tucker’s distinct perspectives on Haacke’s practice – one as heroically ethical, the other as a sobering critical challenge – exemplify broader shifts in the perception of institutional critique (the art of the socio-political reveal) over this thirty-year period. In the words of Pamela M. Lee, between 1986 and 2019 the art world has undergone a “seismic transformation”, becoming “a sphere of influence at once more rapacious, acquisitive, and overweening but arguably more democratizing and ecumenical with respect to new audiences and artists involved” (87). Haacke’s reputation over this period has taken a similar shift, from him being a controversial opponent of art’s autonomy (an erudite postmodern conceptualist) to a figurehead for moral integrity and cohesive artistic experimentation.As Rosalyn Deutsche pointed out in the catalogue to Haacke’s 1986 exhibition, a potential trap of such a retrospective is that, through biographical positioning, Haacke might be seen as an “exemplary political artist” (210). With this, the specific political issues motivating his work would be overshadowed by the perception of the “great artist” – someone who brings single-issue politics into the narrative of postmodern art, but at the expense of the issues themselves. This is exactly what Douglas Crimp discovered in Unfinished Business. In a 1987 reflection on the show, Crimp argued that, when compared with an AIDS-themed display, Homo Video, staged at the New Museum at the same time, reviewers of Haacke’s exhibition tended to analyse his politics “within the context of the individual artist’s body of work … . Political issues became secondary to the aesthetic strategies of the producer” (34). Crimp, whose activism would be at the forefront of his career in subsequent years, was surprised at how Homo Video and Unfinished Business spawned different readings. Whereas works in the former exhibition tended to be addressed in terms of the artists personal and partisan politics, Haacke’s prompted reflection on the aesthetics-politics juxtaposition itself. For Crimp, the fact that “there was no mediation between these two shows”, spoke volumes about the divisions between political and activist art at the time.New York Times critic Michael Brenson, reiterating a comment made by Fredric Jameson in the catalogue for Unfinished Business, describes the timeless appearance of Haacke’s work in 1986, which is “surprising for an artist whose work is in some way about ideology and history” (Brenson). The implication is that the artist gives a surprisingly long aesthetic afterlife to the politically specific – to ordinarily short shelf-life issues. In this mode of critical postmodernism in which we are unable to distinguish clearly between intervening in and merely reproducing the logic of the system, Haacke is seen as an astute director of an albeit ambiguous push and pull between political specificity and aesthetic irreducibility, political externality and the internalist mode of art about art. Jameson, while granting that Haacke’s work highlights the need to reinvent the role of the “ruling class” in the complex, globalised socio-economic situation of postmodernism, claims that it does so as representative of the “new intellectual problematic” of postmodernism. Haacke, according Jameson, stages postmodernism’s “crisis of ‘mapping’” whereby capitalism’s totalizing, systemic forms are “handled” (note that he avoids “critiqued” or “challenged”) by focusing on their manifestation through particular (“micro-public”) institutional means (49, 50).We can think of the above examples as constituting the postmodern version of Haacke, who frames very specific political issues on the one hand, and the limitless incorporative power of appropriative practice on the other. To say this another way, Haacke, circa 1986, points to specific sites of power struggle at the same time as revealing their generic absorption by an art-world system grown accustomed to its “duplicate anything” parameters. For all of his political intent, the artistic realm, totalised in accordance with the postmodern image, is ultimately where many thought his gestures remained. The philosopher turned art critic Arthur Danto, in a negative review of Haacke’s exhibition, portrayed institutional critique as part of an age-old business of purifying art, maintaining that Haacke’s “crude” and “heavy-handed” practice is blind to how art institutions have always relied on some form of critique in order for them to continue being respected “brokers of spirit”. This perception – of Haacke’s “external” critiques merely serving to “internally” strengthen existing art structures – was reiterated by Leo Steinberg. Supportively misconstruing the artist in the exhibition catalogue, Steinberg writes that Haacke’s “political message, by dint of dissonance, becomes grating and shrill – but shrill within the art context. And while its political effectiveness is probably minimal, its effect on Minimal art may well be profound” (15). Hans Haacke, MOMA Poll, 1970 All ConnectedSo, what do we make of the transformed reception of Haacke’s work since the late 1980s: from a postmodern ouroboros of “politicizing aesthetics and aestheticizing politics” to a revelatory exemplar of art’s moral power? At a period in the late 1980s when the culture wars were in full swing and yet activist groups remained on the margins of what would become a “mainstream” art world, Unfinished Business was, perhaps, blindingly relevant to its times. Unusually for a retrospective, it provided little historical distance for its subject, with Haacke becoming a victim of the era’s propensity to “compartmentalize the interpretive registers of inside and outside and the terms corresponding to such spatial­izing coordinates” (Lee 83).If commentary surrounding this 2019 retrospective is anything to go by, politics no longer performs such a parasitic, oppositional or even dialectical relation to art; no longer is the political regarded as a real-world intrusion into the formal, discerning, longue-durée field of aesthetics. The fact that protests inside the museum have become more visible and vociferous in recent years testifies to this shift. For Jason Farrago, in his review of All Connected for the New York Times, “the fact that no person and no artwork stands alone, that all of us are enmeshed in systems of economic and social power, is for anyone under 40 a statement of the obvious”. For Alyssa Battistoni, in Frieze magazine, “if institutional critique is a practice, it is hard to see where it is better embodied than in organizing a union, strike or boycott”.Some responders to All Connected, such as Ben Lewis, acknowledge how difficult it is to extract a single critical or political strategy from Haacke’s body of work; however, we can say that, in general, earlier postmodern questions concerning the aestheticisation of the socio-political reveal no longer dominates the reception of his practice. Today, rather than treating art and politics are two separate but related entities, like form is to content, better ideas circulate, such as those espoused by Bruno Latour and Jacques Rancière, for whom what counts as political is not determined by a specific program, medium or forum, but by the capacity of any actor-network to disrupt and change a normative social fabric. Compare Jameson’s claim that Haacke’s corporate and museological tropes are “dead forms” – through which “no subject-position speaks, not even in protest” (38) – with Battistoni’s, who, seeing Haacke’s activism as implicit, asks the reader: “how can we take the relationship between art and politics as seriously as Haacke has insisted we must?”Crimp’s concern that Unfinished Business perpetuated an image of the artist as distant from the “political stakes” of his work did not carry through to All Connected, whose respondents were less vexed about the relation between art and politics, with many noting its timeliness. The New Museum was, ironically, undergoing its own equity crisis in the months leading up to the exhibition, with newly unionised staff fighting with the Museum over workers’ salaries and healthcare even as it organised to build a new $89-million Rem Koolhaas-designed extension. Battistoni addressed these disputes at-length, claiming the protests “crystallize perfectly the changes that have shaped the world over the half-century of Haacke’s career, and especially over the 33 years since his last New Museum exhibition”. Of note is how little attention Battistoni pays to Haacke’s artistic methods when recounting his assumed solidarity with these disputes, suggesting that works such as Creating Consent (1981), Helmosboro Country (1990), and Standortkultur (Corporate Culture) (1997) – which pivot on art’s public image versus its corporate umbilical cord – do not convey some special aesthetico-political insight into a totalizing capitalist system. Instead, “he has simply been an astute and honest observer long enough to remind us that our current state of affairs has been in formation for decades”.Hans Haacke, News, 1969/2008 Hans Haacke, Wide White Flow, 1967/2008 Showing Systems Early on in the 1960s, Haacke was influenced by the American critic, artist, and curator Jack Burnham, who in a 1968 essay, “Systems Esthetics” for Artforum, inaugurated the loose conceptualist paradigm that would become known as “systems art”. Here, against Greenbergian formalism and what he saw as the “craft fetishism” of modernism, Burnham argues that “change emanates, not from things, but from the way things are done” (30). Burnham thought that emergent contemporary artists were intuitively aware of the importance of the systems approach: the significant artist in 1968 “strives to reduce the technical and psychical distance between his artistic output and the productive means of society”, and pays particular attention to relationships between organic and non-organic systems (31).As Michael Fried observed of minimalism in his now legendary 1967 essay Art and Objecthood, this shift in sixties art – signalled by the widespread interest in the systematic – entailed a turn towards the spatial, institutional, and societal contexts of receivership. For Burnham, art is not about “material entities” that beautify or modify the environment; rather, art exists “in relations between people and between people and the components of their environment” (31). At the forefront of his mind was land art, computer art, and research-driven conceptualist practice, which, against Fried, has “no contrived confines such as the theatre proscenium or picture frame” (32). In a 1969 lecture at the Guggenheim, Burnham confessed that his research concerned not just art as a distinct entity, but aesthetics in its broadest possible sense, declaring “as far as art is concerned, I’m not particularly interested in it. I believe that aesthetics exists in revelation” (Ragain).Working under the aegis of Burnham’s systems art, Haacke was shaken by the tumultuous and televised politics of late-1960s America – a time when, according to Joan Didion, a “demented and seductive vortical tension was building in the community” (41). Haacke cites Martin Luther King’s assassination as an “incident that made me understand that, in addition to what I had called physical and biological systems, there are also social systems and that art is an integral part of the universe of social systems” (Haacke, Conversation 222). Haacke created News (1969) in response to this awareness, comprising a (pre-Twitter) telex machine that endlessly spits out live news updates from wire services, piling up rolls and rolls of paper on the floor of the exhibition space over the course of its display. Echoing Burnham’s idea of the artist as a programmer whose job is to “prepare new codes and analyze data”, News nonetheless presents the museum as anything but immune from politics, and technological systems as anything but impersonal (32).This intensification of social responsibility in Haacke’s work sets him apart from other, arguably more reductive techno-scientific systems artists such as Sonia Sheridan and Les Levine. The gradual transformation of his ecological and quasi-scientific sculptural experiments from 1968 onwards could almost be seen as making a mockery of the anthropocentrism described in Fried’s 1967 critique. Here, Fried claims not only that the literalness of minimalist work amounts to an emphasis on shape and spatial presence over pictorial composition, but also, in this “theatricality of objecthood” literalness paradoxically mirrors (153). At times in Fried’s essay the minimalist art object reads as a mute form of sociality, the spatial presence filled by the conscious experience of looking – the theatrical relationship itself put on view. Fried thought that viewers of minimalism were presented with themselves in relation to the entire world as object, to which they were asked not to respond in an engaged formalist sense but (generically) to react. Pre-empting the rise of conceptual art and the sociological experiments of post-conceptualist practice, Fried, unapprovingly, argues that minimalist artists unleash an anthropomorphism that “must somehow confront the beholder” (154).Haacke, who admits he has “always been sympathetic to so-called Minimal art” (Haacke, A Conversation 26) embraced the human subject around the same time that Fried’s essay was published. While Fried would have viewed this move as further illustrating the minimalist tendency towards anthropomorphic confrontation, it would be more accurate to describe Haacke’s subsequent works as social-environmental barometers. Haacke began staging interactions which, however dry or administrative, framed the interplays of culture and nature, inside and outside, private and public spheres, expanding art’s definition by looking to the social circulation and economy that supported it.Haacke’s approach – which seems largely driven to show, to reveal – anticipates the viewer in a way that Fried would disapprove, for whom absorbed viewers, and the irreduction of gestalt to shape, are the by-products of assessments of aesthetic quality. For Donald Judd, the promotion of interest over conviction signalled scepticism about Clement Greenberg’s quality standards; it was a way of acknowledging the limitations of qualitative judgement, and, perhaps, of knowledge more generally. In this way, minimalism’s aesthetic relations are not framed so much as allowed to “go on and on” – the artists’ doubt about aesthetic value producing this ongoing temporal quality, which conviction supposedly lacks.In contrast to Unfinished Business, the placing of Haacke’s early sixties works adjacent to his later, more political works in All Connected revealed something other than the tensions between postmodern socio-political reveal and modernist-formalist revelation. The question of whether to intervene in an operating system – whether to let such a system go on and on – was raised throughout the exhibition, literally and metaphorically. To be faced with the interactions of physical, biological, and social systems (in Condensation Cube, 1963-67, and Wide White Flow, 1967/2008, but also in later works like MetroMobiltan, 1985) is to be faced with the question of change and one’s place in it. Framing systems in full swing, at their best, Haacke’s kinetic and environmental works suggest two things: 1. That the systems on display will be ongoing if their component parts aren’t altered; and 2. Any alteration will alter the system as a whole, in minor or significant ways. Applied to his practice more generally, what Haacke’s work hinges on is whether or not one perceives oneself as part of its systemic relations. To see oneself implicated is to see beyond the work’s literal forms and representations. Here, systemic imbrication equates to moral realisation: one’s capacity to alter the system as the question of what to do. Unlike the phenomenology-oriented minimalists, the viewer’s participation is not always assumed in Haacke’s work, who follows a more hermeneutic model. In fact, Haacke’s systems are often circular, highlighting participation as a conscious disruption of flow rather than an obligation that emanates from a particular work (148).This is a theatrical scenario as Fried describes it, but it is far from an abandonment of the issue of profound value. In fact, if we accept that Haacke’s work foregrounds intervention as a moral choice, it is closer to Fried’s own rallying cry for conviction in aesthetic judgement. As Rex Butler has argued, Fried’s advocacy of conviction over sceptical interest can be understood as dialectical in the Hegelian sense: conviction is the overcoming of scepticism, in a similar way that Geist, or spirit, for Hegel, is “the very split between subject and object, in which each makes the other possible” (Butler). What is advanced for Fried is the idea of “a scepticism that can be remarked only from the position of conviction and a conviction that can speak of itself only as this scepticism” (for instance, in his attempt to overcome his scepticism of literalist art on the basis of its scepticism). Strong and unequivocal feelings in Fried’s writing are informed by weak and indeterminate feeling, just as moral conviction in Haacke – the feeling that I, the viewer, should do something – emerges from an awareness that the system will continue to function fine without me. In other words, before being read as “a barometer of the changing and charged atmosphere of the public sphere” (Sutton 16), the impact of Haacke’s work depends upon an initial revelation. It is the realisation not just that one is embroiled in a series of “invisible but fundamental” relations greater than oneself, but that, in responding to seemingly sovereign social systems, the question of our involvement is a moral one, a claim for determination founded through an overcoming of the systemic (Fry 31).Haacke’s at once open and closed works suit the logic of our algorithmic age, where viewers have to shift constantly from a position of being targeted to one of finding for oneself. Peculiarly, when Haacke’s online digital polls in All Connected were hacked by activists (who randomized statistical responses in order to compel the Museum “to redress their continuing complacency in capitalism”) the culprits claimed they did it in sympathy with his work, not in spite of it: “we see our work as extending and conversing with Haacke’s, an artist and thinker who has been a source of inspiration to us both” (Hakim). This response – undermining done with veneration – is indicative of the complicated legacy of his work today. Haacke’s influence on artists such as Tania Bruguera, Sam Durant, Forensic Architecture, Laura Poitras, Carsten Höller, and Andrea Fraser has less to do with a particular political ideal than with his unique promotion of journalistic suspicion and moral revelation in forms of systems mapping. It suggests a coda be added to the sentiment of All Connected: all might not be revealed, but how we respond matters. Hans Haacke, Large Condensation Cube, 1963–67ReferencesBattistoni, Alyssa. “After a Contract Fight with Its Workers, the New Museum Opens Hans Haacke’s ‘All Connected’.” Frieze 208 (2019).Bishara, Hakim. “Hans Haacke Gets Hacked by Activists at the New Museum.” Hyperallergic 21 Jan. 2010. <https://hyperallergic.com/538413/hans-haacke-gets-hacked-by-activists-at-the-new-museum/>.Brenson, Michael. “Art: In Political Tone, Works by Hans Haacke.” New York Times 19 Dec. 1988. <https://www.nytimes.com/1986/12/19/arts/artin-political-tone-worksby-hans-haacke.html>.Buchloh, Benjamin. “Hans Haacke: Memory and Instrumental Reason.” Neo-Avantgarde and Culture Industry. Cambridge: MIT P, 2000.Burnham, Jack. “Systems Esthetics.” Artforum 7.1 (1968).Butler, Rex. “Art and Objecthood: Fried against Fried.” Nonsite 22 (2017). <https://nonsite.org/feature/art-and-objecthood>.Carrion-Murayari, Gary, and Massimiliano Gioni (eds.). Hans Haacke: All Connected. New York: Phaidon and New Museum, 2019.Crimp, Douglas. “Strategies of Public Address: Which Media, Which Publics?” In Hal Foster (ed.), Discussions in Contemporary Culture, no. 1. Washington: Bay P, 1987.Danto, Arthur C. “Hans Haacke and the Industry of Art.” In Gregg Horowitz and Tom Huhn (eds.), The Wake of Art: Criticism, Philosophy, and the Ends of Taste. London: Routledge, 1987/1998.Didion, Joan. The White Album. London: 4th Estate, 2019.Farago, Jason. “Hans Haacke, at the New Museum, Takes No Prisoners.” New York Times 31 Oct. 2019. <https://www.nytimes.com/2019/10/31/arts/design/hans-haacke-review-new-museum.html>.Fried, Michael. “Art and Objecthood.” Artforum 5 (June 1967).Fry, Edward. “Introduction to the Work of Hans Haacke.” In Hans Haacke 1967. Cambridge: MIT List Visual Arts Center, 2011.Glueck, Grace. “The Guggenheim Cancels Haacke’s Show.” New York Times 7 Apr. 1971.Gudel, Paul. “Michael Fried, Theatricality and the Threat of Skepticism.” Michael Fried and Philosophy. New York: Routledge, 2018.Haacke, Hans. Hans Haacke: Framing and Being Framed: 7 Works 1970-5. Halifax: P of the Nova Scotia College of Design and New York: New York UP, 1976.———. “Hans Haacke in Conversation with Gary Carrion-Murayari and Massimiliano Gioni.” Hans Haacke: All Connected. New York: Phaidon and New Museum, 2019.Haacke, Hans, et al. “A Conversation with Hans Haacke.” October 30 (1984).Haacke, Hans, and Brian Wallis (eds.). Hans Haacke: Unfinished Business. New York: New Museum of Contemporary Art; Cambridge, Mass: MIT P, 1986.“Haacke’s ‘All Connected.’” Frieze 25 Oct. 2019. <https://frieze.com/article/after-contract-fight-its-workers-new-museum-opens-hans-haackes-all-connected>.Judd, Donald. “Specific Objects.” Complete Writings 1959–1975. Halifax: P of the Nova Scotia College of Design and New York: New York UP, 1965/1975.Lee, Pamela M. “Unfinished ‘Unfinished Business.’” Hans Haacke: All Connected. New York: Phaidon P Limited and New Museum, 2019.Ragain, Melissa. “Jack Burnham (1931–2019).” Artforum 19 Mar. 2019. <https://www.artforum.com/passages/melissa-ragain-on-jack-burnham-78935>.Sutton, Gloria. “Hans Haacke: Works of Art, 1963–72.” Hans Haacke: All Connected. New York: Phaidon P Limited and New Museum, 2019.Tucker, Marcia. “Director’s Forward.” Hans Haacke: Unfinished Business. New York: New Museum of Contemporary Art; Cambridge, Mass: MIT P, 1986.

Public engagement of scientists is defined as “all kinds of publicly accessible communication carried out by people presenting themselves as scientists. This includes scholarly communication directed at peers as well as science communication directed at lay publics” (Jünger & Fähnrich, 2019, p. 7). Field of application/theoretical foundation: The variable “public engagement of scientists” can be differentiated according to the following three main dimensions (Jünger & Fähnrich, 2019): Directions of engagement: Describes the extent to which communication scientists on Twitter connect with people from different sectors of society (e.g. science, politics, media, economy). This allows conclusions to the potential influence of scientists reaching specific audiences beyond the scientific community (Jünger & Fähnrich, 2019). Topics of engagement: Previous research reveals that social scientists not only act as experts in their research field, but often present themselves as public intellectuals by also referring to political and social issues (Albæk, Christiansen, & Togeby, 2003; Fähnrich & Lüthje, 2017). For this reason, communication scientists are expected to communicate not only on scientific but also on political or economic issues. Modes of engagement: In addition to disseminating information, social networking sites also allow for more interactive ways of maintaining relationships. Thus, following Ellison and Boyd (2013), it can be assumed that communication on social networking sites can be both content-centered and user-centered. This dimension can be linked to the speech act theory (Klemm, 2000; Searle, 1990), according to which every use of language has a performative function. References/combination with other methods of data collection: In some cases, a mixed method approach, employing two data collection methods, is applied: a content analysis is complemented by a survey to gain information about the science communicators such as demographic information (Hara, Abbazio, & Perkins, 2019). Furthermore, their social networks are investigated by means of network analysis (Walter, Lörcher, & Brüggemann, 2019). Example studies: Hara et al. (2019); Jahng & Lee (2018); Kouper (2010); Mahrt & Puschmann (2014); Walter et al. (2019) Information on Jünger & Fähnrich, 2019 Authors: Jakob Jünger & Birte Fähnrich, 2019 Research questions: How can the public engagement of scientists in the context of online communication be conceptualized? Which types of engagement occur in the Twitter activity of communication scholars? Object of analysis: Tweets and followers belonging to the Twitter profiles of communication scientists who are following the International Communication Association (ICA) on Twitter (only German- and English-speaking users) Timeframe of analysis: Data collection in September 2017 Info about variables Variable name/definition: Subject area of the content of the tweets Level of analysis: Tweet Values: - Science-related topics (research, teaching) - Non-scientific topics (politics, economy, media, sports, environment, society, leisure time, and others) Scale of measurement: Nominal Reliability: Gwet’s AC1: 0,71 – 1,00; Holsti: 0,82 – 1,00 Variable name/definition: Language patterns of communication scientists (Speech acts) Level of analysis: Tweet Values: - Actor-centered patterns (discussing, activating, socializing), - Content-centered patterns (reporting, commenting), - Other language patterns Scale of measurement: Nominal Reliability: Gwet’s AC1: 0,54 – 0,95; Holsti: 0,75 – 1,00 Variable name/definition: References of the communication scientists on Twitter Level of analysis: Tweet Values: - Self-reference, - Reference to specific actor, - Reference to other unspecific actor, - No reference to actors Scale of measurement: Nominal Reliability: Gwet’s AC1: 0,83 – 0,87; Holsti: 0,88 – 0,93 Variable name/definition: Type of actor (followers of the investigated scientists) Level of analysis: Self description in profile Values: Person, Organization Scale of measurement: Nominal Reliability: Gwet’s AC1: 0,89; Holsti: 0,91; Kappa: 0,84; Krippendorffs’ Alpha: 0,84 Variable name/definition: Social sphere of action of the followers Level of analysis: Self description in profile Values: - Science (communication science, other sciences, science in general) - Politics (party, state/administration, activists & lobbyists) - Media (media & journalism, news & comments) - Economy (communication industry, other economic sectors) - Arts & Entertainment - Health - Other (Other areas of activity, personal interests) Scale of measurement: Nominal Reliability: Gwet’s AC1: 0,81 – 0,87; Holsti: 0,82 – 0,88; Kappa: 0,83 – 0,85; Krippendorffs’ Alpha: 0,83 – 0,85 Codebook: in the appendix (in German) Information on Walter, Lörcher & Brüggemann, 2019 Authors: Stefanie Walter, Ines Lörcher & Michael Brüggemann Research question: How do scientists interact with politicians and civil society on Twitter? Object of analysis: Climate-related English-language Tweets posted by scientists from the United States (to classify the Twitter users, an automated content analysis, a dictionary approach, was applied; Krippendorffs’ Alpha: 0,74) Timeframe of analysis: Data collection took place from October 1, 2017 to March 31, 2018 Variable name/definition: Mode and content of communication Level of analysis: Tweet Values: Negative emotion, Certainty Scale of measurement: Linguistic Inquiry and Word Count (LIWC) program for computerized text analysis Reliability: – Codebook: in the appendix (R-Script) Information on Hara et al., 2019 Authors: Noriko Hara, Jessica Abbazio & Kathryn Perkins Research questions: What kind of demographic characteristics do the scientists participating in “Science” subreddit AMAs have? [survey] What was the experience like to host an AMA in the “Science” subreddit? [survey] What type of discussions did “Science” subreddit AMA participants engage in? Do questions receive answers? What are posters’ intentions? What kind of content features appear? Who is posting comments? What kind of responses do posts receive? Object of analysis: Six Ask Me Anything (AMA) sessions on Reddit’s “Science” subreddit (r/science) Timeframe of analysis: – Info about variable Variable name/definition: Poster’s intentions (PI); Answer status (AS); Comment status (CS); Poster’s identity (PID); Content features (CF) Level of analysis: Post Values: - PI: Seeking information, Seeking discussion, Non-questions/comments, Further discussion/interaction among users, Answering a question - AS: Answered, Not answered - CS: Commented on, Not commented on - PID: Host, Participant – flair, Participant – no flair - CF: Providing factual information, Providing opinions, Providing resources, Providing personal experience, Providing guidance on forum governance, Making an inquiry – initial question, Making an inquiry – embedded question, Requesting resources, Off-topic comment Scale of measurement: Nominal Reliability: Intercoder reliability ranged between 0.66 and 1.0 calculated by Cohen’s Kappa Codebook: in the appendix (in English) References Albæk, E., Christiansen, P. M., & Togeby, L. (2003). Experts in the mass media: Researchers as sources in Danish daily newspapers, 1961–2001. Journalism & Mass Communication Quarterly, 80(4), 937–948. Ellison, N. B., & Boyd, D. M. (2013). Sociality through social network sites. In W. H. Dutton, N. B. Ellison, & D. M. Boyd (Eds.), The Oxford Handbook of Internet Studies (pp. 151–172). Oxford: Oxford University Press. Fähnrich, B., & Lüthje, C. (2017). Roles of Social Scientists in Crisis Media Reporting: The Case of the German Populist Radical Right Movement PEGIDA. Science Communication, 39(4), 415–442. Hara, N., Abbazio, J., & Perkins, K. (2019). An emerging form of public engagement with science: Ask Me Anything (AMA) sessions on Reddit r/science. PloS One, 14(5), e0216789. Jahng, M. R., & Lee, N. (2018). When scientists tweet for social changes: Dialogic communication and collective mobilization strategies by flint water study scientists on Twitter. Science Communication, 40(1), 89–108. https://doi.org/10.1177/1075547017751948 Jünger, J., & Fähnrich, B. (2019). Does really no one care?: Analyzing the public engagement of communication scientists on Twitter. New Media & Society, 7(2), 146144481986341. Klemm, M. (2000). Zuschauerkommunikation: Formen und Funktionen der alltäglichen kommunikativen Fernsehaneignung [Audience Communication: Forms and Functions of Everyday Communicative Appropriation of Television]. Frankfurt am Main: Lang. Kouper, I. (2010). Science blogs and public engagement with science: Practices, challenges, and opportunities. Journal of Science Communication, 09(01). Mahrt, M., & Puschmann, C. (2014). Science blogging: An exploratory study of motives, styles, and audience reactions. Journal of Science Communication, 13(03). Searle, J. R. (1990). Sprechakte: Ein sprachphilosophischer Essay [Speech Acts: An Essay on the Philosophy of Language]. Frankfurt am Main: Suhrkamp. Walter, S., Lörcher, I., & Brüggemann, M. (2019). Scientific networks on Twitter: Analyzing scientists’ interactions in the climate change debate. Public Understanding of Science, 28(6), 696–712.