Journal articles on the topic 'Mines Charbon'

RésuméEntre le début du xviiie siècle et les années 1970, il s’est noué dans les Alpes briançonnaises un ensemble de relations entre une ressource, le charbon, et une population d’hommes, paysans et montagnards, concrétisées dans des formes spécifiques d’exploitation, les char-bonnières, qui ont cohabité durablement avec les petites mines industrielles installées progressivement dans le bassin. Contre le point de vue surplombant d’une histoire des techniques pointant le défaut de rationalité des travaux miniers paysans, rejoignant ainsi le procès en irrationalité et en gaspillage des ressources instruit par les représentants de la technologie minière, les ingénieurs des mines, cet article veut souligner l’intérêt d’une approche pragmatique qui, appliquant le principe de symétrie généralisée de la « sociologie de la traduction », s’attache à faire le récit de ces relations, à parcourir la chaîne des associations au moyen desquelles les paysans et le charbon se sont simultanément inventés, concourant à la constitution d’une «socio-nature». Ainsi l’activité charbonnière paysanne tient-elle principalement à quatre associations: la relation au charbon et sa naturalisation comme charbon adapté au marché; l’investissement « communaliste » de la forme d’État de la concession; la stabilisation d’un dispositif sociotechnique qui offre une troisième voie à l’alternative socio-économique à laquelle sont soumises les populations montagnardes: émigrer ou rester et subir le « bagne » de la mine industrielle; enfin une relation instrumen-tale à la technologie, c’est-à-dire à l’équipement pratique et discursif de la mine rationnelle et industrielle porté par les ingénieurs des mines.

"Upper Silesia is a region that still defines itself (despite the ongoing closure of mines) using the symbolism of coal. In the article, I analyze this symbolism, indicating four levels on which, in my opinion, this symbolism is manifested. These levels – stereotypical, idealizing, conjectural, and mystical – combine in the carbon myth that constitutes the identity of the region and its inhabitants."

Jouxtant la frontière du Bengale et relativement proche de Calcutta, le district de Dhanbad est le plus urbanisé et le plus alphabétisé des « districts » du Bihar, lui-même le plus densément peuplé, le plus rural et le plus pauvre des 22 États de l'Union indienne. Les mines de charbon du bassin de Dhanbad ont été ouvertes et développées au XIXe siècle par les Britanniques dans une région encore incomplètement défrichée, habitée alors en grande partie par des populations aborigènes. Ces dernières fournirent longtemps l'essentiel d'une maind'œuvre instable, l'encadrement et le travail qualifié étant effectués par des migrants venus de toute l'Inde.

Japanese species of the muscaeforme-group, charon-group, and floridanum-group of Gryon have been revised. Among the species of the muscaeforme-group, G. fulvicoxasp. nov. is newly described. Gryon misha Kozlov & Kononova, syn. nov. is considered a junior synonym of G. japonicum (Ashmead). Gryon maruzzae Mineo, syn. nov. and G. sugonjaevi Kozlov & Kononova, syn. nov. are considered junior synonyms of G. yamagishii Mineo. Among the species of the charon-group, G. shisasp. nov. is newly described. Gryon hakonense (Ashmead) syn. nov. is considered as a junior synonym of G. philippinense (Ashmead). Among the species of the floridanum-group, G. pennsylvanicum (Ashmead) is recognized. Host records of the three species groups are also revised.

Este artigo apresenta resultados parciais de uma pesquisa com estudantes do 9º ano do ensino fundamental, matriculados na Escola em Tempo Integral (ETI) do município de Governador Valadares, Minas Gerais, atingido pelo desastre provocado pelo rompimento da barragem de Fundão, situada no município de Mariana, Minas Gerais, que atingiu o rio Doce, em novembro de 2015. O estudo se insere no debate da Educação Ambiental e mobiliza as contribuições de Bernard Charlot para buscar compreender as relações que esses estudantes estabelecem com o rio Doce, como objeto de saber. Para a coleta dos dados, foi o utilizado o “balanço de saber”, instrumento adaptado com base na proposta de Charlot (2009), que consistiu na demanda da elaboração de um texto por parte dos estudantes, no qual eles foram convidados a narrar suas experiências com o rio Doce. Os balanços de saber foram lidos como um texto único, e buscamos capturar as regularidades do grupo com relação às experiências com o rio Doce, centradas nas experiências dos sujeitos com as pessoas e os lugares, entre eles, a escola. A análise indica que a relação com o saber desses estudantes se entrelaça nas relações com as pessoas e o ambiente, e é marcada pela denúncia dos impactos desse desastre, por uma postura solidária com as pessoas e com o ambiente atingido pelo processo. As conclusões possibilitam refletir sobre a importância da Educação Ambiental, transversalizando as práticas escolares no sentido de fortalecimento dos laços identitários e em uma dimensão política, nos processos desencadeados por agressões à natureza e às pessoas, como os vivenciados por um enorme contingente de grupos e populações que vivem às margens do rio Doce.

Introduction Using the National Cancer Database (NCDB), we seek to analyze the relationship of patient distance to hospital of treatment on mortality trends after surgery, since patients often travel large distances to referral centers. Methods A retrospective cohort study of the NCDB from 2004 to 2013 was performed, and patients with gastrointestinal, melanoma, and head and neck primary site tumors who underwent surgery were included. We excluded cases with no recorded mortality status or distance from the hospital. A multivariable logistic regression was conducted with adjustments for population density, treating facility location, age, race, gender, education, income, insurance, comorbidities (Charlson-Deyo score), days from diagnosis to treatment, positive margin, tumor stage and grade, and lymph or vascular invasion. Results A total of 1 424 482 patients were included. Overall median distance to hospital was 9.7 miles (range 4.2-23.7 miles); 696 647 (48.91%) of the sample traveled a distance greater than 10 miles to the institution where the procedure was performed. The multivariable regression analysis demonstrated overall lower mortality for those patients travelling a longer distance to care for multiple tumor types, including: liver (OR .87, .77-.99, P = .032), pancreas (OR .82, .76-.89, P < .001), colon (OR .92, .89-.95, P < .001), rectum (OR .90, .83-.96, P = .003), melanoma (OR .83, .79-.88, P < .001), and tumors of the larynx (OR .80, .69-.94, P = .005). Discussion Increased distance traveled for surgical treatment has a significant correlation with decreased odds of mortality for multiple cancers, highlighting the importance of centralized referral patterns for oncology care.

Este artigo apresenta resultados de uma investigação que buscou compreender a relação com o saber de estudantes universitários, utilizando como referencial a teoria da relação com o saber de Bernard Charlot. O campo de pesquisa foi uma universidade comunitária localizada em um município de porte médio do estado de Minas Gerais, sendo que os sujeitos da pesquisa foram 400 estudantes de 24 cursos de graduação. A coleta de dados foi realizada por meio dos balanços de saber, instrumento proposto por Bernard Charlot, que consiste na demanda da produção de um texto a respeito das aprendizagens do sujeito. Após a apresentação dos aspectos quantitativos da classificação das aprendizagens evocadas pelos estudantes, o artigo discute a preponderância das aprendizagens ligadas ao desenvolvimento pessoal e utiliza as categorias mobilização e sentido para aprofundar a compreensão dos relatos produzidos pelos estudantes nos balanços de saber. Conclui que a relação com o saber dos sujeitos da pesquisa está baseada na valorização das aprendizagens ligadas a seu desenvolvimento pessoal, inclusive ao tratarem do que aprenderam na universidade, e que uma parcela deles consegue reconhecer as especificidades dessa instituição como espaço de aprendizagem. A pesquisa identificou três polos nos quais se organizam os sentidos atribuídos pelos estudantes à formação universitária: a conquista de uma vida melhor, a transformação da maneira de ver o mundo e a mobilização em relação ao saber em si.

Purpose To study the prognostic value for overall survival of baseline assessment of functional status, comorbidity, and quality of life (QoL) in elderly patients with advanced non—small-cell lung cancer treated with chemotherapy. Patients and Methods Data from 566 patients enrolled onto the phase III randomized Multicenter Italian Lung Cancer in the Elderly Study (MILES) study were analyzed. Functional status was measured as activities of daily living (ADL) and instrumental ADL (IADL). The presence of comorbidity was assessed with a checklist of 33 items; items 29 and 30 of the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire QLQ-C30 (EORTC QLQ-C30) were used to estimate QoL. ADL was dichotomized as none versus one or more dependency. For IADL and QoL, three categories were defined using first and third quartiles as cut points. Comorbidity was summarized using the Charlson scale. Analysis was performed by Cox model, and stratified by treatment arm. Results Better values of baseline QoL (P = .0003) and IADL (P = .04) were significantly associated with better prognosis, whereas ADL (P = .44) and Charlson score (P = .66) had no prognostic value. Performance status 2 (P = .006) and a higher number of metastatic sites (P = .02) also predicted shorter overall survival. Conclusions Pretreatment global QoL and IADL scores, but not ADL and comorbidity, have significant prognostic value for survival of elderly patients with advanced non—small-cell lung cancer who were treated with chemotherapy. Using these scores in clinical practice might improve prognostic prediction for treatment planning.

Support in sport is certainly one of the oldest human passions. Residents of the eastern Roman imperial capital cheered the chariot drivers The passion for supporting the drivers was common for all groups and social classes. The hippodrome was visited by the representatives of the aristocracy, artisans and the poor of the city alike. The popularity of chariot racing is evidenced by their frequency 66 days were reserved for circenses, that is racing. Organizing the competition along with all the accompanying events has been an essential task of circus factions (demes) In the empire, there were four factions named Blues, Greens, Whites and Reds. These factions were real sports associations, which can be compared to modern clubs. They had significant financial resources at their disposal. Each faction had their own racing team. They paid for and supported a number of drivers, runners, trainers of horses and wild animals, mimes, dancers, acrobats, poets, musicians and singers. They cared for their recruitment and training They also employed caretakers, messengers, artisans of various specialties, grooms, etc Expectations of subjects meant that emperors put great emphasis on the organization of shows and they were actively engaged in them themselves The preparation was personally supervised by the city prefect, and in the relations with the factions the emperor was represented by the praepositus sacri cubiculi. The latter managed the Hippodrome staff. Byzantine supporters, like their modern counterparts, had their idols. The object of their worship, and at the same time the elite among those working on the hippodrome, were charioteers. Outstanding competitors enjoyed immense popularity, just like modern stars of football or volleyball. They had monuments and stelae dedicated to them, as well as poems which praised their achievements. The ceiling in the gallery above the imperial kathisma featured images of famous drivers.

82 Background: Controversy exists regarding the benefit of whole breast radiation (RT) after breast conservation surgery (BCS) in elderly early stage breast cancer patients. We investigated the clinical and pathological characteristics that influence referral patterns and consent for RT. Methods: Between 2006 and 2011, 93 women, aged ≥ 70 were treated with BCS at the University of California Davis Medical Center (UCDMC). Electronic medical records were reviewed to identify pathological and clinical tumor characteristics, including stage, nodal involvement, lymphovascular invasion, margin status and molecular subtype. Patient factors including Karnofsky performance status, Charlson comorbidity index, and distance from UCDMC were recorded. Adjuvant therapy recommendations regarding RT, radiation dose and fractionation, hormonal and chemotherapy, and the ultimate treatment plan were noted. Descriptive statistics were used to characterize the referral pattern data. Patient and tumor characteristics were compared between those referred and not referred for RT using chi-square tests for categorical variables and Student’s t tests for continuous variables. Similar comparisons were also conducted for those who consented and declined RT. Results: Of the 93 women eligible for adjuvant whole breast radiation, 79 (85%) were referred to radiation oncology. Sixty five patients had stage I, 16 had stage II, and 4 had stage III breast cancer. Seventy four patients had a luminal A molecular subtype, 11 of whom declined RT. Hormonal therapy was recommended for 78 patients, of which 11 were not referred to RT. The mean age of those referred to RT was significantly less than those not referred, 76 vs. 81 years, P = 0.006. Mean distance to UCDMC was 17.2 miles for those not referred and 34.4 miles for those referred, P = 0.02. There were no significant correlation between stage, molecular subtype, margin status or lymph node involvement and referral to RT. Conclusions: The majority of elderly patients are referred to RT but increased age and comorbidity were associated with non-referral. Patients’ perception of their own comorbidity, previous experience with RT and the decision to pursue hormonal therapy contributed to patients’ decisions to decline RT.

This article is part of the discussion on the Education of women in situations of deprivation of liberty, a topic that has received attention from scholars in the field of Young and Adult Education. The data presented were collected in the context of a study that analyzed how the educational experiences of educated women are shaped in situations of imprisonment in the State of Minas Gerais. It refers specifically to reports produced on interviews with 5 women who attend school in one of these institutions, and 1 educator who is responsible for monitoring educational experiences in state prisons. The analysis of the interviews uses the theory of relationship with knowledge proposed by Bernard Charlot, especially the concepts of mobilization, sense and activity. The reports of school experiences show two different situations with regard to the conditions of access to basic education and the retention of students to it: paths marked by difficulties and halted prematurely, and other more regular and long lasting trajectories. Therefore prison is for some women the possibility of resuming elementary school, and for others, the inability to get to secondary school. Despite these differences, it is possible to identify common aspects in the stories that range from the perspectives on school education to the mobilization in relation to learning and achievement in school activities in prison. These aspects are presented and discussed as essentially important elements in order to understand the complex reality of the education of young and adult females in the prison system.

686 Background: Neoadjuvant chemoradiotherapy (NCRT) is generally accepted as the optimal treatment strategy compared to adjuvant chemoradiotherapy (ACRT) for locally advanced rectal cancer due to improvement in local control and reduced toxicity. However, NCRT has not been shown to improve overall survival (OS). We investigated the effect of NCRT versus ACRT on OS as well as the impact of demographic factors and clinical stage for the selection of each treatment approach utilizing the National Cancer Data Base. Methods: Adult patients with stage II and stage III adenocarcinoma of the rectum diagnosed from 2004-2013 were included. Chi-square analysis was used to compare demographic variables and clinical stage between the NCRT and ACRT treatment groups. Univariate and multivariate logistic regression modeling was used to identify factors predictive of each treatment strategy. Kaplan Meier and log-rank analysis along with propensity score matching was performed to determine the effect on OS. Results: A total of 20,262 patients were identified: 17,737 (87.5%) received NCRT and 2,525 (12.5%) received ACRT. Utilization of NCRT increased over the study period (p < 0.01). Factors associated with receipt of NCRT on multivariate analysis include: treatment at an academic institution (OR 0.76, 95% CI 0.68-0.85), income greater than $46,000 (OR 0.79, 95% CI 0.67-0.92), and living greater than 50 miles from a treatment facility. Factors associated with receipt of ACRT on multivariate analysis include: female sex (OR 1.12, 95% CI 1.01-1.24), Charlson comorbidity index of 1 (OR 1.18, 95% CI 1.04-1.34), and radiotherapy dose greater than 5040 centigray (OR 1.76, 95% CI 1.56-1.98). Compared to ACRT, NCRT was associated with a decreased risk of death on multivariate analysis (HR 0.91, 95% CI 0.84-1.00), which persisted after propensity score analysis. Conclusions: The use of NCRT for locally advanced rectal cancer is increasing and is associated with an OS benefit compared to ACRT.

173 Background: We have previously described an association between a greater than 8-week interval to initiation of adjuvant chemotherapy after resection of stage III adenocarcinoma of the colon and an approximately 20% increased risk of mortality. We sought to understand the factors that lead to delay in chemotherapy initiation. Methods: Patients who received adjuvant chemotherapy after resection of stage III colon cancer between 2003 and 2007 were identified from the National Cancer Data Base. Delayed chemotherapy was defined as the first date of chemotherapy administration being eight weeks or more after surgical resection. Comorbidity was categorized using the Charlson/Deyo index. Prolonged length of stay and unplanned readmission were used as surrogates for surgical complications. Multivariate logistic regression was performed to examine the associations between various clinical and socioeconomic variables and delay in the receipt of adjuvant chemotherapy. Results: 33,011 stage III colon cancer patients who received chemotherapy after surgery were identified. 8,036 (24.3%) initiated chemotherapy more than eight weeks after surgical resection. Unplanned readmission (OR 1.76, 95% CI 1.58-1.95), prolonged postoperative stay (OR 1.56, 95% CI 1.48-1.65), and comorbidity (OR 1.18, 95% CI 1.12-1.25) were all independent predictors of delay. Nonclinical factors, including African-American race (OR 1.34, 95% CI 1.24-1.45), lack of insurance (OR 1.63, 95% CI 1.43-1.87), and residence more than 100 miles from treating center (OR 1.23, 95% CI 1.01-1.51) were also independently associated with delayed chemotherapy. Conclusions: Delay in the initiation of adjuvant therapy for colon cancer beyond 8 weeks has previously been found to be an independent predictor of increased mortality. While some delays may result from patient frailty or postoperative complications, these data suggest that nonclinical factors may also contribute to delays. Increased focus on overcoming barriers to coordinated care should be prioritized to ensure that those patients who may benefit from adjuvant therapy receive it in a timely fashion to optimize survival advantages.

96 Background: Clinical trials are critical for the development of new treatment paradigms for Prostate Cancer (PCa). The primary aim of this study was to characterize the factors associated with clinical trial participation for patients with PCa. The secondary objective was to examine survival outcomes in the clinical trial and control cohorts. Methods: The National Cancer Database (NCDB) was queried for patients with PCa who were coded as having enrolled in a clinical trial. Trial patients were matched in a 1:8 ratio to controls based on clinical stage. Sociodemographic variables were compared between the two groups and univariate and multivariate logistic regression models evaluated factors associated with clinical trial participation. Kaplan-Meier product limit estimate was used to compare overall survival (OS) between the groups. Results: From 2004-2015, 495 patients enrolled in clinical trials were included for analysis. The mean age of trial patients was 63.2 compared to 66.4 in the matched cohort (p < 0.0001). More patients in the trial group had a Charlson-Deyo comorbidity score of 0 (89.3% vs. 82.1%, p = 0.0002). On multivariate analysis, patients who traveled between 50-250 miles (OR 1.59; 95%CI 1.15-2.19, p = 0.005) or came from a zip code where greater than 93% of the population has a high school degree (OR 4.97; 95%CI 2.89-8.54, p < 0.0001) were more likely to participate in a clinical trial. There was no association between race and insurance status on clinical trial participation. Median OS was not significantly different among clinical trial participants than the control cohort (120.9 months vs. not reached, p = 0.928). Conclusions: In this contemporary analysis of PCa patients from a national hospital registry database, we found that certain patient sociodemographic factors remain associated with clinical trial participation, though clinical trial participants do not seem to experience a difference in OS. Further work, both qualitative and quantitative, is necessary to identify clinical and non-clinical barriers to research participation in order to improve the validity of PCa trials.

503 Background: High rates of disease control with systemic therapy (ST) in the post-cytokine era for metastatic renal cell carcinoma (mRCC) cause apprehension that cytoreductive nephrectomy (CN) may delay effective therapy. We therefore evaluated factors associated with early mortality and time to ST after CN. We hypothesized markers of poor performance status and morbid CN would be associated with postoperative mortality and therapeutic delays. Methods: The National Cancer Database was screened for adult mRCC cases having CN followed by ST, years 2006-2013. We classified a delay in systemic therapy as interval > 45 days (median time to ST in the cohort). Multivariable logistic regression was performed, identifying factors associated with perioperative mortality and delays to initiation of ST. Results: Of 10,913 patients with initial CN (45% of mRCC), 30- and 90-day mortality were 3% and 11%, respectively. 6,362 later received ST (87% targeted therapy, 13% immunotherapy), median start was 45 days post-operatively (IQR 9-72), with 73% receiving ST within 30 days of CN. Multivariable factors associated with 30-day mortality included, older age, (OR 2.3, 95% CI 1.5-3.5 for those >75 [referent < 55 years]), Charlson index >0 (OR 1.3, 95% CI 1.0-1.6), lack of insurance (OR 1.9, 95% CI 1.2-2.8 [referent private payer]), node-positive disease (OR 1.4 95% CI 1.1-1.7), length of stay > 90th percentile (> 10 days, OR 3.2, 95% CI 2.0-5.3), larger tumor size (T4 lesion OR 1.7, 95% CI 1.2-2.5 [referent T1]). Delayed ST was associated with travel burden > 50 miles (OR 1.2, 95% CI 1.0-1.4), concurrent metastasectomy (OR 1.3, 95% CI 1.2-1.5), and length of stay > 90th percentile (OR 1.5, 95% CI 1.1-2.3). Conclusions: These data suggest that markers of frailty, more progressive disease, and surgical morbidity may contribute to surgical-related deaths or hinder patients receiving potentially disease-controlling therapy when treated with initial CN in mRCC. Going forward, existing surgical prognostic models could incorporate risks of surgical-related mortality and delay to ST when considering CN.

AbstractThe great amount of data observed in recent years coupled with modelling using evolutionary synthesis codes (BPASS, COELHO, GALAXEV, GALEV, MILES, PÉGASE, etc. . .) to compute Single Stellar Populations (SSPs) and the availability of fast and ingenious spectral synthesis codes such as starlight, ULySS and VESPA, have significantly shed light on our knowledge about the formation and evolution of galaxies. However, there are still open issues concerning the stellar populations in nearby galaxies, particularly those harbouring Active Galactic Nuclei (AGN): can stellar populations mimic nuclear activity, leading to a misclassification based on optical emission line ratios (Stasińska et al. 2008)? We have applied the starlight code (Cid Fernandes et al. 2005) to a well studied sample of nearby galaxies' nuclear spectra (r < ~ 200 pc), observed with the Hale 5 m telescope at Palomar Observatory in two different regions: ~ 4230-5110 Å and ~ 6210-6860 Å (Ho et al. 1995), with spectral resolutions of approximately 4 Å, and 2.5 Å. The aim is to properly derive the star-formation history (SFH), mean stellar age and metallicity and total stellar mass. Our results show that the star-formation history of Seyfert galaxies are very heterogeneous, i.e. these are composed of young, intermediate and old stellar populations, while the SFH of Low-Ionization Nuclear Emission-Line Regions (LINERs) are basically composed of old stellar populations. The absence of young stars in LINERs indicates that these are not responsible for the observed low-ionization emission lines. Furthermore, although a significant fraction of AGN spectra require a featureless continuum in their Spectral Energy Distribution (SED) modelling, this is not an indicative of the presence of an AGN, instead the continuum may simulate the presence of young stellar populations. The main objective of this research is to complement the study of spectroscopic parameters from 486 galaxies analyzed by Ho et al. (1995) that are public available in the VizieR catalog (Ho et al. 1997, 2009) and provide information about their stellar population content by means of the starlight. The base of Simple Stellar Populations used here was taken from Bruzual & Charlot (2003) and spans 25 ages (from 1 Myr to 18 Gyr) and 6 metallicities (Z = 0.005, 0.02, 0.2, 0.4, 1 & 2.5 Z⊙).

Objective. Few studies have evaluated the prognostic implication of the length of time from diagnosis to treatment initiation in bone sarcoma. The purpose of this study is to determine if time to treatment initiation (TTI) influences overall survival in adults diagnosed with primary bone sarcoma. Methods. A retrospective analysis of the National Cancer Database identified 2,122 patients who met inclusion criteria with localized, high-grade bone sarcoma diagnosed between 2004 and 2012. TTI was defined as length of time in days from diagnosis to initiation of treatment. Patient, disease-specific, and healthcare-related factors were also assessed for their association with overall survival. Kruskal-Wallis analysis was utilized for univariate analysis, and Cox regression modeling identified covariates associated with overall survival. Results. Any 10-day increase in TTI was not associated with decreased overall survival (hazard ratio (HR) = 1.00; P=0.72). No differences in survival were detected at 1 year, 5 years, and 10 years, when comparing patients with TTI = 14, 30, 60, 90, and 150 days. Decreased survival was significantly associated P<0.05 with patient ages of 51–70 years (HR = 1.66; P=0.004) and > 71 years (HR = 2.89; P<0.001), Charlson/Deyo score ≥2 (HR = 2.02; P<0.001), pelvic tumor site (HR = 1.58; P<0.001), tumor size >8 cm (HR = 1.52; P<0.001), radiation (HR = 1.81; P<0.001) as index treatment, and residing a distance of 51–100 miles from the treatment center (HR = 1.30; P=0.012). Increased survival was significantly associated P<0.05 with chordoma (HR = 0.27; P=0.010), chondrosarcoma (HR = 0.75; P=0.002), treatment at an academic center (HR = 0.64; P=0.039), and a private (HR = 0.67; P=0.006) or Medicare (HR = 0.71; P=0.043) insurer. A transition in care was not associated with a survival disadvantage (HR = 0.90; P=0.14). Conclusions. Longer TTI was not associated with decreased overall survival in localized, high-grade primary bone sarcoma in adults. This is important in counseling patients, who may delay treatment to receive a second opinion or seek referral to a higher volume sarcoma center.

492 Background: Penile cancer remains a rare disease in the United States and may be associated with substantial morbidity and even mortality. Though the understanding of penile cancer is limited by the uncommon nature of the disease, the use of large volume datasets may help reveal recent management trends and clinical factors associated with treatment. We sought to describe penis cancer management over the past several years using the National Cancer Data Base. Methods: We performed a retrospective review of data obtained from the National Cancer Data Base from 1998-2012. We analyzed patient characteristics, demographic information, and therapeutic approaches within two clinical scenarios: 1) use of partial penectomy for early stage (clinical Ta-T2 disease); and 2) use of chemotherapy for metastatic disease. We performed multivariate logistic analysis to determine factors associated with these treatments. Results: A total of 2,677 patients presented with cTa-T2 penile carcinoma. Of these, the proportion receiving partial penectomy increased from 73.9% in 1998-2000, to 80.4% in 2010-2012 (p < 0.001). Compared to those aged 50-59, partial penectomy was more common in the old (age > 80, OR 1.52, 95% CI 1.05 – 2.20) and young (age < 50, OR 1.47, 95% CI 1.04 – 2.07). Treatment at academic centers and those without insurance were less likely to receive partial penectomy (both p < 0.01), as were patients with cT2 and node positive disease (both p < 0.001). Of those presenting with metastatic disease (n = 817), use of chemotherapy increased over the time period from 39% receiving chemotherapy in 1998-2000, to 49% in 2010-2012 (p <0.03). Patients least likely to receive chemotherapy were older and with higher Charlson Comorbidity score (both p < 0.05), African American (OR 0.46, 95% CI 0.29 – 0.70), and those living > 50 miles from the nearest treatment hospital (OR 0.37, 95% CI 0.25 – 0.55). Conclusions: Penile sparing surgery and use of chemotherapy are becoming more commonly utilized over the last several years. Multiple factors appear to be associated with these trends, and further work is needed to define both clinical and non-clinical factors associated with treatment.

Advent of novel anti-myeloma agents and broader use of stem cell transplant has led to significant improvement in survival of patients (pts) with Multiple Myeloma (MM). However, there are well-described issues with affordability of novel drugs and rapidly escalating price of these agents (Shih et al. JCO 2017), leading to significant disparity among different sociodemographic groups. Hereby, we interrogated the National Cancer Database (NCDB) (which covers 70% of MM patient diagnosed nationwide) to assess impact of insurance type on survival. We also sought to investigate if autologous transplant may overcome socioeconomic effects on survival, by potentially minimizing the need for chronic use of expensive drugs. Methods: Data from 117,926 MM pts diagnosed with MM (ICD-O 9732) between year 2005 and 2014 were analyzed.. The comparison of patient characteristics among insurance types was done using ANOVA for continuous measurements and Chi-square test for categorical factors. OS was measured from the date of diagnosis to the date of death, censored at the date of last follow-up for survivors. Survivor distribution was estimated using Kaplan-Meier methods and difference of OS between groups was examined by log-rank test. The effect of continuous measurements including age, distance to medical facility and facility volume on OS was estimated using Cox proportional hazard model. The effect of insurance type on OS was estimated using multivariable Cox proportional hazard regression after adjusting the effects of confounding factors. Results: Median age at diagnosis was 67 years (19-90); 55% were males. 57% of pts lived in areas where the median income was &lt; $46k/year (individual income data was not available); Primary insurance was Medicare (52%), private insurance (35%) or Medicaid (5%), and 3% were uninsured. 40% were treated in academic institutions. Median follow up was 30.2 (range, 0-145.2) months. By univariate analysis, better OS was observed in pts with primary MM, lower Charlson Comorbidity Index (CCI), treatment in academic institutions, higher median regional income, or private insurance (p&lt;0.001 for all) (Table-1). Ninety six percent of patients were treated in facilities located ≤ 120 miles from area of residence. More patients with private insurance (5.7%) travelled &gt; 120 miles to the treatment facility than patients with Medicare (3%).Amongst patients younger than 65 years, 33% of patients with private insurance received transplant compared to 20% of those on Medicare (p&lt;0.001). For those 65 years and older, 11% of privately insured patients were transplanted compared to only 6 % for those on Medicare (p&lt;0.001). Median age of pts on Medicare and private insurance, was 74 and 57 years old, respectively. When restricting the analysis to pts ≥ 65 years old, pts with private insurance had longer OS compared to Medicare pts (p&lt;0.0001). Table-2 shows the results of multivariate analysis. There was a statistically significant difference in survival between patients with private insurance and those with Medicare in favor of the private insurance among patients older than 65 years old (41.9 vs. 30.8 months, p&lt;0.001 (Figure-1)). Similarly insurance type was a significant predictor of survival among patients who received therapies other than transplant among pts younger or older than 65 years old (Figure-2), however when considering patients who received transplant, there was no difference in survival between privately insured patients and Medicare in both age group (Figure-3). Conclusions: Although insurance type and regional income are associated with MM survival among patients who relied on non-transplant modalities, there was no significant impact of these socioeconomic factors on survival of patients that received an autologous transplant in this large database. This finding merits further investigation. Disclosures Malek: Janssen: Speakers Bureau; Amgen: Speakers Bureau; Adaptive: Consultancy; Celgene: Consultancy; Medpacto: Research Funding; Takeda: Consultancy; Sanofi: Consultancy.

Abstract Introduction Waldenstrom macroglobulinemia (WM) is a rare disease accounting for only 1-2% of all hematologic malignancies and with an overall annual, age-adjusted incidence of approximately 3.5 to 5.5 cases per million-person years. With approximately 13,000 active hematologist/oncologists in the US, most of who are in the community oncology setting, it's estimated that a hematologist/oncologist will only diagnose a WM case approximately every 8 years. Therefore, the clinical experience of a general hematologist/oncologist in the management of WM is likely very limited compared to more prevalent malignances. Previous studies in the setting of rare cancers suggest a correlation between higher volume of care and improved outcomes. Therefore, we explored the volume-outcome relationship in WM using the National Cancer Data Base (NCDB). Methods Patient-level data from the NCDB, a nationwide, facility-based, database covering approximately 70% of all newly diagnosed cancer cases in the US, was queried for all new WM cases diagnosed between 2004 and 2014. Only patients requiring treatment were included. Treatment facilities were divided into quartiles based on the average annual volume of newly diagnosed cases of WM seen. Cox regression was used to analyze the association between facility WM volume and survival, adjusted by demographics (sex, age, race), socioeconomic status (income, education, insurance type), geography (area of residence, treatment facility type, travel distance), comorbidity factors (Charlson-Deyo score), and year of diagnosis. Time-to-event analysis was calculated from frontline therapy initiation date using the Kaplan-Meier method and the log-rank test. Results A total of 3,732 patients with WM treated in 831 facilities were included. The median age at diagnosis was 70 years and 75% of the patients were treated within 20 miles from their residency zip code. Patient characteristics per treatment facility volume quartile are shown in table 1. The median annual facility volume was 1 new WM patient/year (range 0.1 to 21). The median follow-up from frontline treatment was 5 years. The unadjusted median OS by facility volume was: Q1: 6.5 years (95% CI: 5.7-7.4), Q2: 7 years (95% CI: 6.3-8.2), Q3: 8.2 years (95% CI: 7.1-8.9), and Q4: NR (95% CI: 8.5-NR), p<0.0001 (figure 1). The estimated 5-year OS by facility volume was: Q1: 56%, Q2: 61%, Q3: 64%, Q4: 71%, p<0.0001. Multivariate analysis including all variables showed in Table 1 demonstrated that facility volume was independently associated with all-cause mortality. Compared to patients treated at Q4 facilities, patients treated at lower-quartiles facilities had a higher incremental risk of death (Q3 hazard ratio [HR], 1.07 [95% CI: 0.88 to 1.29] p=0.46; Q2 HR, 1.34 [95% CI: 1.11 to 1.63] p=0.002; Q1 HR, 1.52 [95% CI: 1.23 to 1.88] p=<0.0001). Conclusion Our results suggest that a volume-outcome relationship exits in WM as patients treated initially at higher-volume facilities had a lower risk of mortality. Although differences in the underlying disease biology, referral patterns after initial therapy, or cumulative treating-physician experience could not be assessed, these potential biases would only underestimate the magnitude of the volume-outcome relationship reported. Disclosures Ansell: Celldex: Research Funding; Trillium: Research Funding; Takeda: Research Funding; Regeneron: Research Funding; Pfizer: Research Funding; Affimed: Research Funding; Merck & Co: Research Funding; Bristol-Myers Squibb: Research Funding; Seattle Genetics: Research Funding; LAM Therapeutics: Research Funding. Gertz:Medscape: Consultancy; janssen: Consultancy; Alnylam: Honoraria; Ionis: Honoraria; Physicians Education Resource: Consultancy; Prothena: Honoraria; Teva: Consultancy; Research to Practice: Consultancy; spectrum: Consultancy, Honoraria; celgene: Consultancy; Amgen: Consultancy; Abbvie: Consultancy; annexon: Consultancy; Apellis: Consultancy. Kapoor:Takeda: Research Funding; Celgene: Research Funding. Ailawadhi:Amgen: Consultancy; Janssen: Consultancy; Pharmacyclics: Research Funding; Celgene: Consultancy; Takeda: Consultancy. Reeder:Affimed: Research Funding. Witzig:Celgene: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding. Dispenzieri:Celgene, Takeda, Prothena, Jannsen, Pfizer, Alnylam, GSK: Research Funding. Lacy:Celgene: Research Funding. Kumar:Celgene: Membership on an entity's Board of Directors or advisory committees, Research Funding; AbbVie: Membership on an entity's Board of Directors or advisory committees, Research Funding; Janssen: Membership on an entity's Board of Directors or advisory committees, Research Funding; KITE: Membership on an entity's Board of Directors or advisory committees, Research Funding.

In this paper we analyze discourses about Human Sciences within the social and political movement called Bolsonarism (movement in favor of the Brazilian president Jair Bolsonaro). Our objective is to relate repetitions of specific truths about this area to practices revealed by institutional attacks that minimize this field of knowledge and the subjects who work with it. Taking it into consideration, we support this work with theoretical perspectives proposed by Michel Foucault about enunciation, discourse, discourse practice, discourse formation, power, knowledge and truth. The corpus of this work surrounds a variety of enunciations made by the president Bolsonaro, former educational ministers and further supporters, which rebounded on digital medias. The study has a descriptive-qualitative character, with predominating qualitative approaches. Our analysis allows to perceive that the repetition of adverse discourses about Human Sciences reveals a project of unilateral and authoritarian power which primarily objectives to hinder a raising of subjects with critical opinions that may counteract the wills of a bolsonarist practical discourse. As it conceives this knowledge field as a target to be aimed, as a potential enemy, the bolsonarist project proposes to mischaracterize Human Sciences’ researches along the public opinion and, therefore, to scrap educational institutions and impoverish the scientific research.ResumoNeste artigo, analisam-se discursos sobre as Ciências Humanas no esteio do movimento social e político denominado de bolsonarismo. O intento é relacionar a repetição de determinadas verdades acerca dessa área do conhecimento com a prática que se revela em ataques institucionais para minimizar esse campo do saber e os sujeitos que nele atuam. Para tanto, busca-se respaldo teórico na perspectiva de Michel Foucault acerca do enunciado, do discurso, da prática discursiva, da formação discursiva, do poder, do saber e da verdade. O corpus de análise percorre diversos enunciados produzidos pelo presidente Bolsonaro, os ex-ministros da Educação e demais apoiadores, os quais tiveram repercussão na mídia digital. Trata-se de um estudo descritivo-qualitativo, cuja abordagem segue um viés predominantemente qualitativo. A análise possibilita entrever que a repetição de discursos desfavoráveis às Ciências Humanas revela um projeto de poder autoritário e unilateral que objetiva, sobretudo, minar a emergência de um sujeito crítico que possa contrariar as vontades de verdade da prática discursiva bolsonarista. Na medida em que concebe esse campo do saber como um alvo a ser atingido, como um inimigo em potencial, o projeto bolsonarista se propõe a descaracterizar as pesquisas das Ciências Humanas junto à opinião pública e, com isso, sucatear as instituições de ensino e precarizar a pesquisa científica.Palavras-chave: Análise do discurso, Ciências humanas, Poder político, Bolsonarismo.Keywords: Discourse analysis, Human Science, Political power, Bolsonarism.ReferencesAGOSTINI, Renata. MEC cortará verba de universidade por ‘balbúrdia’ e já enquadra UnB, UFF e UFBA. O Estado de S. Paulo, 2019. Disponível em: <https://educacao.estadao.com.br/noticias/geral,mec-cortara-verba-de-universidade-por-balburdia-e-ja-mira-unb-uff-e-ufba,70002809579> Acesso em: 02 jul. 2020.AMARAL, Luciana. Weintraub deixa saldo negativo e projeto sem perspectiva no Congresso. UOL, 2020. 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Projeto revoga lei que declarou Paulo Freire patrono da educação. Agência Câmara de Notícias, 2019. Disponível em: <https://www.camara.leg.br/noticias/558470-projeto-revoga-lei-que-declarou-paulo-freire-patrono-da-educacao/> Acesso em: 02 jul. 2020.KLEM, Bruna Sultz. PEREIRA, Mateus; ARAÚJO, Valdei. (Org.). Do fake ao fato: (des) atualizando Bolsonaro. Vitória: Milfontes, 2020.MACHADO, Roberto. Por uma Genealogia do Poder. In.: FOUCAULT, Michel. Microfísica do Poder. Rio de Janeiro: Ed. Graal, 1998.MARTINS, Maria do Carmo. Reflexos reformistas: o ensino das humanidades na ditadura militar brasileira e as formas duvidosas de esquecer, Educ. rev. Curitiba, n. 51, p. 37-50, jan./mar. 2014.MENEZES, Dyelle; PERA, Guilherme. “É a maior revolução na área de ensino no país dos últimos 20 anos”, diz ministro. Gov.br, 2019. 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Disponível em: <http://divulgacandcontas.tse.jus.br/candidaturas/oficial/2018/BR/BR/2022802018/280000614517/proposta_1534284632231.pdf>. Acesso em: 05 jul. 2020.PRATA, Pedro. Propostas para a educação: o que já foi feito pelo governo Bolsonaro? O Estado de S. Paulo, 2019. Disponível em: <https://politica.estadao.com.br/noticias/geral,propostas-para-a-educacao-o-que-ja-foi-feito-pelo-governo-bolsonaro,70002857514> Acesso em: 02 jul. 2020.REZENDE, Costança. Weintraub: 'Não quero sociólogo, antropólogo e filósofo com meu dinheiro', Uol, 2020.Disponível em <https://noticias.uol.com.br/colunas/constanca-rezende/2020/06/14/weintraub-nao-quero-sociologo-antropologo-e-filosofo-com-meu-dinheiro.htm>. Acesso em 07 jul. 2020.ROCHA, Gessyca. Vélez teve a terceira gestão mais curta no MEC desde 1985; veja lista com todos os ministros. G1, 2019. 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A retórica da pós-verdade: o problema das convicções. EID&A, Ilhéus, n. 18, p. 122-138, abr./2019. Disponível em: <file:///C:/Users/Cliente%20Especial/Desktop/MESTRADO/LEITURAS%20DE%20TEXTOS/SEIXAS%20(TEXTO).pdf> Acesso em: 03 jun. 2020.SIMON, Rodrigo. Novos critérios da Capes vão cortar bolsas até de cursos de excelência. Folha de S. Paulo, 2020. Disponível em: <https://www1.folha.uol.com.br/ciencia/2020/03/novos-criterios-da-capes-vao-cortar-bolsas-ate-de-cursos-de-excelencia.shtml> Acesso em: 01 jul. 2020.SOUZA, Isabela. Projeto Escola Sem Partido: argumentos contra e a favor. Politize. 2018. Disponível em: <https://www.politize.com.br/projeto-escola-sem-partido/> Acesso em: 02 jul. 2020.VEJA. Vídeo completo: a reunião de Bolsonaro com Ministros em 22 de abril. 2020. (1h32m40s). Disponível em: <https://www.youtube.com/watch?v=nfgv7DLdCqA> Acesso em: 15 jun. 2020.VEJA. Universidades com ‘balbúrdia’ terão verbas reduzidas, diz Weintraub, 2019. Disponível em: <https://veja.abril.com.br/brasil/universidades-com-balburdia-terao-verbas-reduzidas-diz-weintraub/>. Acesso em: 05 jun. 2020.VILELA, Pedro Rafael. Bolsonaro anuncia Carlos Decotelli como novo ministro da Educação. Agência Brasil, 2020. Política. Disponível em: <https://agenciabrasil.ebc.com.br/politica/noticia/2020-06/bolsonaro-anuncia-carlos-decotelli-como-novo-ministro-da-educacao> Acesso em: 30 jun. 2020.ZINET, Caio. Especialistas descontroem os 5 principais argumentos do Escola Sem Partido. Educação Integral, 2016. Notícias. Disponível em: <https://educacaointegral.org.br/reportagens/especialistas-desconstroem-os-5-principais-argumentos-escola-sem-partido/> Acesso em: 02 jul. 2020.e4524141

Abstract: Technological crises are predictable and inevitable, particularly in a high-risk industry such as mining. Corporations are advised to have a crisis communication plan to facilitate proactive behaviour. Such a plan presumes a commitment to honesty, openness, and ethical behaviour. Journalists are also encouraged to have a crisis communication plan so that they are prepared for inevitable events, informed about the industries in their area, and able to tell the story substantively, accurately, and in context. The Westray coal mine, owned by Curragh Incorporated of Toronto and located in Pictou County, Nova Scotia, exploded on May 9, 1992, killing the 26 miners who were underground. This paper analyzes the relationship between Curragh and the media, particularly during the week following the explosion. It observes that the relationship was severely tested, as is often the case in time of crisis and human tragedy. The paper also observes that neither Curragh nor the participating media had crisis communication plans, which negatively affected their performance. It concludes that Curragh did not satisfy legitimate media needs and that the company's lack of open, prompt, and accessible communication fed a media suspicion that officials had something to hide. On the other hand, journalists relied on human interest, made mistakes, and decontextualized their coverage of the story. Résumé: Les crises technologiques sont prévisibles et inévitables, surtout dans une industrie à haut risque comme celle des mines. Les entreprises sont encouragées à avoir un plan de communication de crises afin de pouvoir agir de manière plus préventive. Un tel plan suppose un engagement à l'honnêteté, l'ouverture d'esprit, et la morale. Les journalistes sont aussi encouragés à avoir un plan de communication de crises pour être prêts à adresser les problèmes inévitables, pour être informés sur les industries dans leurs régions, et pour être capables de rapporter les faits de manière substantive, précise et contextuelle. La mine de charbon Westray, appartenant à la société Curragh de Toronto et située dans le comté Pictou en Nouvelle-Écosse, explosa le 9 mai 1992, tuant les vingt-six mineurs qui étaient sous terre. Cette étude analyse la relation entre Curragh et les médias, particulièrement dans la semaine suivant l'explosion. Elle observe que cette relation fut sévèrement mise à l'épreuve, comme c'est si souvent le cas dans des périodes de crise et de tragédie humaine. Cette étude observe aussi que ni Curragh ni les médias impliqués avaient des plans de communication de crises, ce qui a eu un effet négatif sur leurs actions. Elle conclut que Curragh n'a pas satisfait aux besoins légitimes des médias et que le manque d'une communication ouverte, rapide et accessible de la part de la compagnie encouragea les médias à soupçonner que celle-ci avait quelque chose à cacher. Pour leur part, les journalistes mirent trop d'accent sur les personnalités impliquées dans l'accident, commirent des erreurs, et manquèrent de contexte dans leur comptes rendus.

RESUMO: Este artigo apresenta resultados de uma pesquisa que buscou compreender a constituição das experiências de jovens de 18 a 24 anos, que participam das atividades no Programa Fica Vivo!, na cidade de Governador Valadares, Minas Gerais. O estudo assume como perspectiva teórica estudos do campo da Sociologia da Juventude e dos Estudos Territoriais. Os dados foram coletados por meio de questionário e entrevistas, e, para a análise, buscou-se o conceito de mobilização de Bernard Charlot. Os resultados apontam significados atribuídos pelos(as) jovens às experiências vivenciadas nesse Programa, relações com o trabalho e com o mundo da cultura, destacando-se, nesse processo, a presença dos(as) oficineiros(as). Conclui-se que o Programa tem cumprido a função protetiva naquele território, além de propiciar experiências educativas ali desenvolvidas, aprendizagens que se revestem de significados para esses(as) jovens, ampliando o acesso à cultura, ao lazer e à cidade.

Background: Medicare’s Readmission Reduction program fines hospitals with readmission rates that exceed the national average; however, standardized risk adjustment models do not take into account how far people live from an institution. Larger academic medical centers may be disadvantaged by this oversight. The purpose of this study was to determine if distance travelled could be predicted by length of stay (LOS) and comorbidity. Methods: The Bridging the Discharge Gap Effectively (BRIDGE) was accessed to obtain ZIP code, LOS and to calculate the Charlson Comorbidity Index for patients referred in 2012. Mean LOS was compared to national data from the HCUP database for acute coronary syndrome (ACS), heart failure (HF), and atrial fibrillation (AF). Distance from the medical center (MC) to the center of each ZIP code was evaluated for correlation with LOS and comorbidity. Local and Distant patients were defined as patients who lived within or outside a 40 mile radius of the MC. Results: A total of 785 were included in this analysis; mean age was 66.0 + 14.3 years and 60.9% were male. Overall, ACS patients had an average LOS 1 day less than the national average, whereas HF and AF patients stayed respectively 1.6 and 1.3 days longer than the national average. There was a significant difference in mean LOS for both ACS and HF patients who lived greater than 40 miles from the MC, (p=0.014, p=0.046). Although insignificant, Distant AF patients also had a mean LOS longer than that of local patients (p=0.12). For all patients who participated in the study, and for ACS patients in particular, there was a weak, but significant, relationship between LOS and distance from the MC (All: r=.18, n=785, p< .001; ACS: r=0.25, n=217, p<0.001), Conclusions: In this sample, LOS is positively correlated with distance from the MC. Because our institution is a large referral center, those referred from a distance are those who likely cannot be managed near their homes. As seen here, more complex HF and AF patients travel greater than 40 miles to receive treatment. Programs designed to decrease readmissions, like BRIDGE, may be less effective in these referral populations who may be less likely to travel for follow-up appointments. Further study is warranted to ascertain if distance should be part of standardized risk adjusting calculations.

OBJECTIVEFor symptomatic nonsecreting pituitary adenomas (PAs), resection remains a critical option for treatment. In this study, the authors used a large-population national database to compare endoscopic surgery (ES) to nonendoscopic surgery (NES) for the surgical management of PA.METHODSThe National Cancer Database was queried for all patients diagnosed with histologically confirmed PA who underwent resection between 2010 and 2016 in which the surgical approach was specified. Due to database limitations, microsurgery and craniotomy were both categorized as NES.RESULTSOf 30,488 identified patients, 16,373 (53.7%) underwent ES and 14,115 (46.3%) underwent NES. There was a significant increase in the use of ES over time (OR 1.16, p < 0.01). Furthermore, there was a significant temporal increase in ES approach for tumors ≥ 2 cm (OR 1.17, p < 0.01). Compared to NES, patients who underwent ES were younger (p = 0.01), were treated at academic centers (p < 0.01), lived a greater distance from their treatment site (p < 0.01), had smaller tumors (p < 0.01), had greater medical comorbidity burden (p = 0.04), had private insurance (p < 0.01), and had a higher household income (p < 0.01). After propensity score matching to control for age, tumor size, Charlson/Deyo score, and type of treatment center, patients who underwent ES had a shorter length of hospital stay (LOS) (3.9 ± 4.9 days vs 4.3 ± 5.4 days, p < 0.01), although rates of gross-total resection (GTR; p = 0.34), adjuvant radiotherapy (p = 0.41), and 90-day mortality (p = 0.45) were similar. On multivariate logistic regression, African American race (OR 0.85, p < 0.01) and tumor size ≥ 2 cm (OR 0.89, p = 0.01) were negative predictors of receiving ES, whereas diagnosis in more recent years (OR 1.16, p < 0.01), greater Charlson/Deyo score (OR 1.10, p = 0.01), receiving treatment at an academic institution (OR 1.67, p < 0.01) or at a treatment site ≥ 20 miles away (OR 1.17, p < 0.01), having private insurance (OR 1.09, p = 0.01), and having a higher household income (OR 1.11, p = 0.01) were predictive of receiving ES. Compared to the ES cohort, patients who started with ES and converted to NES (n = 293) had a higher ratio of nonwhite race (p < 0.01), uninsured insurance status (p < 0.01), longer LOS (p < 0.01), and higher rates of GTR (p = 0.04).CONCLUSIONSThere is an increasing trend toward ES for PA resection including its use for larger tumors. Although ES may result in shorter LOS compared to NES, rates of GTR, need for adjuvant therapy, and short-term mortality may be similar. Factors such as tumor size, insurance status, facility type, income, race, and existing comorbidities may predict receiving ES.

The impetus for this issue dates from a symposium on Embodied Knowledges held at Edith Cowan University in Perth in 2011. The Symposium arose from the shared interests of a diverse group, many of them practice-led researchers, and should have been a clue that the call for papers for this issue would attract different conceptions of the body. Nevertheless we were surprised by the many kinds of bodies implied in the 17 papers received and are pleased to offer a selection in the 'embody' issue of M/C Journal.Part of the difficulty of talking about the body as a source of knowledge, and also as a product of culture and history, is the backdrop of unproblematic representation of the body in popular culture. The linkage of the body to the brain, and by implication the mind, is particularly hard to escape. Through a scientific/medical lens, viewers of medical documentaries like The Human Body have learned to interpret representations of the brain. “Slices” of the brain are instantly recognisable through technologies such as Positron Emission Tomography (PET) scans. The metaphor of the brain lighting up due to thought and activity, derived from mediated brain imaging technology, has entered common usage. Such images are understood even by non-scientists as different parts of the brain at work, running the body. Brains, bodies and thinking seem well connected in popular culture.In the academic realm, the relationship of the brain to the mind is contested, as is the place of the body. In Western culture a dualist mind/body division has contributed to a particular understanding of the body, and of knowledge making, in which objective, propositional knowledge has been privileged. An alternative monist view has variously been used by theorists of the body from Nietsche to Deleuze but also by contemporary neurophysiologists such as Damasio. Using these philosophical positions, the body is either the weaker side of a partnership, or subsumed into a whole which does not acknowledge the specificity of actual bodies, or their potential as sites of knowledge making.Merleau-Ponty posited the body as both object and subject and that access to knowledge could only be obtained by the lived experience of the body. He suggested that we can only know other objects and perceive space and time through our own bodies. The phenomenological approaches resulting from this stance have, to some extent, recovered the status of bodily knowledge. Psychoanalytical thought has contributed to the extension of what we consider to be the boundaries of the body and blurred the articulation of mind through concepts like body image and body schema (see Weiss) and later neural maps (e.g. Damasio). However, Elizabeth Grosz went further when she issued a challenge in the early 90s “that all the significant facets and complexities of subjects, can be as adequately explained using the subject’s corporeality as a framework as it would be using consciousness or the unconscious” (vii). The body has been shown to be plastic when considered within lived physical and cultural spaces (Giblett; Grosz). Regardless of where one positions the body on a continuum from pure nature to a surface overwritten by culture and history, it seems foolish to disregard it as a source of knowledge.The authors of the papers presented in this issue attempt to show that knowledge resides in, can be acquired through, and flows out from, the body. Many of them see a connection between how and what can be known and their practice as artists, performers, researchers and writers. This way of knowing – through the thinking body – is connected to a developing family of methodologies called practice-based or practice-led research. It is research that aims to add to knowledge and understanding by carrying out an original investigation “in and through the acts of creating and performing” (Borgdorff 46). While many art practices clearly involve the body, Mercer and Robson point out that practice-led researchers often put the body at the centre of the inquiry and that “corporeal attention and information completes an otherwise insufficient way of theorising and philosophising” (18).Jo Taylor’s feature article on embodied trauma traverses 118 years between Jean-Martin Charcot and Robert Scaer. It captures both the problem of separating mind and body and the importance to recovery, of acknowledging knowledge held in the body. In the accounts of two physicians working in different times, cultures and places of access to scientific knowledge, it is the knowledge available through their patients’ bodies that is common. The image of the body arched in hysteria, the experience of trauma locked inside, will perhaps ensure that the body is not lost in this selection of writings.Ffion Murphy and Richard Nile also address trauma but with respect to the lost body in relation to an imagined community. Both the personal trauma of war and the communal experience of war can be sensed in the lost literature of the First World War. These attempts to represent or resurrect the war dead through writing can be considered acts of grief for embodiment. Karina Quinn and Kirsten Hudson ignore the spectre of the hysterical in examining maternal embodiment. Quinn takes up Julia Kristeva’s challenge to write from the body, providing a visceral account. Hudson also writes her lived experience, and offers her embodied art practice as site of resistance to cultural expectations of Australian motherhood.The bodily experience of art by the viewer is addressed by Prue Gibson, while Roz Drummond, Jondi Keane and Patrick West consider the interaction between embodiment and place from three different artistic practices. Chaim Noy’s detailed discussion conveys the kinaesthetic skill of the martial arts practitioner within a community of practice. His autoethnographic narrative highlights the knowledge of the body-in-motion against his written reflection.Vanessa Bradshaw, Cynthia Witney, Lelia Green and Leesa Costello show that embodied knowledge can be shared in a community even when that community is a virtual one. Whilst being diagnosed and treated within a dominant scientific/medical discourse, which prescribes one way of knowing breast cancer, women’s embodied experiences can be exchanged through an online support site to provide an alternative source of knowledge. Re-enactment and embodiment of cultural memory is explored by Michaela Callaghan in her work on the carnival dances of the displaced campesinos of the Andes. Within an urban setting, the campesinos collectively dance into being their ancestral place using physical memory. Her description of the body within place implies movement, perhaps showing that writing need not take us away from the body.The bodies represented in this issue feel like living bodies, they are not the bodies without organs of Deleuze and Guattari or the flesh of later Merleau-Ponty. They are bodies of sexual difference, bodies interacting with, and reacting to, other bodies, within particular spaces. Even the ghostly dead bodies of the war poetry, reported by Murphy and Nile, exert a powerful influence over the living.In using the term embodied knowledge we affirm that knowledge making includes the body. This 'embody' issue of M/C Journal is not about rejecting the mind in favour of the body. It is about the richness of knowledge and practice, grounded in our bodies-in-the world. As Grosz (vii) would have it: “Bodies have all the explanatory power of minds”.ReferencesBorgdorff, Henk. “The Production of Knowledge in Artistic Research”. The Routledge Companion to Research in the Arts. Eds. Michael Biggs and Henrik Karlsson. London: Routledge, 2010. 44-63.Damasio, Antonio. Looking for Spinoza: Joy, Sorrow and the Feeling Brain. London: Vintage, 2004.Deleuze, Gilles, and Félix Guattari. A Thousand Plateaus. Minneapolis: University of Minnesota Press, 1987.Giblett, Rodney. The Body of Nature and Culture. Basingstoke, UK: Palgrave Macmillan, 2008.Grosz, Elizabeth. Volatile Bodies: Toward a Corporeal Feminism. St Leonards, NSW: Allen & Unwin, 1994.Kristeva, Julia, and Arthur Goldhammer (Trans.). "Stabat Mater." Poetics Today 6.1-2 (1985): 133-52.Mercer, Leah, and Julie Robson. “The Backbone of Live Research: A Synthesis of Method in Performance Based Inquiry”. Live Research: Methods of Practice-led Inquiry in Performance. Eds. Leah Mercer, Julie Robson and David Fenton. Nerang, QLD: Ladyfinger, 2012. 11-19.Merleau-Ponty, Maurice. Phenomenology of Perception. Trans. Colin Smith. London: Routledge & Kegan Paul, 1962.---. The Visible and the Invisible. Trans. Alphonso Lingis. Evanston: Northwestern University Press, 1968.The Human Body. Prod/Dir. Richard Dale. BBC, 1998.Weiss, Gail. Body Images: Embodiment as Intercorporeality. New York and London: Routledge, 1999.