Journal articles on the topic 'Newton Adams'

Take typical parallel mechanism 3PTT as research subject, its inverse kinematic analysis solution was gotten. Dynamic model of the mechanism was established by Newton-Euler method, and the force and torque equations were derived. Dynamic simulation of 3PTT parallel mechanism was done by using ADAMS software, and simulation results have verified the correctness of the theoretical conclusions.

John Couch Adams predicted the location of Neptune in the sky, calculated the expectation of the change in the mean motion of the Moon due to the Earth’s pull, and determined the origin and the orbit of the Leonids meteor shower which had puzzled astronomers for almost a thousand years. With his achievements Adams can be compared with his good friend George Stokes. Not only were they born in the same year but were also both senior wranglers, received the Smith’s Prizes and Copley medals, lived, thought and researched at Pembroke College, and shared an appreciation of Newton. On the other hand, Adams’ prediction of Neptune’s location had absolutely no influence on its discovery in Berlin. His lunar theory did not offer a physical explanation for the Moon’s motion. The origin of the Leonids was explained by others before him. Adams refused a knighthood and an appointment as Astronomer Royal. He was reluctant and slow to publish, but loved to derive the values of logarithms to 263 decimal places. The maths and calculations at which he so excelled mark one of the high points of celestial mechanics, but are rarely taught nowadays in undergraduate courses. The differences and similarities between Adams and Stokes could not be more striking. This volume attests to the lasting legacy of Stokes’ scientific work. What is then Adams’ legacy? In this contribution, I will outline Adams’ life, instances when Stokes’ and Adams’ lives touched the most, his scientific achievements and a usually overlooked legacy: female higher education and support of a woman astronomer. This article is part of the theme issue ‘Stokes at 200 (part 2)’.

This paper examines the performance of the 3rd and 4th order implicit Adams methods in the framework of the two-loop implicit sparse matrix numerical integration method in solving the differential/algebraic equations of heavily constrained dynamical systems. The variable-step size two-loop implicit sparse matrix numerical integration/Adams method proposed in this investigation avoids numerical force differentiation, ensures satisfying the nonlinear algebraic constraint equations at the position, velocity, and acceleration levels, and allows using sparse matrix techniques for efficiently solving the dynamical equations. The iterative outer loop of the two-loop implicit sparse matrix numerical integration/Adams method is aimed at achieving the convergence of the implicit integration formulae used to solve the independent differential equations of motion, while the inner loop is used to ensure the convergence of the iterative procedure used to satisfy the algebraic constraint equations. To solve the independent differential equations, two different implicit Adams integration formulae are examined in this investigation; a 3rd order implicit Adams-Moulton formula with a 2nd order explicit predictor Adams Bashforth formula, and a 4th order implicit Adams-Moulton formula with a 3rd order explicit predictor Adams Bashforth formula. A standard Newton–Raphson algorithm is used to satisfy the nonlinear algebraic constraint equations at the position level. The constraint equations at the velocity and acceleration levels are linear, and therefore, there is no need for an iterative procedure to solve for the dependent velocities and accelerations. The algorithm used for the error check and step-size change is described. The performance of the two-loop implicit sparse matrix numerical integration/Adams algorithm developed in this investigation is evaluated by comparison with the explicit predictor-corrector Adams method which has a variable-order and variable-step size. Simple and heavily constrained dynamical systems are used to evaluate the accuracy, robustness, damping characteristics, and effect of the outer-loop iterations of the proposed implicit schemes. The results obtained in this investigation show that the two-loop implicit sparse matrix numerical integration methods proposed in this study can be more efficient for stiff systems because of their ability to damp out high-frequency oscillations. Explicit integration methods, on the other hand, can be more efficient in the case of non-stiff systems.

These In order to overcome the behindhand and inefficient design of potato diggers, feature-based parametric modeling software Autodesk Inventor was used for the modeling of potato diggers. The swing sieve, movement simulation with ADAMS was carried out. The complex velocity acceleration and displacement curves were analyzed. Collision pressure curves were analyzed too. νis less than or equal to 500 mm/s, and αis more than or equal to 2.5m/s2, and less than or equal to 20m/s2. Test results indicated that Collision pressures of small and medium tubers are 120 Newton and 250 Newton respectively, which are all smaller than damaging pressure. Potato can be transferred freely and damage rate is less than or equal to 4% when the frequency is 5.5Hz and the swing is 30mm. It satisfies the design request.

SUMMARYIn this study, the kinematics and dynamics of a six-degree-of-freedom parallel manipulator, known as Hexarot, are evaluated. Hexarot is classified under axis-symmetric robotic mechanisms. The manipulator comprises a cylindrical base column and six actuated upper arms, which are connected to a platform through passive joints and six lower arms. The actuators of the mechanism are located inside a cylindrical-shaped base, which allows the mechanism to rotate infinitely about the axes of the latter column. In the context of kinematics, the inverse-kinematic problem is solved using positions, velocities, and accelerations of the actuated joints with respect to the position, orientation, and motion of the platform. Accordingly, the main objective of this study is to dynamically model the manipulator using the Newton–Euler approach. For validation, the obtained dynamic model of the Hexarot manipulator is simulated in MATLAB based on the formulations presented in this paper. The kinematic and dynamic models of the manipulator are simulated for a given motion scenario using MATLAB and ADAMS. The results of the mathematical model obtained using MATLAB are in good agreement with that using the ADAMS model, confirming the effectiveness of the proposed mathematical model.

A 2-DOF manipulator is modeled in PROE. In MATLAB, inverse kinematics is solved by geometric method. The desired trajectory, angular velocity and angular acceleration of each joint are obtained by the linear interpolation of parabola transition to complete the kinematics planning of the manipulator. The velocity of the end-point and the kinematics analysis are got by Newton-Euler method. In PROE, the expected trajectory of the end point is got by the simulation of the position planning. Kinematics simulation on the model is made in ADAMS. The simulation results are consistent with theoretical calculations to verify the correctness of the theory computing, which can provide an effective basis for the control of the manipulator.

Selection of drive components and determination of dynamics properties are extremely important technical components for overall design of palletizing robot. As an example, the paper firstly introduce how to establish mathematical model and finish kinematics analysis. Based on the previous work, MATLAB scripts are written through the use of Newton-Euler Method to analyze and calculate dynamic analysis, after which the parameters of dynamics are obtained. Then the dynamic behavior is studied by multi-body system simulation using ADAMS software to testify the former analysis in MATLAB. Lastly, two speed trajectory algorithm were adopted to simulate for the same working condition, in an attempt to investigate the difference in their dynamic behavior and provide a reliable theoretical basis for optimal control method.

The new type of three jaw docking mechanism is designed for use in orbiting spacecraft, the mathematical model is given and its working characteristics are analyzed. By establishing the mathematical model of the interaction of the parts under the different coordinate system, it is obtained that the corresponding kinematic characteristics; contact collision dynamics model is established by using the Hertz model theory, dynamic equation is established by Newton-Euler method, and simulation analysis are carried out by using the dynamics simulation software ADAMS, through the simulation analysis of three groups with different initial conditions, the results show that it achieve reliable grasp with good performance, it provides the lock claw curve in contact collision force and movement characteristics curve. These curves provide reference to improve the performance of docking mechanism.

This work deals with the estimation and the sensitivity analysis of the 3-UPU parallel robot error. Based on the Newton–Euler formalism, the robot dynamic model is given in a closed form. This model is validated by the software ADAMS. Using the interval analysis method, a new algorithm is proposed, which estimates the errors in the motion of the end-effector and the errors in the actuator forces as a function of the design parameters uncertainties. The obtained results show that the kinematic errors are minimal at the workspace center. Moreover, these errors increase as the platform moves along the vertical axis. It is also shown that kinematic errors in the actuator joints are the most influential parameters on the manipulator accuracy. Therefore, using actuators with a higher accuracy can highly reduce the errors in motion of the platform.

In signal cylinder diesel engine we often use dual shaft balance mechanism to balance reciprocating inertia force produced by the piston and moving parts, and reduce vibration of diesel engine. For this paper, the model crank -connecting rod and balance mechanism of a signal cylinder diesel engine were built in simulation software ADAMS. Piston’s movement law and its force curve have got through multi-body dynamics simulation to the model .By further processing to the simulation results, we got curves of piston’s reciprocating inertia force and balance shaft’s balance force. Comparing the two curves, we got the following conclusions: the difference between positive and negative peak for reciprocating inertia force that haven’t balanced was about 5500 Newton, which was equal to around 34% of the difference between the positive and negative peak for reciprocating inertia force, and the main reason for this is the dual shaft balance mechanism only balanced one step reciprocating inertia force; Though the balance effect was quite obvious, for ideal conditions there is a difference, and further improve can be done.

For spatial multibody systems, the dynamic equations of multibody systems with compound clearance joints have a high level of nonlinearity. The coupling between different types of clearance joints may lead to abundant dynamic behavior. At present, the dynamic response analysis of the spatial parallel mechanism considering the three-dimensional (3D) compound clearance joint has not been reported. This work proposes a modeling method to investigate the influence of the 3D compound clearance joint on the dynamics characteristics of the spatial parallel mechanism. For this purpose, 3D kinematic models of spherical clearance joint and revolute joint with radial and axial clearances are derived. Contact force is described as normal contact and tangential friction and later introduced into the nonlinear dynamics model, which is established by the Lagrange multiplier technique and Jacobian of constraint matrix. The influences of compound clearance joint and initial misalignment of bearing axes on the system are analyzed. Furthermore, validation of dynamics model is evaluated by ADAMS and Newton–Euler method. This work provides an essential theoretical basis for studying the influences of 3D clearance joints on dynamic responses and nonlinear behavior of parallel mechanisms.

This paper presents a novel six-degree-of-freedom (6-DOF) parallel platform that is used as the third mirror adjustment system of a large space telescope. In order to meet the design requirements of high precision, a large load–size ratio, and high stiffness in both the transverse and the vertical directions, the parallel platform is designed to be a 6-P-RR-R-RR structure via use of offset RR-joints. The inverse kinematics problem of the designed platform with offset RR-joints is much more complicated than that of a parallel platform with common universal joints owing to the presence of joint-dependent variables in the former problem. In this study, inverse kinematics of the designed parallel platform is mathematically modeled and the Newton–Raphson numerical iterative computation is performed. The accuracy and effectiveness of the proposed mathematical approach are verified by numerical co-simulations using MATLAB and ADAMS. The initial position of the platform is determined by a precision measuring arm. A test system is constructed, and then inverse kinematics solution, resolutions and adjusting steps accuracies of the platform are tested using grating length gauges. Motion strokes of the parallel mechanism are measured using laser tracker.

Background: The parallel mechanism is widely used in motion simulators, parallel machine tools, medical equipment and other fields. It has advantages of high rigidity, stable structure and high carrying capacity. However, the control strategy and control method are difficult to study because of the complexity of the parallel mechanism system. Objective: The purpose of this paper was to verify the dynamic model of a hydraulic driven 3-DOF parallel mechanism and propose a compound control strategy to broaden the bandwidth of the control system. Methods: The single rigid body dynamic model of the parallel mechanism was established by the Newton Euler method. The feed forward control strategy based on joint space control with inverse kinematic was designed to improve the bandwidth and control precision. The co-simulation method based on MATLAB / SIMULINK and ADAMS was adopted to verify the dynamics and control strategy. Results: The bandwidth of each degree of freedom in the 3-DOF parallel mechanism was used to expand about 10Hz and the amplitude error was controlled below 5%. Conclusion: Based on the designed dynamic model and composite control strategy, the controlled accuracy of the parallel mechanism is improved and the bandwidth of the control system is broadened. Furthermore, the improvements can be made in aspects of control accuracy and real-time performance to compose more patents on parallel mechanisms.

Foldable origami-based structures are a type of deployable structures that are increasingly applied in the space and building industries. When folded, the small size of such structures facilitates transportation and storage. Meanwhile, the properties of their larger deployed state may be of interest to different applications. A stable working condition is established by locking the structure in its deployed state, as in the process of deployment, the driving forces may generate a dynamic effect, thus leading to instability of the system. Hence, the study of dynamic characteristics of such structures, including trajectory, duration, velocity, and acceleration is of paramount importance. In this paper, based on the general dynamic equation and Lagrange’s equations of the first kind, the finite element method is adopted to investigate the dynamic deployment of foldable plate structures in terms of the generalized nodal coordinates. The proposed geometric description of a quadrilateral plate element is based on a folding plate composed of refined triangular elements, which are used to approximate the real shells in the structure. Subsequently, a MATLAB framework is developed on the basis of the element using the Newmark integration and the Newton–Raphson iteration method to simulate the deployment process of the structure. Comparisons between MATLAB results and ADAMS results verify the reliability of the framework in analyzing the dynamic deployment of the foldable origami-based structures with sufficient accuracy.

The recognition of the astronomical origin of meteors is intimately connected to the Leonid meteors, and their tendency to “storm” with a period of 33 years. It was the Leonid storm of 1799, observed by Alexander von Humboldt among others, that first established the geographical extent of the phenomenon, with observations reported over 90 degrees of longitude and 60 degrees of latitude. During the 1833 storm, Olmsted (1834) at Yale and Twining (1834) at West Point established the radiant point in Leo, and the cosmic origin was clinched when H. A. Newton (1863), also at Yale, determined that the cycle repeated in intervals of sidereal years, not tropical years. Inspired by the 1866 storm, Adams (1866), Schiaparelli (1867), and Le Verrier (1867) determined a 33.25 year period and other orbital elements for the meteor stream; two years after the discovery of Comet Tempel-Tuttle in 1865, that comet was recognized as the parent body of the Leonid stream after von Oppolzer (1867) calculated a period of 33.17 years for the comet. Astronomers confidently predicted another storm in 1899, but none appeared, though there were good showers in 1901-1903. The years 1930-32 also brought fairly good showers, but 1966 brought the strongest storm witnessed in modern times, with an estimated 100,000 meteors per hour. Steady progress was made in meteor studies in the 20th century, especially with new photographic and radar techniques. The current question is what will happen in the 1997-1999 period; the only certainty is that the event will be studied with an even wider array of techniques.

To reduce the failure probability of gas drainage drilling holes in coal mines, a new modeling method of gas drainage drilling machine is presented. Firstly, each drill pipe is regarded as a flexible body, and the Lagrange’s equation of second kind is used to model it. Secondly, the joint of drill bit, hole wall and drill pipe are regarded as rigid bodies, and the Newton-Euler method is used to model it. Thirdly, the rigid-flexible coupling multi-body dynamic model of drilling rig-drill pipe-hole wall system in medium and short horizontal section of soft coal seam is established by using relative node coordinate method, and the time complexity and operation complexity of modeling are reduced by using ADAMS macro program. Finally, the finite element method is used to discretize the model, and the virtual prototyping technology is used to solve the mathematical model. The simulation results show that the coupling of friction and vibration does not necessarily increase the probability of drilling failure, but sometimes reduces the amplitude of vibration. Compared with the length of each drill pipe, the influence of drilling depth on the system is greater, and the bit-bounce behaviours is more likely to occur in the deep hole. The operating frequency range of the drilling rig is 6.9E-3 to 2.1E+4Hz. When the length of the drill pipe is constant, the natural frequency of the system increases with the increase of the order, while the natural frequency of the deep hole section is almost unaffected by the order. In practical engineering, the vibration excitation of the actuator should be controlled to avoid the natural frequency. Meanwhile, the modal frequency should be avoided as far as possible to reduce the vibration and the failure probability of drilling holes. The model can simulate a series of dynamic responses of drilling rig system in drilling process, and provide theoretical support for subsequent multi-factor coupling modeling.

The problem of calculating the shells of rotation of a variable along the meridian of rigidity under asymmetric loading is reduced o a set of systems of one-dimensional boundary value problems with respect to the amplitudes of decomposition of the required functions into trigonometric Fourier series.
 A method for reducing the number of one-dimensional boundary value problems required to achieve a given accuracy in determining the stress-strain state of the shells of rotation with a variable along the meridian wall thickness under asymmetric load. The idea of the proposed approach is to apply periodic extrapolation (prediction) of the values of the decomposition coefficients of the required functions using the results of calculations of previous coefficients of the corresponding trigonometric series, thus replacing them with some prediction values calculated by simple formulas.
 To solve this problem, we propose the joint use of Aitken-Steffens extrapolation dependences and Adams method in the form of incremental component, which is quite effective in solving the Cauchy problem for systems of ordinary differential equations and is based on Lagrange and Newton extrapolation dependences.
 The validity of the proposed approach was verified b the results of a systematic numerical experiment by predicting the values of the expansion coefficients in the Fourier series of known functions of one variable.
 The approach is quite effective in the calculation of asymmetrically loaded shells of rotation with variable along the meridian thickness, when the coefficients of decomposition of the required functions into Fourier series are functions of the longitudina lcoordinate and are calculated by solving the corresponding boundary value problem. In this case, the approach allows solving solutions of differential equations for the amplitudes of decompositionin to trigonometric series only for individual "reference" harmonics, and the amplitudes for every third harmonic can be calculated by interpolating their values for all node integration points of the corresponding boundary value problem. This significantly reduces the computational cost of obtaining the solution as a whole.
 As an example, the results of the calculation of the stress-strain state of a steel annular plate under asymmetric transverse loading are given.

Aplasia cutis congenita is a very rare and heterogeneous disease. It is characterized by a localized or extensive skin defect, isolated or associated with damage to the underlying structures, including the bone. The diagnosis is based on the clinical examination. Other abnormalities of various etiologies and severities may be associated with this pathology. Adams-Oliver syndrome is a genetic polymalformative syndrome. The typical form is defined by the presence of Aplasia cutis congenita and limb anomalies. Managing Aplasia cutis congenita, especially in severe cases, is a real challenge. We report a case of a newborn, treated surgically, for extensive occipito-parietal Aplasia cutis congenita. The clinical presentation was suggestive of AdamsOliver syndrome. The evolution was favorable. Describing our experience of managing a case of Aplasia cutis congenita is interesting because: the proposed treatment is very controversial, the rarity and the high morbidity and mortality of Aplasia cutis congenita and Adams-Oliver syndrome. As well as clinical and genetic diversity.

Abstract The article presents the results of modelling the friction phenomenon using artificial neural networks and analysis of variance. The test material was composed of strip specimens made of 0.5-mm-thick alpha-beta Grade 5 (Ti-6Al-4V) titanium alloy sheet. A special tribotester was used in the tests to simulate the friction conditions between the punch and the sheet metal in the sheet metal forming process. A test called the strip drawing test has been conducted in conditions in which the sheet surface is lubricated with six environmentally friendly oils (palm, coconut, olive, sunflower, soybean and linseed). Based on the results of the strip drawing test, a regression model and an artificial neural network model were built to determine the complex interactions between the process parameters and the friction coefficient. A multilayer perceptron with one hidden layer and eight neurons in this layer showed the best fit to the training data. The network training was conducted using three algorithms, i.e. Levenberg-Marquardt, back propagation and quasi-Newton. Taking into consideration both the coefficient of determination R2 (0.962) and S.D. ratio (0.272), the best regression characteristics were presented by the network trained using the Levenberg-Marquardt algorithm. From the response surfaces of the quadratic regression model it was found that an increase in the density of lubricant at a specific pressure causes a reduction in the coefficient of friction. Low density and high kinematic viscosity of the oil leads to a high coefficient of friction.

Transgenic mice were prepared with inactive alleles for procollagen N-proteinase (ADAMTS-2; where ADAMTS stands for adisintegrin and metalloproteinase with thrombospondin repeats). Homozygous mice were grossly normal at birth, but after 1-2 months they developed thin skin that tore after gentle handling. Although the gene was inactivated, a large fraction of the N-propeptides of type I procollagen in skin and the N-propeptides of type II procollagen in cartilage were cleaved. Therefore the results suggested the tissues contained one or more additional enzymes that slowly process the proteins. Electron microscopy did not reveal any defects in the morphology of collagen fibrils in newborn mice. However, in two-month-old mice, the collagen fibrils in skin were seen as bizarre curls in cross-section and the mean diameters of the fibrils were approx. half of the controls. Although a portion of the N-propeptides of type II procollagen in cartilage were not cleaved, no defects in the morphology of the fibrils were seen by electron microscopy or by polarized-light microscopy. Female homozygous mice were fertile, but male mice were sterile with a marked decrease in testicular sperm. Therefore the results indicated that ADAMTS-2 plays an essential role in the maturation of spermatogonia.

Degradation of the cartilage proteoglycan, aggrecan, is an essential aspect of normal growth and development, and of joint pathology. The roles of different proteolytic enzymes in this process can be determined from the sites of cleavage in the aggrecan core protein, which generates novel termini (neoepitopes). Antibodies specific for the different neoepitopes generated by such cleavage events provide powerful tools with which to analyse these processes. The same approach can be used to differentiate the processed, active forms of proteases from their inactive pro-forms. Since the proteolytic processing of these enzymes requires the removal of the inhibitory pro-region, it also results in the generation of N-terminal neoepitopes. Using the newborn rat long bone as a model system, it was shown that the active form of ADAMTS-4 [ADAM (a disintegrin and metalloproteinase) with thrombospondin motifs-4], but not ADAMTS-5, co-localizes with the aggrecan cleavage neoepitopes known to be produced by this metalloproteinase. Thus, in long bone growth, aggrecan turnover seems to be dependent on ADAMTS-4 activity. To demonstrate the molecular basis of the specificity of anti-neoepitope antibodies, the Fv region of a monoclonal antibody specific for a neoepitope generated by the ADAMTS-4-mediated cleavage of aggrecan has been modelled and the binding of the peptide epitope simulated. In the docked structure, the N-terminus of the peptide antigen is clearly buried in the binding-site cavity. The absence of an open cleft makes it impossible for the intact substrate to pass through the binding site, providing a rationale for the specificity of this class of antibodies.

Two simple and improved models — energy-balance and spring-mass — were developed to calculate impact force and duration during low-velocity impact of circular composite plates. Both models include the contact deformation of the plate and the impactor as well as bending, transverse shear, and membrane deformations of the plate. The plate was a transversely isotropic graphite/epoxy composite laminate and the impactor was a steel sphere. In the energy-balance model, a balance equation was derived by equating the kinetic energy of the impactor to the sum of the strain energies due to contact, bending, transverse shear, and membrane deformations at maximum deflection. The resulting equation was solved using the Newton-Raphson numerical technique. The energy-balance model yields only the maximum force; hence a less simple spring-mass model is presented to calculate the force history. In the spring-mass model, the impactor and the plate were represented by two rigid masses and their deformations were represented by springs. Springs define the elastic contact and plate deformation characteristics. Equations of equilibrium of the resulting two degree-of-freedom system, subjected to an initial velocity, were obtained from Newton’s second law of motion. The two coupled nonlinear differential equations were solved using Adam’s numerical integration technique. Calculated impact forces from the two analyses agreed with each other. The analyses were verified by comparing the results with reported test data.

Studies in vitro by Pasvol et al (Nature, 270:171, 1977) have indicated that the growth of Plasmodium falciparum in cells containing fetal hemoglobin (HbF = α2γ2) is retarded, but invasion is increased, at least in newborn cells. Normal neonates switch from about 80% HbF at birth to a few percent at the end of the first year of life. Carriers of β-thalassemia trait exhibit a delay in the normal HbF switch-off, which might partially explain the protection observed in populations with this gene. To study this hypothesis in vivo, we used transgenic (γ) mice expressing human Aγ and Gγ chains resulting in 40% to 60% α2Mγ2 hemoglobin, infected with rodent malaria. Two species of rodent malaria were studied.P chabaudi adami causes a nonlethal infection, mainly in mature red blood cells (RBC). P yoelii 17XNL is a nonlethal infection, invading primarily reticulocytes, whereas P yoelii 17XL is a lethal variant of P yoelii 17XNL and causes death of mice in approximately 1 to 2 weeks. Data indicate that this strain may cause a syndrome resembling cerebral malaria caused by P falciparum (Am J Trop Med Hyg, 50:512, 1994). In γ transgenic mice infected with P chabaudi adami, the parasitemia rose more quickly (in agreement with Pasvol) than in control mice, but was cleared more rapidly. In mice infected with P yoelii 17XNL, a clear reduction in parasitemia was observed. Interestingly, splenectomy before this infection, did not reverse protection. The most striking effect was in lethal P yoelii17XL infection. Control mice died between 11 to 13 days, whereas γ mice cleared the infection by day 22 and survived, a phenomenon also observed in splenectomized animals. These results suggest that HbF does indeed have a protective effect in vivo, which is not mediated by the spleen. In terms of mechanisms, light microscopy showed that intraerythrocytic parasites develop slowly in HbF erythrocytes, and electron microscopy showed that hemozoin formation was defective in transgenic mice. Finally, digestion studies of HbF by recombinant plasmepsin II demonstrated that HbF is digested only half as well as hemoglobin A (HbA). We conclude that HbF provides protection from P falciparum malaria by the retardation of parasite growth. The mechanism involves resistance to digestion by malarial hemoglobinases based on the data presented and with the well-known properties of HbF as a super stable tetramer. In addition, the resistance of normal neonates for malaria can now be explained by a double mechanism: increased malaria invasion rates, reported in neonatal RBC, will direct parasites to fetal cells, as well as F cells, and less to the ≈20% of HbA containing RBC, amplifying the antimalarial effects of HbF.

Abstract Abnormal high velocities are predictive of high stroke risk which can be significantly reduced by transfusion program (Adams and al). They are related to stenosis, severe anemia or tissue hypoxia. We hypothesized that high velocities observed in patients with normal MRA and normalized on transfusion program (TP), were anemia related and could be safely decreased with hydroxyurea (HU)-therapy. Patients and Methods: since 1992, 291 pediatric SCD patients (235 SS, 40 SC, 3 Sb0, 11 Sb+) were systematically explored once a year by TCD. The newborn screened cohort (n=149) had the first TCD exploration between 12 and 18 months age. TCD was performed with a real-time imaging unit, using a 2 MHz sector transducer with color Doppler capabilities. When abnormal high velocities (defined as mean maximum velocities > 200 cm/sec in MCA, ACA or ICA) were observed, TCD was controlled and the patient treated with TP and cerebral imaging (MRI/MRA) was performed within 3 months. In patients with severe stenosis, TP was pursued or transplantation performed. In patients with normal MRA and transfusion-normalized velocities, a progressive switch towards HU therapy was applied and TCD controlled once a trimester. Results: among the stroke-free patients (n=281), abn. high velocities were detected in 25 patients (all SS:11% of incidence in SS patients). In the newborn screened population, velocities became abnormal in 10 patients at the median age of 5.7 years (range 1.4 – 12.5 y). The first MRI/MRA (n=24/25) performed in the 3 months following the detection of high velocities showed MRI/silent infarcts in 9/24 (38%): only 1/11 among the newborn screened cohort had silent infarcts in contrast with 8/13 older patients secondary referred in our center. MRA detected severe vascular abnormalities in 10 and mild in 3 patients. Mean velocities (2.69 m/sec) were significantly higher (p=0.002) in the 7 patients with abn. MRI and MRA than in the 10 patients (2.11m/sec) who had normal MRI and MRA. One stroke occurred in a very young 1.6 y old girl just before the second TCD evaluation (first abn. TCD had been observed at 1.5 y) and before the beginning of the TP. Long-term outcome: no stroke was observed following the initiation of the TP. With a median follow-up of 4.4 years (0.5 to 11.4 y.), velocities remained abnormal in 11/25 patients: 7 of them had abnormal MRA and among the 4 patients with normal MRA at first exploration MRA became abnormal in 2 cases showing that abnormal TCD can precede the occurrence of cerebral vasculopathy. TP was maintained in 7 patients and safely stopped in 4 patients transplanted with genoidentical donor. Velocities normalization (defined as < 170 cm/sec) was observed in 13/25 patients in a median delay of 0.75 years (0.25 – 2.3 years). TP was stopped in 10 patients with normal MRA and therapy was switched towards HU in 7 patients with abstention in 3. However, abnormal TCD relapsed in 4 patients who were again placed on TP. Conclusion: abnormal high velocities concerned 11% of SS patients and were predictive of MRA and MRI lesions occurrence. TP was efficient to prevent the stroke risk and normalized velocities in about 50% of patients but relapses were observed in 4/7 patients following TP stop and HU switch. Only few patients with high velocities history did not develop cerebral vasculopathy. Also, early TCD allows a selection of very high risk patients justifying the research of suitable donors.

Abstract Studies in vitro by Pasvol et al (Nature, 270:171, 1977) have indicated that the growth of Plasmodium falciparum in cells containing fetal hemoglobin (HbF = α2γ2) is retarded, but invasion is increased, at least in newborn cells. Normal neonates switch from about 80% HbF at birth to a few percent at the end of the first year of life. Carriers of β-thalassemia trait exhibit a delay in the normal HbF switch-off, which might partially explain the protection observed in populations with this gene. To study this hypothesis in vivo, we used transgenic (γ) mice expressing human Aγ and Gγ chains resulting in 40% to 60% α2Mγ2 hemoglobin, infected with rodent malaria. Two species of rodent malaria were studied.P chabaudi adami causes a nonlethal infection, mainly in mature red blood cells (RBC). P yoelii 17XNL is a nonlethal infection, invading primarily reticulocytes, whereas P yoelii 17XL is a lethal variant of P yoelii 17XNL and causes death of mice in approximately 1 to 2 weeks. Data indicate that this strain may cause a syndrome resembling cerebral malaria caused by P falciparum (Am J Trop Med Hyg, 50:512, 1994). In γ transgenic mice infected with P chabaudi adami, the parasitemia rose more quickly (in agreement with Pasvol) than in control mice, but was cleared more rapidly. In mice infected with P yoelii 17XNL, a clear reduction in parasitemia was observed. Interestingly, splenectomy before this infection, did not reverse protection. The most striking effect was in lethal P yoelii17XL infection. Control mice died between 11 to 13 days, whereas γ mice cleared the infection by day 22 and survived, a phenomenon also observed in splenectomized animals. These results suggest that HbF does indeed have a protective effect in vivo, which is not mediated by the spleen. In terms of mechanisms, light microscopy showed that intraerythrocytic parasites develop slowly in HbF erythrocytes, and electron microscopy showed that hemozoin formation was defective in transgenic mice. Finally, digestion studies of HbF by recombinant plasmepsin II demonstrated that HbF is digested only half as well as hemoglobin A (HbA). We conclude that HbF provides protection from P falciparum malaria by the retardation of parasite growth. The mechanism involves resistance to digestion by malarial hemoglobinases based on the data presented and with the well-known properties of HbF as a super stable tetramer. In addition, the resistance of normal neonates for malaria can now be explained by a double mechanism: increased malaria invasion rates, reported in neonatal RBC, will direct parasites to fetal cells, as well as F cells, and less to the ≈20% of HbA containing RBC, amplifying the antimalarial effects of HbF.

Abstract Abstract 4614 Brazil is characterized by free miscegenation of populations of African and Mediterranean ancestry. On the basis of surveys and hospital-based series, the Brazilian Ministry of Health has recently estimated that approximately 2 million individuals carry the gene for HbS and nearly 8 thousand people having homozygous SCD. Given the burden of SCD in Brazil, this group of disorders has been declared a public health problem, and a strategy of awareness, diagnosis and prevention of complications is currently ongoing under the auspices of the Brazilian Ministry of Health. OBJECTIVES Standardize TCD examination of children with SCD in three Sickle Cell Units in Brazil, to assess TAMMV in consecutive children with SCD, to allow treatment decisions for such children, based on TCD results and to estimate the prevalence of neurological complications in Brazilian children with SCD (before and after newborn screening). METHODS All of the pediatric patients with SCD from newborn screening, who underwent a TCD examination between 2 and 11 y.o. were included. Consecutive patients seen at three tertiary-care hematology centers (HEMORIO, HEMOPE and HEMOMINAS) made TCD screening, with determination of blood flow-velocity. This study begun in January, 2008. Legal representatives of patients assigned the informed consent TCD procedures followed the technique used in STOP study (Adams et al 1998). Identical equipment and software were used (2-MHz pulsed Doppler- Nicolet EME) in the three Sickle Cell Units and investigators studied transtemporal and transforaminal windows and recorded the highest time-averaged mean of the maximun velocity (TAMMV) in middle cerebral artery (MCA), distal internal carotid artery (ICA), anterior cerebral artery (ACA) and biffurcation (BIF). All TCD studies were performed by one physician of each Sickle Cell Unit (ACC Leite – HEMORIO, C Silva – HEMOMINAS and R Azevedo – HEMOPE). Data were collected and stored in EPIDATA and exported to SPSS for Statistical analysis. RESULTS From January 2008 to July 2009 (18 months) the three centers followed about one thousand children with HbSS or SB-thalassemia, who underwent at least one TCD examination. There is no difference about gender. The mean age of the first TCD was 3.2 yo (HEMOPE), 5.8 (HEMRIO and 6.8 (HEMOMINAS). The main genotype was SS (95%). In the study of acute preliminary event there was high prevalence of acute chest syndrome and dactilitis in the three hemocenters and statisitical significant correlation between ACS and dactilitis versus abnormal TCD. The principal compromised artery was media cerebral (MCA). When we performed MRA and MRI in patients with abnormal TCD we found significant number of silent infarcts. CONCLUSIONS TCD screening has had a substantial impact to prevent primary stroke in SCD patients. The transfusions were efficacious but discontinuation resulted in new events. Long term therapy is needed (HU?). In patients with conditional TCD and comorbidities (ACS and dactilitis) the risk to develop stroke is higher than in patients with normal TCD and then, the use of hydroxiurea should be considered. The patient number of inadequate TCD is still significant. Since the cost of MRI in Brazil is high we suggest TCD imaging as screening if suspect of severe arterial disease. Disclosures: No relevant conflicts of interest to declare.

Abstract Background: Stroke is the most severe complication in children with SCA and has been reported to concern 11% of patients by the age of 18 years. Transcranial Doppler detects patients at risk for stroke and transfusion program significantly reduces the risk of stroke in patients with abnormal TCD (Adams, NEJM 1998, 2005). However, the estimate of overt and silent strokes occurrence in a newborn SCA cohort explored early with TCD has not yet been reported. Methods: In our Créteil pediatric center, TCD was systematically performed annually since 1992 as soon as 12–18 months of age and patients were assessed by MRI/MRA every 2 years after the age of 5 years or earlier in case of abnormal TCD. Time-averaged mean of maximum velocities higher than 200 cm/sec were considered as abnormal, resulting in initiation of a transfusion program (TP). A switch to hydroxyurea was proposed to patients with normalized velocities on TP (< 170 cm/sec) and normal MRA, but TP was reinitiated if abnormal velocities recurred. Patients with “conditional velocities” (170–199 cm/sec) were assessed with TCD every three months. Alpha genes and beta-globin haplotypes were determined. Baseline biological parameters (G6PD activity; WBC, PMN, Reticulocytes, Platelets counts; Hemoglobin, Hematocrit, HbF%; LDH levels; MCV; SpO2) were obtained after 12 months of age, before the first TCD, a minimum of 3 months away from a transfusion, one month from a painful episode, and always before intensive therapy. One patient refused initiation of TP for abnormal TCD and was excluded from the analysis. Results: This study included 217 SS/Sb0 children (114 M, 103 F), annually explored by TCD before age 5 (mean age at first TCD±SD: 2.2±1.1yr). They were followed for a total of 1627 patient-years. Eighty-two of 187 patients had alpha-Thal (44%); beta genotype, available in 157, was BaBa in 67 (43%), BeBe in 36 (23%), SeSe in 11 (7%) and “other” in 43 (27%); 21 of 182 (11.5%) had G6PD deficiency. TCD became “conditional” in 57 of 217 (26.3%) at the median age of 3.3 yr (range 1.2–8), and abnormal in 45 of 217 patients (20.7%) at the median age of 3.2 yr (range 1.3–8.3). Three patients had a stroke at the ages of 1.6, 4.2 and 4.4 yr: the first one had a first abnormal TCD at the age of 1.5 but had a stroke just before the TCD control at 1.6 yr; the second one had normal TCD on one side but unaivalable window on the other side and had a stroke before the first MRI/MRA; the third one had normal TCD just before the occurrence of an ACS and had a massive thrombotic stroke in intensive unit. The Kaplan-Meier (KM) estimate of stroke occurrence was 1.9% by the age of 18 yr. MRA, available in 126, was normal in 104 and showed stenoses in 22 (17.5%) at the median age of 4.8 yr (range 2.6–11.5). In stroke-free patients, MRI showed silent infarcts in 31 of 122 patients (25.4%) at the median age of 5.9 yr (range 3.5–15.3); 10 of the 31 had a history of abnormal TCD. KM estimate for abnormal TCD was 29.7% by the ages of 10 and 18 yr. KM was higher in case of G6PD deficiency: 52% vs. 26% (Log Rank, p=0.059), significantly lower in case of alpha-Thal: 16.3% vs. 36.9% (Log Rank p=0.005) and significantly dependent on the degree of hemolysis: LDH IU/l <750:11.6%; 750–1209:27%; >1209: 40.3% (Log-rank < 0.026). KM estimate of stenoses on MRA was 23.6% by the age of 18 yr, was highly significantly higher in case of G6PD deficiency: 53.3% vs 15.8% (Log Rank p<0.001), lower in case of alpha-Thal: 8.7% vs 29.9% (p=0.022), and significantly dependent on hemolysis: LDH IU/l <750: 0%; 750–1209:13.9%; >1209: 37.1% (Log Rank p=0.013). KM estimate of silent infarcts was significantly dependent on the presence of stenoses on MRA (Log Rank p=0.002), and on gender (male older than 8) (Log Rank p=0.038). Conclusion:This monocenter prospective study reports a significant decrease in the risk of stroke at 18 yr (KM 1.9% vs. 11–11.5%, previously published by Ohene-Frempong [Blood, 1998] and Quinn [Blood, 2004]) demonstrating the strong efficacy of systematic and early screening by TCD in association with TP to prevent stroke. It confirms our recent study that G6PD deficiency, absence of alpha-Thal and hemolysis significantly and independently increase the risk for abnormal velocities (Blood 2008 in press), which are themselves highly significantly predictive of stenosis occurrence. Morever, this study shows that the risk of silent infarcts remains high, even in patients with normal TCD, and is higher in males than in girls after the age of 8 years.

Abstract Abstract 88 Background. Strokes are a well-known complication of sickle-cell anemia (SCA), and are largely due to intracranial arteriopathy, detected by routine transcranial Doppler (TCD). Adams et al. showed in the STOP I trial (N Engl J Med, 1998) the efficiency of transfusion programs for primary stroke prevention in patients identified by TCD as being at risk of stroke. We recently reported in the CHIC newborn cohort (Bernaudin et al., Blood, 2011) that early TCD imaging (TCDI) screening significantly reduces the risk of stroke by age 18 from the previously reported 11% to only 1.9%, but has not allowed adequate prevention of silent infarcts, with a risk of 37.1% by age 14, suggesting that TCDI does not distinguish all SCA-patients at risk of silent infarcts. Extracranial internal carotid artery (eICA) vasculopathy is considered rare and has not been routinely assessed; however, several recent cases of stroke with extracranial arteriopathy prompted the inclusion of eICA evaluation in routine screening. The aim of the study was to establish the ranges of eICA velocities in SCA-patients, to determine the cut-off limits of velocities predictive of eICA stenoses by extracranial MRA, to evaluate the prevalence of abnormal eICA velocities and to determine their association with intracranial stenoses and/or silent infarcts by MRI. Methods. Since June-2011, all stroke-free SCA patients from the CHIC and Debre cohorts who had routine yearly TCDI for intracranial arteries were also systematically assessed for eICA using submandibular windows (Gorman et al., Neurology 2009) and the same 2Mhz TCDI transducer probe. Time-averaged mean of maximum velocities (TAMMV) were obtained for intra and extracranial cerebral arteries. By color Doppler mapping, the course of eICA was considered as straight, or as tortuous if the artery changed direction with an angle > 120° between adjacent segments. Extracranial cervical MRA was added to routine intracranial MRI/MRA, performed every 2 years or as soon as abnormal velocities were found. Results. Between June 2011 and January 2012, 435 consecutive SCA-children from the two cohorts (202M, 233F) were assessed by Doppler at the median age of 8.5 years (range: 1.3–18.7). MRI/intra and extracranial MRA was performed in 104 patients. At time of Doppler assessment, mean±SD hemoglobin was 9.1±1.6 g/dl. eICA velocities were significantly correlated with middle cerebral arteries (MCA) velocities (r=0.234, p<0.001), and were about 25–30% lower than MCA velocities (mean:95±38 vs 127±32 cm/sec). As for MCA, eICA velocities were maxima between 3–7 years of age. eICA tortuosities were echo-detected in 25% cases (107/435), and were more frequent in boys (65/202; 32%) than in girls (42/233; 18%), p<0.001. Regression logistic analysis showed that tortuosities were not associated with age, but significantly associated with males (OR:2.2, 95%CI:1.4–3.4, p=0.001). Cervical MRA found stenoses in 40/104 patients. ROC curve showed that eICA velocities ≥ 160 cm/sec were highly predictive of stenoses on eMRA (100% specificity, 80% sensitivity). The prevalence of eICA velocities ≥ 160 cm/sec was 10.3% (45/435), and was significantly higher in males (14.9% vs 6.4%; p=0.004). Low hemoglobin (OR:2.6/1g/dl decrease, 95%CI:1.4–4.6; p=0.002) and tortuosities (OR:14.5, 95%CI:4.1–50; p<0.001) were significant and independent risk factors for eICA velocities ≥ 160cm/sec. Intracranial stenoses were detected in 29/104 patients, while 40/104 patients had extracranial stenoses with 31/40 showing no intracranial stenoses. Silent infarcts were detected in 35/104 patients, and were highly associated with the presence of intra and/or extracranial stenoses (30/35: 86%, p<0.001). Intra (OR:5.1,95% CI:1.9–13.8, p=0.002) and extracranial (OR:4.5, 95% CI:1.7–11.6; p=0.002) stenoses were significant and independent risk factors for silent infarcts. Conclusion. This study shows for the first time that in cohorts previously assessed early by TCDI for intracranial arteries, about 10% stroke-free patients have eICA vasculopathy. Moreover, we show that intra and/or extracranial stenoses are significant risk factors for silent infarcts. These data may explain why silent infarcts still occurred in patients early assessed by TCDI exploring only intracranial arteries. Thus, extracranial Doppler assessment should be routinely done with TCD to evaluate the full extent of cerebral vasculopathy in SCA. Disclosures: No relevant conflicts of interest to declare.

Immobility, fixation, or paralysis of the vocal folds is an ominous sign when encountered in the clinics. This may be due to a variety of diseases, lesions, injuries, or vascular compromise which may affect the integrity and physiologic mechanism of the vocal folds. The common etiologies include infectious processes such as laryngeal or pulmonary tuberculosis (PTB), malignancy or neoplasms, central problems such as cerebrovascular accidents (CVA), stroke and others.1,2,3 The problem should be addressed immediately because this potentially life threatening and imminent narrowing of the glottic opening may lead to respiratory distress. Vocal fold paralysis due to compression of the recurrent laryngeal nerve from PTB and laryngeal cancer are perennially seen in clinical practice, but immobility of the vocal folds due to cricoarytenoid joint fixation or ankylosis is seldom seen and appreciated.
 Hence, we present a case of bilateral cricoarytenoid joint ankylosis and discuss its etiology, pathophysiology, differential diagnoses, ancillary procedures, and management.
 
 CASE REPORT
 A 60-year-old man was admitted for the first time because of difficulty of breathing and stridor. One week prior to admission he started to experience difficult breathing associated with productive cough and colds. He consulted in a primary private hospital and was managed as a case of bronchial asthma in exacerbation. Nebulization with salbutamol afforded temporary relief.
 A few hours prior to admission, difficulty of breathing and productive cough worsened, prompting emergency room consult. He was referred to us for further evaluation of stridor.
 The patient had no diabetes mellitus, hypertension or allergies to food and drugs. He was diagnosed with refractory bronchial asthma during childhood and had frequent hospitalizations for pulmonary infections. He had no maintenance medication for bronchial asthma and was nebulized with salbutamol during exacerbations. He had PTB and completed six months’ anti-TB medications in 2013. The patient claimed that he had no dyspneic episodes during routine daily activities or upon exertion. No history of hoarseness or joint pain was noted either. A golf caddy, he was a previous 15-pack-year smoker, occasional alcoholic beverage drinker and denied use of illicit drugs.
 Upon admission, the patient was awake, coherent, not in cardiorespiratory distress. Blood pressure was 110/70 mmHg, pulse rate was 74/minute, respiration was tachypneic at 24 cycles per minute, afebrile. Ear examination showed normal pinnae, no tragal tenderness, patent external auditory canals with no discharge and 80-90% dry central perforations of both tympanic membranes. Anterior rhinoscopy, nasal endoscopy and the oral cavity examination were unremarkable. Head and neck examination showed no cervical lymphadenopathy or palpable mass.
 Video laryngoscopy showed both vocal folds were immobile and fixed in paramedian position upon inspiration, with a 1–2 mm glottic opening and no mass or lesion appreciated. (Figure 1)
 The initial impression was impending upper airway obstruction secondary to bilateral vocal fold paralysis. Under general anesthesia, direct laryngoscopy revealed no mass or lesion on both vocal folds and passive mobility test demonstrated resistance and limitation of lateral rotation and movement of the arytenoids on both sides. (Figure 2) The vocal folds did not abduct on lateral retraction of the arytenoids. Tracheostomy was performed and he was discharged after a few days.
 A subsequent laryngeal electromyography (EMG) study showed no signs of myopathy or acute or chronic denervation changes of the thyroarytenoid muscles, and rheumatoid factor was normal. At this point, bilateral cricoarytenoid fixation or ankylosis was considered and posterior interarytenoid web and bilateral vocal fold paralysis were ruled out. 
 We recommended a lateralization procedure such as unilateral arytenoidectomy with cordectomy. The patient is currently well while he and his family are still contemplating whether he will undergo the surgical procedure.
 
 DISCUSSION
 Respiratory stridor is always considered an ominous sign which implies upper airway obstruction. If severe, stridor may compromise breathing and in some instances is life threatening and a telltale sign of imminent danger requiring immediate endotracheal intubation. Stridor is a musical, high-pitched sound which may be elicited in the presence of laryngeal and upper tracheal obstruction while wheezes are defined as high-pitched, continuous, adventitious lung sounds.4,5
 Stridor may be due to several reasons such as immaturity of the laryngeal structures seen in laryngomalacia in newborns, laryngeal infection, foreign body in the airway, and chronic obstructive pulmonary disease.3,6 This may be the reason why bronchial asthma was entertained in the clinical course of our patient and initially at the emergency room. It is unfortunate that despite the non-responsiveness of bronchial asthma to medical therapy and persistence of stridor, no ENT referral to evaluate the upper airway was made until recently. It should be emphasized that patients who develop stridor need to be evaluated by otolaryngologists specifically to ascertain the status of the vocal folds, which in this case turned out to be fixed or ankylosed, a condition which is rarely seen and encountered in clinical practice.
 Among the differential diagnoses considered in this case were laryngeal cancer, vocal fold paralysis, interarytenoid web, and arthritis.7,8,9
 Initially, laryngeal cancer was entertained because of his age, however no mass or suspicious lesion was appreciated on video laryngoscopy and this was ruled out. Because the vocal folds were immobile and fixed in paramedian position upon inspiration, bilateral vocal fold paralysis was considered with the etiology to be determined.
 Vocal fold paralysis occurs when nerve impulses to the laryngeal muscles are disrupted in case of CVA or stroke, recurrent nerve injury after thyroid surgery or compression of the inferior laryngeal nerve due to pulmonary TB or lung cancer.8,11 On the other hand, vocal fold fixation occurs when movement of the cricoarytenoid joint is compromised in cases of rheumatoid arthritis provided that the innervation is intact.10,11
 Another common differential diagnosis which may be entertained is laryngeal TB in which nodular lesions may be seen in the vocal folds, granulation tissues are usually present in the posterior commissure and histopathology shows Langhans cells and caseation necrosis.8 Paralysis is oftentimes unilateral due to compression of the recurrent laryngeal nerve from apical PTB. Although the patient has a history of TB, he was asymptomatic and close examination of the vocal folds revealed no lesions except for bilateral fixation, and this was ruled out.
 Direct laryngoscopy (DL), the gold standard in the evaluation of laryngeal anatomy especially when dealing with the vocal folds,3 showed smooth, normal-looking vocal folds with no lesions. The passive mobility test is done to differentiate vocal fold paralysis from cricoarytenoid ankylosis, by retracting or pushing the arytenoid laterally. If there is limitation of rotation and movement of the arytenoid laterally and the vocal folds do not abduct, then cricoarytenoid ankylosis or fixation is considered. On the contrary, if the arytenoid rotates and abducts laterally when retracted by forceps, then vocal fold paralysis is considered.1,6 Hence, because there was limitation of rotation and movement of the arytenoids, cricoarytenoid joint fixation was entertained and vocal fold paralysis was ruled out.
 Interarytenoid web was excluded because the vocal folds had no mucosal adhesions, synechiae, or any scarring within the posterior portion of the glottis. In addition, although the patient’s glottic opening was restricted, no difficulty was encountered during endotracheal intubation since a smaller caliber tube was used.
 To further confirm the diagnosis of cricoarytenoid fixation, laryngeal electromyography (EMG) revealed no paralysis of the thyroarytenoid muscles with no signs of myopathy and acute or chronic denervation, making bilateral vocal fold paralysis unlikely in this case. Laryngeal EMG is indicated to determine the integrity of the laryngeal muscles and innervation especially in cases of vocal fold paralysis.11 In post-thyroidectomy patients, laryngeal EMG is done 6 months after surgery to determine if the laryngeal nerve injury may recover or is irreversible. The 6-month waiting period is to allow swelling or inflammation to subside and to observe whether the injured nerve will recover prior to further intervention.12
 The findings on direct laryngoscopy, passive mobility test and laryngeal electromyography clearly favor the diagnosis of cricoarytenoid joint ankylosis. Other ancillary procedures such as a CT scan may show sclerosis of the arytenoids1,11 in elderly patients and videostroboscopy may be useful in determining the relative vertical height and tension of the vocal folds for assessing the cricoarytenoid function.1 A CT scan was not done because there was no palpable neck mass and no other lesion was entertained that would warrant CT imaging. Videostroboscopy may help and may further show and magnify the movement of the vocal folds for observation however, the findings seen on direct laryngoscopy and laryngeal EMG were deemed enough to support and confirm the diagnosis.
 The patient may be classified under type IV posterior glottic stenosis - congenital or acquired bilateral cricoarytenoid fixation with or without interarytenoid scarring - based on the classification by Bogdasarian and Olson which was later modified by Irving and associates.3 Interarytenoid web and scarring presents as bilateral impaired abduction but adduction is normal and patients affected tend to have a normal voice while the main presenting symptom is airway compromise. In cricoarytenoid joint ankylosis, adduction and abduction of the vocal folds are limited.3 As previously mentioned, to distinguish cricoarytenoid joint ankylosis from vocal fold paralysis, palpation of the cricoarytenoid joint on rigid endoscopy and laryngeal EMG are necessary for definitive diagnosis.6
 The patient’s voice was normal because the vocal folds approximate each other with a 1 to 2 mm glottic opening while no history of aspiration was apparent because the vocal folds are fixed in paramedian position which may prevent fluid from entering the larynx during swallowing. Although the patient’s voice is normal, respiration is compromised manifested as stridor and difficulty of breathing requiring tracheostomy. 
 In contrast, patients with acute or recent unilateral vocal fold paralysis in post-thyroidectomy or post-CVA (stroke) conditions may initially manifest with aspiration. This is because the vocal fold assumes an intermediate position in which the glottic opening is relatively wider compared with the paramedian position. In a few months’ time, the paralyzed fold will compensate, move medially, and assume a paramedian position and aspiration may eventually resolve.13
 Cricoarytenoid ankylosis has several etiologies which include arthritides, bacterial infection and trauma. Rheumatoid arthritis may account for numerous clinical diagnoses of cricoarytenoid ankylosis.2 Other causes include gout, Reiter Syndrome, and ankylosing spondylitis. Some anecdotal evidence suggests a mump-associated laryngeal arthritis and fixation secondary to radiation therapy.2, 8 Bacterial involvement of the joint space with infectious microorganisms such as streptococcal species, with resultant ankylosis is also well established.8 External and direct laryngeal trauma may also result in cricoarytenoid joint injury.8 Documented and retrospective studies suggest intubation-related joint injury and posterior or anterior arytenoid displacement secondary to the distal tip of the endotracheal tube engaging the arytenoid during intubation.8 Traumatic obstetric delivery using forceps and postpartum newborn care through vigorous cleansing and suctioning the mouth and pharynx of the newborn are also mentioned in the literature.11 Posterior dislocation resulting from extubation with a partially inflated endotracheal tube cuff is another probable cause.7, 8 Another potential etiology is arytenoid chondritis secondary to prolonged endotracheal intubation, which results in fibrosis.8, 16 Reviewing the patient’s history, however, showed no history of trauma, previous intubation, signs and symptoms of arthritis and serious laryngeal infections. The patient was delivered via normal spontaneous delivery by a traditional birth attendant (“hilot”) and no apparent respiratory distress or postpartum hospitalization was known of by the patient.
 Cricoarytenoid ankylosis is usually associated with cases of rheumatoid arthritis with 17 to 33% incidence among RA patients.9 House et al. in 2010 described approximately 0.1% incidence of cricoarytenoid joint ankylosis in endotracheal intubations.16 Most cases of vocal fold immobility seen under the service is secondary to vocal fold paralysis due to cerebrovascular accident (stroke), pulmonary problems such as PTB, or laryngeal malignancy and to our knowledge, this is the first reported case of cricoarytenoid joint ankylosis in our institution. 
 Chronic cricoarytenoid joint ankylosis may be mistaken for asthma or chronic bronchitis, with symptoms of dyspnea, hoarseness, or stridor.3 In rheumatoid arthritis, laryngoscopy may show rough and thick mucosa and narrowed glottic chink which were contrary to the recent endoscopic findings. If the etiology is bacterial, there is direct involvement of the joint space with infectious agents, such as streptococcal species, which leads to scarring and thickening of the cricoarytenoid joints.8 Airway compromise occurs most commonly in patients with long-standing cricoarytenoid ankylosis and laryngeal stridor has been described as the sole presentation of the disease as manifested in this case.8, 14, 17 To rule out RA in this case, rheumatoid factor (RF) was done with negative results.
 
 Finally, when it comes to upper airway obstruction, the glottic opening or opening of the vocal folds should be thoroughly evaluated. The normal glottic opening in newborns opens approximately 4 mm in a lateral direction. Congenital subglottic stenosis is defined as a subglottic diameter of less than 4 mm.13 In retrospect, it may be presumed that the patient’s glottis may not be seriously compromised since birth because he was able to thrive and breathe with no apparent difficulty. It may be conjectured that narrowing of the glottic opening occurred only later in life. Although asymptomatic, rheumatoid factor was negative, and the etiology of the patient’s ankylosis remains perplexing and elusive.
 The management of cricoarytenoid ankylosis includes tracheostomy to address the upper airway obstruction. Surgical management includes open arytenoidectomy, arytenoidpexy and endoscopic arytenoidectomy or transverse cordectomy and all have their advantages and disadvantages.6, 11, 16 These are lateralization procedures which aim to widen the glottic opening and wean the patient from tracheostomy afterwards.
 In closing, when bronchial asthma remains refractory to treatment, the physician should not hesitate to refer to otolaryngologists to rule out other probable upper airway pathologies. Although rare, ankyloses of the cricoarytenoid joint should be considered especially when the movement of the vocal folds is compromised. Although direct laryngoscopy, passive mobility tests and laryngeal EMG are indispensable in clinching the diagnosis, the clinical history is important in determining etiology which in this case remains elusive and perplexing.
 
 
 
 
 
 
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IntroductionFood Studies is a relatively recent area of research enquiry in Australia and Magazine Studies is even newer (Le Masurier and Johinke), with the consequence that Australian culinary magazines are only just beginning to be investigated. Moreover, although many major libraries have not thought such popular magazines worthy of sustained collection (Fox and Sornil), considering these publications is important. As de Certeau argues, it can be of considerable consequence to identify and analyse everyday practices (such as producing and reading popular magazines) that seem so minor and insignificant as to be unworthy of notice, as these practices have the ability to affect our lives. It is important in this case as these publications were part of the post-war gastronomic environment in Australia in which national tastes in domestic cookery became radically internationalised (Santich). To further investigate Australian magazines, as well as suggesting how these cosmopolitan eating habits became more widely embraced, this article will survey the various ways in which the idea of “abroad” is expressed in one Australian culinary serial from the post-war period, Australian Wines & Food Quarterly magazine, which was published from 1956 to 1960. The methodological approach taken is an historically-informed content analysis (Krippendorff) of relevant material from these magazines combined with germane media data (Hodder). All issues in the serial’s print run have been considered.Australian Post-War Culinary PublishingTo date, studies of 1950s writing in Australia have largely focused on literary and popular fiction (Johnson-Wood; Webby) and literary criticism (Bird; Dixon; Lee). There have been far fewer studies of non-fiction writing of any kind, although some serial publications from this time have attracted some attention (Bell; Lindesay; Ross; Sheridan; Warner-Smith; White; White). In line with studies internationally, groundbreaking work in Australian food history has focused on cookbooks, and includes work by Supski, who notes that despite the fact that buying cookbooks was “regarded as a luxury in the 1950s” (87), such publications were an important information source in terms of “developing, consolidating and extending foodmaking knowledge” at that time (85).It is widely believed that changes to Australian foodways were brought about by significant post-war immigration and the recipes and dishes these immigrants shared with neighbours, friends, and work colleagues and more widely afield when they opened cafes and restaurants (Newton; Newton; Manfredi). Although these immigrants did bring new culinary flavours and habits with them, the overarching rhetoric guiding population policy at this time was assimilation, with migrants expected to abandon their culture, language, and habits in favour of the dominant British-influenced ways of living (Postiglione). While migrants often did retain their foodways (Risson), the relationship between such food habits and the increasingly cosmopolitan Australian food culture is much more complex than the dominant cultural narrative would have us believe. It has been pointed out, for example, that while the haute cuisine of countries such as France, Italy, and Germany was much admired in Australia and emulated in expensive dining (Brien and Vincent), migrants’ own preference for their own dishes instead of Anglo-Australian choices, was not understood (Postiglione). Duruz has added how individual diets are eclectic, “multi-layered and hybrid” (377), incorporating foods from both that person’s own background with others available for a range of reasons including availability, cost, taste, and fashion. In such an environment, popular culinary publishing, in terms of cookbooks, specialist magazines, and recipe and other food-related columns in general magazines and newspapers, can be posited to be another element contributing to this change.Australian Wines & Food QuarterlyAustralian Wines & Food Quarterly (AWFQ) is, as yet, a completely unexamined publication, and there appears to be only three complete sets of this magazine held in public collections. It is important to note that, at the time it was launched in the mid-1950s, food writing played a much less significant part in Australian popular publishing than it does today, with far fewer cookbooks released than today, and women’s magazines and the women’s pages of newspapers containing only small recipe sections. In this environment, a new specialist culinary magazine could be seen to be timely, an audacious gamble, or both.All issues of this magazine were produced and printed in, and distributed from, Melbourne, Australia. Although no sales or distribution figures are available, production was obviously a struggle, with only 15 issues published before the magazine folded at the end of 1960. The title of the magazine changed over this time, and issue release dates are erratic, as is the method in which volumes and issues are numbered. Although the number of pages varied from 32 up to 52, and then less once again, across the magazine’s life, the price was steadily reduced, ending up at less than half the original cover price. All issues were produced and edited by Donald Wallace, who also wrote much of the content, with contributions from family members, including his wife, Mollie Wallace, to write, illustrate, and produce photographs for the magazine.When considering the content of the magazine, most is quite familiar in culinary serials today, although AWFQ’s approach was radically innovative in Australia at this time when cookbooks, women’s magazines, and newspaper cookery sections focused on recipes, many of which were of cakes, biscuits, and other sweet baking (Bannerman). AWFQ not only featured many discursive essays and savory meals, it also featured much wine writing and review-style content as well as information about restaurant dining in each issue.Wine-Related ContentWine is certainly the most prominent of the content areas, with most issues of the magazine containing more wine-related content than any other. Moreover, in the early issues, most of the food content is about preparing dishes and/or meals that could be consumed alongside wines, although the proportion of food content increases as the magazine is published. This wine-related content takes a clearly international perspective on this topic. While many articles and advertisements, for example, narrate the long history of Australian wine growing—which goes back to early 19th century—these articles argue that Australia's vineyards and wineries measure up to international, and especially French, examples. In one such example, the author states that: “from the earliest times Australia’s wines have matched up to world standard” (“Wine” 25). This contest can be situated in Australia, where a leading restaurant (Caprice in Sydney) could be seen to not only “match up to” but also, indeed to, “challenge world standards” by serving Australian wines instead of imports (“Sydney” 33). So good, indeed, are Australian wines that when foreigners are surprised by their quality, this becomes newsworthy. This is evidenced in the following excerpt: “Nearly every English businessman who has come out to Australia in the last ten years … has diverted from his main discussion to comment on the high quality of Australian wine” (Seppelt, 3). In a similar nationalist vein, many articles feature overseas experts’ praise of Australian wines. Thus, visiting Italian violinist Giaconda de Vita shows a “keen appreciation of Australian wines” (“Violinist” 30), British actor Robert Speaight finds Grange Hermitage “an ideal wine” (“High Praise” 13), and the Swedish ambassador becomes their advocate (Ludbrook, “Advocate”).This competition could also be located overseas including when Australian wines are served at prestigious overseas events such as a dinner for members of the Overseas Press Club in New York (Australian Wines); sold from Seppelt’s new London cellars (Melbourne), or the equally new Australian Wine Centre in Soho (Australia Will); or, featured in exhibitions and promotions such as the Lausanne Trade Fair (Australia is Guest;“Wines at Lausanne), or the International Wine Fair in Yugoslavia (Australia Wins).Australia’s first Wine Festival was held in Melbourne in 1959 (Seppelt, “Wine Week”), the joint focus of which was the entertainment and instruction of the some 15,000 to 20,000 attendees who were expected. At its centre was a series of free wine tastings aiming to promote Australian wines to the “professional people of the community, as well as the general public and the housewife” (“Melbourne” 8), although admission had to be recommended by a wine retailer. These tastings were intended to build up the prestige of Australian wine when compared to international examples: “It is the high quality of our wines that we are proud of. That is the story to pass on—that Australian wine, at its best, is at least as good as any in the world and better than most” (“Melbourne” 8).There is also a focus on promoting wine drinking as a quotidian habit enjoyed abroad: “We have come a long way in less than twenty years […] An enormous number of husbands and wives look forward to a glass of sherry when the husband arrives home from work and before dinner, and a surprising number of ordinary people drink table wine quite un-selfconsciously” (Seppelt, “Advance” 3). However, despite an acknowledged increase in wine appreciation and drinking, there is also acknowledgement that this there was still some way to go in this aim as, for example, in the statement: “There is no reason why the enjoyment of table wines should not become an Australian custom” (Seppelt, “Advance” 4).The authority of European experts and European habits is drawn upon throughout the publication whether in philosophically-inflected treatises on wine drinking as a core part of civilised behaviour, or practically-focused articles about wine handling and serving (Keown; Seabrook; “Your Own”). Interestingly, a number of Australian experts are also quoted as stressing that these are guidelines, not strict rules: Crosby, for instance, states: “There is no ‘right wine.’ The wine to drink is the one you like, when and how you like it” (19), while the then-manager of Lindemans Wines is similarly reassuring in his guide to entertaining, stating that “strict adherence to the rules is not invariably wise” (Mackay 3). Tingey openly acknowledges that while the international-style of regularly drinking wine had “given more dignity and sophistication to the Australian way of life” (35), it should not be shrouded in snobbery.Food-Related ContentThe magazine’s cookery articles all feature international dishes, and certain foreign foods, recipes, and ways of eating and dining are clearly identified as “gourmet”. Cheese is certainly the most frequently mentioned “gourmet” food in the magazine, and is featured in every issue. These articles can be grouped into the following categories: understanding cheese (how it is made and the different varieties enjoyed internationally), how to consume cheese (in relation to other food and specific wines, and in which particular parts of a meal, again drawing on international practices), and cooking with cheese (mostly in what can be identified as “foreign” recipes).Some of this content is produced by Kraft Foods, a major advertiser in the magazine, and these articles and recipes generally focus on urging people to eat more, and varied international kinds of cheese, beyond the ubiquitous Australian cheddar. In terms of advertorials, both Kraft cheeses (as well as other advertisers) are mentioned by brand in recipes, while the companies are also profiled in adjacent articles. In the fourth issue, for instance, a full-page, infomercial-style advertisement, noting the different varieties of Kraft cheese and how to serve them, is published in the midst of a feature on cooking with various cheeses (“Cooking with Cheese”). This includes recipes for Swiss Cheese fondue and two pasta recipes: spaghetti and spicy tomato sauce, and a so-called Italian spaghetti with anchovies.Kraft’s company history states that in 1950, it was the first business in Australia to manufacture and market rindless cheese. Through these AWFQ advertisements and recipes, Kraft aggressively marketed this innovation, as well as its other new products as they were launched: mayonnaise, cheddar cheese portions, and Cracker Barrel Cheese in 1954; Philadelphia Cream Cheese, the first cream cheese to be produced commercially in Australia, in 1956; and, Coon Cheese in 1957. Not all Kraft products were seen, however, as “gourmet” enough for such a magazine. Kraft’s release of sliced Swiss Cheese in 1957, and processed cheese slices in 1959, for instance, both passed unremarked in either the magazine’s advertorial or recipes.An article by the Australian Dairy Produce Board urging consumers to “Be adventurous with Cheese” presented general consumer information including the “origin, characteristics and mode of serving” cheese accompanied by a recipe for a rich and exotic-sounding “Wine French Dressing with Blue Cheese” (Kennedy 18). This was followed in the next issue by an article discussing both now familiar and not-so familiar European cheese varieties: “Monterey, Tambo, Feta, Carraway, Samsoe, Taffel, Swiss, Edam, Mozzarella, Pecorino-Romano, Red Malling, Cacio Cavallo, Blue-Vein, Roman, Parmigiano, Kasseri, Ricotta and Pepato” (“Australia’s Natural” 23). Recipes for cheese fondues recur through the magazine, sometimes even multiple times in the same issue (see, for instance, “Cooking With Cheese”; “Cooking With Wine”; Pain). In comparison, butter, although used in many AWFQ’s recipes, was such a common local ingredient at this time that it was only granted one article over the entire run of the magazine, and this was largely about the much more unusual European-style unsalted butter (“An Expert”).Other international recipes that were repeated often include those for pasta (always spaghetti) as well as mayonnaise made with olive oil. Recurring sweets and desserts include sorbets and zabaglione from Italy, and flambéd crepes suzettes from France. While tabletop cooking is the epitome of sophistication and described as an international technique, baked Alaska (ice cream nestled on liquor-soaked cake, and baked in a meringue shell), hailing from America, is the most featured recipe in the magazine. Asian-inspired cuisine was rarely represented and even curry—long an Anglo-Australian staple—was mentioned only once in the magazine, in an article reprinted from the South African The National Hotelier, and which included a recipe alongside discussion of blending spices (“Curry”).Coffee was regularly featured in both articles and advertisements as a staple of the international gourmet kitchen (see, for example, Bancroft). Articles on the history, growing, marketing, blending, roasting, purchase, percolating and brewing, and serving of coffee were common during the magazine’s run, and are accompanied with advertisements for Bushell’s, Robert Timms’s and Masterfoods’s coffee ranges. AWFQ believed Australia’s growing coffee consumption was the result of increased participation in quality internationally-influenced dining experiences, whether in restaurants, the “scores of colourful coffee shops opening their doors to a new generation” (“Coffee” 39), or at home (Adams). Tea, traditionally the Australian hot drink of choice, is not mentioned once in the magazine (Brien).International Gourmet InnovationsAlso featured in the magazine are innovations in the Australian food world: new places to eat; new ways to cook, including a series of sometimes quite unusual appliances; and new ways to shop, with a profile of the first American-style supermarkets to open in Australia in this period. These are all seen as overseas innovations, but highly suited to Australia. The laws then controlling the service of alcohol are also much discussed, with many calls to relax the licensing laws which were seen as inhibiting civilised dining and drinking practices. The terms this was often couched in—most commonly in relation to the Olympic Games (held in Melbourne in 1956), but also in relation to tourism in general—are that these restrictive regulations were an embarrassment for Melbourne when considered in relation to international practices (see, for example, Ludbrook, “Present”). This was at a time when the nightly hotel closing time of 6.00 pm (and the performance of the notorious “six o’clock swill” in terms of drinking behaviour) was only repealed in Victoria in 1966 (Luckins).Embracing scientific approaches in the kitchen was largely seen to be an American habit. The promotion of the use of electricity in the kitchen, and the adoption of new electric appliances (Gas and Fuel; Gilbert “Striving”), was described not only as a “revolution that is being wrought in our homes”, but one that allowed increased levels of personal expression and fulfillment, in “increas[ing] the time and resources available to the housewife for the expression of her own personality in the management of her home” (Gilbert, “The Woman’s”). This mirrors the marketing of these modes of cooking and appliances in other media at this time, including in newspapers, radio, and other magazines. This included features on freezing food, however AWFQ introduced an international angle, by suggesting that recipe bases could be pre-prepared, frozen, and then defrosted to use in a range of international cookery (“Fresh”; “How to”; Kelvinator Australia). The then-new marvel of television—another American innovation—is also mentioned in the magazine ("Changing concepts"), although other nationalities are also invoked. The history of the French guild the Confrerie de la Chaine des Roitisseurs in 1248 is, for instance, used to promote an electric spit roaster that was part of a state-of-the-art gas stove (“Always”), and there are also advertisements for such appliances as the Gaggia expresso machine (“Lets”) which draw on both Italian historical antecedence and modern science.Supermarket and other forms of self-service shopping are identified as American-modern, with Australia’s first shopping mall lauded as the epitome of utopian progressiveness in terms of consumer practice. Judged to mark “a new era in Australian retailing” (“Regional” 12), the opening of Chadstone Regional Shopping Centre in suburban Melbourne on 4 October 1960, with its 83 tenants including “giant” supermarket Dickens, and free parking for 2,500 cars, was not only “one of the most up to date in the world” but “big even by American standards” (“Regional” 12, italics added), and was hailed as a step in Australia “catching up” with the United States in terms of mall shopping (“Regional” 12). This shopping centre featured international-styled dining options including Bistro Shiraz, an outdoor terrace restaurant that planned to operate as a bistro-snack bar by day and full-scale restaurant at night, and which was said to offer diners a “Persian flavor” (“Bistro”).ConclusionAustralian Wines & Food Quarterly was the first of a small number of culinary-focused Australian publications in the 1950s and 1960s which assisted in introducing a generation of readers to information about what were then seen as foreign foods and beverages only to be accessed and consumed abroad as well as a range of innovative international ideas regarding cookery and dining. For this reason, it can be posited that the magazine, although modest in the claims it made, marked a revolutionary moment in Australian culinary publishing. As yet, only slight traces can be found of its editor and publisher, Donald Wallace. The influence of AWFQ is, however, clearly evident in the two longer-lived magazines that were launched in the decade after AWFQ folded: Australian Gourmet Magazine and The Epicurean. Although these serials had a wider reach, an analysis of the 15 issues of AWFQ adds to an understanding of how ideas of foods, beverages, and culinary ideas and trends, imported from abroad were presented to an Australian readership in the 1950s, and contributed to how national foodways were beginning to change during that decade.ReferencesAdams, Jillian. “Australia’s American Coffee Culture.” Australian Journal of Popular Culture 2.1 (2012): 23–36.“Always to Roast on a Turning Spit.” The Magazine of Good Living: Australian Wines and Food 4.2 (1960): 17.“An Expert on Butter.” The Magazine of Good Living: The Australian Wine & Food 4.1 (1960): 11.“Australia Is Guest Nation at Lausanne.” The Magazine of Good Living: Australian Wines and Food 4.2 (1960): 18–19.“Australia’s Natural Cheeses.” The Magazine of Good Living: The Australian Wine & Food 4.1 (1960): 23.“Australia Will Be There.” The Magazine of Good Living: Australian Wines and Food 4.2 (1960): 14.“Australian Wines Served at New York Dinner.” Australian Wines & Food Quarterly 1.5 (1958): 16.“Australia Wins Six Gold Medals.” Australian Wines & Food: The Magazine of Good Living 2.11 (1959/1960): 3.Bancroft, P.A. “Let’s Make Some Coffee.” The Magazine of Good Living: The Australian Wine & Food 4.1 (1960): 10. 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Photograph by Gonzalo Echeverria (2010)Donald Crowhurst wanted to sail around the world. Or he wanted the world to believe he had sailed around it. Whilst the rest of the competitors in the 1968-9 Sunday Times Golden Globe Race sailed their wonky crafts through treacherous seas, Crowhurst dropped anchor in the quiet waters of the South Atlantic and falsified his logs. For artist Tacita Dean, who has made a number of works about Crowhurst (Disappearance at Sea, Teignmouth Electron): Crowhurst's problem was that he had an imagination. You can't have any imagination if you are going to sail around the world, otherwise you have doubt. Crowhurst had doubt, he imagined failure ... . I think it’s crucial to art as well that you somehow imagine failure. Doubt is very important (17). ** In developing this issue of M/C Journal we were interested in two related questions about doubt. On the one hand, we hoped to gather case studies that can give some indication of where and how doubt surfaces in contemporary media, culture and politics. We have collected a diverse sample of case studies considering the role of doubt in the American political response to 9/11 (Burns), the media’s reporting of sexual assault (Waterhouse-Watson), how scientists talk about climate change (Simpson) and the philosophy of religion (Brown). However, we were also interested in attracting articles that could contribute to our thinking about doubt as a method and mode of practice. Our feature article, by Sydney based artist and writer Ryszard Dabek presents both a case study, discussing Jean Luc Godard’s doubts about cinema through selected films from his oeuvre, while also demonstrating how a methodology of doubt can produce insightful cultural criticism. Elisabeth Hanscombe writes from a perspective that seeks to hold in tension the doubts that haunt interdisciplinary research (and the researcher) with the need to produce rigorous research outcomes. David Macarthur has written a useful and accessible introduction to how doubt can be applied to this end, making an argument for the pragmatist approach to doubt as a tool for valuable, critical thinking. Gonzalo Echeverria's series of delicate black and white landscape photographs, one of which we have placed at the opening of each article, are all located within walking distance of his home in Nidé, Turkey. He deliberately avoids the 'true' blacks and whites of black and white photography which were once the holy grail of Ansel Adams and Edward Weston and with which we are now so familiar. Working with analogue equipment and on film, and printing his work in a traditional darkroom (and even mixing his own custom chemicals) Echeverria creates a range of greys which recall the early days of photography. Yet these images are undeniably rooted in the present both culturally and photographically. The recurring presence, and at times almost absence, of the minuets in the photographs asks us to consider doubt as much faith. In our formulation then, doubt has two sides. It can be a subject – like any other – which we can study and consider using the tools of scholarship founded on objectivity and the norms of knowledge production. Yet, doubt also has the potential to challenge those accepted methods. The definition of knowledge at the base of all scholarship, and by association the methods used to acquire it, has its foundations in Descartes’s formulation that what counts as knowledge is a conviction which is beyond doubt (Newman). In the method that leads to knowledge so-defined “doubt is predicated only to be ingeniously harnessed as the means of its own overcoming” (Fleissner 116). In her fascinating analysis of Obsessive Compulsive Disorder as being founded on doubt rather than obsession, Fleissner traces the extent to which the role of doubt in the project of modernity is far more complicated than this definition of knowledge and its production implies. It appears, Fleissner argues, that Descartes’s revolutionary formulation of the cogito (“I am thinking, therefore I exist”) (Baron) “depends on recasting… doubts as themselves proof of the one thing, thought, that cannot be doubted” (Fleissner 115). Indeed, the use of doubt in the methodology inaugurated by Descartes “construes sceptical doubts as the ground clearing tools of epistemic demolition” (Newman, emphasis in original). As Fleissner discusses, the perceived potential for this demolition to produce mania and madness has haunted modernity, and proved a difficult problem for psychology. Despite Descartes’s insistence that this demolition ultimately lead to construction (Newman, see also Macarthur in this issue), there is a persistent fear that once doubting has begun, it cannot be brought to an end (Fleissner 113-20). Over the years that we have discussed the possibility of a methodology of doubt with colleagues and peers, an expression of this fear has been the most consistent response. On closer inspection we can see that doubt is asked to play numerous, conflicting roles in the epistemology inaugurated by Descartes: it is a tool (or, as Newman characterisies it, a “bulldozer”) in the project of knowledge production; its presence is used as criteria for dismissing false knowledge; and its presence in the mind of the philosopher is taken as evidence of his existence. As Fleissner suggests: Indeed, what is perhaps most striking about The Meditations Concerning First Philosophy is the sense that Descartes wishes both to be rid of doubt and to preserve it; it is this combination, not the final overcoming of doubt in favour of the certainty of the mind’s powers, that the cogito might be said most strongly to install. (133) Let us now apologise if the above paragraphs offend our philosopher colleagues, for we have likely clumsily wandered through foundational arguments in the discipline that have a level of nuance and complexity to which we have not given adequate acknowledgment. However, m/c is a journal of media and culture, and for us what is interesting about the argument presented above is its potential to draw our attention to the conundrum presented by doubt and doubting in fields far removed from disciplined and technical arguments about epistemology. We are interested in how the foundational arguments presented by Descartes, and the complex status of doubt within them, have continued ramifications far beyond their original context. We are interested, in a way, in their trace in contemporary media culture and in the scholarship and creative practice that engages with it. At the end of her article, Fleissner concludes with a hope “for a doubt with a voice of its own” (134), and it is the potential for doubt to positively influence our ways of writing about our thinking that has attracted us to it. We should not hold Descartes responsible for the flow-on effects that his epistemology has had on writing in the humanities, but we do believe that the continued trace of the Cartesian method has lead to ossification of the expression of research. This part of the introduction is a perfect example of this: dense, littered with references, cautious yet authoritarian. The doubts I have had whilst writing it are silenced in order for the writing to proceed. The speaking-position required to perform the Cartesian method is, let’s be honest, not one which can often result in writing that can even hope to engage or inspire readers who do not wish to be the audience for a performance of the author’s ability to be disciplined. (And of course, as I write that sentence I consider how many readers will not make it through the proceeding paragraphs to get to this point. They’ll find the whole ‘Descartes bit’ too dry or dense.) We too want to know about how doubt might find a voice of its own, and are particularly interested in how doubt might be kept in focus in the writing of research, rather than be a point of departure that is ultimately erased. ** (The Dutch writer Gerard van't Reve once began an autobiographical piece with the words: “I was born stupid, as my father used to say”. My father never said this — and in fact I rather suffered from the inverse or opposite problem — but it is such a lovely opening that I would like to make use of it.) I was born stupid, but my mother was always telling people how smart I was. And like most people I just assumed that my parents always spoke the truth. Luckily, I was good at creating the impression that I was intelligent. But it took me a long time to work out that my mother was wrong and that parents are capable of saying things that are not true. For example my father was a great practical joker. He loved the idea that a child would believe anything you said. When I was five he told me that chewing gum was made from old bicycle tyres. It was not until I was about thirty years old that I suddenly realised this was not the case. It was not as if I actively continued to believe for a quarter of a century that chewing gum is actually made from old bicycle tyres. It is unlikely that I thought about what chewing gum is made of during those twenty five years at all. But my five year old self had stored this 'fact' in the part of my brain where things are stored about which there is no doubt. And when I accidentally chanced upon it there many years later, he had been dead for more than ten years. It was like the last pocket money cheque he sent which I received the day after I arrived home from his funeral, only funnier. My father loved to laugh and he loved to make other people laugh. This is why my mother fell in love with him. The problem was he also loved a drink or two and my mother didn't drink, neither did my grandmother, or anyone else in her family. This would later turn into a problem for everyone. But his alcoholism was still in its early stages when he married my mother, and it is easy to hide your drinking from people who don't drink: it is just not within their realm of possibilities that you would go to a bar after you kiss them goodbye at the end of the evening instead of going home to go to bed and sleep. I think it was because my mother desperately wanted an intelligent child that she was always telling people how smart I was. I think all of my family on my mother’s side spent their lives wishing they were just a little bit more intelligent, and pretending that they were. So this is where I got my gift. I just did what everyone else did. This stood me in good stead when I moved to an English speaking country where, when I had no idea what was being said, I just tried to look intelligent and pretended to understand. And generally that worked pretty well. Not many people are game to challenge other people's understanding. If it seems like you do (or should) understand, most people assume that you do. In places where you would expect people’s understanding to be challenged, such as universities, this now results in negative student feedback which academics have to explain at their performance management meetings. In today’s universities academics are expected to be dispensers of information who only utter absolute truths. The job of a student is to put the received information into that part of the brain where things are stored about which there is no doubt. And in Zygmunt Bauman’s liquid society, "where the individual must act, plan actions and calculate the likely gains and losses of acting (or failing to act) under conditions of endemic uncertainty" (4), the ability to conceal your doubt is your most crucial weapon. ** In her mythologising of Donald Crowhurst, Tacita Dean unwittingly animates the key terms of any consideration of doubt: fear, imagination and denial. For many, doubt cannot be disconnected from these properties that can be energised by its presence. Doubt always carries with it the potential to turn on those who acknowledge it and seek to apply it, to ricochet off the subject of doubt and create a doubting subject. Doubt is seen as the trigger for uncontrollable fantasies of failure. This issue attempts to untie this association. And we look forward to the companion issue of m/c, on failure, that will hopefully appear in the journal’s future. We would like to thank: the authors, Gonzalo Echeverria, Stephen Hetherington, and our peer reviewers for their willingness to assist us in developing this issue. We also thank Axel Bruns for his support. References Bauman, Zygmunt. Liquid Times: Living in an Age of Uncertainty. Cambridge: Polity Press, 2007. Fleissner, Jennifer L. “Obsessional Modernity: The ‘Institutionalization of Doubt’.” Critical Inquiry 34 (Autumn 2007): 106-134. Newman, Lex. “Descartes' Epistemology”. The Stanford Encyclopedia of Philosophy (Fall 2010 Edition). Ed. Edward N. Zalta. ‹http://plato.stanford.edu/entries/descartes-epistemology/›. Reed, Baron. "Certainty." The Stanford Encyclopedia of Philosophy (Fall 2008 Edition). Ed. Edward N. Zalta. ‹http://plato.stanford.edu/entries/certainty/›. Warner, Marina. “Interview with Tacita Dean.” In Jean-Christophe Royoux, Marina Warner and Germaine Greer. Tacita Dean. New York: Phaidon, 2006. 7-41.

The objective of this article is to explore how suitable Team-Based Learning (TBL) is for students with social and communication disabilities, such as those on the autism spectrum or with social anxiety. TBL is a structured form of Active Collaborative Learning, combining a flipped classroom approach with students working in permanent teams to apply concepts, models and theories into practice. The design of the study was based on an idiographic case study approach at Anglia Ruskin University, UK, treating each student as an individual rather than a representative sample. Towards the end of the academic year 2017/18, an electronic questionnaire was sent out to all students who had taken TBL modules at ARU during the preceding academic year, asking about various aspects of TBL experience. The questionnaire was repeated towards the end of the first semester of 2018/19. The questionnaire was analysed with a focus on questions relating to inclusivity, and the responses related to students who had declared a disability. The questionnaire was followed by semi-structured interviews with students with disabilities who had experienced TBL. We focused primarily on disabilities broadly related to communication, notably with dyslexia, dysgraphia, social phobia and autism that may impair students’ abilities to work in teams. Interviews were audio recorded and then transcribed. Transcriptions were thematically analysed by the research team using NVivo. The results of the study provide anonymized case studies for each of the students who took part in an interview, explaining their disability or condition, their coping strategies for studying in HE, and their experiences, both positive and negative, of the TBL modules they had taken.
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Introdução: O recém-nascido (RN) é classificado como prematuro quando apresenta idade gestacional inferior a 37 semanas e peso de nascimento igual ou abaixo de 2.550g. Devido à imaturidade do sistema respiratório, o neonato está sujeito a apresentar diversas complicações, dentre elas, as respiratórias, o que ocasiona o seu prolongamento na unidade de terapia intensiva neonatal (UTIN). A fisioterapia respiratória é de grande importância no tratamento e recuperação do RN através da aplicação de técnicas de higiene brônquica (HB). O estudo teve como objetivo investigar os efeitos da fisioterapia respiratória no recém-nascido prematuro publicados na literatura científica. Materiais e Métodos: Trata-se de um a revisão integrativa realizada nas bases de dados Biblioteca Virtual em Saúde, LILACS, Medline, SciELO, SCOPUS e ISI Web of Knowledge, incluindo artigos publicados no período de 2007 a 2015. Oito artigos foram incluídos nesta revisão. Resultados e Discussão: A atuação da fisioterapia respiratória foi analisada mediante os efeitos da aplicação das técnicas de HB mais utilizadas no recém-nascido pré-termo (RNPT), podendo destacar a tapotagem, vibrocompressão, drenagem postural e aspiração. Foram realizadas comparações para comprovar a eficácia e os possíveis efeitos colaterais que pudessem alterar o funcionamento da mecânica respiratória do RN. Os estudos mostraram a efetividade da fisioterapia respiratória e os efeitos das manobras na condição respiratória do neonato de risco. Conclusão: A fisioterapia tem um papel importante no cuidado ao recém-nascido pré-termo, mas necessita de mais estudos que comprovem sua eficácia e sua importância na melhora da condição de vida do neonato.Descritores: Recém-Nascido; Nascimento Prematuro; Fisioterapia.ReferênciasNikolovi V. Congenital malformations and perinatal mortality at the Saint Antoine University Obstetric. 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Introduction With a deluge of mouthwatering pre-publicity, the opening of The Spotted Pig, the USA’s first self-identified British-styled gastropub, in Manhattan in February 2004 was much anticipated. The late Australian chef, food writer and restauranteur Mietta O’Donnell has noted how “taking over a building or business which has a long established reputation can be a mixed blessing” because of the way that memories “can enrich the experience of being in a place or they can just make people nostalgic”. Bistro Le Zoo, the previous eatery on the site, had been very popular when it opened almost a decade earlier, and its closure was mourned by some diners (Young; Kaminsky “Feeding Time”; Steinhauer & McGinty). This regret did not, however, appear to affect The Spotted Pig’s success. As esteemed New York Times reviewer Frank Bruni noted in his 2006 review: “Almost immediately after it opened […] the throngs started to descend, and they have never stopped”. The following year, The Spotted Pig was awarded a Michelin star—the first year that Michelin ranked New York—and has kept this star in the subsequent annual rankings. Writing Restaurant Biography Detailed studies have been published of almost every type of contemporary organisation including public institutions such as schools, hospitals, museums and universities, as well as non-profit organisations such as charities and professional associations. These are often written to mark a major milestone, or some significant change, development or the demise of the organisation under consideration (Brien). Detailed studies have also recently been published of businesses as diverse as general stores (Woody), art galleries (Fossi), fashion labels (Koda et al.), record stores (Southern & Branson), airlines (Byrnes; Jones), confectionary companies (Chinn) and builders (Garden). In terms of attracting mainstream readerships, however, few such studies seem able to capture popular reader interest as those about eating establishments including restaurants and cafés. This form of restaurant life history is, moreover, not restricted to ‘quality’ establishments. Fast food restaurant chains have attracted their share of studies (see, for example Love; Jakle & Sculle), ranging from business-economic analyses (Liu), socio-cultural political analyses (Watson), and memoirs (Kroc & Anderson), to criticism around their conduct and effects (Striffler). Eric Schlosser’s Fast Food Nation: The Dark Side of the All-American Meal is the most well-known published critique of the fast food industry and its effects with, famously, the Rolling Stone article on which it was based generating more reader mail than any other piece run in the 1990s. The book itself (researched narrative creative nonfiction), moreover, made a fascinating transition to the screen, transformed into a fictionalised drama (co-written by Schlosser) that narrates the content of the book from the point of view of a series of fictional/composite characters involved in the industry, rather than in a documentary format. Akin to the range of studies of fast food restaurants, there are also a variety of studies of eateries in US motels, caravan parks, diners and service station restaurants (see, for example, Baeder). Although there has been little study of this sub-genre of food and drink publishing, their popularity can be explained, at least in part, because such volumes cater to the significant readership for writing about food related topics of all kinds, with food writing recently identified as mainstream literary fare in the USA and UK (Hughes) and an entire “publishing subculture” in Australia (Dunstan & Chaitman). Although no exact tally exists, an informed estimate by the founder of the Gourmand World Cookbook Awards and president of the Paris Cookbook Fair, Edouard Cointreau, has more than 26,000 volumes on food and wine related topics currently published around the world annually (ctd. in Andriani “Gourmand Awards”). The readership for publications about restaurants can also perhaps be attributed to the wide range of information that can be included a single study. My study of a selection of these texts from the UK, USA and Australia indicates that this can include narratives of place and architecture dealing with the restaurant’s location, locale and design; narratives of directly food-related subject matter such as menus, recipes and dining trends; and narratives of people, in the stories of its proprietors, staff and patrons. Detailed studies of contemporary individual establishments commonly take the form of authorised narratives either written by the owners, chefs or other staff with the help of a food journalist, historian or other professional writer, or produced largely by that writer with the assistance of the premise’s staff. These studies are often extensively illustrated with photographs and, sometimes, drawings or reproductions of other artworks, and almost always include recipes. Two examples of these from my own collection include a centennial history of a famous New Orleans eatery that survived Hurricane Katrina, Galatoire’s Cookbook. Written by employees—the chief operating officer/general manager (Melvin Rodrigue) and publicist (Jyl Benson)—this incorporates reminiscences from both other staff and patrons. The second is another study of a New Orleans’ restaurant, this one by the late broadcaster and celebrity local historian Mel Leavitt. The Court of Two Sisters Cookbook: With a History of the French Quarter and the Restaurant, compiled with the assistance of the Two Sisters’ proprietor, Joseph Fein Joseph III, was first published in 1992 and has been so enduringly popular that it is in its eighth printing. These texts, in common with many others of this type, trace a triumph-over-adversity company history that incorporates a series of mildly scintillating anecdotes, lists of famous chefs and diners, and signature recipes. Although obviously focused on an external readership, they can also be characterised as an instance of what David M. Boje calls an organisation’s “story performance” (106) as the process of creating these narratives mobilises an organisation’s (in these cases, a commercial enterprise’s) internal information processing and narrative building activities. Studies of contemporary restaurants are much more rarely written without any involvement from the eatery’s personnel. When these are, the results tend to have much in common with more critical studies such as Fast Food Nation, as well as so-called architectural ‘building biographies’ which attempt to narrate the historical and social forces that “explain the shapes and uses” (Ellis, Chao & Parrish 70) of the physical structures we create. Examples of this would include Harding’s study of the importance of the Boeuf sur le Toit in Parisian life in the 1920s and Middlebrook’s social history of London’s Strand Corner House. Such work agrees with Kopytoff’s assertion—following Appadurai’s proposal that objects possess their own ‘biographies’ which need to be researched and expressed—that such inquiry can reveal not only information about the objects under consideration, but also about readers as we examine our “cultural […] aesthetic, historical, and even political” responses to these narratives (67). The life story of a restaurant will necessarily be entangled with those of the figures who have been involved in its establishment and development, as well as the narratives they create around the business. This following brief study of The Spotted Pig, however, written without the assistance of the establishment’s personnel, aims to outline a life story for this eatery in order to reflect upon the pig’s place in contemporary dining practice in New York as raw foodstuff, fashionable comestible, product, brand, symbol and marketing tool, as well as, at times, purely as an animal identity. The Spotted Pig Widely profiled before it even opened, The Spotted Pig is reportedly one of the city’s “most popular” restaurants (Michelin 349). It is profiled in all the city guidebooks I could locate in print and online, featuring in some of these as a key stop on recommended itineraries (see, for instance, Otis 39). A number of these proclaim it to be the USA’s first ‘gastropub’—the term first used in 1991 in the UK to describe a casual hotel/bar with good food and reasonable prices (Farley). The Spotted Pig is thus styled on a shabby-chic version of a traditional British hotel, featuring a cluttered-but-well arranged use of pig-themed objects and illustrations that is described by latest Michelin Green Guide of New York City as “a country-cute décor that still manages to be hip” (Michelin 349). From the three-dimensional carved pig hanging above the entrance in a homage to the shingles of traditional British hotels, to the use of its image on the menu, website and souvenir tee-shirts, the pig as motif proceeds its use as a foodstuff menu item. So much so, that the restaurant is often (affectionately) referred to by patrons and reviewers simply as ‘The Pig’. The restaurant has become so well known in New York in the relatively brief time it has been operating that it has not only featured in a number of novels and memoirs, but, moreover, little or no explanation has been deemed necessary as the signifier of “The Spotted Pig” appears to convey everything that needs to be said about an eatery of quality and fashion. In the thriller Lethal Experiment: A Donovan Creed Novel, when John Locke’s hero has to leave the restaurant and becomes involved in a series of dangerous escapades, he wants nothing more but to get back to his dinner (107, 115). The restaurant is also mentioned a number of times in Sex and the City author Candace Bushnell’s Lipstick Jungle in relation to a (fictional) new movie of the same name. The joke in the book is that the character doesn’t know of the restaurant (26). In David Goodwillie’s American Subversive, the story of a journalist-turned-blogger and a homegrown terrorist set in New York, the narrator refers to “Scarlett Johansson, for instance, and the hostess at the Spotted Pig” (203-4) as the epitome of attractiveness. The Spotted Pig is also mentioned in Suzanne Guillette’s memoir, Much to Your Chagrin, when the narrator is on a dinner date but fears running into her ex-boyfriend: ‘Jack lives somewhere in this vicinity […] Vaguely, you recall him telling you he was not too far from the Spotted Pig on Greenwich—now, was it Greenwich Avenue or Greenwich Street?’ (361). The author presumes readers know the right answer in order to build tension in this scene. Although this success is usually credited to the joint efforts of backer, music executive turned restaurateur Ken Friedman, his partner, well-known chef, restaurateur, author and television personality Mario Batali, and their UK-born and trained chef, April Bloomfield (see, for instance, Batali), a significant part has been built on Bloomfield’s pork cookery. The very idea of a “spotted pig” itself raises a central tenet of Bloomfield’s pork/food philosophy which is sustainable and organic. That is, not the mass produced, industrially farmed pig which produces a leaner meat, but the fatty, tastier varieties of pig such as the heritage six-spotted Berkshire which is “darker, more heavily marbled with fat, juicier and richer-tasting than most pork” (Fabricant). Bloomfield has, indeed, made pig’s ears—long a Chinese restaurant staple in the city and a key ingredient of Southern US soul food as well as some traditional Japanese and Spanish dishes—fashionable fare in the city, and her current incarnation, a crispy pig’s ear salad with lemon caper dressing (TSP 2010) is much acclaimed by reviewers. This approach to ingredients—using the ‘whole beast’, local whenever possible, and the concentration on pork—has been underlined and enhanced by a continuing relationship with UK chef Fergus Henderson. In his series of London restaurants under the banner of “St. John”, Henderson is famed for the approach to pork cookery outlined in his two books Nose to Tail Eating: A Kind of British Cooking, published in 1999 (re-published both in the UK and the US as The Whole Beast: Nose to Tail Eating), and Beyond Nose to Tail: A Kind of British Cooking: Part II (coauthored with Justin Piers Gellatly in 2007). Henderson has indeed been identified as starting a trend in dining and food publishing, focusing on sustainably using as food the entirety of any animal killed for this purpose, but which mostly focuses on using all parts of pigs. In publishing, this includes Hugh Fearnley-Whittingstall’s The River Cottage Meat Book, Peter Kaminsky’s Pig Perfect, subtitled Encounters with Some Remarkable Swine and Some Great Ways to Cook Them, John Barlow’s Everything but the Squeal: Eating the Whole Hog in Northern Spain and Jennifer McLagan’s Fat: An Appreciation of a Misunderstood Ingredient, with Recipes (2008). In restaurants, it certainly includes The Spotted Pig. So pervasive has embrace of whole beast pork consumption been in New York that, by 2007, Bruni could write that these are: “porky times, fatty times, which is to say very good times indeed. Any new logo for the city could justifiably place the Big Apple in the mouth of a spit-roasted pig” (Bruni). This demand set the stage perfectly for, in October 2007, Henderson to travel to New York to cook pork-rich menus at The Spotted Pig in tandem with Bloomfield (Royer). He followed this again in 2008 and, by 2009, this annual event had become known as “FergusStock” and was covered by local as well as UK media, and a range of US food weblogs. By 2009, it had grown to become a dinner at the Spotted Pig with half the dishes on the menu by Henderson and half by Bloomfield, and a dinner the next night at David Chang’s acclaimed Michelin-starred Momofuku Noodle Bar, which is famed for its Cantonese-style steamed pork belly buns. A third dinner (and then breakfast/brunch) followed at Friedman/Bloomfield’s Breslin Bar and Dining Room (discussed below) (Rose). The Spotted Pig dinners have become famed for Henderson’s pig’s head and pork trotter dishes with the chef himself recognising that although his wasn’t “the most obvious food to cook for America”, it was the case that “at St John, if a couple share a pig’s head, they tend to be American” (qtd. in Rose). In 2009, the pigs’ head were presented in pies which Henderson has described as “puff pastry casing, with layers of chopped, cooked pig’s head and potato, so all the lovely, bubbly pig’s head juices go into the potato” (qtd. in Rose). Bloomfield was aged only 28 when, in 2003, with a recommendation from Jamie Oliver, she interviewed for, and won, the position of executive chef of The Spotted Pig (Fabricant; Q&A). Following this introduction to the US, her reputation as a chef has grown based on the strength of her pork expertise. Among a host of awards, she was named one of US Food & Wine magazine’s ten annual Best New Chefs in 2007. In 2009, she was a featured solo session titled “Pig, Pig, Pig” at the fourth Annual International Chefs Congress, a prestigious New York City based event where “the world’s most influential and innovative chefs, pastry chefs, mixologists, and sommeliers present the latest techniques and culinary concepts to their peers” (Starchefs.com). Bloomfield demonstrated breaking down a whole suckling St. Canut milk raised piglet, after which she butterflied, rolled and slow-poached the belly, and fried the ears. As well as such demonstrations of expertise, she is also often called upon to provide expert comment on pork-related news stories, with The Spotted Pig regularly the subject of that food news. For example, when a rare, heritage Hungarian pig was profiled as a “new” New York pork source in 2009, this story arose because Bloomfield had served a Mangalitsa/Berkshire crossbreed pig belly and trotter dish with Agen prunes (Sanders) at The Spotted Pig. Bloomfield was quoted as the authority on the breed’s flavour and heritage authenticity: “it took me back to my grandmother’s kitchen on a Sunday afternoon, windows steaming from the roasting pork in the oven […] This pork has that same authentic taste” (qtd. in Sanders). Bloomfield has also used this expert profile to support a series of pork-related causes. These include the Thanksgiving Farm in the Catskill area, which produces free range pork for its resident special needs children and adults, and helps them gain meaningful work-related skills in working with these pigs. Bloomfield not only cooks for the project’s fundraisers, but also purchases any excess pigs for The Spotted Pig (Estrine 103). This strong focus on pork is not, however, exclusive. The Spotted Pig is also one of a number of American restaurants involved in the Meatless Monday campaign, whereby at least one vegetarian option is included on menus in order to draw attention to the benefits of a plant-based diet. When, in 2008, Bloomfield beat the Iron Chef in the sixth season of the US version of the eponymous television program, the central ingredient was nothing to do with pork—it was olives. Diversifying from this focus on ‘pig’ can, however, be dangerous. Friedman and Bloomfield’s next enterprise after The Spotted Pig was The John Dory seafood restaurant at the corner of 10th Avenue and 16th Street. This opened in November 2008 to reviews that its food was “uncomplicated and nearly perfect” (Andrews 22), won Bloomfield Time Out New York’s 2009 “Best New Hand at Seafood” award, but was not a success. The John Dory was a more formal, but smaller, restaurant that was more expensive at a time when the financial crisis was just biting, and was closed the following August. Friedman blamed the layout, size and neighbourhood (Stein) and its reservation system, which limited walk-in diners (ctd. in Vallis), but did not mention its non-pork, seafood orientation. When, almost immediately, another Friedman/Bloomfield project was announced, the Breslin Bar & Dining Room (which opened in October 2009 in the Ace Hotel at 20 West 29th Street and Broadway), the enterprise was closely modeled on the The Spotted Pig. In preparation, its senior management—Bloomfield, Friedman and sous-chefs, Nate Smith and Peter Cho (who was to become the Breslin’s head chef)—undertook a tasting tour of the UK that included Henderson’s St. John Bread & Wine Bar (Leventhal). Following this, the Breslin’s menu highlighted a series of pork dishes such as terrines, sausages, ham and potted styles (Rosenberg & McCarthy), with even Bloomfield’s pork scratchings (crispy pork rinds) bar snacks garnering glowing reviews (see, for example, Severson; Ghorbani). Reviewers, moreover, waxed lyrically about the menu’s pig-based dishes, the New York Times reviewer identifying this focus as catering to New York diners’ “fetish for pork fat” (Sifton). This representative review details not only “an entree of gently smoked pork belly that’s been roasted to tender goo, for instance, over a drift of buttery mashed potatoes, with cabbage and bacon on the side” but also a pig’s foot “in gravy made of reduced braising liquid, thick with pillowy shallots and green flecks of deconstructed brussels sprouts” (Sifton). Sifton concluded with the proclamation that this style of pork was “very good: meat that is fat; fat that is meat”. Concluding remarks Bloomfield has listed Michael Ruhlman’s Charcuterie as among her favourite food books. Publishers Weekly reviewer called Ruhlman “a food poet, and the pig is his muse” (Q&A). In August 2009, it was reported that Bloomfield had always wanted to write a cookbook (Marx) and, in July 2010, HarperCollins imprint Ecco publisher and foodbook editor Dan Halpern announced that he was planning a book with her, tentatively titled, A Girl and Her Pig (Andriani “Ecco Expands”). 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