Articles de revues sur le sujet « Vargem Grande (MA) »

Introdução: A satisfação no trabalho, definida como um estado emocional agradável ou positivo, resultado da avaliação de alguém em relação ao seu trabalho ou suas experiências no trabalho. Em especial, na área da saúde, a satisfação profissional tem se mostrado de grande relevância por transparecer na qualidade da assistência e na vida pessoal. Objetivo: Este estudo teve por objetivo avaliar o nível de satisfação profissional da equipe de enfermagem no Hospital Municipal de Vargem-Grande, MA. Metodologia: Tratou-se de um estudo descritivo e prospectivo com análise quantitativa dos dados. Realizado no Hospital Municipal da rede pública Benito Mussolini de Sousa no município de Vargem-Grande, MA, no período de março a abril de 2017. Resultados: A população do estudo foi composta por 41 profissionais de enfermagem, que trabalharam no hospital municipal dentro do período estudado. Resultados: Conforme a análise dos dados, constataram-se os seguintes resultados: Observou-se que Status profissional foi o componente de trabalho com maior satisfação, em média 80% da equipe, seguido por interação com média de 61%, requisitos de trabalho com 45%, normas organizacionais com 35%, remuneração com 34% e autonomia com 28%, sendo o componente com menor índice de satisfação. Conclusão: Concluímos que a satisfação profissional motiva-se por uma série de fatores associando-se com a subjetividade do trabalhador. O estudo respeitou a pesquisa em seres humanos de acordo as recomendações do Conselho Nacional de Saúde e Resolução 466/12. NURSING STAFF: A REVIEW OF PROFESSIONAL SATISFACTION AT A MUNICIPAL HOSPITAL IN VARGEM-GRANDE, MA ABSTRACT Introduction: Satisfaction at work, defined as a pleasant or positive emotional state, resulting from someone’s evaluation regarding his work and experiences. In particular, in the health field, professional satisfaction bears great relevance since it dwells on the quality of assistance and personal life. Purpose: This paper aims to review the level of professional satisfaction of the nursing team at a municipal hospital in Vargem-Grande, MA. Methodology: It is a descriptive and prospective study with quantitative data analysis. It was carried out at Benito Mussolini de Souza municipal public hospital in the municipality of Vargem-Grande, MA, in the period from March to April 2017. Results: The population in this study comprised 41 nurse practitioners, who worked at a municipal hospital during the period of the study. Results: According to data analysis, the following results were obtained: It was observed that the professional Status was the work element with the highest satisfaction, on average 80% of the team, followed by interaction on average 61%, labor requirements with 45%, organizational standards with 35%, remuneration with 34%, and autonomy 28% being the element with the lowest level of satisfaction. Conclusion: We conclude that professional satisfaction is motivated by a number of factors and it is combined with the practitioner’s subjectivity. The study respected the research in human beings according to the advice from the National Health Council and Resolution 466/12. Keywords: Evaluation. Professional Satisfaction. Nursing.

Este trabalho tem por objetivo analisar as contribuições do curso de Pedagogia do PROFEBPAR/UFMA de Vargem Grande – MA na construção da identidade de professores-alunos à luz da Teoria das Representações Sociais – TRS. Fundamenta-se no referencial teórico das representações sociais, por favorecer a compreensão do objeto na sua integralidade. A discussão aqui realizada é de abordagem qualitativa e os sujeitos da pesquisa são 20 (vinte) professores-alunos do curso de Pedagogia do PROFEBPAR/UFMA de Vargem Grande - MA. A partir da Técnica “Quem Sou eu? aplicada percebe-se que as respostas predominantes indicam que a maioria dos participantes da pesquisa se considera professor, alegre e amigo do que se infere que o curso de Pedagogia contribuído positivamente para que os sujeitos incorporem a docência em sua formação acadêmica. A análise de conteúdo adotada permitiu a sistematização dos dados coletados por meio de questionário de perfil, entrevistas semiestruturadas e a compreensão do objeto de estudo. Foi possível, assim, elencar duas Unidades Temáticas para a pesquisa: Sou professor e o PROFEBPAR/ UFMA em tudo isto. Assim, o estudo sugere ampliar o debate sobre a construção da identidade dos professores-alunos em cursos de graduação.Palavras-chave: Identidade docente. Representações Sociais. ROFEBPAR/UFMA. Social Representations and Teaching Identity: a study with teachers-students of PROFEBPAR / UFMAABSTRACTThis paper aims to analyze the contributions of the PROFEBPAR / UFMA Pedagogy course of Vargem Grande - MA in the construction of teacher - student identity in light of the Social Representation Theory - TRS. It is based on the theoretical reference of social representations, because it favors the comprehension of the object in its integrality. The discussion here is from a qualitative approach and the subjects of the research are 20 (twenty) professors-students of the Pedagogy course of PROFEBPAR / UFMA of Vargem Grande - MA. From the Technique “Who Am I? applied it is noticed that the predominant answers indicate that the majority of the participants of the research consider teacher, cheerful and friend. It is inferred that the course of Pedagogy contributed positively so that the subjects incorporate the teaching in its academic formation.The content analysis allowed the systematization of the data collected through a profi le questionnaire, semi-structured interviews and the understanding of the object of study. It was possible, therefore, to list two Thematic Units for the research: I am a teacher and PROFEBPAR / UFMA in all this. Thus, the study suggests expanding the debate about the construction of the identity of teachers-students in undergraduate courses.Keywords: Teaching identity. Social Representations. PROFEBPAR / UFMA. Representaciones Sociales e Identidad Docente: un estudio con profesores-alumnos del PROFEBPAR / UFMARESUMENEste trabajo tiene por objetivo analizar las contribuciones del curso de Pedagogía del PROFEBPAR / UFMA de Vargem Grande - MA en la construcción de la identidad de profesores-alumnos a la luz de la Teoría de las Representaciones Sociales - TRS. Se fundamenta en el referencial teórico de las representaciones sociales, por favorecer la comprensión del objeto en su integralidad. La discusión aquí realizada es de abordaje cualitativo y los sujetos de la investigación son 20 (veinte) profesores- alumnos del curso de Pedagogía del PROFEBPAR / UFMA de Vargem Grande - MA. A partir de la técnica “¿Quién soy yo? se observa que las respuestas predominantes indican que la mayoría de los participantes de la investigación se considera profesor, alegre y amigo de lo que se infi ere que el curso de Pedagogía contribuido positivamente para que los sujetos incorporen la docencia en su formación académica. El análisis de contenido adoptado permitió la sistematización de los datos recolectados por medio de cuestionario de perfil, entrevistas semiestructuradas y la comprensión del objeto de estudio. Fue posible, así, enumerar dos Unidades Temáticas para la investigación: Soy profesor y el PROFEBPAR / UFMA en todo esto. Así, el estudio sugiere ampliar el debate sobre la construcción de la identidad de los profesores-alumnos en cursos de graduación.Palabras clave: Identidad docente. Representaciones Sociales. PROFEBPAR / UFMA.

QUILOMBOLA SCHOOL CHILDREN’S EDUCATION: a history of struggle, resistance and the right to the children’s education in Vargem Grande-MAEDUCACIÓN INFANTIL ESCOLAR DE KILOMBOLA: una historia de lucha, resistencia y derecho a la educación de niños pequeños en Vargem Grande-MARESUMOEsta investigação versa sobre a educação infantil e escolar em comunidades quilombolas que fazem parte do território Rampa, situado no município de Vargem Grande, interior do estado do Maranhão, e tem por objetivo observar como é oferecida a educação infantil nas escolas que estão situadas nessas comunidades. Como procedimentos metodológicos, utilizou-se a revisão de literatura, a respeito da temática e, também, a pesquisa in loco nas comunidades Rampa e Piqui da Rampa. Na pesquisa de campo, observou-se que as escolas que atendem às crianças pequenas ainda necessitam de um olhar mais atento às questões pedagógicas, bem como à infraestrutura física. Após as análises, considerou-se que a equipe pedagógica do território Rampa, especificamente nos povoados de Piqui da Rampa e Rampa, preocupa-se em cumprir a legislação nacional, evidenciando as Diretrizes Curriculares Nacionais da Educação Escolar Quilombola na Educação Básica e trazendo tímidas inovações nas formações para os educadores que ali trabalham em prol das crianças quilombolas. Palavras-chave: Educação; Educação Infantil; Território Quilombola; Crianças.ABSTRACTThis research is about children and school education in quilombola communities that are part of the Rampa territory, located in the municipality of Vargem Grande, interior of the state of Maranhão, and aims to observe how children's education is offered in the schools that are located in these communities. As methodological procedures, we used the literature review, regarding the theme and also the in loco research in the Ramp and Piqui da Rampa communities. In the field research, it was observed that schools that attend young children still need a more attentive look at pedagogical issues, as well as the physical infrastructure. After the analyses, it was considered that the pedagogical team of the territory Ramp, specifically in the villages of Piqui da Rampa and Rampa, is concerned with complying with national legislation, highlighting the National Curricular Guidelines of Quilombola School Education in Basic Education and bringing timid innovations in training for the educators who work there on behalf of quilombola children.Keywords: Education; Kindergarten Education; Quilombola Territory; Children.RESUMENEsta investigación trata de los niños y la educación escolar en las comunidades quilombolas que forman parte del territorio de Rampa, situadas en el municipio de Vargem Grande, en el interior del estado de Maranhão, y tiene por objeto observar cómo se ofrece la educación de los niños en las escuelas que se encuentran en estas comunidades. Como procedimientos metodológicos, se utilozó la revisión de la literatura, en relación con el tema y también la investigación in situ en las comunidades de Ramp y Piqui da Rampa. En la investigación de campo se observó que las escuelas que atienden a los niños pequeños todavía necesitan una mirada más atenta a las cuestiones pedagógicas, así como a la infraestructura física. Después de estos análisis, se consideró que el equipo pedagógico del territorio Rampa, concretamente en las aldeas de Piqui da Rampa y Rampa, se ocupa de cumplir la legislación nacional, poniendo de relieve las Directrices Curriculares Nacionales de la Educación Escolar Quilombola en la Educación Básica y aportando tímidas innovaciones en la formación de los educadores que trabajan allí en favor de los niños quilombolas.Palabras clave: Educación; Educación Infantil; Territorio Quilombola; Niños.

RÉSUMÉ:Nul ne peut ignorer que les centres d’entrainement physique sont plus que jamais fréquentés. Particulièrement populaire, l’entrainement prend désormais une grande place dans la vie de plusieurs. Habitude saine, certes, mais jusqu’à une certaine limite. Cette limite se trace par ailleurs au moment où l’un des résultats de l’entrainement musculaire, soit une apparence corporelle musclée, deviennent l’unique préoccupation. La dysmorphie musculaire, ou communément appelée la « bigorexie », est le nom que l’on donne à ce trouble psychologique. Il décrit l’obsession compulsive de l’entrainement et des muscles. Cette maladie étant complexe, de raisons variées et d’importantes conséquences et complications s’y rattachent.ABSTRACT:No one can ignore that physical training centers are more popular than ever. With its increased popularity, training now takes an important place in the lives of many. Although certainly a healthy habit, there are limits. These limits become evident when one of the results of strength training, a muscular body appearance, becomes one’s only concern. Muscle dysmorphia, or commonly called “bigorexia,” is the name we give to this psychological disorder. Bigorexia is a compulsive obsession with training and a muscular build. This disease is complex, for varied reasons and related to important consequences and complications.

This study, which used a sample of 137,346 students from thirty three countries that participated in the TIMSS 2003 project in the eighth grade, examined the features of the individual and collective relations of three dimensions of mathematics attitude to mathematics achievement (MA), searching for the dimension mostly related to that achievement. The three dimensions of mathematics attitude were self-confidence in learning mathematics (SCLM), liking mathematics (LM) and usefulness of mathematics (UM). By utilizing psychometrically valid and reliable measures of the three dimensions, it was found that: (1) each dimension of mathematics attitude alone was positively related to MA for almost all thirty three countries; (2) SCLM was primarily related to MA for thirty one countries; (3) when the two other dimensions were held constant, SCLM was positively related to MA for thirty three countries, LM was negatively related to MA for thirty countries, whereas UM was not related to MA for twenty one countries; (4) positive collective relationships of SCLM, LM and UM to MA considerably varied from country to country. Implications for research and practice are included.

In the Godthabsfjord region of southern West Greenland a NE-SW-trending belt of rocks of very varied age and origin, here named the Akulleq terrane, is separated by major faults from more extensive blocks of typical high-grade Archaean rocks that, although they are superficially similar, have different ages and metamorphic histories. The continental crust that forms the block to the north-west, the Akia terrane, was accreted between ea. 3200 and 2980 Ma, and that forming the block to the south-east, the Tasiusarsuaq terrane, between 2920 and 2800 Ma. It is suggested that the Godthabsfjord belt is the result of collision of the two continental blocks between 2800 and 2650 Ma. The rocks of the Akulleq terrane are interpreted as fragments of different parts of the crust that originally separated the two continents. They include early Archaean continental crust, possible oceanic crust, and acid to intermediate rocks of intrusive and possibly also extrusive origin that may have been generated in a subduction-related environment.

AbstractMetamorphic grade, palaeothermal history and the influence of tectonic strain on clay minerals and organic matter transformation were studied in the eastern part of the Teplá-Barrandian unit in the Czech Republic. The metamorphic grade of pelitic sediments ranges from the lower anchizone (IC ~0.30–0.36Δº2θ) to the lowermost epizone (IC ~0.24–0.26Δº2θ). Increase in metamorphic grade is paralleled by the development of anastomosing cleavage and lenticular quartz grains in the anchizone which give way to slaty cleavage and dynamically recrystallized ribbon quartz grains in the lower epizone. White mica in highly strained rocks generally has greater IC values whereas chlorite displays reduced values in deformed and cleaved samples. The organic matter dispersed in the sediments represents a complex assemblage of highly matured particles of uncertain origin, pyrobitumen and ‘transitional matter’. The reflectance of organic fragments generally varies from 3.1% to 7.7% of Rmax which suggests anthracite to meta-anthracite rank progrades to semigraphite in higher-grade samples, although the overall link between Rmax and IC values is weak, if present at all. Newly formed shear-induced graphite appears abruptly near the anchizone-epizone boundary and correlates with the onset of plastic deformation and dynamic recrystallization of quartz grains in the host sediments.Maximum metamorphic temperatures within the Neoproterozoic sequence in the range of 250–350ºC were attained during the Cadomian (Pan-African) orogeny at 540–550 Ma. Apatite fission-track analysis reveals a subsequent decrease in rock temperature over the period 340–350 Ma that persisted throughout the late Palaeozoic. The most recent episode of accelerated cooling occurred between 20 and 40 Ma, corresponding with the regional uplift of the Bohemian Massif due to the Alpine orogeny.

Math anxiety (MA) affects students of all age groups. Because of its effects on children’s academic development, the need to recognize its early manifestations has been highlighted. We designed a European-Spanish version of the Scale for Early Mathematics Anxiety (SEMA; Wu et al. (2012)), and assessed its psychometric properties in a sample of children aged 7 to 12 years. The participants (967 typically developing children) were elementary school students recruited from ten schools. Children reported their general and math anxiety levels in an individual session and performed nonverbal IQ and math abilities subtests in a group session. Teachers reported the final math grades. The psychometric indices obtained, and the resulting factor structure revealed that the European-Spanish version of the SEMA developed in this study is a reliable and valid measure to evaluate MA in children from 3rd to 6th grade. Moreover, we explored gender differences, that resulted in small effect sizes, which disappeared when controlling for trait anxiety. Differences across grades were found for both global MA and the numerical processing anxiety factor but not for the situational and performance anxiety factor. Finally, MA was negatively associated with students’ math achievement, although the strength of the associations varied with the MA measure selected, the kind of math achievement analyzed, and the school stage considered. Our findings highlight the relevance of MA in elementary school and highlight the need for an early identification of students at risk of suffering MA to palliate the negative consequences of MA in children’s cognitive and academic development.

The Las Lozas volcanic sequence, which crops out at northwestern border of the Famatina belt-southeastern Puna, NW Argentina, is constituted mainly by rhyolites and a lesser volume of basalts and trachytes, and volcanoclastic deposits. These rocks, previously considered of Early Paleozoic age, are now assigned to the Lower Pennsylvanian (320 Ma U-Pb age). They represent a bimodal volcanic succession that plot in the subalkaline/tholeiitic (rhyolites), alkaline basalts (basalts) and alkaline (trachytes) fields on the total alkali-silica diagram. The basalts display features comparable to transitional MORB and within-plate tholeiites, with contributions from a mantle source affected by crustal contamination. The acid members also show geochemical affinities to within-plate magmas, and their composition suggest a derivation from continental crustal material with mantle source interaction or a juvenile essentially mantle derived crust. The 320 Ma age from the Las Lozas volcanic succession as well as the 342 and 348 Ma U-Pb ages, from rocks in the nearby Cazadero Grande section, to the south, and the U-Pb ages from Sierra Pampeanas granites (332-357 Ma) highlight the importance achieved by Carboniferous magmatic activity in that region, framed between 320 and 350 Ma. Low strontium initial ratios from the Las Lozas (0.70479-0.70164) indicate a predominant contribution by a juvenile component, while the ratios in the nearby Cazadero Grande (0.71433-0.71233) and Sierras Pampeanas granites (0.717 to 0.7124) point to an input by enriched sources with restricted contribution of a mantle component. Nd isotopes from a basalt from the Las Lozas section (εNd(320) with +3.11, TDM with 774.6 Ma) indicates a possible asthenospheric source, with evidence for some mixture between juvenile and reworked crustal material. In contrast Sr-Nd isotopes in a rhyolite from Cazadero Grande (εNd(t) of -2.91 and -0.3, TDM of 1.09 and 1.1 Ga) and of Sierra Pampeanas granites (εNd(t) of -0.6, TDM of 1.19 and 1.1 Ga) suggest a crustal source with minor juvenile input. Taking in account the age difference in the region between Mississippian and the Lower Pennsylvanian magmatism, this would indicate a change in the magma source consistent with a more pronounced extensional tectonic regime for the Lower Pennsylvanian. This assumption need to be considered together with observations along a transect at 27º30’S, where the Carboniferous Eastern Sierras Pampeanas granitic rocks show, regardless of age, a greater contribution of juvenile material of mantle character to the west. Among these rocks, with a major juvenile component, are those of the Las Lozas succession as well the Cerro Gloria Granite, the eastern manifestations of the Carboniferous Eastern Sierras Pampeanas magmatism. From the foregoing emerges that the contribution of juvenile material could be continuously varied in the region through the Carboniferous, due to varying lithospheric extension. An example of this arise from the presented data of the Lozas succession, which indicate that this rocks resulted from reworking of supra-crustal material with input of juvenile magmas, linked to the change in the lithospheric extension

RESUMO: O Granito Chasqueiro aflora como campos de matacões e lajeados, que em planta constituem um corpo alongado segundo N50oE com área de aproximadamente 400 km2, localizado no sul da porção oriental do Escudo Sul-Rio-Grandense. Compreende de monzo a sienogranito, leucocrático de cor cinza-clara e textura porfirítica com megacristais de K-feldspatos em matriz equigranular, hipidiomórfica grossa, composta por quartzo, K-feldspato, plagioclásio, biotita, hornblenda, minerais opacos e acessórios. Os megacristais atingem proporções modais entre 30,0 e 60,0%, e variam entre 4 e 8 cm, que com os minerais máficos da matriz evidenciam uma foliação de fluxo magmático subvertical bem desenvolvida que transaciona lateralmente para uma foliação tectônica nos bordos do granito próximo às zonas de cisalhamento onde ocorrem extensas faixas marcadas por intensa deformação dúctil e geração de protomilonitos. O granito apresenta enclaves máficos microgranulares de composição diorítica, apresentando diferentes formas e tamanhos. Geoquimicamente, é caracterizado por um magmatismo subalcalino do tipo cálcio-alcalino de alto potássio, metaluminoso a levemente peraluminoso, com assinatura característica de granitos gerados em ambiente pós-colisional. Processos de fusão crustal, mistura de magmas e cristalização fracionada são sugeridos para a sua evolução. Análises geocronológicas obtidas pelo método U-Pb (LA-ICP-MS) e geoquímica isotópica de Lu-Hf (LA-ICP-MS) em zircões indicaram, respectivamente, idade de cristalização 574 ± 3 Ma e valores negativos para εHf, sugerindo assim uma relação do Granito Chasqueiro com o evento deformacional D2 e fontes magmáticas dominantemente crustais com participação de componente mantélico subordinado.

Background Recommendations regarding the technical aspects of nerve stimulator-assisted nerve localization are conflicting. The objectives of this study were to determine whether the placement of the cutaneous electrode affects nerve stimulation and to determine the duration and intensity of an electrical stimulus that allows nerve stimulation with minimal discomfort. Methods Ten healthy volunteers underwent an interscalene and a femoral nerve block. After obtaining a clearly visible motor response of the biceps (interscalene) and quadriceps (femoral) muscles at the minimal current (0.1 ms, 2 Hz), the position of the cutaneous electrode was varied. Next, the duration of the stimulating current was set at 0.05, 0.1, 0.3, 0.5, or 1.0 ms, in random order. Intensity of the motor response and discomfort on stimulation were recorded. Results The minimal current at which a visible motor response was obtained was 0.32 +/- 0.1 mA (0.23-0.38 mA) for the inter-scalene block and 0.29 +/- 0.1 mA (0.15-0.4 mA) for the femoral block. Changing the position of the return electrodes did not result in any change in the grade of the motor response or in the current required to maintain it. Currents of longer duration caused discomfort and more forceful contraction at a lower current intensity as compared with currents of shorter duration (P < 0.01). When the current was adjusted to maintain the same visible motor response, there was no significant discomfort among studied current durations. Conclusion Site of placement of the cutaneous electrode is not important when constant current nerve stimulators are used during nerve localization in regional anesthesia. There is an inverse relation between the current required to obtain a visible motor response and current duration. Selecting a current duration between 0.05 and 1.0 ms to specifically stimulate sensory or motor components of a mixed nerve does not seem to be important in clinical practice.

Background:There is growing recognition of the importance of recreational space utilization for promoting physical activity (PA) among youth.Methods:An cross-sectional study was conducted with a sample of 926 diverse 6th-8th grade students in Somerville, MA. Participants completed the 2007 Youth Risk Surveillance Survey (YRBS). Chi-square testing and logistical regression modeling were performed to predict meeting national PA recommendations for moderate, vigorous, and 60 minutes or more (60+) PA.Results:The participants reported meeting recommended PA levels for moderate (27%), vigorous (70%) and 60+ (21%) PA. In multivariate analysis, being male and speaking English were significantly associated with meeting all 3 PA recommendations. Recreational spaces significantly associated with meeting PA recommendations included neighborhood parks and walk/bike paths, playing fields and courts, and recreational centers. Recreational space utilization varied by gender, race/ethnicity, and language.Conclusions:Recreational space utilization was an important predictor of meeting PA recommendations among middle school students. Our results showed that PA attainment and recreational space utilization varied by demographic characteristics. The role of each recreational space in predicting PA varied depending on the outcome used. This study demonstrates the potential use of YRBS data to inform resource allocation for PA promotion in diverse communities.

AbstractThe ages obtained by the 40Ar–39Ar encapsulation technique (retention and total gas ages) on <2 μm fractions of five metapelites from the Eastern Andean Metamorphic Complex and two from the Chonos Metamorphic Complex allow discussion of the latest recorded metamorphic event in each zone. The Kübler Index (KI) of illite/muscovite (principal component of the metapelites) varies between 0.15° and 0.45° Δ°2θ, indicating regional variation from diagenetic to epizonal metamorphic grade. The 40Ar–39Ar encapsulation analyses reveal 39Ar loss varying between 21 and 25%, which shows a limited positive correlation with KI values. The obtained retention and total gas metapelite ages reflect distinct metamorphic conditions. Retention ages most probably indicate burial or regional metamorphic events without plutonic influence in the southern Eastern Andean Metamorphic Complex. Total gas ages reflect contact ages for metapelites close to intrusions in the northern and southern Eastern Andean Metamorphic Complex and in the Chonos Metamorphic Complex. The thermal overprinting of metapelites occurred in Early Cretaceous times at 130 Ma and 145 Ma and is related to the contact metamorphism of an emplacement pulse of the North Patagonian Batholith. Total gas metapelite ages obtained from the western belt of the Chonos Metamorphic Complex suggest a thermal event related to a distinct pulse of the North Patagonian Batholith.

Mastery of physics concepts of students including low category and application of learning model has not varied, still refers to the old paradigm such as teaching by lecture method. This study aims to determine the application of STAD model (Student Teams Achievement Division) to improve student learning outcomes of grade X MA Zainul Musthafa NW Pengadang academic year 2012/2013. This research is a classroom action research conducted in 2 cycles consisting of planning, implementation, observation, evaluation and reflection. The first cycle consists of three sessions and the second cycle is two sessions. Data on student learning outcomes is obtained from multiple choice tests at the end of the cycle. The results showed that the completeness of classical learning in the first cycle was 64.00% and 91.67% for the second cycle. We conclude that the application of the STAD model has a positive impact on student learning outcomes.

Copper Indium Selenide (CIS) thin films were pulse electrodeposited at room temperature and at different duty cycles in the range of 6 – 50 %. Deposition current density was kept constant at 5 ma cm-2 in the present work. The total deposition time was 60 min. The precursors used were AR grade 0.3 M of each CuCl2 and InCl3, along with 0.2 M of SeO2. Thickness of the films estimated by Mitutoyo surface profilometer varied in the range of 0.8 to 1.2 μm with increase of duty cycle. XRD patterns of CIS films deposited at different duty cycles exhibit the chalcopyrite structure. Composition of the films indicated Cu/In ratio is greater than 1. Optical absorption studies indicated a direct energy band gap of 0.95 eV. Surface morphology of the films indicated that the grain size increased from 15 nm to 40 nm as the duty cycle increased. It is observed that as the duty cycle increases, the resistvity increases from 1.0 ohm cm to 10 ohm cm. The films were used as photoelectrodes in 0.5 M polysulphide redox electrolyte (0.5 M each Na2S, NaOH, S). At 60 mW cm-2, an open circuit voltage of 0.465 V and short circuit current density of 3.87 mA cm-2 were observed for the films deposited at 50 % duty cycle.

The purpose was to describe the engagement of students with mild intellectual disabilities (MID) and their nondisabled peers (NDP) in regular physical education lessons and to determine whether this varied with gender, grade, or disability. Participants were 24 students with MID and 48 NDP Data on student behavior were gathered using an Academic Learning Time—Physical Education (ALT-PE) systematic observation instrument. Each lesson, including one student with MID and two same-gender NDP, was observed on five occasions (120 total). Data from primary and secondary levels were pooled. A MANOVA with PE Time, PE Engaged, Motor Engaged (ME), and Motor Appropriate (MA) as dependent measures revealed significant main effects for disability and gender. Follow-up analyses disclosed that the only difference between boys and girls was PE Time and that engagement level showed no difference. Students with MID spent significantly less time (p ≤ .01) than NDPs at each level.

High-grade Zr–Nb–Y–rare earth element (REE) mineralization occurs as zircon–allanite–magnetite bands in layered Paleozoic alkali rocks which intruded the Gyemyeongsan Formation of the Chungju unit, South Korea. The mineralization period and genesis have been controversial. We investigated the petrological and mineralogical properties of the newly discovered zircon–allanite–magnetite bands and the geochronological properties of zircon within the bands in the alkali granite. We analyzed the zircon with laser ablation multi-collector inductively coupled plasma mass spectrometry (LA-MC-ICP-MS). The repeated quartz–feldspar-rich layers in the alkali granite show grain-sized grading textures and equilibrium igneous textures. Magnetite and allanite grains in these layers varied in size and exhibited isolated, aggregated, and coalesced textures. In addition, the settling texture of zircon grains onto the other minerals was observed. These observations could reasonably be explained by the process of gravitational accumulation during the solidification of magma. The 206Pb/238U ages obtained from zircon from the zircon–allanite–magnetite-rich layer and the alkali aplite were 331.1 ± 1.5 Ma and 334.5 ± 8.9 Ma, respectively. Therefore, we suggest that the Zr–Y–Nb–REE mineralization developed in the alkali rocks and the Gyemyeongsan Formation in the Chungju unit were formed by fractional crystallization of alkali magma and hydrothermal fluids which evolved from alkali magma fractional crystallization, respectively. The correlation between alkaline granite and REE mineralization found in this study could be used as a tool for REE exploration in other regions where the permeable geological unit is intruded by the alkali granite.

A compositionally varied swarm of mafic dykes in the Jetty Peninsula area was emplaced about 320 Ma ago (K-Ar age). There are three major groups: Group 1 dykes range from transitional-alkaline dolerites to camptonites, Group 2 are trachydolerites, and Group 3 are diorite to quartz diorite porphyries. Group 1 dykes have very similar ratios of most incompatible elements and were derived from the same (or a very similar) enriched lithospheric mantle source region (∈Nd −0.18 to −3.05) with high Nb and Ta (i.e., OIB, ocean island basalt, characteristics). However, the presence of several distinct subgroups with different incompatible element abundances implies significantly different degrees of melting. Group 2 trachy dolerites are much more fractionated (mg 22–36), but were apparently derived from a similar, although somewhat more enriched (∈Nd −2.26 to −4.63) source. Group 3 diorites are compositionally quite distinct and may have been derived by intracrustal melting. Enrichment of the mantle source(s) of Groups 1 and 2 dykes apparently occurred about the same time as high-grade metamorphism in the area, and may have been coeval with crust formation in nearby parts of Gondwana.

Alternating greenstone–granite and metasedimentary gneiss belts are a first-order tectonic feature of the southern Superior Province. The tectonic development of the Quetico metasedimentary belt is reviewed with regard to depositional, structural, and metamorphic–plutonic history. Over its 1200 km length, the belt consists of marginal metasedimentary schists of turbiditic origin and interior metasedimentary migmatite and peraluminous leucogranite. Polyphase deformation has resulted in a steep easterly-striking foliation and regional, gently east-plunging stretching lineation. Metamorphic grade varies in a low-P facies series from greenschist at the belt margins to upper amphibolite and local granulite in the central migmatite – intrusive granite zone. Mineral assemblages in the central zone yield estimates of metamorphic pressure that increase systematically eastward over 800 km from about 250 MPa (2.5 kbar) near the Canada – United States border to 600 MPa (6 kbar) in granulites adjacent to the Kapuskasing structural zone.Geochronology suggests that sediments were deposited at approximately the same time as active volcanism in adjacent volcanic belts, although evidence of volcanic–sedimentary stratigraphic contiguity is weak as a result of later transcurrent movement parallel to major lithological boundaries. Adjacent belts are inferred to have been contiguous since common D2 deformation, 2689–2684 Ma ago. Major plutonism and associated metamorphism occurred in the Quetico Belt approximately 2670–2650 Ma ago, significantly later than major plutonism in the adjacent volcanic belts.The linear disposition of greywacke-rich sediments over 1200 km invites an analogy with modern accretionary prisms. However, the high-temperature, low-pressure metamorphism of the Quetico Belt is inconsistent with such a low-heat-flow environment, and a change in tectonic regime would be required to account for the metamorphism and intracrustal plutonism. Simple cessation of subduction beneath the thick sedimentary prism could have led to restoration of isotherms, with possible attendant crustal melting and isostatic recovery.

<p>Em decorrência da escassez de madeira para produção energética, alguns setores tem se empenhado com grandes esforços para a produção de seus próprios insumos. Uma alternativa a essa problemática é a utilização do bambu na produção de carvão vegetal, pois é uma espécie tolerante aos mais variados tipos de ambientes e apresenta boa capacidade produtiva. Nesse contexto, o presente estudo teve como objetivo<strong> </strong>avaliar o potencial produtivo de carvão vegetal de <em>Bambusa vulgaris </em>Schrad<em>.</em> cultivado em Timon, MA. As amostras foram coletadas num bambuzal de 48,56 ha dividido em quatro talhões (tratamentos), no município de Timon, MA. Em seguida, levadas ao Laboratório de Tecnologia da Madeira da UFCG/CSTR onde se determinou a densidade básica dos colmos do bambu, o rendimento em carvão, rendimento em líquido pirolenhoso, gases incondensáveis e análise química imediata. A densidade básica média do bambu foi de 490 kg/m³, não apresentando diferença significativa entre as médias dos quatro tratamentos. O rendimento médio em carvão vegetal foi de 39,05%, sendo que os tratamentos 1 e 4 apresentaram os maiores valores, com médias de 40,34% e 39,85%, entretanto não diferiram estatisticamente. O rendimento médio em gases condensáveis foi de 12,17%. A densidade aparente variou de 1,945 a 2,833 g/cm³. Os teores médios de materiais voláteis, carbono fixo e rendimento em carbono fixo foram respectivamente 28,55%, 64,11% e 25,04%, não apresentando diferença significativa entre os tratamentos. De acordo com as análises realizadas, verificou-se que o carvão vegetal produzido a partir dos colmos de <em>Bambusa vulgaris </em>Schrad. possui potencial para comercialização e utilização como fonte energética.</p><p align="center"><strong><em>Productive potential of species Bambusa vulgaris Schrad. charcoal grown in Timon, Ma</em></strong></p><p>As a result of the scarcity of raw material (wood) for the production of energy, some sectors have committed themselves with great efforts to produce their own inputs. An alternative for this problem is the usage of bamboo in the production of vegetable coal, as it is a species which is tolerant to various types of environment and presents a good productive capacity. In this context, the present study aimed to assess the production potential of vegetable coal of <em>Bambusa vulgaris </em>Schrad, cultivated in Timon, MA. The samples were collected in a bamboo grove of 48,56 ha divided into four stands (treatments), located in the municipality of Timon, MA. Subsequently, taken to the Laboratory of Wood Technology of the UFCG/CSTR, where the basic density of the bamboo poles, the efficiency in the conversion into coal, efficiency in pyrolysis liquid, incondensable gases and immediate chemical analysis were determined. The average basic density of the bamboo was of 490kg/m³, not presenting significant difference between the averages of the four treatments. The average yield in vegetable coal was of 39,05%, and the treatments 1 and 4 presented higher values, with averages of 40,34% and 39,85%, however they did not differ statistically. The average yield of the condensable gases was of 12,17%. The apparent density varied from 1,945 to 2,833 g/cm³. The average contents of volatile materials, fixed carbon and fixed carbon efficiency were respectively 28,55%, 64,11% and 25,04%, not presenting significant difference among the treatments According to the analysis carried out, it was verified that the vegetable coal produced from the poles of <em>Bambusa vulgaris </em>Schrad. has potential for commercialization and use as an energy source.</p>

O Complexo Pontas do Salso ocorre no extremo sudeste do Terreno São Gabriel, porção oeste do Cinturão Dom Feliciano, centro-oeste do Rio Grande do Sul. Para avaliar as relações estratigráficas e caracterizar as unidades do complexo foi realizado mapeamento geológico e estrutural detalhado, com análise petrográfica, avaliação das relações entre metamorfismo e deformação e contagem modal dos minerais constituintes para definição da proveniência dos metassedimentos. O Complexo Pontas do Salso é composto por meta-arcóseos, com ocorrência restrita de metaconglomerados e metapelitos. Os meta-arcóseos apresentam textura blastopsamítica fina a grossa, com porfiroclastos de quartzo hexagonal. Os metaconglomerados polimíticos são matriz suportados e mostram entre 15 e 55% de clastos. Os metapelitos são formados essencialmente por muscovita filitos. As amostras analisadas foram classificadas como arcóseos e arcóseos líticos, com a maioria se posicionando no campo de Arco Dissecado. As associações minerais encontradas nos metapelitos (clorita, biotita-cloritóide e granada) e nos meta-arenitos (actinolita e hornblenda) indicam que as condições metamórficas variam da fácies xistos verdes inferior a anfibolito inferior. As rochas metassedimentares ainda foram submetidas a um metamorfismo termal, entretanto, preservaram parte das características de sua origem sedimentar e da contribuição vulcanogênica e granítica. A presença de clastos de tonalitos e granodioritos correlatos aos da Suíte Lagoa da Meia Lua sugere que a deposição do complexo é posterior à colocação desta suíte, cujas idades U-Pb SHRIMP em zircão estão entre 690 e 680 Ma.

This study was carried out in order to determine the effects of Mychorrizal Preparation (MP) applications on final take and root quality in grafted and potted grapevine sapling production. In this research, cuttings of five different Vine rootstocks (140 Ru, 110 R, 41 B, 1103 P and 5 BB) and scions of Narince grape cultivar were used. In addition, 5 commercials symbiotic mychorriza preparations (MP); Roots Deep Gel (RD), Endo Roots Soluble (ER), Myco Apply (MA), Bio-one (BO) and Biovam were applied. Scions were grafted on rootstocks by omega table grafting machine and then grafted cuttings were stored for three weeks at stratification room. The grafted cuttings were planted into polyethylene bags (12 × 20 cm size) containing 1:1 sterile perlite-peat mixture. Grafted cuttings were kept in greenhouse during 2 months for growing. After grapevine final take rates were determined, grapevine saplings were transferred to acclimatization environment. Root fresh and dry weights of grapevine saplings were detected in the first week of September. Research was designed according to completely randomized plot as three replications and as 50 grafted cuttings each plot. At the end of study, it was determined that both MP applications and rootstocks have a significant effect on final take and sapling quality. The ratios of first grade sapling varied from 21.5% to 93.3% in first year and from 10.3% to 79.3% in second year. Effects of MP applications on the total final take ratios differed depending on the rootstocks in both years. MP applications showed significant effect on total final take ratios of 110 R and 41 B in the first year, and total final take ratios of 5 BB, 41 B and 140 Ru in the second year. While the best results were obtained from MA, EN, RD applications in the first year, the highest final take ratios were in EN, RD and BO applications in the second year. The highest value on final take was obtained from 5BB rootstock, while the lowest value was recorded in 140 Ru rootstock. Effect of MP applications on the fresh and dry weight of root changed according to rootstocks.

1101 Background: A recent randomized trial (MA.20) showed that regional nodal irradiation (RNI) in addition to breast irradiation in high risk node negative and 1-3 node positive patients undergoing breast-conserving therapy (BCT) reduced the risk of recurrence and improved disease-free survival. We investigated the trends of RNI use in the United States and related factors for the use of RNI using the National Cancer Data Base. Methods: This study includes 292,598 stage I-III breast cancer patients without neoadjuvant therapy who underwent BCT from 2003-2007. We investigated pathological, patient, and facility factors related to RNI use, by multivariable logistic regression, with odds ratio (OR) estimations. Results: The proportion of radiotherapy use after BCT slightly declined from 78.6% in 2003 to 75.6% in 2007. The use of breast irradiation plus RNI decreased from 10.8% in 2003 to 8.3% in 2007 (p<0.0001). The number of tumor positive lymph nodes strongly determined the use of additional RNI: 4.4% patients with negative nodes, 22.8% patients with 1-3 nodes, and 39.7% patients with 4 or more nodes received breast irradiation plus RNI after undergoing BCT (p<0.0001). The proportion of patients undergoing RNI significantly decreased over the study period from 43.3% to 37.2% in the 4+ node positive group, and from 23.6% to 22.0% in the 1-3 node positive group. At comprehensive community cancer centers, 25.5% patients with 1-3 positive nodes were treated with breast irradiation plus RNI (vs. 23.2% in community cancer centers and 21.1% in academic/research cancer centers). Among node negative patients, 11.5% of those with tumor size greater than 5 cm received additional RNI, compared to 4.3% in patients with tumors less than 5cm (p<0.0001). Other significant factors related to RNI use included higher tumor grade, younger age, facility location, and facility volume. Conclusions: The use of RNI varies by number of tumor positive nodes and facility factors. Only 22.8% of patients with 1-3 positive nodes underwent RNI. Future studies are needed to determine if the use of RNI will increase after publication of the MA.20 trial especially for the 1-3 node positive group.

Listado: 52 semanas de tratamiento con análogos de somatostatina: respuesta bioquímica y tamaño tumoral en pacientes con acromegalia. Abreu A, Osorio CV, Salgado CA, Ramírez A, Barakat S, Carvajal R. Carcinoma adrenocortical con ACTH elevada: reporte de caso. Fierro F1 , Fuentes O2 , Coy AF3. Diabetes no controlada, Cushing incidental. Reporte de caso. Jaramillo A, Mejía H. Fiebre de origen desconocido (FOD) secundaria a feocromocitoma. González AM1, 2, Fierro LF2 , Muñoz JD1 , Bermúdez LN1 , Guzmán JD1 , Vanegas JJ1 Hallazgos de patología suprarrenal en autopsias en el departamento de patología del Hospital Universitario de Santander, 2012-2018. Mantilla AF, Lozano JF, Padilla LE, Mantilla JC. Hipofisitis por IgG4: reporte de un caso. Guzmán G1, 2, Hormaza A2, 3, Martínez V1, 3, Ortega S2 , Ortiz D2 . Hiponatremia por insuficiencia suprarrenal secundaria. Una serie de casos de un hospital universitario de tercer nivel en Pereira, Colombia. Guzmán ES, Giraldo J, Medina DA, Forero JE, Alzate JA, Vallejo S. Linfoma de células B grande difuso que se presentó con infiltración hipofisaria, hipopituitarismo y compromiso del nervio oculomotor. Reporte de caso. Arias D, Revelo S, Forero JE, Vallejo S. Supervivencia de pacientes con tumores neuroendocrinos en un hospital de tercer nivel, 2012-2017. Pinzón A, Jiménez CE, Mondragón AE, Gutiérrez Y, García HA. Pegvisomant, un último recurso en acromegalia no respondedora al manejo medicoquirúrgico inicial: reporte de caso. Sánchez PE, Rojas W, Tovar H Prolactinoma abscedado: absceso hipofisario asociado a un macroadenoma productor de prolactina. Importancia clínica y diagnóstica de las secuencias de resonancia en lesiones selares. Reporte de caso. Torres JL, Vargas MA, Coronel N, Aristizábal N. Síndrome de Cushing de difícil diagnóstico secundario al uso de un “producto naturista” para los dolores articulares y musculares. Fierro LF1 , González AM1, 2, Álvarez MA2 , Moreno GA2 , Rodríguez S2 , Tarquino D2 . Síndrome de Cushing, comportamiento posterior al tratamiento. Salgado CA, Muñoz JP, Bedoya V, Osorio CV, Tabares AA, Abreu A.

Introduction Peripheral neuropathy (PNP) remains one of the most common adverse events during multiple myeloma (MM) treatment. The immunomodulatory agent thalidomide and proteasome inhibitor bortezomib are particularly prone to induce PNP (Dimopoulos MA et al., Leukemia., 2010). Both agents are part of standard treatment regimens for newly diagnosed transplant-eligible MM patients. PNP varies from mild symptoms to severe disability, depending on timely dose reduction or discontinuation of treatment. Currently, incidence or severity of PNP cannot be predicted. Therefore, it is of utmost importance to monitor incidence of PNP in different treatment combinations, and in order to identify risk factors for developing PNP. Aims To investigate the incidence of PNP in patients treated in the Cassiopeia trial, to evaluate the role of CD38 antibody (daratumumab) treatment in development of PNP, and to identify risk factors for the development of PNP. Methods We retrospectively analysed incidence of PNP grade 2 to 4, scored according to common terminology criteria for adverse events version 4 (CTCAE) in the Cassiopeia study, a phase III trial conducted by IFM/HOVON, investigating the efficacy of adding daratumumab to bortezomib, thalidomide and dexamethasone (VTD). 1074 newly diagnosed MM patients were randomised. Patients received 4 induction cycles and 2 post transplantation consolidation cycles of 28 days each. Cycles included subcutaneous bortezomib (1.3 mg/m2 days 1,4,8,11), oral thalidomide (100 mg daily), dexamethasone (20-40 mg) and daratumumab intravenously (16 mg/kg and weekly during induction cycles 1 and 2 and once every two weeks during induction cycles 3,4 and consolidation). This trial was registered as ClinicalTrials.gov NCT02541383 and was supported by the French IFM and Dutch HOVON groups (Moreau et al., Lancet, 2019). Multivariate analysis was performed including sex, age, arm, body mass index (BMI), cytogenetics, ISS stage, country, diabetes mellitus (DM), creatinine clearance, liver function, ECOG, baseline PNP and disease characteristics. Results Baseline characteristics in dara-VTD and VTD arms were similar. Overall, 380/1074 (35%) patients developed grade ≥2 PNP and 102/1074 (9%) patients developed grade ≥3 PNP. Multivariate analysis indicated that the cumulative incidence of PNP grade ≥2 was significantly lower in the dara-VTD arm (33%) when compared to the VTD arm (38%) (hazard ratio (HR)=0.73, 95% confidence interval (CI) 0.59-0.91, P=0.004). Furthermore, risk factors associated with a higher cumulative incidence of PNP grade ≥2 included older age (HR=1.03; P=0.020), grade 1 PNP at baseline (HR= 2.75; P= 0.002) and higher BMI (HR=1.46, P=0.003 for BMI 25-30 to HR=2.02, P=0.004 for BMI &gt; 35). Progression free survival (PFS) from the end of induction was similar (86% vs 80% at 2 years, HR = 0.74, 95% CI 0.41-1.33, P=0.32) for patients developing grade ≥2 PNP during induction (179 pts, 17%). An unexpected finding was the difference in cumulative incidence between countries participating in this trial: in the Netherlands 68/141 (49%) of patients developed grade ≥2 PNP, while in France this was 280/846 (33%) and in Belgium 31/87 (36%) (p&lt;0.001). The protocol of the Cassiopeia trial included instructions of discontinuation and dose modification, when PNP grade ≥2 was observed. However, in a subset of patients reaching PNP grade ≥ 2 the (temporary) discontinuation or adjustment of dose as described in the treatment protocol had not been applied (respectively in 148/352 (42%) with PNP ≥ 2 and in 39/97 (40%) with PNP ≥3). Conclusions Despite bortezomib being administered subcutaneously and clear instructions on discontinuation and dose modification, we observed a clinically relevant incidence of grade ≥2 PNP (35%) and grade ≥3 PNP (9%) in patients treated in the Cassiopeia trial. Patients in the dara-VTD arm showed less grade ≥2 PNP, suggesting a possible positive effect of daratumumab. Risk factors for the development of grade ≥2 PNP included older age, PNP at baseline and BMI &gt; 25. Differences in incidence between countries were observed, however no clear explanation was found. Furthermore, standard measures for grading PNP, such as CTCAE criteria, are subject to interpretation bias of both the patient and the treating physician. Continuous screening and correct grading of PNP and strict compliance with guidelines is warranted. Disclosures Moreau: Amgen: Consultancy, Honoraria; Celgene/Bristol-Myers Squibb: Consultancy, Honoraria; Janssen: Consultancy, Honoraria; Abbvie: Consultancy, Honoraria; Takeda: Honoraria; Sanofi: Consultancy, Honoraria; Novartis: Honoraria. Vermeulen:Janssen: Current Employment, Current equity holder in publicly-traded company. Broyl:Janssen, Celgene, Takeda, Amgen: Honoraria. Sonneveld:Sanofi: Consultancy; Takeda: Consultancy, Honoraria, Research Funding; Bristol-Myers Squibb: Consultancy, Honoraria, Research Funding; Janssen: Consultancy, Honoraria, Research Funding; Karyopharm: Consultancy, Honoraria, Research Funding; Skyline Dx: Honoraria, Research Funding; Amgen: Consultancy, Honoraria, Research Funding.

A radiografia digital representa um grande avanço na radiologia bucomaxilofacial porque incorpora a tecnologia informática na captura, interpretação e arquivamento de imagens radiográficas. Estudos anteriores demonstraram que é possível usar os valores de cinza no diagnóstico e na proservação das lesões ósseas. No entanto, essas aplicações dependem da qualidade do sistema radiológico e do tempo de exposição. O objetivo deste estudo foi avaliar a reprodutibilidade do valor de cinza e o ruído produzido pelo sistema IDA da Dabi Atlante, um sistema de radiografia digital direto. As radiografias foram obtidas de maneira padronizada (70 kV, 7 mA e filtração de 2,2 mm) com um sensor digital direto e um penetrômetro colocados em um fantoma a uma distância de filme-foco de 30 cm. Dez imagens radiográficas consecutivas foram obtidas com tempos de exposição de 0,10-s, 0,15-s e 0,20-s. Os valores de cinza foram analisados em cinco regiões de interesse (ROIs): tecido ósseo (TO), tecido mole (TM) e três degraus do penetrômetro (Degrau 1, Degrau 2 e Degrau 3). Os valores de cinza médios diferiram significativamente entre os tempos de exposição (p <0,05) em todos as cinco ROIs. A ROI com maior variabilidade do valor de cinza (25,36%) e ruído (9,46%) foi TM. Em conclusão, a reprodutibilidade do valor de cinza e o ruído do sistema IDA variam entre áreas com radiolucência diferente. Assim, atenção especial é necessária para o diagnóstico e proservação de lesões radiolucentes devido à interferência dos valores cinza relativamente alta.Palavras-chave: Radiografia Dentária Digital. Reprodutibilidade dos Testes. Diagnóstico por Imagem. AbstractThe digital radiograph represents a great advance in oral maxillofacial radiology because it incorporates informatics technology in the capture, interpretation, and archiving of radiographic images. Previous studies have demonstrated that it is possible to use gray values in bone lesion diagnosis and follow-up. However, these applications depend on radiograph system quality and exposure time. The aim of this study was to evaluate the gray-value reproducibility and noise produced by Dabi Atlante’s IDA system, a direct digital radiography system. Radiographs were obtained in a standardized manner (70 kV, 7 mA, and 2.2-mm filtration) with a direct digital sensor and a stepwedge placed in a phantom at a 30-cm focus-film distance. Ten consecutive x-ray imaging series were completed at 0.10-s, 0.15-s, and 0.20-s exposure times. Gray values were analyzed in five regions of interest (ROIs): bone tissue (BT), soft tissue (ST), and three stepwedge steps (Step 1, Step 2, and Step 3). Mean gray values differed significantly across exposure times (p < .05) in all five ROIs. The ROI with the greatest gray-value variability (25.36%) and noise (9.46%) was ST. In conclusion, gray-value reproducibility and noise of the IDA system vary across areas with differing radiolucency. Thus, special attention is necessary for the diagnosis and follow-up of radiolucent lesions due to relatively high gray-value interference.Keywords: Radiography, Dental, Digital. Reproducibility of Results. Diagnostic Imaging.

BackgroundThe programmed death-1 (PD-1) and programmed death ligand-1 (PD-L1) inhibitors are increasingly studied and are known to have unique inflammatory side effects due to non-specific immune system activation.1 While rare, PD-1/PD-L1 inhibitors can cause ocular toxicities, including inflammatory eye disease.2 However, these ocular adverse events are less well-studied.MethodsThis was a retrospective review of two adverse event (AE) monitoring databases maintained by the National Cancer Institute’s Cancer Therapy Evaluation Program (CTEP), one of the largest public sponsors of clinical trials worldwide. One database (CTEP-AERS) is used for study sites to expeditiously report serious AEs for potential FDA review, while the other database (CDUS) is updated quarterly to reflect all the adverse events from the Phase 1 and Phase 2 trials in the CTEP network.ResultsThe two adverse event databases were queried for ocular adverse events up to May 19, 2020. A total of 331 adverse events from 259 patients were found. 73 patients (28%) were exposed to nivolumab, 117 patients (45%) were exposed to combination nivolumab and ipilimumab, 41 (16%) were exposed to pembrolizumab, 26 (10%) were exposed to atezolizumab, and 2 (0.8%) were exposed to durvalumab. 59 adverse events from 47 patients were reported by the study site as serious AEs and had more detailed clinical information available. Ocular AEs occurred within several months of initiating the study treatment (all ocular AEs: median 6 weeks, IQR 0–18, ocular AEs reported as serious: median 12 weeks, IQR 6–20). CTCAE grade for ocular AEs was generally mild to moderate (all ocular AEs: grade 1, IQR 1-2, ocular AEs reported as serious: grade 2, IQR 2-3). Clinical workup and treatment varied for the ocular AEs reported as serious. 30/47 patients (64%) receiving ophthalmologic evaluation.16/47 (34%) of patients with serious ocular AEs had to delay or discontinue study drug treatment. However, 14/47 (30%) had improvement in their ocular AE and 16/47 patients (34%) had resolution of their ocular AE. The most common ocular AE treatments in our dataset were steroids (intravenous, oral, and steroid eye drops).ConclusionsOcular adverse events are rare complications of PD-1/PD-L1 inhibitor therapy, can be severe enough to cause PD-1/PD-L1 treatment discontinuation or delay, but patients may not always be referred to eye specialists. Future PD-1/PD-L1 inhibitor studies would benefit from standardized plans for ophthalmologic evaluation of ocular toxicities.ReferencesPostow MA, Sidlow R, Hellmann MD. Immune-related adverse events associated with immune checkpoint blockade. Longo DL, ed. N Engl J Med. 2018;378(2):158–168.Dalvin LA, Shields CL, Orloff M, Sato T, Shields JA. Checkpoint inhibitor immune therapy. Retina 2018;38(6):1063–1078.

Abstract Background: The use of peripheral blood stem cell source (PBSC) continues to grow in the setting of haploidentical hematopoietic stem cell transplantation (haplo-SCT), mainly due to the ease of collection and rapid peripheral blood count recovery. We conducted a systematic review and meta-analysis of the published literature to evaluate the outcomes of unmanipulated bone marrow (BM) and PB haplo-SCT for adult leukemia patients. Method: A comprehensive literature search of electronic databases (Medline, Embase, and Cochrane library) for studies published between 1 January 2004 to 24 June 2018 was conducted. We included the studies of unmanipulated BM and/or PB haplo-SCT in adult acute myeloid leukemia (AML) and acute lymphoblastic leukemia ( ALL) . We excluded the studies which combined PB and BM stem cell sources and the studies which did not report the results of BM and PB haplo-SCT for ALL and AML separately. CMA software v.3 was used for the analysis. Heterogeneity among studies was assessed using the I2 test. Random-effect model was applied. Publication bias was assessed using funnel plots. Primary endpoints were engraftment, 2-year overall survival (OS), disease-free survival (DFS), relapse incidence (RI); grade II-IV, III-IV acute and chronic GVHD. Results: Out of 1548 publications, 3 studies (n = 672 patients; retrospective; multi-center) met our inclusion criteria. The sample size of the studies varied between 71 and 451 patients. The median follow-up ranged from 18 to 46 months. PB haplo-SCT was used in 191 patients (Ruggeri, A. et al. 2018) and BM haplo-SCT was used in 481 patients (Arcese, W. et al. 2015; Ruggeri, A. et al. 2018; Chiusolo, P. et al. 2018). Myeloablative (MA) conditioning was used in majority of patients. The pooled (95%CI) engraftment rate was 93% (88-95) in BM group and 95% (91-97) in PBSC group. The pooled estimates (95%CI) of BM studies showed a 2-year OS rate of 56.1% (51.6-60.4), 2-year DFS of 48.9% (43.5-54.2) and 2-year cumulative RI of 24.6%(20.7-29).There was no heterogeneity in BM group (I2=0%) for 2-year OS, DFS and RI. For PBSC group, the pooled estimates (95%CI) for 2-year OS, DFS and RI were 56 % (48.9-62.9; I2=0%), 54% (46.9-60.9; I2=0%) and 22% (16.7-28.4; I2=0%), respectively. Incidences of grade II-IV, grade III-IV aGVHD and cGVHD from a pooled analysis (95%CI) were 23.1% (17.2-30.3; I2=55%), 5.4% (3.4-8.3; I2=16%) and 19.5% (9.7-35.3; I2=88%) for BM group in comparison to 38% (31.4-45.1; I2=0%), 14% (9.8-19.7; I2=0%) and 32% (25.8-38.9; I2=0%) for PBSC group. Pooled estimates were shown in figure 1. Conclusions: In this analysis, higher pooled rates of grade II-IV aGVHD (38% vs 23.1%), III-IV aGVHD (14% vs 5.4%) and cGVHD (32% vs 19.5%) were observed in PBSC group vs BM group, respectively. Based on comparable OS, DFS and RI, PB haplo-SCT appears to be a good alternative option for adult AML and ALL patients. Large prospective randomized controlled trials are required to confirm these results. Figure 1. Figure 1. Disclosures No relevant conflicts of interest to declare.

Abstract Background: Ex-vivo T-cell-depleted graft is used to prevent acute and chronic GVHD for haploidentical hematopoietic SCT (HSCT). We conducted a systematic review and meta-analysis to evaluate the outcomes of T-cell-depleted grafts for peripheral blood haploidentical stem cell transplantation in patients with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Method: A comprehensive literature search on PubMed, Embase, Cochrane and Web of Science was conducted up to July 25, 2018. Two independent reviewers screened the literature and extracted data. The methodological quality was assessed using modified Newcastle-Ottawa Scale. CMA software v.3 was used for the analysis. Heterogeneity among studies was assessed using the I2 test. Random-effect model was applied. Results: The search strategy identified over 550 articles; three studies (n = 404 patients; 1 prospective; 1 multi-center) were selected for this meta-analysis. The sample size of the studies varied between 34 and 266 patients. The median follow-up ranged from 6 to 47 months. Two studies (Aversa, F. et al. 2005)(n=104 patients); (Ciceri, F. et al. 2008)(n=266 patients) used CD34+ selected cells and other study used TCR-αβ depleted PBSC graft (Kaynar, L. et al. 2016) (n=34). All studies used myeloablative (MA) conditioning. In vivo T-cell-depletion by ATG was used in two studies. Two studies using mega-dose of CD34+ did not use GVHD prophylaxis and other study with αβ T-cell depleted graft used mycophenolate mofetil (MMF). Engraftment rates ranged from 91% to 98%. Pooled rates (95%CI) of grade II-IV, III-IV aGVHD and chronic GVHD were 9% (4-20; I2=82%), 4.8% (1.7-13.1; I2=78%) and 10.7% (6.3-17.6; I2=64%), respectively. The pooled estimates (95%CI) showed a 2-year disease-free survival (DFS) rate of 30.8% (24.2-38.3; I2=54%), 2-year relapse incidence of 21.5% (17.4-26.2; I2=85%). The results are shown in figure 1. Conclusion: T-cell-depleted peripheral blood stem cell graft for haploidentical transplantation in acute leukemia may be an alternative treatment option. Larger prospective studies are needed to evaluate the outcomes of different manipulation techniques. Disclosures No relevant conflicts of interest to declare.

Non-equilibrium plasma is widely used for surface modification of polymer materials. Reactions of plasma active species with polymers lead not only to the surface modification, but to the formation of gaseous products, which change the plasma composition and internal plasma parameters. It results in the dependence of surface etching and modification kinetics on the quantity of material been treated (on sample sizes in a reactor). These phenomena are known as so called “loading effect” and have been studied for the treatment of polypropylene and polyimide films, poly(ethylene terephthalate) films and fabrics in oxygen and air plasma. It can be expected that gas products of noble gas plasma action on polymers will change strongly plasma parameters and modification results. In this paper, experimental data are represented on composition of gas products and their evolution rates at the treatment of polyaramid films, fibers and poly(ethylene terephthalate) fabric in low-pressure argon plasma. Poly(ethylene terephthalate) textile fabric (PET) made of monofilament yarns (SAATI, S.p.A., Italy) and polyaramide (PA) films and complex yarns “Rusar®” (Termotex, Russia) were used in experiments. Direct current discharge was excited in a flow of argon (technical grade) in a glass tube reactor with 3 cm inner diameter. Fabric samples were placed as cylinders on the reactor wall in the discharge positive column. Square of PET samples was varied from 18 to 111 cm2. The PA yarns with the total length of 550 or 1020 cm were placed in the reactor on special holder with the length of 20 cm. Total gas pressure in reactor was varied from 30 to 300 Pa at discharge current of 20 – 110 mA. Gas flow rate in the reactor was kept constant and equal to 30 cm´s-1. Gas phase analysis was carried out by the methods of plasma emission spectroscopy and mass-spectrometry. Plasma emission spectra and mass-spectra show evolution of H2, CO and H2O molecules at the treatment of PA and PET in argon plasma. Evolution rates for different gas products and their mole fractions have been obtained as functions of total gas pressure. Increase in polymer sample square has been shown to result in changing the ratios between evolution rates for different gas products. Sum of CO, H2 and H2O mole fractions increases with polymer sample square and decreases with gas pressure. Dissociation of molecular gas products results in the changing plasma active species. Oxygen and hydrogen atom lines and OH emission bands are observed in plasma emission spectra. Alteration of intensity ratio for О(3p3P ® 3s3S0) and Ar (4p3D3 ® 4s3P2) lines (IO/IAr) versus time after discharge starting shows the possible participation of oxygen atoms in heterogeneous reactions with polymers. Evolution of molecular gas products of heterogeneous reactions influences plasma properties and rates of plasma chemical reactions. The data obtained will be used for the further analysis of mechanisms of heterogeneous reactions of plasma active species with polymers.

ABSTRACT Ediacaran-age (635–542 Ma) oil-bearing strata in the Yarakta Horizon at the Verkhnechonskoye and Yaraktinskoye fields, East Siberia, consist of conglomerate, sandstone, dolomitic sandstone, and mudstone overlying and onlapping igneous to metasedimentary highlands of the East Siberia craton. Initial drainage networks formed within structurally defined valleys, and early deposition occurred in localized alluvial to shallow-marine depositional systems. Base-level-controlled depositional cycles aggraded the valleys; thus, as valleys aggraded, they buried interfluves and coalesced forming broad alluvial and coastal plains. Three to seven bedsets of variable net-to-gross content constitute a genetic cycle. Depositional cycles varied locally, as nine and eight cycles separated by decimeter- to multi-meter-thick mudstones are defined at Verknechonskoye and Yaraktinskoye, respectively. Within one genetic cycle, facies associations grade basinward from alluvial (channel-bar, channel-fill, floodplain, playa, and crevasse-splay) to shallow marine (sabkha, tidal-flat, estuarine-channel, and poorly developed shoreface). Coarse-grained lithofacies are typically arranged in decimeter- to meter-scale bedsets with sharp to scoured bases. Bedsets commonly, but not always, show an upward decrease in grain size, bed thickness, and scale of sedimentary structure. Typically, medium-grained sandstones exhibit low-angle cross bedding and are gradationally overlain by fine-grained sandstones exhibiting scour-and-fill, cuspate-ripple lamination, climbing-ripple lamination, and parallel lamination. Clay clasts and small pebbles are accessories. Interbedded mudstones, siltstones, and sandstones show ripple cross bedding, wavy to lenticular bedding, abundant soft-sediment deformation (e.g., shear, fluid-escape, slump features), and slickensides. Thin-bedded sandstones are micaceous and contain granule-size mud chips. Some mudstones exhibit crinkled to parallel laminae indicative of algal growth. Sandstone fills mudcracks. Interbedded green and black mudstones, plus pyrite and siderite cements, indicate alternating redox conditions. Alluvial facies have patchy quartz, anhydrite, and carbonate cements. Marine-influenced facies show early and well-developed quartz cement as well as abundant halite. Gypsum and halite dissolution formed secondary pores. Calculated estimates of fluvial-channel dimensions and sinuosities indicate that despite the lack of vegetation, fluvial channels in the Yarakta Horizon were shallow and relatively narrow, moderately sinuous, and exhibited varying degrees of mud-prone overbank deposition. Recognition and correlation of flooding surfaces and channel diastems bounding genetically related strata identified multiple stratigraphic compartments in each field. Porosity loss at chronostratigraphic boundaries accounts for complex water, oil, and gas contacts. Economic field development is hampered by locally varying reservoir quality and sandstone continuity caused by its channelized and onlapping stratigraphy and diagenesis. Reservoir simulation of varying geostatistical models demonstrate that differing porosity-distribution methods had little effect on estimates of in-place hydrocarbon volumes. Model differences in porosity and permeability distribution and lithofacies connectivity show large variations in recovery factor and productivity/injectivity.

111 Background: Much work has been done to explore how social determinants of health are associated with disparities in the use of chemotherapy for breast cancer. We used a large national registry to explore whether patient decision-making to accept or decline chemotherapy varies geographically across the United States. Methods: This analysis used the National Cancer Database to study decision-making in patients diagnosed with advanced breast cancer (AJCC clinical stage III-IV) between 2004-2017. We identified patients recommended chemotherapy by their physicians, but who declined treatment. We performed multivariate logistic regression modeling to explore variables associated with the decision to decline chemotherapy. Results: A total of n = 167,647 patients with stage III-IV breast cancer were included. After controlling for age, race, ethnicity, Charlson/Deyo comorbidity scoring, receptor status, histology, grade, patient education, insurance status, and facility type, geographic region was found to be significantly associated with the decision to either accept or decline chemotherapy (p < 0.001). Patients in the New England area (i.e. CT, MA, ME, NH, RI and VT) exhibited the highest rate of refusal of chemotherapy (9.3%). In contrast, patients in East South Central states (i.e. AL, KY, MS, TN) were the least likely to decline chemotherapy at 5.5% rate of refusal (OR 0.55, 95% CI: 0.47-0.66, p < 0.001). Rates of refusal were lower for patients with TNBC at 4.1% versus 7.7% in those with HR+/HER2 tumors. Patients aged > 70 had increased odds of declining chemotherapy (OR 9.30, 95% CI: 8.17-10.59, p < 0.001) compared to patients < 50. Race and level of education were not associated with patient decision-making in this cohort, however, Hispanics had lower odds (OR 0.70, 95% CI: 0.60-0.82, p < 0.001) of refusing chemotherapy as compared to Non-Hispanics. Patients with higher comorbidity were also more likely to decline chemotherapy (p < 0.05). As compared to the uninsured, Medicare-insured (OR 0.69, 95% CI: 0.60-0.80, p < 0.001), Medicaid-insured (OR 0.65, 95% CI: 0.56-0.76, p < 0.001) and privately-insured patients (OR 0.39, 95% CI: 0.33-0.44, p < 0.001) were less likely to decline chemotherapy. Lastly, patients treated at academic institutions (OR 0.90, 95% CI: 0.81-0.99, p = 0.029) were less likely to decline chemotherapy compared to those in community cancer programs. Conclusions: This study showed that after adjusting for known social determinants of health, there was a significant difference in rates of refusal of recommended chemotherapy by geographic region, with highest refusal rates in New England states. Of interest, Hispanic ethnicity was associated with lower likelihood to decline chemotherapy, while uninsured status was associated with increased refusal. Researching this geographic differential further will help improve efficacy of care delivery in patients with cancer.

Abstract Introduction and geodynamic setting. – Syn-rift exhumation of mantle rocks in a continental breakup zone was highlighted along the present-day west Iberian passive margin [e.g. Boillot et al., 1988, 1995; Whitmarsh et al., 1995, 2001; Beslier et al., 1996; Brun and Beslier, 1996; Boillot and Coulon, 1998; Krawczyk et al., 1996; Girardeau et al., 1998] and along the fossil Tethyan margins [e.g. Froitzheim and Manatschal, 1996; Manatschal and Bernoulli, 1996; Marroni et al., 1998; Müntener et al., 2000; Desmurs et al., 2001]. Along the west Iberian margin, serpentinized peridotite and scarce gabbro and basalt lay directly under the sediments, over a 30 to 130 km-wide transition between the thinned continental crust and the first oceanic crust [Girardeau et al., 1988, 1998; Kornprobst and Tabit, 1988; Boillot et al., 1989; Beslier et al., 1990, 1996; Cornen et al., 1999]. The formation of a wide ocean-continent transition (OCT), mostly controlled by tectonics and associated with an exhumation of deep lithospheric levels, would be an essential stage of continental breakup and a characteristic of magma-poor passive margins. The southwest Australian margin provides an opportunity to test and to generalize the models proposed for the west Iberian margin, as both margins present many analogies. The south Australian margin formed during the Gondwana breakup in the Mesozoic, along a NW-SE oblique extension direction [Willcox and Stagg, 1990]. From north to south, the continental slope is bounded by (1) a magnetic quiet zone (MQZ) where the nature of the basement is ambiguous [Talwani et al., 1979; Tikku and Cande, 1999; Sayers et al., 2001], (2) a zone where the basement shows a rough topography associated with poorly expressed magnetic anomalies [Cande and Mutter, 1982; Veevers et al., 1990; Tikku and Cande, 1999; Sayers et al., 2001], and which is the eastward prolongation of the Diamantina Zone, and (3) an Eocene oceanic domain. The continental breakup zone is believed to be located near or at the southern edge of the MQZ [Cande and Mutter, 1982; Veevers et al., 1990; Sayers et al., 2001]. Breakup is dated at 125 Ma [Stagg and Willcox, 1992], 95 ± 5 Ma [Veevers, 1986] or at 83 Ma [Sayers et al., 2001], and followed by ultra-slow seafloor spreading until the Eocene (43 Ma), and fast spreading afterwards [Weissel and Hayes, 1972; Cande and Mutter, 1982; Veevers et al., 1990; Tikku and Cande, 1999]. The western end of the margin (fig. 1) is starved and bounded in the OCT by basement ridges where peridotite, gabbro and basalt were previously dredged [Nicholls et al., 1981]. Altimetry data [Sandwell and Smith, 1997] show that some of these ridges are continuous over 1500 km along the OCT of the south Australian margin and of the conjugate Antarctic margin. The objectives of the MARGAU/MD110 cruise (May-June 1998; [Royer et al., 1998]; fig. 2) were to define the morpho-structure and the nature and evolution of the basement in the SW Australian OCT. An area of 180 000 km2 was explored with swath bathymetry. Gravimetric data (11382 km) were simultaneously recorded whereas few single channel seismic (1353 km) and magnetic (5387 km) data were obtained due to technical difficulties. Crystalline basement rocks, made of varied and locally well-preserved lithologies, were dredged at 11 sites located on structural highs. Main results. – The bathymetric map unveils three E-W domains (fig. 2). From north to south, they are the continental slope of Australia, prolonged westward by that of the Naturaliste Plateau, a 160 km-wide intermediate flat sedimented area corresponding to the MQZ, and a 100 km-wide zone of rough E-W oriented topography which continues the Diamantina Zone (fig. 3). The first two domains are cut through in three segments by two major fracture zones (FZ), the Leeuwin FZ along the eastern side of the Naturaliste Plateau, and the Naturaliste FZ along its western flank. These NW-SE trending FZ terminate north of the E-W trending fabric of the Diamantina Zone. Accordingly, extension occurred along the NW-SE direction during the formation of the slope and of the MQZ, and then turned to N-S during the formation of the Diamantina Zone. In the Diamantina Zone, the mantle rocks dredged at Site MG-DR02 are mainly lherzolites, rich in pyroxenitic micro-layers, and pyroxenites. They contain spinel rimmed by plagioclase and locally coronas of olivine + plagioclase between opx and spinel, which suggest that they underwent some subsolidus reequilibration in the plagioclase field (fig. 4C). Westward (Site DR09), the mantle rocks are harzburgitic, with lesser pyroxenitic bandings and no plagioclase. The rocks have coarse-grained porphyroclastic textures that are locally overprinted by narrow mylonitic shear bands, and then by a cataclastic deformation, which indicate decreasing temperatures and increasing stresses during their evolution. Basalts were sampled at Sites MG-DR01, −04, −05, and together with gabbros at Sites MG-DR02, -03, -09. They have a transitional composition as shown by their REE patterns, except one sample from site MG-DR-05 which is an alkaline basalt (fig. 5). The gabbros are clearly intrusive in the peridotite at Sites DR02 and -09. They contain olivine and clinopyroxene (cpx) at Site DR02, cpx, plagioclase and hornblende at Site DR03, and cpx and amphibole or orthopyroxene or olivine at Site DR09 (fig. 4D). At that site, a tonalite containing K-feldspar and biotite and alkaline in composition (fig. 5), has also been sampled. All these plutonic rocks display either their primary magmatic textures or secondary porphyroclastic ones that are locally overprinted by mylonitic shear zones (fig. 4E). Retrograde minerals of amphibolite to greenschist facies developed during the deformation. The basalts are clearly intrusive in the gabbros at Site DR03. They are altered and exhibit porphyric textures with abundant plagioclase and plagioclase + olivine phenocrysts at Sites DR03, -04, -08, -10, and have a transitional composition (fig. 5). The nature and evolution of the peridotites and associated gabbros are compatible with an exhumation under a rift zone, on both sides of the Leeuwin FZ. It includes a mylonitic deformation which attests that these rocks underwent a shearing deformation under lithospheric conditions, in probable relation with their exhumation during the early stages of the oceanic opening. The crustal rocks are represented only by intrusive gabbros and by transitional basalts. In the MQZ, the peridotites recovered at Site MG-DR06 are mainly spinel and plagioclase lherzolites (fig. 4B) and a few pyroxenites (fig. 4A) with high temperature porphyroclastic textures. Their discovery indicates that the basement in the MQZ is not exclusively formed of thinned continental crust. Lavas sampled westward of the Leeuwin FZ at Site DR10 have also transitional compositions (fig. 5). On the Australian slope, samples dredged at Site MG-DR07 are continental quartz-bearing rocks (mostly gneisses and rare granites), some showing a high grade paragenesis (upper amphibolite to granulite facies) marked by the presence of K-feldspar, biotite, sillimanite and/or kyanite and garnet, and without primary muscovite (fig. 4G). Some of these rocks underwent an intense mylonitic shear deformation followed by post-tectonic recrystallisation or migmatization. Depending on the age of the high grade evolution (metamorphism and shearing), these rocks document either the syn-rift exhumation of lower continental crust, or the formation of the older Australian craton. On the slope of the Naturaliste Plateau, at Site DR11, rocks of oceanic origin (gabbro-diorites/dolerite/basalt; fig. 4F) were dredged together with acid rocks (gneiss and granites) of probable continental origin, some having a quartz, K-feldspar, biotite and garnet metamorphic paragenesis (fig. 4H). At that site, the transitional basalts intrude the gabbros and associated dolerites. The presence of metamorphic acid rocks indicate that the Naturaliste Plateau is likely a continental fragment that was later intruded by mafic rocks, whose origin and ages of intrusion have to be determined. Discussion and conclusions. – The retrograde tectono-metamorphic evolution of the peridotites recovered in the MQZ, which includes a reequilibration in the plagioclase field (marked by the development of olivine and plagioclase after spinel and pyroxene), is compatible with an exhumation under a rift zone [Girardeau et al., 1988; Kornprobst and Tabit, 1988; Cornen et al., 1999]. By analogy with the Iberia Abyssal Plain, the MQZ could represent a wide OCT where the mantle was exhumed and stretched mostly by amagmatic extension before the initiation of oceanic accretion [Beslier et al., 1996; Boillot and Coulon, 1998] (fig. 6). This hypothesis is supported by the tectonic structures (horsts and grabens) imaged in the seismic data over the MQZ [Boeuf and Doust, 1975]. Accordingly, the limit of the continental crust would be located at the foot of the slope, i.e. 160 km (or 250 km in the NW-SE extension direction) northward of the assumed location of the OCT at the southern edge of the MQZ. The age of the Australia-Antarctic breakup would thus be (1) older than that inferred from the magnetic anomalies (circa 95 Ma [Cande and Mutter, 1982; Veevers, 1986]), which would rather date the onset of oceanic accretion, and (2) older than the age of the breakup unconformity estimated as Santonian (83 Ma), further east, in the Great Australian Bight [Sayers et al., 2001]. The origin of the Naturaliste Plateau, continental or oceanic, is still disputed. The discovery of metamorphic rocks of probable continental origin on the southern flank of the Plateau (Site DR11) shows that it consists at least partially of rocks of the Gondwana continent. All the samples from the Diamantina Zone confirm that its basement is made of a peridotite-gabbro-basalt assemblage. The nature and age of the peridotites and of the associated magmas will help understanding the origin of this domain, which can result either from Neocomian seafloor spreading with further remobilization during the Australia-Antarctic separation, or from post-Neocomian ultra-slow seafloor spreading. Because of the omnipresence of extensive tectonic structures (fig. 3) and of the relatively small proportion of crustal rocks relative to the mantle rocks, we argue that the formation of the Diamantina Zone was mainly controlled by tectonics rather than by magmatic processes. In conclusion, the data collected along the southwest Australian margin during the MARGAU/MD110 survey evidence two major tectonic phases with formation of a wide OCT where abundant mantle rocks, in association with few mafic rocks, outcrop or lay directly beneath the sediments. The evolution of the crystalline rocks is compatible with an exhumation under a rift zone during a phase of magma-poor extension primarily controlled by tectonic processes. The domains where basement highs were sampled seem to be continuous over more than 1500 km eastward along the south Australian margin. Additional evidence on such large-scale structural continuity and on the nature of the associated basement highs may help generalizing the models for continental breakup and formation of non-volcanic passive margins, where oceanic accretion does not immediately follow continental breakup.

Introduction: Allogeneic stem cell transplant (allo-SCT) plays a key role in the post-remission therapy for acute myeloid leukemia (AML) patients due to its high rates of efficacy as compared to alternate therapies. For patients with relapsed/refractory AML and those with high-risk myelodysplastic syndrome (MDS), it remains the sole curative option. However, these patients continue to have significant obstacles for successful transplant including risk for relapse of underlying disease, graft versus host disease (GVHD), and infectious complications. Outcomes of allo-SCT in these patients have improved over time with the evolution of practice of allo-SCT, including modifications of transplant conditioning regimens, supportive care, and earlier recognition of transplant complications. Our study sought to assess the trends in survival in AML and MDS patients undergoing allogeneic transplant at The Ohio State University from 1984-2018. Methods: We analyzed data from 900 consecutive patients who received an allo-SCT (705 AML and 195 MDS). The patients were stratified into 7 different groups based on year of transplant using 5 year increments; group (gp) 1 included 1984-1988, gp 2 1989-1993, gp 3 1994-1998, gp 4 1999-2003, gp 5 2004-2008, gp 6 2009-2013, and gp 7 2014-2018. Progression free survival (PFS) and overall survival (OS) were utilized as primary end points. PFS and OS were calculated using Kaplan Meier Curves. Secondary endpoints included cumulative incidences of grade II-IV and III-IV acute GVHD (aGVHD), chronic GVHD (cGVHD), and non-relapse mortality (NRM). Cumulative incidence rates were estimated and compared using Gray's test accounting for competing risks. Results: Median age at transplant was 52 years (yrs) old (range 18-76) and 55.6% were male. Patients having myeloablative (MA) conditioning regimen comprised 57.6% of the cohort. From 1984 to 2018, there was a statistically significant improvement in both PFS and OS (Figure 1 a and b; p&lt;0.001). The median PFS improved from 0.8 yrs [95% confidence interval (CI) 0.3-1.2)] in gp 1 to 3.0 yrs (95% CI: 1.7-NR) in gp 7 and the median OS from 0.9 yrs in gp 1 (95% CI:0.4-1.3) to NR (95% CI: 3.0-NR) in gp 7. The 5-yr PFS among the groups was 17, 18, 26, 16, 25, 36 and 49%, respectively, with a significant improvement seen since 2004. Similar improved trends were seen at 10 yrs. The 5-yr OS were 17, 21, 27, 17, 29, 39 and 53%, respectively, with similar significant improvement seen since 2004. Similar improved trends were also seen at 10 yrs. There was also a significant difference between rates of grade II-IV aGVHD between the groups (p&lt;0.001), with a cumulative incidence at day +180 of 40% in gp 4, 23% in gp 5, 45% in gp 6, and 53% in gp 7 (Figure 1c). Grade III-IV aGVHD at day +180 were respectively 23, 6, 14, and 18% with the highest rate seen for gps 4 and 7. Rates of cGVHD also varied between the groups (p=0.002) with cumulative incidence at day +365 of 33% in gps 4 and 5, 38% in gp 6, and 48% in gp 7. Extensive cGVHD at day +365 increased over the years at 22, 27, 36 and 43% respectively (p&lt;0.001). The rate of NRM significantly improved across the years, with 1-yr NRM at 31, 35, 40, 49, 22, 16 and 15% and 5-yr NRM at 45, 41, 52, 62, 35, 24 and 21% respectively, with a significant improvement seen since 2004 (p&lt;0.001, Figure 1d). Conclusion: Our study demonstrates significant improvement over the past several decades in survival in AML and MDS patients undergoing allo-SCT. Major factors that likely contribute to improvement in outcomes throughout the years include adjustments in conditioning regimens and GVHD prophylaxis, earlier recognition of complications as well as improved management, and improved general supportive care. Overall, while outcomes have improved significantly throughout the years, post-transplant relapses remains the leading cause of transplant failure in this group. Preventing relapse post-transplant represents a continued target for research today. Disclosures Chaudhry: Sanofi: Consultancy, Membership on an entity's Board of Directors or advisory committees. Bumma:Amgen: Speakers Bureau; Sanofi: Speakers Bureau. Khan:Amgen: Consultancy; Janssen: Consultancy. Devarakonda:Janssen: Consultancy. Vasu:Omeros: Membership on an entity's Board of Directors or advisory committees; Janssen: Membership on an entity's Board of Directors or advisory committees; Kiadis Inc: Other: Kiadis has obtained exclusive licensing requirements from The OHio State University. Jaglowski:CRISPR: Consultancy; Novartis: Consultancy, Research Funding; Juno: Consultancy; Kite, a Gilead Company: Consultancy, Research Funding. William:Kyowa Kirin: Consultancy, Honoraria; Celgene: Consultancy, Honoraria; Guidepoint Global: Consultancy; Incyte: Research Funding; Seattle Genetics: Research Funding; Merck: Research Funding; Dova: Research Funding. Mims:Novartis: Speakers Bureau; Agios: Consultancy; Leukemia and Lymphoma Society: Other: Senior Medical Director for Beat AML Study; Abbvie: Membership on an entity's Board of Directors or advisory committees; Kura Oncology: Membership on an entity's Board of Directors or advisory committees; Syndax Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees; Jazz Pharmaceuticals: Other: Data Safety Monitoring Board. Brammer:Seattle Genetics, Inc.: Speakers Bureau; Celgene Corporation: Research Funding. Efebera:Celgene: Research Funding; Pharmacyclics: Research Funding; Takeda: Honoraria, Speakers Bureau; Ohio State University: Current Employment.

Introduction: Clostridium difficile (C. difficile) is an anaerobic gram positive rod that colonizes 20-40 % of hospitalized patients and the most common cause of antibiotic-associated diarrhea. The clinical manifestations of C. difficile infection (CDI) range from asymptomatic carriage to severe fulminant infection, leading to bowel perforation and death. Stem cell transplantation (SCT) recipients are at risk of CDI due to prolonged neutropenia, use of broad-spectrum antibiotics, mucosal damage and changes in intestinal microbiota induced by cytotoxic chemotherapy, microbial co-infection and possibly graft-versus-host disease (GVHD). The incidence of CDI amongst patients undergoing autologous SCT varies between five and 15 % and among those undergoing allogenic SCT 12 and 34% in literature1-5. Some studies have found a strong association between CDI and GVHD, gut GVHD and/or severe GVHD1-4 but this was not universally demonstrated5. Many studies looking at CDI in the SCT setting are limited by the ubiquity of traditional risk factors for CDI and small sample sizes. Methods: In this retrospective observational study, we aimed to review the epidemiology and clinical management of CDI in our autologous and allogeneic SCT recipients and subsequent clinical outcomes including development of GVHD. All recipients of autologous and allogeneic SCT at Vancouver General Hospital over the 10-year period between January 1, 2008 and December 31, 2017, who had diarrhoea and at least one positive stool test for C. difficile toxin by polymerase chain reaction were eligible for inclusion. Patient demographics, transplant details including GVHD prophylaxis, treatment for CDI, complications from CDI and subsequent development of acute and chronic GVHD and survival outcomes were collected by means of review of their electronic and written clinical records. An ethics approval was obtained from the hospital ethics committee. Results: Out of the 2104 patients who underwent SCT during the study period, 277 (13.2%) had at least one episode of C. difficile positive diarrhea. The incidence was higher among recipients of allogeneic SCT (19.6%) compared to autologous SCT recipients (9.6%). The majority of the patients (86.7%) were treated with oral metronidazole as a first line therapy and 18.9% required a second line treatment, with oral vancomycin in most cases, due to persistent symptoms with toxin positivity. 21% had recurrence of CDI after an initial successful treatment and 9.4% had two or more recurrences. There was no death directly attributable to acute CDI and the rate of major complications was low. Two patients required an intensive care unit admission with fulminant CDI and one patient underwent bowel resection. 57% of allogeneic SCT patients with post-transplant CDI subsequently developed acute GVHD (45.8% grade 2 or higher acute GVHD, 34% gut GVHD). 60.6% developed chronic GVHD (46.9% moderate to severe GVHD, 19.2% gut chronic GVHD). The median progression free survival was 670.5 days (range 1-3938) and the overall survival time was 984.5 days (range 10-3938). The commonest cause of death was malignancy relapse. Conclusion: The incidence of CDI among autologous and allogeneic SCT recipients in British Columbia was 9.6% and 19.6% respectively. There was no death immediately attributable to CDI and few patients developed fulminant CDI. Of the SCT patients who had CDI, 57% and 60.6% subsequently developed acute and chronic GVHD respectively. References: Trifilio SM et al . Changing epidemiology of Clostridium difficile-associated disease during stem cell transplantation. Biol Blood Marrow Transplant. 2013;19: 405-409.Chakrabarti et al.Clostridium difficile infection in allogeneic stem cell recipients is associated with severe graft-versus-host disease and non-relapse mortality. Bone Marrow Transplant. 2000; 26(8):871-6.Alonso CD et al. Epidemiology and outcomes of Clostridium difficile infections in hematopoietic stem cell transplant recipients. Clinical Infectious Diseases. 2012;54(8):1053-63.Dubberke ER et al. Clostridium difficile-associated disease in allogeneic hematopoietic stem cell transplant recipients: risk associations, protective associations, and outcomes. Clin Transplant. 2010;24(2):192-198.Kinnebrew MA et al. Early Clostridium difficile infection during allogeneic hematopoietic stem cell transplantation. Plos ONE 2014; 9(3):e90158. Disclosures No relevant conflicts of interest to declare.

BackgroundThyroid dysfunction is a well known side effect of immune checkpoint blockade (ICB) and is one of the most common causes of immune-related adverse events (IRAE). The incidence varies with each individual therapy but generally estimated to be in the range between 6–18% per one study. Hypothyroidism and thyroiditis are the most common manifestations. Initial hyperthyroidism followed by hypothyroidism is another manifestation. Hypothyroidism is more common with an incidence of 10% whereas hyperthyroidism has an incidence of 5%. Less is known about the incidence of worsening thyroid dysfunction in patients with pre-existing thyroid dysfunction treated with ICB.MethodsA retrospective analysis was collected on 370 patients who received immunotherapy from April 2015 to April 2019. Of those, 212 had abnormal thyroid function tests. We analyzed a subgroup of these patients who had baseline thyroid dysfunction for worsening thyroid dysfunction after they were given ICB. Fifty-three patients were included in the analysis and had an abnormal baseline TSH at the start of immunotherapy. Type of immunotherapy, worst TSH, duration between initiation of immunotherapy to worst TSH, treatment type, and grade of abnormality as per Immune Checkpoint Inhibitor Related Adverse Events Common Terminology Criteria for Adverse Events (IRAE-CTCAE) were also recorded. Analysis was done for patients to compare likelihood of worsening TSH resulting in change in treatment for thyroid disorder.ResultsOf the identified patients (N=53) with abnormal TSH screening values outside of the institution’s normal reference range 0.35 - 4.95 uIU/ml, 45.7% (N=16) were hypothyroid and 54.3% (N=19) were hyperthyroid at baseline. Of those who were hypothyroid, 50% (N=8) had worsening TSH and 50% (N=8) had unchanged TSH during treatment. Of those who were hyperthyroid, 31.6% (N=6) had unchanged TSH, 52.6% (N=10) had worsened TSH, and 15.8% (N=3) had normalization of TSH compared to baseline. Overall 26.4% had worsening and of those 11.3% required treatment change.ConclusionsThyroid dysfunction is one of the most common IRAE’s associated with immune checkpoint inhibitors. Little is known about the impact of immunotherapy on patients with existing thyroid dysfunction. Patients who have underlying thyroid dysfunction are at an increased risk for worsening thyroid dysfunction with the use of ICB but though not unduly above the risk general population. Of those with change, only a modest percentage required an alteration of their endocrine therapy. Of interest, our data suggests a potential increased risk in patients with baseline hyperthyroidism compared to hypothyroidism which may be clinically relevant.Ethics ApprovalThe study was approved by ECU Brody School of Medicine Institution’s Ethics Board, approval number 19-000710.ReferencesBarroso-Sousa R, Barry WT, Garrido-Castro AC, et al. Incidence of Endocrine Dysfunction Following the Use of Different Immune Checkpoint Inhibitor Regimens: A Systematic Review and Meta-analysis. JAMA oncology. 2018;4:173–182.Fessas P, Possamai LA, Clark J, et al. Immunotoxicity from checkpoint inhibitor therapy: clinical features and underlying mechanisms. Immunology. 2019; 2020;159:167–177.Brody HM, Macherla S, Bulumulle A, Namireddy P, Cherry CR. The real-world incidence of immunotherapy-related thyroid dysfunction: A retrospective analysis of a single center’s experience over five years. Journal of clinical oncology. 2020;38:98–98.Iyer PC, Cabanillas ME, Waguespack SG, et al. Immune-Related Thyroiditis with Immune Checkpoint Inhibitors. Thyroid (New York, N.Y.). 2018;28:1243–1251.Presotto EM, Rastrelli G, Desideri I, et al. Endocrine toxicity in cancer patients treated with nivolumab or pembrolizumab: results of a large multicentre study. Journal of endocrinological investigation. 2019; 2020;43:337–345.Chalan P, Di Dalmazi G, Pani F, De Remigis A, Corsello A, Caturegli P. Thyroid dysfunctions secondary to cancer immunotherapy. Journal of endocrinological investigation. 2017; 2018;41:625–638.Mangla A, Paydary K, Yadav U, Liu J, Lad TE. Predictors and outcomes of thyroid dysfunction with immunotherapy: A single institution observational experience. Journal of clinical oncology. 2019;37:e14134-e14134.Basak EA, van der Meer, Jan W M, Hurkmans DP, et al. Overt Thyroid Dysfunction and Anti-Thyroid Antibodies Predict Response to Anti-PD-1 Immunotherapy in Cancer Patients. Thyroid (New York, N.Y.). 2020;30:966–973.Kassi E, Angelousi A, Asonitis N, et al. Endocrine-related adverse events associated with immune-checkpoint inhibitors in patients with melanoma. Cancer medicine (Malden, MA). 2019;8:6585–6594.

Background: BL is associated with a high risk of primary or secondary CNS involvement, warranting intrathecal (IT) and/or systemic therapy that penetrates the blood-brain barrier (BBB). The lower-intensity DA-EPOCH-R regimen has recently shown high survival rates in BL (Dunleavy, NEJM 2013), but it omits drugs traditionally used for CNS prophylaxis (like high-dose methotrexate [HDMTX]). The objective of this multi-institutional retrospective study was to examine treatments, risk factors, and CNS-related outcomes among patients (pts) with BL. Methods: We collected data from 26 US centers on adult BL pts diagnosed (dx) in 6/2009-6/2018. Using institutional expert pathology review and 2016 WHO criteria, we excluded other high-grade lymphomas (including BL-like/unclassifiable), or cases with inadequate clinicopathologic data. We studied factors associated with baseline CNS involvement (CNSinv) using logistic regression reporting odds ratios (OR). Progression-free (PFS), overall survival (OS), and cumulative incidence function of CNS recurrence (in a competing risk analysis) were examined in Cox or Fine-Gray models reporting hazard (HR) or subhazard ratios (SHR), respectively. All estimates report 95% confidence intervals (in square brackets). Results: Among 557 BL pts (median age, 47 years [yr], 24% women, 23% HIV+), 107 (19%) had CNSinv at dx, including 89 (16%) with leptomeningeal, and 15 (3%) with parenchymal CNS disease. In a multivariable model, factors significantly associated with CNSinv at dx included stage 3/4 (OR, 11.2 [1.47-85.9]), poor performance status (PS; OR, 2.12 [1.22-3.69]), ≥2 extranodal sites (OR, 3.77 [2.02-7.03]), or marrow involvement (OR, 2.44 [1.35-4.39]), whereas intestinal involvement conferred low risk of CNSinv (OR, 0.27 [0.11-0.65]). CNSinv at dx was not significantly associated with use of specific chemotherapy regimens (Fig. A,P=.75) or receipt of IT chemotherapy (91% vs 84%, P=.065). Pts with CNSinv were less likely to achieve a complete response (62% vs 76%, P=.005), had worse 3 yr PFS (47% vs 69%; P&lt;.001, Fig. B) and OS (52% vs 75%; P&lt;.001, Fig. C). However, these associations were not significant when adjusted for other prognostic factors (age ≥40y, poor PS, LDH&gt;3x upper limit of normal [LDH&gt;3x]; see Evens AM et al, ASH 2019 for further details). With median follow up of 3.6 yrs, 33 pts (6%) experienced a CNS recurrence (82% within 1 yr from dx; 79% purely in CNS, and 21% with concurrent systemic BL). The cumulative risk of CNS recurrence was 6% [4-8%] at 3y (Fig. D). Univariate significant predictors of CNS recurrence included baseline CNSinv, HIV+ status, stage 3/4, poor PS, LDH&gt;3x, involvement of ≥2 extranodal sites, marrow, or testis. However, in a multivariate model only baseline CNSinv (SHR, 3.35 [1.53-7.31]) and poor PS (SHR, 2.24 [1.03-4.90]) retained significance. The 3 yr risk of CNS recurrence varied from 3% for pts with no risk factor, to 10% with one, and 17% with both factors (Fig. E). In addition, the risk of CNS recurrence differed according to chemotherapy regimen, and was significantly higher for pts treated with DA-EPOCH (12% at 3y [8-18%]; Fig. F) compared with CODOX-M/IVAC (4% [2-8%]) or hyperCVAD/MA (3% [1-6%]; SHR for DA-EPOCH vs. others, 3.50 [1.69-7.22]). All pts recurring after DA-EPOCH had received IT chemotherapy. Higher risk of CNS recurrence persisted with DA-EPOCH regardless of baseline CNSinv (Pinteraction=.70), poor PS (Pint=.14), or HIV status (Pint=.89). Baseline CNSinv was the strongest factor associated with CNS recurrence after DA-EPOCH (3 yr risk, 30% vs 8%, P&lt;.001). Of 7 pts who received HDMTX with DA-EPOCH (6 with leptomeningeal CNSinv at dx), 3 (43%) experienced CNS recurrence. Median OS among all BL pts with CNS recurrence was 2.8 months [1.9-3.9] (Fig. G). After recurrence, 67% of pts received salvage systemic and 9% IT chemotherapy, 3% radiation, and 21% hospice care. Conclusions: In adult BL, baseline CNSinv and poor PS predicted subsequent CNS recurrence, an outcome that is associated with a dismal prognosis. Furthermore, treatment with DA-EPOCH was associated with a significantly increased risk of CNS recurrence in this real-world analysis. For BL pts with baseline CNSinv treated in routine clinical practice, regimens with highly BBB-penetrant drugs (e.g. CODOX-M/IVAC, hyperCVAD/MA) may be preferred. Studies should delineate ways to mitigate the risk of CNS recurrence with lower-intensity programs. Disclosures Evens: Seattle Genetics: Consultancy, Honoraria; Research to Practice: Honoraria; Verastem: Consultancy, Honoraria; Affimed: Consultancy, Honoraria; Pharmacyclics: Honoraria, Other: DMC; Bayer: Consultancy, Honoraria; Takeda: Research Funding; Merck: Research Funding. Smith:Incyte Corporation: Research Funding; Seattle Genetics: Research Funding; Portola Pharmaceuticals: Research Funding; Pharmacyclics: Research Funding; Acerta Pharma BV: Research Funding; AstraZeneca: Membership on an entity's Board of Directors or advisory committees, Research Funding; Genentech: Research Funding; Ignyta (spouse): Research Funding; Merck Sharp & Dohme Corp: Consultancy, Research Funding; Denovo Biopharma: Research Funding; Bristol-Myers Squibb (spouse): Research Funding; Ayala (spouse): Research Funding. Naik:Celgene: Other: Advisory board. Reddy:KITE Pharma: Consultancy; Abbvie: Consultancy; Genentech: Research Funding; BMS: Consultancy, Research Funding; Celgene: Consultancy. Farooq:Celgene: Honoraria; Kite Pharma: Research Funding. Epperla:Verastem Oncology: Speakers Bureau; Pharmacyclics: Honoraria. Khan:Seattle Genetics: Membership on an entity's Board of Directors or advisory committees; Janssen: Other: Educational Content/Symposium; Abbvie: Membership on an entity's Board of Directors or advisory committees; Bristol Myers: Other: Research Funds. Alderuccio:Puma Biotechnology: Other: Immediate family member; Agios: Other: Immediate family member; Inovio Pharmaceuticals: Other: Immediate family member; Targeted Oncology: Honoraria; OncLive: Consultancy; Foundation Medicine: Other: Immediate family member. Yazdy:Bayer: Honoraria; Genentech: Research Funding; Octapharma: Consultancy; Abbvie: Consultancy. Diefenbach:Bristol-Myers Squibb: Consultancy, Research Funding; Denovo: Research Funding; Genentech: Consultancy, Research Funding; Incyte: Research Funding; LAM Therapeutics: Research Funding; MEI: Research Funding; Merck: Consultancy, Research Funding; Seattle Genetics: Consultancy, Research Funding; Millenium/Takeda: Research Funding; Trillium: Research Funding. Karmali:Astrazeneca: Speakers Bureau; Takeda, BMS: Other: Research Funding to Institution; Gilead/Kite; Juno/Celgene: Consultancy, Speakers Bureau. Martin:Celgene: Consultancy; Teneobio: Consultancy; Karyopharm: Consultancy; Janssen: Consultancy; Sandoz: Consultancy; I-MAB: Consultancy. Magarelli:Tevan Oncology: Speakers Bureau. Kamdar:Seattle Genetics: Speakers Bureau; Pharmacyclics: Consultancy; AstraZeneca: Consultancy; Celgene: Consultancy; University of Colorado: Employment. Portell:Xencor: Research Funding; Roche/Genentech: Research Funding; Infinity: Research Funding; TG Therapeutics: Research Funding; AbbVie: Research Funding; Pharmacyclics: Consultancy; Janssen: Consultancy; Genentech: Consultancy, Research Funding; Amgen: Consultancy; Bayer: Consultancy; BeiGene: Consultancy, Research Funding; Kite: Consultancy, Research Funding; Acerta/AstraZeneca: Research Funding. Lossos:Janssen Scientific: Membership on an entity's Board of Directors or advisory committees; Seattle Genetics: Membership on an entity's Board of Directors or advisory committees; NIH: Research Funding. Olszewski:Genentech: Research Funding; Adaptive Biotechnologies: Research Funding; TG Therapeutics: Research Funding; Spectrum Pharmaceuticals: Research Funding.

This study aimed to explore the perceived barriers to physical activity among college students Study Design: Qualitative research design Eight focus group discussions on 67 college students aged 18-24 years (48 females, 19 males) was conducted on College premises. Data were analysed using inductive approach. Participants identified a number of obstacles to physical activity. Perceived barriers emerged from the analysis of the data addressed the different dimensions of the socio-ecological framework. The result indicated that the young adults perceived substantial amount of personal, social and environmental factors as barriers such as time constraint, tiredness, stress, family control, safety issues and much more. Understanding the barriers and overcoming the barriers at this stage will be valuable. Health professionals and researchers can use this information to design and implement interventions, strategies and policies to promote the participation in physical activity. This further can help the students to deal with those barriers and can help to instil the habit of regular physical activity in the later adult years.

The Acadian and Neoacadian orogenies are widely recognized, yet poorly understood, tectono-thermal events in the New England Appalachian Mountains (USA). We quantified two phases of Paleozoic crustal thickening using geochemical proxies. Acadian (425–400 Ma) crustal thickening to 40 km progressed from southeast to northwest. Neoacadian (400–380 Ma) crustal thickening was widely distributed and varied by 30 km (40–70 km) from north to south. Doubly thickened crust and paleoelevations of 5 km or more support the presence of an orogenic plateau at ca. 380–330 Ma in southern New England. Neoacadian crustal thicknesses show a strong correlation with metamorphic isograds, where higher metamorphic grade corresponds to greater paleo-crustal thickness. We suggest that the present metamorphic field gradient was exposed through erosion and orogenic collapse influenced by thermal, isostatic, and gravitational properties related to Neoacadian crustal thickness. Geobarometry in southern New England underestimates crustal thickness and exhumation, suggesting the crust was thinned by tectonic as well as erosional processes.

Three of the five thrust fault systems defining the boundaries of four lithotectonic terranes of the Himalaya and involved in controversies related to their positions and nomenclature, are the objects of discussion in this paper. Youngest of the five terrane-defining faults, the Himalayan Frontal Fault (HFF) is a series of reverse faults that demarcates the boundary of the Siwalik front of the Himalayan province with the alluvial expanse of the Indo-Gangetic Plains. Over large tracts, it is either concealed under younger sediments or has as yet not reached the ground surface and is therefore a blind fault. The nature of this frontal fault varies along its length. Where the hidden ridges of the Indo-Gangetic basement impinge the Himalaya, the mountain front is ruptured and the HFF is repeatedly reactivated. In the sectors intervening these ridges, it is not expressed on the surface, but the ground of the adjoining Indo-Gangetic Plain is sinking, the rivers are shifting their courses and large tracts of land are waterlogged and characterized by The Vaikrita Thrust is the plane that marks pronounced metamorphic break and abrupt change in style and orientation of structures within the succession of crystalline rocks that build the bulk of the snowy ranges in the Kumaun Himalaya. Not only is there a jump of pressure of the order of 4 kb and a temperature rise of >200 oC, but also is there a conspicuous change of neodymium isotope value across the tectonic plane that separates the low-grade metarnorphics in the lower part from the high-grade metamorphic rocks of the upper part of the Great Himalayan succession. The Vaikrita Thrust is therefore recognised as the Main Central Thrust (MCT). While the basal low-grade metamorphic assemblage comprises 1900±100 Ma old highly tectonised porphyritic granite characterised by low initial strontium isotope ratio, the upper high -grade metamorphic group is intruded by 20±1 Ma old anatectic granites characterised by garnet, kyanite, sillimanite and cordierite, and a high but variable value of strontium isotope ratio. Moreover, the anatectic Lower Miocene granites are singularly absent in the succession of the Lesser Himalayan nappes. Probably it is this thrust that has flexed downwards the plane of decoupling and displacement between the under thrusting Indian plate and the overlying Himalayan mass. The terrane-defining fault between the high-grade metamorphics with granitic rocks of the Himadri (i.e., Great Himalaya) and the Tethyan sedimentary pile was recognised as the Malari Thrust Fault in the northern Kumaun Himalaya in the early seventies, as the South Tibetan Detachment System in southern Tibet adjoining north-eastern Nepal in the early eighties and as the Zanskar Shear Zone in north-western Himachal Pradesh in the late eighties. Not only is there an abrupt change in the metamorphic grade across the tectonic plane, but also an attenuation and wholesale elimination of some lithostratigraphic formations of the hanging wall besides the difference in the style of deformation. Exhibiting predominant dip-slip movement in the central sector of the Himalayan arc, the Trans-Himadri Fault (T-HF) was formed as a consequence of the Tethyan sedimentary cover detaching from its rigid foundation of the basement complex that was squeezed up following blocking or slowing down of tectonic movements related to India-Asia convergence. The sedimentary cover lagging behind the thrust­ up basement complex slid down and toppled over northward and gave rise to back-folds and back-thrusts. In Kashmir, western Himachal Pradesh, central Nepal and north-western Bhutan, in sharp contrast, there was very strong compression, so that the Tethyan sedimentary rocks-along with a slice of the low-grade metamorphic basement in the hanging wall advanced southwards across the Himadri and were emplaced as nappes and klippen south of the Main Central Thrust. The T-HF movement occurred approximately around 20.9 Ma, although the movement had started quite earlier in some places. Quaternary reactivation resulted in river ponding and development of huge lakes such as the Garbyang palaeolake in the Kali valley and the ~ 40,000 year-old Goting palaeolake in the Western Dhauli Valley.

Wenyu River is the “mother river” in Beijing. In recent years, the research on the water quality of the Wenyu River has increased gradually. In this paper, the monitoring data at Shahe Reservoir, Lu Tuan Gate, Xin Bao Gate, and Ma Fang sections for each month in 2019 were adopted. The single-factor evaluation method and the comprehensive pollution index method were selected to analyze the current situation of the water quality of Wenyu River in the Chang Ping section and its temporal and spatial variation trend. The single factor evaluation method showed that the dissolved oxygen exceeded the standard seriously in all other months of the year except that the situation was better in May, June, and July. The ammonia nitrogen content reached the highest level in January, followed by a month-by-month decreasing trend. After June, each section basically met the requirements of Class v water quality. The comprehensive pollution index method shows that the water quality of Shahe reservoir varies greatly throughout the year, and it is in grade v for 6 months. The evaluation results of both methods show that the water quality of all sections of Wenyu River in 2019 was mostly in category v.

Introdução: Os odontomas são tumores odontogênicos benignos e os mais frequentes dos maxilares. Usualmente estão associados à dentição permanente em crianças e adultos jovens, sendo geralmente assintomáticos, podendo causar impactação dental. O aspecto radiográfico é de múltiplas calcificações, semelhantes ao dente, circundadas por um estreito halo radiolúcido, sendo o diagnóstico feito através de exames radiográficos de rotina. Objetivo: Este trabalho teve como objetivo relatar a remoção cirúrgica de um odontoma composto em região anterior da maxila, associado a dentes impactados, em um paciente pediátrico. Relato do caso clínico: Paciente do sexo masculino, 12 anos, foi referido ao serviço de cirurgia oral da Universidade Federal de Campina Grande, Campus Patos – PB, encaminhado pelo ortodontista. Durante anamnese não foram constatados comprometimento sistêmico. Ao exame físico foi observado abaulamento na região maxilar esquerda e retenção prolongada de alguns elementos, como também a ausência de outros. Analisada a radiografia panorâmica, foi observada massa radiopaca, na região anterior da maxila, sugestiva de odontoma composto, com impactação dental. Em decorrência da proximidade da lesão com os dentes anteriores superiores impactados e da localização do elemento 21, foi feita tomografia computadorizada por feixe cônico, o que facilitou o planejamento cirúrgico. O procedimento foi realizado sem intercorrências e no pós-operatório tardio, o paciente evolui satisfatoriamente. Conclusão: Pode-se concluir que o tratamento proposto foi eficaz e que a tomografia computadorizada por feixe cônico é um exame complementar de grande valia no diagnóstico de patologias, assim como no planejamento cirúrgico, devido à alta resolução e precisão das imagens obtidas.Descritores: Tumores Odontogênicos; Odontoma; Tomografia Computadorizada de Feixe Cônico.ReferênciasJayam C, Bandlapalli A, Patel N, Choudhary RS. A case of impacted central incisor due to dentigerous cyst associated with impacted compound odontome. BMJ Case Rep. 2014;2014:bcr2013202447.Abrahams JM, McClure SA. Pediatric Odontogenic Tumors. Oral Maxillofac Surg Clin North Am. 2016;28(1):45-58.Angiero F, Benedicenti S, Parker S, Signore A, Sorrenti E, Giacometti E et al. Clinical and surgical management of odontoma. Photomed Laser Surg. 2014;32(1):47-53.Neville BW, Damm DD, Allen CM, Bouquot JE. Patologia oral e maxilofacial. 4.ed. Rio de Janeiro: Elsevier, 2016.Bereket C, Çakır-Özkan N, Şener İ, Bulut E, Tek M. Complex and compound odontomas: Analysis of 69 cases and a rare case of erupted compound odontoma. Niger J Clin Pract. 2015;18(6):726-30. Malamed SF. Manual de anestesia local. 6. ed. Rio de Janeiro: Elsevier, 2013.Soluk Tekkesin M, Tuna EB, Olgac V, Aksakallı N, Alatlı C. Odontogenic lesions in a pediatric population: Review of the literature and presentation of 745 cases. Int J Pediatr Otorhinolaryngol. 2016;86:196-99.Wang YL, Chang HH, Chang JY, Huang GF, Guo MK. Retrospective survey of biopsied oral lesions in pediatric patients. J Formos Med Assoc. 2009;108(11):862-71.Al-Khateeb T, Al-Hadi Hamasha A, Almasri NM. Oral and maxillofacial tumours in north Jordanian children and adolescents: a retrospective analysis over 10 years. Int J Oral Maxillofac Surg. 2003;32(1):78-83.Guerrisi M, Piloni MJ, Keszler A. Odontogenic tumors in children and adolescents. A 15-year retrospective study in Argentina. Med Oral Patol Oral Cir Bucal. 2007;12(3):E180-85.Lima GS, Fontes ST, Araújo LMA, Etges A, Tarquinio SBC, Gomes APN. A survey of oral and maxillofacial biopsies in children: a single-center retrospective study of 20 years in Pelotas-Brazil. J Appl Oral Sci. 2008;16(6):397-402.Bernardes VF, Cota LOM, Costa FO, Mesquita RA, Gomez RS, Aguiar MCF. Gingival peripheral odontoma in child: case report of an uncommon lesion. Braz J Oral Sci. 2008;7(26):1624-26.Silva AR, Carlos-Bregni R, Vargas PA, de Almeida OP, Lopes MA. Peripheral developing odontoma in newborn. Report of two cases and literature review. Med Oral Patol Oral Cir Bucal. 2009;14(11):e612-15.Owens BM, Schuman NJ, Pliske TA, Culley WL. Compound composite odontoma associated with an impacted cuspid. J Clin Pediatr Dent. 1995; 19(4):293-95.Cildir SK, Sencift K, Olgac V, Sandalli N. Delayed eruption of a mandibular primary cuspid associated with compound odontoma. J Contemp Dent Pract. 2005;6(4):152-59.Altay MA, Ozgur B, Cehreli ZC. Management of a compound odontoma in the primary dentition. J Dent Child. 2016;83(2):98-101.Freires JFV. Remoção cirúrgica de odontoma composto de grande proporção sob anestesia local: relato de caso [monografia]. Patos (PB): Curso de Bacharelado em Odontologia, Universidade Federal de Campina Grande; 2017.Kignel S. Estomatologia – bases do diagnóstico para o clínico geral. 2.ed. São Paulo: Santos; 2013.Bilodeau EA, Collins BM. Odontogenic Cysts and Neoplasms. Surg Pathol Clin. 2017;10(1):177-22.Ladeinde AL, Ajayi OF, Ogunlewe MO, et al. Odontogenic tumors: a review of 319 cases in a Nigerian teaching hospital. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99(2):191-95.Chang JY, Wang JT, Wang YP, Liu BY, Sun A, Chiang CP. Odontoma: a clinicopathologic study of 81 cases. J Formos Med Assoc. 2003;102(12):876-82.Vázquez-Diego J, Gandini Pablo C, Carbajal Eduardo E. Odontoma compuesto: Diagnóstico radiográfico y tratamento quirúrgico de um caso clínico. Av Odontoestomatol. 2008;24(5):307-12.Teruhisa U, Murakami J, Hisatomi M, Yanagi Y, Asaumi J. A case of unerupted lower primary second molar associated with compound odontoma. Open Dent J. 2009;3:173-76.

Introdução: O restabelecimento de um sorriso harmônico constitui um grande desafio para a odontologia restauradora. A sincronia entre diversas especialidades se faz necessária para diagnosticar e tratar alterações estéticas, buscando a excelência do resultado e a satisfação do paciente. Um método bastante citado na literatura e aplicado por muitos clínicos é baseado na teoria da regra de proporção áurea. Quando adotada para situações complexas a proporção áurea pode ser um ponto de referência para a reabilitação. Deste modo, o trabalho tem como objetivo demonstrar uma reabilitação estética de diastemas múltiplos após tratamento ortodôntico, por meio de laminados vitrocerâmicos reforçados com dissilicato de lítio, onde o conceito de proporção áurea é aplicado. Descrição do caso clínico: Primeiramente, o plano de tratamento consistiu na distribuição uniforme dos diastemas, sendo posicionados da maneira mais harmônica e favorável para a oclusão na reabilitação com laminados vitrocerâmicos. A segunda fase consistiu na cimentação dos laminados, a fim de obter um resultado estético agradável. Discussão: A associação de ortodontia prévia a instalação dos laminados, permite uma melhor harmonia estética e oclusal, garantindo uma longevidade do tratamento. Opções restauradoras como laminados vitrocerâmicos reforçados com dissilicato de lítio permitem reabilitações extensas minimamente invasivas. Para casos complexos a proporção áurea, quando alinhada com os conceitos de macro e microestética, pode levar ao sucesso estético.Descritores: Estética Dentária; Facetas Dentárias; Diastema.ReferênciasSoares GP, Silva FAP, Lima DANL, Paulillo LAMS, Lovadino JR. Prevalência da proporção áurea em indivíduos adultos-jovens. Rev odonto ciênc. 2006;21:346-50.Higashi C, Amaral RC, Hilgenberg SP, Gomes JC, Hirata R, Loguercio R, et al. Finalização estética em dentes anteriores pós tratamento ortodôntico: relato de caso clínico. Int J Bras Dent. 2007;3:388-98.Kalia A, Mirdehghan N, Khandekar S, Patil W. Multi-disciplinary approach for enhancing orthodontic esthetics - case report. Clin Cosmet Investig Dent. 2015;13:83-9.Otani T, Raigrodski AJ, Mancl L, Kanuma I, Rosen J. In vitro evaluation of accuracy and precision of automated robotic tooth preparation system for porcelain laminate veneers. J Prosthet Dent. 2015;114:229-35.BaratierI LN. Estética: restaurações adesivas diretas em dentes anteriores fraturados. São Paulo: Santos Editora; 1998.Levin, EI. Dental esthetics and the golden proportion. J Prosthet Dent. 1978;3:244-52.Siqueira PM, Nahsan FPS, Naufel FS, Formighieri LA, Schmitt VL. Incidência da proporção áurea regressiva após tratamento ortodôntico. Rev Odontol Bras Central. 2012;21:515-18.Melo GFB, Menezes Filho PFM. Proporção áurea e sua relevância para a odontologia estética. Int J Dent. 2008;7:234-238.Oliveira VLR. Estudo da proporção áurea entre incisivos centrais. SOTAU R. Virtual Odontol. 2008;5:2-6.Proffit W, Fields HW, Sarver DM. Contemporary orthodontics Fourth edition. Oxford: Elsevier Health Sciences; 2006.Moon JE. Esthetic restorations of maxillary anterior teeth with orthodontic treatment and porcelain laminate veneers: a case report. J Adv Prosthodont. 2010;2:61-63.Keene HJ. Distribution of diastemas in the dentition of man. Am J Phys Anthropol. 1963;21:437-41.Nagalakshmi S, Sathish R, Priya K, Dhayanithi D. Changes in quality of life during orthodontic correction of midline diastema. J Pharm Bioallied Sci. 2014;6:162-64.Jacobson N, Frank CA. The myth of instant orthodontics: an ethical quandary. J Am Dent Assoc. 2008;139:224-34.Bona AD. Bonding to ceramics: scientific evidences for clinical dentistry. São Paulo: Artes Médicas; 2009. p. 91-132.Griggs JA. Recent advances in materials for all-ceramic restorations. Dent Clin North Am. 2007;51:713-27.Gurel G, Sesma N, Calamita MA, Coachman C, Morimoto S. Influence of enamel preservation on failure rates of porcelain laminate veneers. Int J Periodontics Restorative Dent 2013;33:31-9.Vargas MA, Bergeron C, Diaz-Arnold A. Cementing all-ceramic restorations: recommendations for success. J Am Dent Assoc. 2011;142:20-24.Runnacles P, Correr GM, Baratto Filho F, Gonzaga CC, Furuse AY. Degree of conversion of a resin cement light-cured through ceramic veneers of different thicknesses and types. Braz Dent J. 2014; 25:38-42.Almeida JR, Schmitt GU, Kaizer MR, Boscato N, Moraes RR. Resin-based luting agents and color stability of bonded ceramic veneers. J Prosthet Dent. 2015;114:272-77.Marubayashi AMW, Shinike, AY, Terada, HH, Kurihara, E, Terada RSS. Avaliação da proporção áurea em pacientes submetidos ou não a tratamento ortodôntico. Rev Dental Press Estét. 2010;7:72-80.Morley J1, Eubank J. Macroesthetic elements of smile design. J Am Dent Assoc. 2001;132:39-45.Johnston CD, Burden DJ, Stevenson MR. The influence of dental to facial midline discrepancies on dental attractiveness ratings. Eur J Orthod. 1999;21:517-22.Kokich VO Jr, Kiyak HA, Shapiro PA. Comparing the perception of dentists and lay people to altered dental esthetics. J Esthet Dent. 1999;11:311-24.

Introdução: Atualmente, os índices do edentulismo diminuíram, embora a preocupação pela reabilitação dentária aumentaram, o que gera foco de estudos sobre as expectativas que essa população procura os serviços dessa área da odontologia. Objetivo: O objetivo deste estudo foi fazer uma revisão de literatura sobre os impactos psicossociais que a estética dentária pode causar na qualidade de vida de sujeitos que são submetidos a próteses convencionais e sobre implantes. Método: Foram selecionados artigos disponíveis na base de dados MEDLINE (Medical Literature Analysis and Retrieval System on-line) publicados em inglês, no período compreendido entre 2008-2018; Resultados: Os principais resultados encontrados foi que a estética dentária tem influência direta na autoestima e por isso os indivíduos sofrem com uma barreira pessoal e profissional, manifestando negativamente na sua qualidade de vida. Porém, população que são reabilitados com próteses sobre implantes parece ter maior preocupação com sua estética e por isso sofreram mais com depressão, ao passo que isso aumenta quando se trata de dentes posicionados anteriormente na arcada dentária. Conclusão: Conclui-se que a estética dentária influencia psicossocialmente em um indivíduo, causando impactos na qualidade de vida de edêntulos, além disso, há diferenças psicológicas na população que busca reabilitação com próteses convencionais e implantossuportadas e a posição que os dentes perdidos ocupavam no arco dentário.Descritores: Próteses e Implantes; Estética Dentária; Qualidade de Vida.ReferênciasGavric A, Mirceta D, Jakobovic M, Pavlic A, Zrinski MT, Spalj S. Cranio dento facial characteristics, dental esthetics–related quality of life, and self-esteem. Am J Orthod Dentofacial Orthop. 2015;147(6):711-18.Fava J, Lin M, Zahran M, Jokstad A. Single implant‐supported crowns in the aesthetic zone: patient satisfaction with aesthetic appearance compared with appraisals by laypeople and dentists. Clin Oral implants Res. 2015;26(10): 1113-20.de Couto Nascimento V, de Castro Ferreira Conti AC, de Almeida Cardoso M, Valarelli DP, de Almeida-Pedrin RR. Impact of orthodontic treatment on self-esteem and quality of life of adult patients requiring oral rehabilitation. Angle Orthod. 2016;86(5):883-85.Pereira CP, Abreu LG, Dickc BD, de Luca Canto G, Paiva SM, Flores-Mir C. Patient satisfaction after orthodontic treatment combined with orthognathic surgery: A systematic review. Angle Orthod. 2016;86(3):495-508.Chen P, Yu S, Zhu G. The psychosocial impacts of implantation on the dental aesthetics of missing anterior teeth patients. Br Dent J. 2012; 213(11):E20Benic GI, Wolleb K, Sancho-Puchades M, Hämmerle CH. Systematic review of parameters and methods for the professional assessment of aesthetics in dental implant research. Clin Oral implants Res. 2012; 39(Suppl 12):160-92.Peñarrocha MA, Carrillo C, Boronat A, Martí EM. Level of satisfaction in patients with maxillary mull-arch fixed protheses: zigomatic versus convencional implants. Int J Oral Maxillofac Implants. 2007; 22(5):769-73.Benson PE, Da'as T, Johal A, Mandall NA, Williams AC, Baker SR et al. Relationships between dental appearance, selfesteem, socio-economic status, and oral healthrelated quality of life in UK schoolchildren: A 3-year cohort study. Eur J Orthod. 2015;37(5):481-90.Alzarea B. Oral health related quality-of-life outcomes of partially edentulous patients treated with implant-supported single crowns or fixed partial dentures J Clin Exp Dent. 2017;9(5):666-71.Frejmant MW, Vargas IA, Rösing CK, Closs LQ. Dentofacial deformities are associated with lower degrees of self-esteem and higher impact on oral health-related quality of life: results from na observational study involving adults. J Oral Maxillofac Surg.2013;71(4):763-67.Rotundo R, Nieri M, Bonaccini D, Mori M, Lamberti E, Massironi D et al. The Smile Esthetic Index (SEI): a method to measure the esthetics of the smile. an intra-rater and inter-rater agreement study. Eur J Oral Implantol.2015; 8(4):397-403.Clijmans M, Lemiere J, Fieuws S, Willems G. Impact of self-esteem and personality traits on the association between orthodontic treatment need and oral health-related quality of life in adults seeking orthodontic treatment. Eur J Orthod. 2015;37(6):643-50.Cardoso RG, Melo LA, Barbosa GA, Calderon PD, Germano AR, Mestriner W Junior et al. Impact of mandibular conventional denture and overdenture on quality of life and masticatory efficiency. Braz Oral Res. 2016;30(1):e102.Perillo L, Esposito M, Caprioglio A, Attanasio S, Santini AC, Carotenuto M. Orthodontic treatment need for adolescents in the Campania region: the malocclusion impact on self-concept. Patient Prefer Adherence. 2014;8:353-59.Patel P, Brown S, Nazarian A. A better quality of life with implant-retained overdentures. Dent Today. 2012;31(1):156,158.Torres BL, Costa FO, Modena CM, Cota LO, Côrtes MI, Seraidarian PI. Association between personality traits and quality oflife in patients treated with conventional mandibular dentures or implant-supported overdentures. J Oral Rehabil. 2011;38(6):454-61.Al-Omiri MK, Hammad OA, Lynch E, Lamey PJ, Clifford TJ. Impacts of implant treatment on daily living. Int Oral Maxillofac Implants. 2011; 26(4):877-86.Fernandez-Estevan LF, Selva-Otaolaurruchi EJ, Montero J, Sola-Ruiz F. Oral health-related quality of life of implant-supported overdentures versus conventional complete prostheses: Retrospective study of a cohort of edentulous patients. Med Oral Patol Oral Cir Bucal. 2015;20(4):e450-58.Komagamine Y, Kanazawa M, Kaiba Y, Sato Y, Minakuchi S, Sasaki Y. Association between self‐assessment of complete dentures and oral health-related quality of life. J Oral Rehabil. 2012; 39(11):847-57.Mukatash GN, Al-Rousan M, Al-Sakarna B. Needs and demands of prosthetic treatment among two groups of individuals. Indian J Dent Res. 2010;21(4):564-67.Gerritsen AE, Allen PF, Witter DJ, Bronkhorst EM, Creugers NH. Toothlossand oral health-related quality of life: a systematic review and meta-analysis. Health Qual Life Outcomes. 2010;8:126.Kershaw S, Newton JT, Williams DM. The influence of tooth colour on the perception sofpersona lcharacteristics among female dental patients: comparisons of unmodified, decayedand 'whitened' teeth. Br Dent J. 2008;204(5):E9.Towfighi PP, Brunsvold MA, Storey AT, Arnold RM, Willman DE, McMahan CA. Pathologic migration of anterior teeth in patients with moderate to severe periodontitis. J Periodontol. 1997;68(10):967-72.Tatum RC, Tatum BM, Marfatia-Rege AT, Amant KS. Immediate esthetic treatment for anterior teeth: reportof cases. J Am Dent Assoc. 1989; 118(5):575-77.Kapur A, Chawla HS, Goyal A, Gaube K. An esthetic point of view in very young children. J Clin Pediatr Dent.2005; 30(2):99-103.Ponsi J, Lahti S, Rissanen H, Oikarinen K. Change in subjective oral healthafter single dental implanttreatment. Int J Oral Maxillofac Implants. 2011; 26(3):571-77.Shaw WC. Factors influencing the desire for ortho­dontic treatment. Eur J Orthod. 1981;3(3):151-62.Sheats RD, McGorray SP, Keeling SD, Wheeler TT, King GJ. Occlusal traits and perceptionof ortho­dontic need in eighth grade students. Angle Orthod.1998;68(2):107-14.Al-Omiri MK, Karasneh JA, Lynch E, Lamey PJ, Clifford TJ. Impacts of missin gupper anterior teeth on daily living. Int Dent J.2009;59(3):127-32.Carlsson GE, Johansson A, Johansson AK, Ordell S, Ekbäck G, Unell L. Attitudes toward dental appear­ance in 50‑and 60‑year‑old subjects living in Sweden. J Esthet Restor Dent. 2008; 20(1):46-55.Xiao J, Zhou X, Zhu WD, Zhang B, Li JY, Xu X. The prevalence of tooth discolouration and the self-satisfaction with tooth colour in a Chinese urban population. J Oral Rehabil. 2007; 34(5):351-60.Akarslan ZZ, Sadik B, Erten H, Karabulut E. Dental esthetic satisfaction, received and desired dental treatments for improvement of esthetics. Indian J Dent Res. 2009; 20(2):195-200.Wang SW, Repetti RL, Campos B. Job stress andfamily social behavior: themoderating role ofneu­roticism. J Occup Health Psychol. 2011; 16(4):441-56.Samorodnitzky-Naveh GR, Geiger SB, Levin L. Patients’ satisfactionwith dental esthetics. J Am Dent Assoc. 2007;138(6):805-8.Hassel A, Wegener I, Rolko C, Nitschke I. Self-rating of satisfaction with dental appearance in anelderly German population. Int Dent J. 2008; 58(2):98-102.Tin-Oo MM, Saddki N, Hassan N. Factors influenc­ing patient satisfaction with dental appearance and treatments they desire to improve aesthetics. BMC Oral Health.2011;11:6.

Connecting I’ve moved house on the weekend, closer to the centre of an Australian capital city. I had recently signed up for broadband, with a major Australian Internet company (my first contact, cf. Turner). Now I am the proud owner of a larger modem than I have ever owned: a white cable modem. I gaze out into our new street: two thick black cables cosseted in silver wire. I am relieved. My new home is located in one of those streets, double-cabled by Telstra and Optus in the data-rush of the mid-1990s. Otherwise, I’d be moth-balling the cable modem, and the thrill of my data percolating down coaxial cable. And it would be off to the computer supermarket to buy an ASDL modem, then to pick a provider, to squeeze some twenty-first century connectivity out of old copper (the phone network our grandparents and great-grandparents built). If I still lived in the country, or the outskirts of the city, or anywhere else more than four kilometres from the phone exchange, and somewhere that cable pay TV will never reach, it would be a dish for me — satellite. Our digital lives are premised upon infrastructure, the networks through which we shape what we do, fashion the meanings of our customs and practices, and exchange signs with others. Infrastructure is not simply the material or the technical (Lamberton), but it is the dense, fibrous knotting together of social visions, cultural resources, individual desires, and connections. No more can one easily discern between ‘society’ and ‘technology’, ‘carriage’ and ‘content’, ‘base’ and ‘superstructure’, or ‘infrastructure’ and ‘applications’ (or ‘services’ or ‘content’). To understand telecommunications in action, or the vectors of fibre, we need to consider the long and heterogeneous list of links among different human and non-human actors — the long networks, to take Bruno Latour’s evocative concept, that confect our broadband networks (Latour). The co-ordinates of our infrastructure still build on a century-long history of telecommunications networks, on the nineteenth-century centrality of telegraphy preceding this, and on the histories of the public and private so inscribed. Yet we are in the midst of a long, slow dismantling of the posts-telegraph-telephone (PTT) model of the monopoly carrier for each nation that dominated the twentieth century, with its deep colonial foundations. Instead our New World Information and Communication Order is not the decolonising UNESCO vision of the late 1970s and early 1980s (MacBride, Maitland). Rather it is the neoliberal, free trade, market access model, its symbol the 1984 US judicial decision to require the break-up of AT&T and the UK legislation in the same year that underpinned the Thatcherite twin move to privatize British Telecom and introduce telecommunications competition. Between 1984 and 1999, 110 telecommunications companies were privatized, and the ‘acquisition of privatized PTOs [public telecommunications operators] by European and American operators does follow colonial lines’ (Winseck 396; see also Mody, Bauer & Straubhaar). The competitive market has now been uneasily installed as the paradigm for convergent communications networks, not least with the World Trade Organisation’s 1994 General Agreement on Trade in Services and Annex on Telecommunications. As the citizen is recast as consumer and customer (Goggin, ‘Citizens and Beyond’), we rethink our cultural and political axioms as well as the axes that orient our understandings in this area. Information might travel close to the speed of light, and we might fantasise about optical fibre to the home (or pillow), but our terrain, our band where the struggle lies today, is narrower than we wish. Begging for broadband, it seems, is a long way from warchalking for WiFi. Policy Circuits The dreary everyday business of getting connected plugs the individual netizen into a tangled mess of policy circuits, as much as tricky network negotiations. Broadband in mid-2003 in Australia is a curious chimera, welded together from a patchwork of technologies, old and newer communications industries, emerging economies and patterns of use. Broadband conjures up grander visions, however, of communication and cultural cornucopia. Broadband is high-speed, high-bandwidth, ‘always-on’, networked communications. People can send and receive video, engage in multimedia exchanges of all sorts, make the most of online education, realise the vision of home-based work and trading, have access to telemedicine, and entertainment. Broadband really entered the lexicon with the mass takeup of the Internet in the early to mid-1990s, and with the debates about something called the ‘information superhighway’. The rise of the Internet, the deregulation of telecommunications, and the involuted convergence of communications and media technologies saw broadband positioned at the centre of policy debates nearly a decade ago. In 1993-1994, Australia had its Broadband Services Expert Group (BSEG), established by the then Labor government. The BSEG was charged with inquiring into ‘issues relating to the delivery of broadband services to homes, schools and businesses’. Stung by criticisms of elite composition (a narrow membership, with only one woman among its twelve members, and no consumer or citizen group representation), the BSEG was prompted into wider public discussion and consultation (Goggin & Newell). The then Bureau of Transport and Communications Economics (BTCE), since transmogrified into the Communications Research Unit of the Department of Communications, Information Technology and the Arts (DCITA), conducted its large-scale Communications Futures Project (BTCE and Luck). The BSEG Final report posed the question starkly: As a society we have choices to make. If we ignore the opportunities we run the risk of being left behind as other countries introduce new services and make themselves more competitive: we will become consumers of other countries’ content, culture and technologies rather than our own. Or we could adopt new technologies at any cost…This report puts forward a different approach, one based on developing a new, user-oriented strategy for communications. The emphasis will be on communication among people... (BSEG v) The BSEG proposed a ‘National Strategy for New Communications Networks’ based on three aspects: education and community access, industry development, and the role of government (BSEG x). Ironically, while the nation, or at least its policy elites, pondered the weighty question of broadband, Australia’s two largest telcos were doing it. The commercial decision of Telstra/Foxtel and Optus Vision, and their various television partners, was to nail their colours (black) to the mast, or rather telegraph pole, and to lay cable in the major capital cities. In fact, they duplicated the infrastructure in cities such as Sydney and Melbourne, then deciding it would not be profitable to cable up even regional centres, let alone small country towns or settlements. As Terry Flew and Christina Spurgeon observe: This wasteful duplication contrasted with many other parts of the country that would never have access to this infrastructure, or to the social and economic benefits that it was perceived to deliver. (Flew & Spurgeon 72) The implications of this decision for Australia’s telecommunications and television were profound, but there was little, if any, public input into this. Then Minister Michael Lee was very proud of his anti-siphoning list of programs, such as national sporting events, that would remain on free-to-air television rather than screen on pay, but was unwilling, or unable, to develop policy on broadband and pay TV cable infrastructure (on the ironies of Australia’s television history, see Given’s masterly account). During this period also, it may be remembered, Australia’s Internet was being passed into private hands, with the tendering out of AARNET (see Spurgeon for discussion). No such national strategy on broadband really emerged in the intervening years, nor has the market provided integrated, accessible broadband services. In 1997, landmark telecommunications legislation was enacted that provided a comprehensive framework for competition in telecommunications, as well as consolidating and extending consumer protection, universal service, customer service standards, and other reforms (CLC). Carrier and reseller competition had commenced in 1991, and the 1997 legislation gave it further impetus. Effective competition is now well established in long distance telephone markets, and in mobiles. Rivalrous competition exists in the market for local-call services, though viable alternatives to Telstra’s dominance are still few (Fels). Broadband too is an area where there is symbolic rivalry rather than effective competition. This is most visible in advertised ADSL offerings in large cities, yet most of the infrastructure for these services is comprised by Telstra’s copper, fixed-line network. Facilities-based duopoly competition exists principally where Telstra/Foxtel and Optus cable networks have been laid, though there are quite a number of ventures underway by regional telcos, power companies, and, most substantial perhaps, the ACT government’s TransACT broadband network. Policymakers and industry have been greatly concerned about what they see as slow takeup of broadband, compared to other countries, and by barriers to broadband competition and access to ‘bottleneck’ facilities (such as Telstra or Optus’s networks) by potential competitors. The government has alternated between trying to talk up broadband benefits and rates of take up and recognising the real difficulties Australia faces as a large country with a relative small and dispersed population. In March 2003, Minister Alston directed the ACCC to implement new monitoring and reporting arrangements on competition in the broadband industry. A key site for discussion of these matters has been the competition policy institution, the Australian Competition and Consumer Commission, and its various inquiries, reports, and considerations (consult ACCC’s telecommunications homepage at http://www.accc.gov.au/telco/fs-telecom.htm). Another key site has been the Productivity Commission (http://www.pc.gov.au), while a third is the National Office on the Information Economy (NOIE - http://www.noie.gov.au/projects/access/access/broadband1.htm). Others have questioned whether even the most perfectly competitive market in broadband will actually provide access to citizens and consumers. A great deal of work on this issue has been undertaken by DCITA, NOIE, the regulators, and industry bodies, not to mention consumer and public interest groups. Since 1997, there have been a number of governmental inquiries undertaken or in progress concerning the takeup of broadband and networked new media (for example, a House of Representatives Wireless Broadband Inquiry), as well as important inquiries into the still most strategically important of Australia’s companies in this area, Telstra. Much of this effort on an ersatz broadband policy has been piecemeal and fragmented. There are fundamental difficulties with the large size of the Australian continent and its harsh terrain, the small size of the Australian market, the number of providers, and the dominant position effectively still held by Telstra, as well as Singtel Optus (Optus’s previous overseas investors included Cable & Wireless and Bell South), and the larger telecommunications and Internet companies (such as Ozemail). Many consumers living in metropolitan Australia still face real difficulties in realising the slogan ‘bandwidth for all’, but the situation in parts of rural Australia is far worse. Satellite ‘broadband’ solutions are available, through Telstra Countrywide or other providers, but these offer limited two-way interactivity. Data can be received at reasonable speeds (though at far lower data rates than how ‘broadband’ used to be defined), but can only be sent at far slower rates (Goggin, Rural Communities Online). The cultural implications of these digital constraints may well be considerable. Computer gamers, for instance, are frustrated by slow return paths. In this light, the final report of the January 2003 Broadband Advisory Group (BAG) is very timely. The BAG report opens with a broadband rhapsody: Broadband communications technologies can deliver substantial economic and social benefits to Australia…As well as producing productivity gains in traditional and new industries, advanced connectivity can enrich community life, particularly in rural and regional areas. It provides the basis for integration of remote communities into national economic, cultural and social life. (BAG 1, 7) Its prescriptions include: Australia will be a world leader in the availability and effective use of broadband...and to capture the economic and social benefits of broadband connectivity...Broadband should be available to all Australians at fair and reasonable prices…Market arrangements should be pro-competitive and encourage investment...The Government should adopt a National Broadband Strategy (BAG 1) And, like its predecessor nine years earlier, the BAG report does make reference to a national broadband strategy aiming to maximise “choice in work and recreation activities available to all Australians independent of location, background, age or interests” (17). However, the idea of a national broadband strategy is not something the BAG really comes to grips with. The final report is keen on encouraging broadband adoption, but not explicit on how barriers to broadband can be addressed. Perhaps this is not surprising given that the membership of the BAG, dominated by representatives of large corporations and senior bureaucrats was even less representative than its BSEG predecessor. Some months after the BAG report, the Federal government did declare a broadband strategy. It did so, intriguingly enough, under the rubric of its response to the Regional Telecommunications Inquiry report (Estens), the second inquiry responsible for reassuring citizens nervous about the full-privatisation of Telstra (the first inquiry being Besley). The government’s grand $142.8 million National Broadband Strategy focusses on the ‘broadband needs of regional Australians, in partnership with all levels of government’ (Alston, ‘National Broadband Strategy’). Among other things, the government claims that the Strategy will result in “improved outcomes in terms of services and prices for regional broadband access; [and] the development of national broadband infrastructure assets.” (Alston, ‘National Broadband Strategy’) At the same time, the government announced an overall response to the Estens Inquiry, with specific safeguards for Telstra’s role in regional communications — a preliminary to the full Telstra sale (Alston, ‘Future Proofing’). Less publicised was the government’s further initiative in indigenous telecommunications, complementing its Telecommunications Action Plan for Remote Indigenous Communities (DCITA). Indigenous people, it can be argued, were never really contemplated as citizens with the ken of the universal service policy taken to underpin the twentieth-century government monopoly PTT project. In Australia during the deregulatory and re-regulatory 1990s, there was a great reluctance on the part of Labor and Coalition Federal governments, Telstra and other industry participants, even to research issues of access to and use of telecommunications by indigenous communicators. Telstra, and to a lesser extent Optus (who had purchased AUSSAT as part of their licence arrangements), shrouded the issue of indigenous communications in mystery that policymakers were very reluctant to uncover, let alone systematically address. Then regulator, the Australian Telecommunications Authority (AUSTEL), had raised grave concerns about indigenous telecommunications access in its 1991 Rural Communications inquiry. However, there was no government consideration of, nor research upon, these issues until Alston commissioned a study in 2001 — the basis for the TAPRIC strategy (DCITA). The elision of indigenous telecommunications from mainstream industry and government policy is all the more puzzling, if one considers the extraordinarily varied and significant experiments by indigenous Australians in telecommunications and Internet (not least in the early work of the Tanami community, made famous in media and cultural studies by the writings of anthropologist Eric Michaels). While the government’s mid-2003 moves on a ‘National Broadband Strategy’ attend to some details of the broadband predicament, they fall well short of an integrated framework that grasps the shortcomings of the neoliberal communications model. The funding offered is a token amount. The view from the seat of government is a glance from the rear-view mirror: taking a snapshot of rural communications in the years 2000-2002 and projecting this tableau into a safety-net ‘future proofing’ for the inevitable turning away of a fully-privately-owned Telstra from its previously universal, ‘carrier of last resort’ responsibilities. In this aetiolated, residualist policy gaze, citizens remain constructed as consumers in a very narrow sense in this incremental, quietist version of state securing of market arrangements. What is missing is any more expansive notion of citizens, their varied needs, expectations, uses, and cultural imaginings of ‘always on’ broadband networks. Hybrid Networks “Most people on earth will eventually have access to networks that are all switched, interactive, and broadband”, wrote Frances Cairncross in 1998. ‘Eventually’ is a very appropriate word to describe the parlous state of broadband technology implementation. Broadband is in a slow state of evolution and invention. The story of broadband so far underscores the predicament for Australian access to bandwidth, when we lack any comprehensive, integrated, effective, and fair policy in communications and information technology. We have only begun to experiment with broadband technologies and understand their evolving uses, cultural forms, and the sense in which they rework us as subjects. Our communications networks are not superhighways, to invoke an enduring artefact from an older technology. Nor any longer are they a single ‘public’ switched telecommunications network, like those presided over by the post-telegraph-telephone monopolies of old. Like roads themselves, or the nascent postal system of the sixteenth century, broadband is a patchwork quilt. The ‘fibre’ of our communications networks is hybrid. To be sure, powerful corporations dominate, like the Tassis or Taxis who served as postmasters to the Habsburg emperors (Briggs & Burke 25). Activating broadband today provides a perspective on the path dependency of technology history, and how we can open up new threads of a communications fabric. Our options for transforming our multitudinous networked lives emerge as much from everyday tactics and strategies as they do from grander schemes and unifying policies. We may care to reflect on the waning potential for nation-building technology, in the wake of globalisation. We no longer gather our imagined community around a Community Telephone Plan as it was called in 1960 (Barr, Moyal, and PMG). Yet we do require national and international strategies to get and stay connected (Barr), ideas and funding that concretely address the wider dimensions of access and use. We do need to debate the respective roles of Telstra, the state, community initiatives, and industry competition in fair telecommunications futures. Networks have global reach and require global and national integration. Here vision, co-ordination, and resources are urgently required for our commonweal and moral fibre. To feel the width of the band we desire, we need to plug into and activate the policy circuits. Thanks to Grayson Cooke, Patrick Lichty, Ned Rossiter, John Pace, and an anonymous reviewer for helpful comments. Works Cited Alston, Richard. ‘ “Future Proofing” Regional Communications.’ Department of Communications, Information Technology and the Arts, Canberra, 2003. 17 July 2003 <http://www.dcita.gov.au/Article/0,,0_1-2_3-4_115485,00.php> —. ‘A National Broadband Strategy.’ Department of Communications, Information Technology and the Arts, Canberra, 2003. 17 July 2003 <http://www.dcita.gov.au/Article/0,,0_1-2_3-4_115486,00.php>. Australian Competition and Consumer Commission (ACCC). Broadband Services Report March 2003. Canberra: ACCC, 2003. 17 July 2003 <http://www.accc.gov.au/telco/fs-telecom.htm>. —. Emerging Market Structures in the Communications Sector. Canberra: ACCC, 2003. 15 July 2003 <http://www.accc.gov.au/pubs/publications/utilities/telecommu... ...nications/Emerg_mar_struc.doc>. Barr, Trevor. new media.com: The Changing Face of Australia’s Media and Telecommunications. Sydney: Allen & Unwin, 2000. Besley, Tim (Telecommunications Service Inquiry). Connecting Australia: Telecommunications Service Inquiry. Canberra: Department of Information, Communications and the Arts, 2000. 17 July 2003 <http://www.telinquiry.gov.au/final_report.php>. Briggs, Asa, and Burke, Peter. A Social History of the Internet: From Gutenberg to the Internet. Cambridge: Polity, 2002. Broadband Advisory Group. Australia’s Broadband Connectivity: The Broadband Advisory Group’s Report to Government. Melbourne: National Office on the Information Economy, 2003. 15 July 2003 <http://www.noie.gov.au/publications/NOIE/BAG/report/index.htm>. Broadband Services Expert Group. Networking Australia’s Future: Final Report. Canberra: Australian Government Publishing Service (AGPS), 1994. Bureau of Transport and Communications Economics (BTCE). Communications Futures Final Project. Canberra: AGPS, 1994. Cairncross, Frances. The Death of Distance: How the Communications Revolution Will Change Our Lives. London: Orion Business Books, 1997. Communications Law Centre (CLC). Australian Telecommunications Regulation: The Communications Law Centre Guide. 2nd edition. Sydney: Communications Law Centre, University of NSW, 2001. Department of Communications, Information Technology and the Arts (DCITA). Telecommunications Action Plan for Remote Indigenous Communities: Report on the Strategic Study for Improving Telecommunications in Remote Indigenous Communities. Canberra: DCITA, 2002. Estens, D. Connecting Regional Australia: The Report of the Regional Telecommunications Inquiry. Canberra: DCITA, 2002. <http://www.telinquiry.gov.au/rti-report.php>, accessed 17 July 2003. Fels, Alan. ‘Competition in Telecommunications’, speech to Australian Telecommunications Users Group 19th Annual Conference. 6 March, 2003, Sydney. <http://www.accc.gov.au/speeches/2003/Fels_ATUG_6March03.doc>, accessed 15 July 2003. Flew, Terry, and Spurgeon, Christina. ‘Television After Broadcasting’. In The Australian TV Book. Ed. Graeme Turner and Stuart Cunningham. Allen & Unwin, Sydney. 69-85. 2000. Given, Jock. Turning Off the Television. Sydney: UNSW Press, 2003. Goggin, Gerard. ‘Citizens and Beyond: Universal service in the Twilight of the Nation-State.’ In All Connected?: Universal Service in Telecommunications, ed. Bruce Langtry. Melbourne: University of Melbourne Press, 1998. 49-77 —. Rural Communities Online: Networking to link Consumers to Providers. Melbourne: Telstra Consumer Consultative Council, 2003. Goggin, Gerard, and Newell, Christopher. Digital Disability: The Social Construction of Disability in New Media. Lanham, MD: Rowman & Littlefield, 2003. House of Representatives Standing Committee on Communications, Information Technology and the Arts (HoR). Connecting Australia!: Wireless Broadband. Report of Inquiry into Wireless Broadband Technologies. Canberra: Parliament House, 2002. <http://www.aph.gov.au/house/committee/cita/Wbt/report.htm>, accessed 17 July 2003. Lamberton, Don. ‘A Telecommunications Infrastructure is Not an Information Infrastructure’. Prometheus: Journal of Issues in Technological Change, Innovation, Information Economics, Communication and Science Policy 14 (1996): 31-38. Latour, Bruno. Science in Action: How to Follow Scientists and Engineers Through Society. Cambridge, MA: Harvard University Press, 1987. Luck, David. ‘Revisiting the Future: Assessing the 1994 BTCE communications futures project.’ Media International Australia 96 (2000): 109-119. MacBride, Sean (Chair of International Commission for the Study of Communication Problems). Many Voices, One World: Towards a New More Just and More Efficient World Information and Communication Order. Paris: Kegan Page, London. UNESCO, 1980. Maitland Commission (Independent Commission on Worldwide Telecommunications Development). The Missing Link. Geneva: International Telecommunications Union, 1985. Michaels, Eric. Bad Aboriginal Art: Tradition, Media, and Technological Horizons. Sydney: Allen & Unwin, 1994. Mody, Bella, Bauer, Johannes M., and Straubhaar, Joseph D., eds. Telecommunications Politics: Ownership and Control of the Information Highway in Developing Countries. Mahwah, NJ: Erlbaum, 1995. Moyal, Ann. Clear Across Australia: A History of Telecommunications. Melbourne: Thomas Nelson, 1984. Post-Master General’s Department (PMG). Community Telephone Plan for Australia. Melbourne: PMG, 1960. Productivity Commission (PC). Telecommunications Competition Regulation: Inquiry Report. Report No. 16. Melbourne: Productivity Commission, 2001. <http://www.pc.gov.au/inquiry/telecommunications/finalreport/>, accessed 17 July 2003. Spurgeon, Christina. ‘National Culture, Communications and the Information Economy.’ Media International Australia 87 (1998): 23-34. Turner, Graeme. ‘First Contact: coming to terms with the cable guy.’ UTS Review 3 (1997): 109-21. Winseck, Dwayne. ‘Wired Cities and Transnational Communications: New Forms of Governance for Telecommunications and the New Media’. In The Handbook of New Media: Social Shaping and Consequences of ICTs, ed. Leah A. Lievrouw and Sonia Livingstone. London: Sage, 2002. 393-409. World Trade Organisation. General Agreement on Trade in Services: Annex on Telecommunications. Geneva: World Trade Organisation, 1994. 17 July 2003 <http://www.wto.org/english/tratop_e/serv_e/12-tel_e.htm>. —. Fourth protocol to the General Agreement on Trade in Services. Geneva: World Trade Organisation. 17 July 2003 <http://www.wto.org/english/tratop_e/serv_e/4prote_e.htm>. Links http://www.accc.gov.au/pubs/publications/utilities/telecommunications/Emerg_mar_struc.doc http://www.accc.gov.au/speeches/2003/Fels_ATUG_6March03.doc http://www.accc.gov.au/telco/fs-telecom.htm http://www.aph.gov.au/house/committee/cita/Wbt/report.htm http://www.dcita.gov.au/Article/0,,0_1-2_3-4_115485,00.html http://www.dcita.gov.au/Article/0,,0_1-2_3-4_115486,00.html http://www.noie.gov.au/projects/access/access/broadband1.htm http://www.noie.gov.au/publications/NOIE/BAG/report/index.htm http://www.pc.gov.au http://www.pc.gov.au/inquiry/telecommunications/finalreport/ http://www.telinquiry.gov.au/final_report.html http://www.telinquiry.gov.au/rti-report.html http://www.wto.org/english/tratop_e/serv_e/12-tel_e.htm http://www.wto.org/english/tratop_e/serv_e/4prote_e.htm Citation reference for this article Substitute your date of access for Dn Month Year etc... MLA Style Goggin, Gerard. "Broadband" M/C: A Journal of Media and Culture< http://www.media-culture.org.au/0308/02-featurebroadband.php>. APA Style Goggin, G. (2003, Aug 26). Broadband. M/C: A Journal of Media and Culture, 6,< http://www.media-culture.org.au/0308/02-featurebroadband.php>

At one point in Victor Hugo’s novel, The Hunchback of Notre Dame, the archdeacon, Claude Frollo, looked up from a book on his table to the edifice of the gothic cathedral, visible from his canon’s cell in the cloister of Notre Dame: “Alas!” he said, “this will kill that” (146). Frollo’s lament, that the book would destroy the edifice, captures the medieval cleric’s anxiety about the way in which Gutenberg’s print technology would become the new universal means for recording and communicating humanity’s ideas and artistic expression, replacing the grand monuments of architecture, human engineering, and craftsmanship. For Hugo, architecture was “the great handwriting of humankind” (149). The cathedral as the material outcome of human technology was being replaced by the first great machine—the printing press. At this point in the third millennium, some people undoubtedly have similar anxieties to Frollo: is it now the book’s turn to be destroyed by yet another great machine? The inclusion of “post print” in our title is not intended to sound the death knell of the book. Rather, we contend that despite the enduring value of print, digital publishing is “present and active” and is changing the way in which research, particularly in the humanities, is being undertaken. Our approach has three related parts. First, we consider how digital technologies are changing the way in which content is constructed, customised, modified, disseminated, and accessed within a global, distributed network. This section argues that the transition from print to electronic or digital publishing means both losses and gains, particularly with respect to shifts in our approaches to textuality, information, and innovative publishing. Second, we discuss the Children’s Literature Digital Resources (CLDR) project, with which we are involved. This case study of a digitising initiative opens out the transformative possibilities and challenges of digital publishing and e-scholarship for research communities. Third, we reflect on technology’s capacity to bring about major changes in the light of the theoretical and practical issues that have arisen from our discussion. I. Digitising in a “post-print age” We are living in an era that is commonly referred to as “the late age of print” (see Kho) or the “post-print age” (see Gunkel). According to Aarseth, we have reached a point whereby nearly all of our public and personal media have become more or less digital (37). As Kho notes, web newspapers are not only becoming increasingly more popular, but they are also making rather than losing money, and paper-based newspapers are finding it difficult to recruit new readers from the younger generations (37). Not only can such online-only publications update format, content, and structure more economically than print-based publications, but their wide distribution network, speed, and flexibility attract advertising revenue. Hype and hyperbole aside, publishers are not so much discarding their legacy of print, but recognising the folly of not embracing innovative technologies that can add value by presenting information in ways that satisfy users’ needs for content to-go or for edutainment. As Kho notes: “no longer able to satisfy customer demand by producing print-only products, or even by enabling online access to semi-static content, established publishers are embracing new models for publishing, web-style” (42). Advocates of online publishing contend that the major benefits of online publishing over print technology are that it is faster, more economical, and more interactive. However, as Hovav and Gray caution, “e-publishing also involves risks, hidden costs, and trade-offs” (79). The specific focus for these authors is e-journal publishing and they contend that while cost reduction is in editing, production and distribution, if the journal is not open access, then costs relating to storage and bandwith will be transferred to the user. If we put economics aside for the moment, the transition from print to electronic text (e-text), especially with electronic literary works, brings additional considerations, particularly in their ability to make available different reading strategies to print, such as “animation, rollovers, screen design, navigation strategies, and so on” (Hayles 38). Transition from print to e-text In his book, Writing Space, David Bolter follows Victor Hugo’s lead, but does not ask if print technology will be destroyed. Rather, he argues that “the idea and ideal of the book will change: print will no longer define the organization and presentation of knowledge, as it has for the past five centuries” (2). As Hayles noted above, one significant indicator of this change, which is a consequence of the shift from analogue to digital, is the addition of graphical, audio, visual, sonic, and kinetic elements to the written word. A significant consequence of this transition is the reinvention of the book in a networked environment. Unlike the printed book, the networked book is not bound by space and time. Rather, it is an evolving entity within an ecology of readers, authors, and texts. The Web 2.0 platform has enabled more experimentation with blending of digital technology and traditional writing, particularly in the use of blogs, which have spawned blogwriting and the wikinovel. Siva Vaidhyanathan’s The Googlization of Everything: How One Company is Disrupting Culture, Commerce and Community … and Why We Should Worry is a wikinovel or blog book that was produced over a series of weeks with contributions from other bloggers (see: http://www.sivacracy.net/). Penguin Books, in collaboration with a media company, “Six Stories to Start,” have developed six stories—“We Tell Stories,” which involve different forms of interactivity from users through blog entries, Twitter text messages, an interactive google map, and other features. For example, the story titled “Fairy Tales” allows users to customise the story using their own choice of names for characters and descriptions of character traits. Each story is loosely based on a classic story and links take users to synopses of these original stories and their authors and to online purchase of the texts through the Penguin Books sales website. These examples of digital stories are a small part of the digital environment, which exploits computer and online technologies’ capacity to be interactive and immersive. As Janet Murray notes, the interactive qualities of digital environments are characterised by their procedural and participatory abilities, while their immersive qualities are characterised by their spatial and encyclopedic dimensions (71–89). These immersive and interactive qualities highlight different ways of reading texts, which entail different embodied and cognitive functions from those that reading print texts requires. As Hayles argues: the advent of electronic textuality presents us with an unparalleled opportunity to reformulate fundamental ideas about texts and, in the process, to see print as well as electronic texts with fresh eyes (89–90). The transition to e-text also highlights how digitality is changing all aspects of everyday life both inside and outside the academy. Online teaching and e-research Another aspect of the commercial arm of publishing that is impacting on academe and other organisations is the digitising and indexing of print content for niche distribution. Kho offers the example of the Mark Logic Corporation, which uses its XML content platform to repurpose content, create new content, and distribute this content through multiple portals. As the promotional website video for Mark Logic explains, academics can use this service to customise their own textbooks for students by including only articles and book chapters that are relevant to their subject. These are then organised, bound, and distributed by Mark Logic for sale to students at a cost that is generally cheaper than most textbooks. A further example of how print and digital materials can form an integrated, customised source for teachers and students is eFictions (Trimmer, Jennings, & Patterson). eFictions was one of the first print and online short story anthologies that teachers of literature could customise to their own needs. Produced as both a print text collection and a website, eFictions offers popular short stories in English by well-known traditional and contemporary writers from the US, Australia, New Zealand, UK, and Europe, with summaries, notes on literary features, author biographies, and, in one instance, a YouTube movie of the story. In using the eFictions website, teachers can build a customised anthology of traditional and innovative stories to suit their teaching preferences. These examples provide useful indicators of how content is constructed, customised, modified, disseminated, and accessed within a distributed network. However, the question remains as to how to measure their impact and outcomes within teaching and learning communities. As Harley suggests in her study on the use and users of digital resources in the humanities and social sciences, several factors warrant attention, such as personal teaching style, philosophy, and specific disciplinary requirements. However, in terms of understanding the benefits of digital resources for teaching and learning, Harley notes that few providers in her sample had developed any plans to evaluate use and users in a systematic way. In addition to the problems raised in Harley’s study, another relates to how researchers can be supported to take full advantage of digital technologies for e-research. The transformation brought about by information and communication technologies extends and broadens the impact of research, by making its outputs more discoverable and usable by other researchers, and its benefits more available to industry, governments, and the wider community. Traditional repositories of knowledge and information, such as libraries, are juggling the space demands of books and computer hardware alongside increasing reader demand for anywhere, anytime, anyplace access to information. Researchers’ expectations about online access to journals, eprints, bibliographic data, and the views of others through wikis, blogs, and associated social and information networking sites such as YouTube compete with the traditional expectations of the institutions that fund libraries for paper-based archives and book repositories. While university libraries are finding it increasingly difficult to purchase all hardcover books relevant to numerous and varied disciplines, a significant proportion of their budgets goes towards digital repositories (e.g., STORS), indexes, and other resources, such as full-text electronic specialised and multidisciplinary journal databases (e.g., Project Muse and Proquest); electronic serials; e-books; and specialised information sources through fast (online) document delivery services. An area that is becoming increasingly significant for those working in the humanities is the digitising of historical and cultural texts. II. Bringing back the dead: The CLDR project The CLDR project is led by researchers and librarians at the Queensland University of Technology, in collaboration with Deakin University, University of Sydney, and members of the AustLit team at The University of Queensland. The CLDR project is a “Research Community” of the electronic bibliographic database AustLit: The Australian Literature Resource, which is working towards the goal of providing a complete bibliographic record of the nation’s literature. AustLit offers users with a single entry point to enhanced scholarly resources on Australian writers, their works, and other aspects of Australian literary culture and activities. AustLit and its Research Communities are supported by grants from the Australian Research Council and financial and in-kind contributions from a consortium of Australian universities, and by other external funding sources such as the National Collaborative Research Infrastructure Strategy. Like other more extensive digitisation projects, such as Project Gutenberg and the Rosetta Project, the CLDR project aims to provide a centralised access point for digital surrogates of early published works of Australian children’s literature, with access pathways to existing resources. The first stage of the CLDR project is to provide access to digitised, full-text, out-of-copyright Australian children’s literature from European settlement to 1945, with selected digitised critical works relevant to the field. Texts comprise a range of genres, including poetry, drama, and narrative for young readers and picture books, songs, and rhymes for infants. Currently, a selection of 75 e-texts and digital scans of original texts from Project Gutenberg and Internet Archive have been linked to the Children’s Literature Research Community. By the end of 2009, the CLDR will have digitised approximately 1000 literary texts and a significant number of critical works. Stage II and subsequent development will involve digitisation of selected texts from 1945 onwards. A precursor to the CLDR project has been undertaken by Deakin University in collaboration with the State Library of Victoria, whereby a digital bibliographic index comprising Victorian School Readers has been completed with plans for full-text digital surrogates of a selection of these texts. These texts provide valuable insights into citizenship, identity, and values formation from the 1930s onwards. At the time of writing, the CLDR is at an early stage of development. An extensive survey of out-of-copyright texts has been completed and the digitisation of these resources is about to commence. The project plans to make rich content searchable, allowing scholars from children’s literature studies and education to benefit from the many advantages of online scholarship. What digital publishing and associated digital archives, electronic texts, hypermedia, and so forth foreground is the fact that writers, readers, publishers, programmers, designers, critics, booksellers, teachers, and copyright laws operate within a context that is highly mediated by technology. In his article on large-scale digitisation projects carried out by Cornell and University of Michigan with the Making of America collection of 19th-century American serials and monographs, Hirtle notes that when special collections’ materials are available via the Web, with appropriate metadata and software, then they can “increase use of the material, contribute to new forms of research, and attract new users to the material” (44). Furthermore, Hirtle contends that despite the poor ergonomics associated with most electronic displays and e-book readers, “people will, when given the opportunity, consult an electronic text over the print original” (46). If this preference is universally accurate, especially for researchers and students, then it follows that not only will the preference for electronic surrogates of original material increase, but preference for other kinds of electronic texts will also increase. It is with this preference for electronic resources in mind that we approached the field of children’s literature in Australia and asked questions about how future generations of researchers would prefer to work. If electronic texts become the reference of choice for primary as well as secondary sources, then it seems sensible to assume that researchers would prefer to sit at the end of the keyboard than to travel considerable distances at considerable cost to access paper-based print texts in distant libraries and archives. We considered the best means for providing access to digitised primary and secondary, full text material, and digital pathways to existing online resources, particularly an extensive indexing and bibliographic database. Prior to the commencement of the CLDR project, AustLit had already indexed an extensive number of children’s literature. Challenges and dilemmas The CLDR project, even in its early stages of development, has encountered a number of challenges and dilemmas that centre on access, copyright, economic capital, and practical aspects of digitisation, and sustainability. These issues have relevance for digital publishing and e-research. A decision is yet to be made as to whether the digital texts in CLDR will be available on open or closed/tolled access. The preference is for open access. As Hayles argues, copyright is more than a legal basis for intellectual property, as it also entails ideas about authorship, creativity, and the work as an “immaterial mental construct” that goes “beyond the paper, binding, or ink” (144). Seeking copyright permission is therefore only part of the issue. Determining how the item will be accessed is a further matter, particularly as future technologies may impact upon how a digital item is used. In the case of e-journals, the issue of copyright payment structures are evolving towards a collective licensing system, pay-per-view, and other combinations of print and electronic subscription (see Hovav and Gray). For research purposes, digitisation of items for CLDR is not simply a scan and deliver process. Rather it is one that needs to ensure that the best quality is provided and that the item is both accessible and usable by researchers, and sustainable for future researchers. Sustainability is an important consideration and provides a challenge for institutions that host projects such as CLDR. Therefore, items need to be scanned to a high quality and this requires an expensive scanner and personnel costs. Files need to be in a variety of formats for preservation purposes and so that they may be manipulated to be useable in different technologies (for example, Archival Tiff, Tiff, Jpeg, PDF, HTML). Hovav and Gray warn that when technology becomes obsolete, then content becomes unreadable unless backward integration is maintained. The CLDR items will be annotatable given AustLit’s NeAt funded project: Aus-e-Lit. The Aus-e-Lit project will extend and enhance the existing AustLit web portal with data integration and search services, empirical reporting services, collaborative annotation services, and compound object authoring, editing, and publishing services. For users to be able to get the most out of a digital item, it needs to be searchable, either through double keying or OCR (optimal character recognition). The value of CLDR’s contribution The value of the CLDR project lies in its goal to provide a comprehensive, searchable body of texts (fictional and critical) to researchers across the humanities and social sciences. Other projects seem to be intent on putting up as many items as possible to be considered as a first resort for online texts. CLDR is more specific and is not interested in simply generating a presence on the Web. Rather, it is research driven both in its design and implementation, and in its focussed outcomes of assisting academics and students primarily in their e-research endeavours. To this end, we have concentrated on the following: an extensive survey of appropriate texts; best models for file location, distribution, and use; and high standards of digitising protocols. These issues that relate to data storage, digitisation, collections, management, and end-users of data are aligned with the “Development of an Australian Research Data Strategy” outlined in An Australian e-Research Strategy and Implementation Framework (2006). CLDR is not designed to simply replicate resources, as it has a distinct focus, audience, and research potential. In addition, it looks at resources that may be forgotten or are no longer available in reproduction by current publishing companies. Thus, the aim of CLDR is to preserve both the time and a period of Australian history and literary culture. It will also provide users with an accessible repository of rare and early texts written for children. III. Future directions It is now commonplace to recognize that the Web’s role as information provider has changed over the past decade. New forms of “collective intelligence” or “distributed cognition” (Oblinger and Lombardi) are emerging within and outside formal research communities. Technology’s capacity to initiate major cultural, social, educational, economic, political and commercial shifts has conditioned us to expect the “next big thing.” We have learnt to adapt swiftly to the many challenges that online technologies have presented, and we have reaped the benefits. As the examples in this discussion have highlighted, the changes in online publishing and digitisation have provided many material, network, pedagogical, and research possibilities: we teach online units providing students with access to e-journals, e-books, and customized archives of digitised materials; we communicate via various online technologies; we attend virtual conferences; and we participate in e-research through a global, digital network. In other words, technology is deeply engrained in our everyday lives. In returning to Frollo’s concern that the book would destroy architecture, Umberto Eco offers a placatory note: “in the history of culture it has never happened that something has simply killed something else. Something has profoundly changed something else” (n. pag.). Eco’s point has relevance to our discussion of digital publishing. The transition from print to digital necessitates a profound change that impacts on the ways we read, write, and research. As we have illustrated with our case study of the CLDR project, the move to creating digitised texts of print literature needs to be considered within a dynamic network of multiple causalities, emergent technological processes, and complex negotiations through which digital texts are created, stored, disseminated, and used. Technological changes in just the past five years have, in many ways, created an expectation in the minds of people that the future is no longer some distant time from the present. 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