Journal articles: '338.473 06' – Grafiati (2024)

Abstract:

4508 Background: In a phase II trial in 52 PC pts, GB yielded a 21% response rate and a median survival of 8.8 months (mo) (Kindler, JCO 2005). These data led CALGB to conduct a phase III trial of GB vs. GP in advanced PC pts. Methods: This randomized trial was double-blind, placebo-controlled. Eligible pts had no prior therapy for advanced disease, PS 0–2, no tumor invasion of adjacent organs, no increased bleeding risk. Primary endpoint: overall survival (OS). Stratification: PS (0/1 or 2), disease extent (locally advanced or metastatic), prior radiation (RT) (yes/no). Statistics: 90% power to detect a difference in median OS of 6 vs. 8.1 mo. Treatment: Pts received G 1,000 mg/m2 over 30 minutes days (D) 1, 8, 15 Q28D; B 10 mg/kg or P D 1, 15 Q28D. CT scans: Q2 cycles. Results: 602 pts enrolled 6/30/04–4/14/06. Based on a protocol-specified interim analysis with 64% of information on OS, the CALGB Data Safety Monitoring Board released study data in 6/06 because a futility boundary was crossed. Pts on treatment were notified and unblinded. Pt characteristics (302GB/300GP): male 58%/51%; median age 63.8/65.0; PS 2 9%/9%; stage IV 85%/84%; prior RT 11%/11%. Median follow-up: 11.3/11.7 mo. As of 12/22/06, 436 pts (224/212) have died (93% of total expected deaths at planned final analysis). Median OS 5.7/6.0 mo (95% CI: 4.9, 6.5/5.0, 6.9). Median failure-free survival 4.8/4.3 mo (95% CI: 4.3, 5.7/3.8, 5.6). Response (includes unconfirmed responses): complete (CR) 1.9%/3.0%; partial (PR) 11.2%/8.3%, stable disease (SD) 40.7%/35.7%. Disease control rate (CR/PR/SD) 54%/47%. 525 pts (268/257) are currently evaluable for toxicity. Median cycles 3.5/3.1 (p=0.09). Total mg/m2 G received 9095/8334 (p=0.22). Grade ¾ toxicity (%pts GB/GP): neutropenia 33%/30%; anemia 5%/8%; thrombocytopenia 12%/12%; hypertension 8%/2%; perforation 0.4%/0%; GI bleed 3%/2%; CVA 2%/2%; proteinuria 4%/1%; venous thrombosis 9%/9%. Conclusion: The addition of B to G does not improve survival in advanced PC. [Table: see text]

Abstract:

Oocyte cryopreservation by vitrification affects spindle integrity and causes oxidative stress induced by reactive oxygen species (ROS). Glutathione (GSH) ensures the correct assembly of microtubules, prevents ROS from attacking tubulin assembly, and ensures normal spindle function during meiosis. We hypothesised that addition of GSH ethyl ester (GSH-OEt), a cell-permeable GSH donor, to IVM medium before vitrification may improve oocyte cryotolerance by maintaining spindle morphology and preventing ROS production. For the IVM, viable cumulus-oocyte complexes were randomly distributed into two groups: 1) control: conventional IVM media with tissue culture medium-199 + 20% fetal calf serum + epidermal growth factor and 2) GSH-OEt: IVM medium supplemented with 5mM GSH-OEt at 38.5°C in a 5% CO2 humidified air atmosphere. After 22h of IVM, half of the oocytes from each group were vitrified/warmed using the Cryotop method (Kitazato Corp.). After 24h of IVM, oocytes were denuded, fixed, and microtubule and chromosome distribution were analysed by immunofluorescence. To measure ROS, oocytes were denuded and incubated in 5μM 2′,7′-dichlorodihydrofluorescein diacetate. Fluorescence was acquired, and resulting images were quantified with ImageJ software. A linear mixed effect followed by a pairwise comparison test (Tukey adjustment) were performed to analyse differences in meiotic spindle configuration and ROS production (P<0.05). No significant differences in percentages of MII or normal spindle configuration were observed among treatments. Treatment with GSH-OEt before vitrification resulted in similar percentages of abnormal spindle configuration to control oocytes, whereas vitrified oocytes showed significantly higher percentages of abnormal spindle configuration relative with control oocytes (Table 1). When the content of ROS was measured, vitrification resulted in significantly higher levels (15.1E+06±1.2E+06; P<0.05) when compared with other treatments. However, oocytes vitrified after IVM with GSH-OEt (11.8E+06±0.6E+06) showed similar ROS levels to control (10.7E+06±0.2E+06) and GSH-OEt (10.0E+06±0.1E+06) groups. In conclusion, addition of GSH-OEt to IVM before vitrification did not have detrimental effects on spindle morphology and was able to reduce ROS content. Further experiments are warranted to assess whether the addition of GSH-OEt to IVM medium can improve oocyte development competence after vitrification. Table 1.Assessment of spindle morphology after oocyte vitrification (VIT) following IVM in the presence of glutathione ethyl ester (GSH-OEt) Item n MII (%) Spindle configuration (%) Chromosome distribution (%) Normal Abnormal Absent Dispersed Decondensed Absent Control 127 79.4±92 74.1±4.4 16.2±5.6a 9.7±1.1 16.2±3.8 9.7±1.1 0 GSH-OEt 113 76.5±6.5 65.6±5.7 26.2±9.0ab 8.1±4.3 19.5±2.6 13.7±3.0 1.1±1.1 VIT 71 60.0±5.6 54.8±7.8 32.7±10.8b 12.4±1.4 34.4±8.7 10.7±6.4 0 GSH-OEt VIT 53 57.4±10.7 58.5±8.8 31.1±9.3ab 10.4±5.8 34.8±5.6 6.7±6.7 0 a,bDifferent superscripts indicate significant differences (P<0.05). *Percentage referred to the total number of oocytes at MII. This work was supported by MCIU, Spain (AGL2016-79802-P) and Generalitat de Catalunya (García-Martínez, 2017_FI_00451).

Abstract:

Objective: We studied posterior pituitary function in 27 patients with Sheehan’s syndrome and 14 controls. Design: All patients were investigated by water deprivation test and 26 of them by 5% hypertonic saline infusion test. None of the patients had symptoms of diabetes insipidus and all patients were on adequate glucocorticoid and thyroid hormone replacement therapy before testing. Results: According to dehydration test, 8 (29.6%) patients had partial diabetes insipidus (PDI group) and 19 (70.3%) had normal response (non-DI group). During the 5% hypertonic saline infusion test, the maximal plasma osmolality was higher in PDI (305 ± 4.3) and non-DI (308 ± 1.7) groups when compared with controls (298 ± 1.7 mOsm/kg; P < 0.005), but the maximal urine osmolality was lower in PDI group (565 ± 37) than in non-DI (708 ± 45) and control (683 ± 17 mOsm/kg) groups (P < 0.05). The osmotic threshold for thirst perception was higher in PDI (296 ± 4.3) and non-DI (298 ± 1.4) groups when compared with control group (287 ± 1.5 mOsm/kg) (P < 0.005). Basal plasma osmolalities were also higher in PDI (294 ± 1.0) and non-DI (297 ± 1.1) groups than in controls (288 ± 1.2 mOsm/kg; P < 0.001). Conclusions: Our findings demonstrated that patients with Sheehan’s syndrome have an impairment of neurohypophyseal function. The thirst center may be affected by ischemic damage and the osmotic threshold for the onset of thirst in patients with Sheehan’s syndrome is increased.

Abstract:

423 Background: The most important determinant of prognosis for localized colon cancer is metastatic lymph node involvement. The American Joint Commission on Cancer and the College of American Pathologists have recommended examination ≥ 12 lymph nodes to ensure adequate staging. We hypothesized that surgeon education would improve the extent of lymphadenectomy in patients being treated for colon cancer. A large community based metropolitan health care system served as a model for testing this hypothesis. Methods: 906 patients comprising AJCC stage I (n=265), stage II (n=304), and stage III (n=337) colon cancers were evaluated. Surgical approach was either open (n=567), laparoscopic (n=310), or unknown (n=29). Lymphadenectomy results obtained from post-operative pathology reports were tracked across four separate time periods: era 1 (1/1/02-1/31/04), era 2 (1/1/05-1/31/06), and era 3 (1/1/07-1/31/07). Results were then compared against a study endpoint measurement of 2008, era four. Results: Upon analysis and comparison of individual era results, a significant improvement in lymphadenectomy (percentage of patients with ≥12 nodes harvested) was noted for all AJCC stages (p-values compare era 4 versus era 1): I (34.2% vs. 59% vs. 65% vs. 69%, P=0.0001), II (62% vs. 76% vs. 90% vs. 91%, P=0.0004), and III (55% vs. 72% vs. 84% vs. 86%, P<0.0001; see table). Surgical approach was not a significant factor. Neither age nor sex was significant. Conclusions: Through physician education, we were able to increase awareness of optimal staging practice for lymphadenectomy in colon cancer. This resulted in significantly improved patient outcomes within a large metropolitan health care system. No significant financial relationships to disclose.

Abstract:

Abstract Background:Von Willebrand disease (VWD) is the most common inherited bleeding disorder that is characterized by deficiency or abnormality of von Willebrand factor (VWF). VWF, synthesized by endothelium and magakaryocytes, circulates in plasma and is present in sub-endothelium and platelets: therefore it is an ideal marker for endothelial formation/damage and megakaryocytopoiesis. Circulating (CEC) and progenitor (EPC) endothelial cells have been also proposed as markers of bone marrow-derived angiogenesis. Aims of the study: to evaluate the association of CEC/EPC with cellular and circulating VWF, we have measured the number of CEC/EPC together with VWF and cytokines involved in angiogenesis in a cohort of 84 patients with different VWD types. Methods: Eighty-four VWD patients were diagnosed according to the recommendations of the Scientific Standardization Committee Sub-committee on VWF of the ISTH. The VWD cohort was composed by the following VWD types (number): 1 (27); 2A (10); 2B (23); 2M (17), 3 (7). Twenty healthy individuals were used as controls. CEC (CD146+, CD31+,CD45−) and EPC (CD34+, CD133+, CD45−) were evaluated by cytometry. Circulating levels of VEGF, E-selectin and EPO were determined by ELISA. Both CEC/EPC and cytokines were tested in blind. i.e. without knowing in advance the type of VWD diagnosis. Results: Median (range)[* = p &lt;0.05] of CEC/EPC measured in controls and in different VWD types are shown below together with those of VEGF, E-selectin and EPO (Table). Patients (n) CECs (cells ×106/l) EPCs (cells ×106/l) VEGF (pg/ml) E-Selectin (ng/ml) EPO (mIU/ml) Controls (20) 13.4 (4.3–33.0) 0.24 (0.04–0.60) 224 (92–392) 28 (14.6–34.2) 7.1 (3,0–16,6) All VWD (84) 20.0 (2.0–133.2)* 0.09 (0.00–1.14)* 334 (88–1286)* 34.1 (13.0–125.5)* 10.5 (1.7–53.0)* VWD1 (27) 19.2 (4.2–133.2) 0.08 (0.00–1.14)* 296 (121–1103)* 28.7 (13.0–74.3) 11.9 (1.7–26.6)* VWD2A/2M (27) 16.5 (2.0–58.9)* 0.08 (0.00–0.53)* 371 (88–1286)* 41.9 (19.6–117.3)* 10.2 (6.3–44.7)* VWD2B (23) 30.1 (9.0–108.8)* 0.13 (0.00–0.96)* 330 (142–675)* 33.8 (13.8–103.9)* 12.9 (2.9–53.0)* VWD3 (7) 41.3 (5.2–78.9)* 0.13 (0.00–0.37) 475 (131–676) 33.8 (22.6–125.5)* 10.5 (7.2–19.0) The global VWD population had higher CEC (p=.002) and lower EPC (p=.001) than controls. These data were associated with high VEGF (p=.003), E-selectin (p=.001) and EPO (p=.001) levels. As far as VWD types, VWD1 patients showed slightly high CEC (p=.06), normal E-selectin, markedly low EPC (p=.002) and high VEGF (p=.02). VWD2A/2M, grouped together, showed higher CEC (p=.05) and low EPC (p=.009) together with high VEGF (p=.005), EPO (p=.004) and markedly higher E-selectin (p&lt;.0001). Conversely, VWD2B, characterized by enhanced interactions with platelet glycoproteins Ib (GpIb), and VWD3, by virtually complete deficiency of VWF, showed high CEC (p=.0002 and .01) and relatively reduced EPC (p=.03 and .05) with elevated VEGF (p=.01 and .13), E-selectin (p=.002 and .02) and EPO (p=.005 and 0.1). Discussion and conclusions: Based on these results, we can conclude that CEC are increased in VWD patients, especially in VWD2B and 3: high CEC are associated with increased levels of cytokines involved in angiogenesis (up-regulation). Conversely, EPC are always decreased in VWD patients, especially in VWD1 and VWD2A/2M, suggesting down-regulation of bone marrow-derived angiogenesis. These preliminary data might be important to better understand the role of VWF in the pathogenesis of different VWD types as well as in bone marrow-derived angiogenesis

Abstract:

Abstract Objectives To evaluate the proficiency of microbiology laboratories in Spain in antimicrobial susceptibility testing (AST) of Staphylococcus spp. Materials and methods Eight Staphylococcus spp. with different resistance mechanisms were selected: six Staphylococcus aureus (CC-01/mecA, CC-02/mecC, CC-03/BORSA, CC-04/MLSBi, CC-06/blaZ and CC-07/linezolid resistant, cfr); one Staphylococcus epidermidis (CC-05/linezolid resistant, 23S rRNA mutation); and one Staphylococcus capitis (CC-08/daptomycin non-susceptible). Fifty-one laboratories were asked to report: (i) AST system used; (ii) antimicrobial MICs; (iii) breakpoints used (CLSI or EUCAST); and (iv) clinical category. Minor, major and very major errors (mEs, MEs and VMEs, respectively) were determined. Results The greatest MIC discrepancies found were: (i) by AST method: 19.4% (gradient diffusion); (ii) by antimicrobial agent: daptomycin (21.3%) and oxacillin (20.6%); and (iii) by isolate: CC-07/cfr (48.0%). The greatest error rates were: (i) by AST method: gradient diffusion (4.3% and 5.1% VMEs, using EUCAST and CLSI, respectively); (ii) by breakpoint: 3.8% EUCAST and 2.3% CLSI; (iii) by error type: mEs (0.8% EUCAST and 1.0% CLSI), MEs (1.8% EUCAST and 0.7% CLSI) and VMEs (1.2% EUCAST and 0.6% CLSI); (iii) by antimicrobial agent: VMEs (4.7% linezolid and 4.3% oxacillin using EUCAST); MEs (14.3% fosfomycin, 9.1% tobramycin and 5.7% gentamicin using EUCAST); and mEs (22.6% amikacin using EUCAST). Conclusions Clinical microbiology laboratories should improve their ability to determine the susceptibility of Staphylococcus spp. to some antimicrobial agents to avoid reporting false-susceptible or false-resistant results. The greatest discrepancies and errors were associated with gradient diffusion, EUCAST breakpoints and some antimicrobials (mEs for aminoglycosides; MEs for fosfomycin, aminoglycosides and oxacillin; and VMEs for linezolid and oxacillin).

Abstract:

3012 Background: Translational research studies in the context of clinical trials using targeted therapies are essential for the identification of biomarkers of response or resistance. However, many challenges (e.g. logistic, technical) can impede proper biological sample collection. The NEOALTTO study provided an excellent opportunity to address these issues. Methods: In this large neoadjuvant phase III multicenter, multinational clinical trial, serial samples (plasma, serum, frozen and FFPE specimens) from patients with breast cancer were collected in 86 sites (23 countries) at several time points (baseline, week 2 and surgery). Standardized operating procedures were made available to sites together with pre-assembled kits for sample collection, processing, storage, and shipment to reduce the variability and increase compliance with the study protocol. All biospecimens were centralized for long term storage. Baseline fresh/frozen samples were processed for downstream analyses according to a pre-defined workflow. Evaluable sample population (ESP) was determined based on the following criteria: tumor cellularity, RNA integrity (RIN), and yield. Results: A total of 12,193 serial samples from 449 of 455 randomized patients was collected. The overall sample missing rate was 9.5% (includes samples not collected by site, withdrawn patients and pCR). Missing rates were 9%, 8%, 13%, and 9% for plasma, serum, frozen and FFPE specimens, respectively. At least 1 frozen tumor tissue was available for 423 (94%), 431 (96%), and 334 (74%) patients at baseline, week 2, and surgery, respectively. After 2 extraction cycles, 629 and 516 baseline frozen samples were processed for RNA and DNA extraction, respectively. The ESP was 71% (58% when RIN considered) and 80% for downstream RNA- and DNA-based analyses, respectively. Incorrect material, inappropriate sample processing and low or absent tumor cellularity were some of the factors affecting the ESP. Conclusions: These results show that careful upfront logistic and technical planning in NEOALTTO had a significant impact on the compliance and the quality of collected material, which may ultimately result in valuable research data. Clinical trial information: NCT00553358.

Abstract:

ABSTRACT Background Many female residents choose to start families during training, and they want to breastfeed their infants. Continuing lactation while balancing service and education demands can be challenging. Objective We hypothesized that the presence of a dedicated and fully equipped lactation room with a hospital-grade pump (HGP) would increase ease and efficiency of lactation during residency. Methods A quiet HGP was purchased for resident use, and it was stored in a designated room with a computer, telephone, and dictation system. Lactating residents provided information about pumping time and production using their own portable double electric pump (PP) versus the HGP based on the first pump of the morning (for consistency), averaged over the first month back from maternity leave. Results Among 6 residents, lactation time with PP averaged 24 minutes (range, 15–40 minutes) versus 15.5 minutes with HGP (range, 10–32 minutes). Use of the HGP reduced total pumping time by 8.5 minutes (95% confidence interval 3.8–12.2, P = .045). Production volume increased from 6 ounces (range, 3.5–8.5 ounces) with PP to 8.8 ounces (range, 8–11 ounces) with HGP, for a mean increase of 2.8 ounces (95% confidence interval 1.2–4.3, P = .06) despite decreased lactation time. Conclusions In our pilot, an HGP significantly decreased lactation time, while increasing expressed milk volume. Residents completed clinical and educational tasks while pumping. Providing an HGP and equipped lactation space helped residents continue breastfeeding and decreased the burden of lactation on patient care and educational tasks.

Abstract:

Abstract Cancer patients face an increased risk of arterial thromboembolism; however, it is uncertain when this excess risk begins. This study evaluated the risk of arterial thromboembolism before cancer diagnosis. Using the population-based Surveillance Epidemiology and End Results-Medicare linked dataset, we identified 374 331 patients ≥67 years of age with a new primary diagnosis of breast, lung, prostate, colorectal, bladder, uterine, pancreatic, gastric cancer, or non-Hodgkin lymphoma from 2005 through 2013. Cancer patients were individually matched by demographics and comorbidities to Medicare beneficiaries without cancer, who served as controls. Validated diagnosis codes were used to identify arterial thromboembolic events, defined as a composite of myocardial infarction or ischemic stroke. The Mantel-Haenszel estimator was used to compare risks of arterial thromboembolic events between cancer and noncancer groups during 30-day periods in the 360 days before date of cancer diagnosis. From 360 to 151 days before cancer diagnosis, the 30-day interval risks of arterial thromboembolic events were similar between cancer patients and matched controls. From 150 to 1 day before cancer diagnosis, the interval 30-day risks of arterial thromboembolic events were higher in cancer patients vs matched controls, progressively increasing as the cancer diagnosis date approached and peaking during the 30 days immediately before cancer diagnosis, when 2313 (0.62%) cancer patients were diagnosed with an arterial thromboembolic event vs 413 (0.11%) controls (odds ratio, 5.63; 95% confidence interval, 5.07-6.25). In conclusion, the risk of arterial thromboembolic events begins to increase 150 days before the date of cancer diagnosis in older persons and peaks in the 30 days before.

Abstract:

Purpose Etoposide and cisplatin (EP) has been a standard treatment for extensive-disease small-cell lung cancer (SCLC). An earlier phase III trial reported improved survival for patients receiving irinotecan plus cisplatin (IP) versus EP. Our trial was designed to determine if a modified weekly regimen of IP would provide superior survival with less toxicity than EP. Patients and Methods The primary objective was to compare overall survival in extensive-disease SCLC patients randomly assigned to receive IP (n = 221) or EP (n = 110). Patients were randomly assigned in 2:1 ratio to cisplatin 30 mg/m2 intravenously (IV) + irinotecan 65 mg/m2 IV on days 1 and 8 every 21 days, or cisplatin 60 mg/m2 IV on day 1, and etoposide 120 mg/m2 IV on days 1 to 3 every 21 days for at least four cycles, until progressive disease, or until intolerable toxicity resulted. Results Selected grade 3/4 toxicities for IP/EP were: neutropenia (36.2% v 86.5%; P < .01), febrile neutropenia (3.7% v 10.4%; P = .06), anemia (4.8% v 11.5%; P = .02), thrombocytopenia (4.3% v 19.2%; P < .01), vomiting (12.5% v 3.8%; P = .04), and diarrhea (21.3% v 0%; P < .01). There was no significant difference in response rates (48% v 43.6%), median time to progression (4.1 v 4.6 months), or overall survival (median survival time, 9.3 months v 10.2 months; P = .74). Conclusion Treatment with this dose and schedule of IP did not result in improved survival when compared with EP. Fewer patients receiving IP had grade 3/4 anemia, thrombocytopenia, neutropenia, and febrile neutropenia compared with patients receiving EP, but more had grade 3/4 diarrhea and vomiting.

Abstract:

Background:When not responding to conventional synthetic DMARDs (csDMARDs), rheumatoid arthritis (RA) patients may receive biological DMARDs (bDMARDs) or targeted synthetic DMARDs (tsDMARDs) including baricitinib (BARI). While BARI has demonstrated efficacy in randomized controlled trials, limited studies have established comparative effectiveness in real world settings, in particular when used in b/tsDMARD-naïve patients.Objectives:To analyze the effectiveness of BARI versus alternative bDMARDs, as assessed by drug maintenance over time and by response rates at 12 months.Methods:This is a nested study of RA patients, within the prospective Swiss Clinical Quality Management (SCQM) observational cohort.All treatment courses (TC) with BARI or alternative bDMARDs initiated between 2017-09-01 and 2020-06-01, with at least one follow-up visit, were included. TC with BARI were compared to TC with alternative bDMARDs (non-BARI), including all b/tsDMARDs except rituximab. The non-BARI group was then subdivided into TNF inhibitors (TNFi) and other mode of action bDMARDs (OMA), excluding tsDMARDs. A secondary analysis focusing specifically on b/tsDMARD naïve patients was conducted.Baseline characteristics were compared using ANOVA or χ2 tests. A Cox-model survival analysis assessed drug maintenance. 12-month response rates were estimated using an attrition-corrected, confounder-adjusted approach (1). CDAI score ≤10 defined low disease activity state (LDA), and CDAI score ≤2.8 defined remission.Results:Overall, 1218 eligible TC (from 1028 patients) were initiated during the study period (273 in BARI, 154 other tsDMARD, 473 in TNFi and 318 in OMA). Drug maintenance was significantly shorter for TNFi compared to BARI, even after adjustment for potential confounders (Hazard ratio (HR) for drug discontinuation 1.85 (95% CI [1,40 – 2,43]); p < 0.001). Drug maintenance was also numerically shorter for the OMA group compared to BARI, but the difference was not significant (HR 1.18 (95% CI [0.87 – 1.60]); p = 0.28). These differences were larger when analysing only bDMARD-naïve patients (Figure 1a).All TC taken together, the rates of LDA and remission did not differ significantly between the 3 groups at 12 months. LDA ranged from 63% to 67% (BARI vs OMA p = 0.87; BARI vs TNFi p = 0.81) and remission from 19% to 23% (BARI vs OMA p = 0.30; BARI vs TNFi p = 0.77; Figure 1b).Conclusion:BARI demonstrated a significantly higher overall drug maintenance than TNFi, and a similar drug maintenance to OMA, both in a bDMARD-naïve population and in the overall population. The adjusted 12-month response rates did not differ between BARI, TNFi and OMA groups. These results suggest that prescription of BARI after csDMARD has at least similar outcomes as alternative bDMARDs.References:[1]Lauper, K., et al. Sat0588. Annals of the Rheumatic Diseases 78 (2019).Table 1.Baseline characteristics of studied populationVariableOverall comparison:BARI vs non-BARISubgroup analysis 1:by bDMARD type (tsDMARD excluded)Subgroup analysis 2:In b/tsDMARD-naïve patientsBARI(TC = 273; 273 patients)Non-BARI(altogether)(TC = 945; 755 patients)p valuesTNFi(TC = 473; 408 patients)OMA(TC = 318; 298 patients)p values(vs BARI)BARI(n = 46)TNFi(n = 225)OMA(n = 65)p valuesMean (SD)Otherwise: n %Mean (SD)Otherwise: n %Mean (SD)Otherwise: n %Concomitant csDMARD41 %46 %0.1754 %41 %<0.0150 %61 %48 %0.1Line of Therapy-1st (= bio-naive)17 %35 %<0.0148 %20 %<0.01100 %100 %100 %-2nd20 %23 %23 %23 %-3rd19 %16 %11 %24 %-4th or later44 %26 %18 %33 %Female78%74 %<0.2174 %73 %0.2870 %71 %74 %0.88Age59 (14)56 (14)0.0152 (15)58 (13)<0.0157 (15)51 (14)57 (16)<0.01Disease duration (years)13 (10)10 (9)<0.018 (9)11 (9)<0.015.5 (6.45)5 (7)6.5 (9)0.243CDAI baseline15 (9)15 (10)0.914 (9)16 (11)0.0513 (7)14 (9)14 (10)0.72Previous tsDMARD (non-BARI)33 %8 %<0.014 %11 %<0.010 %0 %0 %TC duration > 12-months37 %29 %0.0127 %30 %0.0237 %29 %34 %0.52BARI = baricitinib, TNFi = TNF inhibitors, OMA = other mode of action, Non-BARI = TNFi + OMA + other tsDMARDs, SD = standard deviation.Disclosure of Interests:Benoit GILBERT: None declared, Delphine Courvoisier: None declared, Denis Mongin: None declared, Kim Lauper Consultant of: Gilead Galapagos, Grant/research support from: AbbVie, Clementine Perrier Shareholder of: Eli Lilly, Employee of: Eli Lilly, Rudiger Muller Consultant of: AbbVie, Novartis, Grant/research support from: GEBRO Pharma, Axel Finckh Speakers bureau: AbbVie, BMS, Pfizer, Eli-Lilly, Consultant of: AbbVie, BMS, Pfizer, Eli-Lilly, Grant/research support from: BMS, Pfizer, Eli-Lilly

Abstract:

Abstract In addition to its common bone and visceral manifestations GD is frequently associated with B cell proliferation leading possibly to MG. The objective of our study was to determine the frequency and presentation of MG in GD patients. Material and methods. FROG is a cross-sectionnal epidemiological study on adult GD involving 64 French centers. Standard clinical, biological(including serum protein electrophoresis) and imaging data performed as part of usual management within the 3 previous years were collected at the time of a routine visit. In patients with suspected MG specific additionnal data were studied:immunofixation, dosage of immunoglobulins, bone marrow aspiration. Results. From 05/2005 to 06/2006 seventy seven adult GD type 1(38 male,39 female;mean age 47.3 years, range 18 to 78 years) were included. Sixteen cases of MG(20.8%) were observed (10 male and 6 female;mean age 61.25 years, range 47 to 79 years). Mean age of 61 cases of GD without MG(43.8 years;range 18 to 70 years)was significantly lower(p&lt;0.0001). Thirteen cases(17%)were classified as MGUS and 3 (3.8%) as B cell malignancy:1 multiple myeloma, 1 Chronic Lymphocytic Leukemia, 1 Non Hodgkin Lymphoma. In 3 cases MG and GD were diagnosed simultaneously. In 13 cases MG was diagnosed in the course of GD(mean interval 12.2 years;range 6.7 to 16 years). MG immunochemical typing revealed 75 % Ig G, 12.5 %Ig A, 12.5 %Ig M, 75 % Kappa and 25 % Lambda. We observed one biclonal gammopathy(IgG and IgA Kappa). One case of MGUS was associated with capillary leak syndrome. In two patients MG level decreased with enzyme replacement therapy. Conclusion. Frequency of MG in GD observed in our study (20.8%)is largely higher than in general population (1%). Furthermore this frequency is higher than in previous series of GD. However in GD patients, as observed in general population, frequency of MG seems to be related to age as mean age of patients with MG is significantly higher than mean age of patients without MG. Finally these data assess the need of specific follow-up regarding the high frequency of MG and the risk of B cell malignancy in GD patients.

Abstract:

242 Background: Two recent clinical trials (IMPRESS and APACT) suggest the overall survival (OS) of patients with resected pancreatic cancer (RPC) is far longer than previously believed. Improvements in patient selection, intra/post-operative surgical care adjch are suggested as explanations for the improved OS. RWE of time to progression (TTP) from surgery were calculated to assess if the results of these trials are generalizable. Methods: RPC patients (ICD-9=157.x, excluding 157.4; CPT=48140, 48146, 48150, 48152-5) diagnosed between 03/2012-06/2015 were selected from the Inovalon More2 administrative claims database. Adjch was defined as initiating chemotherapy within 90 days of surgery. TTP was the time from surgery until the first claim for metastatic disease (ICD-9 =196.0-.3, .5-.6, 197.0-.8, 198.0-.8) using the Kaplan-Meier method. Patients without a metastatic diagnosis during their follow-up were censored at 12 months to adjust for underreporting of metastatic disease codes in claims. Results: 1,014 RPC patients selected. Mean follow-up time was 12.9 months (SD = 10.8). Mean age at diagnosis was 62.7 years (SD = 13.0) and 39.7% (n=403) had commercial insurance, 40.9% (n=415) Medicare and 18.5% (n=188) Medicaid. Of all RPC patients, 54.4% (n=552) received any chemotherapy of which 59.8% (n=330) was adjch; 37.4% (n=379) were diagnosed with metastatic disease at the time of or following resection. The rate of progression events was 40.5% (n=277) without adjch and 30.9% (n=102) with adjch (p<0.01). Among all resected patients, median TTP was 15.7 months (95% CI: 13.8-26.0) with 93.7% (n=355) of progression events by 12 months. Median TTP was 20.4 months (95% CI: 15.5-NR) in patients receiving adjch vs 17.7 months (95% CI: 17.7-31.5) without adjch (p=<0.0001). Conclusions: This analysis demonstrated a 2.7 month longer TTP for patients who received adjch compared to those who did not (p<0.0001). The median TTP in both adjch and non-adjch groups was longer than the observed in the ESPAC-1 trial for adjch patients TTP (15.3 months) and OS (20.1 months). These data support a new baseline for efficacy in adjch trials and are in line with more recent RCT estimates.

Abstract:

Abstract Background: In our GHSG HD18 study for patients with newly diagnosed advanced-stage Hodgkin's lymphoma (HL), we used early interim positron emission tomography after 2 cycles of eBEACOPP (PET-2) to guide further treatment. In contrast to other groups, we defined a Deauville score at interim staging (iDS) ≥ 3 as positive. The prognostic impact of PET-2 in the context of eBEACOPP was and still is unclear, however. We thus investigated its association with baseline characteristics and treatment outcome in patients treated with eBEACOPP in our international phase 3 HD18 trial (NCT00515554). Methods: We recruited 2101 patients aged 18-60 years between 05/2008 and 07/2014. All patients received 2xeBEACOPP followed by centrally assessed PET-2, determining the iDS ranging from 1 (no FDG uptake) to 4 (FDG uptake above liver). Before 06/2011, patients were randomized 1:1 between 8xeBEACOPP and experimental treatment depending on iDS. After 06/2011, patients with iDS 1-2 were randomized 1:1 between 6xeBEACOPP and 4xeBEACOPP treatment, while all patients with iDS 3-4 received 6xeBEACOPP. Radiotherapy was recommended in case of residual lesions with DS ≥ 3 (until 04/2014)/ DS 4 (after 04/2014) after chemotherapy. We explored the association of iDS with baseline characteristics, and assessed treatment outcomes according to iDS among patients treated with 6xeBEACOPP within our trial after 06/2011, considering different cutoffs for positivity. We applied means of descriptive statistics, Fisher's exact test and multivariate logistic regression, and analyzed survival outcomes according to Kaplan-Meier, using Cox regression for comparisons. Findings: Among 1945 randomized patients, 1005 (52%), 471 (24%) and 469 (24%) had iDS 1-2, 3 and 4, respectively, according to central review of PET-2. Many clinical risk factors were associated with an unfavorable iDS, including adverse performance status, high international prognostic score (IPS) and the presence of large mediastinal mass (LMM), extranodal disease, 3 or more nodal areas and elevated ESR. Since patients with clinical stage (CS) IIB were only qualified for the trial when presenting with a large mediastinal mass, they had a high iDS more often than patients with CS III or IV or without B symptoms. Accordingly, in a multivariate analysis including all factors with univariate p&lt;0.001, only LMM, extranodal involvement and a high IPS remained significant. After 06/2011, 216 patients with iDS 1-2 and all 506 patients with iDS 3-4 were assigned to receive 6xeBEACOPP. Among those 722 patients, PET after chemotherapy due to the presence of residual lesions was done in 83 (38%), 204 (76%) and 188 (80%) of patients with iDS of 1-2, 3, and 4, respectively, and FDG uptake above the liver (DS4) was observed in 3 (1%), 19 (7%) and 73 (31%), respectively (p&lt;0.0001 each). Radiotherapy was performed in 9 (4%), 89 (33%) and 108 (46%), respectively (p&lt;0.0001). With a median observation time of 37 months, 3-year PFS was 92.2%, 95.9% and 87.6% with iDS 1-2, 3 and 4, respectively (figure 1). The Hazard Ratio (HR) for iDS 3-4 vs. 1-2 was 1.1 (95% CI 0.6-1.9, p=0.8), but for iDS 4 vs. 1-3 it was 2.3 (95% CI 1.3-3.8, p=0.002). When including the associated baseline factors LMM, extranodal involvement and elevated IPS, the effect of iDS 4 remained significant (HR 2.4, 95% CI 1.4-4.1, p=0.002). Overall survival after 3 years was 97.6%, 99.0% and 96.8% with iDS of 1-2, 3 and 4, respectively, with a univariate HR for score 3-4 vs. 1-2 of 0.9 (95% CI 0.3-2.3, p=0.8) and for score 4 vs. 1-3 of 2.6 (95% CI 1.0-6.6, p=0.04). In the multivariate model, the effect of iDS 4 was even more pronounced (HR 3.2, 95% CI 1.3-8.3, p=0.02). Conclusion: The Deauville score after 2xeBEACOPP is associated with many clinical risk factors at baseline. For patients treated with 6xeBEACOPP followed by irradiation of PET-positive residuals, iDS 3 does not indicate an increased risk of treatment failure and is associated with long-term outcomes identical to those after clearly negative PET-2 (iDS 1-2). DS 4 at PET-2 adds some prognostic information to the baseline risk factors, but 3-year outcomes do not suggest a need for treatment intensification beyond standard therapy. Based on these results, the GHSG has decided to adopt the more widely used cutoff of iDS 4 for PET positivity. Thereby, about 75% of patients could take advantage of the abbreviated treatment with only 4 cycles of eBEACOPP in a PET-2-guided approach as defined in the HD18 study. Figure 1 Figure 1. Disclosures Borchmann: Novartis Pharmaceuticals Corporation: Honoraria. Greil: Takeda: Honoraria, Research Funding; Roche: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: travel support, Research Funding; Novartis, Celgene: Research Funding; BMS, Amgen: Honoraria. Meissner: Takeda: Other: Non-Financial Support; BMS: Other: Non-Financial Support; Celgene: Other: Non-Financial Support; Amgen: Other: Non-Financial Support. Krause: Novartis: Honoraria. Engert: Affimed: Consultancy, Research Funding; Amgen: Consultancy, Research Funding; Bristol-Meyers Squibb: Consultancy, Research Funding; Takeda Oncology: Consultancy, Research Funding.

Abstract:

Abstract Abstract 3384 Poster Board III-272 Purpose: Hematopoietic stem cell transplantation (HSCT) is routinely offered to suitable candidates with high-risk or advanced acute lymphoblastic leukemia. In this report we describe our experience with a novel conditioning regimen, previously reported to confer low TRM and high OS in AML, in this population. Patients and Methods: Between 05/2000 and 06/2008 44 patients with high-risk (either adverse cytogenetics, age > 35 or high WBC at diagnosis) or advanced (>CR1) ALL received HSCT after myeloablative conditioning using Fludarabine 50 mg/m2 days -6 to -2, Busulfan 3.2 mg/kg days -5 to -2, and TBI 2 Gy x 2 doses. GVHD prophylaxis was with rabbit ATG 0.5 mg/kg day -2, then 2 mg/kg days -1 and 0, CyA (tapered on day +56) and short-course methotrexate. All patients were in remission at the time of transplant. Imatinib mesylate (Gleevec) was not used routinely before or after transplant for patients with BCR-Abl+ ALL. Median (range) follow-up of surviving patients is 4.3 (1.0 – 9.0) years. All patients were followed for at least 1 year after BCT. Results: The cohort consists of 32 patients with high-risk (median age 40 (19-64) years) and 12 patients with advanced (median age 25 (19-65) years) disease who received bone marrow (n=5), G-CSF mobilized blood stem cells (n=38) or umbilical cord blood stem cells (n=1) from 25 related (21 fully-matched) or 19 unrelated (16 fully-matched) donors. Median times to neutrophil and platelet engraftment were 14 (11-28) days and 18 (9-105) days, respectively. Five patients did not require platelet transfusion. Cumulative incidences of grade II-IV and grade III-IV acute GVHD were 53.2% (95% CI 36.3%-67.5%) and 20.6% (95% CI 3.5%-47.6%), respectively. Chronic GVHD complicated 55% (95% CI 38.4%-68.8%) of transplants. Six patients (13.6%) died in remission before day +100. Event-free and overall survivals at 5 years were 56.7% (95% CI 39.1%-71.0%) and 66.0% (95% CI 48.8%-78.6%), respectively. Nine patients (20%) died in remission, 6 (14%) died after relapse and two patients remain alive following second transplants for relapsed disease. Five of 11 patients age > 50, 8/12 patients with advanced disease and 13/23 patients with adverse-risk cytogenetics remain alive. Conclusion: We found encouraging results with FluBup-ATG-TBI in a cohort of patients with advanced or high-risk ALL. These results warrant comparison with other conditioning regimens in a randomized, multi-center study. Disclosures: Daly: Hoffmann-Laroche: Advisory Board, Honoraria. Stewart:Hoffmann La Roche: Advisory Board, Honoraria, Research Funding.

Abstract:

e11063 Background: The goal of this study was to compare treatment patterns and outcomes in patients receiving a HER2 directed therapy for the treatment of HER2+ metastatic breast cancer (mBC). Methods: Female mBC patients (with ≥2 claims with ICD9 diagnosis codes for mBC), age ≥18 years receiving treatment with trastuzumab (T) or lapatinib (L) between 1/1/06 and 8/31/11 were identified in the HealthCore Integrated Research Database (HIRDSM). The earliest mBC claim was defined as index date. Patients with <12 months preindex and ≥6 months postindex continuous eligibility were excluded. Two cohorts were identified: T group received T only; TL group received both L and T (sequentially or together). Treatment duration, metastasis site (mets) at mBC diagnosis, no. of chemotherapy agents, no. of hospitalizations, and total cost of care were assessed in the two groups. Results: Of 1449 patients who received a HER2 directed agent, 1165 were in the T group (mean age 56 yrs) and 284 in the TL group (mean age 54 yrs). T group mets included bone (n=553, 48%), liver (n=336, 29%) and brain (n=283, 24%) mets; TL group had bone mets (n=225, 79%), brain mets (n=167, 59%) and liver mets (n=153, 54%). Mean no. of chemotherapy agents received was lower in T group 3.3 (SD 1.7) compared to TL group 5.8 (SD 2.1) (p=0.0002). The time from 1st mBC diagnosis to treatment with T or L was 117 (SD 217) days in T group and 107 (SD 208) days in TL group. For TL group, time between index date and treatment was 114 (SD 214) days for T and 690 (SD 400) days for L. The mean treatment duration was shorter in T group 417 (SD 366) days compared to TL group 724 (SD 433) days (p<0.0001). TL patients received 579 (SD 402) days of T and 205 (SD 234) days with L. Number of hospitalizations and total cost of care (mean monthly) were 0.1 (SD 0.2) and $12561 (SD $10,975), respectively for T group and 0.1 (SD 0.1) and $13,532 (SD $7,220), respectively for TL group. Conclusions: Mean treatment duration and mean number of chemotherapy agents suggest that the TL group may have received more lines of treatment than the T group. There was no difference in mean monthly costs between the two groups. Medical chart data will be used to confirm treatment patterns and evaluate treatment outcomes in both groups.

Abstract:

Eucalyptus spp., most of which are native to Australia, are one of the world's most commonly planted forestry crops, and have been widely planted in the tropics and subtropics. Eucalyptus trees are distributed in more than 600 counties in 19 provinces/regions throughout China, especially in the southern regions of the country (1). From April of 2013 to May of 2014, eucalyptus trees were noted to be wilting and dying rapidly in Kunming, Yunnan Province (25°02′ N, 102°42′ E), southwest China. Symptomatic trees typically have many wilted or dead leaves hanging throughout the tree or on some major branches, sometimes followed by death of the whole tree. Dark brown to black discoloration can be seen in the woody xylem, and elongated cankers were also present on some affected trees. A fungus was consistently isolated from the leaves and cankers when symptomatic tissue was incubated between two slices of fresh carrot root. Spore masses were removed from the apices of perithecia, transferred to malt extract agar medium (MEA), and incubated at 25°C. Perithecia developed on the medium, and were black, globose, 212.5 to 242.4 × 207.5 to 254.2 μm, and possessed a long black neck (952.3 to 1,303.3 μm). Ascospores had the typical “hat” morphology and were 4.3 to 5.2 × 3.0 to 3.8 μm. Cylindrical endoconidia (11.2 to 22.2 × 3.9 to 6.1 μm) were found. Chlamydospores produced on media were ovoid and smooth, and were 7.8 to 9.7 × 9.9 to 12.8 μm. Chains of barrel-shaped conidia were not found. PCR amplification and sequencing of the ITS region of rDNA were carried out for one isolate, E2-2, using the procedures of Thorpe et al. (3). Analysis of ITS sequence data (GenBank Accession No. KJ511481) showed that the isolates were 99% hom*ologous to the isolate of C. fimbriata from diseased Colocasia esculenta in Cuba, China, and Hawaii (AY526304 to 06) by BLAST analysis. Thus, the fungus was identified as C. fimbriata based on morphological and molecular characteristics. Pathogenicity tests were made on 1-year-old E. grandis seedlings as follows. A conidial suspension of each isolate was diluted to 106 conidia/ml, and 0.2 ml was injected into wounds on three petioles on each of five healthy plants of E. grandis, and control seedlings were injected with sterile water that had been placed on MEA plates. The seedlings were incubated at 25°C in moist chambers. After 3 days, all inoculated E. grandis plants showed dark brown to black discoloration in the leaf axils. After 5 days, leaf wilting was present. C. fimbriata was re-isolated from all inoculated symptomatic tissue. No symptoms were visible in the control plants and no fungus was isolated from them. Ceratocystis wilt was first observed in eucalyptus in 1997 in the state of Bahia. This was followed by a report of C. fimbriata causing wilt of E. grandis in the Republic of Congo, Uganda, and Uruguay (2). Chen et al. reported two species of Ceratocystis, C. acaciivora and a previously undescribed species C. chinaeucensis, from eucalyptus plantations in Guangdong Province in China (1). To our knowledge, this is the first report of C. fimbriata causing wilt of eucalyptus in China. References: (1) S. F. Chen et al. Fungal Diversity 58:267, 2011. (2) F. A. Ferreira et al. Fitopatol. Bras. 24:284, 1999. (3) D. J. Thorpe et al. Phytopathology 95:316, 2005.

Abstract:

Background:IgA vasculitis (IgAV) and IgA nephropathy (IgAN) are inflammatory conditions that share pathogenic and molecular mechanisms [1] and may represent different outcomes of a continuous spectrum of disease [2]. Interleukin (IL)17A has been identified as a common genetic risk locus for several immune-mediated diseases [3, 4].Objectives:To determine whether IgAV and IgAN exhibit a different IL17A association pattern.Methods:Five IL17A tag polymorphisms (rs4711998, rs8193036, rs3819024, rs2275913 and rs7747909) were genotyped in 388 Caucasian patients with IgAV, 99 patients with IgAN and 1,003 sex and ethnically matched healthy controls.Results:No statistically significant differences between patients with IgAV and healthy controls and between patients with IgAN and healthy controls were observed when each IL17A genetic variant was analyzed independently (Table 1). Similarly, IgAV patients exhibited similar genotype and allele IL17A frequencies than those with IgAN (Table 1). Moreover, no genotype or allele differences between IgAV patients who developed nephritis and patients with IgAN were detected. Furthermore, haplotype frequencies were similar in patients with IgAV, IgAV and nephritis and those with IgAN.Table 1.Genotype and allele frequencies of IL17A gene in patients with IgA vasculitis, patients with IgA nephropathy and healthy controls.PolymorphismChangeData set1/11/22/212rs4711998G/AIgAV53.4 (207)38.9 (151)7.7 (30)72.8 (565)27.2 (211)IgAN49.0 (48)42.9 (42)8.2 (8)70.4 (138)29.6 (58)Controls52.7 (529)41.2 (413)6.1 (61)73.3 (1471)26.7 (535)rs8193036T/CIgAV57.0 (221)38.4 (149)4.6 (18)76.2 (591)23.8 (185)IgAN64.3 (63)31.6 (31)4.1 (4)80.1 (157)19.9 (39)Controls60.3 (605)35.2 (353)4.5 (45)77.9 (1563)22.1 (443)rs3819024A/GIgAV44.1 (171)43.3 (168)12.6 (49)65.7 (510)34.3 (266)IgAN39.4 (39)54.5 (54)6.1 (6)66.7 (132)33.3 (66)Controls45.6 (457)44.6 (447)9.9 (99)67.8 (1361)32.2 (645)rs2275913G/AIgAV44.6 (172)43.3 (167)12.2 (47)66.2 (511)33.8 (261)IgAN39.8 (39)53.1 (52)7.1 (7)66.3 (130)33.7 (66)Controls44.8 (449)44.2 (443)11.1 (111)66.8 (1341)33.2 (665)rs7747909G/AIgAV53.9 (209)39.4 (153)6.7 (26)73.6 (571)26.4 (205)IgAN41.1 (39)54.7 (52)4.2 (4)68.4 (130)31.6 (60)Controls53.0 (532)39.4 (395)7.6 (76)72.7 (1459)27.3 (547)Conclusion:Our results revealed that IgAV and IgAN share a similar IL17A association pattern.References:[1]N Engl J Med 2013;368:2402-14.[2]Am J Kidney Dis 1988;12:373-7.[3]Ann Rheum Dis 2014;73:1742-5.[4]Mediators Inflamm 2018;2018:1395823.Acknowledgements:This study was supported by European Union FEDER funds and “Fondo de Investigaciones Sanitarias” (grant PI18/00042) from ‘Instituto de Salud Carlos III’ (ISCIII, Health Ministry, Spain). DP-P is a recipient of a Río Hortega programme fellowship from the ISCIII, co-funded by the European Social Fund (ESF, `Investing in your future´) [grant number CM20/00006]; SR-M is supported by funds of the RETICS Program co-funded by the European Regional Development Fund (ERDF) [grant number RD16/0012/0009]; VP-C is supported by a pre-doctoral grant from IDIVAL [grant number PREVAL 18/01]; BA-M is a recipient of a `López Albo´ Post-Residency Programme funded by Servicio Cántabro de Salud; LL-G is supported by funds of IDIVAL [grant number INNVAL20/06]; RL-M is a recipient of a Miguel Servet type I programme fellowship from the ISCIII, co-funded by the European Social Fund (ESF, `Investing in your future´) [grant number CP16/00033].Disclosure of Interests:Diana Prieto-Peña: None declared, Fernanda Genre: None declared, Sara Remuzgo Martinez: None declared, Verónica Pulito-Cueto: None declared, Belén Atienza-Mateo: None declared, Belén Sevilla: None declared, Javier Llorca: None declared, Norberto Ortego: None declared, Leticia Lera-Gómez: None declared, Maite Leonardo: None declared, Ana Peñalba: None declared, Luis Martín-Penagos: None declared, Jose Alberto Miranda-Filloy: None declared, J. Narváez: None declared, LUIS CAMINAL MONTERO: None declared, PAZ COLLADO: None declared, Antonio Fernandez-Nebro: None declared, Gisela Díaz-Cordoves: None declared, Secundino Cigarrán: None declared, Jesús Calviño: None declared, Carmen Cobelo: None declared, Javier Sanchez Perez: None declared, Diego de Argila: None declared, Esteban Rubio-Romero: None declared, MANUEL LEON LUQUE: None declared, Juan María Blanco-Madrigal: None declared, E. Galindez: None declared, Javier Martin Ibanez: None declared, Santos Castañeda: None declared, Ricardo Blanco Speakers bureau: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen and MSD, Consultant of: Abbvie, Pfizer, Roche, Bristol-Myers, Janssen and MSD, Grant/research support from: Abbvie, MSD and Roche, Miguel A González-Gay Speakers bureau: Pfizer, Abbvie, MSD, Grant/research support from: Pfizer, Abbvie, MSD, Raquel López-Mejías: None declared

Abstract:

Abstract Introduction: Chronic myeloid leukemia (CML) accounts for 7%-15% of all leukemias affecting adults. The incidence in Algeria is 0.4/100,000 inhabitants in 2009. The aim of this study is to establish an Algerian-Tunisian epidemiological approach of CML and to know the characteristics of the disease in both countries. Materials and methods: This is a retrospective, longitudinal and multicenter study, including Algerian and Tunisian patients with CML diagnosed between January 2010 and December 2014. Through a data form distributed to various hematology departments, we collected and analyzed the following information: Patient's general characteristics, profession, circ*mstances of discovery of the disease, clinical and para-clinical examinations outcomes at the time of diagnosis including blood count, blood smear, bone marrow aspiration, cytogenetics, molecular biology, stages of the disease and the Sokal and Eutos prognostic classification scores. Bio-statistical tests: incidence, prevalence and rate of prevalence or relative prevalence (reported to 100,000 inhabitants / year). The descriptive analysis of quantitative and qualitative variables as percentages and 95% confidence interval. The Chi2 test is used to compare two variables. Results: We collected 1349 cases, including 325 from 06 Tunisian hematology units and 1024 from 18 Algerian units. The incidence in the Algerian-Tunisian population was 0.67/100,000 inhabitants with a prevalence rate of 2.72/100,000 inhabitants. The incidence in Tunisia was 0.50 / 100,000 inhabitants with a prevalence of 227 cases in 2014. In Algeria the incidence was 0.53/100,000 inhabitants with a prevalence of 1030 in 2014. The median age is 48 years (03-90) with a peak incidence in the age group (45-49 ans) and slight male predominance (sex ratio: 1,2). There was any notion of risk exposure. The average time between the start of the unrest and the date of diagnosis is 127 days (1-667). The circ*mstances of discovery: fortuitous in 30.5% (n = 355), splenomegaly in 39.7% (n = 463), asthenia in 24.6% (n = 287), a complication in 8.4% (n =95). Clinical examination includes general signs in 424 cases (36.4%): Weight loss 22.6% (n = 263), profuse sweating 13.8% (n = 13, 8%), bone pains found in 7.8%, splenomegaly in 81.7% (n = 952) with an overhang splenic average of 11.5 ± 5.3 cm (1-28), cutaneous and subcutaneous bleeding: 13.5% (n = 97), thrombosis 0.9% (n = 09). Biological characteristics: the Complete blood count (n = 1185) shows a white blood cells average rate of 171,223 G/L (34,700-984,800), hemoglobin average rate of 10.2 g/dl (4-17), platelets at 394,070 g/l (85-1340). Blood smear 96.3% (n = 1121): the average myelemia was 43.2% (10-98%). The Myelogram is practiced in 55% (n = 641), the average rate of the granular 76,5% (40-99%), erythroblasts 10.5% (0-82%), average blasts 3.6%. The karyotype 38.1% (n = 444), the Philadelphia chromosome was found in 423 cases (95, 3%); additional abnormalities were found in 17 cases (3.8%). The Fish was practiced in 281 cases (24.1%) and transcribed bcr/abl was found in 257 cases (91.4%). Molecular biology is practiced in 672 cases (57.7%) the transcript bcr/abl is found in 100%, the transcript of the type is specified in 373 cases, it is kind of b2a2 in 159 cases (42.6%), a b3a2 type in 180 cases (48.3%) and other transcribed in 34 cases (9.1%). CML chronic phase is diagnosed in 88.8% (n = 1051), acceleration phase in 9% (n = 107) acutisation phase in 3.1% (= 37). The distribution of pts according to Sokal prognostic classification (n = 948) describes a predominance of intermediate risk in 54% (n = 511), high risk in 30.3% (n = 287) and low risk in 16% (n = 152). The Eutos score is specified in 769 cases (66%), it is less than 87 in 661 cases (86%) and more than 87 in 108 cases (14%). Conclusion: The incidence of CML in the Algerian-Tunisian population is 0.67/100,000 population with a prevalence rate of 2.72/100,000 inhabitants. The young adult is more affected with a peak incidence between 45 and 49. The average time between the onset of the disease and the diagnosis remains long and the delay probably explains the frequency of tumor forms encountered in Algeria and the prevalence of high and intermediate risk, according to Sokal prognostic classification. Disclosures No relevant conflicts of interest to declare.

Abstract:

Abstract Abstract 3389 Poster Board III-277 Introduction: The optimal preparative regimen for allogeneic hematopoietic stem cell transplantation (alloHCT) using matched unrelated donors (MUD) for adult patients (pts) with acute lymphoblastic leukemia (ALL) in first complete remission (CR1) is currently undefined. There is some evidence from one comprehensive retrospective comparative analysis that a higher dose of hyperfractionated total body irradiation (fTBI) or the use of high-dose etoposide instead of cyclophosphamide is able to reduce the leukemic relapse risk of adult pts transplanted in second CR from HLA-identical sibling donors (ISD) (Marks, DI et al. J Biol Blood Marrow Transplant 12: 438-453, 2006). Purpose: Within the framework of the German multicenter study group for adult ALL (GMALL) protocols 06/1999 and 07/2003, the combination of 12 Gy fTBI + 120 mg/kg cyclophosphamide is the standard preparative regimen for MUD alloHCT in CR1. In these protocols, a preparative regimen of 12 Gy fTBI + 60 mg/kg etoposide before ISD alloHCT in CR1 has shown particular promising results compared to 12 Gy fTBI + cyclophosphamide. Therefore, this pilot study tested the feasibility of the12 Gy fTBI + etoposide regimen for MUD alloHCT in CR1 adult ALL pts. Patients and methods: In the GMALL protocol 07/2003, alloHCT is generally performed after the first consolidation therapy according to predefined prognostic disease features indicating a high relapse risk for pts up to the age of 55 years (yrs). This study prospectively included 20 consecutive (very) high-risk pts (median age: 39 [range 17 to 55] yrs) from two major GMALL transplant centers, who underwent alloHCT using MUD between 01/07 and 03/09. TBI was applied in 2 daily fractions of 2 Gy on 3 consecutive days (days -6 to -4) followed by etoposide on day -3 (alloHCT on day 0). For prophylaxis of acute graft-versus-host disease (GvHD), 3 × 20 mg/kg antithymocyte globuline was given on days -3 to -1 and ciclosporin combined with prednisone thereafter. Results: Neutrophil reconstitution > 0.5/nL was reached after a median of 18 (range 12 to 32) days and self-sustaining platelet counts > 20/nL were attained after a median of 25 (range 13 to 36) days. The cumulative incidence of grades I – IV acute GvHD reached 64 %. Three pts. (15 %) developed acute GvHD > grade II. The cause-specific non-relapse mortality (NRM) incidences at 3, 12 and 24 months are 5 %, 18 %, and 22 % (4/20 pts), respectively. Causes of NRM were infections (2 pts), graft failure and toxic epidermiolysis (1 patient each). The cause-specific leukemic relapse incidence reaches 18 % (3/20 pts) after 12 and 24 months. Two pts were successfully rescued by a 2nd alloHCT after leukemic relapse. After a median follow-up period of 22 months for the 15 surviving pts, the 2-year overall survival estimate is 73 % (95 % confidence limits: 47 % - 89 %). Conclusions: This pilot study demonstrates that the preparative regimen of fTBI + etoposide before MUD alloHCT is feasible in CR1 adult high-risk ALL pts after intensive induction and consolidation courses as applied in the GMALL protocol 07/2003. The comparatively low relapse rate in high-risk ALL pts further supports that the substitution of cyclophosphamide by etoposide leads to better disease control and may thereby improve transplant outcome in this setting. Based on these results, a prospective study comparing fTBI in combination with either etoposide or cyclophosphamide appears justified. Disclosures: No relevant conflicts of interest to declare.

Abstract:

This article presents a specific case study: the proposal to create a new Graduate Program at the School of Education of the University of São Paulo (FEUSP). Everything was precipitated after the results of CAPES´four-year evaluation (2013-16) were published in the last quarter of 2017, since the program´s score was reduced from 6 to 5, that is, it was from now on regulated by the PROAP instead PROEX, because the “excellence” is exclusive from those classified with concepts 6 and 7. This implied a reduction of funds and academic prestige. The consequent divisions and internal cleavages led to a group of teachers taking the initiative to structure a new Program at FEUSP, which, after completing internal procedures to the course (which were not exempt from considerable tensions) and the Rectory of USP, was sent to CAPES for necessary assessment procedures. In December 2019, the outcome, the agency did not to appeal the decision. At the beginning of March 2019, the outcome of the reconsideration request is still pending. The empirical material that grounds the analysis consists of minutes of meetings of the congregation, the departments, the post-graduation committee, as well as written records of the meetings held by professors who intend to integrate the new Program, as also exchanges of electronic messages between the various agents involved in the process.ResumoO artigo faz um estudo de caso específico: o da proposta de criação de um novo Programa de Pós-Graduação junto à Faculdade de Educação da Universidade de São Paulo (FEUSP). Tudo se precipitou após a divulgação dos resultados da avaliação quadrienal (2013-16) da CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior) em fins de 2017, sendo a nota do Programa reduzida de 6 para 5, passando o mesmo a ser regulado pelas normas do PROAP (Programa de Apoio à Pós-Graduação) ao invés do PROEX (Programa de Excelência Acadêmica), pois a “excelência” é restrita aos classificados com conceitos 6 e 7. Isso implicou em redução de verbas e prestígio acadêmico. As consequentes cisões e clivagens internas levou um grupo de professores a estruturar um novo Programa na FEUSP que, após cumprir os trâmites internos à Faculdade (não isentos de consideráveis tensões) e à Reitoria da USP, foi remetido à CAPES para os procedimentos de avaliação de praxe. Em dezembro de 2018 a agência não aprovou a proposta e, dias depois, o grupo de acadêmicos reunidos decidiu recorrer da decisão. No início de março de 2019 ainda se aguardava o resultado do pedido de reconsideração. O material empírico que arrima a análise é constituído por atas de reuniões da congregação, dos departamentos, da comissão de pós-graduação, de registros escritos dos encontros realizados pelos docentes que pretendem integrar o novo Programa, além de trocas de mensagens eletrônicas entre os diversos agentes envolvidos no processo. Keywords: Knowledge production, University graduate in education, Brazilian university Campus, Academic fights.Palavras-chave: Produção do conhecimento, Pós-graduação em educação, Campo universitário brasileiro, Lutas acadêmicas.ReferencesATA da 111ª. Reunião Extraordinária da Congregação (CGR) da Faculdade de Educação da Universidade de São Paulo (FEUSP). São Paulo, 06.03.2018. 18 p.ATA da 492ª. Reunião Ordinária da CGR - FEUSP. São Paulo, 30.11.2017. 17 p.ATA da 432ª. Reunião Ordinária do Conselho do Departamento de Filosofia da Educação e Ciências da Educação (EDF) da FEUSP. São Paulo, 10.11.2017. 5 p. ATA da 434ª. Reunião Ordinária do Conselho do EDF - FEUSP. São Paulo, 09. 02. 2018. 6 p.ATA da 479ª. Reunião Ordinária do Conselho do EDM - FEUSP. São Paulo, 01.12.2017. 8 p.ATA da 482ª. Reunião Ordinária do Conselho do EDM - FEUSP. São Paulo, 06. 04. 2018. 10 p.BOURDIEU, Pierre. Esquisse d´une théorie de la pratique. Genève: Droz, 1972, 282 p.BOURDIEU, Pierre. O mercado de bens simbólicos. In: ______. A economia das trocas simbólicas. São Paulo: Perspectiva, 1974, p. 99-181. 368 p.BOURDIEU, Pierre. La distinction: critique sociale du jugement. Paris: Minuit, 1979, 672 p.BOURDIEU, Pierre. hom*o academicus. Paris: Minuit, 1984, 318 p.BOURDIEU, Pierre. La noblesse d´État: grandes écoles et esprit de corps. Paris: Minuit, 1989, 572 p.CARTA Aberta à Comunidade FEUSP [de membros da CGR/FEUSP]. São Paulo, 26. 02. 2018. 2 p.CARTA de apoio da linha de Pós de Filosofia e Educação à Carta Aberta de 26. 02. 18 de membros da Congregação da FEUSP. São Paulo, 04. 03. 2018. 3 p.CATANI, Afrânio. Esboço de auto-análise: breve trajetória de um professor tupiniquim. In: LUCENA, Carlos; SILVA JR., João R. (Org.). Trabalho e educação no século XXI: experiências internacionais. São Paulo: Xamã, 2012, p. 47-63, 231 p.CATANI, Afrânio. Anotações da reunião dos docentes interessados na criação de novo PPG em Educação/FEUSP. São Paulo: manuscrito, 12.12. 2017a, 3 p.CATANI, Afrânio. Anotações da reunião dos docentes interessados em permanecer no PPG em Educação/FEUSP. São Paulo: manuscrito, 12.12. 2017b, 2 p.CIRCULAR. CoPGr/74/2018 – São Paulo: Universidade de São Paulo, 05. 12. 2017. 5 p.CONTRIBUIÇÃO ao debate sobre o PPG/Educação da FEUSP. São Paulo, 13.12.2017. 3 p.DOCUMENTO base para a plenária final em 27.11.2017. São Paulo: CPG/FEUSP, s.d. 3p.E-MAIL de Universidade de São Paulo: fe@usp.br – Cronograma de reuniões da CPG – 06. 10. 2017. Acesso em: 06.10.2017.E-MAIL de USP: xxx@usp.br – Reunião Geral da Pós – Avaliação CAPES – 16. 10. 2017. Acesso em: 05. 10. 2017.E-MAIL de USP: xxx@usp.br – 22. 11.2017 – Sem assunto. Acesso em: 23.11.2017.E-MAIL de USP: posfe@usp.br – 23.11. 2017 -- Sem assunto. Acesso em: 25. 11. 2017.E-MAIL de USP: xxx@usp.br – 13.12.2017 – Contribuições para a reorganização do PPG/FEUSP. Acesso em: 15.12.2017.E-MAIL de USP: xxx@usp.br – 14.12.2017 – Contribuições para a reorganização do PPG/FEUSP. Acesso em: 15.12.2017.E-MAIL de USP: xxx@usp.br – 17. 12. 2017 – Sobre a reunião do dia 12/12, à tarde. Acesso em: 18.12.2017.E-MAIL de USP: xxx@usp.br -- 04. 02. 2018a – Sobre a próxima reunião da CPG – apontamentos. Acesso em: 06.02.2018.E-MAIL de USP: xxx@usp.br -- 04. 02. 2018b – Sobre a próxima reunião da CPG – apontamentos. Acesso em: 06.02. 2018.E-MAIL de USP: xxx@usp.br -- 13. 03. 2018 – Reunião do PPG Educação em Fronteiras em 16/03. Acesso em: 12. 03. 2018.E-MAIL de USP: xxx@usp.br -- 02. 04. 2018 – Memória da reunião da Pós e convocação de reunião da Área. Acesso em: 04. 04. 2018.E-MAIL de USP: xxx@usp.br -- 12. 12. 2018 – Três assuntos. Acesso em: 12. 12. 2018.E-MAIL de USP: xxx@usp.br -- 12. 02. 2019 – [Declaração da produção de 2018]. Acesso em: 12. 02. 2019.ENCAMINHAMENTOS da Plenária Discente [Representação discente junto ao PPG – FEUSP] de 03. 05. 2018 – Ofício n. 4, de 28. 05. 2018. São Paulo, 2 p.LIMA, Roberto Kant de. A antropologia da academia: Quando os índios somos nós. Niterói: EDUFF (2ª. ed.), 1997. 65 p.MEMÓRIA da Reunião do PPGEF em 17.08.2018. São Paulo: FEUSP. 2 p.MEMÓRIA da Reunião Plenária da CPG-FEUSP. São Paulo, 27.11.2017. 2 p.MEMÓRIA da Reunião Pós 11. 12. 2018. São Paulo: FEUSP. 2 p.MEMÓRIA da Segunda Reunião do PPG Educação em Fronteiras – 16. 03. 2018. São Paulo: FEUSP. 2p.MEMÓRIA da Terceira Reunião do PPG Educação em Fronteiras – 20. 04. 2018. São Paulo: FEUSP. 2 p.MEMÓRIAS e Reflexões da 374ª. Reunião Ordinária da CPG – 05. 02. 2018. São Paulo: FEUSP, 18. 02. 2018. 3 p.MILLS, C. Wright. A elite do poder. Rio de Janeiro: Zahar, 1962, 430 p.PARECER CAPES referente à APCN 453/2018 (PPG Educação em Fronteiras). Brasília: CAPES, 06. 12. 2018, 3 p.PARECER relativo ao conjunto de disciplinas proposto pelo PPG Educação em Fronteiras, da FEUSP. São Paulo, 3 p.PEDIDO de Reconsideração de Resultado da Avaliação da APCN 453/2018 (PPG Educação em Fronteiras – FEUSP). São Paulo: FEUSP, dez. 2018. 3 p.PINA, Manuel António. O coração pronto para o roubo. São Paulo: Editora 34, 2018, 160 p.PLANO de transição [PPG Educação/PPG Educação em Fronteiras]. São Paulo: FEUSP, s. d. 2 p.PROGRAMA de Pós-Graduação Educação em Fronteiras – Proposta de Criação do PPG Educação em Fronteiras. São Paulo: FEUSP, fev., 2018. 36 p.PROGRAMA de Pós-Graduação em Educação – Apresentação – FEUSP: São Paulo. Disponível em: http://www4.fe.usp.br/pos-graduacao/apresentacao. Acesso em: 22.01.2019.PROPOSTA de reenquadramento dos atuais orientadores até o próximo momento de recredenciamento. São Paulo: CPG/FEUSP, s.d., 2 p.RESPOSTA da Coordenação do PPG em Educação da FEUSP ao Ofício n. 4, 28. 05. 2018, da Representação Discente junto ao PPG/FEUSP. São Paulo, s. d. 4 p.SINTESE da Reunião Plenária da Pós-Graduação – 26. 06. 2018. São Paulo, PPG em Educação, FEUSP, s. d., 2 p.SINTESE das Reuniões da Comissão Assessora da Pós-Graduação (15 e 27. 02. 2018) e da 375ª. Reunião Ordinária da CPG – 05. 03. 2018. São Paulo: FEUSP, s. d. 4 p.

Abstract:

Abstract Abstract 1441 Introduction: AML with translocations involving the mixed-lineage leukemia gene (MLL) on chromosome band 11q23 occur in 5–10% of adult cases. Outcome of patients with t(11q23) is generally poor, except for AMLs with t(9;11) that are associated with an intermediate prognosis. Clinical risk factors have been proposed, however, due to the rarity of these AML subtypes and to the great heterogeneity of MLL fusion partners, validation of such risk factors remains a challenge. In two previous studies (Lugthart S et al., Blood 2008; Gröschel S, Lugthart S et al., J Clin Oncol 2010) that included all AML subsets, it has been shown that high expression of the ecotropic viral integration 1 gene (EVI1+ ) is associated with t(11q23) AML; furthermore, EVI1+ appeared to be associated with inferior prognosis in this subset of AML. The aim of this study was to evaluate the prognostic impact of EVI1+ in a large cohort of AMLs with t(11q23) in the context of clinical features and cytogenetic and molecular genetic markers. Patients and Methods: In the AMLSG data base we identified 147 AMLs with t(11q23). In 109 cases material was available for EVI1 expression analysis. Patients were treated on seven different prospective treatment protocols of the German-Austrian AMLSG (HD93, HD98A, HD98B, 07–04, 06–04, SHG295, SHG0199). Results: The 147 MLL -rearranged AMLs were divided into three subgroups: t(9;11)(p22;q23), n=70 (47.6%); t(6;11)(q27;q23), n=26 (17.7%); and t(v; 11q23), n=51 (34.7%). Most common translocation partners within t(v; 11q23) were t(11;19)(q23;p13) (n=15, 29.4%) and t(10;11)(p13;q23) (n=6, 11.8%). Comparison of clinical characteristics between the three subgroups revealed significantly higher LDH levels (median 550 U/L, p=.049), higher rate of therapy-related AML (33.8%, p=.002), and higher incidence of trisomy 8 (25.7%, p=.05) in AML with t(9;11). Deregulated expression of EVI1 was found in 55/109 (50.5%) of all t(11q23) cases; AMLs with t(6;11) showed the highest frequency of EVI1+ (85.7%), followed by AMLs with t(9;11) (44.2%), and t(v; 11q23) (38.9%) (p=.001). Concurrent gene mutations were virtually absent in t(9;11) AMLs; only rare FLT3 -ITDs were identified (3/70 cases; 4.3%), whereas no sequence variations were found for all other genes analyzed (CEBPA, NPM1, RUNX1, IDH1/2, ASXL1, TET2, DNMT3A). There was no difference in achievement of complete remission (CR) between EVI1− and EVI1+ t(11q23) AMLs. In multivariable analysis of the entire t(11q23) cohort, EVI1+ was the only prognostic factor predicting for inferior overall survival (OS) (p=.017, HR 1.88, 95%-CI: 1.12–3.16) and relapse-free survival (RFS) (p=.013, HR 1.96, 95%-CI: 1.15–3.32). EVI1+ AMLs with t(11q23) in first CR had significantly better outcome (OS, p=.01; RFS, p=.002) after allogeneic stem-cell transplantation compared with other consolidation therapies; the 5-year OS rate of EVI1+ AML was 53 % and 0 % after allogeneic SCT and other consolidation therapies, respectively. We also separately analyzed the subset of t(9;11) AML: compared with EVI1− patients, EVI1+ patients had higher white blood cell counts (p=.045); additional presence of trisomy 8 was only found in EVI1- t(9;11) AMLs (11/29, 37.9%; p=.001). In multivariable analysis, EVI1+ again was the sole independent adverse prognostic factor for OS (p=.017, HR 2.55, 95%-CI: 1.18–5.51) and RFS (p=.02, HR 2.39, 95%-CI: 1.14–4.97). Conclusion: Deregulated expression of EVI1 is found in about half of t(11q23) AMLs. EVI1+ is the strongest prognostic factor in all t(11q23) AMLs and in the subset of t(9;11) AMLs. Patients with EVI1+MLL -rearranged AML appear to benefit from allogeneic SCT in first CR. Disclosures: Germing: Celgene: Consultancy, Research Funding.

Abstract:

Abstract In this study priapism is defined as a prolonged erection (&gt; 45 minutes in the absence of sexual stimulation) or any painful erection. Boys and young men with SCD were eligible to participate in completing daily diary pages and overnight hormonal monitoring; the data presented are from 1486 diary days collected from 6 young men with mean age of 20.7 years (range 17 to 23). One subject is SCD-SC and the others SCD-SS. Three had had priapism in the 6 months preceding the study and three had not. Erections and Priapism by Subject Subject Diary&#x2028; Days Days w/any Erection (Erection Days) Erection Days as % of Diary Days Total Days w/Priapism (Priapism Days) Priapism Days as % of Erection Days 1 244 69 28 16 23 2 290 216 74 5 2 3 302 106 35 54 51 4 278 125 45 8 6 5 318 21 7 10 48 6 54 29 54 7 24 Total 1486 566 38 100 18 Mean 248 94 41 17 26 Characterization of Priapism: Priapism occurred on an average of 6.7% of diary days. Eighty-four percent of these episodes were painful but not prolonged, ten percent were prolonged but not painful, and 4% were both. Of the painful erections, 42% lasted &lt;15 minutes, 45% were &gt;15 to 45 min, and 12% were &gt;45 min to 3 hrs. The mean pain score was 4.3 out of 10. Painful events occurred most frequently between 6 am – 12 noon (37%); midnight (MN) to 6 am was the next most frequent time (29%). Erections occurred on 36% of days following a day with priapism; 75% of these erections were also painful or prolonged. Priapism and Normal Erectile Function: Erections occurred on a mean of 38% of all diary days. The proportion of erection days which were priapism days were .02, .06, .23, .24, .48 and .51 for the 6 subjects. Normal erections occurred most frequently between 6am – 12 noon (45%); 6pm – 12 MN was the next most frequent time (24%). Sexual activity (sex), defined as viewing stimulating media, masturbation, sexual intercourse or contact was reported on 22% of the total diary days. On 72% of days where sex was reported, erections were reported, vs 28% of days with no sex. Of erection days, painful erections were reported on 12% where sex occurred and on 20% of days where no sex occurred. Erection days were 50% of days following days with sex, vs 33% of days following days without sex. On erection days following sex days participants reported painful erections on 14% of the days versus 17% of the days following days with no sex. Conclusions: The data suggest some differences with the usual conception of priapism. Most of the episodes which the individuals reported as painful were short, the majority between 15 and 45 minutes, and a sizeable minority were &lt; 15 minutes. The proportion of all erections that were priapic varied greatly within the group, but for 4 of the 6, 25–50% of days on which there was any erection there was priapism. The relationship between sexual activity and priapism in these data suggests fewer painful erections on days where there are both sex and erections, than on days when there are erections but no sexual activity. This is also true on the day following a day with sex—if any erection occurs on these days, fewer are painful than on erection days that occur after a day with no sex. Confirmation of the trends awaits the analysis of more subjects.

Abstract:

Abstract INTRODUCTION: Daratumumab (DARA) is a human IgGκ monoclonal anti-CD38 antibody for treatment of multiple myeloma (MM). In clinical trials, median durations for the 1st, 2nd and subsequent infusions were 7.0, 4.3 and 3.5 hours, respectively. To optimize the first infusion duration of DARA, the US Oncology Network (USON), a community oncology practice network, implemented a split first dose protocol. The USON split first dose protocol requires 2 IV bags, one for Day 1 and one for Day 2 of consecutive days. On each day, DARA is diluted with normal saline to a total volume of 500 mL. On each day, DARA is administered at 50 mL/hour for one hour. If no infusion events occur, the infusion rate can be increased in 50 mL/hour increments every hour to a maximum of 200 mL/hour. While the split first dose may increase convenience, limited information is available on the safety of split first dose DARA. METHODS: This was a retrospective, observational study of adult MM patients who initiated DARA in routine care within USON between 11/01/2015 - 06/30/2017 to compare infusion times and safety of DARA split first dose vs DARA standard dose schedule (i.e., 1 infusion of 16 mg/kg per FDA-approved prescribing information). In this study, patients were grouped into either the split first dose cohort or the standard dose schedule cohort according to the dosing schedule that they had experienced. Data were sourced from USON's electronic healthcare record system. Information on infusion reactions was available only through chart review, which was conducted among a random sample of patients in each study cohort. Descriptive analyses were conducted to compare demographic, clinical and treatment characteristics of MM patients who received split first dose schedule vs standard dosing schedule. Chi-square tests or Fisher's exact tests were used to assess associations between categorical variables. ANOVA/t-tests or Kruskal-Wallis tests were used to assess associations for continuous variables. A p-value of <0.05 was considered as statistically significant. RESULTS: Of the 622 patients included in the landscape analysis, 365 (58.5%) had received the split first dose schedule and 258 (41.5%) had received the standard dosing schedule. Overall, the median age was 63.6 years, 54.2% male and 78.3% Caucasian. The utilization of the split first dose schedule increased significantly over time with more patients in 2017 Q2 having received split dose vs standard dose (p< 0.0001). Karnofsky performance status (KPS) scores differed significantly between patients treated with split first dose vs standard dose (p=0.02). No other baseline differences between groups were found. The median infusion duration was 4.5 hours for Day 1 of split first dose and 6.5 hours for standard dose (p<0.0001). Among patients selected for chart review (n = 302), 47.8% (88/184) of split first dose patients and 48.3% (57/118) of standard dose patients experienced at least one infusion reaction. The most common infusion reactions included lower-respiratory (26.1%), upper-respiratory (17.2%) and gastrointestinal reactions (12.5%), chills (8.9%), flushing (6.6%), with no statistically significant differences between study groups for any infusion reaction. Among patients treated with split first dose DARA, 3.8% experienced an infusion reaction during Day 2 of the split dose schedule. CONCLUSIONS: As a retrospective observational study at community-based oncology clinics, these findings provide real-world evidence on the infusion time and safety of the first infusion of DARA. This study found that the utilization of split first dose has increased over time. Interestingly, more patients in the split dose group had higher KPS scores than patients in the standard dose group, which may be due to selection of patients, at least initially, for the split first dose. This study found also that the length of the first day of the split first dose schedule is shorter than the length of the standard dosing schedule. Additionally, although determination of severity or grade was not feasible in this study, the proportion of patients in split first and standard dosing schedule groups who experienced infusion reactions was equal. This study suggests that the split first dose is comparable to the standard dose schedule and may be a practical option for patients and institutions seeking options to manage the operational considerations of DARA administrations. Table. Table. Disclosures Rifkin: Takeda: Consultancy; EMD Serono: Consultancy; Sandoz: Consultancy; Celgene: Consultancy; McKesson: Equity Ownership; Boehringer Ingelheim: Consultancy; Amgen: Consultancy. Singer:Janssen Scientific Affairs, LLC: Research Funding. Aguilar:McKesson Specialty Health: Employment. Baidoo:McKesson Specialty Health: Employment. Maiese:Janssen Scientific Affairs,LLC: Employment, Equity Ownership.

Abstract:

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Abstract:

Предлагаемая статья состоит из трех небольших очерков. Первый очерк посвящен 60-летнему юбилею доктора исторических наук И.Л. Измайлова. Второй очерк содержит критический обзор версии польского исследователя В. Свентославского о реальности использования татаро-монголами в битве под Легницей (1241 г.) «боевых отравляющих газов». Построенная на сведениях польского историка ХV в. Яна Длугоша версия не имеет никаких серьезных оснований. Последний, третий очерк содержит обзор не всегда позитивного опыта характеристики украинским исследователем – доктором исторических наук Я.В. Пилипчуком (г. Киев) комплекса вооружения предков средневековых ингушей. Простой перечень известных категорий вооружения предков ингушей не дает ясного понимания процесса и динамики развития их военного дела, упрощая осознание всей сложности его формирования. Я.В. Пилипчук, уходя от демонстрации историографического наследия своих предшественников, допускает и неоправданные неточности. 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Abstract:

Inclusion is part of the promotion and exercise of citizenship, and consequently promotes the warranty of rights to all for full social participation, in a fair and egalitarian manner. Considering the several legal mechanisms created to guarantee the equality of rights and the primordial role of education in establishing the inclusion movement, this study aimed to understand through the vision of students with disabilities the educational inclusion in the public university state of the interior of São Paulo (Brazil). The study had as participants five students. In order to reach the objectives, instrument was used to collect data, a semi-structured. The results suggest that the institution does not have an effective culture of accessibility, some barriers were evidenced, such as the lack of identification in the institutional documents of the real type of deficiency that the student; support actions that the institution takes too long to offer or offers through different means than what was requested by the students, and the architectural accessibility of the campus that is not sufficient for all students to have autonomy. However, it is verified that FCL has advanced in the process of inclusion of students with disabilities, as there are some actions by the institution towards an inclusive university. It is possible to observe advances and limits in the process of inclusion of institution.ResumoA inclusão faz parte da promoção e o exercício da cidadania, e consequentemente promove a garantia de direitos a todos para a plena participação social, de forma justa e igualitária. Tendo em vista os diversos mecanismos criados para garantir a igualdade de direitos e o papel primordial da educação para o movimento de inclusão, esse estudo teve como objetivo compreender por meio da visão de alunos com deficiência a inclusão em uma universidade pública do interior do estado de São Paulo. O estudo teve cinco alunos participantes. Para alcançar os objetivos foi utilizada para a coleta de dados uma entrevista semiestruturada. Os resultados sugerem que a instituição não possui uma cultura efetiva de inclusão, algumas barreiras foram evidenciadas, como a falta de identificação nos documentos institucionais do tipo real de deficiência do aluno; ações de suporte que a instituição demora a oferecer ou oferece por meios diferentes do que foi solicitado pelos alunos, e a acessibilidade arquitetônica do campus que não é suficiente para que todos os alunos tenham autonomia. No entanto, verifica-se que a Faculdade de Ciências e Letras tem avançado no processo de inclusão de alunos com deficiência, porque existem algumas ações por parte da instituição que caminham para uma universidade inclusiva. É possível constatar avanços e limites no processo de inclusão da instituição.Palavras-chave: Inclusão, Aluno com deficiência, Educação superior.Keywords: Inclusion, Student with disabilities, Higher education.ReferencesALMEIDA, J.G. A; BELLOSI, T.C; FERREIRA, E.L. Evolução da matrícula de pessoas com deficiência na educação superior brasileira: subsídios normativos e ações institucionais para acesso e permanência. Revista Ibero-Americana de Estudos em Educação. Araraquara, v.10 n.esp., p. 643-660, 2015.ANACHE, A. A.; ROVETTO, S. S. M.; OLIVEIRA, R. A. D. Desafios da implantação do atendimento educacional especializado no Ensino Superior. Revista Educação Especial. Santa Maria, v. 27, n.49, p. 299-312, maio/ago. 2014.BARDIN, L. Análise de conteúdo. 70. ed. 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Abstract:

Background: Although sleep has been identified as an important modifiable risk factor for sports injury, the effect of decreased sleep on sports injuries in adolescents is poorly studied. Purpose: To systematically review published literature to examine if a lack of sleep is associated with sports injuries in adolescents and to delineate the effects of chronic versus acute lack of sleep. Methods: PubMed and EMBASE databases were systematically searched for studies reporting statistics regarding the relationship between sleep and sports injury in adolescents aged <19 years published between 1/1/1997 and 12/21/2017. From included studies, the following information was extracted: bibliographic and demographic information, reported outcomes related to injury and sleep, and definitions of injury and decreased sleep. Additionally, a NOS (Newcastle-Ottawa Scale) assessment and an evaluation of the OCEM (Oxford Center for Evidence-Based Medicine) level of evidence for each study was conducted to assess each study’s individual risk of bias, and the risk of bias across all studies. Results: Of 907 identified articles, 7 met inclusion criteria. Five studies reported that adolescents who chronically slept poorly were at a significantly increased likelihood of experiencing a sports or musculoskeletal injury. Two studies reported on acute sleep behaviors. One reported a significant positive correlation between acutely poor sleep and injury, while the other study reported no significant correlation. In our random effects model, adolescents who chronically slept poorly were more likely to be injured than those who slept well (OR 1.58, 95% CI 1.05 to 2.37, p = 0.03). OCEM criteria assessment showed that all but one study (a case-series) were of 2b level of evidence—which is the highest level of evidence possible for studies which were not randomized control trials or systematic reviews. NOS assessment was conducted for all six cohort studies to investigate each study’s individual risk of bias. Five out of six of these studies received between 4 to 6 stars, categorizing them as having a moderate risk of bias. One study received 7 stars, categorizing it as having a low risk of bias. NOS assessment revealed that the most consistent source of bias was in ascertainment of exposure: all studies relied on self-reported data regarding sleep hours rather than a medical or lab record of sleep hours. Conclusions: Chronic lack of sleep in adolescents is associated with greater risk of sports and musculoskeletal injuries. Current evidence cannot yet definitively determine the effect of acute lack of sleep on injury rates. 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Abstract:

O presente estudo tem como objeto a Auditoria como ferramenta de gestão para a eficiência alocativa de recursos financeiros no Sistema Único de Saúde (SUS) no município Norte Fluminense. A escolha por esta temática emergiu a partir atuação profissional como enfermeiro auditor em saúde. Objetivos: Como objetivo geral, analisar o impacto da Auditoria como ferramenta de gestão para a eficiência alocativa de recursos financeiros do SUS. Método: Trata-se de um estudo descritivo, do tipo estudo de caso, que utilizou a avaliação econômica em saúde para analisar a Auditoria como ferramenta de gestão para a eficiência alocativa de recursos financeiros. A amostra do estudo foi composta pelas contas médicas dos pacientes do Serviço e internação domiciliar (SID) no município durante a prestação do serviço de janeiro a outubro do ano de 2015. Foram consideradas todas as contas, independente de tempo de permanência de internação, que contabilizou um total de 608 faturas, sendo que apenas três não foram localizadas (duas do mês de janeiro e uma do mês de fevereiro). Das 605 faturas analisadas, 569 delas apresentaram glosas parciais ou totais realizadas pelos Auditores em Saúde por diversas inconformidades. O estudo foi submetido e aprovado pelo Comitê de Ética em Pesquisa (CEP) da Universidade Federal do Estado do Rio de Janeiro (UNIRIO), enquanto instituição proponente, que serviu de base para o município Norte Fluminense pela não implantação do CEP, com número de registro CAAE 62231416.3.00005285. Resultados: Estudou-se 612 contas no período, representando quase 100% da amostra do SID. Mapeou-se a clientela levando-se em conta as variáveis traçadas que definem o perfil do SID, como a distribuição dos pacientes por distrito, a distribuição da faixa etária, a idade média, o gênero, a modalidade do Home Care em atendimento e os diagnósticos/Classificação Internacional das Doenças (CID) dos pacientes internados. Na distribuição dos pacientes por distrito, o local com maior número de pacientes no SID é o nível urbano da cidade, concentrando 88,15% dos casos do SID. A distribuição da faixa etária, pode-se observar, que 47,37% do atendimento do SID é representado pelos idosos, seguido dos Adultos com 23,68%, as crianças com 18,42%, Jovens com 9,21%. Identificou-se uma frequência média de 75 anos de idade para os idosos, 44 anos para os adultos, 21 anos para os Jovens e 06 anos para as crianças no SID. Identificou-se a predominância do gênero masculino dos pacientes sob atendimento no SID. Pode-se verificar que a modalidade com maior número de pacientes no SID é a 2, seguida da 1 e da 3. Na análise sobre os diagnósticos mais evidenciados no SID, ressaltam-se, as sequelas de doenças cerebrovasculares, o traumatismo de nervos cranianos, outros transtornos de encéfalo e a doença de Alzheimer entre os mais evidentes. Os CIDS mais glosados foram as sequelas de doenças cerebrovasculares – I69 (35%), seguidas por outros transtornos do encéfalo – G93 (14,8%), traumatismo dos nervos cranianos – S04 (9,1%) e Doença de Alzheimer (8,46%). A modalidade do SID mais glosada no município, foi a 2 com 62,6% representando a maior frequência de dentre todas as modalidades pesquisadas. O custo das glosas pela modalidade do SID na variável custo foi a modalidade 2 que apresentou o maior custo das glosas, seguida pelas modalidade 1 e 3, sucessivamente, na maioria dos meses pesquisados. De acordo com as glosas nos itens das contas médicas por frequência, observa-se que os materiais (38,3%) representam, na maioria dos meses, o item mais glosado pela equipe de auditores, seguido pelos medicamentos (25%), apoio respiratório (21,3%) e atendimento profissional (8,0%). Observou-se que os subitens glosados com mais frequência representaram 47,9 % do percentual glosado sendo eles compressa não Estéril 7,5 x 7,5 (16,8%), oxigênio e aspiração (8,6%), aspirador elétrico portátil (4,9%), sonda de aspiração traqueal (4,3%), acetilcisteína 600mg Envelope (3,8%), nebulizador (3,5%), supervisão de enfermagem (3,1%) e seringa descartável 20 ml (2,9%). As justificativas das glosas mais evidentes conforme a frequência durante o período de 2015 foram cobrança em excesso (38,8%), cobrança indevida (21,6%), diferença de valor (16,2%), não evoluído (9,2%), não checado (7,1%) etc. Em relação às glosas nos itens das contas médicas, de acordo com o custo, observa-se que o apoio respiratório (47,7%) representou, na maioria dos meses, o item mais glosado em valor pela equipe de auditores, seguido pelos materiais (23,2%), medicamentos (14,2%) e atendimento profissional (9,9%). No período do estudo, o valor glosado de R$ 453.895,30 do faturamento total gerou uma economia aos cofres públicos de 4,3% do valor apresentado pela empresa prestadora do serviço, representando ganhos financeiros ao município que poderão ser aplicados em outras áreas como base para os blocos de financiamento da área da saúde, segundo a necessidade local. O custo-oportunidade dos recursos glosados pelos Auditores, com base no repasse dos recursos federais, baseada no Sistema de Informações sobre Orçamentos Públicos em Saúde (SIOPS) do ano de 2015, especificamente nos blocos de financiamento, representaram os seguintes indicadores: atenção básica (2,9%), assistência farmacêutica (20,7%), média e alta complexidade (0,4%), investimentos (9,3%), vigilância em saúde (9,7%) e gestão do SUS (1.335,0%). Considerações Finais: Constatou-se com este estudo um percentual considerado elevado de contas médicas para as doenças crônicas não transmissíveis (DCNT). Com base no estudo, pode-se observar que as instituições de saúde em geral estão evoluindo em relação à tecnologia dos serviços prestados, porém a visão financeira e holística do cliente ainda não alcançou a mesma evolução, seja pela falta de protocolos assistenciais baseados em evidências científicas como elementos de sistematizar a uniformização dos registros a serem auditados, seja pelo tipo de remuneração a ser proposta entre as partes. Com a descrição do impacto orçamentário realizado, comprovou-se um saldo positivo aos cofres públicos, através das diferentes glosas realizadas, na ordem de R$ 453.895,30, que, segundo o custo de oportunidade proposto com base nos blocos de financiamentos de recursos públicos federais de 2015, poderá ampliar a atuação, dando-se sempre preferência para as ações de promoção e prevenção de doenças.

Abstract:

One of the main tasks of structural biology is comparing the structure of proteins. Comparisons of protein structure can determine their functional similarities. Multigraph alignment is a useful tool for identifying functional similarities based on structural analysis. This article proposes a new algorithm for aligning protein binding sites called ACOTS-MGA. This algorithm is based on the memetic scheme. It uses the ACO method to construct a set of solutions, then selects the best solution for implementing Tabu Search to improve the solution quality. Experimental results have shown that ACOTS-MGA outperforms state-of-the-art algorithms while producing alignments of better quality.KeywordsMultiple Graph Alignment, Tabu Search, Ant Colony Optimization, local search, memetic algorithm, SMMAS pheromone update rule, protein active sitesReferencesE. Todd, C. A. Orengo, and J. M. Thornton, “Evolution of function in protein superfamilies, from a structural perspective,” J. Mol. 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Abstract:

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Abstract:

Introduction As the country with the fifth largest population in the world, Indonesia is a massive potential market for mobile technology adoption and development. Despite an annual per capita income of only $1,280 USD (World Bank), there are 63 million mobile phone users in Indonesia (Suhartono, sec. 1.7) and it is predicted to reach 80 million in 2007 (Jakarta Post 1). Mobile phones are not only a symbol of Indonesian modernity (Barendregt 5), but like other communication technology can become a platform through which to explore socio-political issues (Winner 28). In this article we explore the role mobile phone technology in contemporary forms of social, intimate, and sexual relationships in Indonesia. We argue that new forms of expression and relations are facilitated by the particular features of mobile technology. We discuss two cases from contemporary Indonesia: a mobile dating service (BEDD) and mobile phone p*rnography. For each case study, we first discuss the socio-political background in Indonesia, then describe the technological affordances of the mobile phone which facilitate dating and p*rnography, and finally give examples of how the mobile phone is effecting change in dating and p*rnographic practices. This study is placed at a time when social relations, intimacy, and sexuality in Indonesia have become central public issues. Since the end of the New Order whilst many people have embraced the new freedoms of reformasi and democratization, there is also a high degree of social anxiety, tension and uncertainty (Juliastuti 139-40). These social changes and desires have played out in the formations of new and exciting modes of creativity, solidarity, and sociality (Heryanto and Hadiz 262) and equally violence, terror and criminality (Heryanto and Hadiz 256). The diverse and plural nature of Indonesian society is alive with a myriad of people and activities, and it is into this diverse social body that the mobile phone has become a central and prominent feature of interaction. The focus of our study is dating and p*rnography as mediated by the mobile phone; however, we do not suggest that these are new experiences in Indonesia. Rather over the last decade social, intimate, and sexual relationships have all been undergoing change and their motivations can be traced to a variety of sources including the factors of globalization, democratization and modernization. Throughout Asia “new media have become a crucial site for constituting new Asian sexual identities and communities” (Berry, Martin, and Yue 13) as people are connecting through new communication technologies. In this article we suggest that mobile phone technology opens new possibilities and introduces new channels, dynamics, and intensities of social interaction. Mobile phones are particularly powerful communication tools because of their mobility, accessibility, and convergence (Ling 16-19; Ito 14-15; Katz and Aakhus 303). These characteristics of mobile phones do not in and of themselves bring about any particular changes in dating and p*rnography, but they may facilitate changes already underway (Barendegt 7-9; Barker 9). Mobile Dating Background The majority of Indonesians in the 1960s and 1970s had arranged marriages (Smith-Hefner 443). Education reform during the 70s and 80s encouraged more women to attain an education which in turn led to the delaying of marriage and the changing of courtship practices (Smith-Hefner 450). “Compared to previous generations, [younger Indonesians] are freer to mix with the opposite sex and to choose their own marriage,” (Utomo 225). Modern courtship in Java is characterized by “self-initiated romance” and dating (Smith-Hefner 451). Mobile technology is beginning to play a role in initiating romance between young Indonesians. Technology One mobile matching or dating service available in Indonesia is called BEDD (www.bedd.com). BEDD is a free software for mobile phones in which users fill out a profile about themselves and can meet BEDD members who are within 20-30 feet using a Bluetooth connection on their mobile devices. BEDD members’ phones automatically exchange profile information so that users can easily meet new people who match their profile requests. BEDD calls itself mobile social networking community; “BEDD is a new Bluetooth enabled mobile social medium that allows people to meet, interact and communicate in a new way by letting their mobile phones do all the work as they go throughout their day.” As part of a larger project on mobile social networking (Humphreys 6), a field study was conducted of BEDD users in Jakarta, Indonesia and Singapore (where BEDD is based) in early 2006. In-depth interviews and open-ended user surveys were conducted with users, BEDD’s CEO and strategic partners in order to understand the social uses and effects BEDD. The majority of BEDD members (which topped 100,000 in January 2006) are in Indonesia thanks to a partnership with Nokia where BEDD came pre-installed on several phone models. In management interviews, both BEDD and Nokia explained that they partnered because both companies want to help “build community”. They felt that Bluetooth technology such as BEDD could be used to help youth meet new people and keep in touch with old friends. Examples One of BEDD’s functions is to help lower barriers to social interaction in public spaces. By sharing profile information and allowing for free text messaging, BEDD can facilitate conversations between BEDD members. According to users, mediating the initial conversation also helps to alleviate social anxiety, which often accompanies meeting new people. While social mingling and hanging out between Jakarta teenagers is a relatively common practice, one user said that BEDD provides a new and fun way to meet and flirt. In a society that must balance between an “idealized morality” and an increasingly sexualized popular culture (Utomo 226), BEDD provides a modern mode of self-initiated matchmaking. While BEDD was originally intended to aid in the matchmaking process of dating, it has been appropriated into everyday life in Indonesia because of its interpretive flexibility (Pinch & Bjiker 27). Though BEDD is certainly used to meet “beautiful girls” (according to one Indonesian male user), it is also commonly used to text message old friends. One member said he uses BEDD to text his friends in class when the lecture gets boring. BEDD appears to be a helpful modern communication tool when people are physically proximate but cannot easily talk to one another. BEDD can become a covert way to exchange messages with people nearby for free. Another potential explanation for BEDD’s increasing popularity is its ability to allow users to have private conversations in public space. Bennett notes that courtship in private spaces is seen as dangerous because it may lead to sexual impropriety (154). Dating and courtship in public spaces are seen as safer, particularly for conserving the reputation young Indonesian women. Therefore Bluetooth connections via mobile technologies can be a tool to make private social connections between young men and women “safer”. Bluetooth communication via mobile phones has also become prevalent in more conservative Muslim societies (Sullivan, par. 7; Braude, par. 3). There are, however, safety concerns about meeting strangers in public spaces. When asked, “What advice would you give a first time BEDD user?” one respondent answered, “harus bisa mnilai seseorang krn itu sangat penting, kita mnilai seseorang bukan cuma dari luarnya” (translated: be careful in evaluating (new) people, and don’t ever judge the book by its cover”). Nevertheless, only one person participating in this study mentioned this concern. To some degree meeting someone in a public may be safer than meeting someone in an online environment. Not only are there other people around in public spaces to physically observe, but co-location means there may be some accountability for how BEDD members present themselves. The development and adoption of matchmaking services such as BEDD suggests that the role of the mobile phone in Indonesia is not just to communicate with friends and family but to act as a modern social networking tool as well. For young Indonesians BEDD can facilitate the transfer of social information so as to encourage the development of new social ties. That said, there is still debate about exactly whom BEDD is connecting and for what purposes. On one hand, BEDD could help build community in Indonesia. One the other hand, because of its privacy it could become a tool for more promiscuous activities (Bennett 154-5). There are user profiles to suggest that people are using BEDD for both purposes. For example, note what four young women in Jakarta wrote in the BEDD profiles: Personal Description Looking For I am a good prayer, recite the holy book, love saving (money), love cycling… and a bit narcist. Meaning of life Ordinary gurl, good student, single, Owen lover, and the rest is up to you to judge. Phrenz ?! Peace?! Wondeful life! I am talkative, have no patience but so sweet. I am so girly, narcist, shy and love cute guys. Check my fs (Friendster) account if you’re so curious. Well, I am just an ordinary girl tho. Anybody who wants to know me. A boy friend would be welcomed. Play Station addict—can’t live without it! I am a rebel, love rock, love hiphop, naughty, if you want proof dial 081********* phrenz n cute guyz As these profiles suggest, the technology can be used to send different kinds of messages. The mobile phone and the BEDD software merely facilitate the process of social exchange, but what Indonesians use it for is up to them. Thus BEDD and the mobile phone become tools through which Indonesians can explore their identities. BEDD can be used in a variety of social and communicative contexts to allow users to explore their modern, social freedoms. Mobile p*rnography Background Mobile phone p*rnography builds on a long tradition of p*rnography and sexually explicit material in Indonesia through the use of a new technology for an old art and product. Indonesia has a rich sexual history with a documented and prevalent sex industry (Suryakusuma 115). Lesmana suggests that the country has a tenuous p*rnographic industry prone to censorship and nationalist politics intent on its destruction. Since the end of the New Order and opening of press freedoms there has been a proliferation in published material including a mushrooming of tabloids, men’s magazines such as FHM, Maxim and Playboy, which are often regarded as p*rnographic. This is attributed to the decline of the power of the bureaucracy and government and the new role of capital in the formation of culture (Chua 16). There is a parallel p*rnography industry, however, that is more amateur, local, and homemade (Barker 6). It is into this range of material that mobile phone p*rnography falls. Amongst the myriad forms of p*rnography and sexually explicit material available in Indonesia, the mobile phone in recent years has emerged as a new platform for production, distribution, and consumption. This section will not deal with the ethics of representation nor engage with the debate about definitions and the rights and wrongs of p*rnography. Instead what will be shown is how the mobile phone can be and has been used as an instrument/medium for the production and consumption of p*rnography within contemporary social relationships. Technology There are several technological features of the mobile phone that make p*rnography possible. As has already been noted the mobile phone has had a large adoption rate in Indonesia, and increasingly these phones come equipped with cameras and the ability to send data via MMS and Bluetooth. Coupled with the mobility of the phone, the convergence of technology in the mobile phone makes it possible for p*rnography to be produced and consumed in a different way than what has been possible before. It is only recently that the mobile phone has been marketed as a video camera with the release of the Nokia N90; however, quality and recording time are severely limited. Still, the mobile phone is a convenient and at-hand tool for the production and consumption of individually made, local, and non-professional pieces of p*rn, sex and sexuality. It is impossible to know how many such films are in circulation. A number of websites that offer these films for downloads host between 50 and 100 clips in .3gp file format, with probably more in actual circulation. At the very least, this is a tenfold increase in number compared to the recent emergence of non-professional VCD films (Barker 3). This must in part be attributed to the advantages that the mobile phone has over standard video cameras including cost, mobility, convergence, and the absence of intervening data processing and disc production. Examples There are various examples of mobile p*rnography in Indonesia. These range from the p*rnographic text message sent between lovers to the mobile phone video of explicit sexual acts (Barendregt 14-5). The mobile phone affords privacy for the production and exchange of p*rnographic messages and media. Because mobile devices are individually owned, however, p*rnographic material found on mobile phones can be directly tied to the individual owners. For example, police in Kotabaru inspected the phones of high school students in search of p*rnographic materials and arrested those individuals on whose phones it was found (Barendregt 18). Mobile phone p*rnography became a national political issue in 2006 when an explicit one-minute clip of a singer and an Indonesian politician became public. Videoed in 2004, the clip shows Maria Eva, a 27 year-old dangdut singer (see Browne, 25-6) and Yahya Zaini, a married 42 year-old who was head of religious affairs for the Golkar political party. Their three-year affair ended in 2005, but the film did not become public until 2006. It spread like wildfire between phones and across the internet, however, and put an otherwise secret relationship into the limelight. These types of affairs and relationships were common knowledge to people through gossip, exposes such as Jakarta Undercover (Emka 93-108) and stories in tabloids; yet this culture of adultery and prostitution continued and remained anonymous because of bureaucratic control of evidence and information (Suryakusuma 115). In this case, however, the filming of Maria Eva once public proves the identities of those involved and their infidelity. As a result of the scandal it was further revealed that Maria Eva had been forced by Yayha Zaini and his wife to have an abortion, deepening the moral crisis. Yahya Zaini later resigned as his party’s head of Religious Affairs (Asmarani, sec. 1-2), due to what was called the country’s “first real sex scandal” (Naughton, par. 2). As these examples show, there are definite risks and consequences involved in the production of mobile p*rnography. Even messages/media that are meant to be shared between two consenting individuals can eventually make their way into the public mobile realm and have serious consequences for those involved. Mobile video and photography does, however, represent a potential new check on the Indonesian bureaucratic elite which has not been previously available by other means such as a watchdog media. “The role of the press as a control mechanism is practically nonexistent [in Jakarta], which in effect protects corruption, nepotism, financial manipulation, social injustice, and repression, as well as the murky sexual life of the bureaucratic power elite,” (Suryakusuma 117). Thus while originally a mobile video may have been created for personal pleasure, through its mass dissemination via new media it can become a means of sousveillance (Mann, Nolan and Wellman 332-3) whereby the control of surveillance is flipped to reveal the often hidden abuses of power by officials. Whilst the debates over p*rnography in Indonesia tend to focus on the moral aspects of it, the broader social impacts of technology on relationships are often ignored. Issues related to power relations or even media as cultural expression are often disregarded as moral judgments cast a heavy shadow over discussions of locally produced Indonesian mobile p*rnography. It is possible to move beyond the moral critique of p*rnographic media to explore the social significance of its proliferation as a cultural product. Conclusion In these two case studies we have tried to show how the mobile phone in Indonesia has become a mode of interaction but also a platform through which to explore other current issues and debates related to dating, sexuality and media. Since 1998 and the fall of the New Order, Indonesia has been struggling with blending old and new, a desire of change and nostalgia for past, and popular desire for a “New Indonesia” (Heryanto, sec. Post-1998). Cultural products within Indonesia have played an important role in exploring these issues. The mobile phone in Indonesia is not just a technology, but also a product in and through which these desires are played out. Changes in dating and p*rnography practices have been occurring in Indonesia for some time. As people use mobile technology to produce, communicate, and consume, the device becomes intricately related to identity struggle and cultural production within Indonesia. It is important to keep in mind, however, that while mobile technology adoption within Indonesia is growing, it is still limited to a particular subset of the population. As has been previously observed (Barendregt 3), it is wealthier, young people in urban areas who are most intensely involved in mobile technology. As handset prices decrease and availability in rural areas increases, however, no longer will mobile technology be so demographically confined in Indonesia. The convergent technology of the mobile phone opens many possibilities for creative adoption and usage. As a communication device it allows for the creation, sharing, and viewing of messages. Therefore, the technology itself facilitates social connections and networking. As demonstrated in the cases of dating and p*rnography, the mobile phone is both a tool for meeting new people and disseminating sexual messages/media because it is a networked technology. The mobile phone is not fundamentally changing dating and p*rnography practices, but it is accelerating social and cultural trends already underway in Indonesia by facilitating the exchange and dissemination of messages and media. As these case studies show, what kinds of messages Indonesians choose to create and share are up to them. The same device can be used for relatively innocuous behavior as well as more controversial behavior. With increased adoption in Indonesia, the mobile will continue to be a lens through which to further explore modern socio-political issues. 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"Modernity and the Mobile Phone: Exploring Tensions about Dating and Sex in Indonesia." M/C Journal 10.1 (2007). echo date('d M. Y'); ?> <http://journal.media-culture.org.au/0703/06-humphreys-barker.php>. APA Style Humphreys, L., and T. Barker. (Mar. 2007) "Modernity and the Mobile Phone: Exploring Tensions about Dating and Sex in Indonesia," M/C Journal, 10(1). Retrieved echo date('d M. Y'); ?> from <http://journal.media-culture.org.au/0703/06-humphreys-barker.php>.

Abstract:

Lists and Social MediaLists have long been an ordering mechanism for computer-mediated social interaction. While far from being the first such mechanism, blogrolls offered an opportunity for bloggers to provide a list of their peers; the present generation of social media environments similarly provide lists of friends and followers. Where blogrolls and other earlier lists may have been user-generated, the social media lists of today are more likely to have been produced by the platforms themselves, and are of intrinsic value to the platform providers at least as much as to the users themselves; both Facebook and Twitter have highlighted the importance of their respective “social graphs” (their databases of user connections) as fundamental elements of their fledgling business models. This represents what Mejias describes as “nodocentrism,” which “renders all human interaction in terms of network dynamics (not just any network, but a digital network with a profit-driven infrastructure).”The communicative content of social media spaces is also frequently rendered in the form of lists. Famously, blogs are defined in the first place by their reverse-chronological listing of posts (Walker Rettberg), but the same is true for current social media platforms: Twitter, Facebook, and other social media platforms are inherently centred around an infinite, constantly updated and extended list of posts made by individual users and their connections.The concept of the list implies a certain degree of order, and the orderliness of content lists as provided through the latest generation of centralised social media platforms has also led to the development of more comprehensive and powerful, commercial as well as scholarly, research approaches to the study of social media. Using the example of Twitter, this article discusses the challenges of such “big data” research as it draws on the content lists provided by proprietary social media platforms.Twitter Archives for ResearchTwitter is a particularly useful source of social media data: using the Twitter API (the Application Programming Interface, which provides structured access to communication data in standardised formats) it is possible, with a little effort and sufficient technical resources, for researchers to gather very large archives of public tweets concerned with a particular topic, theme or event. Essentially, the API delivers very long lists of hundreds, thousands, or millions of tweets, and metadata about those tweets; such data can then be sliced, diced and visualised in a wide range of ways, in order to understand the dynamics of social media communication. Such research is frequently oriented around pre-existing research questions, but is typically conducted at unprecedented scale. The projects of media and communication researchers such as Papacharissi and de Fatima Oliveira, Wood and Baughman, or Lotan, et al.—to name just a handful of recent examples—rely fundamentally on Twitter datasets which now routinely comprise millions of tweets and associated metadata, collected according to a wide range of criteria. What is common to all such cases, however, is the need to make new methodological choices in the processing and analysis of such large datasets on mediated social interaction.Our own work is broadly concerned with understanding the role of social media in the contemporary media ecology, with a focus on the formation and dynamics of interest- and issues-based publics. We have mined and analysed large archives of Twitter data to understand contemporary crisis communication (Bruns et al), the role of social media in elections (Burgess and Bruns), and the nature of contemporary audience engagement with television entertainment and news media (Harrington, Highfield, and Bruns). Using a custom installation of the open source Twitter archiving tool yourTwapperkeeper, we capture and archive all the available tweets (and their associated metadata) containing a specified keyword (like “Olympics” or “dubstep”), name (Gillard, Bieber, Obama) or hashtag (#ausvotes, #royalwedding, #qldfloods). In their simplest form, such Twitter archives are commonly stored as delimited (e.g. comma- or tab-separated) text files, with each of the following values in a separate column: text: contents of the tweet itself, in 140 characters or less to_user_id: numerical ID of the tweet recipient (for @replies) from_user: screen name of the tweet sender id: numerical ID of the tweet itself from_user_id: numerical ID of the tweet sender iso_language_code: code (e.g. en, de, fr, ...) of the sender’s default language source: client software used to tweet (e.g. Web, Tweetdeck, ...) profile_image_url: URL of the tweet sender’s profile picture geo_type: format of the sender’s geographical coordinates geo_coordinates_0: first element of the geographical coordinates geo_coordinates_1: second element of the geographical coordinates created_at: tweet timestamp in human-readable format time: tweet timestamp as a numerical Unix timestampIn order to process the data, we typically run a number of our own scripts (written in the programming language Gawk) which manipulate or filter the records in various ways, and apply a series of temporal, qualitative and categorical metrics to the data, enabling us to discern patterns of activity over time, as well as to identify topics and themes, key actors, and the relations among them; in some circ*mstances we may also undertake further processes of filtering and close textual analysis of the content of the tweets. Network analysis (of the relationships among actors in a discussion; or among key themes) is undertaken using the open source application Gephi. While a detailed methodological discussion is beyond the scope of this article, further details and examples of our methods and tools for data analysis and visualisation, including copies of our Gawk scripts, are available on our comprehensive project website, Mapping Online Publics.In this article, we reflect on the technical, epistemological and political challenges of such uses of large-scale Twitter archives within media and communication studies research, positioning this work in the context of the phenomenon that Lev Manovich has called “big social data.” In doing so, we recognise that our empirical work on Twitter is concerned with a complex research site that is itself shaped by a complex range of human and non-human actors, within a dynamic, indeed volatile media ecology (Fuller), and using data collection and analysis methods that are in themselves deeply embedded in this ecology. “Big Social Data”As Manovich’s term implies, the Big Data paradigm has recently arrived in media, communication and cultural studies—significantly later than it did in the hard sciences, in more traditionally computational branches of social science, and perhaps even in the first wave of digital humanities research (which largely applied computational methods to pre-existing, historical “big data” corpora)—and this shift has been provoked in large part by the dramatic quantitative growth and apparently increased cultural importance of social media—hence, “big social data.” As Manovich puts it: For the first time, we can follow [the] imaginations, opinions, ideas, and feelings of hundreds of millions of people. We can see the images and the videos they create and comment on, monitor the conversations they are engaged in, read their blog posts and tweets, navigate their maps, listen to their track lists, and follow their trajectories in physical space. (Manovich 461) This moment has arrived in media, communication and cultural studies because of the increased scale of social media participation and the textual traces that this participation leaves behind—allowing researchers, equipped with digital tools and methods, to “study social and cultural processes and dynamics in new ways” (Manovich 461). However, and crucially for our purposes in this article, many of these scholarly possibilities would remain latent if it were not for the widespread availability of Open APIs for social software (including social media) platforms. APIs are technical specifications of how one software application should access another, thereby allowing the embedding or cross-publishing of social content across Websites (so that your tweets can appear in your Facebook timeline, for example), or allowing third-party developers to build additional applications on social media platforms (like the Twitter user ranking service Klout), while also allowing platform owners to impose de facto regulation on such third-party uses via the same code. While platform providers do not necessarily have scholarship in mind, the data access affordances of APIs are also available for research purposes. As Manovich notes, until very recently almost all truly “big data” approaches to social media research had been undertaken by computer scientists (464). But as part of a broader “computational turn” in the digital humanities (Berry), and because of the increased availability to non-specialists of data access and analysis tools, media, communication and cultural studies scholars are beginning to catch up. Many of the new, large-scale research projects examining the societal uses and impacts of social media—including our own—which have been initiated by various media, communication, and cultural studies research leaders around the world have begun their work by taking stock of, and often substantially extending through new development, the range of available tools and methods for data analysis. The research infrastructure developed by such projects, therefore, now reflects their own disciplinary backgrounds at least as much as it does the fundamental principles of computer science. In turn, such new and often experimental tools and methods necessarily also provoke new epistemological and methodological challenges. The Twitter API and Twitter ArchivesThe Open API was a key aspect of mid-2000s ideas about the value of the open Web and “Web 2.0” business models (O’Reilly), emphasising the open, cross-platform sharing of content as well as promoting innovation at the margins via third-party application development—and it was in this ideological environment that the microblogging service Twitter launched and experienced rapid growth in popularity among users and developers alike. As José van Dijck cogently argues, however, a complex interplay of technical, economic and social dynamics has seen Twitter shift from a relatively open, ad hoc and user-centred platform toward a more formalised media business: For Twitter, the shift from being primarily a conversational communication tool to being a global, ad-supported followers tool took place in a relatively short time span. This shift did not simply result from the owner’s choice for a distinct business model or from the company’s decision to change hardware features. Instead, the proliferation of Twitter as a tool has been a complex process in which technological adjustments are intricately intertwined with changes in user base, transformations of content and choices for revenue models. (van Dijck 343)The specifications of Twitter’s API, as well as the written guidelines for its use by developers (Twitter, “Developer Rules”) are an excellent example of these “technological adjustments” and the ways they are deeply interwined with Twitter’s search for a viable revenue model. These changes show how the apparent semantic openness or “interpretive flexibility” of the term “platform” allows its meaning to be reshaped over time as the business models of platform owners change (Gillespie).The release of the API was first announced on the Twitter blog in September 2006 (Stone), not long after the service’s launch but after some popular third-party applications (like a mashup of Twitter with Google Maps creating a dynamic display of recently posted tweets around the world) had already been developed. Since then Twitter has seen a flourishing of what the company itself referred to as the “Twitter ecosystem” (Twitter, “Developer Rules”), including third-party developed client software (like Twitterific and TweetDeck), institutional use cases (such as large-scale social media visualisations of the London Riots in The Guardian), and parasitic business models (including social media metrics services like HootSuite and Klout).While the history of Twitter’s API rules and related regulatory instruments (such as its Developer Rules of the Road and Terms of Use) has many twists and turns, there have been two particularly important recent controversies around data access and control. First, the company locked out developers and researchers from direct “firehose” (very high volume) access to the Twitter feed; this was accompanied by a crackdown on free and public Twitter archiving services like 140Kit and the Web version of Twapperkeeper (Sample), and coincided with the establishment of what was at the time a monopoly content licensing arrangement between Twitter and Gnip, a company which charges commercial rates for high-volume API access to tweets (and content from other social media platforms). A second wave of controversy among the developer community occurred in August 2012 in response to Twitter’s release of its latest API rules (Sippey), which introduce further, significant limits to API use and usability in certain circ*mstances. In essence, the result of these changes to the Twitter API rules, announced without meaningful consultation with the developer community which created the Twitter ecosystem, is a forced rebalancing of development activities: on the one hand, Twitter is explicitly seeking to “limit” (Sippey) the further development of API-based third-party tools which support “consumer engagement activities” (such as end-user clients), in order to boost the use of its own end-user interfaces; on the other hand, it aims to “encourage” the further development of “consumer analytics” and “business analytics” as well as “business engagement” tools. Implicit in these changes is a repositioning of Twitter users (increasingly as content consumers rather than active communicators), but also of commercial and academic researchers investigating the uses of Twitter (as providing a narrow range of existing Twitter “analytics” rather than engaging in a more comprehensive investigation both of how Twitter is used, and of how such uses continue to evolve). The changes represent an attempt by the company to cement a certain, commercially viable and valuable, vision of how Twitter should be used (and analysed), and to prevent or at least delay further evolution beyond this desired stage. Although such attempts to “freeze” development may well be in vain, given the considerable, documented role which the Twitter user base has historically played in exploring new and unforeseen uses of Twitter (Bruns), it undermines scholarly research efforts to examine actual Twitter uses at least temporarily—meaning that researchers are increasingly forced to invest time and resources in finding workarounds for the new restrictions imposed by the Twitter API.Technical, Political, and Epistemological IssuesIn their recent article “Critical Questions for Big Data,” danah boyd and Kate Crawford have drawn our attention to the limitations, politics and ethics of big data approaches in the social sciences more broadly, but also touching on social media as a particularly prevalent site of social datamining. In response, we offer the following complementary points specifically related to data-driven Twitter research relying on archives of tweets gathered using the Twitter API.First, somewhat differently from most digital humanities (where researchers often begin with a large pre-existing textual corpus), in the case of Twitter research we have no access to an original set of texts—we can access only what Twitter’s proprietary and frequently changing API will provide. The tools Twitter researchers use rely on various combinations of parts of the Twitter API—or, more accurately, the various Twitter APIs (particularly the Search and Streaming APIs). As discussed above, of course, in providing an API, Twitter is driven not by scholarly concerns but by an attempt to serve a range of potentially value-generating end-users—particularly those with whom Twitter can create business-to-business relationships, as in their recent exclusive partnership with NBC in covering the 2012 London Olympics.The following section from Twitter’s own developer FAQ highlights the potential conflicts between the business-case usage scenarios under which the APIs are provided and the actual uses to which they are often put by academic researchers or other dataminers:Twitter’s search is optimized to serve relevant tweets to end-users in response to direct, non-recurring queries such as #hashtags, URLs, domains, and keywords. The Search API (which also powers Twitter’s search widget) is an interface to this search engine. Our search service is not meant to be an exhaustive archive of public tweets and not all tweets are indexed or returned. Some results are refined to better combat spam and increase relevance. Due to capacity constraints, the index currently only covers about a week’s worth of tweets. (Twitter, “Frequently Asked Questions”)Because external researchers do not have access to the full, “raw” data, against which we could compare the retrieved archives which we use in our later analyses, and because our data access regimes rely so heavily on Twitter’s APIs—each with its technical quirks and limitations—it is impossible for us to say with any certainty that we are capturing a complete archive or even a “representative” sample (whatever “representative” might mean in a data-driven, textualist paradigm). In other words, the “lists” of tweets delivered to us on the basis of a keyword search are not necessarily complete; and there is no way of knowing how incomplete they are. The total yield of even the most robust capture system (using the Streaming API and not relying only on Search) depends on a number of variables: rate limiting, the filtering and spam-limiting functions of Twitter’s search algorithm, server outages and so on; further, because Twitter prohibits the sharing of data sets it is difficult to compare notes with other research teams.In terms of epistemology, too, the primary reliance on large datasets produces a new mode of scholarship in media, communication and cultural studies: what emerges is a form of data-driven research which tends towards abductive reasoning; in doing so, it highlights tensions between the traditional research questions in discourse or text-based disciplines like media and communication studies, and the assumptions and modes of pattern recognition that are required when working from the “inside out” of a corpus, rather than from the outside in (for an extended discussion of these epistemological issues in the digital humanities more generally, see Dixon).Finally, even the heuristics of our analyses of Twitter datasets are mediated by the API: the datapoints that are hardwired into the data naturally become the most salient, further shaping the type of analysis that can be done. For example, a common process in our research is to use the syntax of tweets to categorise it as one of the following types of activity: original tweets: tweets which are neither @reply nor retweetretweets: tweets which contain RT @user… (or similar) unedited retweets: retweets which start with RT @user… edited retweets: retweets do not start with RT @user…genuine @replies: tweets which contain @user, but are not retweetsURL sharing: tweets which contain URLs(Retweets which are made using the Twitter “retweet button,” resulting in verbatim passing-along without the RT @user syntax or an opportunity to add further comment during the retweet process, form yet another category, which cannot be tracked particularly effectively using the Twitter API.)These categories are driven by the textual and technical markers of specific kinds of interactions that are built into the syntax of Twitter itself (@replies or @mentions, RTs); and specific modes of referentiality (URLs). All of them focus on (and thereby tend to privilege) more informational modes of communication, rather than the ephemeral, affective, or ambiently intimate uses of Twitter that can be illuminated more easily using ethnographic approaches: approaches that can actually focus on the individual user, their social contexts, and the broader cultural context of the traces they leave on Twitter. ConclusionsIn this article we have described and reflected on some of the sociotechnical, political and economic aspects of the lists of tweets—the structured Twitter data upon which our research relies—which may be gathered using the Twitter API. As we have argued elsewhere (Bruns and Burgess)—and, hopefully, have begun to demonstrate in this paper—media and communication studies scholars who are actually engaged in using computational methods are well-positioned to contribute to both the methodological advances we highlight at the beginning of this paper and the political debates around computational methods in the “big social data” moment on which the discussion in the second part of the paper focusses. One pressing issue in the area of methodology is to build on current advances to bring together large-scale datamining approaches with ethnographic and other qualitative approaches, especially including close textual analysis. More broadly, in engaging with the “big social data” moment there is a pressing need for the development of code literacy in media, communication and cultural studies. In the first place, such literacy has important instrumental uses: as Manovich argues, much big data research in the humanities requires costly and time-consuming (and sometimes alienating) partnerships with technical experts (typically, computer scientists), because the free tools available to non-programmers are still limited in utility in comparison to what can be achieved using raw data and original code (Manovich, 472).But code literacy is also a requirement of scholarly rigour in the context of what David Berry calls the “computational turn,” representing a “third wave” of Digital Humanities. Berry suggests code and software might increasingly become in themselves objects of, and not only tools for, research: I suggest that we introduce a humanistic approach to the subject of computer code, paying attention to the wider aspects of code and software, and connecting them to the materiality of this growing digital world. With this in mind, the question of code becomes increasingly important for understanding in the digital humanities, and serves as a condition of possibility for the many new computational forms that mediate our experience of contemporary culture and society. (Berry 17)A first step here lies in developing a more robust working knowledge of the conceptual models and methodological priorities assumed by the workings of both the tools and the sources we use for “big social data” research. Understanding how something like the Twitter API mediates the cultures of use of the platform, as well as reflexively engaging with its mediating role in data-driven Twitter research, promotes a much more materialist critical understanding of the politics of the social media platforms (Gillespie) that are now such powerful actors in the media ecology. ReferencesBerry, David M. “Introduction: Understanding Digital Humanities.” Understanding Digital Humanities. Ed. David M. Berry. 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COST Action ISO906 Transforming Audiences, Transforming Societies, Brussels, Belgium, pp. 13-17. 18 Sept. 2012 http://www.cost-transforming-audiences.eu/system/files/essays-and-interview-essays-18-06-12.pdfLotan, Gilad, Erhardt Graeff, Mike Ananny, Devin Gaffney, Ian Pearce, and danah boyd. “The Arab Spring: The Revolutions Were Tweeted: Information Flows during the 2011 Tunisian and Egyptian Revolutions.” International Journal of Communication 5 (2011): 1375-1405. 18 Sep. 2012 ‹http://ijoc.org/ojs/index.php/ijoc/article/view/1246/613›.Manovich, Lev. “Trending: The Promises and the Challenges of Big Social Data.” Debates in the Digital Humanities. Ed. Matthew K. Gold. Minneapolis: U of Minnesota P, 2012. 460-75.Mejias, Ulises A. “Liberation Technology and the Arab Spring: From Utopia to Atopia and Beyond.” Fibreculture Journal 20 (2012). 18 Sep. 2012 ‹http://twenty.fibreculturejournal.org/2012/06/20/fcj-147-liberation-technology-and-the-arab-spring-from-utopia-to-atopia-and-beyond/›.O’Reilly, Tim. “What is Web 2.0? Design Patterns and Business Models for the Next Generation of Software.” O’Reilly Network 30 Sep. 2005. 18 Sep. 2012 ‹http://www.oreillynet.com/pub/a/oreilly/tim/news/2005/09/30/what-is-web-20.html›.Papacharissi, Zizi, and Maria de Fatima Oliveira. “Affective News and Networked Publics: The Rhythms of News Storytelling on #Egypt.” Journal of Communication 62.2 (2012): 266-82.Sample, Mark. “The End of Twapperkeeper (and What to Do about It).” ProfHacker. 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Abstract:

From the mid-twentieth century, state and public conceptions of deviance and crime control have turned increasingly punitive (Hallett 115; Hutchinson 138). In a Western context, criminal justice has long been retributive, prioritising punishment over rehabilitation (Wenzel et al. 26). Within that context, there has been an increase in punitiveness—understood here as a measure of a punishment’s severity—the intention of which has been to help restore the moral imbalance created by offending while also deterring future crime (Wenzel et al. 26). Entangled with the global spread of neoliberal capitalism, punitiveness has become internationally pervasive to a near-hegemonic degree (Sparks qtd. in Jennings et al. 463; Unnever and Cullen 100).The punitive turn has troubling characteristics. Punitive policies can be expensive, and increased incarceration stresses the criminal justice system and leads to prison overcrowding (Hutchinson 135). Further, punitiveness is not only applied unequally across categories such as class, race, and age (Unnever and Cullen 105-06; Wacquant 212) but the effectiveness of punitive policy relative to its costs is contested (Bouffard et al. 466, 477; Hutchinson 139). Despite this, evidence suggests public demand is driving punitive policymaking, but that demand is only weakly related to crime rates (Jennings et al. 463).While discussion of punitiveness in the public sphere often focuses on measures such as boot camps for young offenders, increased incarceration, and longer prison sentences, punitiveness also has a darker side. Our research analysing discussion taking place on a large, regional, crime-focused online forum reveals a startling degree and intensity of violence directed at offenders and related groups. Members of the discussion forum do propose unsurprising measures such as incarceration and boot camps, but also an array of violent alternatives, including beating, shooting, dismemberment, and conversion into animal food. This article draws on our research to explore why discussion of punitiveness can be so intensely violent.Our research applies thematic analysis to seven discussion threads posted to a large regional online forum focused on crime, made between September and November 2017. One discussion thread per week of the study period was purposively sampled based on relevance to the topic of punitiveness, ultimately yielding 1200 individual comments. Those comments were coded, and the data and codes were reiteratively analysed to produce categories, then basic, organising, and global themes. We intended to uncover themes in group discussion most salient to punitiveness to gain insight into how punitive social interactions unfold and how those who demand punitiveness understand their interactions and experiences of crime. We argue that, in this online forum, the global theme—the most salient concept related to punitiveness—is a “subaltern citizenship”. Here, a clear division emerges from the data, where the group members perceive themselves as “us”—legitimate citizens with all attendant rights—in opposition to an external “them”, a besieging group of diverse, marginalised Others who have illegitimately usurped certain rights and who victimise citizens. Group members often deride the state as too weak and untrustworthy to stop this victimisation. Ironically, the external Others perceived by the group to hold power are themselves genuinely marginalised, though the group does not recognise or see that form of marginalisation as legitimate. In this essay, to preserve the anonymity of the forum and its members, we refer to them only as “the Forum”, located in “the City”, and refrain from direct quotes except for commonly used words or phrases that do not identify individuals.It is also important to note that the research described here deliberately focused on a specific group in a specific space who were concerned about specific groups of offenders. Findings and discussion, and the views on punitiveness described, cannot be generalised to the broader community. Nor do we suggest these views can be considered representative of all Forum members as we present here only a limited analysis of some violent discourse emerging from our research. Likewise, while our discussion often centres on youth and other marginalised groups in the context of offending, we do not intend to imply that offending is a characteristic of these groups.Legitimate CitizenshipCommonly, citizenship is seen as a conferred status denoting full and equal community membership and the rights and responsibilities dictated by community values and norms (Lister 28-29). Western citizenship norms are informed by neoliberal capitalist values: individual responsibility, an obligation to be in paid employment, participation in economic consumption, the sanctity of ownership, and that the principal role of government is to defend the conditions under which these norms can freely thrive (Walsh 861-62). While norms are shaped by laws and policy frameworks, they are not imposed coercively or always deployed consciously. These norms exist as shared behavioural expectations reproduced through social interaction and embodied as “common sense” (Kotzian 59). As much as Western democracies tend to a universalist representation of one, undifferentiated citizenship, it is clear that gender, race, sexual orientation, religion, ethnicity, and migrant status all exist in different relationships to citizenship as an identity category. Glass ceilings, stolen generations, same-sex marriage debates, and Australian Government proposals to strip citizenship from certain types of criminal offender all demonstrate that the lived experience of norms surrounding citizenship is profoundly unequal for some (Staeheli et al. 629-30). An individual’s citizenship status, therefore, more accurately exists on a spectrum between legitimacy—full community membership, possessing all rights and living up to all associated responsibilities—and illegitimacy—diminished membership, with contested rights and questionable fulfilment of associated responsibilities—depending on the extent of their deviation from societal norms.Discussing punitiveness, Forum members position themselves as “us”, that is, legitimate citizens. Words such as “we” and “us” are used as synonyms for society and for those whose behaviours are “normal” or “acceptable”. Groups associated with offending are described as “they”, “them”, and their behaviours are “not normal”, “disgusting”, “feral”, and merit the removal of “them” from civilisation, usually to “the middle of nowhere” or “the Outback”. Possession of legitimate citizenship is implicit in assuming authority over what is normal and who should be exiled for failing the standard.Another implicit assumption discernible in the data is that Forum members perceive the “normal we” as good neoliberal citizens. “We” work hard, own homes and cars, and take individual responsibility. There is a strong imputation of welfare dependency among offenders, the poor, and other suspect groups. Offending is presented as something curable by stripping offenders or their parents of welfare payments. Members earn their status as legitimate citizens by adhering to the norms of neoliberal citizenship in opposition to potential offenders to whom the benefits of citizenship are simply doled out.Forum members also frame their citizenship as legitimate by asserting ownership over community spaces and resources. This can be seen in their talking as if they, their sympathetic audience, and “the City” are the same (for example, declaring that “the City” demands harsher punishments for juvenile offenders). There are also calls to “take back” the streets, the City, and Australia from groups associated with offending. That a space can and should be “taken back” implies a pre-existing state of control interrupted by those who have no right to ownership. At its most extreme, the assertion of ownership extends to a conviction that members have the right to position offenders as enemies of the state and request that the army, the ultimate tool of legitimate state violence, be turned against them if governments and the criminal justice system are too “weak” or “soft” to constrain them.The Illegitimate OtherThroughout the data, perceived offenders are spoken of with scorn and hatred. “Perceived offenders” may include offenders and their family, youths, Indigenous people, and people of low socioeconomic status, and these marginalised groups are referenced so interchangeably it can be difficult to determine which is being discussed.Commenting on four “atsi [sic] kids” who assaulted an elderly man, group members asserted “they” should be shot like dogs. The original text gives no antecedents to indicate whether “they” is meant to indicate youths, Indigenous youths, or offenders in general. However, Australia has a colonial history of conflating crime and indigeneity and shooting Indigenous people to preserve white social order (Hill and Dawes 310, 312), a consequence of the tendency of white people to imagine criminals as black (Unnever and Cullen 106). It must be noted that the racial identity of individual Forum members is unknown. This does constitute a limitation in the original study, as identity categories such as race and class intersect and manifest in social interactions in complex ways. However, that does not prevent analysis of the text itself.In the Forum’s discursive space, “they” is used to denote offenders, Indigenous youths, youths, or the poor interchangeably, as if they were all a hom*ogeneous, mutually synonymous “Other”. Collectively, these groups are represented as so generally hopeless that they are imagined as choosing to offend so they will be sentenced to the comforts of “holiday camp” prisons where they can access luxuries otherwise beyond their reach: freedom from addicted parents, medical care, food, television, and computers. A common argument, that crime is an individual choice, is often based on the idea that prison is a better option for the poor than going home. As a result, offending by marginalised offenders is reconstructed as a rational choice or a failure of individual responsibility rather than a consequence of structural inequality.Further, parents of those in suspect populations are blamed for intergenerational maintenance of criminality. They are described as too drunk or drugged to care, too unskilled in parenting due to their presumed dreadful upbringing, or too busy enjoying their welfare payments to meet their responsibility to control their children or teach them the values and skills of citizenship. Comments imply parents probably participated in their children’s crimes even when no evidence suggests that possibility and that some groups simply cannot be trusted to raise disciplined children owing to their inherent moral and economic dissipation. That is, not just offenders but entire groups are deemed illegitimate, willing to enjoy benefits of citizenship such as welfare payments but unwilling or unable to earn them by engaging with the associated responsibilities. This is a frequent argument for why they deserve severely punitive punishment for deviance.However, the construction of the Other as illegitimate in Forum discussions reaches far beyond imagining them as lacking normative skills and values. The violence present on the Forum is startling in its intensity. Prevalent within the data is the reduction of people to insulting nicknames. Terms used to describe people range from the sarcastic— “little darlings”—through standard abusive language such as “bastards”, “sh*ts”, “dickhe*ds”, “lowlifes”, to dehumanising epithets such as “maggots”, “scum”, and “subhuman arsewipes”. Individually and collectively, “they” are relentlessly framed as less than human and even less than animals. They are “mongrels” and “vermin”. In groups, they are “packs”, and they deserve to be “hunted” or just shot from helicopters. They are unworthy of life. “Oxygen thieves” is a repeated epithet, as is the idea that they should be dropped out at sea to drown. Other suggestions for punishment include firing squads, lethal injections, and feeding them to animals.It is difficult to imagine a more definitive denial of legitimacy than discursively stripping individuals and groups of their humanity (their most fundamental status) and their right to existence (their most fundamental right as living beings). The Forum comes perilously close to casting the Other as Agamben’s hom*o sacer, humans who live in a “state of exception”, subject to the state’s power but excluded from the law’s protection and able to be killed without consequence (Lechte and Newman 524). While it would be hyperbole to push this comparison too far—given Agamben had concentration camps in mind—the state of exception as a means of both excluding a group from society and exercising control over its life does resonate here.Themes Underlying PunitivenessOur findings indicate the theme most salient to punitive discussion is citizenship, rooted in persistent concerns over who is perceived to have it, who is not, and what should be done about those Others whose deviance renders their citizenship less legitimate. Citizenship norms—real or aspirational—of society’s dominant groups constitute the standards by which Forum members judge their experiences of and with crime, perceived offenders, the criminal justice system, and the state. However, Forum members do not claim a straightforward belonging to and sharing in the maintenance of the polity. Analysis of the data suggests Forum members consider their legitimate citizenship tainted by external forces such as politics, untrustworthy authorities and institutions, and the unconstrained excess of the illegitimate Other. That is, they perceive their citizenship to be simultaneously legitimate and undeservedly subaltern.According to Gramsci, subaltern populations are subordinate to dominant groups in political and civil society, lulled by hegemonic norms to cooperate in their own oppression (Green 2). Civil society supports the authority of political society and, in return, political society uses the law and criminal justice system to safeguard civil society’s interests against unruly subalterns (Green 7). Rights and responsibilities of citizenship reside within the mutual relationship between political and civil society. Subalternity, by definition, exists outside this relationship, or with limited access to it.Forum members position themselves as citizens within civil society. They lay emphatic claim to fulfilling their responsibilities as neoliberal citizens. However, they perceive themselves to be denied the commensurate rights: they cannot rely on the criminal justice system to protect them from the illegitimate Other. The courts are “soft”, and prisons are “camps” with “revolving doors”. Authorities pamper offenders while doing nothing to stop them from hurting their victims. Human rights are viewed as an imposition by the UN or as policy flowing from a political sphere lacking integrity and dominated by “do gooders”. Rights are reserved only for offenders. Legitimate citizens no longer even have the right to defend themselves. The perceived result is a transfer of rights from legitimate to illegitimate, from deserving to undeserving. This process elides from view the actual subalterns of Australian society—here, most particularly Indigenous people and the socioeconomically vulnerable—and reconstructs them as oppressors of the dominant group, who are reframed as legitimate citizens unjustly made subaltern.The Violence in PunitivenessOn the Forum, as in the broader world, a sense of “white victimisation”—the view, unsupported by history or evidence, that whites are an oppressed people within a structure systematically doling out advantage to minorities (King 89)—is a recurrent legitimising argument for punitiveness and vigilantism. Amid the shrinking social safety nets and employment precarity of neoliberal capitalism, competitiveness increases, and white identity forms around perceived threats to power and status incurred by “losing out” to minorities (Sacks and Lindholm 131). One 2011 study finds a majority of white US citizens believe themselves subject to more racism than black people (King 89). However, these assumptions of whiteness tend to be spared critical examination because, in white-dominated societies, whiteness is the common-sense norm in opposition to which other racial categories are defined (Petray and Collin 2). When whiteness is made the focus of critical questioning, white identities gain salience and imaginings of the “dark other” and besieged white virtues intensify (Bonilla-Silva et al. 232).With respect to feelings of punitiveness, Unnever and Cullen (118-19) find that the social cause for punitiveness in the United States is hostility towards other races, that harsh punishments, including the death penalty, are demanded and accepted by the dominant group because they are perceived to mostly injure “people they do not like” (Unnever and Cullen 119). Moreover, perception that a racial group is inherently criminal amplifies more generalised prejudices against them and diminishes the capacity of the dominant group to feel empathy for suffering inflicted upon them by the criminal justice system (Unnever and Cullen 120).While our analysis of the Forum supports these findings where they touch on crimes committed by Indigenous people, they invite a question. Why, where race is not a factor, do youths and the socioeconomically disadvantaged also inspire intensely violent punitiveness as described above? We argue that the answer relates to status. From this perspective, race becomes one of several categories of differentiation from legitimate citizenship through an ascription of low status.Wenzel, Okimoto, and Cameron (29) contend punitiveness, with respect to specific offences, varies according to the symbolic meaning the offence holds for the observer. Crimes understood as a transgression against status or power inspire a need for “revenge, punishment, and stigmatisation” (Wenzel et al. 41) and justify an increase in the punitiveness required (Wenzel et al. 29, 34). This is particularly true where an offence is deemed to make someone unfit for community membership, such that severe punishment serves as a symbolic marker of exile and a reaffirmation for the community of the violated values and norms (Wenzel et al. 41). Indeed, as noted, Forum posts regularly call for offenders to be removed from society, exiled to the outback, or shipped beyond Australia’s territorial waters.Further, Forum members’ perception of subaltern citizenship, with its assumption of legitimate citizenship as being threatened by undeserving Others, makes them view crime as implicitly a matter of status transgression. This is intensified by perception that the political sphere and criminal justice system are failing legitimate citizens, refusing even to let them defend themselves. Virulent name-calling and comparisons to animals can be understood as attempts by the group to symbolically curtail the undeservedly higher status granted to offenders by weak governments and courts. More violent demands for punishment symbolically remove offenders from citizenship, reaffirm citizen values, and vent anger at a political and criminal justice system deemed complicit, through weakness, in reducing legitimate citizens to subaltern citizens.ConclusionsIn this essay, we highlight the extreme violence we found in our analysis of an extensive online crime forum in a regional Australian city. We explore some explanations for violent public punitiveness, highlighting how members identify themselves as subaltern citizens in a battle against undeserving Others, with no support from a weak state. This analysis centres community norms and a problematic conception of citizenship as drivers of both public punitiveness and dissatisfaction with crime control policy and the criminal justice system. We highlight a real dissonance between community needs and public policy that may undermine effective policymaking. That is, evidence-based crime control policies, successful crime prevention initiatives, and falling crime rates may not increase public satisfaction with how crime is dealt with if policymakers pursue those measures without regard for how citizens experience the process.While studies such as that by Wenzel, Okimoto, and Cameron identify differences in status between legitimate citizens and offenders as amplifiers of punitiveness, we suggest the amplification may be mediated by the status relationship between legitimate citizens and authority figures within legitimate society. The offender and their crime may not contribute as much to the public’s outrage as commonly assumed. Instead, public punitiveness may predominantly arise from the perception that the political sphere, media, and criminal justice system respond to citizens’ experience of crime in ways that devalue the status of legitimate citizens. At least in the context of this regional city, this points to something other than successful crime control being integral to building more effective and satisfactory crime control policy: in this case, the need to rebuild trust between citizens and authority groups.ReferencesBonilla-Silva, Eduardo, Carla Goar, and David G. Embrick. “When Whites Flock Together: The Social Psychology of White Habitus.” Critical Sociology 32.2-3 (2006): 229–253.Bouffard, Jeff, Maisha Cooper, and Kathleen Bergseth. “The Effectiveness of Various Restorative Justice Interventions on Recidivism Outcomes among Juvenile Offenders.” Youth Violence and Juvenile Justice 15.4 (2017): 465–480.Green, Marcus. “Gramsci Cannot Speak: Presentations and Interpretations of Gramsci’s Concept of the Subaltern.” Rethinking Marxism 14.3 (2002): 1–24.Hallett, Michael. “Imagining the Global Corporate Gulag: Lessons from History and Criminological Theory.” Contemporary Justice Review 12.2 (2009): 113–127.Hill, Richard, and Glenn Dawes. “The ‘Thin White Line’: Juvenile Crime, Racialised Narrative and Vigilantism—A North Queensland Study.” Current Issues in Criminal Justice 11.3 (2000): 308–326.Hutchinson, Terry. “‘A Slap on the Wrist’? The Conservative Agenda in Queensland, Australia.” Youth Justice 15.2 (2015): 134–147.Jennings, Will, Stephen Farrall, Emily Gray, and Colin Hay. “Penal Populism and the Public Thermostat: Crime, Public Punitiveness, and Public Policy.” Governance: An International Journal of Policy, Administration, and Institutions 30.3 (2017): 463–481.King, Mike. “The ‘Knockout Game’: Moral Panic and the Politics of White Victimhood.” Race & Class 56.4 (2015): 85–94.Kotzian, Peter. “Good Governance and Norms of Citizenship: An Investigation into the System- and Individual-Level Determinants of Attachment to Civic Norms.” American Journal of Economics and Sociology 73.1 (2014): 58–83.Lechte, John, and Saul Newman. “Agamben, Arendt and Human Rights: Bearing Witness to the Human.” European Journal of Social Theory 15.4 (2012): 522–536.Lister, Ruth. “Citizenship: Towards a Feminist Synthesis.” Feminist Review 57 (1997): 28–48.Petray, Theresa L., and Rowan Collin. “Your Privilege is Trending: Confronting Whiteness on Social Media.” Social Media + Society 3.2 (2017): 1–10.Sacks, Michael A., and Marika Lindholm. “A Room without a View: Social Distance and the Structuring of Privileged Identity.” Working through Whiteness: International Perspectives. Ed. Cynthia Levine-Rasky. Albany, NY: State U of New York P, 2002. 129-151.Staeheli, Lynn A., Patricia Ehrkamp, Helga Leitner, and Caroline R. Nagel. “Dreaming the Ordinary: Daily Life and the Complex Geographies of Citizenship.” Progress in Human Geography 36.5 (2012): 628–644.Unnever, James D., and Francis T. Cullen. “The Social Sources of Americans’ Punitiveness: A Test of Three Competing Models.” Criminology 48.1 (2010): 99–129.Wacquant, Loïc. “Crafting the Neoliberal State: Workfare, Prisonfare, and Social Insecurity.” Sociological Forum 25.2 (2010): 197–220.Walsh, James P. “Quantifying Citizens: Neoliberal Restructuring and Immigrant Selection in Canada and Australia.” Citizenship Studies 15.6-7 (2011): 861–879.Wenzel, Michael, Tyler Okimoto, and Kate Cameron. “Do Retributive and Restorative Justice Processes Address Different Symbolic Concerns?” Critical Criminology 20.1 (2012): 25–44.

Abstract:

IntroductionThey shall grow not old, as we that are left grow old; Age shall not weary them, nor the years condemn. At the going down of the sun and in the morning We will remember them.Recited at many Anzac and Remembrance Day services, ‘The Ode’, an excerpt from a poem by Laurence Binyon, speaks of a timelessness within the inexorable march of time. When we memorialise those for whom time no longer matters, time stands still. Whether those who died in service of their country have finally “beaten time” or been forced to acknowledge that “their time on earth was up”, depends on your preference for clichés. Time and death are natural bedfellows. War memorials, be they physical or digital, declare a commitment to “remember them”. This article will compare and contrast the purpose of, and community response to, virtual and physical war memorials. It will examine whether virtual war memorials are a sign of the times – a natural response to the internet era. If, as Marshall McLuhan says, the medium is the message, what experiences do we gain and lose through online war memorials?Physical War MemorialsDuring and immediately after the First World War, physical war memorials were built in almost every city, town and village of the Allied countries involved in the war. They served many purposes. One of the roles of physical war memorials was to keep the impact of war at the centre of a town’s consciousness. In a regional centre like Bathurst, in New South Wales, the town appears to be built around the memorial – the court, council chambers, library, churches and pubs gather around the war memorials.Similarly, in small towns such as Bega, Picton and Kiama, war memorial arches form a gateway to the town centre. It is an architectural signal that you are entering a community that has known pain, death and immense loss. Time has passed, but the names of the men and women who served remain etched in stone: “lest we forget”.The names are listed in a democratic fashion: usually in alphabetical order without their rank. However, including all those who offered their service to “God, King and Country” (not just those who died) also had a more sinister and divisive effect. It reminded communities of those “eligibles” in their midst whom some regarded as “shirkers”, even if they were conscientious objectors or needed to stay and continue vital industries, like farming (Inglis & Phillips 186).Ken Inglis (97) estimated that every second Australian family was in mourning after the Great War. Jay Winter (Sites 2) goes further arguing that “almost every family” in the British Commonwealth was grieving, either for a relative; or for a friend, work colleague, neighbour or lover. Nations were traumatised. Physical war memorials provided a focal point for that universal grief. They signalled, through their prominence in the landscape or dominance of a hilltop, that it was acceptable to grieve. Mourners were encouraged to gather around the memorial in a public place, particularly on Anzac Day and Remembrance Day each year. Grief was seen, observed, respected.Such was the industrial carnage of the Western Front, that about one third of Australia and New Zealand’s fatal casualties were not brought home. Families lost a family member, body and soul, in the Great War. For those people who subscribed to a Victorian view of death, who needed a body to grieve over, the war memorial took on the role of a gravesite and became a place where people would place a sprig of wattle, poke a poppy into the crevice beside a name, or simply touch the letters etched or embossed in the stone (Winter, Experience 206). As Ken Inglis states: “the statue on its pedestal does stand for each dead man whose body, identified or missing, intact or dispersed, had not been returned” to his home town (11).Physical war memorials were also a place where women could forge new identities over time. Women accepted, or claimed their status as war widows, grieving mothers or bereft fiancés, while at the same time coming to terms with their loss. As Joy Damousi writes: “mourning of wartime loss involved a process of sustaining both a continuity with, and a detachment from, a lost soldier” (1). Thus, physical war memorials were transitional, liminal spaces.Jay Winter (Sites 85) believes that physical war memorials were places to both honour and mourn the dead, wounded, missing and shell-shocked. These dual functions of both esteeming and grieving those who served was reinforced at ceremonies, such as Anzac or Remembrance Day.As Joy Damousi (156) and Ken Inglis (457, 463) point out, war memorials in Australia are rarely sites of protest, either for war widows or veterans campaigning for a better pension, or peace activists who opposed militarism. When they are used in this way, it makes headlines in the news (Legge). They are seldom used to highlight the tragedy, inhumanity or futility of war. The exception to this, were the protests against the Vietnam War.The physical war memorials which mushroomed in Australian country towns and cities after the First World War captured and claimed those cataclysmic four years for the families and communities who were devastated by the war. They provided a place to both honour and mourn those who served, not just once, but for as long as the memorial remained. They were also a place of pilgrimage, particularly for families who did not have a grave to visit and a focal point for the annual rituals of remembrance.However, over the past 100 years, some unmaintained physical war memorials are beginning to look like untended graves. They have become obstacles rather than sentinels in the landscape. Laurence Aberhart’s haunting photographs show that memorials in places like Dorrigo in rural New South Wales “go largely unnoticed year-round, encroached on by street signage and suburbia” (Lakin 49). Have physical war memorials largely fulfilled their purpose and are they becoming obsolete? Perhaps they have been supplanted by the gathering space of the 21st century: the Internet.Digital War MemorialsThe centenary of the Great War heralded a mushrooming of virtual war memorials. Online First World War memorials focus on collecting and amassing information that commemorates individuals. They are able to include far more information than will fit on a physical war memorial. They encourage users to search the digitised records that are available on the site and create profiles of people who served. While they deal in records from the past, they are very much about the present: the user experience and their connection to their ancestors who served.The Imperial War Museum’s website Lives of the First World War asks users to “help us build the permanent digital memorial to all who contributed during the First World War”. This request deserves scrutiny. Firstly, “permanent” – is this possible in the digital age? When the head of Google, Vint Cerf, disclosed in 2015 that software programming wizards were still grappling with how to create digital formats that can be accessed in 10, 100 or a 1000 years’ time; and recommended that we print out our precious digital data and store it in hard copy or risk losing it forever; then it appears that online permanency is a mirage.Secondly, “all who contributed” – the website administrators informed me that “all” currently includes people who served with Canada and Britain but the intention is to include other Commonwealth nations. It seems that the former British Empire “owns” the First World War – non-allied, non-Commonwealth nations that contributed to the First World War will not be included. One hundred years on, have we really made peace with Germany and Turkey? The armistice has not yet spread to the digital war memorial. The Lives of the First world War website missed an opportunity to be leaders in online trans-national memorialisation.Discovering Anzacs, a website built by the National Archives of Australia and Archives New Zealand, is a little more subdued and honest, as visitors are invited to “enhance a profile dedicated to the wartime journey of someone who served”.Physical and online war memorials can work in tandem. In 2015, the Supreme Court of Victoria created a website that provides background information on the military service of the 159 members of the legal profession who are named on their Memorial board. This is an excellent example of a digital medium expanding on and reinvigorating a physical memorial.It is noteworthy that all of these online memorial websites commemorate those who served in the First World War, and sometimes the Boer or South African War. There is no space for remembering those who served or died in more recent wars like Afghanistan or Iraq. James Brown and others discuss how the cult of Anzac is overshadowing the service and sacrifices of the men and women who have been to more recent wars. The proximity of their service mitigates against its recognition – it is too close for comfortable, detached remembrance.Complementary But Not ExclusiveA comparison of their functions indicates that online memorials which focus on the First World War complement, but will never replace the role of physical war memorials. As discussed, physical war memorials were sites for grieving, pilgrimage and collectively honouring the men and women who served and died. Online websites which allow users to upload scanned documents and photographs; transcribe diary entries or letters; post tribute poems, songs or video clips; and provide links to other relevant records online are neither places of pilgrimage nor sites for grieving. They are about remembrance, not memory (Scates, “Finding” 221).Ken Inglis describes physical war memorials as “bearers of collective memory” (7). In a sense, online war memorials are keepers of individual, user-enhanced archival records. It can be argued that online memorials to the First World War tap into the desire for hero-worship, the boom in family history research and what Scates calls the “cult of remembrance” (“Finding” 218). They provide a way for individuals, often two or three generations removed, to discover, understand and document the wartime experiences of individuals in their family. By allowing descendants to situate their family story within the larger, historically significant narrative of the First World War, online memorials encourage people to feel that the suffering and untimely death of their forbear wasn’t in vain – that it contributed to something worthwhile and worth remembering. At a collective level, this contributes to the ANZAC myth and former Australian Prime Minister John Howard’s attempt to use it as a foundational myth for Australia’s nationhood.Kylie Veale (9) argues that cyberspace has encouraged improvements on traditional memorial practices because online memorials can be created in a more timely fashion, they are more affordable and they are accessible and enable the sharing of grief and bereavement on a global scale. As evidence of this, an enterprising group in the USA has developed an android app which provides a template for creating an online memorial. They compete with Memorialsonline.com. Veale’s arguments remind us that the Internet is a hyper-democratic space where interactions and sites that are collaborative or contemplative exist alongside trolling and prejudice. Veale also contends that memorial websites facilitate digital immortality, which helps keep the memory of the deceased alive. However, given the impermanence of much of the content on the Internet, this final attribute is a bold claim.It is interesting to compare the way individual soldiers are remembered prior to and after the arrival of the Internet. Now that it is possible to create a tribute website, or Facebook page in memory of someone who served, do families do this instead of creating large physical scrapbooks or photo albums? Or do they do both? Garry Roberts created a ‘mourning diary’ as a record of his journey of agonising grief for his eldest son who died in 1918. His diary consists of 27 scrapbooks, weighing 10 kilograms in total. Pat Jalland (318) suggests this helped Roberts to create some sort of order out of his emotional turmoil. Similarly, building websites or digital tribute pages can help friends and relatives through the grieving process. They can also contribute the service person’s story to official websites such as those managed by the Australian Defence Forces. Do grieving family members look up a website or tribute page they’ve created in the same way that they might open up a scrapbook and remind themselves of their loved one? Kylie Veale’s research into online memorials created for anyone who has died, not necessarily those killed by war, suggests online memorials are used in this way (5).Do grieving relatives take comfort from the number of likes, tags or comments on a memorial or tribute website, in the same way that they might feel supported by the number of people who attend a memorial service or send a condolence card? Do they archive the comments? Garry Roberts kept copies of the letters of sympathy and condolence that he received from friends and relatives after his son’s tragic death and added them to his 27 scrapbooks.Both onsite and online memorials can suffer from lack of maintenance and relevance. Memorial websites can become moribund like untended headstones in a graveyard. Once they have passed their use as a focal point of grief, a place to post tributes; they can languish, un-updated and un-commented on.Memorials and PilgrimageOne thing that online memorials will never be, however, are sites of pilgrimage or ritual. One does not need to set out on a journey to visit an online memorial. It is as far away as your portable electronic device. Online memorials cannot provide the closure or sense of identity and community that comes from visiting a memorial or gravesite.This was evident in December 2014 when people felt the need to visit the Lindt Café in Sydney’s Martin Place after the terrorist siege and lay flowers and tributes. While there were also Facebook tribute pages set up for these victims of violence, mourners still felt the need to visit the sites. A permanent memorial to the victims of the siege has now opened in Martin Place.Do people gather around a memorial website for the annual rituals which take place on Anzac or Remembrance Day, or the anniversaries of significant battles? In 2013, the Australian War Memorial (AWM) saw a spike in people logging onto the Memorial’s Remembrance Day web page just prior to 11am. They left the site immediately after the minute’s silence. The AWM web team think they were looking for a live broadcast of the Remembrance Day service in Canberra. When that wasn’t available online, they chose to stay on the site until after the minute’s silence. Perhaps this helped them to focus on the reason for Remembrance Day. Perhaps, as Internet speeds get faster, it will be possible to conduct your own virtual ceremony in real time with friends and family in cyberspace.However, I cannot imagine a time when visiting dignitaries from other countries will post virtual wreaths to virtual war memorials. Ken Inglis argues that the tomb of the Unknown Soldier in the AWM has become the ritual centre of the Australian nation, “receiving obligatory wreaths from every visiting head of state” (459).Physical and Online Memorials to the War in AfghanistanThere are only eight physical war memorials to the Afghanistan conflict in Australia, even though this is the longest war Australia has been involved in to date (2001-2015). Does the lack of physical memorials to the war in Afghanistan mean that our communities no longer need them, and that people are memorialising online instead?One grieving father in far north Queensland certainly felt that an online memorial would never suffice. Gordon Chuck’s son, Private Benjamin Chuck, was killed in a Black Hawk helicopter crash in Afghanistan in 2010 when he was only 27 years old. Spurred by his son’s premature death, Gordon Chuck rallied family, community and government support, in the tiny hinterland town of Yungaburra, west of Cairns in Queensland, to establish an Avenue of Honour. He knocked on the doors of local businesses, the Returned Servicemen’s League (RSL), the Australian Defence Forces and every level of government to raise $300,000. His intention was to create a timeless memorial of world standard and national significance. On 21 June 2013, the third anniversary of his son’s death, the Chief of the Defence Force and the Prime Minister formally opened the Avenue of Honour in front of “thousands” of people (Nancarrow).Diggers from Afghanistan who have visited the Yungaburra Avenue of Honour speak of the closure and sense of healing it gave them (Nancarrow). The Avenue, built on the shores of Lake Tinaroo, features parallel rows of Illawarra flame trees, whose red blossoms are in full bloom around Remembrance Day and symbolise the blood and fire of war and the cycle of life. It commemorates all the Australian soldiers who have died in the Afghanistan war.The Avenue of Honour, and the memorial in Martin Place clearly demonstrate that physical war memorials are not redundant. They are needed and cherished as sites of grief, hope and commemoration. The rituals conducted there gather gravitas from the solemnity that falls when a sea of people is silent and they provide healing through the comfort of reverent strangers.ConclusionEven though we live in an era when most of us are online every day of our lives, it is unlikely that virtual war memorials will ever supplant their physical forebears. When it comes to commemorating the First World War or contemporary conflicts and those who fought or died in them, physical and virtual war memorials can be complementary but they fulfil fundamentally different roles. Because of their medium as virtual memorials, they will never fulfil the human need for a place of remembrance in the real world.ReferencesBinyon, Laurence. “For the Fallen.” The Times. 21 Sep. 1914. 7 Oct. 2019 <https://www.army.gov.au/our-history/traditions/for-the-fallen>.Brown, James. Anzac’s Long Shadow. Sydney: Black Inc., 2014.Damousi, Joy. The Labour of Loss. Great Britain: Cambridge UP, 1999.Hunter, Kathryn. “States of Mind: Remembering the Australian-New Zealand Relationship.” Journal of the Australian War Memorial 36 (2002). 7 Oct. 2019 <https://www.awm.gov.au/articles/journal/j36/nzmemorial>.Inglis, Ken. Sacred Places: War Memorials in the Australian Landscape. Melbourne: Melbourne UP, 1998.Inglis, Ken, and Jock Phillips. “War Memorials in Australia and New Zealand: A Comparative Survey.” Australian Historical Studies 24.96 (1991): 179-191.Jalland, Pat. Australian Ways of Death: A Social and Cultural History 1840-1918. London: Oxford University Press, 2002.Knapton, Sarah. “Print Out Digital Photos or Risk Losing Them, Google Boss Warns.” Telegraph 13 Feb. 2015. 7 Oct. 2019 <http://www.telegraph.co.uk/news/science/science-news/11410506/Print-out-digital-photos-or-risk-losing-them-Google-boss-warns.html>.Lakin, Shaune. “Laurence Aberhart ANZAC.” Artlink 35.1 (2015): 48-51.Legge, James. “Vandals Deface Two London War Memorials with ‘Islam’ Graffiti”. Independent 27 May 2013. 7 Oct. 2019 <https://www.independent.co.uk/news/uk/crime/vandals-deface-two-london-war-memorials-with-islam-graffiti-8633386.html>.Luckins, Tanya. The Gates of Memory. Fremantle, WA: Curtin University Books, 2004.McLuhan, Marshall. Understating Media: The Extensions of Man. New York: Mentor, 1964.McPhedran, Ian. “Families of Dead Soldiers Angered after Defence Chief David Hurley Donates Memorial Plinth to Avenue of Honour.” Cairns Post 7 June 2014. 7 Oct. 2019 <http://www.cairnspost.com.au/news/cairns/families-of-dead-soldiers-angered-after-defence-chief-david-hurley-donates-memorial-plinth-to-avenue-of-honour/story-fnjpusyw-1226946540125>.McPhedran, Ian. “Backflip over Donation of Memorial Stone from Afghanistan to Avenue of Honour at Yungaburra.” Cairns Post 11 June 2014. 7 Oct. 2019 <http://www.cairnspost.com.au/news/cairns/backflip-over-donation-of-memorial-stone-from-afghanistan-to-avenue-of-honour-at-yungaburra/story-fnkxmm0j-1226950508126>.Ministry for Culture and Heritage. “Interpreting First World War Memorials.” Updated 4 Sep. 2014. <http://www.nzhistory.net.nz/war/interpreting-first-world-war-memorials>.Nancarrow, Kirsty. “Thousands Attend Opening of Avenue of Honour, a Memorial to Diggers Killed in Afghanistan”. ABC News 7 Nov. 2014. 2 Oct. 2014 <http://www.abc.net.au/news/2013-06-22/avenue-of-honour-remembers-fallen-diggers/4773592>.Scates, Bruce. “Finding the Missing of Fromelles: When Soldiers Return.” Anzac Legacies: Australians and the Aftermath of War. Eds. Martin Crotty and Marina Larsson. Melbourne: Australian Scholarly Publishing, 2010. 212-231.Scates, Bruce. “Soldiers’ Journeys: Returning to the Battlefields of the Great War.” Journal of the Australian War Memorial 40 (2007): n.p.Scott, Ernest. Australia during the War: The Official History of Australia in the War of 1914–1918. Vol. XI. Sydney: Angus and Robertson, 1941.Stanley, Peter. “Ten Kilos of First World War Grief at the Melbourne Museum.” The Conversation 27 Aug. 2014. 10 Oct. 2019 <https://theconversation.com/ten-kilos-of-first-world-war-grief-at-the-melbourne-museum-30362>.Veale, Kylie. “Online Memorialisation: The Web as a Collective Memorial Landscape for Remembering the Dead.” Fibreculture Journal 3 (2004). 7 Oct. 2019 <http://three.fibreculturejournal.org/fcj-014-online-memorialisation-the-web-as-a-collective-memorial-landscape-for-remembering-the-dead/>.Winter, Jay. Sites of Memory, Sites of Mourning. Cambrigde: Cambridge UP, 1995.———. The Experience of World War I. London: Macmillan, 1988.

Abstract:

We need a clear, unified, and consistent voice to effect the complete dismantling, the abolition, of the mechanisms of animal exploitation.And that will only come from what we say and do, no matter who we are.— Gary L. Francione, animal rights theoristThe history of hashtags is relatively short but littered with the remnants of corporate hashtags which may have seemed a good idea at the time within the confines of the boardroom. It is difficult to understand the rationale behind the use of hashtags as an effective communications tactic in 2019 by corporations when a quick stroll through their recent past leaves behind the much-derided #qantasluxury (Glance), #McDstories (Hill), and #myNYPD (Tran).While hashtags have an obvious purpose in bringing together like-minded publics and facilitating conversation (Kwye et al. 1), they have also regularly been the subject of “hashtag takeovers” by activists and other interested parties, and even by trolls, as the Ecological Society of Australia found in 2015 when their seemingly innocuous #ESA15 hashtag was taken over with p*rnographic images (news.com.au). Hashtag takeovers have also been used as a dubious marketing tactic, where smaller and less well-known brands tag their products with trending hashtags such as #iphone in order to boost their audience (Social Garden). Hashtags are increasingly used as a way for activists or other interested parties to disrupt a message. It is, I argue, predictable that any hashtag related to an even slightly controversial topic will be subject to some form of activist hashtag takeover, with varying degrees of success.That veganism and the dairy industry should attract such conflict is unsurprising given that the two are natural enemies, with vegans in particular seeming to anticipate and actively engage in the battle for the opposing hashtag.Using a comparative analysis of the #Veganuary and #Februdairy hashtags and how they have been used by both pro-vegan and pro-dairy social media users, this article illustrates that the enthusiastic and well-meaning social media efforts of farmers and dairy supporters have so far been unable to counteract those of well-organised and equally passionate vegan activists. This analysis compares tweets in the first week of the respective campaigns, concluding that organisations, industries and their representatives should be extremely wary of engaging said activists who are not only highly-skilled but are also highly-motivated. Grassroots, ideology-driven activism is a formidable opponent in any public space, let alone when it takes place on the outspoken and unstructured landscape of social media which is sometimes described as the “wild West” (Fitch 5) where anything goes and authenticity and plain-speaking is key (Macnamara 12).I Say Hashtag, You Say Bashtag#Februdairy was launched in 2018 to promote the benefits of dairy. The idea was first mooted on Twitter in 2018 by academic Dr Jude Capper, a livestock sustainability consultant, who called for “28 days, 28 positive dairy posts” (@Bovidiva; Howell). It was a response to the popular Veganuary campaign which aimed to “inspire people to try vegan for January and throughout the rest of the year”, a campaign which had gained significant traction both online and in the traditional media since its inception in 2014 (Veganuary). Hopes were high: “#Februdairy will be one month of dairy people posting, liking and retweeting examples of what we do and why we do it” (Yates). However, the #Februdairy hashtag has been effectively disrupted and has now entered the realm of a bashtag, a hashtag appropriated by activists for their own purpose (Austin and Jin 341).The Dairy Industry (Look Out the Vegans Are Coming)It would appear that the dairy industry is experiencing difficulties in public perception. While milk consumption is declining, sales of plant-based milks are increasing (Kaiserman) and a growing body of health research has questioned whether dairy products and milk in particular do in fact “do a body good” (Saccaro; Harvard Milk Study). In the 2019 review of Canada’s food guide, its first revision since 2007, for instance, the focus is now on eating plant-based foods with dairy’s former place significantly downgraded. Dairy products no longer have their own distinct section and are instead placed alongside other proteins including lentils (Pippus).Nevertheless, the industry has persevered with its traditional marketing and public relations activities, choosing to largely avoid addressing animal welfare concerns brought to light by activists. They have instead focused their message towards countering concerns about the health benefits of milk. In the US, the Milk Processing Education Program’s long-running celebrity-driven Got Milk campaign has been updated with Milk Life, a health focused campaign, featuring images of children and young people living an active lifestyle and taking part in activities such as skateboarding, running, and playing basketball (Milk Life). Interestingly, and somewhat inexplicably, Milk Life’s home page features the prominent headline, “How Milk Can Bring You Closer to Your Loved Ones”.It is somewhat reflective of the current trend towards veganism that tennis aces Serena and Venus Williams, both former Got Milk ambassadors, are now proponents for the plant-based lifestyle, with Venus crediting her newly-adopted vegan diet as instrumental in her recovery from an auto-immune disease (Mango).The dairy industry’s health focus continues in Australia, as well as the use of the word love, with former AFL footballer Shane Crawford—the face of the 2017 campaign Milk Loves You Back, from Lion Dairy and Drinks—focusing on reminding Australians of the reputed nutritional benefits of milk (Dawson).Dairy Australia meanwhile launched their Legendairy campaign with a somewhat different focus, promoting and lauding Australia’s dairy families, and with a message that stated, in a nod to the current issues, that “Australia’s dairy farmers and farming communities are proud, resilient and innovative” (Dairy Australia). This campaign could be perceived as a morale-boosting exercise, featuring a nation-wide search to find Australia’s most legendairy farming community (Dairy Australia). That this was also an attempt to humanise the industry seems obvious, drawing on established goodwill felt towards farmers (University of Cambridge). Again, however, this strategy did not address activists’ messages of suffering animals, factory farms, and newborn calves being isolated from their grieving mothers, and it can be argued that consumers are being forced to make the choice between who (or what) they care about more: animals or the people making their livelihoods from them.Large-scale campaigns like Legendairy which use traditional channels are of course still vitally important in shaping public opinion, with statistics from 2016 showing 85.1% of Australians continue to watch free-to-air television (Roy Morgan, “1 in 7”). However, a focus and, arguably, an over-reliance on traditional platforms means vegans and animal activists are often unchallenged when spreading their message via social media. Indeed, when we consider the breakdown in age groups inherent in these statistics, with 18.8% of 14-24 year-olds not watching any commercial television at all, an increase from 7% in 2008 (Roy Morgan, “1 in 7”), it is a brave and arguably short-sighted organisation or industry that relies primarily on traditional channels to spread their message in 2019. That these large-scale campaigns do little to address the issues raised by vegans concerning animal welfare leaves these claims largely unanswered and momentum to grow.This growth in momentum is fuelled by activist groups such as the People for the Ethical Treatment of Animals (PETA) who are well-known in this space, with 5,494,545 Facebook followers, 1.06 million Twitter followers, 973,000 Instagram followers, and 453,729 You Tube subscribers (People for the Ethical Treatment of Animals). They are also active on Pinterest, a visual-based platform suited to the kinds of images and memes particularly detrimental to the dairy industry. Although widely derided, PETA’s reach is large. A graphic video posted to Facebook on February 13 2019 and showing a suffering cow, captioned “your cheese is not worth this” was shared 1,244 times, and had 4.6 million views in just over 24 hours (People for the Ethical Treatment of Animals). With 95% of 12-24 year olds in Australia now using social networking sites (Statista), it is little wonder veganism is rapidly growing within this demographic (Bradbury), with The Guardian labelling the rise of veganism unstoppable (Hancox).Activist organisations are joined by prominent and charismatic vegan activists such as James Aspey (182,000 Facebook followers) and Earthling Ed (205,000 Facebook followers) in distributing information and images that are influential and often highly graphic or disturbing. Meanwhile Instagram influencers and You Tube lifestyle vloggers such as Ellen Fisher and FreeLee share information promoting vegan food and the vegan lifestyle (with 650,320 and 785,903 subscribers respectively). YouTube video Dairy Is Scary has over 5 million views (Janus) and What the Health, a follow-up documentary to Cowspiracy: The Sustainability Secret, promoting veganism, is now available on Netflix, which itself has 9.8 million Australian subscribers (Roy Morgan, “Netflix”). BOSH’s plant-based vegan cookbook was the fastest selling cookbook of 2018 (Chiorando).Additionally, the considerable influence of celebrities such as Miley Cyrus, Beyonce, Alicia Silverstone, Zac Efron, and Jessica Chastain, to name just a few, speaking publicly about their vegan lifestyle, encourages veganism to become mainstream and increases its widespread acceptance.However not all the dairy industry’s ills can be blamed on vegans. Rising costs, cheap imports, and other pressures (Lockhart, Donaghy and Gow) have all placed pressure on the industry. Nonetheless, in the battle for hearts and minds on social media, the vegans are leading the way.Qualitative research interviewing new vegans found converting to veganism was relatively easy, yet some respondents reported having to consult multiple resources and required additional support and education on how to be vegan (McDonald 17).Enter VeganuaryUsing a month, week or day to promote an idea or campaign, is a common public relations and marketing strategy, particularly in health communications. Dry July and Ocsober both promote alcohol abstinence, Frocktober raises funds for ovarian cancer, and Movember is an annual campaign raising awareness and funds for men’s health (Parnell). Vegans Matthew Glover and Jane Land were discussing the success of Movember when they raised the idea of creating a vegan version. Their initiative, Veganuary, urging people to try vegan for the month of January, launched in 2014 and since then 500,000 people have taken the Veganuary pledge (Veganuary).The Veganuary website is the largest of its kind on the internet. With vegan recipes, expert advice and information, it provides all the answers to Why go vegan, but it is the support offered to answer How to go vegan that truly sets Veganuary apart. (Veganuary)That Veganuary participants would use social media to discuss and share their experiences was a foregone conclusion. Twitter, Facebook, and Instagram are all utilised by participants, with the official Veganuary pages currently followed/liked by 159,000 Instagram followers, receiving 242,038 Facebook likes, and 45,600 Twitter followers (Veganuary). Both the Twitter and Instagram sites make effective use of hashtags to spread their reach, not only using #Veganuary but also other relevant hashtags such as #TryVegan, #VeganRecipes, and the more common #Vegan, #Farm, and #SaveAnimals.Februdairy Follows Veganuary, But Only on the CalendarCalling on farmers and dairy producers to create counter content and their own hashtag may have seemed like an idea that would achieve an overall positive response.Agricultural news sites and bloggers spread the word and even the BBC reported on the industry’s “fight back” against Veganuary (BBC). However the hashtag was quickly overwhelmed with anti-dairy activists mobilising online. Vegans issued a call to arms across social media. The Vegans in Australia Facebook group featured a number of posts urging its 58,949 members to “thunderclap” the Februdairy hashtag while the Project Calf anti-dairy campaign declared that Februdairy offered an “easy” way to spread their information (Sandhu).Februdairy farmers and dairy supporters were encouraged to tell their stories, sharing positive photographs and videos, and they did. However this content was limited. In this tweet (fig. 1) the issue of a lack of diverse content was succinctly addressed by an anti-Februdairy activist.Fig. 1: Content challenges. (#Februdairy, 2 Feb. 2019)MethodUtilising Twitter’s advanced search capability, I was able to search for #Veganuary tweets from 1 to 7 January 2019 and #Februdairy tweets from 1 to 7 February 2019. I analysed the top tweets provided by Twitter in terms of content, assessed whether the tweet was pro or anti Veganuary and Februdairy, and also categorised its content in terms of subject matter.Tweets were analysed to assess whether they were on message and aligned with the values of their associated hashtag. Veganuary tweets were considered to be on message if they promoted veganism or possessed an anti-dairy, anti-meat, or pro-animal sentiment. Februdairy tweets were assessed as on message if they promoted the consumption of dairy products, expressed sympathy or empathy towards the dairy industry, or possessed an anti-vegan sentiment. Tweets were also evaluated according to their clarity, emotional impact and coherence. The overall effectiveness of the hashtag was then evaluated based on the above criteria as well as whether they had been hijacked.Results and FindingsOverwhelmingly, the 213 #Veganuary tweets were on message. That is they were pro-Veganuary, supportive of veganism, and positive. The topics were varied and included humorous memes, environmental facts, information about the health benefits of veganism, as well as a strong focus on animals. The number of non-graphic tweets (12) concerning animals was double that of tweets featuring graphic or shocking imagery (6). Predominantly the tweets were focused on food and the sharing of recipes, with 44% of all pro #Veganuary tweets featuring recipes or images of food. Interestingly, a number of well-known corporations tweeted to promote their vegan food products, including Tesco, Aldi, Iceland, and M&S. The diversity of veganism is reflected in the tweets. Organisations used the hashtag to promote their products, including beauty and shoe products, social media influencers promoted their vegan podcasts and blogs, and, interestingly, the Ethiopian Embassy of the United Kingdom tweeted their support.There were 23 (11%) anti-Veganuary tweets. Of these, one was from Dr. Jude Capper, the founder of Februdairy. The others expressed support for farming and farmers, and a number were photographs of meat products, including sausages and fry-ups. One Australian journalist tweeted in favour of meat, stating it was yummy murder. These tweets could be described as entertaining and may perhaps serve as a means of preaching to the converted, but their ability to influence and persuade is negligible.Twitter’s search tool provided access to 141 top #Februdairy tweets. Of these 82 (52%) were a hijack of the hashtag and overtly anti-Februdairy. Vegan activists used the #Februdairy hashtag to their advantage with most of their tweets (33%) featuring non-graphic images of animals. They also tweeted about other subject matters, including environmental concerns, vegan food and products, and health issues related to dairy consumption.As noted by the activists (see fig. 1 above), most of the pro-Februdairy tweets were images of milk or dairy products (41%). Images of farms and farmers were the next most used (26%), followed by images of cows (17%) (see fig. 2). Fig. 2: An activist makes their anti-Februdairy point with a clear, engaging image and effective use of hashtags. (#Februdairy, 6 Feb. 2019)The juxtaposition between many of the tweets was also often glaring, with one contrasting message following another (see fig. 3). Fig. 3: An example of contrasting #Februdairy tweets with an image used by the activists to good effect, making their point known. (#Februdairy, 2 Feb. 2019)Storytelling is a powerful tool in public relations and marketing efforts. Yet, to be effective, high-quality content is required. That many of the Februdairy proponents had limited social media training was evident; images were blurred, film quality was poor, or they failed to make their meaning clear (see fig. 4). Fig. 4: A blurred photograph, reflective of some of the low-quality content provided by Februdairy supporters. (#Februdairy, 3 Feb. 2019)This image was tweeted in support of Februdairy. However the image and phrasing could also be used to argue against Februdairy. We can surmise that the tweeter was suggesting the cow was well looked after and seemingly content, but overall the message is as unclear as the image.While some pro-Februdairy supporters recognised the need for relevant hashtags, often their images were of a low-quality and not particularly engaging, a requirement for social media success. This requirement seems to be better understood by anti-Februdairy activists who used high-quality images and memes to create interest and gain the audience’s attention (see figs. 5 and 6). Fig. 5: An uninspiring image used to promote Februdairy. (#Februdairy, 6 Feb. 2019) Fig. 6: Anti-Februdairy activists made good use of memes, recognising the need for diverse content. (#Februdairy, 3 Feb. 2019)DiscussionWhat the #Februdairy case makes clear, then, is that in continuing its focus on traditional media, the dairy industry has left the battle online to largely untrained, non-social media savvy supporters.From a purely public relations perspective, one of the first things we ask our students to do in issues and crisis communication is to assess the risk. “What can hurt your organisation?” we ask. “What potential issues are on the horizon and what can you do to prevent them?” This is PR101 and it is difficult to understand why environmental scanning and resulting action has not been on the radar of the dairy industry long before now. It seems they have not fully anticipated or have significantly underestimated the emerging issue that public perception, animal cruelty, health concerns, and, ultimately, veganism has had on their industry and this is to their detriment. In Australia in 2015–16 the dairy industry was responsible for 8 per cent (A$4.3 billion) of the gross value of agricultural production and 7 per cent (A$3 billion) of agricultural export income (Department of Agriculture and Water Resources). When such large figures are involved and with so much at stake, it is hard to rationalise the decision not to engage in a more proactive online strategy, seeking to engage their publics, including, whether they like it or not, activists.Instead there are current attempts to address these issues with a legislative approach, lobbying for the introduction of ag-gag laws (Potter), and the limitation of terms such as milk and cheese (Worthington). However, these measures are undertaken while there is little attempt to engage with activists or to effectively counter their claims with a widespread authentic public relations campaign, and reflects a failure to understand the nature of the current online environment, momentum, and mood.That is not to say that the dairy industry is not operating in the online environment, but it does not appear to be a priority, and this is reflected in their low engagement and numbers of followers. For instance, Dairy Australia, the industry’s national service body, has a following of only 8,281 on Facebook, 6,981 on Twitter, and, crucially, they are not on Instagram. Their Twitter posts do not include hashtags and unsurprisingly they have little engagement on this platform with most tweets attracting no more than two likes. Surprisingly they have 21,013 subscribers on YouTube which featured professional and well-presented videos. This demonstrates some understanding of the importance of effective storytelling but not, as yet, trans-media storytelling.ConclusionSocial media activism is becoming more important and recognised as a legitimate voice in the public sphere. Many organisations, perhaps in recognition of this as well as a growing focus on responsible corporate behaviour, particularly in the treatment of animals, have adjusted their behaviour. From Unilever abandoning animal testing practices to ensure Dove products are certified cruelty free (Nussbaum), to Domino’s introducing vegan options, companies who are aware of emerging trends and values are changing the way they do business and are reaping the benefits of engaging with, and catering to, vegans. Domino’s sold out of vegan cheese within the first week and vegans were asked to phone ahead to their local store, so great was the demand. From their website:We knew the response was going to be big after the demand we saw for the product on social media but we had no idea it was going to be this big. (Domino’s Newsroom)As a public relations professional, I am baffled by the dairy industry’s failure to adopt a crisis-based strategy rather than largely rely on the traditional one-way communication that has served them well in the previous (golden?) pre-social media age. However, as a vegan, persuaded by the unravelling of the happy cow argument, I cannot help but hope this realisation continues to elude them.References@bovidiva. “Let’s Make #Februdairy Happen This Year. 28 Days, 28 Positive #dairy Posts. From Cute Calves and #cheese on Crumpets, to Belligerent Bulls and Juicy #beef #burgers – Who’s In?” Twitter post. 15 Jan. 2018. 1 Feb. 2019 <https://twitter.com/bovidiva/status/952910641840447488?lang=en>.Austin, Lucinda L., and Yan Jin. Social Media and Crisis Communication. 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