Zeitschriftenartikel zum Thema „Description and travel, 50 1800“

Abstract Introduction : Daratumumab (DARA), a CD38-targeted human monoclonal antibody, is approved as monotherapy and in combination with bortezomib (proteasome inhibitor; PI) or immunomodulatory drugs (IMiD; lenalidomide or pomalidomide) in pts with RRMM. DARA is administered intravenously (IV) and is associated with infusion related reactions (IRRs) in 46% of pts. We previously reported data from PAVO (NCT02519452), an open-label, multicenter, phase 1b study in RRMM, showing that subcutaneous (SC) delivery of DARA with recombinant human hyaluronidase enzyme (rHuPH20) by SC infusion of a mix and deliver formulation (DARA-MD) was well tolerated with low rates of IRRs (Usmani SZ, et al. ASH 2016; abstract 1149). DARA + rHuPH20 also demonstrated an efficacy profile consistent with IV DARA. We present updated data, including initial safety and efficacy findings from an additional cohort that received DARA co-formulated with rHuPH20 (DARA SC), which was delivered by manual SC injection. Methods : RRMM pts had an Eastern Cooperative Oncology Group performance status ≤2 and received ≥2 prior lines of therapy including a PI and an IMiD. To determine the recommended SC dose for Part 2 of this 2-part study, DARA-MD was administered via SC infusion through a syringe pump from 20 to 30 min in Part 1. Pts were administered DARA 1200 mg + rHuPH20 30000 U (in 60 mL) or DARA 1800 mg + rHuPH20 45000 U (in 90 mL) in 28-day cycles: weekly in Cycles 1-2, every 2 weeks in Cycles 3-6, and every 4 weeks thereafter. The 1,800 mg dose level was selected for Part 2. In Part 2, a concentrated co-formulation of the selected DARA SC (1800 mg in 15 mL) and rHuPH20 (30000 U) dose in a single, pre-mixed vial was administered in 3 to 5 minutes by manual SC injection. In both parts, the primary endpoints were Ctrough of DARA up to Cycle 3 Day 1 and safety. Secondary endpoints included overall response rate (ORR), rate of complete response (CR), and time to response. Results : At the clinical cut-off of June 30, 2017, 53 pts were enrolled in Part 1 (DARA-MD 1200 mg, n=8; DARA-MD 1800 mg, n=45) and 25 pts were enrolled in Part 2 (DARA SC 1800 mg). 0/8 (0%), 12/45 (27%), and 25/25 (100%) pts receiving DARA-MD 1200 mg, DARA-MD 1800 mg, and DARA SC 1800 mg, respectively, remain on treatment; the median duration of treatment was 2.6 (0.7-12.0), 5.4 (0.7-16.6+), and 1.4 (0.5-2.3+) months, respectively. In Part 1, 100% and 73% of pts discontinued treatment in the DARA-MD 1200 mg and DARA-MD 1800 mg dose cohorts, respectively, due to progressive disease (75% and 58%), physician decision (0% and 9%), death (13% and 2%), withdrawal by pt (13% and 2%), and other (0% and 2%); in Part 2 with shorter follow up, none discontinued treatment. One pt receiving DARA-MD 1200 mg died due to adverse event (aspiration pneumonia) and 2 pts receiving DARA-MD 1800 mg died due to disease progression; no deaths occurred in the DARA SC 1800 mg cohort. IRRs were reported in 13%, 24% and 4% pts receiving DARA-MD 1200 mg, DARA-MD 1800 mg, and DARA SC 1800 mg, respectively. One grade 3 IRR of dyspnea occurred in the DARA-MD 1200 mg cohort; no grade 3/4 IRRs occurred in pts receiving DARA-MD 1800 mg or DARA SC 1800 mg. SC administration was well tolerated in the DARA-MD 1200 mg, DARA-MD 1800 mg, and DARA SC 1800 mg cohorts, with 63%, 29%, and 20% of pts experiencing reversible erythema and 50%, 22%, and 0% of pts experiencing reversible induration at the infusion/injection site, respectively. Among DARA-MD 1200 mg, DARA-MD 1800 mg, and DARA SC 1800 mg cohorts, treatment-emergent adverse events (TEAEs) occurred in 100%, 98% and 84% pts, respectively; 63%, 49% and 32% were grade 3 or 4 (Table). Serious TEAEs occurred in 50%, 31%, and 4% pts. No pts discontinued treatment due to TEAEs. As of August 1, 2017, in the DARA-MD 1800 mg cohort, ORR was 42%, and the rates of ≥VGPR and ≥CR were 20% and 7%, respectively. In the DARA SC 1800 mg cohort, a preliminary ORR of 42% was observed which requires confirmation at follow up. Updated safety, efficacy and pharmacokinetic data will be presented at the meeting. Conclusions : SC administration of DARA + rHuPH20 was well tolerated, with lower than expected rates of IRRs in all groups, but particularly in those treated with DARA SC 1800 mg administered over only 3-5 minutes. Planned phase 3 studies will use DARA SC at the dose identified in Part 2. Disclosures Chari: Acetylon Pharmaceuticals: Other: Research funding (to AC's institution); Millennium: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Array BioPharma: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Bristol-Myers Squibb: Consultancy, Other: Research funding (to AC's institution); travel; Takeda: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Research Funding; Celgene: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other, Research Funding; Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Research Funding; Onyx: Research Funding; Pharmacyclics: Research Funding; Biotest: Other: Research funding (to AC's institution); Janssen: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Research Funding; Amgen: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Research Funding. Mateos: Janssen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Takeda: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Amgen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees. Lokhorst: Amgen: Membership on an entity's Board of Directors or advisory committees; Janssen, Genmab: Membership on an entity's Board of Directors or advisory committees, Research Funding. Kaufman: Amgen, Novartis: Research Funding; Amgen, Roche, BMS, Seattle Genetics, Sutro Biopharma, Pharmacyclics: Consultancy. Moreau: Takeda: Honoraria; Celgene, Janssen, Takeda, Novartis, Amgen, Roche: Membership on an entity's Board of Directors or advisory committees; Amgen: Honoraria; Bristol-Myers Squibb: Honoraria; Novartis: Consultancy, Honoraria; Onyx Pharmaceutical: Consultancy, Honoraria; Celgene: Consultancy, Honoraria; Millennium: Consultancy, Honoraria; Janssen: Consultancy, Honoraria. Oriol: Celgene: Speakers Bureau; Janssen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: sponsored symposia, Speakers Bureau; Takeda: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: sponsored symposia; Amgen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: sponsored symposia, Speakers Bureau. Plesner: Janssen: Research Funding; Janssen, Takeda: Consultancy; Janssen, Genmab: Membership on an entity's Board of Directors or advisory committees. Benboubker: Takeda, Celgene, Janssen, Amgen: Consultancy. Hellemans: Janssen: Employment. Masterson: Janssen: Employment. Clemens: Janssen: Employment. Liu: Janssen: Employment. San-Miguel: Takeda, Celgene, Novartis, Amgen, Janssen, Bristol-Myers Squibb: Consultancy. Usmani: Skyline: Honoraria, Membership on an entity's Board of Directors or advisory committees; Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Novartis: Speakers Bureau; Takeda: Consultancy, Honoraria, Research Funding, Speakers Bureau; Onyx: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Array BioPharma: Honoraria, Research Funding; Pharmacyclics: Honoraria, Research Funding; Sanofi: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Bristol-Myers Squibb: Honoraria, Research Funding; Millennium: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Amgen: Consultancy, Honoraria, Speakers Bureau.

The article features an original excursion tourist route which follows the path of discoverers Semyon Dezhnev and Fedot Popov; it gives a short description of places of interest. The route provides comfortable motorboat conditions for tourists who are physically unprepared to travel in the Northern regions. The paper also features an original map of the mainstream tourist route with travel expenses. The itinerary presupposes lectures and fi that would allow one to learn the details of Semyon Dezhnyov and Fedot Popov’s expedition. The target audience of this tourist route are young people aged 18 - 35, who are always eager to learn new things and travel. However, the route can be adapted for tourists of other age groups, with some modifi According to the author, this tourist product can increase the tourist fl into the Russian Arctic and, in particular, into the territory of the Chukotka Autonomous district.

The 12th ACM Multimedia Systems Conference (MMSys'21) happened from September 28th through October 1st, 2021. The MMSys conference is an important forum for researchers in multimedia systems. But, due to the ongoing pandemic, the event was held in a hybrid mode - onsite in Istanbul, Turkey, and online. Organizers and chairs (Özgü Alay, Cheng-Hsin Hsu, and Ali C. Begen) worked very hard to make sure the conference was successful, both for the on-site participants (around 50) and the online participants (with a peak of 330 concurrent viewers). For a small description of the event, take a look at the text written by Ali Begen, one of the general chairs. To encourage student authors to participate on-site, SIGMM has sponsored a group of students with Student Travel Grant Awards. Students who wanted to apply for this travel grant needed to submit an online form before the submission deadline. Then, the selection committee chose 7 travel grant winners. The selected students received either 1,000 or 2,000 USD to cover their airline tickets as well accommodation costs for this event. We asked the travel grant winners to share their unique experiences attending MMSys'21. The following are their comments.

Two years before Johann David Schöpf (1752-1800) published his Beyträge … (1787), Franz Joseph Märter (1753-1827) sent letters from Pennsylvania, Virginia, South Carolina, and East-Florida to Ignaz von Born, describing plants, animals, and geological features of the newly independent states. These letters were speedily printed in Physikalische Arbeiten … in Vienna (1785). A last letter sent from the Bahamas appeared in the same periodical in 1786. Märter's geological observations are translated and analyzed here for the first time. His descriptions of various rocks along the Schuylkill River, upstream from Philadelphia (granites, limestones, marble quarries, widespread weathered iron ores), and his interpretation of the fossiliferous sandstones in the Appalachian mountains are very similar to those by Schöpf. So are Märter's observations of shell banks, either exposed in ditches many miles from the sea, or in cliffs at Yorktown, Virginia, and Wilmington, North Carolina, as well as his description of granite and of a large coal mine near Richmond, Virginia. Finally, both travelers noticed that the rocky cliffs in the Bahamas consisted of limestone formed by Muschelsand [beachrock]. We established that Märter and Schöpf traveled together from Philadelphia to the Bahamas (November 1783 to March 1784). But neither acknowledged the influence, or at least the presence of the other, probably for political reasons.

This current study aimed to reveal expert opinions on the development of informative text-writing skills through descriptive writing practices. The methodological design of this study is a case study that is one of the qualitative research types. In the process of data collection, 65 expert opinions were sought, 55 of whom were Turkish Language teachers, 5 English Language teachers, 3 Turkish Literature teachers, and 2 Primary-School teachers. In the formation of the study group, it was ensured that the participants were either Turkish Language teachers or had a master’s degree or doctorate in the field of Turkish Language Education. In the data collection phase, expert opinions were obtained on the development of informative text-writing skills through descriptive writing practices via the expert opinion form and then the data obtained were thematized and divided into categories and codes. As a result of the study, the first five informative text types recommended by the experts were essays, autobiographies, petitions, travel writing, and diaries, respectively. Among the activity suggestions of the experts for the development of informative text writing skills are the use of appropriate materials, frequent writing activities, asking students to do research before the writing activity, and paying attention to the principles of writing. Based on the findings obtained from this study, it was seen that the first five themes chosen by the participants for descriptive writing practices were nature, books, culture, travel, and friendship, respectively. According to the expert opinions, it is recommended to organize trips for descriptive writing practices, to describe the places visited, to have students write travel essays, and to create descriptive writing activities by using objects. In addition, it is also suggested to have a description of people, characters, or anyone else in the class.

The objective in introducing tilting systems for passenger trains is to optimize the service, shortening travel time and improving comfort, while making minimum alterations to existing track layouts and service conditions. The development of the Pendolino system is described in this paper, starting from early tests on bogies and on tilting systems. The author then describes the extensive service experience of Fiat, with more than 50 million train-km produced and 100 trainsets in service or under construction for service in European countries. An outline is presented of current developments and the product strategy, together with a description of available R&D prediction/measuring tools.

Sacroiliac joint (SIJ) pathology is a common etiologic cause for 10 – 27% of cases of mechanical low back pain (LBP) below the L5 level. In the absence of definite clinical or radiologic diagnostic criteria, controlled blocks of the SIJ have become the choice assessment method for making the diagnosis of SIJ pain. The SI joint is most often characterized as a large, auricular-shaped, diarthrodial synovial joint. In reality, its synovial characteristic is limited only to the distal third and anterior third. In SIJ interventions, the lateral view has been underutilized. In our technique, we used the lateral view to create a three-dimensional view of the SIJ to aid in gauging the accurateness of the contrast spread and to obtain a precise block. After obtaining appropriate fluoroscopic images, a curved tip spinal needle was directed into the inferior aspect of the SIJ using a posterior approach. As the needle contacts firm tissues on the posterior aspect of the joint, position of the needle tip is checked using lateral fluoroscopy. In the lateral view, the needle tip position is manipulated to keep it in the anterior third of the SIJ and contrast is injected. Our criteria for accurate SIJ block, in posteroanterior (PA) view, is the injection of the contrast medium should outline the joint space and the contrast medium should be seen to travel cephalad along the joint line. In the lateral view, the contrast medium most densely outlines the parameter of the joint. We have utilized this method with good effect in approximately 30 cases over one year. Out of 30 cases, needle position and contrast spread was satisfactory in 28 and 27 cases, respectively. So satisfactory needle placement and contrast spread was in 93% and 87% cases. Pain relief of 80% or more after intra-articular injection of local anaesthetic was seen in 50% (15 of 30) patients; pain relief of 50 – 79% was witnessed in 30% (9 of 30) patients. Thus, pain decreased 50% or more in 80% (24 of 30) of the joints. Out of 24 joints where we got satisfactory needle position and contrast spread, 23 joints got more than 50% relief. Thus, if needle position and contrast spread is satisfactory as per the criteria, pain relief of 50% or more was in 96% (23 of 24) of joints. There are few possible limitations with this study like difficulty to go up to the anterior third of the SIJ, it may be more painful as a narrow joint line has to be travelled in depth, sciatic numbness due to drug leak, or injuring the pelvic structure. Advantages of this method are that depth and level of the needle tip for a SIJ block is described for the more precise block. This will reduce false positive and false negative results, i.e., sensitivity and specificity of SIJ blocks and results for diagnostic blocks become more reliable. It will also reduce the chances of a case getting abandoned due to inappropriate contrast spread obscuring the fluoroscopic landmarks. As we know the depth of the needle, the chances of injuring pelvic structures become less and safety improves. Key words: Sacroiliac joint, low back pain, contrast dye, fluoroscopy, lateral view, pain management, SI joint block, modified technique

This research is based on widespread use of social media as an image for all people and as well as provides benefits for a company. The large number of social media users makes an American travel site provides reviews about travel related content and this includes reviews of restaurants. Hence, this study discusses the case study of TripaAdvisor's review of the five best restaurants in Bali. With various forms of benefits regarding the benefits of information from TripAdvisor, online reviews from consumers in promoting restaurants and consumer reviews in enhancing the image of a restaurant. The research method used is content analysis method to review from five restaurants, the variables were the value of Food, Service, Value and Atmosphere from these five restaurants and ranked five restaurants through an assessment of consumer reviews on TripAdvisor. The data source is through primary data and secondary data, namely through TripAdvisor. The description of this research is to look at every consumer online review on TripAdvisor, by choosing five of the best TripAdvisor restaurants in Bali and taking 50 consumer reviews from the top five TripAdvisor restaurants in Bali to see the benefits of these consumer reviews in promoting and improving the image of these five restaurants. The results of this study indicate that TripAdvisor is very useful in providing information to restaurants and with consumer reviews can be a tool for restaurant's promotion and able to enhance the image of a restaurant. Keywords : TripAdvisor, Consumer reviews, Restaurants, Bali

IntroductionNumerous studies have found associations between characteristics of urban environments and risk factors for dementia and cognitive decline, such as physical inactivity and obesity. However, the contribution of urban environments to brain and cognitive health has been seldom examined directly. This cohort study investigates the extent to which and how a wide range of characteristics of urban environments influence brain and cognitive health via lifestyle behaviours in mid-aged and older adults in three cities across three continents.Methods and analysisParticipants aged 50–79 years and living in preselected areas stratified by walkability, air pollution and socioeconomic status are being recruited in Melbourne (Australia), Barcelona (Spain) and Hong Kong (China) (n=1800 total; 600 per site). Two assessments taken 24 months apart will capture changes in brain and cognitive health. Cognitive function is gauged with a battery of eight standardised tests. Brain health is assessed using MRI scans in a subset of participants. Information on participants’ visited locations is collected via an interactive web-based mapping application and smartphone geolocation data. Environmental characteristics of visited locations, including the built and natural environments and their by-products (e.g., air pollution), are assessed using geographical information systems, online environmental audits and self-reports. Data on travel and lifestyle behaviours (e.g., physical and social activities) and participants’ characteristics (e.g., sociodemographics) are collected using objective and/or self-report measures.Ethics and disseminationThe study has been approved by the Human Research Ethics Committee of the Australian Catholic University, the Institutional Review Board of the University of Hong Kong and the Parc de Salut Mar Clinical Research Ethics Committee of the Government of Catalonia. Results will be communicated through standard scientific channels. Methods will be made freely available via a study-dedicated website.Trial registration numberACTRN12619000817145.

The results of an experimental assessment of the functional characteristics of gel-type traction batteries (AGBT) for small-sized transport and technological vehicles (TVT), depending on various load modes and temperature conditions, are presented. Experimental assessment of the battery life of AGBT in operation and their discharge type characteristics at various storage and operating temperatures. An assessment of changes in the voltage level of an AgBT sample of type RuTrike 6-EVF-32 at room temperature and in a freezer (from -7.8 to -20.2 °C) with a connected electrical load and in storage mode was carried out at the first stage. Temperature fluctuations were set randomly to simulate real operating conditions of the TTS in the cold season. At the second stage of testing, the continuous operation time of a set of five battery packs as part of a small-sized vehicle, the D4 1800 tricycle, was assessed. The tests were carried out in the early spring on the territory of the Federal National Research Center VIM. Both batteries were discharged by only 0.05 V during four days of studying self-discharge characteristics at different temperatures. After removing the load, the batteries are regenerated to a voltage of 12 V (50% charge). A cold battery discharges faster by 2-3 hours, but when the load is removed it is regenerated faster. The tricycle can travel 22.21 km at a speed of 13.3 km/h on a single AkBg charge. The voltage drop across the batteries has an almost linear dependence on the distance traveled and the test time. Timely charging of the battery, as well as the provision of design and technological measures for insulating the battery pack, is recommended for operation in the cold season. Tests with cycles of movement and stopping to assess the influence of the battery’s ability to self-recovery to increase the duration of movement needs to be continued, as well as testing for the duration of recovery after turning on/removing the load, depending on the magnitude of the residual stress.

IntroductionDepression is the disease with the greatest burden of disability. Despite pharmacological options, up to 30% of depressions are considered resistant to treatment (RTD). Theta burst transcranial magnetic stimulation (TBS) on the dorsolateral prefrontal cortex allows the application of shorter protocols and with longer-lasting effects than conventional TMS. Its implementation in the Public Health System requires the design of efficient, cost-effective and accessible protocols for patients.ObjectivesThe objective of this project is to assess the efficacy and safety of two intensive and spaced protocols (unilateral and bilateral) of 1800 pulses TBS compared to sham stimulation in outpatients with unipolar and bipolar TRD in a public hospital.MethodsThis project is the 1st double-blind placebo-controlled RCT with TBS in Spain. It is now in the recruitment phase. Patients receive a total of 22 sessions of 1800 pulses in 6 weeks: 5 days/week the 1st and 2nd weeks (10 sessions) and 3 sessions/week the following weeks (12 sessions). Patients are randomized into three groups: i) bilateral, ii) left unilateral, and iii) sham. The main variable is the change in the HDRS-17 score at the end of treatment compared to baseline. The results were analyzed with a general linear model of HDRS, using time as the intrasubject factor and randomization group as the intersubject factor, using resistance to treatment (Maudsley Score) and diagnosis (bipolar, unipolar) as covariates.ResultsPreliminary results from 13 participants (nbil=4, nuni=4, nsham=5) reveal a significant effect of (group x time) on HDRS change (p= 0.020) with no influence of Maudsley Score or diagnosis. The bilateral group presented a greater decrease in the HDRS with a mean difference of 4,38 points [CI95% 0,17-8,58), (p=0.043)] with respect to the unilateral group and a difference of 8.23 [CI95% 4,24-12,21)(p =0.001)] compared to the sham group.Table 1:Sample description. Data shown are means and standar deviations. In bold significant diferences p<0,05.Bilateral TBS(n=4)UnilateralTBS(n=4)ShamTBS(n=5)Age [M (SD)]55,50(5,80)48,50(16,86)56,40(5,86)Male: Female [n]0:42:23:2Depression:Bipolar disorder [n]3:13:14:1Length of depresive episode (months) [M (SD)]12,00(4,08)16,50(6,61)15,00(5,83)Current number of antidepressants [M (SD)]2,00(0,82)1,75(0,50)2,60(0,55)Maudsley score [M (SD)]7,00(1,82)8,75(1,5)7,90(1,30)Basal HDRS basal [M (SD)]16,00(1,82)19,75(4,03)20,40(3,21)Final HDRS [M (SD)]5,75(3,30)10,75(3,10)17,80(2,49)Response /Remission[n (%)]3:3 (75%)2:0(50:0%)0:0 (0%)Image:ConclusionsThe results demonstrate the preliminary efficacy of intensive TBS protocols relative to sham.Disclosure of InterestNone Declared

The present article was partly inspired by G. Pollack’s book, and also Dadoloff, Saxena & Jensen (2010). As a senior physicist colleague and our friend, Robert N. Boyd, wrote in a journal (JCFA, Vol. 1, No. 2, 2022), for example, things and Beings can travel between Universes, intentionally or unintentionally [4]. In this short remark, we revisit and offer short remark to Neil Boyd’s ideas and trying to connect them with geometry of musical chords as presented by D. Tymoczko and others, then to Escherian staircase and then to Jacob’s ladder which seems to pointto possibility to interpret Jacob’s vision as described in the ancient book of Genesis as interdimensional staircase, e.g. an interdimensional bridge between heaven and earth (cf. classic book: Hofstadter, Godel, Escher, Bach). Jacob’s vision of angels going down to earth from that staircase has been depicted for instance in William Blake art etc. In our communication with others via physics literature and discussions etc, we came to several conclusions as follows: Firstly, possibility of wormhole effect to mirror particle universe, which sometimes it is termed non-orientable wormhole. While such mirror particles effect have been more than 50 years predicted with the so-called parity violation (cf. Lee & Yang, 1950s), and that is called symmetry breaking. Secondly, a series of extended experiments on laser irradiated cold water may suggest possible transition from a phase of water to be at least partially fourth phase of water, which may be composed of crystalline water (see e.g. Gerald Pollack, and also Harold Aspden on liquid crystalline). If we can imagine laser cooling effect can be done in protracted time, then we can achieve a physical representation of Aspden‘s liquid crystalline. Therefore, in this article we outline a series of simple experiments of laser irradiated iced-water along with beryl and selenite crystals in order to see possibility of such a quantum tunneling via quantum liquid crystalline Universe hypothesis, which may likely be modeled with iced-water. It is interesting to remark here that certain experiments by Stockholm University scientists have shown that X-ray triggered water can exhibit properties just like liquid crystal (cf. PRL, 2020). That is why we consider it possible that there can be quantum phase transition where liquid water (comprised of iced cubes and water) can exhibit effects such as tunneling in quantum liquid crystalline Universe. Last but not least, we admit that what we outlined here is just aninitial phase; and if you wish, perhaps we can call such experiments as “wormhole-at-lab” experiments (abbreviated: WHALE).

Abstract Background: Marginal zone lymphoma (MZL) is an indolent and heterogeneous B-cell lymphoma. Because of its very indolent course, many time-to-endpoints are used across MZL trials without clear consensus on their definitions. Our aim was to carry out a description of the endpoints used in trials involving MZL patients and to point out the different definitions of time-to-event (TTE) endpoints, both in the literature and among the MZL experts. Methods: We searched over the last 35 years via PubMed, The Cochrane Library, clinicaltrials.gov and clinicaltrialsregister.eu for published and registered clinical trials using the keyword "marginal zone lymphoma". We excluded studies focusing on pediatric populations, cutaneous MZL and on use of allogenic stem cell transplant. Endpoints were reviewed and definitions were analyzed. Afterwards, an online questionnaire was sent to a panel of leading international experts involved in the conduct of lymphoma clinical trials. Experts were selected for their commitment in published phase 2/phase 3 indolent lymphoma trials or for their membership in international lymphoma study groups (International Extranodal Lymphoma Study Group, Lymphoma Research Foundation). The questionnaire proposed 12 criteria to define Progression-free survival (PFS), Event-free survival (EFS), Time to failure (TTF), and Time to next treatment (TTNT). Results: 1192 references were identified by the initial screening. Among the 309 included references (111 published, 198 registered), 213 (69%) were phase 2, 65 (21%) phase 1/2 and 31 (10%) phase 3 trials. The majority of them were open-label (n=295, 95%) non-randomized (n=256, 83%) trials, included all subtypes of MZLs (n=239, 77%), and also non-MZL patients (n=232, 75%). Among phase 1/2 and 2 trials, Overall/complete response rate (ORR/CRR) was the most used primary endpoint (n=196, 70.5%), followed by PFS (n=28, 10.1%); in phase 3 trials PFS was the most used primary endpoint (n=18, 58.1%; ORR/CRR n=6, 19.4%, p&lt;0.001). Overall, the most frequent secondary endpoints were overall survival (OS, n=153, 50%), PFS (n=142, 46%) and ORR/CRR (n=116, 38%). Distribution of endpoints was similar when considering trials with only MZL patients. Time-to-event endpoints definitions were inconsistent across published trials, with up to 9 different definitions of EFS and TTF, and 4 different definitions of Duration of response. A total of 60 MZL experts from 16 different countries (Europe 66%, Northern America 26%, Asia 4%, Oceania 2%, Southern America 2%) took the questionnaire. Forty-nine (82%) of them were clinicians hematologists, and the other were oncologists, radiologists, nuclear medicine physicians, or radiotherapists. Eighty percent and 75% of them had already been primary investigator or coinvestigator in a prospective clinical trial including either MZL-only patients or MZL patients merged with other lymphoma patients, respectively. Among the experts' answers, a total of 23 different definitions of PFS were retrieved, 44 of EFS, 38 of TTF and TTNT. The main divergences concerned the consideration as event of: the add-on of a new therapy and the non-lymphoma related death for PFS; the treatment discontinuation due to adverse events and the add-on of a new therapy for EFS and TTF; the progression of the disease for TTNT. Conclusion: Trials involving MZL patients showed marked heterogeneity both in the choice and definitions of primary and secondary endpoints, thus hampering comparability between trials. This heterogeneity was confirmed through a survey among leading international MZL experts. If PFS and TTNT definitions have been well established by the Food Drug Administration and the European Medicines Agency, a consensus shall be pursued on EFS and TTF definitions within the MZL community. Disclosures Zucca: AstraZeneca: Research Funding; BeiGene: Membership on an entity's Board of Directors or advisory committees; Celgene/BMS: Membership on an entity's Board of Directors or advisory committees, Research Funding; Incyte: Membership on an entity's Board of Directors or advisory committees, Research Funding; Janssen: Membership on an entity's Board of Directors or advisory committees, Research Funding; Merck: Membership on an entity's Board of Directors or advisory committees; Miltenyi Biomedicine: Membership on an entity's Board of Directors or advisory committees; Roche: Membership on an entity's Board of Directors or advisory committees, Research Funding; Celltrion Healthcare: Membership on an entity's Board of Directors or advisory committees; Gilead, Kite: Membership on an entity's Board of Directors or advisory committees; Abbvie: Other: Travel Support. Thieblemont: Kyte: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accommodations, Expenses ; Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees; Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accommodations, Expenses ; Gilead Sciences: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accommodations, Expenses ; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees; Roche: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accommodations, Expenses , Research Funding; Incyte: Honoraria, Membership on an entity's Board of Directors or advisory committees; Bristol Myers Squibb/Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accommodations, Expenses ; Abbvie: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accommodations, Expenses ; Cellectis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accommodations, Expenses ; Hospira: Research Funding; Bayer: Honoraria; Amgen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accommodations, Expenses .

Running is an accelerated step so that when running there is a tendency for the body to float. This means that when running, both feet do not touch the ground or at least when the feet remain on the ground Handoyo in Jafar (2022: 8).Running numbers are numbers that are referred to as non-technical, because running is a relatively simple natural activity when compared to pole vault numbers or hammer throw numbers (Sidik, 2014: 1). The method in a study is needed to measure whether or not the assessment will be carried out by a researcher. So it is expected that with a good and correct research method will get coherent and accurate results. This type of research is a qualitative approach. The method used in this research is descriptive method. According to Sukardi (2016: 52) descriptive method is a method used to describe and interpret objects as they are. In this study, the descriptive method was used to obtain a description of the short distance running ability of Class V students of Madrasah Ibtidaiyah Swasta 01 Lebong. The method used in this research is descriptive method. According to Sukardi (2016: 52) descriptive method is a method used to describe and interpret objects as they are. In this study, the descriptive method was used to obtain a description of the short distance running ability of Class V students of Madrasah Ibtidaiyah Swasta 01 Lebong. Based on the research data for the speed score, it was found that the highest score was 3.52 and the lowest score was 5.95. From the data analysis, the mean was 4.59, the standard deviation was 0.60, the median was 4.78, and the mode was 4.92. Based on the calculations listed in Table 4, it can be seen that: 5 people or (8.7%) were in the interval class 3.52-3.96, 11 people or (47.83%) were in the interval class 4.42-4.86, 6 people or (26.08%) were in the interval class 4.87-5.31, and 1 person or (4.35%) was in the interval class 5.77-6.21. Running will feel heavier than running on a flat area or on a real track. Therefore, when running training feels heavy, it will feel light when running on the real track, so that it can improve students' 50 meter running ability and can create better running travel times.

One of disasters caused by volcanic activity of Mount Merapi is secondary disaster. The disaster usually occurs after eruption and this volcanic activity produces volcanic and pyroclastic material deposit around the top of the mountain as a result of previous eruption. This material might collapse downward in the form of debris flow as it is affected by natural event such as high intensity rainfall. Therefore, a research is needed to analyze whether existing forecasting and early warning system are capable to provide information for the people living in hazardous area before the debris flood occur. This research was carried out using field survey, observation and interview method. Data analysis used qualitative descriptive method by making description of actual condition of the researched location general condition and qualitative analysis of telemetry system installed on Mount Merapi. The qualitative analysis of telemetry system covers network, hardware, software, power supply, security system, operation and maintenance, also human resources. Research analysis used primary and secondary data. Research results revealed that mean rainfall intensity above of 60 mm/hour might trigger debris flood. Early warning should be given at the rainfall intensity level of 50-55 mm/hour, and debris flood time travel from the upstream to the observed location in Pulowatu Village is 45 minute. Based on the analysis of the present forecasting and early warning system, it is known that some of the equipment is not well functioned, so that debris flow cannot be predicted and detected. This is caused by the lack of human resource quality of the officers in operating and maintaining the equipment. Concerning that matter, it is necessary to conduct some improvement to achieve better forecasting and early warning system in order to give information regarding occurrence of debris flow.

The Volga Travelogue is a large layer of travel essays in the 19th-century Russian literature. This layer has not become a subject of special research in literature studies. The “journey along the Volga” is distinguished by the wide diversity of issues and themes it discusses: the economic and industrial activities of the region, its cultural and historical sights, the uniqueness of the Volga region in an ethnographic perspective – of the multifaceted “Volga region resident”. One of the structural components of the travelogue is the Volga mythology and folklore: historical-geographical and cultural-ethnic information is supplemented with legends of the ancient Volga, Russian and non- Russian (Tatar, Mordovian, German, Kalmyk) legends. Describing the “non-Russian Volga”, writers refer to the national aspects of the life of different nationalities, the most important archetypes of their consciousness. A characteristic feature of N.P. Bogolyubov’s travelogue The Volga from Tver to Astrakhan is the non-Russian word as a marker of cultural identity: it is invariably present in the description of national customs. Telling about the “Mordovian places” of the Volga region, Bogolyubov describes specific rituals associated with the birth of a baby and with burials. The Muslim as a different national and cultural tradition of the Volga region particularly attracts writers’ attention. M.I. Nevzorov, in his Journey to Kazan, Vyatka and Orenburg in 1800, tells about the spiritual and religious experience of the Tatar people: writes about the ontological constants, acquaints the reader with epigraphic culture representing Muslims’ existential ideas about people and the universe. S. Monastyrsky, in his Illustrated companion along the Volga, presents Tatar legends about the winged snake Jilantau, about the “Black Chamber” and the khan’s daughter. These legends express the religious and poetic ideas of the people. Telling about the local cultural and mythological tradition is a characteristic feature of the Russian travelogue: an autochthon is represented by its ethnocultural identity. Folklore material functions in structural parallels – multilingual sources: V.I. Nemirovich-Danchenko, in his travelogue The Great River: Pictures from the Life and Nature on the Volga, gives two – Russian and Mordovian – versions of the legend about “Polonyanka”, and notes the particular poetry of the non-Russian text. In the combination of various – Tatar, Russian, Kalmyk – cultural and national constants of the lower Volga. German characterology is particularly expressed. A German legend associated with biblical material about the history of the prophet Elijah’s wandering through the desert to Sarepta of Sidon is fixed in the travelogues of Ya.P. Kuchin, S. Monastyrsky, and A.P. Valueva. The legend conveys the historical “memory of the place” – the foundation of the Sarepta colony. In the travelogues of V. Sidorov, N. Bogolyubov, descriptions of Buddhist Kalmyks, with their way of life, khuruls and gelyungs, are supplemented with Kalmyk legends about the Bogdo-Ola mountain. Folklore and mythology as categories of a non-native cultural text complicate the artistic system of the travelogue and contribute to the poetic comprehension of the poly-ethnic and poly-confessional Volga region.

IntroductionVaginal pain during intercourse and urinary incontinence are common complaints after gynaecological cancer treatments. Pelvic health physiotherapy treatments aim at optimising function through education on the use of vaginal moisturisers, dilation therapy programme and pelvic floor muscle training. Given that barriers such as time, travel, and costs are known to limit access to physiotherapy services, a virtual pelvic health physiotherapy programme may help to facilitate access. The primary objective of this study is to identify preferences, barriers and facilitators from individuals with gynaecological cancer regarding virtual pelvic healthcare survivorship care.Methods and analysisThis patient-oriented, mixed-methods study will involve an online cross-sectional survey data (phase I) and qualitative data from a series of virtual focus groups (phase II). Phase I: an anonymous survey will be used to assess the demographics, health status, prevalence of urogenital symptoms, as well as knowledge, barriers and facilitators to pelvic health services of people with gynaecological cancer. A total of N=50 participants from Canada will be recruited through convenience and self-selection sampling. Phase II: a series of virtual semi-structured focus groups will be conducted with 10–15 participants on key topics related to virtual pelvic healthcare. Interviews will be audio-recorded and transcribed, from which key themes and quotes will be identified. An interpretive description qualitative method will guide analysis and implementation of results.Ethics and disseminationApproval from the Health Research Ethics Board of Alberta—Cancer Committee (HREBA.CC-21-0498) and of the CISSS Bas-Saint-Laurent (CISSSBSL-2021-10) have been obtained. Informed, electronically signed consent will be required from all participants. Results from this work will be published in a peer-reviewed journal and will be used to inform the development and implementation of a new Pelvic eHealth Module for individuals treated for gynaecological cancers. This module will be incorporated into a comprehensive educational and exercise programme offered by a web-based application.

Abstract Background : Treatment for relapsed multiple myeloma (MM) has evolved with the availability of many novel agents; outcomes in patients with newly diagnosed MM have improved with IMiD® agents (lenalidomide [R] or pomalidomide) and proteasome inhibitor (PI) use. Regardless of autologous stem cell transplant, many patients receive R maintenance therapy (Jagannath, Blood Adv 2018; Palumbo, N Engl J Med 2012). However, there is a lack of data describing the nature of relapse and treatment choices for patients progressing on R maintenance therapy. Recent phase III data do not evaluate these patients who are relapsed or refractory to R; current treatment guidelines do not specifically recommend second-line (2L) treatment options for these patients (Laubach, Leukemia 2016). However, phase III data show that pomalidomide in combination with bortezomib and dexamethasone improves progression-free survival (PFS) (HR 0.54; P = 0.0027) in R-exposed and refractory patients, including those with 1 prior line (Richardson, J Clin Oncol 2018). The Connect MM Registry is a US, multicenter, prospective observational cohort study designed to examine diagnostic and treatment patterns, clinical outcomes and quality of life in patients with MM. For patients who received R maintenance therapy, we describe patterns of relapse, 2L treatment choice, and outcomes. Methods : From 250 sites, transplant eligible and ineligible adult patients ≤ 60 days from MM diagnosis were enrolled (N = 3011). Patients were treated at physicians' discretion and followed up for treatment and outcomes until early discontinuation or study end. Patients who relapsed during R maintenance therapy (≤ 15 mg; assessed by treating physician), were analyzed for baseline (BL) characteristics, nature of relapse, and 2L treatment. Patients with symptoms at time of relapse were defined as the presence of ≥ 1 CRAB (hyperCalcemia, Renal failure, Anemia, and Bone disease) criterion ± 60 d from PD; absence of CRAB criteria at PD in this window was considered nonsymptomatic relapse. Primary endpoint was PFS from start of 2L; safety (serious adverse events; SAE) from start of 2L was also assessed. Logistic regression analyses on all BL factors and factors before start of 2L treatment were performed to determine covariates differentiating comparator groups. Survival outcomes were analyzed using a Cox regression after adjusting for covariates. Results : Data cutoff: 1/15/18. Of 2938 treated patients, 1102 entered 2L, 236 having received R maintenance therapy in 1L. Of those patients, 52% (n = 123) and 47% (n = 112) experienced symptoms at time of relapse and nonsymptomatic relapse, respectively (data not available for 1 patient). The top ten 2L regimens are presented in the Table. Median duration of prior maintenance therapy (367 d [IQR: 577] vs 489 d [IQR: 599]) and time from first progression to start of 2L treatment (0.3 vs 0.3 mo) did not notably differ between nature of relapse groups. Prolonged median PFS from start of 2L was observed for patients receiving triplet+ (≥ 3 agents) vs doublet (≤ 2 agents) regimens (HR: 0.72; Figure 1). PFS was better for IMiD agent + PI group compared with PI (without IMiD agents) group (HR, 0.68; Figure 2). Results of sensitivity analyses and overall survival will be presented. SAEs occurred similarly among treatment groups: 42.6% with IMiD agent + PI, 34.5% with IMiD agent (without PI), and 35.8% with PI. Conclusions: This is the first description of relapse patterns, 2L treatment choice and survival outcomes after PD on R maintenance therapy in community-based patients. Nearly equal numbers of patients had symptoms at time of relapse and nonsymptomatic relapse on R maintenance therapy. After PD on R maintenance, approximately 50% of patients switched to PI regimens without IMiD agents, 25% continued with IMiD agent + PI regimens, and 25% continued in the IMiD agents group. Our data show PFS benefit for triplet+ over doublet treatment in 2L. Patients in the IMiD agent + PI group gained survival benefits over patients in the PI group. Further characterization of the patients continuing with IMiD treatment in 2L after R maintenance therapy relapse (~ 25% of patients) are ongoing. Follow-up with recently approved agents (elotuzumab, daratumumab) and their use in 2L is limited in this analysis. These data may be used to better inform treatment choices after relapse on R maintenance therapy. Disclosures Jagannath: Celgene: Consultancy; Merck: Consultancy; Multiple Myeloma Research Foundation: Speakers Bureau; Medicom: Speakers Bureau; Bristol-Myers Squibb: Consultancy; Novartis: Consultancy. Narang:Janssen: Speakers Bureau; Celgene: Consultancy, Speakers Bureau. Ailawadhi:Takeda: Consultancy; Amgen: Consultancy; Janssen: Consultancy; Pharmacyclics: Research Funding; Celgene: Consultancy. Rifkin:Celgene: Consultancy; Boehringer Ingelheim: Consultancy; McKesson: Equity Ownership; EMD Serono: Consultancy; Amgen: Consultancy; Takeda: Consultancy; Sandoz: Consultancy. Terebelo:Celgene: Consultancy; Janssen: Speakers Bureau; Takeda: Speakers Bureau; Pharmacyclics: Speakers Bureau. Toomey:Celgene: Consultancy; Myriad Genetics: Speakers Bureau; Dava Oncology: Other: Travel. Durie:Takeda: Consultancy; Janssen: Consultancy; Celgene: Consultancy; Amgen: Consultancy. Hardin:Celgene: Consultancy. Gasparetto:Janssen: Consultancy, Honoraria, Other: Travel; Bristol-Myers Squibb: Consultancy, Honoraria, Other: Travel; Takeda: Honoraria; Celgene: Consultancy, Honoraria, Other: Travel, Research Funding. Wagner:EveryFit: Consultancy; Gilead: Consultancy; Janssen: Consultancy. Omel:Takeda Oncology: Honoraria, Membership on an entity's Board of Directors or advisory committees; Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees. Srinivasan:Celgene: Employment. Kitali:Celgene: Employment. Agarwal:Celgene Corporation: Employment, Equity Ownership. Abonour:Prothena: Research Funding; Takeda: Consultancy, Research Funding; Celgene: Consultancy, Research Funding.

Introduction. When milling complex-profile surfaces of parts, the selection of tool trajectories and orientations affect the roughness parameters. However, in the studies devoted to the formation of trajectories, recommendations to provide the quality of microgeometry of surfaces were not taken into account. Moreover, when writing programs for CNC equipment in CAM systems, the limitations of cutting modes were determined exclusively using a geometric approach. It did not take into account the influence of the orientation angles of the sphero-cylindrical tool relative to the normal plane on the quality of surface treatment, namely on roughness. The work was aimed at the creation of the methodology for selecting the limiting values of the orientation angles of a sphero-cylindrical tool to optimize the process of machining spatially complex surfaces. The tasks included achieving the minimum values of the amplitude roughness parameter Rz and determining the effectiveness of various machining paths.Materials and Methods. Methods of correlation and regression analysis were used, the results were compared and generalized. The least-squares method was applied to estimate the parameters of the regression equation. The DMU 50 ecoline processing center was used for the experimental studies. Roughness was measured on a Surfcam 1800 D profilometer. The material of the samples was steel 12X18N10T. The material of the tool was hard alloy 1620 Sandvik with PVD coating (physical vapor deposition, the closest domestic analogue is T15K6).Results. It has been shown in detail how roughness parameters Rz depend on the angle of inclination and the diameter of the tool. Twenty examples were summarized in a table. Natural regression coefficients were calculated using linear and hyperbolic models. It was found that the diameter of the tool had a greater effect on the formation of roughness parameter Rz than the angle of inclination. For a detailed description of the influence features, the coefficients of multiple, partial, paired correlation and multiple determination were compared. The limitations associated with the angles of inclination of the tool when processing complex surfaces were determined. A scheme for calculating the angle of the normal was visualized, which included the selected step along the axis to determine the lengths of the segments of the broken curve. The profilograms of surfaces obtained with different shaping trajectories were given in the form of drawings. This allowed us to conclude that milling from top to bottom is unsuitable when the tool is tilted 5°– 35°. A map has been compiled by which it is possible to judge the roughness, knowing the type of milling and the inclination angle (from 5° to 80 °). The dependence of the roughness parameter on the processing speed and the use of coolant was represented graphically. The calculated parameters for determining the optimal angle of inclination of the tool were tabulated. Their analysis proved the adequacy of the proposed method of preparing control information.Discussion and Conclusion. The presented technique made it possible to determine the optimal values of the orientation angles of the sphero-cylindrical tool, taking into account the cutting speed and the minimum possible amplitude roughness parameter Rz. The pattern of feeding fz = 0.4 mm/tooth for surface areas with a total angle of 5°– 50°was considered. In this case, processing along trajectories in the passing, opposite and bottom-top directions, provided roughness in the range of 3–6 µm according to parameter Rz. The top-down toolpath is not recommended for use in final operations due to the significant height of parameter Rz.

Momelotinib (MMB) is a potent, selective, orally-bioavailable, small-molecule inhibitor of JAK1, JAK2 and ACVR1 being developed for the treatment of intermediate and high risk myelofibrosis (MF). Systemic inflammation integral to the pathogenesis of MF leads to increased ACVR1 activity which in turn increases secretion of hepcidin, resulting in perturbed iron homeostasis and an iron-restricted anemia (Physiol Rev. 2013;93:1721-41, Am J Hematol. 2014;89:470-9). MMB's inhibition of ACVR1, unique amongst the JAK inhibitor (JAKi) class, leads to a reduction of hepcidin, restoring iron homeostasis and RBC production and alleviating anemia and transfusion dependency (TD). Chronic, progressive anemia is the key hallmark feature of MF; anemia and TD are strongly predictive of reduced survival (Am J Hematol. 2013;88:312-6). MMB is the only clinical stage JAKi to possess potent ACVR1 inhibitory activity, resulting in improvement of anemia in contrast to ruxolitinib (RUX) which results in worsening. The SIMPLIFY-1 (S1) trial, a double-blind, active-controlled Phase 3 study in which 432 patients received randomized treatment with MMB or RUX for 24 weeks was previously reported (JCO. 2017;35:3844-50). In addition to a significant reduction in splenomegaly and improvement in constitutional symptoms, the study demonstrated that patients in the MMB arm achieved nominal-statistical significance for all anemia endpoints tested, including a higher rate of transfusion independence (p<0.001) and lower rates of TD (p=0.019) at Week 24, compared to patients on RUX, consistent with MMB's pro-erythropoietic effect. Overall, a demonstrably decreased transfusion requirement was noted in patients who received MMB vs RUX. Since transfusion burden is of significant concern to clinicians and patients, to better understand the dynamics of RBC transfusions we further examined the S1 data through statistical models utilizing a variety of novel anemia benefit endpoints including time until transfusion and overall intensity of transfusions across time. The proportions of patients with 0 and 4 transfusions were calculated and time-to-event analyses examining time-to-first and time-to-fifth units transfused also conducted. Since transfusions typically comprise 2 units, the fifth unit transfused represents a de facto third transfusion event. The number of units transfused were also considered to be recurrent events and examined with and without patients' baseline characteristics as covariates. Finally, a mixture model, based on a zero-inflated negative binomial (ZINB) distribution fit to the transfusion data, was employed to compare between the treatment groups the proportions of subjects with zero transfusion burden and the mean transfusion rates. Kaplan-Meier estimates of the proportion of patients who did not require any units transfused during the 24 week randomized treatment period were 73% and 46% for MMB and RUX respectively (p<0.0001; Figure 1), while the proportion of patients requiring 4 or fewer units were 83% and 62% (p<0.0001). When examining units transfused as recurrent events, patients receiving MMB possessed a hazard ratio of approximately one-half that for patients on RUX (HR 0.522; p<0.0001) for models both with and without patients' baseline characteristics as covariates. The ZINB covariate model demonstrated that MMB increased the odds of having zero units transfused in the first 24 weeks by a factor of 9.3 (p<0.0001) vs RUX. Taken together, the novel dynamic and time-to-event analysis methods described are relevant and informative additions to standard measures of transfusion burden in patients with MF. The results of these analyses allow more detailed description of MMB's differentiated anemia benefit as compared to RUX in a double-blind study of JAKi-naïve patients. These results when combined with additional data from the SIMPLIFY studies demonstrate that MMB is able to address the three hallmark features of MF, namely anemia, constitutional symptoms and splenomegaly, differentiating it from other JAK inhibitors. The benefit of MMB in reducing transfusion burden will be further evaluated in MOMENTUM, a future Phase 3 study of MMB in MF patients. In addition to assessment of constitutional symptoms, anemia and splenomegaly, MOMENTUM will provide opportunity to further evaluate associations between anemia benefit and patient reported measures of clinical benefit. Disclosures Mesa: Promedior: Research Funding; Gilead Sciences: Research Funding; Galena Biopharma: Consultancy; AbbVie: Research Funding; Incyte: Other: travel, accommodations, expenses, Research Funding; Genotech: Research Funding; CTI: Research Funding; Novartis: Consultancy, Honoraria, Other: travel, accommodations, expenses; Celgene Corporation: Research Funding; Sierra Oncology: Consultancy; PharmaEssentia: Research Funding; Genentech: Consultancy; NS Pharma: Research Funding; Pfizer: Research Funding; AOP Orphan Pharmaceuticals: Honoraria, Other: travel, accommodations, expenses; LaJolla: Consultancy; Samus: Research Funding; Shire: Honoraria; Baxalta: Consultancy. Catalano:Celgene: Other: Travel support (ASH 2018). Cervantes:Novartis: Honoraria, Speakers Bureau; Celgene: Consultancy, Speakers Bureau. Gotlib:Incyte: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Seattle Genetics: Research Funding; Promedior: Research Funding; Gilead: Membership on an entity's Board of Directors or advisory committees, Research Funding; Pharmacyclics: Research Funding; Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Allakos: Honoraria, Membership on an entity's Board of Directors or advisory committees; Blueprint Medicines: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Deceiphera: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding. Kiladjian:Novartis: Honoraria, Research Funding; Celgene: Consultancy; AOP Orphan: Honoraria, Research Funding. McLornan:Jazz Pharmaceuticals: Honoraria, Speakers Bureau; Novartis: Honoraria. Coart:IDDI: Consultancy, Employment. D'Hollander:IDDI: Consultancy, Employment. Donahue:Sierra Oncology Inc.: Employment. Kowalski:Sierra Oncology Inc.: Employment.

BACKGROUND Novel agents have changed the treatment landscape in chronic lymphocytic leukemia (CLL), however little has been reported about real-world treatment sequence patterns and associated outcomes post-introduction of novel agents. Studies have demonstrated that venetoclax is effective for patients (pts) who have discontinued ibrutinib, however treatments and outcomes post-venetoclax discontinuation remain unclear. The objective of this study was to examine real-world treatment sequence patterns post-introduction of novel agents and specifically understand treatment sequencing following venetoclax. METHODS The CLL Collaborative Study of Real-World Evidence (CORE) is a retrospective, multicenter, collaborative observational study of pts with CLL/small lymphocytic leukemia (SLL). For this analysis, adult pts were eligible for inclusion if they started therapy for CLL/SLL in the relapsed/refractory setting after February 12, 2014 (FDA approval date of first novel agent for CLL/SLL). Interim data are presented; data collection for this analysis is ongoing and is expected to be completed by October 31, 2019. Treatment sequences were characterized specifically focusing on treatment sequencing following venetoclax and other novel agents (i.e., BCRi: e.g., ibrutinib, idelalisib or acalabrutinib). Clinical response, as assessed by physician, was also reported from medical charts (iwCLL criteria were provided as a reference only). RESULTS Of the 267 pts available at the time of interim data analysis, 231 pts (87%) received a novel agent in at least one line of therapy (first-line: 35 pts [15%]; second-line: 133 pts [58%]; third-line or later: 63 pts [27%]). Among novel agents, ibrutinib was the most commonly used first novel agent for 198 pts (86%) followed by venetoclax for 18 pts (8%) and idelalisib for 12 pts (5%). Of those 267 pts, 143 pts (54%) received chemotherapy/chemoimmunotherapy (CT/CIT) followed by a novel agent; 63 pts (24%) received a novel agent followed by a novel agent; 17 (7%) received a novel agent followed by CT/CIT; and 47 (18%) received a CT/CIT followed by CT/CIT. At the time of this interim data cut there were 220 pts (82%) who received BCRi-based regimens (first-line: 33 pts [15%]; second-line: 123 pts [56%]; third-line or later: 64 pts [29%]) and 62 pts (23%) who received venetoclax-based regimens (first-line: 2 pts [3%]; second-line: 22 pts [36%]; third-line or later: 38 pts [61%]). Of the 220 pts who received BCRi-based regimens, 50 (23%) achieved complete remission (CR) and 83 (38%) achieved partial remission (PR) (responses based on physician assessment). Of the 220 pts, 88 (40%) went on to receive a subsequent line of therapy. The most common subsequent treatments administered were venetoclax containing regimens (n= 34, 39%). Of the 88 pts who received a subsequent line of therapy after BCRi-based regimens, 22 pts (25%) achieved CR and 24 pts (27%) achieved PR. Of the 62 pts who received venetoclax-based regimens, 20 pts (32%) achieved CR and 14 pts (23%) achieved PR. Of the 62 pts, 15 pts (24%) went on to receive a subsequent line of therapy. The most common subsequent treatment administered were BCRi containing regimens (n= 10, 67%) primarily ibrutinib-based. Of the 15 pts receiving a subsequent line of therapy after venetoclax-based regimens, 3 pts (20%) achieved CR and 4 pts (27%) achieved PR. While preliminary results are encouraging, further data collection efforts are ongoing and will be included for presentation to confirm the results and outcomes associated with different sequencing options. CONCLUSIONS The treatment paradigm is evolving with the introduction of novel agents. Results from this study will provide a baseline description of treatment sequence patterns enabling clinicians to benchmark the impact of the introduction of novel agents and associated outcomes. Early evidence from these results also suggests that novel agents are most commonly introduced during second line treatment and that other novel agents, including ibrutinib, following venetoclax treatment are being utilized in the real-world settings. Table. Disclosures Mato: Pharmacyclics: Consultancy, Research Funding; Genentech: Consultancy, Research Funding; LOXO: Consultancy, Research Funding; DTRM Biopharma: Research Funding; Johnson & Johnson: Consultancy, Research Funding; TG Therapeutics: Consultancy, Other: DSMB member , Research Funding; Acerta: Consultancy; Janssen: Consultancy; Gilead: Research Funding; AstraZeneca: Consultancy, Research Funding; AbbVie: Consultancy, Research Funding; Sunesis: Consultancy, Research Funding; Celgene: Consultancy. Sail:AbbVie: Employment, Other: may hold stock or stock options. Yazdy:Genentech: Research Funding; Octapharma: Consultancy; Abbvie: Consultancy; Bayer: Honoraria, Speakers Bureau. Hill:Amgen: Research Funding; Seattle Genetics: Consultancy, Honoraria; Celegene: Consultancy, Honoraria, Research Funding; AstraZeneca: Consultancy, Honoraria; Abbvie: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Genentech: Consultancy, Research Funding; Kite: Consultancy, Honoraria; Gilead: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; TG therapeutics: Research Funding; Takeda: Research Funding; Pharmacyclics: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding. Shadman:Bigene: Research Funding; TG Therapeutics: Research Funding; AbbVIe: Consultancy, Research Funding; Genentech, Inc.: Consultancy, Research Funding; AstraZeneca: Consultancy; Sound Biologics: Consultancy; Pharmacyclics: Consultancy, Research Funding; ADC Therapeutics: Consultancy; Atara: Consultancy; Verastem: Consultancy; Mustang Biopharma: Research Funding; Gilead: Research Funding; Merck: Research Funding; Acerta: Research Funding; Emergent: Research Funding; Celgene: Research Funding; Sunesis: Research Funding. Manzoor:AbbVie: Employment, Other: and may hold stock or stock options. Tuncer:Abbvie: Membership on an entity's Board of Directors or advisory committees; 2018 Steering Committee: Other: reimbursement for travel to the steering committee at ASH. Allan:Janssen: Consultancy, Honoraria; Acerta Pharma: Consultancy; Genentech: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; AbbVie, Inc: Consultancy, Membership on an entity's Board of Directors or advisory committees; Pharmacyclics LLC, an AbbVie company: Consultancy; Verastem Oncology, Inc.: Consultancy, Membership on an entity's Board of Directors or advisory committees; Bayer: Consultancy; Sunesis Pharmaceuticals: Consultancy, Membership on an entity's Board of Directors or advisory committees. Ujjani:PCYC: Research Funding; Pharmacyclics: Honoraria; AbbVie: Honoraria, Research Funding; Genentech: Honoraria; Atara: Consultancy; Astrazeneca: Consultancy; Gilead: Consultancy. Sharmokh:AbbVie: Employment, Other: may hold stock or stock options. Jiang:AbbVie: Employment, Other: and may hold stock or stock options. Pena:AbbVie: Employment, Other: and may hold stock or stock options. Marshall:AbbVie: Employment, Other: and may hold stock or stock options. Nielsen:AbbVie: Employment, Other: and may hold stock or stock options. Barr:Janssen: Consultancy; Astra Zeneca: Consultancy, Research Funding; Verastem: Consultancy; Genentech: Consultancy; Seattle Genetics: Consultancy; Merck: Consultancy; Celgene: Consultancy; TG Therapeutics: Consultancy, Research Funding; Pharmacyclics LLC, an AbbVie company: Consultancy, Research Funding; AbbVie: Consultancy; Gilead: Consultancy. Brown:Pfizer: Consultancy; Pharmacyclics: Consultancy; Sunesis: Consultancy; Teva: Honoraria; TG Therapeutics: Consultancy; Verastem: Consultancy, Research Funding; Sun: Research Funding; Sun Pharmaceuticals, Inc: Research Funding; Morphosys: Other: Data safety monitoring boards ; Acerta Pharma: Consultancy; AstraZeneca: Consultancy; BeiGene: Consultancy; Catapult Therapeutics: Consultancy; Dynamo Therapeutics: Consultancy; Genentech/Roche: Consultancy; Gilead: Consultancy, Research Funding; Invectys: Other: other; Janssen: Honoraria; Kite: Consultancy, Research Funding; Loxo: Consultancy, Research Funding; Novartis: Consultancy; Octapharma: Consultancy. Schuh:Pharmacyclics: Consultancy, Speakers Bureau; AbbVie: Consultancy, Speakers Bureau; Genentech: Consultancy, Speakers Bureau; Janssen: Speakers Bureau; Verastem: Speakers Bureau; Kite: Speakers Bureau; Gilead: Speakers Bureau; Seattle Genetics: Speakers Bureau; Jazz Pharmaceuticals: Speakers Bureau; Bristol-Myers Squibb: Research Funding. Eyre:Janssen: Honoraria, Other: travel support; Gilead: Honoraria, Other: travel support; AbbVie: Honoraria, Other: travel support. Wierda:Pharmacyclics LLC: Research Funding; Juno Therapeutics: Research Funding; Gilead Sciences: Research Funding; Miragen: Research Funding; Cyclcel: Research Funding; Oncternal Therapeutics Inc.: Research Funding; GSK/Novartis: Research Funding; Genentech: Research Funding; Xencor: Research Funding; Acerta Pharma Inc: Research Funding; KITE pharma: Research Funding; Sunesis: Research Funding; Loxo Oncology Inc.: Research Funding; Janssen: Research Funding; AbbVie: Research Funding. Skarbnik:Seattle Genetics: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Pharmacyclics: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Janssen: Consultancy, Honoraria, Research Funding, Speakers Bureau; Verastem Oncology: Honoraria, Research Funding, Speakers Bureau; Kite Pharma: Honoraria, Speakers Bureau; Gilead Sciences: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Celgene: Consultancy, Honoraria, Speakers Bureau; Acerta: Research Funding; Genentech: Honoraria, Speakers Bureau; CLL Society: Consultancy, Membership on an entity's Board of Directors or advisory committees; Jazz Pharmaceuticals: Speakers Bureau; Novartis: Speakers Bureau; Abbvie: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Roeker:Abbott Laboratories: Equity Ownership; AbbVie: Equity Ownership. Bannerji:Gilead: Other: travel support; Celgene: Consultancy; Celgene: Consultancy; Regeneron Pharmaceuticals, Inc.: Consultancy, Other: travel support, Research Funding; Merck: Other: travel support, Patents & Royalties: IP rights; Regeneron Pharmaceuticals, Inc.: Consultancy, Other: travel support, Research Funding; Pharmacyclics: Other: travel support; AbbVie, Inc: Consultancy; Pharmacyclics: Other: travel support; Gilead: Other: travel support; AbbVie, Inc: Consultancy, travel support; Merck: Other: travel support, Patents & Royalties: IP rights. Pauff:AbbVie Inc: Employment, Other: may own stock or stock options. Schuster:Novartis, Nordic Nanovector, and Pfizer: Membership on an entity's Board of Directors or advisory committees; Novartis: Other: a patent (with royalties paid to Novartis) on combination therapies of CAR and PD-1 inhibitors.; Novartis, Celgene, Genentech, Merck, Pharmacyclics, Acerta, and Gilead: Other: Grants, Research Funding; Nordic Nanovector, Pfizer, AstraZeneca, Loxo Oncology, Acerta, and Celgene: Honoraria. Follows:Roche: Consultancy, Honoraria, Speakers Bureau; Janssen: Consultancy, Honoraria, Speakers Bureau; AstraZeneca: Consultancy, Honoraria, Speakers Bureau; Gilead: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Abbvie: Consultancy, Honoraria, Speakers Bureau. Cheson:Celgene: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Symbios: Equity Ownership, Membership on an entity's Board of Directors or advisory committees; Abbvie: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Trillium: Research Funding; Pharmacyclics: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Kite: Research Funding; Morphosys: Membership on an entity's Board of Directors or advisory committees; Acerta: Consultancy, Research Funding; Genentech: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; TG Therapeutics: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Seattle Genetics: Research Funding; Bristol Myers Squibb: Research Funding; AstraZeneca: Membership on an entity's Board of Directors or advisory committees; Portola: Research Funding; Gilead: Research Funding; Epizyme: Research Funding. Eichhorst:Gilead Sciences, Inc.: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Janssen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Roche: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; BeiGene: Research Funding; AbbVie: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; ArQule: Membership on an entity's Board of Directors or advisory committees; Novartis: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Brander:Genentech: Consultancy, Honoraria, Research Funding; DTRM Biopharma: Research Funding; TG Therapeutics: Consultancy, Honoraria, Research Funding; AstraZeneca: Consultancy, Research Funding; BeiGene: Research Funding; Novartis: Consultancy; Pharmacyclics LLC, an AbbVie Company: Consultancy; AbbVie: Consultancy, Honoraria, Research Funding; Acerta: Research Funding; Tolero: Research Funding; Teva: Consultancy, Honoraria; MEI: Research Funding. Pivneva:AbbVie: Other: employee of Analysis Group, Inc., which has received consultancy fees from AbbVie. Lamanna:AstraZeneca: Membership on an entity's Board of Directors or advisory committees; Verastem: Research Funding; AbbVie: Membership on an entity's Board of Directors or advisory committees, Research Funding; Janssen: Membership on an entity's Board of Directors or advisory committees; Bei-Gene: Research Funding; TG Therapeutics: Research Funding; Celgene: Membership on an entity's Board of Directors or advisory committees; Roche-Genentech: Membership on an entity's Board of Directors or advisory committees, Research Funding; Pharmacyclics: Membership on an entity's Board of Directors or advisory committees; Gilead: Membership on an entity's Board of Directors or advisory committees, Research Funding.

Background: Systemic AL amyloidosis is characterized by the deposition of insoluble amyloid fibrils produced by light chains synthesized by clonal CD38+ plasma cells. Combining daratumumab (DARA) with bortezomib, cyclophosphamide, and dexamethasone (VCd) has demonstrated significantly improved outcomes in patients with AL amyloidosis. The classification of hematologic complete response (CR) in this disease is evolving, and the absolute reduction of the involved free light chain (iFLC) and the difference between iFLC and uninvolved free light chain (dFLC) are being recognized as very meaningful endpoints. Here, we present results from the ANDROMEDA study (NCT03201965) to demonstrate the impact of achieving deep reductions of iFLC and dFLC on major organ deterioration progression-free survival (MOD-PFS), a novel, key secondary endpoint in this study. Methods: Key eligibility criteria included newly diagnosed AL amyloidosis with measurable hematologic disease (serum monoclonal protein ≥0.5 g/dL by protein electrophoresis or serum free light chain ≥5.0 mg/dL with an abnormal kappa:lambda ratio or dFLC ≥50 mg/L), ≥1 involved organ, cardiac stage I-IIIA, eGFR ≥20 mL/min, and absence of symptomatic multiple myeloma. Patients were randomized (1:1) to receive DARA-VCd or VCd alone. All patients received bortezomib (1.3 mg/m2 subcutaneous [SC] weekly), cyclophosphamide (300 mg/m2 oral [PO] or intravenous [IV] weekly), and dexamethasone (20-40 mg PO or IV weekly) for six 28-day cycles. DARA SC (1800 mg, co-formulated with recombinant human hyaluronidase PH20 in 15 mL) was administered by injection weekly in Cycles 1-2, every other week in Cycles 3-6, and every 4 weeks thereafter for up to 24 cycles. Disease evaluations occurred every 4 weeks (Cycles 1-6) and every 8 weeks (after Cycle 7) until major organ deterioration, death, end of study, or withdrawal. The primary endpoint was overall (ie, at any time) hematologic CR rate, defined here as normalization of FLC levels and ratio (FLCr) and negative serum and urine immunofixation, confirmed at a subsequent visit; normalization of uninvolved FLC level and FLCr were not required if iFLC&lt;upper limit of normal.1-2 The following criteria for deep hematological response were evaluated: iFLC ≤20 mg/L regardless of FLCr3 and dFLC&lt;10 regardless of FLCr.4 MOD-PFS is a composite endpoint defined as any one of the following events (whichever comes first): death; cardiac deterioration (requiring cardiac transplant, left ventricular assist device or intra-aortic balloon pump); end stage renal disease requiring hemodialysis or renal transplant; or hematologic progression per consensus guidelines.1 Analyses of deep hematological responses were performed on the intent-to-treat analysis set; patients without a baseline assessment or post-baseline assessment were considered non-responders. Descriptive statistics were used to summarize overall response rates. Kaplan-Meier curves were plotted for MOD-PFS by hematologic response status. Results: A total of 388 patients were randomized to receive DARA-VCd (n=195) or VCd alone (n=193). Baseline characteristics were well balanced between treatment groups. The median age was 64 years and 65% of patients had ≥2 organs involved. The proportions of patients with heart and kidney involvement were 71% and 59%, respectively, and the proportions of patients with cardiac stage I, II, and IIIA were 23%, 40%, and 37%, respectively. The median duration of treatment was 9.6 months for DARA-VCd and 5.3 months for VCd. Median follow-up was 11.4 months (range, 0.03-21.3+). The rates of deep hematological responses by all criteria strongly favored the DARA-VCd treatment arm (Table). MOD-PFS was longer in patients achieving deep hematological responses by all criteria (Figure). In addition, the corresponding MOD-PFS was similar regardless of the hematological response criteria used. Conclusions: Regardless of the criteria used, the addition of DARA to VCd increased the rates of deep hematologic responses in patients with newly diagnosed AL amyloidosis, which, in turn, was associated with prolonged MOD-PFS. These results support the benefit of DARA in this patient population. References 1. Comenzo RL, et al. Leukemia. 2012;26(11):2317-25 2. Sidana S, et al. Leukemia. 2019;34(5):1472-75 3. Muchtar E, et al. Leukemia. 2019;33(3):790-94 4. Manwani R, et al. Blood. 2019;134(25):2271-2280 Disclosures Comenzo: Amgen: Consultancy; Sanofi: Consultancy; Prothena: Consultancy, Research Funding; Janssen: Consultancy, Research Funding; Unum: Consultancy; Karyopharm: Consultancy, Research Funding; Takeda: Consultancy, Research Funding; Caleum: Consultancy. Kastritis:Pfizer: Consultancy, Honoraria; Amgen: Consultancy, Honoraria, Research Funding; Genesis Pharma: Consultancy, Honoraria; Janssen: Consultancy, Honoraria, Research Funding; Takeda: Consultancy, Honoraria. Palladini:Celgene: Other: Travel support; Jannsen Cilag: Honoraria, Other. Minnema:Celgene: Other: travel support, Research Funding; Kite, a Gilead Company: Speakers Bureau; Amgen: Consultancy; Servier: Consultancy. Wechalekar:Caelum: Other: Advisory; Janssen: Honoraria, Other: Advisory; Takeda: Honoraria, Other: Travel; Celgene: Honoraria. Jaccard:Celgene: Honoraria, Other: A.J. has served in a consulting or advisory role for Janssen and has received honoraria from, received research funding from, and had travel, accommodations, or other expenses paid for or reimbursed by Celgene., Research Funding; Janssen: Consultancy, Honoraria, Other: A.J. has served in a consulting or advisory role for Janssen and has received honoraria from, received research funding from, and had travel, accommodations, or other expenses paid for or reimbursed by Janssen., Research Funding. Sanchorawala:Proclara: Other: advisory board; Abbvie: Other: advisory board; UpToDate: Patents & Royalties; Regeneron: Other: advisory board; Caleum: Other: advisory board; Janssen: Research Funding; Takeda: Research Funding; Celgene: Research Funding; Prothena: Research Funding; Caelum: Research Funding; Oncopeptide: Research Funding. Lee:Janssen: Consultancy, Research Funding; Takeda: Consultancy, Research Funding; Genentech: Consultancy; GlaxoSmithKline: Consultancy, Research Funding; Sanofi: Consultancy; Daiichi Sankyo: Research Funding; Regeneron: Research Funding; Genentech: Consultancy; Celgene: Consultancy, Research Funding; Amgen: Consultancy, Research Funding. Gibbs:Janssen, BMS/Celgene, Amgen, Takeda, Pfizer, Caelum, Abbvie and Eidos: Membership on an entity's Board of Directors or advisory committees. Mollee:Janssen: Membership on an entity's Board of Directors or advisory committees, Research Funding; BMS/Celgene: Membership on an entity's Board of Directors or advisory committees; Amgen: Membership on an entity's Board of Directors or advisory committees; Takeda: Membership on an entity's Board of Directors or advisory committees; Pfizer: Membership on an entity's Board of Directors or advisory committees; Caelum: Membership on an entity's Board of Directors or advisory committees. Venner:Celgene, Amgen: Research Funding; Janssen, BMS/Celgene, Sanofi, Takeda, Amgen: Honoraria. Schönland:Janssen, Prothena, Takeda: Honoraria, Other: travel support to meetings, Research Funding. Suzuki:Takeda, Amgen, Janssen and Celgene: Consultancy; Bristol-Myers Squibb, Celgene and Amgen: Research Funding; Takeda, Celgene, ONO, Amgen, Novartis, Sanofi, Bristol-Myers Squibb, AbbVie and Janssen: Honoraria. Kim:Amgen, BMS, Janssen, Sanofi, Takeda: Consultancy, Honoraria, Research Funding. Cibeira:Janssen, Akcea Therapeutics: Honoraria, Membership on an entity's Board of Directors or advisory committees; Janssen, Celgene, Amgen: Honoraria, Other: Educational lectures. Beksac:Deva: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Celgene: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Takeda: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Sanofi: Speakers Bureau; Amgen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Janssen&janssen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Valent:Amgen Inc.: Other: Teaching, Speakers Bureau; Takeda Pharmaceuticals: Other: Teaching, Speakers Bureau; Celgene: Other: Teaching, Speakers Bureau. Wong:Fortis: Research Funding; GSK: Research Funding; Amgen: Consultancy; Janssen: Research Funding; Roche: Research Funding; Bristol Myers Squibb: Research Funding; Sanofi: Membership on an entity's Board of Directors or advisory committees. Rosenzweig:Janssen: Speakers Bureau. Bumma:Sanofi: Speakers Bureau; Amgen: Speakers Bureau. Dimopoulos:BMS: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Personal fees; Janssen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Personal fees, Research Funding, Speakers Bureau; Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Personal fees, Speakers Bureau; Amgen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Personal fees, Research Funding, Speakers Bureau; Takeda: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Personal fees, Research Funding, Speakers Bureau. Tran:Janssen: Current Employment, Current equity holder in publicly-traded company. Qin:Janssen: Current Employment. Vasey:Janssen Research & Development: Current Employment, Current equity holder in publicly-traded company. Tromp:Janssen: Current Employment, Current equity holder in publicly-traded company. Weiss:Janssen: Current Employment, Current equity holder in publicly-traded company. Vermeulen:Janssen: Current Employment, Current equity holder in publicly-traded company.

BCR-ABL1-positive acute myeloid leukemia (AML) is a rare subtype of acute leukemia and can co-occur with different aberrations such as CBFβ-MYH11, RUNX1-RUNX1T1, PML-RARα, and NPM1. Based on leukemogenesis model, BCR-ABL belongs to the class I mutations, providing a proliferative advantage to the affected cells, where inv(16) is a characteristic class II event, conferring inhibition of differentiation and apoptosis. We observed BCR-ABL1-positive AML de novo without any other molecular/cytogenetic features and CBF-AML (inv(16) at relapse. There are no definite clinical management of BCR-ABL+ AML and it is still a debate whether BCR-ABL1-positive AML patients should be treated with TKI ± chemotherapy as the first-line therapy. A 61-year-old man was diagnosed as having AML in May 2018. Laboratory findings showed: 51.1x 109/L WBC with 58% of blast cells; 38.8% and 4% of blasts in bone marrow and in cerebrospinal fluid (CSF) respectively; but 50% t(9;22) positive cells by fluorescence in situ hybridization (FISH) and conventional cytogenetic analysis (CyG). Both qualitative and quantitative polymerase chain reaction (PCR) tests confirmed the presence of BCR-ABL1p190 (10.2%) without any ABL1 kinase domain mutations. No other molecular abnormalities including mutations FLT3/ITD, NPM1, MLL, JAK2/V617F, DNMT3A, IDH1/IDH2, ASXL1, EZH2 or fusion genes PML-RARα, CBFβ-MYH11, RUNX1-RUNX1T1, BCR-ABL1p210/p230 were found. Also, 5q-, 7q- or 20q deletions were not detected by FISH. Flow cytometry analysis demonstrated single population of leukemic cells with CD34+CD117+CD13+CD33+CD11c+/-CD4+/-MPO+immunophenotype. No organomegaly was revealed. There was no history of antecedent hematological disorder. The patient was diagnosed as BCR-ABL1+ AML with CNS disease. Undetectable MRD was achieved after 1st cycle of FLAG regimen with dasatinib and intrathecal chemotherapy (IC), which was stopped after 1 month because of severe liquor hypotension. There were no matched related/unrelated donor. Due to severe complications during induction chemotherapy (hemorrhoidal bleeding, paroxysmal atrial fibrillation, febrile neutropenia) he continued dasatinib monotherapy for the subsequent 4 months with stable uMRD. Therapy was interrupted for 1 month due to adverse events (grade 3 diarrhea, grade 3 peripheral edema). The relapse occurred in Nov 2018 (after 5 months of uMRD) with 20%, 11% and 3% of blasts in peripheral blood, in bone marrow and in CSF, respectively. Laboratory showed no BCR-ABL1 or t(9;22) by quantitative PCR (qPCR), FISH or CyG, but new transcript CBFβ-MYH11A was detected (100.2%) by qPCR. Cytogenetic analysis showed inv(16)(p13;q22) in 80% cells with absence of additional abnormalities. No mutations of FLT3/ITD,IKZF, TP53 were found. Noteworthy, the patient was refractory to induction chemotherapy "High dose cytarabine (Ara-C) + gemtuzumab ozogamicin (GO)" despite CBF-leukemia. CSF complete response was achieved after triple IC. Hematological remission was achieved after 2 cycles of "Ara-C with 5-azacitidine" in combination with tyrosine kinase inhibitors (TKI) - imatinib 800mg QD. Triple IC was continued once a month as a prophylaxis of CNS disease. After 6 cycles of therapy CBFβ-MYH11A demonstrated 2log reduction, BCR-ABL1 transcript remains undetectable. The patient is in stable hematological and CSF remission. The clone dynamic and treatment see in table 1. BCR-ABL1 positive AML remains a provisional entity inside a huge part of AML with unclear pathogenesis and clinical management. We presented the first description of BCR-ABL1+ AML de novo leukemia followed by CBF-leukemia at relapse, and a clearance of blast cells in preceding BCR-ABL1 positive cells. Despite the absence of leukemic BCR-ABL1 burden, probably its the subliminal expression is able to maintain the mutational background. While TKI treatment may allow to maintain BCR-ABL1+ AML uMRD, it did not prevent the relapse of AML. High dose combination chemotherapy with BCR-ABL inhibitors is advantageous in these leukemia types in patients ineligible for allogeneic hematopoietic stem cell transplantation. Disclosures Lomaia: Novartis: Other: Travel Grant;Lecture fee; Pfizer: Other: Travel Grant. OffLabel Disclosure: Tyrosine kinase inhibitors of BCR-ABL (Dasatinib, Imatinib) were used in case of BCR-ABL positive AML in combination with chemotherapy

Abstract Bakground. The association of light chain (AL) amyloidosis with lymphoplasmacytic lymphoma/Waldenström's Macroglobulinemia is well established. However, both localized and systemic AL amyloidosis have been also reported in other types of lymphoma, but a detailed description of these cases is still lacking. Methods. We systematically searched the database of 1,415 newly diagnosed consecutive patients (pts) with AL amyloidosis of the Pavia Amyloidosis Research and Treatment Center for pts with non-lymphoplasmacytic lymphoma and AL amyloidosis, and identified 34 pts diagnosed between 2004 and 2018. Results. Seventeen pts (50%) had a diagnosis of marginal zone lymphoma (MZL), mainly extranodal MZL (EMZL). Median age at the time of lymphoma diagnosis was 65 years (45-81) and 23 pts (68%) were males. An autoimmune disease was documented in 8 pts (24%), with Sjögren Syndrome as the commonest type. Clinical characteristics of pts according to type of lymphoma (MZL vs non-MZL) and type of AL (systemic vs localized) are presented in Tables 1 and 2. The amyloid deposits were characterized as AL-type by immunoelectron microscopy or mass spectrometry in all cases. Twelve pts (35%) had a concomitant diagnosis of AL (within 12 months before or after the diagnosis of lymphoma). In 2 cases the diagnosis of lymphoma occurred after 16 and 45 months from diagnosis of AL, respectively. In 20 pts (10 MZLs), the lymphoma was diagnosed a median time of 58.6 months (range: 13.6-320.8 months) before AL diagnosis: all but 1 of these cases were treated for the underlying lymphoma and 16 of them had a complete remission at the time of AL diagnosis. Twenty-nine pts (85%) had positive serum and/or urine immunofixation and/or an abnormal free light chains ratio (FLCR), while 5 pts had no detectable monoclonal component (MC) and normal FLCR: these pts developed only localized AL amyloidosis. Localized AL was documented in 10 pts (29%), 7 of them had a MZL. Involved organs were represented by MALT sites (6 nodular pulmonary, 1 tracheobronchial, 2 skin, 1 bladder). Eleven pts with systemic AL amyloidosis died for progression of amyloidosis and 1 because of gastric cancer, while no patient with localized AL died during follow-up. The median overall survival (OS) from the diagnosis of AL amyloidosis was 42.5 months (Fig.1). Conclusions. In our series collected in a referral center, MZL is the most common non-lymphoplasmacytic lymphoma that associates with AL amyloidosis. Hematologists should be aware that MZL is associated not only with localized light chain deposition at the lymphoma site, but also with systemic AL amyloidosis. Systemic AL amyloidosis could be itself an indication to start a specific treatment for the lymphoproliferative disease, even in otherwise asymptomatic lymphomas. The presence of a MC and elevated FLC are clues for systemic AL amyloidosis. Figure 1. Figure 1. Disclosures Merlini: Prothena: Consultancy; Janssen: Consultancy; Ionis: Consultancy; Millenium: Consultancy; Akcea: Consultancy; Pfizer: Consultancy. Palladini:Janssen: Membership on an entity's Board of Directors or advisory committees; Celgene: Other: Travel support; Prothena: Honoraria.

Background:Ehlers-Danlos Syndromes are heritable connective tissue disorders.They are multisystemic and patients can present with several symptoms such as joint pain and instability, visceral and autonomic dysfunction, as well as significant psychosocial sequela. Managing this cohort of young patients is usually challenging as many patients present late due to delayed diagnosis, often with several complications, problems with mobility and opioid use. Furthermore, there is often a prolonged lack of coordinated healthcare and access to social care services. A recent parliamentary debate in the U.K. highlighted that hEDS services are excluded from specialist Rheumatology commissioning services. In order to ascertain the relevance and utility of specialist services in this population, we conducted this study.Objectives:The objective of this study was to map the patient experience following a referral to the specialist clinic in order to assess the need for an integrated, multidisciplinary approach to treating patients with hypermobility EDS.Methods:We retrospectively reviewed the records of 50 patients with the diagnosis of hypermobility EDS who were seen in a specialist hypermobility clinic at University College Hospital UCLH between January 2016 and March 2016. Relevant data was collected regarding their medical care in our hospital up to October 2019.Results:The median age was 37 (range 21-59). We had 10 males and 40 females. The diagnosis of hypermobility EDS was based on the 1997 criteria as these patients were seen prior to the 2017 classification. Overall, the study yielded 6 key themes: 1. All patients experienced chronic pain, with 36% reporting use of opioids for pain management. 2. Patients were referred to multiple medical specialities within the same hospital trust, (22% patients were referred to ≥5 specialities). 3. Patients required a high number of follow up appointments (28% of patients required ≥20 follow-up visits). 4. Failed discharges were common; patients were often referred back to the Rheumatology Clinic despite being discharged to primary care. 5. Patients had a significant number of comorbidities, reflected by polypharmacy. (36% of patients were prescribed ≥5 medications). 6. Disability was high (20% of patients reported severe mobility problems).Conclusion:This study shows that patients with hEDS referred to UCLH have significant levels of disability, opioids use and polypharmacy especially for a relatively young population of patients. They need a complex interdisciplinary approach in a timely manner. In order to minimise delays and allow earlier diagnosis and intervention, we have recently adopted a multidisciplinary team approach, including pain specialists, rheumatologists, psychologists, physiotherapists, nurse specialists, urogynaecologists and neurogastroenterologists. This allows more coordinated and efficient care and incorporates an EDS-specific pain management programme. Specialised services for complex hEDS cases should be established and adequately resourced. Moreover, it would be cost effective to commission a patient-centred “one-stop-shop” service, where patients, who often travel from long distances with severe disabilities, can be seen by multiple specialities in a single visit.References:[1]Bennett, S., Walsh, N., Moss, T. and Palmer, S. (2019). Understanding the psychosocial impact of joint hypermobility syndrome and Ehlers–Danlos syndrome hypermobility type: a qualitative interview study. Disability and Rehabilitation, pp.1-10. Healthwatch Calderdale. (2019). Hypermobility Syndromes Project - Healthwatch Calderdale.[2]Tinkle, B., Castori, M., Berglund, B., Cohen, H., Grahame, R., Kazkaz, H. and Levy, H. (2017). Hypermobile Ehlers-Danlos syndrome (a.k.a. Ehlers-Danlos syndrome Type III and Ehlers-Danlos syndrome hypermobility type): Clinical description and natural history. American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 175(1), pp.48-69.Disclosure of Interests:None declared

Abstract Introduction Multiple myeloma (MM) can be associated with paraskeletal (PP) or extramedullary (EMP) plasmocytomas (PL). Although PLs are relatively frequent, even at diagnosis, our knowledge on the subject mainly relies on small case series or single center experiences. Remarkably, little is known regarding the role of new drugs on MM with PL. Aim To perform a meta-analysis of 8 EMN-GIMEMA studies focused on the description of PLs characteristics, clinical outcome, and response to new drugs. The trials involved in this meta-analysis have the following identification codes: EUDRACT 2005-00473041, NCT01093196, NCT01063179, NCT01091831, NCT01857115, NCT01190787, NCT00551928, NCT01346787. Patients A total of 2332 newly diagnosed MM patients have been included in the analysis, and 267 (11.4%) had a PL, defined as PP in 243 (10.4%), EMP in 12 (0.5%), and not classified in 12 (0.5%) patients. PLs were evaluated with different techniques as PET, CT, NMR or physical examination accordingly to their site and local guidelines. PP and EMP were single in 195, and multiple in 60 cases, and their median size was 4 cm (range 1-26 cm). Median age at diagnosis was 68 years (range 18-87) in PL, and 69 years (range 25-91) in non-PL patients; male patients were 149 (55.8%) in PL and 1007 (48.8) in non-PL patients. ISS stage in PL and non-PL patients was as follows: stage I in 119 (44.6%) and 682 (33.0%), stage II in 89 (33.3%) and 792 (38.3%), stage III in 38 (14.2%) and 508 (24.6%), unknown in 21 (7.8%) and 83 (4.0%) patients, respectively. Cytogenetics was available in 166 PL, and 1528 non-PL patients, and high risk status, defined as having t(4;14) or t(14;16) or del(17p), was observed in 51 (30.7%) PL, and 446 (21.6%) non-PL patients. PL and non-PL patients received treatment with the following drugs: bortezomib in 65 (24.3%) and 598 (29.0%), lenalidomide in 182 (68.1%) and 1366 (66.1%), and carfilzomib in 20 (7.5%) and 101 (4.9%), respectively. Autologous stem cell transplantation (ASCT) was performed in 112 (41.9%) PL and 782 (37.9) non-PL patients. PL and non-PL patients received maintenance in 108 (40.4%) and 815 (39.5%), continuous treatment in 128 (47.9%) and 1007 (48.7%), and fixed-duration treatment in 31 (11.6%) and 243 (11.7%) cases, respectively. Results With a median follow-up of 62 months (IQ range 34-75) in PL and 65 months (IQ range 40-77) in non-PL patients, 4-years overall survival (OS) was 56% in PL and 67% in non-PL patients (p<0.001). In multivariate analysis for OS the presence of PL confers a HR 1.41 (95% CI, 1.17-1.71), high risk cytogenetics a HR 1.68 (95% CI, 1.44-1.96), ISS III vs I HR 2.36 (95% CI, 1.98-2.82), while ASCT a HR 0.78 (95% CI, 0.63-0.98). Four-years OS was not affected by the PL size, both considering a 3 cm threshold (58% >3 cm PL, 53% ≤3 cm PL vs 67% in non-PL), and a 5 cm threshold (55% >5 cm PL, 57% ≤5 cm PL vs 67% in non-PL), neither by the number of PLs (58% single PL, 50% multiple PLs vs 67% in non-PL), or the onset site (57% PP, 55% EMP vs 67% in non-PL). Four-years OS in PL patients treated with either bortezomib or carfilzomib was 44%; it was 56% in patients treated with lenalidomide; in non-PL patients was 62% when treated with bortezomib or carfilzomib, or 65% when treated with lenalidomide. Four-year progression-free survival (PFS) was 26% in PL and 27% in non-PL patients. In patients that received maintenance, the 4-years PFS from maintenance start was 24% in PL and 30% in non-PL patients. When considering the PFS-2, i.e. the PFS calculated from the treatment start to the time of second relapse/progression, the median time was 42.3 months (95% CI, 36.3 - 51.5) in PL and 46.4 months (95% CI, 44.1 - 48.9) in non-PL patients. Conclusions Our meta-analysis studied the largest number of newly diagnosed MM patients with PL so far reported. We observed that in patients treated with new generation therapies incorporating new drugs, the detrimental effect of PL at diagnosis is limited. The 4-years OS is modestly reduced for PL patients, while we observed that PSF and PFS-2 were similar in PL and non-PL patients, suggesting that effective treatment can overcome the unfavorable prognostic significance of PLs. We also observed that lenalidomide is effective in patients with MM and PL, as are bortezomib and carfilzomib. Disclosures Montefusco: Janssen: Other: Advisory Board; Amgen: Other: Advisory Board; Celgene: Other: Advisory Board. Gay:Roche: Other: Advisory Board; Seattle Genetics: Other: Advisory Board; BMS: Honoraria; Janssen: Honoraria; Celgene: Honoraria, Other: Advisory Board; Amgen: Honoraria; Takeda: Honoraria, Other: Advisory Board. De Paoli:Gilead: Other: Advisory Board; Celgene: Other: Advisory Board; Amgen: Other: Advisory Board; Janssen: Other: Advisory Board. Di Raimondo:Celgene: Honoraria; Takeda: Honoraria, Research Funding. Patriarca:Janssen: Other: advisory role; Celgene: Other: advisory role & travel, accommodations, expenses; MSD Italy: Other: advisory role; Medac: Other: travel, accommodations, expenses; Jazz: Other: travel, accommodations, expenses. Musto:Amgen: Honoraria; BMS: Honoraria; Takeda: Honoraria; Janssen: Honoraria; Celgene: Honoraria. Cavo:GlaxoSmithKline: Honoraria, Membership on an entity's Board of Directors or advisory committees; AbbVie: Honoraria, Membership on an entity's Board of Directors or advisory committees; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees; Bristol-Myers Squibb: Honoraria, Membership on an entity's Board of Directors or advisory committees; Adaptive Biotechnologies: Honoraria, Membership on an entity's Board of Directors or advisory committees; Amgen: Honoraria, Membership on an entity's Board of Directors or advisory committees; Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau. Ballanti:BMS: Honoraria; Amgen: Honoraria; Janssen: Honoraria; Celgene: Honoraria. Hajek:Takeda: Consultancy, Honoraria, Research Funding; Bristol Myers Squibb: Consultancy, Honoraria; Amgen: Consultancy, Honoraria, Research Funding; Janssen: Consultancy, Honoraria, Research Funding; Celgene: Consultancy, Honoraria, Research Funding; Novartis: Research Funding. Offidani:Amgen: Honoraria, Other: Advisory Board; Takeda: Honoraria, Other: Advisory Board; Janssen: Honoraria, Other: Advisory Board; Celgene: Honoraria, Other: Advisory Board; Bristol-Myers Squibb: Honoraria, Other: Advisory Board. Corradini:Gilead: Honoraria, Other: Advisory Board & Lecturer; Amgen: Honoraria, Other: Advisory Board & Lecturer; Takeda: Honoraria, Other: Advisory Board & Lecturer; Celgene: Honoraria, Other: Advisory Board & Lecturer; Roche: Honoraria, Other: Advisory Board & Lecturer; Sanofi: Honoraria, Other: Advisory Board & Lecturer; Sandoz: Other: Advisory Board; Novartis: Honoraria, Other: Advisory Board & Lecturer; Abbvie: Honoraria, Other: Advisory Board & Lecturer; Janssen: Honoraria, Other: Lecturer. Boccadoro:Janssen: Honoraria, Research Funding; Novartis: Honoraria, Research Funding; AbbVie: Honoraria; Bristol-Myers Squibb: Honoraria, Research Funding; Mundipharma: Research Funding; Amgen: Honoraria, Research Funding; Sanofi: Honoraria, Research Funding; Celgene: Honoraria, Research Funding.

Background: Inotuzumab ozogamicin (InO) is an antibody-drug conjugate composed of anti-CD22 antibody conjugated to the cytotoxic agent calicheamicin, which is approved for relapsed/ refractory (RR) B-cell acute lymphocytic leukemia (ALL), based on efficacy demonstrated in a randomized control trial. We sought to investigate the safety and efficacy of InO in the "real world" setting. Methods: We conducted a retrospective multicenter study in collaboration with 11 U.S. academic institutions, and evaluated the outcome of patients (pts) with RR B-cell ALL, who received InO outside of clinical trials. These pts were evaluated for response to InO, duration of response, overall survival (OS) and toxicity. Demographic and disease characteristics were summarized using descriptive statistics. Survival curves were estimated using the Kaplan-Meier method and compared via log-rank test. Duration of response was estimated among pts who achieve complete remission (CR)/CR with incomplete count recovery (CRi). Results: From June 2016 to May 2019, 84 pts with RR-B cell ALL were identified. Baseline characteristics are summarized in Table 1. The median age of pts at InO initiation was 50 years (yrs) (range, 20-87). Twenty-two (27.5%) pts had t(9;22) (Ph+ve) and 6 (7.5%) pts had t(4;11) (MLL gene) chromosomal abnormalities. Nine (11%) and 20 (25%) pts had CNS disease at diagnosis and at relapse, respectively. Median number of therapies prior to InO was 2 (range, 0-7), 40 (48%) pts had ≥ 3 therapies and 23 (27%) pts had allogeneic stem cell transplantation (allo-HCT) prior to InO. Forty (48%) pts received blinatumomab prior to InO. Fourteen (17%) pts received InO in combination with chemotherapy and/ or tyrosine kinase inhibitor (TKI). Overall response rate (CR/CRi) was 63%; 44% had CR with minimal residual disease (MRD) negativity by flow cytometry. Response rate in Ph+ve B-cell ALL was 73%. Twenty-three (27%) pts were successfully bridged to allo-HCT. Median response duration with InO was 11.5 months (mo); 32.5% had sustained response at 2 yrs (Fig. 1a). Median response duration post InO, censored at allo-HCT was not reached (NR) (51% in remission at 2 yrs) (Fig. 1b). Median OS after InO was 11.6 mo and 32% were alive at 2 yrs (Fig. 1c). Median OS post InO, censored at of allo-HCT was 13.6 mo (Fig. 1d). Median OS after InO in Ph+ve pts was NR (71% alive at 1 yr). Forty-nine percent, 27%, 6% and 5% of pts discontinued InO due to progression, allo-HCT, adverse events and maintenance therapy, respectively. Nineteen (30%) pts had dose interruptions. In terms of toxicities, 14 (17%) and 7 (8%) pts had grade (G)1-2 and G3 transaminases secondary to InO, respectively. One pt each had G2 and G3 pancreatitis, respectively. One (1%) and 2 (2%) pts had G2 and G4 veno-occlusive disease secondary to InO, respectively. Two of these pts were treated with defibrotide. Two (2%) pts died due to InO toxicity. A complete description of adverse events are summarized in Table 1. Conclusion: Our real-world data obtained by multicenter collaboration suggest that InO was well tolerated and had significant efficacy in this heavily treated patient population of RR B-cell ALL. Disclosures Liedtke: Celator: Research Funding; Celgene: Membership on an entity's Board of Directors or advisory committees, Research Funding; Genentech/Roche: Research Funding; Gilead: Membership on an entity's Board of Directors or advisory committees, Research Funding; IQVIA/Jazz: Membership on an entity's Board of Directors or advisory committees; Janssen: Membership on an entity's Board of Directors or advisory committees, Research Funding; Pfizer: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Prothena: Membership on an entity's Board of Directors or advisory committees, Research Funding; Takeda: Membership on an entity's Board of Directors or advisory committees, Research Funding; Caelum: Membership on an entity's Board of Directors or advisory committees; BlueBirdBio: Research Funding; Adaptive: Membership on an entity's Board of Directors or advisory committees; Agios: Research Funding; Amgen/Onyx: Consultancy, Honoraria, Research Funding. Aldoss:Jazz Pharmaceuticals: Honoraria, Other: travel/accommodation/expenses, Speakers Bureau; Agios: Consultancy, Honoraria; AUTO1: Consultancy; Helocyte: Consultancy, Honoraria, Other: travel/accommodation/expenses. Curran:Incyte: Research Funding; Merck: Research Funding; Gilead: Research Funding. Podoltsev:Celgene: Other: Grant funding, Research Funding; Genentech: Research Funding; AI Therapeutics: Research Funding; Agios Pharmaceuticals: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Blueprint Medicines: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Incyte: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Novartis: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Boehringer Ingelheim: Research Funding; Astellas Pharma: Research Funding; Daiichi Sankyo: Research Funding; Sunesis Pharmaceuticals: Research Funding; Jazz Pharmaceuticals: Research Funding; Pfizer: Research Funding; Astex Pharmaceuticals: Research Funding; CTI Biopharma: Research Funding; Samus Therapeutics: Research Funding; Arog Pharmaceuticals: Research Funding; Kartos Therapeutics: Research Funding; Alexion: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Pfizer: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees. Yang:AstraZeneca: Research Funding; Agios: Consultancy. Mattison:Pfizer: Membership on an entity's Board of Directors or advisory committees. Advani:Pfizer: Honoraria, Research Funding; Amgen: Research Funding; Macrogenics: Research Funding; Glycomimetics: Consultancy, Research Funding; Kite Pharmaceuticals: Consultancy; Abbvie: Research Funding. Atallah:Takeda: Consultancy, Research Funding; Jazz: Consultancy; Helsinn: Consultancy; Novartis: Consultancy; Pfizer: Consultancy; Jazz: Consultancy; Helsinn: Consultancy.

Abstract Introduction: Extramedullary disease (EMD) in patients (pts) with multiple myeloma (MM) is a poor prognostic feature which is not curable with currently approved treatments. Consequently, there is a significant unmet need for effective therapies with good safety profiles. Daratumumab with cyclophosphamide, bortezomib and dexamethasone (daraVCD) is a novel treatment combination with a good efficacy profile in pts with EMD based on preclinical synergistic data. Methods: EMN19 is a phase 2, open-label, multicenter study which aims to enroll 40 MM pts presenting with EMD either at diagnosis or following one line of treatment but not refractory to bortezomib-based regimens, from 8 sites in Turkey, Greece and Italy. Pts with bortezomib or daratumumab hypersensitivity, who received previous autologous stem cell transplant (ASCT) ≤12 weeks before Day 1 of treatment Cycle 1, or with previous allogenic stem cell transplant were excluded. Daratumumab was initially administered intravenously at 16 mg/mL, and since July 2020 has been administered subcutaneously at a fixed dose of 1800 mg, weekly during Cycles 1-2, every 2 weeks for Cycles 3-6, and every 4 weeks thereafter. Intravenous bortezomib 1.5 mg/m 2 and oral/intravenous cyclophosphamide 300 mg/m 2 is administered weekly, and oral/intravenous dexamethasone 20 mg is administered on Days 1, 2, 8, 9, 15, 16, 22 and 23. DaraVCD will be administered until progression or unacceptable toxicity unless refractory disease is detected by the end of Cycle 3 (progressive disease [PD] or failure to achieve a confirmed partial response [PR] or better). The present analysis includes pts who initiated study treatment ≥3 months prior to the cut-off date (01 June 2021). Results: In total, 34 patients were screened, 27 patients were enrolled, 2 relapsing patients died during the screening phase due to severe COVID-19 infection, 22 pts were analyzed (59% female; median age 56 years, range 44-77); 14 pts (64%) were still on treatment and 8 (36%) discontinued; due to inadequate response after 3 cycles of treatment (n=3, 38%), PD (n=4, 50%), death (n=1, 13%). Fourteen pts (64%) were newly diagnosed and 8 (36%) first relapsed. International Staging System stage at baseline was I, II and III for 8 (36%), 9 (41%) and 5 (23%) pts, respectively. Eastern Cooperative Oncology Group performance status was 0, 1 and 2 for 14 (64%), 7 (32%), and 1 patient (5%), respectively. On average, 3.0 (range 1-20) extramedullary plasmacytomas were observed per patient; most commonly reported sites were thorax (6 pts, 27%), brain, head and lower extremities (4 pts, 18% each). Twenty (91%) pts had ≥1 serious or non-serious treatment-emergent adverse event (TEAE); 8 pts (36.4%) experienced ≥1 sTEAEs; COVID-19 infection (n=3, 14%) urinary tract infection (n=2, 9%), infectious myocarditis, hip arthroplasty, pneumonia, cytomegaloviral pneumonia and thrombocytopenia (n=1 each, 4.5%). Thirteen (59%) pts ≥1 Grade 3/4 TEAE; neutropenia observed in 8 pts (36%), followed by thrombocytopenia (n=4, 18%) and COVID-19 infection (n=3, 14%). Overall, 16 (73%) pts missed ≥1 dose of any of the study drugs; 2 (9%) pts missed ≥1 dose due to COVID-19 infection (7 doses), 8 (36%) due to COVID-19 vaccination (37 doses), 2 (9%) due to other COVID-19-related issues (65 doses), 10 (46%) due to other safety events (104 doses) and 9 (41%) due to other reasons (25 doses). Overall, 20 cycle delays were observed in 13 (59%) pts, with median (range) delay of 12.0 (4-133) days. Two pts (9%) had a cycle delay due to COVID-19 infection (2 cycles), 1 (5%) due to COVID-19 vaccination (1 cycle), 5 (23%) due to adverse events (8 cycles), 2 (9%) due to ASCT (2 cycles) and 7 (32%) due to other reasons (7 cycles). Total number of missed doses (missed doses due to COVID-19-related issues) were 17 (3) for daratumumab, 53 (11) for bortezomib, 45 (9) for cyclophosphamide and 123 (86) for dexamethasone; 238 doses missed in total. No fatalities occurred due to any infection. Conclusions: DaraVCD was associated with a good safety profile in this high risk MM with EMD patient population. The COVID-19 impact on missed doses was greater for dexamethasone (&gt;60% of missed doses) than other components (~20%), however overall, the pandemic did not significantly affect the patients' safety and data integrity of the study. The enrollment in the study is ongoing, and more safety and efficacy data will become available with the inclusion of additional pts in an updated analysis. Disclosures Beksac: Amgen,Celgene,Janssen,Takeda,Oncopeptides,Sanofi: Consultancy, Speakers Bureau. Tuglular: GSK: Honoraria, Research Funding; Amgen: Honoraria, Research Funding; Karyopharm: Honoraria, Research Funding; Abbvie: Honoraria, Research Funding; Janssen-Cilag: Honoraria, Research Funding; Genesis Pharma: Honoraria, Research Funding; Sanofi: Honoraria, Research Funding. Cavo: Takeda: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Novartis: Honoraria; Amgen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel Accommodations, Speakers Bureau; Janssen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: TRAVEL, ACCOMMODATIONS, EXPENSES, Speakers Bureau; Sanofi: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; GlaxoSmithKline: Consultancy, Honoraria; AbbVie: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Bristol-Myers Squib: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Adaptive Biotechnologies: Consultancy, Honoraria. Gay: GSK: Honoraria, Membership on an entity's Board of Directors or advisory committees; Bristol-Myers Squibb: Honoraria, Membership on an entity's Board of Directors or advisory committees; AbbVie: Honoraria, Membership on an entity's Board of Directors or advisory committees; Roche: Membership on an entity's Board of Directors or advisory committees; Adaptive Biotechnologies: Membership on an entity's Board of Directors or advisory committees; Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees; Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees; Amgen: Honoraria, Membership on an entity's Board of Directors or advisory committees; Oncopeptides: Membership on an entity's Board of Directors or advisory committees; Bluebird bio: Membership on an entity's Board of Directors or advisory committees. Katodritou: GSK, Amgen, Karyopharm, Abbvie, Janssen-Cilag, Genesis Pharma, Sanofi: Honoraria, Research Funding. Merante: EMN Italy Medical Monitor: Research Funding. Manousou: Health Data Specialists: Current Employment. Sonneveld: Karyopharm: Consultancy, Honoraria, Research Funding; Janssen: Consultancy, Honoraria, Research Funding; Celgene/BMS: Consultancy, Honoraria, Research Funding; SkylineDx: Honoraria, Research Funding; Takeda: Consultancy, Honoraria, Research Funding; Amgen: Consultancy, Honoraria, Research Funding. Terpos: GSK: Honoraria, Research Funding; Celgene: Consultancy, Honoraria, Research Funding; Genesis: Consultancy, Honoraria, Research Funding; Novartis: Honoraria; Janssen-Cilag: Consultancy, Honoraria, Research Funding; Amgen: Consultancy, Honoraria, Research Funding; BMS: Honoraria; Takeda: Consultancy, Honoraria, Research Funding; Sanofi: Consultancy, Honoraria, Research Funding.

En las últimas décadas las referencias al Análisis de Redes han ganado protagonismo entre los historiadores. Hemos asistido a una auténtica proliferación de artículos, monográficos y proyectos de investigación en los que el estudio de las interconexiones en sociedades del pasado ocupa un papel central. Desafortunadamente, en algunos de estos trabajos la conceptualización y la cuantificación han estado ausentes. El presente artículo pretende explorar el potencial del Análisis de Redes como herramienta metodológica aplicable a la disciplina histórica en sus distintos campos de investigación. Pretendemos hacer una apuesta clara por la integración de esta herramienta, superando la retórica de las palabras, pero también de la imagen. Para ello, incorporamos una panorámica de las principales aportaciones al Análisis de Redes en la historiografía. Además, analizamos sus elementos fundamentales y describimos su uso con ejemplos de publicaciones recientes, explorando los retos que se plantean de cara al futuro. Palabras Claves: Análisis de Redes, Metodología, Métricas, VisualizaciónTopónimos: Latinoamérica, EuropaPeriodo: Neolítico-Siglo XX ABSTRACTDuring recent decades, historians have referred with increasing frequency to network analysis. We have witnessed a veritable proliferation of papers, monographs and research projects in which the study of interconnections among individuals from past societies plays a central role. Unfortunately, conceptualization and quantifications have been absent from most of these works. This paper aims to explore the potential of network analysis as a methodological tool applied to history. The objective is to integrate this tool into the historian’s work, transcending the rhetoric of words and images. 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An Introduction, Charlosttesville, University of Virginia Press.Mac Shane, B. A. (2018), “Visualising the Reception and Circulation of Early Modern Nuns’ Letters”, Journal of Historical Network Research, 2, pp. 1-25.Maillard Álvarez, N. (en prensa), “Las grandes compañías europeas en el mercado hispano del libro durante siglo XVI: el caso de Sevilla y Ciudad de México”, en P. Bravo (ed.), Livres écrits, lus, transmis, échangés, collectionnés: circulation des livres et des hommes au Siècle d'Or, París, Presses de la Sorbonne Nouvelle.Martín Romera, M. Á. (2010), “Nuevas perspectivas para el estudio de las sociedades medievales: el análisis de redes sociales”, Studia Historia. Historia Medieval, 28, pp. 217-239.Martínez Carro, E. y Ulla Lorenzo, A. (2019), “Redes de colaboración entre dramaturgos en el teatro español del Siglo de Oro: nuevas perspectivas digitales”, RILCE: Revista de Filología Hispánica, 35-3, pp.896-917.Molina, J. L. (2001), El análisis de redes sociales. Una introducción, Barcelona, Edicions Bellaterra.Pascua Echegaray, E. (1993), “Redes personales y conflicto social. Santiago de Compostela en tiempos de Diego Gelmírez”, Hispania, 53-185, pp. 1069-1089.Picazo Muntaner, A (2015), “Comparative systems and the functioning of networks: the Caribbean and Indo-Pacific models of trade. XVII and XVIII centuries”, Culture History Digital Journal, 4 (1): e0009.Polonia, A., Pinto, S. y Ribeiro, A. S. (2014), “Trade Networks in the First Global Age. The case study of Simon Ruiz Company: Visualization Methods and Spatial Projections”, en A. Crespo Solana, Spatio-Temporal Narratives: Historical GIS and the Study of Global Trading Networks (1500-1800), Cambridge, Cambridge Scholars Publishing, pp. 140-177.Ponce Leiva, P. y Amadori, A. (2008), “Redes sociales y ejercicio del poder en la América Hispana: consideraciones teóricas y propuestas de análisis”, Revista Complutense de Historia de América, 34, pp. 15-42.Rodríguez Treviño, Julio César (2013), “Cómo utilizar las Redes Sociales para temas de historia”. Signos Históricos, 29, pp. 102-141.Rubio, J. A. y Garrués-Irurzun, J. (2017), “Escasez de vínculos débiles: el atraso económico de la Andalucía contemporánea desde la perspectiva de redes empresariales”, Hispania, 257, pp. 793-826.Sánchez Balmaseda, M. I. (2002), Análisis de redes sociales e historia, una metodología para el estudio de redes clientelares, Madrid, Universidad Complutense.Sarno, E. (2017), “Análisis de redes sociales e historia contemporánea”, Ayer, 105, pp. 23-50.Shepard, J. (2018), “Networks”, Past Present, 238, supplement 13, pp. 116-157.Smith, R. M. (1979), “Kin and Neighbors in a Thirteenth-Century Suffolk Community”, Journal of Family History, 4, pp. 27-62.Starnini, M. (2012), “Random walks on temporal networks”, Physical Review, 85, núm. 5.Vieira Ribeiro, A. S. (2011), Mechanisms and Criteria of Cooperation in Trading Networks of the First Global Age. The case study of Simón Ruiz network. 1557-1597 (Tesis doctoral defendida en la Universidad de Oporto), http://www.cervantesvirtual.com/obra/mechanisms-and-criteria-of-cooperation-in-trading-networks-of-the-first-global-age-the-case-study-of-simon-ruiz-network-1557-1597/ (Consulta: 23-12-2020)Vieira Ribeiro, A. S. (2015), Early Modern Trading Networks in Europe. Cooperation and the case of Simon Ruiz, Abingdon, Routledge.Wetherell, C. (1998), “Historical Social Network Analysis”, International Review of Social History, 43, pp. 125-144.

Abstract Background: Despite recent advances in the treatment of multiple myeloma (MM) patients, cure remains rare. MM is in an era of intense clinical research and the molecular abnormalities landscape of refractory and relapsed (R/R) patients is of major interest for drug development. Furthermore, innovative molecular-oriented treatments for these R/R patients could be oriented by mutational characterization of myeloma plasma cells (PC). At relapse but also for clonal minimal residual disease monitoring on therapy, bone marrow aspiration is an invasive procedure that can give limited information since PC infiltration is heterogeneous and can be modest. Mutational profiling on circulating cell-free tumoral DNA (ctDNA) could be a simple and appropriate alternative. Method: We compared molecular landscape in myeloma PC versus in ctDNA in a cohort of 45 R/R MM patients screened at Gustave Roussy for a salvage therapy, most of them for a Phase I trial in the DITEP department, with a median age at time of molecular analysis of 69 years. All patients had received ≥ 1 prior lines of myeloma therapy (median: 2, range: 1-8), 33/45 (73%) had previously undergone autologous stem cell transplant and 14/45 (31%) had received prior daratumumab; 6/45 (13%) were double-refractory (to at least a proteasome inhibitor (PI) and an immunomodulatory imide drug (IMiD), 4/45 (9%) were triple-refractory and 1/45 (2%) was penta-refractory. Four patients (9%) had prior daratumumab and were also double-refractory. Paired samples, as well as normal sorted CD3 + T cells were sequenced using an Ion Torrent custom panel covering 30 myeloma-related genes previously reported as the most frequent mutated ones. The human biological samples were sourced ethically and their research use was in accord with the terms of the informed consents under an IRB/EC approved protocol. Results: One hundred and two variants were found in magnetic-sorted CD138 + myeloma PC, and 99 variants were detected in ctDNA; more than half of the variants detected in myeloma PC were also found in ctDNA (55/102, 54%). Variant allelic frequencies (VAF) in PC and in ctDNA were significantly correlated (p&lt;0.001). Mean VAF was 25% in myeloma PC (median 19%, range: 0.40-99%) and 5.4% in ctDNA (median 0.33%, range: 0-50%) considering the 102 mutations found in myeloma PC. KRAS, NRAS, FAM46C, DIS3 and TP53 were the most frequently mutated genes (i.e. &gt;10% of R/R MM). Considering these five key driver genes, the kappa coefficient of concordance per gene was medium/good between both samples, as defined by the Landis-Koch scale. The mean and median sensitivity of ctDNA detection per gene was 55% and 58% respectively (range: 38-67), and specificity 94% and 97% (range: 80-100); positive predictive value of TP53 mutations detection was poor as theses mutations were more frequently detected in ctDNA (12/45, 27%) than in myeloma PC (6/45, 13%). At the patient level, the similarity between myeloma PC and ctDNA (level defined as the ratio between SNV number in PC and SNV number in ctDNA) was greater than a threshold of 80% in 20/39 (51%) cases (median level: 100%). Importantly, key driver gene mutations were reported in ctDNA for 13/28 (48%) patients without cytological evidence of infiltrated plasmocytosis (less than 10% PC) in the bone marrow aspiration. Conclusions: ctDNA profiling may complete molecular description of R/R MM patients thanks to a less-invasive procedure, allowing to fully characterize mutational profile prior to molecular-oriented treatment decision. ctDNA can give information on the clonal architecture in patients without bone marrow infiltration even after CD138 + cells magnetic-sorted isolation. Disclosures Michot: BMS: Consultancy, Honoraria; GSK: Consultancy, Honoraria. Lazarovici: Mundipharma: Other: Travel grant. Ribrag: Infinity Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees; Incyte: Membership on an entity's Board of Directors or advisory committees; Nanostring: Membership on an entity's Board of Directors or advisory committees; Astex Pharmaceuticals: Research Funding; Bristol Myers Squibb: Membership on an entity's Board of Directors or advisory committees; Roche: Membership on an entity's Board of Directors or advisory committees; Roche: Membership on an entity's Board of Directors or advisory committees; AstraZeneca: Membership on an entity's Board of Directors or advisory committees; Argen-X: Research Funding; GSK: Research Funding; Epizyme: Honoraria, Research Funding; MSD Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees; PharmaMar: Honoraria, Membership on an entity's Board of Directors or advisory committees; Servier: Consultancy, Membership on an entity's Board of Directors or advisory committees; Gilead: Membership on an entity's Board of Directors or advisory committees.

Summary Carmópolis field, in northeastern Brazil's Sergipe/Alagoas basin, is the country's largest onshore oil accumulation at 253×106 m3 original oil in place (OOIP) and a current total oil production of 2880 m3/d. Discovered in 1963, it was quickly put into primary production. Waterflooding followed in 1971 at the central portion of the field. The combination of adverse fluid mobility ratio, reservoir heterogeneity, and the lack of proper selective injection led to the quick decline of production; however, a major program of selective plugging, stimulation, and selective injection was able to stabilize production immediately. Waterflooding was then extended to the entire main block of the field. The well pattern was changed from five- to nine-spot arrangement, with a corresponding downsizing in well spacing and injection rates. Carmópolis also was subjected to an intense improved oil recovery (IOR) campaign with pilot tests on polymer flooding, steamflooding and in-situ combustion. The history of Carmópolis field and the significance of waterflooding to oil production in Brazil, with approximately 2000×106 m3 OOIP currently submitted to this method of recovery, led to the selection of Carmópolis as the target for one of the projects in the PRAVAP (Petrobras Strategic IOR Program) portfolio. The scope of this project included a review of the waterflooding operation through improved reservoir characterization and flow simulation, as well as the investigation of other IOR methods that might reverse the declining production trend. This paper reviews the IOR history of Carmópolis field and summarizes the outcome of the PRAVAP project that led to the approval of field implementations worth U.S. $34 million net present value (NPV). Introduction Waterflooding has come a long way since its accidental implementation in 1865,1 in the area around the city of Pithole, Pennsylvania. Less than a century later, this improved method of recovery was responsible for more than 10% of the total oil production in the U.S. By 1986, this share was thought to be in the 50% range.2 This scenario is not any different around the world, especially in major producing regions like the former USSR and the Middle East. A good example is the giant field of Ghawar in Saudi Arabia, already partially under waterflooding. The situation in Brazil is very similar. Close to 2000×106 m3 OOIP are currently under the influence of water injection. In the near future, water injection rates will reach more than 500 000 m3/d in the discovered fields of Campos basin. In that basin, water injection in Marlim field alone is expected to peak around 100 000 m3/d. In fact, the history of waterflooding in Brazil dates back to the early 1950's, and Carmópolis field onshore Sergipe/Alagoas basin, as shown in Fig. 1, is a very characteristic part of it. Discovered in 1963 and quickly brought on stream, it produces predominantly from the sandstone and conglomerate reservoirs of the Carmópolis/Muribeca formation and secondarily from the deeper Barra de Itiuba formation and the fractured basement (see Fig. 2). Accordingly, oil quality varies considerably throughout the stratigraphic column. General reservoir data is given in Table 1; for a good description of the reservoir geology, refer to Candido and Wardlaw.3 This paper focuses on the review of IOR applications in Carmópolis field over the past 28 years, the results of the recently concluded project within the PRAVAP portfolio, and the corresponding field pilot implementations. History of IOR Applications in Carmópolis Field Waterflooding. Waterflooding was first implemented in Carmópolis field in 1968 on a 65-ha inverted nine-spot pattern in the southern part of the field. The target was the 2.97×106 m3 OOIP in zones CPS-1, −2 and −3. This project was operated for 3 years at an injection rate of 0.01 PV/yr, with no significant results. Injection was then confined to zones CPS-1 and −2 alone; still, after 2 years of close monitoring, results were inconclusive. Eventually, poor performance led to project abandonment. Meanwhile, in 1971, waterflooding had been initiated at the main block of the field, where substantial reservoir depletion (40 kg/cm2) had led to an average well productivity decline of 30%. The project was designed as nine inverted nine-spot patterns occupying an area of 576 ha. The target oil was 42×106 m3 in zones CPS-1, −2, −3, and −4 of the Carmópolis/Muribeca formation, as well as the reservoirs in the Barra de Itiuba formation. The final estimated recovery factor (FR) was 25.3% for a projected injection rate of 1800 m3/d (200 m3/d/well). During this 8-year project, injection in the Barra de Itiuba formation and zones CPS-3 and −4 of the Carmópolis/Muribeca was suspended owing to the high oil viscosity in the former and the bad quality of the conglomerate reservoirs in the latter. Despite the difficulties in managing selective injection, the project was considered an overall success. Reservoir pressure was restored and well productivity increased. However, the price hike that culminated with the second oil shock of 1979, as well as the fact that the project life expectancy was estimated at 30 years under the original design specifications, led to an effort to upgrade the project design to anticipate production from that area of the field. The result was the conversion of the original nine-spot arrangement of the waterflooding operation to 44 inverted five-spot patterns of 8 ha each, with water injection concentrated in zones CPS-1 and −2 alone. Forty-four new injectors and 28 production wells were drilled and completed only in zones CPS-1 and −2 for a target oil of 15×106 m3. Former injection wells were converted into producers. Injection began in April 1978 at a rate of 100 m3/d/well totaling 4400 m3/d for the entire operation. Because of the downsizing in well patterns and the increase in injection rate, oil production in the area rose from 600 to 800 m3/d within 3 years. Water/oil ratio then began to increase sharply with massive water breakthrough in the producing wells. Originally thought to be simply inherent to the higher injection rates, this breakthrough was later found to be associated to the high mobility ratio of the fluid displacement and reservoir high-permeability streaks. Together with the decrease of the injection rate and the extension of completion to zone CPS-3, an ambitious program of injection well profile modification, through stimulation and selectivity plugging, was implemented. It ensured the maintenance of oil production at acceptable levels up to the mid-1980's. By 1986, however, with the profile modification treatments losing their effectiveness, production went into a sharp decline once again. Fig. 3 gives an overall view of the exploitation history in the main block of Carmópolis field.

Gevninge – the gateway to LejreGevninge is one of many Danish villages characterised by having extensive modern housing estates built around a medieval core. The oldest part of the village, with a late Romanesque church, lies on the west side of a small river, Lejre Å, about 2 km from its mouth at Roskilde Fjord (fig. 1).Both in the 1880s and in the 1970s, remains of human skeletons were found in Grydehøj to the west of the old village core (fig. 2). These clearly originate from burials, but the finds are undated. In 1974, remains of an inhumation grave from Viking times were found a short distance from a sunken road which, up until the 18th century, was part of the main road between Kalundborg and Roskilde. In 1979, a gilded bronze strap-end mount from the 8th century AD was found less than 200 m south of the sunken road, but it was first in the winter of 1999-2000 that settlement remains from Viking times were discovered.The archaeological investigationsThe excavation in 2000 uncovered 3600 m2 of settlement remains; these had been heavily damaged by site development in the 1960s and 1970s (fig. 3). On the basis of the evidence available, it is impossible to determine whether these represent several phases of a single farmstead or a portion of a larger settlement. The absence of any traces of structures in the northern evaluation trenches indicates that the settlement did not extend to the north of the sunken road where the graves were found. The terrain falls relatively steeply away from the excavation to the east towards Gevninge Bygade and, although it is possible, it seems rather unlikely that the Viking Age settlement extended in this direction. Relative to the topography, an extension to the south and west seems most obvious.There is no doubt that the site should be assigned to the Viking period. House I is unlikely to be earlier than 10th century (fig. 4), whereas the rectangular pit-house belongs to the end of the same century or the subsequent one. House II (fig. 5) and the other pit-houses are – typologically – less useful for a precise dating of the site. The metal artefacts, including the strap-end mount and a handful of coins from the time of the Civil War, span the period from the 8th to the 14th century, but the majority belong in the 9th-10th centuries (figs. 9-13). Pottery is the most common artefact type and occurs as un-ornamented flat-bottomed settlement wares and Baltic ware (fig. 8). The former have typically inwardly curved rim sections, the sides of the vessels are un-ornamented and they are generally bucket-shaped (fig. 14). The Baltic ware pottery is characterised by more angular rims, which have often been finished off using a wooden shaping tool. Decoration is mostly in the form of encircling grooves, waved furrows and a series of slanting or circular impressions. Compared with the other finds from the structures, the Baltic ware from the excavation belongs in the latter part of the 10th century and up into the 11th century.Traces of crafts were not conspicuous. In one pit-house there were several un-fired clay loom weights, while two deep postholes in the bottom of another pit-house are interpreted as the base for a loom. The distaff whorls and – possibly – the few bone and antler needles also belong to textile production (fig. 7). Iron slag, which definitely was not one of the most conspicuous aspects, originates from “fire-based” crafts. Textile production and iron working are the crafts typically seen at agrarian sites, with the former occurring most frequently.On the basis of the buildings, the traces of crafts and the majority of the finds, the site must be categorised as an average farmstead from Viking times. The site did, however, include four unusual finds: a gold armring (figs. 12 and 13), part of a gilded bronze helmet (fig. 10), a bronze bucket and a winged spearhead. These finds give food for thought, nourished by Gevninge’s location in the landscape, combined with its proximity to the legendary Lejre.A main transport junctionThe area south of Gevninge is characterised by a series of branching streams which meet at Gammel Lejre and continue towards Roskilde Fjord in the form of Lejre Å. To the west and southwest there is an area of about 50 km2 with a more-or-less pronounced moraine landscape. Large parts of this have lain through historical times as rough ground, common and forest. This landscape type forms a very clear contrast to the area east of Lejre Å - a flat and fertile plain extending out to the Øresund and Køge Bugt. In landscape terms, this is a border area, running north-south, where crossing points had to be chosen with care. Gammel Lejre, which from the 5th to the 10th century was an important chieftain’s or royal farmstead with magnificent halls, huge long-houses and a cult site, is well-suited to the passage of east-westbound traffic (fig. 15). In the flat terrain to the east of Lejre Å, maps from the end of the 18th century and the beginning of the 19th century show no road network prior to the construction of two highways in the second half of the 18th century. These run in a straight line from Roskilde to Ringsted and Kalundborg, respectively. Between them, Ledreborg Allé can be seen; it was constructed at the same time and probably replaced a road running eastwards from Gammel Lejre. To the west of Lejre Å, the undulating landscape, with its numerous small, steep hills, small lakes, watercourses and wetlands, presented greater challenges. There was an alternative crossing point about 4 km to the northwest, close to the fjord. Today, this place is called Borrevejle, which means “the ford at the edge” (fig. 16). From Borrevejle, the road led to Gevninge and – via the sunken road to the north of the Viking Age settlement – down to Lejre Å. Here lay the ford Langvad, from where the road ran eastwards, south of Lyngbjerg Mose, towards Kattinge. The fact that the roads around 1800 led towards Kattinge is linked with the opportunity here to cross the system of watercourses and lakes which extended from Gammel Lejre and past Kor­nerup to a lake, Store Kattinge Sø, by Roskilde Fjord. At both ends of the lake there were lock bridges to allow passage. Store Kattinge Sø was originally a bay which was dammed in the High Middle Ages so that the water level today lies at +2.5 m. In Viking times the lock bridges at Store Kattinge Sø did not exist, the amount of water on the Kornerup Å drainage system was therefore less, and the possibilities for passage were decidedly different.The road eastwards from the ford in Gevninge could well have gone via Kattinge and crossed the watercourse between Lille Kattinge Sø and the bay. Around 1800, the road continued through Kongemarken, where a Viking Age inhumation grave, a Christian burial ground from the Late Viking and Early Medieval times, as well as remains of a settlement from the same time, have all been found. From here, the road swings northwards, across Gedevad and onwards to the east to the bishop’s thorp, Bistrup, and the village of Bjerget (St. Jørgensbjerg) with St. Clemens’ church on Roskilde Fjord. Neither of these two settlements can, with certainty, be traced back to before AD 1000. It is therefore an obvious possibility that eastward traffic from Kongemarken took a more southerly route, which – perhaps – is indicated by settlement remains and stray finds between Roskilde and Svogerslev Sø (see fig. 16). In this respect, it is worth mentioning that the two stray finds from Viking times from the Borrevejle area lie in association with the old road routes. Similarly, the small hoard of silver rings from Lyngbjerg Mose was found where the road from Gevninge to Kattinge ran from about 1800.From the above, it is apparent that there were two significant possibilities for the passage of east-west land traffic in the Gevninge-Lejre area. Both have topographic advantages and disadvantages, and identification of one as being more important than the other can be based on no more than a guess. However, inclusion of the waterways does contribute a new angle when addressing this question.The sea route to LejreThe Isefjord complex comprises a western and an eastern branch which both extend more than 35 km inland into Zealand. The western arm, Isefjord, is deep and wide and only has narrow passages around Orø (fig. 17). Despite the fact that Isefjord is the most accessible route from a seaward perspective, it is unlikely to have been the route taken by people travelling to Gammel Lejre. The distance over land to the Isefjord is almost three times as great as the shortest route between Gammel Lejre and Roskilde Fjord, and more than half of this distance comprises gently undulating rough ground with numerous ponds and wetlands.Roskilde Fjord is characterised by narrow navigation channels and variable water depth, but these naturally-determined sailing conditions would not have been a problem for people who knew the fjord. The bay, Lejre Vig, is the place closest to Gammel Lejre. The sea route leading to the bay is protected by a natural feature – a transverse bar, which extends from Bognæs in the south to Selsø in the north. The mouth of Lejre Å is, in topographical terms, a well-suited site for a landing place, but there is a lack of archaeological evidence for the existence of such a feature. Given the lack of a demonstrable landing place by the fjord, attention can be focussed on Lejre Å as being Gammel Lejre’s link with the sea.Streams and rivers as travel routesToday, very few watercourses in Denmark appear as being navigable. A very great proportion of them no longer have a natural appearance or water flow. This is primarily due to intensive efforts during the last 200 years to drain wet meadows and fields. Any evaluation of the navigability of a watercourse in Viking times is associated with a number of variable and, in part, unknown factors. Accordingly, any conclusions are vitiated by a degree of uncertainty, not least in the case of smaller watercourses. The width and depth of the stream or river is decisive in determining the size of vessel which can be navigated. The fall and natural course of a watercourse, which in places is sharply meandering with a variable water depth, will be limiting factors relative to the size of the vessel which is able to pass (fig. 18).The appearance of Lejre Å on maps from the 19th century can give some indication of the conditions prior to the time when drainage and water extraction were initiated. It seems that the course of the stream was relatively straight from its mouth up to Gevninge. However, at Gevninge Church there was a very sharp turn and this is still in existence. To the south of the village, the stream is considerably narrower and substantially more winding. Particularly from Kornerup and southwards towards Gammel Lejre, the course is, in places, strongly meandering. Overall, the stream has a fall from Gammel Lejre to its mouth of 7 m, which corresponds to a gradient of 1‰. The fall is not, however, evenly distributed. From Gammel Lejre, and about 1.5 km down its course, the stream falls 2.79‰, whereas the fall over the next 750 m is 1.31‰. From here to the ford in Gevninge, the fall is 0.5‰, with the last section to the mouth of the river having a fall of 0.34‰. Ole Crumlin-Pedersen has suggested that a watercourse is navigable – all things being equal – as long as the fall is less than 2‰. Alone on this basis, it is unlikely in the past that vessels sailed all the way to Gammel Lejre. It is therefore an obvious possibility that Gevninge was the place where the change was made from waterway to roadway.The distance from Gevninge to Gammel Lejre is 3.7 km by road, as shown on maps from around 1800. The road departs from an area where Viking Age settlement has been excavated and it follows the contours of the landscape in such a way that steep passages are avoided. The route taken by this road, rather than the river, constitutes the probable link between the two places.ConclusionGammel Lejre was not established at some random place in the landscape. With regard to resources, it was a border area between the hamlets of the Eastern Zealand plain and the Central Zealand forest settlements. In addition, it provided a satisfactory, potential crossing point east-west over the steam systems from the south. There is archaeological, legendary and historical evidence showing that Gammel Lejre was a very special place in the Late Iron Age and Viking times. This special position arose from its role as a cultic and power-political centre.The same situation was probably the case at the Tissø complex in Western Zealand, which was established at the beginning of the Late Germanic Iron Age. Tissø lies slightly more than 6 km from the coast, and both its name and finds from the lake demonstrate the cultic significance of the site. Almuth Schülke has pointed out that the Tissø complex lies virtually on an island, with the lake to one side and wetlands and watercourses to the other. Access to Tissø was made difficult by natural barriers in the landscape which conferred exclusiveness and – not least – the possibility of controlling traffic to the settlement.The topographically determined limitations on potential access to Gammel Lejre are not as clear as in the case of the Tissø complex. Watercourses and wetlands to the south and east form a natural border, and the rough ground of the common landscape to the west contains its own obstacles. None of these barriers was insurmountable but they could well have functioned as a border zone around Gammel Lejre. In the area of common from Borrevejle in the north to Ledreborg Castle in the south, a couple of settlements have been demonstrated along with three graves and a few stray finds from the Roman Iron Age. Similarly, in the Middle Ages there were at least five thorps here, which were later abandoned. For the central period relative to Gammel Lejre, the 5th-10th centuries AD, there are no finds from this area. It was not necessarily a conscious choice that the area lay abandoned. The same tendency to abandon poorer soils at the beginning of the Late Iron Age can be seen elsewhere, such as, for example, in Nordskoven at Jægerspris and on Halsnæs at the northernmost part of Roskilde Fjord. Neither is it unusual that areas such as these were then re-occupied for thorp settlement in the Early Middle Ages. This does not, however, change the fact that the area to the west of Gammel Lejre appears to have lain as a wilderness in Viking times. Apart from one artefact with no details of its exact find spot, there are no recorded finds from the Late Iron Age bet­ween the central site and Elverdamsåen, a watercourse lying about 10 km to the west.Access to Gammel Lejre was obviously regulated so that approved people could enter and intruders were held at a distance. Gevninge was a link in this invisible fence. Gevninge is located where roads running east-west meet to avoid Central Zealand’s areas of hilly rough ground, and where watercourses could be crossed relatively unproblematically. Furthermore, Gevninge was a landing place and offloading point for vessels that were able to enter the lower part of Lejre Å. Larger vessels could perhaps have lain at the mouth of the stream or innermost in Lejre Vig, but from here people would anyway have been directed to follow the road from Gevninge to Gammel Lejre.Seen in the light of this situation, Gevninge could have been the home of the Lejre King’s entrusted servant. He not only controlled the traffic through the area and access to Gammel Lejre, he also represented the Lejre king and, on his behalf, received distinguished personages and – who knows – perhaps escorted them to important meetings in the exclusivity of the magnificent hall. With this position in society, Lejre’s gatekeeper probably received gifts of golden rings, magnificent weapons and vessels from Lejre’s pugnacious king.Jens UlriksenRoskilde Museum

Relapsed or refractory (R/R) peripheral T-cell lymphoma (PTCL) is an aggressive lymphoma with a median overall survival (OS) of 6 months. Most approved therapies have overall response rates (ORR) of &lt; 30%, low complete response (CR) rates, and short progression free survival (PFS). Duvelisib (DUV), a dual PI3K-δ,γ inhibitor, is FDA approved at 25 mg twice daily (BID) for the treatment of R/R chronic lymphocytic leukemia or small lymphocytic lymphoma after ≥ 2 lines of prior therapy and R/R follicular lymphoma after ≥ 2 prior systemic therapies, the latter based on accelerated approval. DUV monotherapy demonstrated an ORR of 50% in patients (pts) with R/R PTCL in a Phase 1 study across multiple subtypes (Horwitz, Blood 2018). In the Phase 2, open-label, multi-center, PRIMO trial of DUV in R/R PTCL, the initial results of the dose-optimization phase (N=33) showed a 54% ORR in the 75 mg BID (N=13) and 35% in the 25 mg BID (N=20) cohorts by investigator assessment (INV) , the primary endpoint (Horwitz, ASH 2019). We report mature dose-optimization results and the initial results of a planned preliminary assessment (N=20) of the dose-expansion (NCT03372057; supported by Verastem Oncology). In the dose-optimization phase, pts received DUV at 25 mg (Cohort 1) or 75 mg BID (Cohort 2). Pts were evaluable if they completed 1 cycle (28 days) of DUV and had ≥ 1 efficacy assessment. The dose-expansion phase is ongoing with a targeted enrollment of 100 pts; pts were eligible if they had histologically confirmed R/R PTCL after ≥2 cycles of a prior standard regimen and a CD4 lymphocyte count of ≥ 50/mm3 (0.05 x 109/L). Based on the initial dose-optimization results, it was determined pts will receive DUV starting at 75 mg BID for 2 cycles to achieve more rapid tumor control, followed by 25 mg to try to maintain long-term disease control and mitigate the potential for later onset toxicities. Pts were to be maintained on therapy continuously until progressive disease (PD) or unacceptable toxicity. For those at 25mg BID, it was permitted for the dose to be re-escalated to 75 mg BID if an assessment shows PD and the pt had not required a dose modification due to toxicity. The primary endpoint is ORR by an Independent Review Committee (IRC), and secondary endpoints include duration of response (DOR), PFS, OS, disease control rate, and safety; all analyses consisted of pts that received at least 1 dose of DUV. The statistical analysis plan was amended to take a preliminary assessment of ORR after approximately 20 pts were evaluated for response in the dose-expansion phase, consistent with the number of pts that were evaluated in the dose-optimization phase (Cohort 2). Dose-Optimization Phase Efficacy Update: As of the data cutoff, 2 pts (1 each cohort) remain on treatment. Efficacy data are summarized in Table 1. Of those pts that achieved a CR, 1 in each cohort proceeded to undergo stem cell transplant or consolidated radiation therapy with curative intent, and are censored in the DOR assessment . Dose-Expansion Phase Initial Summary: As of the data cutoff of 23 March 2020, a total of 25 pts have been dosed, 20 of whom underwent at least 1 disease response assessment (Table 1). Pts had a median age of 61 years (range, 21-86 years) and a median of 2 prior therapies (range, 1-6). Forty-five percent (9/20) of pts remain on treatment (5 responders, 3 with assessments not yet performed, 1 on treatment with stable disease);11 pts discontinued due to PD (n=7), adverse events (n=2) , or to under go transplant (n=2). Responses occurred in 8/20 pts: PTCL-NOS (4 CR, 1 partial response [PR]), ALCL (1 PR), AITL (1 CR) and SPTCL (1 CR). The most frequent adverse events seen were neutrophil count decreased (25%), ALT increased (21%), WBC decreased (21%) and lymphocyte count decreased (21%). In summary, the DUV data observed to date show consistent response rates in a R/R PTCL pt population. The safety profile observed in PRIMO to date is consistent with the current safety profile of DUV. The mature dose-optimization phase results demonstrated a median DOR of 12.2 months for the 75 mg BID cohort. The preliminary results from the PRIMO dose-expansion cohort (75 mg BID followed by 25 mg BID dosing) show an ORR of 40 % and CR rate of 30% (6/20) by INV assessment. These data support continued evaluation of DUV as a treatment option for R/R PTCL. Updated data from the planned interim analysis after 40 pts enroll (occurred June 2020) will be presented. Disclosures Pro: Verastem Oncology: Research Funding. Brammer:Bristol-Myers Squibb: Research Funding; Celgene: Research Funding; Seattle Genetics: Honoraria, Speakers Bureau; Kymera: Honoraria; Verastem Oncology: Other: Travel. Jacobsen:Takeda: Honoraria; Merck, Pharmacyclics, F. Hoffmann-LaRoche, Novartis: Research Funding; Acerta, AstraZeneca, Merck: Consultancy. Mehta-Shah:Corvus: Research Funding; Verastem: Research Funding; Celgene: Research Funding; Bristol Myers-Squibb: Research Funding; Genetech/Roche: Research Funding; C4 Therapeutics: Consultancy; Karyopharm Therapeutics: Consultancy; Innate Pharmaceuticals: Research Funding; Kyowa Hakko Kirin: Consultancy. Zain:Seattle Genetics: Research Funding; Kyowa Kirlin: Research Funding; Mundai Pharma: Research Funding. Zinzani:Immune Design: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Merck: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; MSD: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Sandoz: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Janssen-Cilag: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Celltrion: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Verastem: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Sanofi: Consultancy, Membership on an entity's Board of Directors or advisory committees; ADC Therapeutics: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Kirin Kyowa: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; EUSA Pharma: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Janssen: Consultancy, Honoraria, Speakers Bureau; Servier: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Roche: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; TG Therapeutics, Inc.: Honoraria, Speakers Bureau; Celgene: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Portola: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Eusapharma: Consultancy, Speakers Bureau; Kyowa Kirin: Consultancy, Speakers Bureau; Immune Design: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; BMS: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Gilead: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; AbbVie: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Incyte: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Lustgarten:Verastem Oncology: Current Employment, Current equity holder in publicly-traded company. Youssoufian:Verastem Oncology: Current Employment, Current equity holder in publicly-traded company. Horwitz:Janssen: Consultancy; GlaxoSmithKline: Consultancy; Daiichi Sankyo: Research Funding; C4 Therapeutics: Consultancy; Beigene: Consultancy; Portola: Consultancy, Research Funding; Mundipharma: Consultancy; Innate Pharma: Consultancy; Corvus: Consultancy; Trillium: Consultancy, Research Funding; Seattle Genetics: Consultancy, Research Funding; Millenium/Takeda: Consultancy, Research Funding; Kyowa Hakka Kirin: Consultancy, Research Funding; Infinity/Verastem: Research Funding; Forty Seven: Consultancy, Research Funding; Celgene: Consultancy, Research Funding; Aileron: Consultancy, Research Funding; ADCT Therapeutics: Consultancy, Research Funding; Vividion Therapeutics: Consultancy; Verastem: Consultancy, Research Funding; Myeloid Therapeutics: Consultancy; Miragen: Consultancy; Kura Oncology: Consultancy; ASTEX: Consultancy; Affirmed: Consultancy. OffLabel Disclosure: Duvelisib (DUV), a dual PI3K-δ,γ inhibitor, is FDA approved at 25 mg twice daily (BID) for the treatment of R/R chronic lymphocytic leukemia or small lymphocytic lymphoma after at least 2 lines of prior therapy and R/R follicular lymphoma after at least 2 prior systemic therapies, the latter based on accelerated approval. This indication is approved under accelerated approval based on overall response rate. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials. Duvelisib is not approved for Peripheral T-Cell Lymphoma. This study is investigating treatment or outcomes that have not received approval from a Health Authority. The information presented is not intended to convey conclusions of safety or efficacy. There is no guarantee that the outcome of these studies will result in approval by a Health Authority.

Since the 1960s, many electronic travel aids have been developed for people with low vision or blindness to improve their independent travel skills, but uptake of these specialist devices has been limited. This study investigated what technologies orientation and mobility (O&M) clients in Australia and Malaysia have, use, like, and want to support their travel, to inform technology research and development. This two-phase mixed-methods study surveyed O&M clients face-to-face in Malaysia ( n = 9), and online in Australia ( n = 50). Participants managed safe walking using a human guide, long cane, or guide dog when their vision was insufficient to see hazards, but a smartphone is now a standard travel aid in both Australia and Malaysia. Participants relied on smartphone accessibility features and identified 108 apps they used for travel: for planning (e.g., public transport timetables), sourcing information in transit (e.g., GPS location and directions, finding a taxi), sensory conversion (e.g., camera-to-voice, voice-to-text, video-to-live description), social connections (e.g., phone, email, Facebook), food (e.g., finding eateries, ordering online), and entertainment (e.g., music, games). They wanted to ‘carry less junk’, and sought better accessibility features, consistency across platforms, and fast, reliable, real-time information that supports confident, non-visual travel, especially into unfamiliar places.

Abstract Objectives Financial protection mechanisms are in place to overcome the costs of a few diseases in India. Our objective was to estimate the costs incurred due to Oral Potentially Malignant Disorders (OPMD) and to determine predictors of such costs. Results We found that the median (Interquartile range IQR) total costs of OPMD was Indian Rupees (INR) 500 (350–750), direct medical costs was INR 0 (0–50), direct non-medical costs was INR 150 (40–200) and indirect costs was INR 350 (250–500). The travel cost to attend the health facilities [INR 100 (40–150)] and the patient’s loss of wages [INR 200 (150–400)] mainly accounted for the direct non-medical and indirect costs respectively. The median expenditure on smokeless and smoking forms of tobacco was INR 6000 (5400–7200) and INR 2400 (1800–3600) respectively. On multiple linear regression analysis, rural residence, belonging to below poverty line family, being a sole earner in the family, number of months since diagnosis and first visit at a private provider were found to be the significant predictors of total costs of OPMD. Financial protection mechanisms are needed for covering the direct non-medical and indirect costs. Early management of OPMD might mitigate the costs of OPMD.

The COVID-19 pandemic restricted most economic and social activities, impacting travel demand for all transportation modes and especially for transit. We hypothesize that the shifts in travel demand varied by socioeconomic status, and we assess the differential impact of COVID-19 in the Bus Rapid Transit (BRT) patronage across various socioeconomic groups in Bogotá. We built a database of frequent transit users with data collected by smartcards in Bogota’s BRT system between January and October 2020. For each user in the database, we labeled their home and work stations. Transactions at other stations are classified as “other.” The stratum (a government socioeconomic classification of residential units in Colombia) of a BRT station’s service area was assigned using an estimated probability vector for each user belonging to a specific stratum; this data is validated with aggregate strata distributions in the 2019 household travel survey. Our study found that the reduction in transactions for lower-strata users is significantly less than that of the middle and high strata. The magnitude of this difference varies over time but stabilizes after the end of the lockdown. The growth rate of “other” transactions per thousand people is greater than the growth for home and work locations, especially for the lowest strata. Other studies have shown that the radius of gyration (Rg) (a measure of how far individuals travel away from home) has decreased about 50% after the lockdowns. Our study shows that when measuring Rg only for users who continued using BRT, the Rg slightly decreased for lower and medium strata but increased for high strata. The contribution of this study is a method to classify BRT transactions of frequent users by strata, as well as a description of trends in BRT use by strata to expand our understanding of the COVID-19 lockdowns impacts in the Global South context. These results are a starting point to inform policy and decision-makers to guide the recovery efforts to improve transit accessibility and level of service for captive users such as low-stratum users.

Background: In-person hand therapy is commonly prescribed for rehabilitation after thumb carpometacarpal (CMC) arthroplasty but may be burdensome to patients because of the need to travel to appointments. Asynchronous, video-assisted home therapy is a method of care in which videos containing instructions and exercises are provided to the patient, without the need for in-person or telemedicine visits. The purpose of the present study was to evaluate the effectiveness of providing video-only therapy (VOT) as compared with scheduled in-person therapy (IPT) after thumb CMC arthroplasty. Methods: We performed a single-site, prospective, randomized controlled trial of patients undergoing primary thumb CMC arthroplasty without an implant. The study included 50 women and 8 men, with a mean age of 61 years (range, 41 to 83 years). Of these, 96.6% were White, 3.4% were Black, and 13.8% were of Hispanic ethnicity. The primary outcome measure was the Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity (UE) score. Subjects in the VOT group were provided with 3 videos of home exercises to perform. Subjects in the control group received standardized IPT with a hand therapist. Improvements in the PROMIS UE score from preoperatively to 12 weeks and 1 year postoperatively were compared. Results: Fifty-eight subjects (29 control, 29 experimental) were included in the analysis at the 12-week time point, and 54 (27 control, 27 experimental) were included in the analysis at the 1-year time point. VOT was noninferior to IPT for the PROMIS UE score at 12 weeks and 1 year postoperatively, with a difference of mean improvement (VOT − IPT) of 1.5 (95% confidence interval [CI], −3.6 to 6.6) and 2.2 (95% CI, −3.0 to 7.3), respectively, both of which were below the minimal clinically important difference (4.1). Patients in the VOT group potentially saved on average 201.3 miles in travel. Conclusions: VOT was noninferior to IPT for upper extremity function after thumb CMC arthroplasty. Time saved in commutes was considerable for those who did not attend IPT. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Abstract Issue In the last 10 years, the migrant population residing in Malta has increased exponentially. The COVID-19 epidemic impacted disproportionally migrants which are often in disadvantaged positions due to the lower socioeconomic status, communication barriers and lower education levels. Description of the Problem During the COVID-19 epidemic migrants were particularly affected due to multiple factors including communication barriers, restriction measures imposed, loss of employment, challenges accessing the healthcare system, travel ban and mental health issues. Ports were closed preventing disembarkation of migrant boats and asylum request applications were put on hold. Results As of the 16th of June, a total of 30.2% (n = 198) confirmed COVID-19 cases were migrants. A strategy to support migrants was designed and implemented. The COVID-19 outbreak in a migrant centre resulted in all the 800 residents being placed in lock-down for 38 days (5th April till 13th May) and a total of 50 COVID-19 cases. Migrant boats that arrived before ports were closed were placed under quarantine. Migrants reported difficulties seeking healthcare, using the helpline, and higher exposure risk due to overcrowded living conditions. Lessons Migrants faced additional challenges due to the impact of the pandemic. The public health response measures implemented for the general population were not always feasible or accessible for the migrant population including hygiene recommendations, access to testing, isolation and quarantine and access to accurate scientific information. The mental health impact of COVID-19 among migrant populations was enhanced due to loneliness, lack of communication with their families and financial instability. Challenges accessing the healthcare system, understanding the restriction measures and the evolving public health recommendations were highlighted. Future strategies to control epidemics should always include specific plans to support migrant populations. Key messages The public health strategy must incorporate specific plans to support migrants in order to control and reduce the impact of the COVID-19 epidemic. Transdisciplinary policy needs to be developed considering the ethical, socio-economical, psychological and human right aspects of the migrant population.

Proton therapy enables to deliver highly conformed dose distributions owing to the characteristic Bragg peak and the finite range of protons. However, during proton therapy, secondary neutrons are created, which can travel long distances and deposit dose in out-of-field volumes. This out-of-field absorbed dose needs to be considered for radiation-induced secondary cancers, which are particularly relevant in the case of pediatric treatments. Unfortunately, no method exists in clinics for the computation of the out-of-field dose distributions in proton therapy. To help overcome this limitation, a computational tool has been developed based on the Monte Carlo code TOPAS. The purpose of this work is to evaluate the accuracy of this tool in comparison to experimental data obtained from an anthropomorphic phantom irradiation. An anthropomorphic phantom of a 5-year-old child (ATOM, CIRS) was irradiated for a brain tumor treatment in an IBA Proteus Plus facility using a pencil beam dedicated nozzle. The treatment consisted of three pencil beam scanning fields employing a lucite range shifter. Proton energies ranged from 100 to 165 MeV. A median dose of 50.4 Gy(RBE) with 1.8 Gy(RBE) per fraction was prescribed to the initial planning target volume (PTV), which was located in the cerebellum. Thermoluminescent detectors (TLDs), namely, Li-7-enriched LiF : Mg, Ti (MTS-7) type, were used to detect gamma radiation, which is produced by nuclear reactions, and secondary as well as recoil protons created out-of-field by secondary neutrons. Li-6-enriched LiF : Mg,Cu,P (MCP-6) was combined with Li-7-enriched MCP-7 to measure thermal neutrons. TLDs were calibrated in Co-60 and reported on absorbed dose in water per target dose (μGy/Gy) as well as thermal neutron dose equivalent per target dose (μSv/Gy). Additionally, bubble detectors for personal neutron dosimetry (BD-PND) were used for measuring neutrons (&gt;50 keV), which were calibrated in a Cf-252 neutron beam to report on neutron dose equivalent dose data. The Monte Carlo code TOPAS (version 3.6) was run using a phase-space file containing 1010 histories reaching an average standard statistical uncertainty of less than 0.2% (coverage factor k = 1) on all voxels scoring more than 50% of the maximum dose. The primary beam was modeled following a Fermi–Eyges description of the spot envelope fitted to measurements. For the Monte Carlo simulation, the chemical composition of the tissues represented in ATOM was employed. The dose was tallied as dose-to-water, and data were normalized to the target dose (physical dose) to report on absorbed doses per target dose (mSv/Gy) or neutron dose equivalent per target dose (μSv/Gy), while also an estimate of the total organ dose was provided for a target dose of 50.4 Gy(RBE). Out-of-field doses showed absorbed doses that were 5 to 6 orders of magnitude lower than the target dose. The discrepancy between TLD data and the corresponding scored values in the Monte Carlo calculations involving proton and gamma contributions was on average 18%. The comparison between the neutron equivalent doses between the Monte Carlo simulation and the measured neutron doses was on average 8%. Organ dose calculations revealed the highest dose for the thyroid, which was 120 mSv, while other organ doses ranged from 18 mSv in the lungs to 0.6 mSv in the testes. The proposed computational method for routine calculation of the out-of-the-field dose in proton therapy produces results that are compatible with the experimental data and allow to calculate out-of-field organ doses during proton therapy.

Abstract Introduction/Background Reactive and post-infectious arthritides can be challenging to diagnose and manage. Establishing a causative link between pathogen, if indeed one is identified, and subsequent rheumatological symptoms can be difficult. Infection may mimic rheumatic disease, exacerbate it and has consequences for treatment decisions as well. Increasing globalisation has lead to the spread of disease from endemic to non-endemic regions, making this issue ever more relevant. We present the case of a patient with inflammatory symptoms ultimately diagnosed with Entamoeba histolytica parasitic infection. Description/Method A 56-year-old Italian restaurant manager developed acute bilateral hip pain soon after his first coronavirus vaccination in June 2021. Prior to the joint symptoms he reported an episode of conjunctivitis, as well as right testicular pain which was treated as epididymo-orchitis. He had a past medical history of hypertension and asthma. He developed progressive stiffness and pain affecting his shoulders and arms, and was commenced on 15mg of prednisolone for suspected polymyalgia rheumatica (PMR) in the context of raised inflammatory markers. On review in our department, the patient reported very limited response to steroid therapy. He had also developed vomiting, diarrhoea, fever, night sweats and weight loss, exacerbated when weaning prednisolone. These symptoms persisted despite increasing the dose to 20mg. He recalled having a few months of diarrhoea prior to his presentation, up to 5 times a day. Examination did not reveal synovitis or muscle weakness; cardiopulmonary and abdominal examination were normal with no palpable lymphadenopathy. CRP was persistently elevated at 38 mg/L. Serology was negative for ANA, ANCA, CCP, RhF and HLA B27. HIV and TB Elispot were negative, with evidence of previous hepatitis C infection. Urinalysis was negative for haematoproteinuria. PET scan showed colonic inflammation suggestive of ascending colitis with ileocolic lymphadenopathy. Subsequent colonoscopy demonstrated patchy macroscopic inflammation; biopsies were positive for Entamoeba histolytica infection. Suspected method of acquisition was by ingesting unwashed tropical fruits, which he consumed frequently. He was treated with Metronidazole and Paromomycin with rapid resolution of his joint and constitutional symptoms. He was able to successfully wean steroids for the first time since feeling unwell, however began developing peripheral joint pain with bilateral metacarpophalangeal joint synovitis evident on clinical examination on weaning to 2mg of prednisolone. He was commenced on Methotrexate, with follow-up due in the near future. Discussion/Results 90% of patients with Entamoeba histolytica amoebiasis are asymptomatic, however some will present with a subacute colitis. Recent reports have identified this parasite as a rare potential cause for reactive arthritis, which is the likely scenario in this case. Our patient developed conjunctivitis and genito-urinary symptoms (usually urethritis but epididymitis has been reported) in conjunction with joint symptoms, as is classically described. The patient had significant diarrhoea and vomiting throughout his illness; the former pre-dated steroid therapy, although it is possible that steroids exacerbated his symptoms. Prompt resolution of his joint pain and stiffness upon treatment of the parasitic infection is also strongly suggestive of a link between the two, and is unlikely to have occurred if the Entamoeba was purely incidental. He may have gone on to develop a chronic reactive arthritis given the occurrence of peripheral inflammation on lower doses of prednisolone, now requiring disease modifying therapy. Alternatively, the patient may have developed a polymyalgic onset of inflammatory arthritis with incidental Entamoeba infection, however given the reasons above and atypical steroid response this is thought to be less likely. We also considered the possibility of polyarteritis nodosa (PAN) given prominent abdominal symptoms and testicular involvement at onset, however he had no aneurysmal disease on imaging and no other specific features of this condition. Key learning points/Conclusion Literature review suggests that arthritis induced by parasitic infestation is polymorphic and heterogenous, and is likely to involve genetic predisposition in terms of patients who ultimately develop rheumatological sequelae. Minimal response to classical anti-rheumatic agents, including steroids and anti-inflammatories with subsequent profound improvement secondary to anti-parasitic treatment is an important clue to the diagnosis. A variety of microbes can trigger HLA B27 non-associated reactive arthritis, in which a polyarthritis is more common compared to oligoarthritis. Interestingly in a series of cases of parasitic infection with rheumatic manifestations, HLA B27 was negative in 9 out of 13 patients, of whom 7 had a symmetrical polyarthritis. A recent Egyptian study analysed stool samples from 107 patients with unexplained rheumatic pain - 50 had parasitic infection. Parasitic rheumatism was ultimately diagnosed in 16 of these patients, with Entamoeba histolytica found in 8% of cases; around a third of these patients had resolution of their symptoms after anti-parasitic therapy. It remains important, however, to avoid over-attributing pathology to reactive phenomena and alternative diagnoses such as malignancy and vasculitides should always be considered. Our patient had not travelled abroad for 5 years and a lack of travel history may distract from parasitic disease as a diagnosis; nevertheless increasing global connectivity and emigration means that non-endemic infection is rising in developed countries. More detailed evaluation of his history may have highlighted symptoms of diarrhoea and prompted stool culture and colonoscopy prior to steroid therapy, potentially leading to an earlier diagnosis. Overall, this case highlights the importance of accurate diagnosis in patients who present atypically, and re-evaluation of patients who do not respond to treatment as expected. Infectious diseases remain a vital consideration in the assessment of patients presenting with systemic symptoms, and histopathological assessment should be sought were possible.

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Beiträge der Abschlusstagung des Essener Arbeitskreises für die Erforschung des Frauenstifts (Essener Forschungen zum Frauenstift, 15), Essen 2018, Klartext, 364 S. / Abb., € 32,00. (Helmut Flachenecker, Würzburg) Schöller, Bettina, Zeiten der Erinnerung. Muri und die Habsburger im Mittelalter (Murenser Monografien, 2), Zürich 2018, Chronos, 191 S. / Abb., € 38,00. (Bruno Meier, Baden (CH)) Mandry, Julia, Armenfürsorge, Hospitäler und Bettel in Thüringen in Spätmittelalter und Reformation (1300 – 1600) (Quellen und Forschungen zu Thüringen im Zeitalter der Reformation, 10), Wien / Köln / Weimar 2018, Böhlau, 1052 S. / Abb., € 125,00. (Stefan Michel, Leipzig) Roth, Stefan, Geldgeschichte und Münzpolitik im Herzogtum Braunschweig-Lüneburg im Spätmittelalter, 2 Bde., Teil 1: Die Rechnungsbücher der Braunschweiger Münzstätte; Teil 2: Geldgeschichte und Münzkatalog (Veröffentlichungen der Historischen Kommission für Niedersachsen und Bremen, 293 bzw. 294), Göttingen 2018, Wallstein, 292 S. / Abb., € 19,90 bzw. 717 S. / Abb., € 49,00. (Manfred Mehl, Hamburg) Föller, Carola, Königskinder. Erziehung am Hof Ludwigs IX. des Heiligen von Frankreich (Beihefte zum Archiv für Kulturgeschichte, 88), Wien / Köln / Weimar 2018, Böhlau, 252 S., € 50,00. (Benjamin Müsegades, Heidelberg) Das Urbar des Hochstifts Augsburg von 1316, bearb. v. Thaddäus Steiner (Veröffentlichungen der Schwäbischen Forschungsstelle Augsburg der Kommission für Bayerische Landesgeschichte bei der Bayerischen Akademie der Wissenschaften und der Schwäbischen Forschungsgemeinschaft. Reihe 5a: Urbare, 4), Augsburg 2019, Wißner, VIII u. 168 S., € 19,80. (Wolfgang Wüst, Erlangen) Just, Thomas / Kathrin Kininger / Andrea Sommerlechner / Herwig Weigl (Hrsg.), Privilegium maius. Autopsie, Kontext und Karriere der Fälschungen Rudolfs IV. von Österreich (Veröffentlichungen des Instituts für Österreichische Geschichtsforschung, 69; Mitteilungen des Österreichischen Staatsarchivs, Sonderband 15), Wien / Köln / Weimar 2018, Böhlau, 388 S. / Abb., € 70,00. (Patrick Fiska, Wien) Wolfinger, Lukas, Die Herrschaftsinszenierung Rudolfs IV. von Österreich. Strategien – Publikum – Rezeption (Symbolische Kommunikation in der Vormoderne), Wien / Köln / Weimar 2018, Böhlau, 924 S. / Abb., € 110,00. (Benjamin Müsegades, Heidelberg) Brachthäuser, Urs, Der Kreuzzug gegen Mahdiya 1390. Konstruktionen eines Ereignisses im spätmittelterlichen Mediterraneum (Mittelmeerstudien, 14), Paderborn 2017, Fink / Schöningh, 822 S., € 99,00. (Georg Jostkleigrewe, Halle) Pilat, Liviu / Ovidiu Cristea, The Ottoman Threat and Crusading on the Eastern Border of Christendom during the 15th Century (East Central and Eastern Europe in the Middle Ages, 450 – 1450, 48), Leiden / Boston 2018, Brill, VIII u. 337 S. / Abb., € 174,00. (Thomas Woelki, Berlin) Dümling, Sebastian, Träume der Einfachheit. Gesellschaftsbeobachtungen in den Reformschriften des 15. Jahrhunderts (Historische Studien, 511), Husum 2017, Matthiesen, 250 S., € 39,00. (Birgit Studt, Freiburg i. Br.) Buondelmonti, Christoforo, Description of the Aegean and Other Islands. Copied, with Supplemental Material, by Henricus Martellus Germanus. A Facsimile of the Manuscript at the James Ford Bell Library, University of Minnesota, hrsg. u. übers. v. Evelyn Edson, New York 2018, Italica Press, X u. 190 S. / Abb., $ 100,00. (Ingrid Baumgärtner, Kassel) Schneider, Joachim, Eberhard Windeck und sein „Buch von Kaiser Sigmund“. Studien zu Entstehung, Funktion und Verbreitung einer Königschronik im 15. Jahrhundert (Geschichtliche Landeskunde, 73), Stuttgart 2018, Steiner, 369 S. / Abb., € 62,00. (Gerhard Fouquet, Kiel) The London Customs Accounts. 24 Henry VI (1445/46), hrsg. v. Stuart Jenks (Quellen und Darstellungen zur Hansischen Geschichte. Neue Folge, 74), Köln / Weimar / Wien 2018, Böhlau, LXIII u. 407 S., € 60,00. (Harm von Seggern, Kiel) Pietro Montes „Collectanea“. The Arms, Armour and Fighting Techniques of a Fifteenth-Century Soldier, hrsg. u. übers. v. Jeffrey L. Forgeng, Woodbridge 2018, The Boydell Press, VII u. 313 S. / Abb., £ 60,00. (Patrick Leiske, Heidelberg) Sander-Faes, Stephan, Europas habsburgisches Jahrhundert. 1450 – 1550 (Geschichte kompakt), Darmstadt 2018, Wissenschaftliche Buchgesellschaft, 160 S. / Abb., € 19,95. (Thomas Winkelbauer, Wien) Helmrath, Johannes / Ursula Kocher / Andrea Sieber (Hrsg.), Maximilians Welt. 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MacDougall, Philip, Islamic Seapower during the Age of Fighting Sail, Woodbridge 2017, The Boydell Press, XVII u. 241 S. / Abb., £ 65,00. (Stefan Hanß, Manchester) Head, Randolph C., Making Archives in Early Modern Europe. Proof, Information, and Political Record-Keeping, 1400 – 1700, Cambridge [u. a.] 2019, Cambridge University Press, XVII u. 348 S. / Abb., £ 90,00. (Markus Friedrich, Hamburg) Keller, Vera / Anna M. Roos / Elizabeth Yale (Hrsg.), Archival Afterlives. Life, Death, and Knowledge-Making in Early Modern British Scientific and Medical Archives (Scientific and Learned Cultures and Their Institutions, 23), Leiden / Boston 2018, Brill, XI u. 276 S. / Abb., € 105,00. (Markus Friedrich, Hamburg) Jaumann, Herbert / Gideon Stiening (Hrsg.), Neue Diskurse der Gelehrtenkultur in der Frühen Neuzeit. Ein Handbuch, Berlin / Boston 2016, de Gruyter, XXIII u. 877 S., € 219,00. (Marian Füssel, Göttingen) Reinalter, Helmut, Freimaurerei, Politik und Gesellschaft. Die Wirkungsgeschichte des diskreten Bundes, Wien / Köln / Weimar 2018, Böhlau, 255 S., € 20,00. (Joachim Bauer, Jena) Jarzebowski, Claudia, Kindheit und Emotion. Kinder und ihre Lebenswelten in der europäischen Frühen Neuzeit, Berlin / Boston 2018, de Gruyter Oldenbourg, VIII u. 343 S. / Abb., € 89,95. (Christina Antenhofer, Salzburg) Bepler, Jill / Svante Norrhem (Hrsg.), Telling Objects. Contextualizing the Role of the Consort in Early Modern Europe (Wolfenbütteler Forschungen, 153), Wiesbaden 2018, Harrassowitz in Kommission, 269 S. / Abb., € 68,00. (Melanie Greinert, Kiel) Gantet, Claire / Christine Lebeau, Le Saint-Empire. 1500 – 1800 (Collection U: Histoire), Malakoff 2018, Armand Colin, 270 S. / graph. Darst., € 27,00. (Guido Braun, Mülhausen / Mulhouse) Willasch, Friederike, Verhandlungen, Gespräche, Briefe. Savoyisch-französische Fürstenheiraten in der Frühen Neuzeit (Beihefte der Francia, 85), Ostfildern 2018, Thorbecke, 344 S., € 45,00. (Matthias Schnettger, Mainz) Del Soldato, Eva / Andrea Rizzi (Hrsg.), City, Court, Academy. Language Choice in Early Modern Italy, London / New York, Routledge 2018, IX u. 228 S., £ 105,00. (Bettina Pfotenhauer, München) Lobenwein, Elisabeth / Martin Scheutz / Alfred St. Weiß (Hrsg.), Bruderschaften als multifunktionale Dienstleister der Frühen Neuzeit in Zentraleuropa (Veröffentlichungen des Instituts für Österreichische Geschichtsforschung, 70), Wien 2018, Böhlau, 548 S. / Abb., € 90,00. (Patrick Schmidt, Rostock) Bergerfurth, Yvonne, Die Bruderschaften der Kölner Jesuiten 1576 bis 1773 (Studien zur Kölner Kirchengeschichte, 45), Siegburg 2018, Schmitt, 438 S., € 34,90. (Hans-Wolfgang Bergerhausen, Würzburg) Walter, Philipp, Universität und Landtag (1500 – 1700). Akademische Landstandschaft im Spannungsfeld von reformatorischer Lehre, landesherrlicher Instrumentalisierung und ständischer Solidarität (Quellen und Forschungen zu Thüringen im Zeitalter der Reformation, 8), Wien / Köln / Weimar 2018, Böhlau, 1093 S., € 125,00. (Bernhard Homa, Stade) Kikuchi, Yuta, Hamburgs Ostsee- und Mitteleuropahandel 1600 – 1800. Warenaustausch und Hinterlandnetzwerke (Wirtschafts- und Sozialhistorische Studien, 20), Köln / Weimar / Wien 2018, Böhlau, 426 S. / Abb., € 65,00. (Mark Häberlein, Bamberg) Hoppe, Peter / Daniel Schläppi / Nathalie Büsser / Thomas Meier, Universum Kleinstadt. Die Stadt Zug und ihre Untertanen im Spiegel der Protokolle von Stadtrat und Gemeinde (1471 – 1798) (Beiträge zur Zuger Geschichte, 18), Zürich 2018, Chronos in Kommission, 320 S. / Abb., € 38,00. (Volker Reinhardt, Fribourg) Griffin, Carl J. / Briony McDonagh (Hrsg.), Remembering Protest in Britain since 1500. Memory, Materiality and the Landscape, Cham 2018, Palgrave Macmillan, XIV u. 253 S. / Abb., € 96,29. (Georg Eckert, Wuppertal / Potsdam) Queckbörner, Boris, Englands Exodus. Form und Funktion einer Vorstellung göttlicher Erwählung in Tudor-England, Bielefeld 2017, transcript, 596 S. / Abb., € 49,99. (Andreas Pečar, Halle a. d. S.) Fleming, Gillian B., Juana I. Legitimacy and Conflict in Sixteenth-Century Castile (Queenship and Power), Cham 2018, Palgrave Macmillan, XXI 356 S. / Abb., € 103,99. (Pauline Puppel, Berlin) Heidenreich, Benjamin, Ein Ereignis ohne Namen? Zu den Vorstellungen des „Bauernkriegs“ von 1525 in den Schriften der „Aufständischen“ und in der zeitgenössischen Geschichtsschreibung (Quellen und Forschungen zur Agrargeschichte, 9), Berlin / Boston 2019, de Gruyter Oldenbourg, IX u. 350 S., € 99,95. (Wiebke Voigt, Dresden) Lehmann, Sarah, Jrdische Pilgrimschafft und Himmlische Burgerschafft. Leid und Trost in frühneuzeitlichen Leichenpredigten (The Early Modern World, 1), Göttingen 2019, V&amp;R unipress, 374 S. / Abb., € 50,00. (Volker Leppin, Tübingen) Hanß, Stefan, Lepanto als Ereignis. Dezentrierende Geschichte‍(n) der Seeschlacht von Lepanto (1571) (Berliner Mittelalter- und Frühneuzeit-Forschung, 21), Göttingen 2017, Vandenhoeck &amp; Ruprecht, 710 S. / Abb., € 85,00. (Cornel Zwierlein, Berlin) Hanß, Stefan, Die materielle Kultur der Seeschlacht von Lepanto (1571). Materialität, Medialität und die historische Produktion eines Ereignisses, 2 Teilbde. (Istanbuler Texte und Studien, 38.1 u. 38.2), Würzburg 2017, Ergon in Kommission, 1006 S. / Abb., € 148,00. (Cornel Zwierlein, Berlin) Nagel, Ulrich, Zwischen Dynastie und Staatsräson. Die habsburgischen Botschafter in Wien und Madrid am Beginn des Dreißigjährigen Krieges (Veröffentlichungen des Instituts für Europäische Geschichte Mainz. Abteilung für Universalgeschichte, 247), Göttingen 2018, Vandenhoeck &amp; Ruprecht, 464 S., € 80,00. (Hillard von Thiessen, Rostock) Mitchell, Silvia Z., Queen, Mother, and Stateswoman. Mariana of Austria and the Gouvernment of Spain, University Park Pennsylvania 2019, The Pennsylvania State University Press, XII u. 293 S. / Abb., $ 84,95. (Katrin Keller, Wien) Krause, Oliver, Die Variabilität frühneuzeitlicher Staatlichkeit. Die niederländische „Staats“-Formierung der Statthalterlosen Epoche (1650 – 1672) als interkontinentales Regiment (Beiträge zur Europäischen Überseegeschichte, 105), Stuttgart 2018, Steiner, 529 S., € 76,00. (Johannes Arndt, Münster) Stevens, Ralph, Protestant Pluralism. The Reception of the Toleration Act, 1689 – 1720 (Studies in Modern British Religious History, 37), Woodbridge / Rochester 2018, The Boydell Press, XIV u. 201 S., £ 65,00. (Frouke Veenstra-Vis, Groningen) Mitchell, A. Wess, The Grand Strategy of the Habsburg Empire, Princeton / Oxford 2018, Princeton University Press, XIV u. 403 S. / Abb., $ 27,00. (Simon Karstens, Trier) Pohlig, Matthias / Michael Schaich (Hrsg.), The War of the Spanish Succession. New Perspectives (Studies of the German Historical Institute London), Oxford 2018, Oxford University Press, IX u. 509 S. / Abb., £ 85,00. (Anuschka Tischer, Würzburg) Vollhardt, Friedrich, Gotthold Ephraim Lessing. Epoche und Werk, Göttingen 2018, Wallstein, 490 S. / Abb., € 29,90. (Michael Maurer, Jena) Walliss, John, The Bloody Code in England and Wales, 1760 – 1830 (World Histories of Crime, Culture and Violence), Cham 2018, Palgrave Macmillan, XXIII u. 176 S. / graph. Darst., € 85,59. (Benjamin Seebröker, Dresden) „Die Schlesier im Ganzen taugen wahrlich nichts!“ Johann Gustav Gottlieb Büschings Briefe an seine Braut. An der Wiege der Breslauer Germanistik, hrsg., komm. u. mit einem Vorwort versehen v. Krzysztof Żarski / Natalia Żarska (Schlesische Grenzgänger, 10), Leipzig 2018, Leipziger Universitätsverlag, 575 S., € 49,00. (Michael Maurer, Jena)

Classen, Albrecht (Hrsg.), Travel, Time, and Space in the Middle Ages and Early Modern Time. Explorations of World Perceptions and Processes of Identity Formation (Fundamentals of Medieval and Early Modern Culture, 22), Boston / Berlin 2018, de Gruyter, XIX u. 704 S. / Abb., € 138,95. (Stefan Schröder, Helsinki) Orthmann, Eva / Anna Kollatz (Hrsg.), The Ceremonial of Audience. Transcultural Approaches (Macht und Herrschaft, 2), Göttingen 2019, V&amp;R unipress / Bonn University Press, 207 S. / Abb., € 40,00. (Benedikt Fausch, Münster) Bagge, Sverre H., State Formation in Europe, 843 – 1789. A Divided World, London / New York 2019, Routledge, 297 S., £ 120,00. (Wolfgang Reinhard, Freiburg i. Br.) Foscati, Alessandra, Saint Anthony’s Fire from Antiquity to the Eighteenth Century, übers. v. Francis Gordon (Premodern Health, Disease, and Disability), Amsterdam 2020, Amsterdam University Press, 264 S., € 99,00. (Gregor Rohmann, Frankfurt a. M.) Füssel, Marian / Frank Rexroth / Inga Schürmann (Hrsg.), Praktiken und Räume des Wissens. Expertenkulturen in Geschichte und Gegenwart, Göttingen 2019, Vandenhoeck &amp; Ruprecht, 225 S. / Abb., € 65,00. (Lisa Dannenberg-Markel, Aachen) Korpiola, Mia (Hrsg.), Legal Literacy in Premodern European Societies (World Histories of Crime, Culture and Violence), Cham 2019, Palgrave Macmillan, X u. 264 S., € 103,99. (Saskia Lettmaier, Kiel) Stercken, Martina / Christian Hesse (Hrsg.), Kommunale Selbstinszenierung. Städtische Konstellationen zwischen Mittelalter und Neuzeit (Medienwandel – Medienwechsel – Medienwissen, 40), Zürich 2018, Chronos, 391 S. / Abb., € 58,00. (Ruth Schilling, Bremen / Bremerhaven) Thewes, Guy / Martin Uhrmacher (Hrsg.), Extra muros. Vorstädtische Räume in Spätmittelalter und früher Neuzeit / Espaces suburbains au bas Moyen Âge et à l’époque moderne (Städteforschung. Reihe A: Darstellungen, 91), Wien / Köln / Weimar 2019, Böhlau, 521 S. / Abb., € 70,00. (Holger Th. Gräf, Marburg) Bühner, Peter, Die Freien und Reichsstädte des Heiligen Römischen Reiches. Kleines Repertorium (Schriftenreihe der Friedrich-Christian-Lesser-Stiftung, 38), Petersberg 2019, Imhof, 623 S. / Abb., € 39,95. (Stephanie Armer, Eichstätt) Kümin, Beat, Imperial Villages. Cultures of Political Freedom in the German Lands c. 1300 – 1800 (Studies in Central European Histories, 65), Leiden / Boston 2019 Brill, XIV u. 277 S. / Abb., € 121,00. (Magnus Ressel, Frankfurt a. M.) Kälble, Mathias / Helge Wittmann (Hrsg.), Reichsstadt als Argument. 6. Tagung des Mühlhäuser Arbeitskreises für Reichsstadtgeschichte Mühlhausen 12. bis 14. Februar 2018 (Studien zur Reichsstadtgeschichte, 6), Petersberg 2019, Imhof, 316 S. / Abb., € 29,95. (Pia Eckhart, Freiburg i. Br.) Müsegades, Benjamin / Ingo Runde (Hrsg.), Universitäten und ihr Umfeld. Südwesten und Reich in Mittelalter und Früher Neuzeit. Beiträge zur Tagung im Universitätsarchiv Heidelberg am 6. und 7. Oktober 2016 (Heidelberger Schriften zur Universitätsgeschichte, 7), Heidelberg 2019, Universitätsverlag Winter, VIII u. 276 S. / Abb., € 25,00. (Beate Kusche, Leipzig) Drews, Wolfram (Hrsg.), Die Interaktion von Herrschern und Eliten in imperialen Ordnungen des Mittelalters (Das Mittelalter. Beihefte, 8), Berlin / Boston 2018, de Gruyter, VIII u. 321 S. / Abb., € 99,95. (Elisabeth Gruber, Salzburg) Schmidt, Hans-Joachim, Herrschaft durch Schrecken und Liebe. Vorstellungen und Begründungen im Mittelalter (Orbis mediaevalis, 17), Göttingen 2019, V&amp;R unipress, 770 S., € 90,00. (Matthias Becher, Bonn) Wickham, Chris, Das Mittelalter. Europa von 500 bis 1500. Aus dem Englischen von Susanne Held, Stuttgart 2018, Klett-Cotta, 506 S. / Abb., € 35,00. (Hans-Werner Goetz, Hamburg) Gramsch-Stehfest, Robert, Bildung, Schule und Universität im Mittelalter (Seminar Geschichte), Berlin / Boston 2019, de Gruyter, X u. 273 S. / Abb., € 24,95. (Benjamin Müsegades, Heidelberg) Berndt, Rainer SJ (Hrsg.), Der Papst und das Buch im Spätmittelalter (1350 – 1500). Bildungsvoraussetzung, Handschriftenherstellung, Bibliotheksgebrauch (Erudiri Sapientia, 13), Münster 2018, Aschendorff, 661 S. / Abb., € 79,00. (Vanina Kopp, Trier) Eßer, Florian, Schisma als Deutungskonflikt. Das Konzil von Pisa und die Lösung des Großen Abendländischen Schismas (1378 – 1409) (Papsttum im mittelalterlichen Europa, 8), Wien / Köln / Weimar 2019, Böhlau, 874 S., € 120,00. (Bernward Schmidt, Eichstätt) Baur, Kilian, Freunde und Feinde. Niederdeutsche, Dänen und die Hanse im Spätmittelalter (1376 – 1513) (Quellen und Darstellungen zur Hansischen Geschichte. Neue Folge, 76), Wien / Köln / Weimar 2018, Böhlau, 671 S., € 85,00. (Angela Huang, Lübeck) Pietsch, Tobias, Führende Gruppierungen im spätmittelalterlichen Niederadel Mecklenburgs, Kiel 2019, Solivagus-Verlag, 459 S. / graph. Darst., € 58,00. (Joachim Krüger, Greifswald) Putzer, Katja, Das Urbarbuch des Erhard Rainer zu Schambach von 1376. Besitz und Bücher eines bayerischen Niederadligen (Quellen und Erörterungen zur bayerischen Geschichte. Neue Folge, 50), München 2019, Beck, 318 S., € 56,00. (Wolfgang Wüst, Erlangen) Drossbach, Gisela / Klaus Wolf (Hrsg.), Reformen vor der Reformation. Sankt Ulrich und Afra und der monastisch-urbane Umkreis im 15. Jahrhundert (Studia Augustana, 18), Berlin / Boston 2018, VII u. 391 S. / Abb., € 99,95. (Thomas Groll, Augsburg) Ricci, Giovanni, Appeal to the Turk. The Broken Boundaries of the Renaissance, übers. v. Richard Chapman (Viella History, Art and Humanities Collection, 4), Rom 2018, Viella, 186 S. / Abb., € 30,00. (Stefan Hanß, Manchester) Böttcher, Hans-Joachim, Die Türkenkriege im Spiegel sächsischer Biographien (Studien zur Geschichte Ungarns, 20), Herne 2019, Schäfer, 290 S., € 19,95. (Fabian Schulze, Elchingen / Augsburg) Shaw, Christine, Isabella d’Este. A Renaissance Princess (Routledge Historical Biographies), London / New York 2019, Routledge, 312 S., £ 90,00. (Christina Antenhofer, Salzburg) Brandtzæg, Siv G. / Paul Goring / Christine Watson (Hrsg.), Travelling Chronicles. News and Newspapers from the Early Modern Period to the Eighteenth Century (Library of the Written Word, 66 / The Handpress World, 51), Leiden / Boston 2018, Brill, XIX u. 388 S. / Abb., € 129,00. (Andreas Würgler, Genf) Graheli, Shanti (Hrsg.), Buying and Selling. The Business of Books in Early Modern Europe (Library of the Written Word, 72; The Handpress World, 55), Leiden / Boston 2019, Brill, XXIII u. 559 S. / Abb., € 159,00. (Johannes Frimmel, München) Vries, Jan de, The Price of Bread. Regulating the Market in the Dutch Republic (Cambridge Studies in Economic History), Cambridge [u. a.] 2019, Cambridge University Press, XIX u. 515 S. / graph. Darst., £ 34,99. (Justus Nipperdey, Saarbrücken) Caesar, Mathieu (Hrsg.), Factional Struggles. Divided Elites in European Cities and Courts (1400 – 1750) (Rulers and Elites, 10), Leiden / Boston 2017, Brill, XI u. 258 S., € 119,00. (Mathis Leibetseder, Berlin) Freytag, Christine / Sascha Salatowsky (Hrsg.), Frühneuzeitliche Bildungssysteme im interkonfessionellen Vergleich. Inhalte – Infrastrukturen – Praktiken (Gothaer Forschungen zur Frühen Neuzeit, 14), Stuttgart 2019, Steiner, 320 S., € 58,00. (Helmut Puff, Ann Arbor) Amend-Traut, Anja / Josef Bongartz / Alexander Denzler / Ellen Franke / Stefan A. Stodolkowitz (Hrsg.), Unter der Linde und vor dem Kaiser. Neue Perspektiven auf Gerichtsvielfalt und Gerichtslandschaften im Heiligen Römischen Reich (Quellen und Forschungen zur höchsten Gerichtsbarkeit im Alten Reich, 73), Wien / Köln / Weimar 2020, Böhlau, 320 S., € 65,00. 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Tol, Jonas van, Germany and the French Wars of Religion, 1560 – 1572 (St Andrews Studies in Reformation History), Leiden / Boston 2019, Brill, VIII u. 274 S. / Abb., € 125,00. (Alexandra Schäfer-Griebel, Mainz) Lipscomb, Suzannah, The Voices of Nîmes. Women, Sex, and Marriage in Reformation Languedoc, Oxford / New York 2019, Oxford University Press, XIV u. 378 S., £ 30,00. (Adrina Schulz, Zürich) Kielinger, Thomas, Die Königin. Elisabeth I. und der Kampf um England. Biographie, München 2019, Beck, 375 S. / Abb., € 24,95. (Pauline Puppel, Aumühle) Canning, Ruth, The Old English in Early Modern Ireland. The Palesmen and the Nine Years’ War, 1594 – 1603 (Irish Historical Monograph Series, [20]), Woodbridge 2019, The Boydell Press, XI u. 227 S., £ 75,00. (Martin Foerster, Düsseldorf) Bry, Theodor de, America. Sämtliche Tafeln 1590 – 1602, hrsg. v. Michiel van Groesen / Larry E. Tise, Köln 2019, Taschen, 375 S. / Abb., € 100,00. (Renate Dürr, Tübingen) Haskell, Yasmin / Raphaële Garrod (Hrsg.), Changing Hearts. Performing Jesuit Emotions between Europe, Asia, and the Americas (Jesuit Studies, 15), Leiden / Boston 2019, Brill, XIX u. 328 S. / Abb., € 130,00. (Christoph Nebgen, Saarbrücken) Jackson, Robert H., Regional Conflict and Demographic Patterns on the Jesuit Missions among the Guaraní in the Seventeenth and Eighteenth Centuries (European Expansion and Indigenous Response, 31), Leiden / Boston 2019, Brill, XVII u. 174 S. / Abb., € 100,00. (Irina Saladin, Tübingen) Kelly, James / Hannah Thomas (Hrsg.), Jesuit Intellectual and Physical Exchange between England and Mainland Europe, c. 1580 – 1789: „The world is our house“? (Jesuit Studies, 18), Leiden / Boston 2019, Brill, XIV u. 371 S., € 140,00. (Martin Foerster, Hamburg) Wilhelm, Andreas, Orange und das Haus Nassau-Oranien im 17. Jahrhundert. Ein Fürstentum zwischen Souveränität und Abhängigkeit, Berlin [u. a.] 2018, Lang, 198 S., € 39,95. 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Nicolaus Schaffshausens „De Pace“ und der positive Frieden in der Politiktheorie (Bibliothek Altes Reich, 25), Berlin / Boston 2018, de Gruyter Oldenbourg, IX u. 294 S., € 89,95. (Fabian Schulze, Elchingen / Augsburg) Zirr, Alexander, Die Schweden in Leipzig. Die Besetzung der Stadt im Dreißigjährigen Krieg (1642 – 1650) (Quellen und Forschungen zur Geschichte der Stadt Leipzig, 14), Leipzig 2018, Leipziger Universitätsverlag, 939 S. / Abb., € 98,00. (Philip Hoffmann-Rehnitz, Münster) Fehler, Timothy G. / Abigail J. Hartman (Hrsg.), Signs and Wonders in Britain’s Age of Revolution. A Sourcebook, London / New York 2019, Routledge, XVII u. 312 S. / Abb., £ 110,00. (Doris Gruber, Wien) Dorna, Maciej, Mabillon und andere. Die Anfänge der Diplomatik, aus dem Polnischen übers. v. Martin Faber (Wolfenbütteler Forschungen, 159), Wiesbaden 2019, Harrassowitz in Kommission, 287 S. / Abb., € 49,00. (Wolfgang Eric Wagner, Münster) Kramper, Peter, The Battle of the Standards. 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(Michael Kaiser, Bonn) Querengässer, Alexander, Das kursächsische Militär im Großen Nordischen Krieg 1700 – 1717 (Krieg in der Geschichte, 107), Berlin 2019, Duncker &amp; Humblot, 628 S. / graph. Darst., € 148,00. (Tilman Stieve, Aachen) Sirota, Brent S. / Allan I. Macinnes (Hrsg.), The Hanoverian Succession in Great Britain and Its Empire (Studies in Early Modern Cultural, Political and Social History, 35), Woodbridge 2019, The Boydell Press, IX u. 222 S. / graph. Darst., £ 65,00. (Georg Eckert, Wuppertal / Potsdam) Petersen, Sven, Die belagerte Stadt. Alltag und Gewalt im Österreichischen Erbfolgekrieg (1740 – 1748) (Krieg und Konflikt, 6), Frankfurt a. M. / New York 2019, Campus, 487 S., € 45,00. (Bernhard R. Kroener, Freiburg i. Br.) Lounissi, Carine, Thomas Paine and the French Revolution, Cham 2018, Palgrave Macmillan, IX u. 321 S., € 96,29. (Volker Depkat, Regensburg) Kern, Florian, Kriegsgefangenschaft im Zeitalter Napoleons. 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Introduction 1. In an era of globalization, international trade is inevitable. When we walk into a supermarket and find South American bananas, Malaysian rubber products, Brazilian coffee, we simply experience the impact of global trade. Global trade allows all countries around the world to publicise their markets and to supply goods and services that otherwise would not have been open to the domestic economy. As all goods and services are available at relatively cheaper prices in the international market, therefore domestic market becomes more competitive. People have got choices for competitive products. Therefore, the difference in the prices of goods of the foreign economy and domestic economy results in international trade. 2. Why nations trade with each other ? Not a single nation alone can generate all the goods and services for its households in today’s world of limitless desires. There is an unequal distribution of factors of production over the countries of the world. Countries of the world differ from each other in terms of natural resources, technology, entrepreneurial and managerial skills which determine the ability of the country concerned, at the lowest cost of production, to manufacture goods and services. For example, South Korea can manufacture cars or microelectronic products effectively in comparison with any other nation in the world, similarly Malaysia could produce rubber and palm oil more efficiently. The ability to manufacture these products, such as electronics or rubber, is much greater than their ability to consume these goods within the country so that they can sell these goods at comparatively cheaper prices to other countries around the world. Similarly, India and Brazil can import certain products from South Korea and Malaysia at lower prices and can in exchange, import Brazilian coffee or Indian textiles at a lower price. Therefore, generally trade benefits all the countries of the world provided it is free trade. If one country has a belief in free trade and the other beliefs in the opposite, only the previous one will end practicing free trade and suffering in the end. Economists say that trade conflicts safeguard economic interests and are advantageous to the local market, but critics claim that they ultimately hurt local companies, consumers, and the economy in long run. Protectionist policies always harm the concept of globalization. According to the World Commission on the social dimension of globalization (2004). “Globalisation should benefit all the countries and should raise the welfare of all people throughout the world”. Advocates of protectionist view put arguments in favour of restrictions of the trade like the expansion of the home market, keeping money at home, counteracting foreign low wages, defence or national security arguments, protection of infant industry, anti-dumping arguments, and balance of payment arguments. Trade restrictions are of two types; tariff barriers and non-tariff barriers. The tariff barrier is the most common barrier to trade. It is the tax or duties that one country imposes on exported or imported goods. There are various types of tariff barriers in international trade. If the tariff is imposed based on the physical weight of some goods, imported or exported, called a specific tariff. • If a tariff is imposed on the value of some goods, imported or exported is called “Ad Valorem tariff”. • If different rates of the tariff are imposed on different countries called discriminatory tariffs. • If the same rates of a tariff are imposed on different countries, called non-discriminatory tariff’. • If the main purpose of imposing a tariff is to produce revenue, called a revenue tariff. • And the most commonly used tariff is the Protective tariff. if the tariff is imposed mainly to protect domestic industries from foreign competitions are called the protective tariff 4. Followers of the protectionist policy argue that tariff imposition has two impacts; revenue increases after the imposition of tariff and home production increases which is called protective effect but if other countries retaliate in the same manner, the trade war is inevitable. A situation of trade war erupts when one nation or economy strike back against another economy by imposing trade barriers. The application of trade restrictions is not a new concept in international trade. If we study the background of the global trade war, we find that countries frequently used trade restrictions in global trade. The situation was aggravated after the second world war. Most of the countries were intentionally devaluing their currency to increase their export and minimise imports. This was also the reason for the currency war between countries. 5. We can divide the world trade in the pre-Bretton Woods and post Bretton Woods period. An efficient international monetary system is very essential for the smooth functioning and expansion of international trade. From the early 19th century until the first world war, the era was regarded as a period of internationalism. Most of the major industrialised nations of the world started participating in world trade. After the second world war and the hectic slump and currency war that followed it all the countries of the world wished to return to normalcy. Two causes were responsible for this wish: - • Reconstruction of the economies ravaged by the war. • To end the currency war. As far as the second cause is concerned many countries or the trading partners of the world started devaluating its currency to improve the conditions of their BOP. This resulted in a trade war between nations. Therefore, in Bretton Woods, New Hampshire, USA, members of 44 countries met to discuss these problems and to find realistic solutions for them. This conference proposed the establishment of: - • The International Monetary Fund (IMF), to help member countries to meet their BOP deficit problem. • IBRD, to reconstruct and develop economies of member countries. • An International Trade Organisation (ITO), to solve the problem of international trade and proper liberalisation of it. 6. However, the proposal for the International Trade Organisation did not materialise and the General Agreement on Tariff and Trade (GATT) was formed. The GATT was established in 1948 with a big and important objective of “free trade” and “no trade war”. Its main purpose was to remove trade restrictions which sooner or later converts into a trade war. The first seven rounds of GATT were focussed on the removal of trade barriers only. Despite these discussions in several rounds of GATT, it couldn’t provide a useful forum for discussion on international trade issues. 7. The 8th round of GATT is called Uruguay Round which started in 1986. Member countries negotiated in the areas of Tariffs, Non-Tariff Measures, Tropical Production, Natural resource-based products, Agriculture, GATT articles, Safeguards, Multilateral trade negotiation agreement, Subsidies, Disputes Settlement, Trade-Related Intellectual Property Rights (TRIPPS), Trade-Related Investments measures (TRIMS), Functioning of GATT system (FOGS). Despite serious discussion on these issues’ agreement could not be reached and member countries kept on using trade and non-trade barriers on each other. 8. COVID-19 pandemic, which started in March 2020, has adversely affected global trade. As per WTO statistics, a 3% fall in the volume of merchandise (export and import) trade is seen in the first quarter of 2020. Lockdown in many economies of the world aggravated the problem and declines are historically large. Strict social distancing and majors and restrictions on travel and transport adversely affected the service sector of the world economy which is the main contributor to gross domestic product (GDP) of many countries. Therefore, the economic recovery from the COVID situation is highly uncertain. This situation might give a boost to the global trade war which will be the endeavour during the research to be found out and a description of the same has been covered in Chapter 3. The research has tried to reveal how the pandemic has crippled the world economy and aggravating the pre-existing problem of the trade war. The recent trade war between China and the USA is an apt example. Recent Examples of Trade War​​ 9. Since the year 2018 world has been witnessing trade conflict which was earlier currency conflict between the USA and its economic partners mainly the EU and China. But in this conflict US’s all-weather friend Canada and Mexico were also hit. However, retaliation by other countries has been very limited. In March 2018, the United States announced the imposition of additional tariffs under Section 232 on imports of steel (25%) and aluminium (10%) from China to the United States. This might harm the Chinese economy as China is the major contributor of crude and finished steel in the world. 10. In the same month, the US President announced his strategy to endorse restrictions against China over its Intellectual Property Rights (IPR) policies which were severely affecting its stakeholders. In this sanction, the US raised tariffs by 24 to 25% on selected Chinese products which were valued to the tune of approximately $50 billion. By adopting the policy of quid pro quo China on 01 April responded with 25% tariffs on $50 billion in US exports on various American products, like agriculture, pork, and cars. On 3rd April 2018, the US administration released a list of 1,333 goods equivalent to $50 billion in trade, which it said would enforce a 25% tariff. 11. These Chinese products mainly belong to the category of important sectors like robotics, rail and shipping, information technology, health care, and medicine, and high-technology. China retaliated and published a list of 106 products on which 25% tariffs were imposed and its value was worth $50 billion in trade. Thus, quid pro quo tactics kept ongoing between China and the US. The US plans to tax $50 billion worth of Chinese imports was replied with threats by China to impose tariffs on American products worth $50 billion. China announced to hit back with additional taxes on American chemicals, automobiles, and other products. Interestingly all these 106 American products are produced in those regions of the US where President Trump enjoys great support of his people. Earlier this year both countries signed the first phase of the trade agreement to reduce trade pressures between them, which last year weakened global growth and scaled-down business investment around the world. But due to the blame game over the pandemic, progress has been derailed. 12. Apart from the above, the subsidy has been one of the major causes of dispute amongst countries of the world. According to the WTO agreement on agriculture, developed economies had to reduce their subsidies by 21% in six years and developing countries by 12% in 10 years. Recently restriction on Indian agriculture produce by US, EU, Canada, Brazil, and Japan has been imposed in August 2020. They have questioned that India is not following the WTO peace clause for surpassing the limit on support or, subsidy it can render to its peasants. In the platform of WTO, the ceiling for subsidy is 10% of the value of the produce. India provided the WTO with details that the value of its rice production in 2018 was $43.6 billion and subsidies were worth just $5 billion. Subsidies have therefore remained a major bone of contention between the various countries of the world, but there is one peace arrangement in the WTO that protects the WTO members’ food procurement program for developing countries from taking action in the event of a violation of the subsidy cap. It will also be a litmus test to observe if in circumstances like the ongoing pandemic, WTO members grant food security pre-eminence to emerging economies or whether developed nations are pursuing market entree. Globalisation has reached a few obstructions in recent times, following decades of surges in world trade, worldwide tourism, and global cooperation, as some of the development achieved in the past has been undone by the re-emergence of patriotism and protectionism. The COVID-19 pandemic is predicted to trigger an unprecedented deterioration in global trade after trade growth decelerated dramatically in 2019, owing in huge part to trade conflict between the United States and China. As per the forecasts of the WTO, merchandise business is going to plunge between 12.98% and 31.88% this year, depending on how easily the coronavirus is controlled and trade will return to pre-crisis levels. According to the WTO Director-General, Roberto Azevêdo, the swift and robust rebound is only possible through the focus on free trade. Global markets have to be kept open and predictable, in addition to promoting a more desirable business climate. 13. Though before the onset of the pandemic, the Indian economy was not affected much by the ongoing trade conflict between the USA and China because of the combined effect of the pandemic and trade war India’s GDP shrunk by 23.9% in the first quarter of FY 2020-21. In the first quarter, the worst-hit industry was construction, which contracted by 50 percent. The hotel industry contracted by 47%, production by 39.3%, and mining by 23.3%. Agriculture, which posted a 3.4 percent rise, was the only industry that managed to survive the recession. The economy is believed to have suffered the most during the June quarter as a result of the nationwide lockdown. 14. In January 2019, as the trade war was raging, India also placed anti-dumping duties on more than 99 Chinese goods to protect its domestic markets, such as anti-dumping duties on chemicals, petrochemicals, fabrics, yarn, pharmaceutical equipment, rubber, and steel products. As a follower of protectionist policy Indian government also imposes anti-dumping duty on imports of steel products, an alloy of aluminium. The total value of duty imposed was $13.07 per ton to $ 173.1 per ton, which is a big amount. China, Vietnam, South Korea for five years in June 2020. India needs to take some major steps and reforms to bounce back its economy back on track. 15. Review of Literature… To complete the research number of books, literatures in the forms of articles, journals, independent views of various economists have been reviewed and referred. Books…. ​Various books reviewed and which have contributed in the course of the research include the following: - (a) ​Trade War Are Class War: How Rising Inequality Distorts the Global Economy and Threatens International Peace by Mathew C. Klein and Michael Pettis published by Yale University Press, May 19, 2020. ​The roots of today’s trade wars are traced by Klein and Pettis to decisions taken over the past thirty years by policymakers and business leaders in China, Europe, and the United States. The authors include a coherent narrative in this book that demonstrates how the growing injustice of class wars is a challenge to the global economy and international peace, and what the ways ahead are. (b)​ Has China Won by Kishore Mahbubani published by PublicAffairs, March 2020. ​​The author of this book aims to provide an insight into the trade war between the USA and China. He also claims that China is not as is claimed, an expansionist country. By extending its trade, diplomacy and military might in the region, it secures its national interest. But his view appears to be skewed toward the Chinese target. (c)​ Superpower Showdown: How the Battle between Trump and Xi Threaten a New Cold War by Bob Davis and Lingling Wei published by HarperCollins, June 9, 2020. ​As told by two Wall Street Journal reporters, one based in Washington, D.C., the other in Beijing, who had more access to the decision-makers in the White House and China’s Zhongnanhai leadership compound than anyone else, this is the inside story of the US-China trade war, how ties between these superpowers unravelled, darkening prospects for global peace and prosperity. Over the seven years, they have collaborated on writing for the Wall Street Journal, Davis and Wei have conducted hundreds of interviews with government and business officials in both nations. They explain how we have reached this turning point and look at where we might be going, evaluating U.S.-China ties. (d) ​COVID-19 Challenges for the Indian Economy: Trade and Foreign Policy Effects by EEPCINDIA and AIC, 2020. ​​A study entitled ‘COVID-19: Challenges for the Indian Economy – Trade and Foreign Policy Consequences’ was developed by the ASEAN-India Centre(AIC) Research and Information System for Developing Countries(RIS) in collaboration with the Engineering Export Promotion Council (EEPC), it presents freshly written 40 primary comments on India’s trade and foreign policy challenges raised by this crisis and the way forward by Indian professors, economists, and practitioners. (e ) ​Global Economic Effects of COVID-19 by Congressional Research Service August 2020 by James K. Jackson, Martin A. Weiss, and Rebecca M. Nelson.​ It’s a Congressional Research paper published to analyse the effects of the pandemic on the world economy particularly, the USA. It’s a crystal gazing done by two seasoned economists and gives an excellent perspective of ongoing trade and its likely directions post COVID-19. Research is full of authentic data, facts and Pictures gathered from governmental and non-governmental sources. (f) ​Trade is Not a Four-Letter Word: How Six Everyday Products make the case for Trade, January 2014 by Fred Hochberg published by Simon and Schuster. ​Fred P. Hochberg breaks down colourful and convincing real-world examples through the prism of six traditional American items to reject the common myths and misunderstandings surrounding trade. Mr. Hochberg illustrates the story of America’s most unexpected business partnerships by using six commonly consumed American products; the taco salad, the minivan, the banana, the iPhone, the college degree, and the HBO series Game of Thrones – thus sharing the fundamentals of trade that everybody should know. (g) ​Indian Economy by Dutta and Sundhram published by S. Chand, New Delhi, 66th Revised Edition.​This book analyses structure of the Indian Economy, national income, study of human and natural resources in the context of economic development, pattern of foreign trade of India, broad cross-section of the Indian economy. Chapter 6 of this book deals with foreign trade in India and its balance of payment position which is significant for my study. (h) ​International Economics by Francis Cherunilam published by Tata McGraw Hill Publishing Company Limited, New Delhi, Third Edition. The author is a professor at the School of Management Studies at Cochin University of Science and Technology. This book deals with the conflicting national interest, international economic relations, and solutions of conflicting interests. Chapter 3 of this book shows the picture of international trade. Chapter 9th and 10th clear the picture of free trade versus protection and different types of trade barriers. (i) ​International Economics by H.G. Mannur published by Vikas Publishing House Private Limited, Second Revised Edition. ​The author of this book, H.G. Mannur paid his gratitude to the school of social sciences of the university of science in Penang Malaysia, which provided him a great opportunity to learn about the International economics of Malaysia related to the world. This book is dealing with the International economy of Malaysia which is the highest foreign trade-dependent economy. Chapter 1 explains why do nations trade with each other. Chapter 7 of this book deals with obstacles to trade and trade restrictions. (j) ​International Economics by Dominick Salvatore by Wiley, January 1, 2014. ​​Dominick Salvatore, the author of international economics is an American economist. This book presents theories of international economics and its relevance through real-world examples and applications. Articles. ​ Several articles on the subject relating to the global trade, trade conflict and its effects on world have been written by many noted columnists and authors. Apart from that in last 10 months number of organisations and research bodies also carried out the analysis and likely effects of the COVID-19 pandemic on the world trade and ongoing trade conflict. Articles from publications such as ‘The Economics Times’, ‘Business Today’, ‘The Hindu’, ‘National Council of Applied Economic Research’, ‘BBC Economic Research’, ‘Economic Research and Statistics Division (ERSD)’, ‘Investopedia’ and ‘Business Insider’ form a part of the literature review for the research. In addition to the articles and journals by various writers certain data were also taken from the governmental and non-governmental reports like United Nations Conference on Trade and Development(UNCTAD), WTO Press releases and Economic Survey of India. The existing literature provides great insight into the reasons of trade between the countries, trade conflict and its catalyst and how an unforeseen event like the pandemic brings the entire world to a standstill where even largest and strongest have no solution. There are number of literature and research available which brings out many scenarios where the current trade conflict can go. Besides, a large number of research papers have also been written about the likely recovery of the world trade in various different scenarios. Study of some of has definitely given an insightful perspective on the subject. There is, however a void in the research writings on the subject from Indian government’s concerned ministry like Ministry of Finance, Ministry of Trade and Commerce and Ministry of Agriculture. The Economic Survey of India was the only document where authentic data could have been found but that too was almost six to eight months old. The updated analytical facts and data from the ministry’s sites will go a long way in helping a researcher for his work. A critical study of books and articles mentioned above has assisted in the research to address the issues identified. ​16. Statement of Problem.​ The research seeks to investigate: - (a) ​How the current global trade war (GTW) has impacted the nations having a considerable share in world trade? (b) ​How has the Global Trade War (GTW) impacted the Indian economy? (c)​What are the effects of the COVID-19 pandemic on the Global Trade War? (d) ​What are the likely effects of the COVID -19 pandemic on the Indian economy? 17. Statement of Problem.​ The research seeks to investigate: - (a) ​How the current global trade war (GTW) has impacted the nations having a considerable share in world trade? (b) ​How has the Global Trade War (GTW) impacted the Indian economy? (c)​What are the effects of the COVID-19 pandemic on the Global Trade War? (d) ​What are the likely effects of the COVID -19 pandemic on the Indian economy? 18. Objectives of the Study. The specific objectives of the study are as under: - (a) ​To study the reasons and effects of the global trade war on nations having a major share in world trade. (b) ​To study the effects of COVID-19 pandemic and GTW on international trade with specific emphasis on the Indian economy. 19. Hypothesis The research is intended to deliberate and validate the following hypothesis: - (a) ​Global Trade War has severely impacted nations from having a major share in world trade. (b) ​India has not been affected much by the Global Trade War. (c)​COVID-19 pandemic is going to aggravate the Global Trade War. (d) ​Indian economy will be adversely affected by the ongoing pandemic. 20. The relevance of the Study… This study will contribute to academia with an in-depth insight into the existent trend of international trade and trade war. The present study will evaluate the effect of COVID-19 on international trade and its role in aggravating trade war. Besides, this study will also endeavour to furnish both analysis and suggestions towards: - (a) ​Trend of global trade and reasons behind trade war. (b) ​Likely direction of international trade post-COVID-19. (c)​Its impact on the Indian economy and recommendations for future economic policies. 21. Research Methodology Owing to the current and contemporary nature of the topic, research was based on the primary and secondary method of data collection wherein the number of books, open-source articles, internet blogs, periodicals, and research papers were referred and perused. Apart from the same reports and analysis of both governmental and non-governmental agencies, which were available in the open domain, were also accessed during the research. To support the arguments, an online public opinion, based on close-ended questionnaire, was be taken through Google forms. The survey questionnaire was analysed based on responses using Likert Scale. Non-random convenient sampling was used for selection of participants. A total of 114 respondents took part in the survey. 22. Organisation of the Research Research has been completed under five chapters. Headings of the chapters and their broad contents have been covered in succeeding paragraphs. (a) ​Chapter 1: Introduction and Research Methodology. In this chapter background of global trade, particularly after World War II, the role of WTO for free and fair trade amongst member nations along with research methodology have been covered in detail. (b) ​Chapter 2: Background of Global Trade War and Situation up to the onset of the COVID-19 pandemics. In this chapter issues like background of trade war, currency war and current state of global trade amidst ongoing trade conflict between the USA and China has been covered in detail. Apart from the same it has also been brought out in this chapter that which are the countries and which all products and services have been severely affected. All the affected nations are adopting their own policies to deal with the current situation of COVID-19 and ripples of trade dispute. Same have also been brought forward in this chapter. (c)​Chapter 3: Likely Directions of Global Trade War post-COVID-19 pandemics. COVID-19 pandemic has added a new dimension to the way nations were doing trade with each other, particularly in the light of disruption in production, supply chain, unpredicted market, and labour issues. Apart from that, it has severely affected the ongoing global trade war. The revival of the economy is incumbent on medical success in finding the vaccine for the disease. In this chapter likely direction of the trade war has been discussed in details. Apart from the foregoing, long and short term effects of the pandemic on global trade have also been covered in this chapter. (d) ​Chapter 4: Impact of Global Trade War and COVID-19 pandemics on the Indian Economy. The Indian economy was not affected much by the global trade war but since the onset of a pandemic, the combined effect of COVID-19 and trade war has started affecting the Indian economy. Apart from the same in this chapter impact on export and import capability of India during pandemic times have also been covered in detail. Recent development at Galwan valley in Eastern Ladakh which includes the steps taken by India and its likely implications on the trade between India and China has also been covered in this chapter. In the end an analysis of the Online survey with the help of Google form has been covered to check the hypothesis. (e)​ Chapter 5: Way Ahead for the Indian Economy, Recommendations and Conclusion. ​In continuation of the previous chapter, this chapter contains nthe state of global trade in the current times along with certain recommendations which can be followed to have a fair world trade. During COVID-19 pandemic the Indian government has taken large number of fiscal measures to control to the damage and bring the economy back on track and same have been covered in great details in this chapter. Apart from that actions which Indian government should take to minimise the impact of trade dispute between other nations have also been recommended. In last way ahead for the Indian economy has been recommended.

Introduction The aim of this paper is to examine whether recent catastrophic tsunamis have driven a cultural shift in the awareness of Australians to the danger associated with this natural hazard and whether the media have contributed to the emergence of “tsunami” as a new Australian catastrophe. Prior to the devastating 2004 Indian Ocean Tsunami disaster (2004 IOT), tsunamis as a type of hazard capable of generating widespread catastrophe were not well known by the general public and had barely registered within the wider scientific community. As a university based lecturer who specialises in natural disasters, I always started my public talks or student lectures with an attempt at a detailed description of what a tsunami is. With little high quality visual and media imagery to use, this was not easy. The Australian geologist Ted Bryant was right when he named his 2001 book Tsunami: The Underrated Hazard. That changed on 26 December 2004 when the third largest earthquake ever recorded occurred northwest of Sumatra, Indonesia, triggering the most catastrophic tsunami ever experienced. The 2004 IOT claimed at least 220,000 lives—probably more—injured tens of thousands, destroyed widespread coastal infrastructure and left millions homeless. Beyond the catastrophic impacts, this tsunami was conspicuous because, for the first time, such a devastating tsunami was widely captured on video and other forms of moving and still imagery. This occurred for two reasons. Firstly, the tsunami took place during daylight hours in good weather conditions—factors conducive to capturing high quality visual images. Secondly, many people—both local residents and westerners who were on beachside holidays and at the coast at multiple locations impacted by the tsunami—were able to capture images of the tsunami on their cameras, videos, and smart phones. The extensive media coverage—including horrifying television, video, and still imagery that raced around the globe in the hours and days after the tsunami, filling our television screens, homes, and lives regardless of where we lived—had a dramatic effect. This single event drove a quantum shift in the wider cultural awareness of this type of catastrophe and acted as a catalyst for improved individual and societal understanding of the nature and effects of disaster landscapes. Since this event, there have been several notable tsunamis, including the March 2011 Japan catastrophe. Once again, this event occurred during daylight hours and was widely captured by multiple forms of media. These events have resulted in a cascade of media coverage across television, radio, movie, and documentary channels, in the print media, online, and in the popular press and on social media—very little of which was available prior to 2004. Much of this has been documentary and informative in style, but there have also been numerous television dramas and movies. For example, an episode of the popular American television series CSI Miami entitled Crime Wave (Season 3, Episode 7) featured a tsunami, triggered by a volcanic eruption in the Atlantic and impacting Miami, as the backdrop to a standard crime-filled episode ("CSI," IMDb; Wikipedia). In 2010, Warner Bros Studios released the supernatural drama fantasy film Hereafter directed by Clint Eastwood. In the movie, a television journalist survives a near-death experience during the 2004 IOT in what might be the most dramatic, and probably accurate, cinematic portrayal of a tsunami ("Hereafter," IMDb; Wikipedia). Thus, these creative and entertaining forms of media, influenced by the catastrophic nature of tsunamis, are impetuses for creativity that also contribute to a transformation of cultural knowledge of catastrophe. The transformative potential of creative media, together with national and intergovernmental disaster risk reduction activity such as community education, awareness campaigns, community evacuation planning and drills, may be indirectly inferred from rapid and positive community behavioural responses. By this I mean many people in coastal communities who experience strong earthquakes are starting a process of self-evacuation, even if regional tsunami warning centres have not issued an alert or warning. For example, when people in coastal locations in Samoa felt a large earthquake on 29 September 2009, many self-evacuated to higher ground or sought information and instruction from relevant authorities because they expected a tsunami to occur. When interviewed, survivors stated that the memory of television and media coverage of the 2004 IOT acted as a catalyst for their affirmative behavioural response (Dominey-Howes and Thaman 1). Thus, individual and community cultural understandings of the nature and effects of tsunami catastrophes are incredibly important for shaping resilience and reducing vulnerability. However, this cultural shift is not playing out evenly.Are Australia and Its People at Risk from Tsunamis?Prior to the 2004 IOT, there was little discussion about, research in to, or awareness about tsunamis and Australia. Ted Bryant from the University of Wollongong had controversially proposed that Australia had been affected by tsunamis much bigger than the 2004 IOT six to eight times during the last 10,000 years and that it was only a matter of when, not if, such an event repeated itself (Bryant, "Second Edition"). Whilst his claims had received some media attention, his ideas did not achieve widespread scientific, cultural, or community acceptance. Not-with-standing this, Australia has been affected by more than 60 small tsunamis since European colonisation (Dominey-Howes 239). Indeed, the 2004 IOT and 2006 Java tsunami caused significant flooding of parts of the Northern Territory and Western Australia (Prendergast and Brown 69). However, the affected areas were sparsely populated and experienced very little in the way of damage or loss. Thus they did not cross any sort of critical threshold of “catastrophe” and failed to achieve meaningful community consciousness—they were not agents of cultural transformation.Regardless of the risk faced by Australia’s coastline, Australians travel to, and holiday in, places that experience tsunamis. In fact, 26 Australians were killed during the 2004 IOT (DFAT) and five were killed by the September 2009 South Pacific tsunami (Caldwell et al. 26). What Role Do the Media Play in Preparing for and Responding to Catastrophe?Regardless of the type of hazard/disaster/catastrophe, the key functions the media play include (but are not limited to): pre-event community education, awareness raising, and planning and preparations; during-event preparation and action, including status updates, evacuation warnings and notices, and recommendations for affirmative behaviours; and post-event responses and recovery actions to follow, including where to gain aid and support. Further, the media also play a role in providing a forum for debate and post-event analysis and reflection, as a mechanism to hold decision makers to account. From time to time, the media also provide a platform for examining who, if anyone, might be to blame for losses sustained during catastrophes and can act as a powerful conduit for driving socio-cultural, behavioural, and policy change. Many of these functions are elegantly described and a series of best practices outlined by The Caribbean Disaster Emergency Management Agency in a tsunami specific publication freely available online (CDEMA 1). What Has Been the Media Coverage in Australia about Tsunamis and Their Effects on Australians?A manifest contents analysis of media material covering tsunamis over the last decade using the framework of Cox et al. reveals that coverage falls into distinctive and repetitive forms or themes. After tsunamis, I have collected articles (more than 130 to date) published in key Australian national broadsheets (e.g., The Australian and Sydney Morning Herald) and tabloid (e.g., The Telegraph) newspapers and have watched on television and monitored on social media, such as YouTube and Facebook, the types of coverage given to tsunamis either affecting Australia, or Australians domestically and overseas. In all cases, I continued to monitor and collect these stories and accounts for a fixed period of four weeks after each event, commencing on the day of the tsunami. The themes raised in the coverage include: the nature of the event. For example, where, when, why did it occur, how big was it, and what were the effects; what emergency response and recovery actions are being undertaken by the emergency services and how these are being provided; exploration of how the event was made worse or better by poor/good planning and prior knowledge, action or inaction, confusion and misunderstanding; the attribution of blame and responsibility; the good news story—often the discovery and rescue of an “iconic victim/survivor”—usually a child days to weeks later; and follow-up reporting weeks to months later and on anniversaries. This coverage generally focuses on how things are improving and is often juxtaposed with the ongoing suffering of victims. I select the word “victims” purposefully for the media frequently prefer this over the more affirmative “survivor.”The media seldom carry reports of “behind the scenes” disaster preparatory work such as community education programs, the development and installation of warning and monitoring systems, and ongoing training and policy work by response agencies and governments since such stories tend to be less glamorous in terms of the disaster gore factor and less newsworthy (Cox et al. 469; Miles and Morse 365; Ploughman 308).With regard to Australians specifically, the manifest contents analysis reveals that coverage can be described as follows. First, it focuses on those Australians killed and injured. Such coverage provides elements of a biography of the victims, telling their stories, personalising these individuals so we build empathy for their suffering and the suffering of their families. The Australian victims are not unknown strangers—they are named and pictures of their smiling faces are printed or broadcast. Second, the media describe and catalogue the loss and ongoing suffering of the victims (survivors). Third, the media use phrases to describe Australians such as “innocent victims in the wrong place at the wrong time.” This narrative establishes the sense that these “innocents” have been somehow wronged and transgressed and that suffering should not be experienced by them. The fourth theme addresses the difficulties Australians have in accessing Consular support and in acquiring replacement passports in order to return home. It usually goes on to describe how they have difficulty in gaining access to accommodation, clothing, food, and water and any necessary medicines and the challenges associated with booking travel home and the complexities of communicating with family and friends. The last theme focuses on how Australians were often (usually?) not given relevant safety information by “responsible people” or “those in the know” in the place where they were at the time of the tsunami. This establishes a sense that Australians were left out and not considered by the relevant authorities. This narrative pays little attention to the wide scale impact upon and suffering of resident local populations who lack the capacity to escape the landscape of catastrophe.How Does Australian Media Coverage of (Tsunami) Catastrophe Compare with Elsewhere?A review of the available literature suggests media coverage of catastrophes involving domestic citizens is similar globally. For example, Olofsson (557) in an analysis of newspaper articles in Sweden about the 2004 IOT showed that the tsunami was framed as a Swedish disaster heavily focused on Sweden, Swedish victims, and Thailand, and that there was a division between “us” (Swedes) and “them” (others or non-Swedes). Olofsson (557) described two types of “us” and “them.” At the international level Sweden, i.e. “us,” was glorified and contrasted with “inferior” countries such as Thailand, “them.” Olofsson (557) concluded that mediated frames of catastrophe are influenced by stereotypes and nationalistic values.Such nationalistic approaches preface one type of suffering in catastrophe over others and delegitimises the experiences of some survivors. Thus, catastrophes are not evenly experienced. Importantly, Olofsson although not explicitly using the term, explains that the underlying reason for this construction of “them” and “us” is a form of imperialism and colonialism. Sharp refers to “historically rooted power hierarchies between countries and regions of the world” (304)—this is especially so of western news media reporting on catastrophes within and affecting “other” (non-western) countries. Sharp goes much further in relation to western representations and imaginations of the “war on terror” (arguably a global catastrophe) by explicitly noting the near universal western-centric dominance of this representation and the construction of the “west” as good and all “non-west” as not (299). Like it or not, the western media, including elements of the mainstream Australian media, adhere to this imperialistic representation. Studies of tsunami and other catastrophes drawing upon different types of media (still images, video, film, camera, and social media such as Facebook, Twitter, and the like) and from different national settings have explored the multiple functions of media. These functions include: providing information, questioning the authorities, and offering a chance for transformative learning. Further, they alleviate pain and suffering, providing new virtual communities of shared experience and hearing that facilitate resilience and recovery from catastrophe. Lastly, they contribute to a cultural transformation of catastrophe—both positive and negative (Hjorth and Kyoung-hwa "The Mourning"; "Good Grief"; McCargo and Hyon-Suk 236; Brown and Minty 9; Lau et al. 675; Morgan and de Goyet 33; Piotrowski and Armstrong 341; Sood et al. 27).Has Extensive Media Coverage Resulted in an Improved Awareness of the Catastrophic Potential of Tsunami for Australians?In playing devil’s advocate, my simple response is NO! This because I have been interviewing Australians about their perceptions and knowledge of tsunamis as a catastrophe, after events have occurred. These events have triggered alerts and warnings by the Australian Tsunami Warning System (ATWS) for selected coastal regions of Australia. Consequently, I have visited coastal suburbs and interviewed people about tsunamis generally and those events specifically. Formal interviews (surveys) and informal conversations have revolved around what people perceived about the hazard, the likely consequences, what they knew about the warning, where they got their information from, how they behaved and why, and so forth. I have undertaken this work after the 2007 Solomon Islands, 2009 New Zealand, 2009 South Pacific, the February 2010 Chile, and March 2011 Japan tsunamis. I have now spoken to more than 800 people. Detailed research results will be presented elsewhere, but of relevance here, I have discovered that, to begin with, Australians have a reasonable and shared cultural knowledge of the potential catastrophic effects that tsunamis can have. They use terms such as “devastating; death; damage; loss; frightening; economic impact; societal loss; horrific; overwhelming and catastrophic.” Secondly, when I ask Australians about their sources of information about tsunamis, they describe the television (80%); Internet (85%); radio (25%); newspaper (35%); and social media including YouTube (65%). This tells me that the media are critical to underpinning knowledge of catastrophe and are a powerful transformative medium for the acquisition of knowledge. Thirdly, when asked about where people get information about live warning messages and alerts, Australians stated the “television (95%); Internet (70%); family and friends (65%).” Fourthly and significantly, when individuals were asked what they thought being caught in a tsunami would be like, responses included “fun (50%); awesome (75%); like in a movie (40%).” Fifthly, when people were asked about what they would do (i.e., their “stated behaviour”) during a real tsunami arriving at the coast, responses included “go down to the beach to swim/surf the tsunami (40%); go to the sea to watch (85%); video the tsunami and sell to the news media people (40%).”An independent and powerful representation of the disjunct between Australians’ knowledge of the catastrophic potential of tsunamis and their “negative” behavioral response can be found in viewing live television news coverage broadcast from Sydney beaches on the morning of Sunday 28 February 2010. The Chilean tsunami had taken more than 14 hours to travel from Chile to the eastern seaboard of Australia and the ATWS had issued an accurate warning and had correctly forecast the arrival time of the tsunami (approximately 08.30 am). The television and radio media had dutifully broadcast the warning issued by the State Emergency Services. The message was simple: “Stay out of the water, evacuate the beaches and move to higher ground.” As the tsunami arrived, those news broadcasts showed volunteer State Emergency Service personnel and Surf Life Saving Australia lifeguards “begging” with literally hundreds (probably thousands up and down the eastern seaboard of Australia) of members of the public to stop swimming in the incoming tsunami and to evacuate the beaches. On that occasion, Australians were lucky and the tsunami was inconsequential. What do these responses mean? Clearly Australians recognise and can describe the consequences of a tsunami. However, they are not associating the catastrophic nature of tsunami with their own lives or experience. They are avoiding or disallowing the reality; they normalise and dramaticise the event. Thus in Australia, to date, a cultural transformation about the catastrophic nature of tsunami has not occurred for reasons that are not entirely clear but are the subject of ongoing study.The Emergence of Tsunami as a “New Australian Catastrophe”?As a natural disaster expert with nearly two decades experience, in my mind tsunami has emerged as a “new Australian catastrophe.” I believe this has occurred for a number of reasons. Firstly, the 2004 IOT was devastating and did impact northwestern Australia, raising the flag on this hitherto, unknown threat. Australia is now known to be vulnerable to the tsunami catastrophe. The media have played a critical role here. Secondly, in the 2004 IOT and other tsunamis since, Australians have died and their deaths have been widely reported in the Australian media. Thirdly, the emergence of various forms of social media has facilitated an explosion in information and material that can be consumed, digested, reimagined, and normalised by Australians hungry for the gore of catastrophe—it feeds our desire for catastrophic death and destruction. Fourthly, catastrophe has been creatively imagined and retold for a story-hungry viewing public. Whether through regular television shows easily consumed from a comfy chair at home, or whilst eating popcorn at a cinema, tsunami catastrophe is being fed to us in a way that reaffirms its naturalness. Juxtaposed against this idea though is that, despite all the graphic imagery of tsunami catastrophe, especially images of dead children in other countries, Australian media do not and culturally cannot, display images of dead Australian children. Such images are widely considered too gruesome but are well known to drive changes in cultural behaviour because of the iconic significance of the child within our society. As such, a cultural shift has not yet occurred and so the potential of catastrophe remains waiting to strike. Fifthly and significantly, given the fact that large numbers of Australians have not died during recent tsunamis means that again, the catastrophic potential of tsunamis is not yet realised and has not resulted in cultural changes to more affirmative behaviour. Lastly, Australians are probably more aware of “regular or common” catastrophes such as floods and bush fires that are normal to the Australian climate system and which are endlessly experienced individually and culturally and covered by the media in all forms. The Australian summer of 2012–13 has again been dominated by floods and fires. If this idea is accepted, the media construct a uniquely Australian imaginary of catastrophe and cultural discourse of disaster. The familiarity with these common climate catastrophes makes us “culturally blind” to the catastrophe that is tsunami.The consequences of a major tsunami affecting Australia some point in the future are likely to be of a scale not yet comprehensible. References Australian Broadcasting Corporation (ABC). "ABC Net Splash." 20 Mar. 2013 ‹http://splash.abc.net.au/media?id=31077›. Brown, Philip, and Jessica Minty. “Media Coverage and Charitable Giving after the 2004 Tsunami.” Southern Economic Journal 75 (2008): 9–25. Bryant, Edward. Tsunami: The Underrated Hazard. First Edition, Cambridge: Cambridge UP, 2001. ———. Tsunami: The Underrated Hazard. Second Edition, Sydney: Springer-Praxis, 2008. Caldwell, Anna, Natalie Gregg, Fiona Hudson, Patrick Lion, Janelle Miles, Bart Sinclair, and John Wright. “Samoa Tsunami Claims Five Aussies as Death Toll Rises.” The Courier Mail 1 Oct. 2009. 20 Mar. 2013 ‹http://www.couriermail.com.au/news/samoa-tsunami-claims-five-aussies-as-death-toll-rises/story-e6freon6-1225781357413›. CDEMA. "The Caribbean Disaster Emergency Management Agency. Tsunami SMART Media Web Site." 18 Dec. 2012. 20 Mar. 2013 ‹http://weready.org/tsunami/index.php?Itemid=40&id=40&option=com_content&view=article›. Cox, Robin, Bonita Long, and Megan Jones. “Sequestering of Suffering – Critical Discourse Analysis of Natural Disaster Media Coverage.” Journal of Health Psychology 13 (2008): 469–80. “CSI: Miami (Season 3, Episode 7).” International Movie Database (IMDb). ‹http://www.imdb.com/title/tt0534784/›. 9 Jan. 2013. "CSI: Miami (Season 3)." Wikipedia. ‹http://en.wikipedia.org/wiki/CSI:_Miami_(season_3)#Episodes›. 21 Mar. 2013. DFAT. "Department of Foreign Affairs and Trade Annual Report 2004–2005." 8 Jan. 2013 ‹http://www.dfat.gov.au/dept/annual_reports/04_05/downloads/2_Outcome2.pdf›. Dominey-Howes, Dale. “Geological and Historical Records of Australian Tsunami.” Marine Geology 239 (2007): 99–123. Dominey-Howes, Dale, and Randy Thaman. “UNESCO-IOC International Tsunami Survey Team Samoa Interim Report of Field Survey 14–21 October 2009.” No. 2. Australian Tsunami Research Centre. University of New South Wales, Sydney. "Hereafter." International Movie Database (IMDb). ‹http://www.imdb.com/title/tt1212419/›. 9 Jan. 2013."Hereafter." Wikipedia. ‹http://en.wikipedia.org/wiki/Hereafter (film)›. 21 Mar. 2013. Hjorth, Larissa, and Yonnie Kyoung-hwa. “The Mourning After: A Case Study of Social Media in the 3.11 Earthquake Disaster in Japan.” Television and News Media 12 (2011): 552–59. ———, and Yonnie Kyoung-hwa. “Good Grief: The Role of Mobile Social Media in the 3.11 Earthquake Disaster in Japan.” Digital Creativity 22 (2011): 187–99. Lau, Joseph, Mason Lau, and Jean Kim. “Impacts of Media Coverage on the Community Stress Level in Hong Kong after the Tsunami on 26 December 2004.” Journal of Epidemiology and Community Health 60 (2006): 675–82. McCargo, Duncan, and Lee Hyon-Suk. “Japan’s Political Tsunami: What’s Media Got to Do with It?” International Journal of Press-Politics 15 (2010): 236–45. Miles, Brian, and Stephanie Morse. “The Role of News Media in Natural Disaster Risk and Recovery.” Ecological Economics 63 (2007): 365–73. Morgan, Olive, and Charles de Goyet. “Dispelling Disaster Myths about Dead Bodies and Disease: The Role of Scientific Evidence and the Media.” Revista Panamericana de Salud Publica-Pan American Journal of Public Health 18 (2005): 33–6. Olofsson, Anna. “The Indian Ocean Tsunami in Swedish Newspapers: Nationalism after Catastrophe.” Disaster Prevention and Management 20 (2011): 557–69. Piotrowski, Chris, and Terry Armstrong. “Mass Media Preferences in Disaster: A Study of Hurricane Danny.” Social Behavior and Personality 26 (1998): 341–45. Ploughman, Penelope. “The American Print News Media Construction of Five Natural Disasters.” Disasters 19 (1995): 308–26. Prendergast, Amy, and Nick Brown. “Far Field Impact and Coastal Sedimentation Associated with the 2006 Java Tsunami in West Australia: Post-Tsunami Survey at Steep Point, West Australia.” Natural Hazards 60 (2012): 69–79. Sharp, Joanne. “A Subaltern Critical Geopolitics of The War on Terror: Postcolonial Security in Tanzania.” Geoforum 42 (2011): 297–305. Sood, Rahul, Stockdale, Geoffrey, and Everett Rogers. “How the News Media Operate in Natural Disasters.” Journal of Communication 37 (1987): 27–41.

Since the late 1990s, W. G. Sebald’s innovative contribution to the genre of prose fiction has been the source of much academic scrutiny. His books Vertigo, The Rings of Saturn, The Emigrants and Austerlitz have provoked interest from diverse fields of inquiry: visual communication (Kilbourn; Patt; Zadokerski), trauma studies (Denham and McCulloh; Schmitz), and travel writing (Blackler; Zisselsberger). His work is also claimed to be a bastion for both modernist and postmodernist approaches to literature and history writing (Bere; Fuchs and Long; Long). This is in addition to numerous “guide to” type books, such as Mark McCulloh’s Understanding Sebald, Long and Whitehead’s W. G. Sebald—A Critical Companion, and the comprehensive Saturn’s Moons: A W. G. Sebald Handbook. Here I have only mentioned works available in English. I should point out that Sebald wrote in German, the country of his birth, and as one would expect much scholarship dealing with his work is confined to this language. In this article I focus on what is perhaps Sebald’s prototypical work, The Rings of Saturn. Of all Sebald’s prose fictional works The Rings of Saturn seems the example that best exhibits his innovative literary forms, including the use of lists. This book is the work of an author who is purposefully and imaginatively concerned with the nature of his vocation: what is it to be a writer? Crucially, he addresses this question not only from the perspective of a subject facing an existential crisis, but from the perspective of the documents created by writers. His works demonstrate a concern with the enabling role documents play in the thinking and writing process; how, for example, pen and paper are looped in with our capacity to reason in certain ways. Despite taking the form of fictional narratives, his books are as much motivated by a historical interest in how ideas and forms of organisation are transmitted, and how they evolve as part of an ecology; how humans become articulate within their surrounds, according to the contingencies of specific epochs and places. The Sebald critic J. J. Long accounts for this in some part in his description “archival consciousness,” which recommends that conscious experience is not simply located in the mind of a knowing, human subject, but is rather distributed between the subject and different technologies (among which writing and archives are exemplary).The most notable peculiarity of Sebald’s books lies in their abundant use of “non-syntactical” kinds of writing or inscription. My use of the term “non-syntactical” has its origins in the anthropological work of Jack Goody, who emphasises the importance of list making and tabulation in pre-literate or barely literate cultures. In Sebald’s texts, kinds of non-syntactical writing include lists, photographic images, tables, signatures, diagrams, maps, stamps, dockets and sketches. As I stress throughout this article, Sebald’s shifts between syntactical and non-syntactical forms of writing allows him to build up highly complex schemes of internal reference. Massimo Leone identifies something similar, when he notes that Sebald “orchestrates a multiplicity of voices and text-types in order to produce his own coherent discourse” (91). The play between multiplicity and coherence is at once a thematic and poetic concern for Sebald. This is to say, his texts are formal experiments with these contrasting tendencies, in addition to discussing specific historical situations in which they feature. The list is perhaps Sebald’s most widely used and variable form of non-syntactical writing, a key part of his formal and stylistic peculiarity. His lengthy sentences frequently spill over into catalogues and inventories, and the entire structure of his narratives is list-like. Discrete episodes accumulate alongside each other, rather than following a narrative arc where episodes of suspenseful gravity overshadow the significance of minor events. The Rings of Saturn details the travels of Sebald’s trademark, nameless, first person narrator, who recounts his trek along the Suffolk coastline, from Lowestoft to Ditchingham, about two years after the event. From the beginning, the narrative is framed as an effort to organise a period of time that lacks a coherent and durable form, a period of time that is in pieces, fading from the narrator’s memory. However, the movement from the chaos of forgetting to the comparatively distinct and stable details of the remembered present does not follow a continuum. Rather, the past and present are both constituted by the force of memory, which is continually crystallising and dissolving. Each event operates according to its own specific arrangement of emphasis and forgetting. Our experience of memory in the present, or recollective memory, is only one kind of memory. Sebald is concerned with a more pervasive kind of remembering, which includes the vectorial existence of non-conscious, non-human perceptual events; memory as expressed by crystals, tree roots, glaciers, and the nested relationship of fuel, fire, smoke, and ash. The Rings of Saturn is composed of ten chapters, each of which is outlined in table form at the book’s beginning. The first chapter appears as: “In hospital—Obituary—Odyssey of Thomas Browne’s skull—Anatomy lecture—Levitation—Quincunx—Fabled creatures—Urn burial.” The Rings of Saturn is of course hardly exceptional in its use of this device. Rather, it is exemplary concerning the repeated emphasis on the tension between syntactical and non-syntactical forms of writing, among which this chapter breakdown is included. Sebald continually uses the conventions of bookmaking in subtle though innovative ways. Each of these horizontally linked and divided indices might put the reader in mind of Thomas Browne’s urns, time capsules from the past, the unearthing of which is discussed in the book’s first chapter (25). The chapter outlines (and the urns) are containers that preserve a fragmentary and suggestive history. Each is a perspective on the narrator’s travels that abstracts, arranges, and uniquely refers to the narrative elaborations to come.As I have already stressed, Sebald is a writer concerned with forms of organisation. His works account for a diverse range of organisational forms, some of which instance an overt, chronological, geometric, or metrical manipulation of space and time, such as grids, star shapes, and Greenwich Mean Time. This contrasts with comparatively suggestive, insubstantial, mutable forms, including various meteorological phenomena such as cloudbanks and fog, dust and sand, and as exemplified in narrative form by the haphazard, distracted assemblage of events featured in dreams or dream logic. The relationship between these supposedly opposing tendencies is, however, more complex and paradoxical than might at first glance appear. As Sebald warily reminds us in his essay “A Little Excursion to Ajaccio,” despite our wishes to inhabit periods of complete freedom, where we follow our distractions to the fullest possible extent, we nonetheless “must all have some more or less significant design in view” (Sebald, Campo 4). It is not so much that we must choose, absolutely, between form and formlessness. Rather, the point is to understand that some seemingly inevitable forms are in fact subject to contingencies, which certain uses deliberately or ignorantly mask, and that simplicity and intricacy are often co-dependent. Richard T. Gray is a Sebald critic who has picked up on the element in Sebald’s work that suggests a tension between different forms of organisation. In his article “Writing at the Roche Limit,” Gray notes that Sebald’s tendency to emphasise the decadent aspects of human and natural history “is continually counterbalanced by an insistence on order and by often extremely subtle forms of organization” (40). Rather than advancing the thesis that Sebald is exclusively against the idea of systematisation or order, Gray argues that The Rings of Saturn models in its own textual make-up an alternative approach to the cognitive order(ing) of things, one that seeks to counter the natural tendency toward entropic decline and a fall into chaos by introducing constructive forces that inject a modicum of balance and equilibrium into the system as a whole. (Gray 41)Sebald’s concern with the contrasting energies exemplified by different forms extends to his play with syntactical and non-syntactical forms of writing. He uses lists to add contrast to his flowing, syntactically intricate sentences. The achievement of his work is not the exclusive privileging of either the list form or the well-composed sentence, but in providing contexts whereby the reader can appreciate subtle modulations between the two, thus experiencing a more dynamic and complex kind of narrative time. His works exhibit an astute awareness of the fact that different textual devices command different experiences of temporality, and our experience of temporality in good part determines our metaphysics. Here I consider two lists featured in The Rings of Saturn, one from the first chapter, and one from the last. Each shows contrasting tendencies concerning systems of organisation. Both are attributable to the work of Thomas Browne, “who practiced as a doctor in Norwich in the seventeenth century and had left a number of writings that defy all comparison” (Sebald, Rings 9). The Rings of Saturn is in part a dialogue across epochs with the sentiments expressed in Browne’s works, which, according to Bianca Theisen, preserve a kind of reasoning that is lost in “the rationalist and scientific embrace of a devalued world of facts” (Theisen 563).The first list names the varied “animate and inanimate matter” in which Browne identifies the quincuncial structure, a lattice like arrangement of five points and intersecting lines. The following phenomena are enumerated in the text:certain crystalline forms, in starfish and sea urchins, in the vertebrae of mammals and the backbones of birds and fish, in the skins of various species of snake, in the crosswise prints left by quadrupeds, in the physical shapes of caterpillars, butterflies, silkworms and moths, in the root of the water fern, in the seed husks of the sunflower and the Caledonian pine, within young oak shoots or the stem of the horse tail; and in the creations of mankind, in the pyramids of Egypt and the mausoleum of Augustus as in the garden of King Solomon, which was planted with mathematical precision with pomegranate trees and white lilies. (Sebald, Rings 20-21)Ostensibly quoting from Browne, Sebald begins the next sentence, “Examples might be multiplied without end” (21). The compulsion to list, or the compulsiveness expressed by listing, is expressed here in a relationship of dual utility with another, dominant or overt, kind of organisational form: the quincunx. It is not the utility or expressiveness of the list itself that is at issue—at least in the version of Browne’s work preserved here by Sebald. In W. G. Sebald: Image, Archive, Modernity, Long notes the historical correspondences and divergences between Sebald and Michel Foucault (2007). Long interprets Browne’s quincunx as exemplifying a “hermeneutics of resemblance,” whereby similarities among diverse phenomena are seen as providing proof of “the universal oneness of all things” (33). This contrasts with the idea of a “pathological nature, autonomous from God,” which, according to Long, informs Sebald’s transformation of Browne into “an avatar of distinctly modern epistemology” (38). Long follows Foucault in noting the distinction between Renaissance and modern epistemology, a distinction in good part due to the experimental, inductive method, the availability of statistical data, and probabilistic reasoning championed in the latter epoch (Whitehead; Hacking). In the book’s final chapter, Sebald includes a list from Browne’s imaginary library, the “Musæum Clausium.” In contrast to the above list, here Sebald seems to deliberately problematise any efforts to suggest an abstract uniting principle. There is no evident reason for the togetherness of the discrete things, beyond the mere fact that they happen to be gathered, hypothetically, in the text (Sebald, Rings 271-273). Among the library’s supposed contents are:an account by the ancient traveller Pytheas of Marseilles, referred to in Strabo, according to which all the air beyond thule is thick, condensed and gellied, looking just like sea lungs […] a dream image showing a prairie or sea meadow at the bottom of the Mediterranean, off the coat of Provence […] and a glass of spirits made of æthereal salt, hermetically sealed up, of so volatile a nature that it will not endure by daylight, and therefore shown only in winter or by the light of a carbuncle or Bononian stone. (Sebald, Rings 272-73)Unlike the previous example attributed to Browne, here the list coheres according to the tensions of its own coincidences. Sebald uses the list to create spontaneous organisations in which history is exhibited as a complex mix of fact and fantasy. More important than the distinction between the imaginary and the real is the effort to account for the way things uniquely incorporate aspects of the world in order to be what they are. Human knowledge is a perspective that is implicated in, rather than excluded from, this process.Lists move us to puzzle over the criteria that their togetherness implies. They might be used inthe service of a specific paradigm, or they might suggest an imaginable but as yet unknown kind of systematisation; a specific kind of relationship, or simply the possibility of a relationship. Take, for example, the list-like accumulation of architectural details in the following description of the decadent Sommerleyton Hall, featured in chapter II: There were drawing rooms and winter gardens, spacious halls and verandas. A corridor might end in a ferny grotto where fountains ceaselessly plashed, and bowered passages criss-crossed beneath the dome of a fantastic mosque. Windows could be lowered to open the interior onto the outside, and inside the landscape was replicated on the mirror walls. Palm houses and orangeries, the lawn like green velvet, the baize on the billiard tables, the bouquets of flowers in the morning and retiring rooms and in the majolica vases on the terrace, the birds of paradise and the golden peasants on the silken tapestries, the goldfinches in the aviaries and the nightingales in the garden, the arabesques in the carpets and the box-edged flower beds—all of it interacted in such a way that one had the illusion of complete harmony between the natural and the manufactured. (Sebald, Rings 33-34)This list shifts emphasis away from preconceived distinctions between the natural and the manufactured through the creation of its own unlikely harmony. It tells us something important about the way perception and knowledge is ordered in Sebald’s prose. Each encounter, or historically specific situation, is considered as though it were its own microworld, its own discrete, synecdochic realisation of history. Rather than starting from the universal or the meta-level and scaling down to the local, Sebald arranges historically peculiar examples that suggest a variable, contrasting and dynamic metaphysics, a motley arrangement of ordering systems that each aspire to but do not command universal applicability. In a comparable sense, Browne’s sepulchral urns of his 1658 work Urn Burial, which feature in chapter I, are time capsules that seem to create their own internally specific kind of organisation:The cremated remains in the urns are examined closely: the ash, the loose teeth, some long roots of quitch, or dog’s grass wreathed about the bones, and the coin intended for the Elysian ferryman. Browne records other objects known to have been placed with the dead, whether as ornament or utensil. His catalogue includes a variety of curiosities: the circumcision knives of Joshua, the ring which belonged to the mistress of Propertius, an ape of agate, a grasshopper, three-hundred golden bees, a blue opal, silver belt buckles and clasps, combs, iron pins, brass plates and brazen nippers to pull away hair, and a brass Jews harp that last sounded on the crossing over black water. (Sebald, Rings 25-26)Regardless of our beliefs concerning the afterlife, these items, preserved across epochs, solicit a sense of wonder as we consider what we might choose for company on our “last journey” (25). In death, the human body is reduced to a condition of an object or thing, while the objects that accompany the corpse seem to acquire a degree of potency as remnants that transcend living time. Life is no longer the paradigm through which to understand purpose. In their very difference from living things these objects command our fascination. Eric Santner coins the term “undeadness” to name the significance of this non-living agency in Sebald’s prose (Santner xx). Santner’s study places Sebald in a linage of German-Jewish writers, including Walter Benjamin, Franz Kafka, and Paul Celan, whose understanding of “the human” depends crucially on the concept of “the creature” or “creatureliness” (Santner 38-41). Like the list of items contained within Sommerleyton Hall, the above list accounts for a context in which ornament and utensil, nature and culture, are read according to their differentiated togetherness, rather than opposition. Death, it seems, is a universal leveller, or at least a different dimension in which symbol and function appear to coincide. Perhaps it is the unassuming and convenient nature of lists that make them enduring objects of historical interest. Lists are a form of writing to which we appeal for immediate mnemonic assistance. They lack the artifice of a sentence. While perhaps not as interesting in the present that is contemporary with their usefulness (a trip to the supermarket), with time lists acquire credibility due to the intimacy they share with mundane, diurnal concerns—due to the fact that they were, once upon a time, so useful. The significance of lists arrives anachronistically, when we look back and wonder what people were really up to, or what our own concerns were, relatively free from fanciful, stylistic adornment. Sebald’s democratic approach to different forms of writing means that lists sit alongside the esteemed poetic and literary efforts of Joseph Conrad, Algernon Swinburne, Edward Fitzgerald, and François René de Chateaubriand, all of whom feature in The Rings of Saturn. His books make the exclusive differences between literary and non-literary kinds of writing less important than the sense of dynamism that is elicited through a play of contrasting kinds of syntactical and non-syntactical writing. The book’s closing chapter includes a revealing example that expresses these sentiments. After tracing over a natural history of silk, with a particular focus on human greed and naivety, the narrative arrives at a “pattern book” that features strips of colourful silk kept in “the small museum of Strangers Hall” (Sebald, Rings 283). The narrator notes that the silks arranged in this book “were of a truly fabulous variety, and of an iridescent, quite indescribable beauty as if they had been produced by Nature itself, like the plumage of birds” (283). This effervescent declamation continues after a double page photograph of the pattern book, which is described as a “catalogue of samples” and “leaves from the only true book which none of our textual and pictorial works can even begin to rival” (286). Here we witness Sebald’s inclusive and variable understanding as to the kinds of thing a book, and writing, can be. The fraying strips of silk featured in the photograph are arranged one below the other, in the form of a list. They are surrounded by ornate handwriting that, like the strips of silk, seems to fray at the edges, suggesting the specific gestural event that occasioned the moment of their inscription—something which tends to be excluded in printed prose. Sebald’s remarks here are not without a characteristic irony (“the only true book”). However, in the greatercontext of the narrative, this comment suggests an important inclination. Namely, that there is much scope yet for innovative literary forms that capture the nuances and complexity of collective and individual histories. And that writing always includes, though to varying degrees obscures, contrasting tensions shared among syntactical and non-syntactical elements, including material and gestural contingencies. Sebald’s works remind us of what potentials might lay ahead for books if the question of what writing can be is asked continually as part of a writer’s enterprise.ReferencesBere, Carol. “The Book of Memory: W. G. Sebald’s The Emigrants and Austerlitz.” Literary Review, 46.1 (2002): 184-92.Blackler, Deane. Reading W. G. Sebald: Adventure and Disobedience. Rochester, New York: Camden House, 2007. Catling Jo, and Richard Hibbitt, eds. Saturn’s Moons: A W. G. Sebald Handbook. Oxford: Legenda, 2011.Denham, Scott and Mark McCulloh, eds. W. G. Sebald: History, Memory, Trauma. Berlin: Walter de Gruyter, 2006. Fuchs, Anne and J. J. Long, eds. W. G. Sebald and the Writing of History. Würzburg: Königshausen & Neumann, 2007. Goody, Jack. The Logic of Writing and the Organization of Society. Cambridge: Cambridge UP, 1986. Gray, Richard T. “Writing at the Roche Limit: Order and Entropy in W. G. Sebald’s The Rings of Saturn.” The German Quarterly 83.1 (2010): 38-57. Hacking, Ian. The Emergence of Probability: A Philosophical Study of Early Ideas about Probability, Induction and Statistical Inference. London: Cambridge UP, 1977.Kilbourn, Russell J. A. “Architecture and Cinema: The Representation of Memory in W. G. Sebald’s Austerlitz.” W. G. Sebald—A Critical Companion. Ed. J. J. Long and Anne Whitehead. Edinburgh: Edinburgh UP, 2004.Leone, Massimo. “Textual Wanderings: A Vertiginous Reading of W. G. Sebald.” W. G. Sebald—A Critical Companion. Ed. J. J. Long and A. Whitehead. Edinburgh: Edinburgh UP, 2004.Long, J. J. W. G. Sebald: Image, Archive, Modernity. New York: Columbia UP, 2007.Long, J. J., and Anne Whitehead, eds. W. G. Sebald—A Critical Companion. Edinburgh: Edinburgh U P, 2004. McCulloh, Mark. Understanding W. G. Sebald. Columbia, S. C.: U of South Carolina P, 2003.Patt, Lise, ed. Searching for Sebald: Photography After W. G. Sebald. Los Angeles: The Institute of Critical Inquiry and ICI Press, 2007. Sadokierski, Zoe. “Visual Writing: A Critique of Graphic Devices in Hybrid Novels from a Visual Communication Design Perspective.” Diss. University of Technology Sydney, 2010. Santner, Eric. On Creaturely Life: Rilke, Benjamin, Sebald. Chicago: U of Chicago P, 2006. Schmitz, Helmut. “Catastrophic History, Trauma and Mourning in W. G. Sebald and Jörg Friedrich.” The German Monitor 72 (2010): 27-50.Sebald, W. G. The Rings of Saturn. Trans. Michael Hulse. London: Harvill Press, 1998.---. Vertigo. Trans. Michael Hulse. London: Harvill Press, 1999.---. Campo Santo. Trans. Anthea Bell. London: Penguin Books, 2005. Print. Theisen, Bianca. “A Natural History of Destruction: W. G. Sebald’s The Rings of Saturn.” MLN, 121. The John Hopkins U P (2006): 563-81.Whitehead, Alfred North. Science and The Modern World. Cambridge: Cambridge UP, 1932.Zisselsberger, Markus. The Undiscover’d Country: W. G. Sebald and the Poetics of Travel. Rochester, NY: Camden House, 2010.

Introduction Australia has embraced Barbie since the doll was launched at the Toy Fair in Melbourne in 1964, with Mattel Australia established in Melbourne in 1969. Barbie was initially sold in Australia with two different hairstyles and 36 separately boxed outfits. As in the US, the initial launch range was soon followed by a constant stream of additional outfits as well as Barbie’s boyfriend Ken and little sister Skipper, pets, and accessories including her dreamhouse and vehicles. Also released were variously themed Barbies (including those representing different careers and nationalities) and a seemingly ever-expanding group of friends (Gerber; Lord, Forever). These product releases were accompanied by marketing, promotion, and prominent placement in toy, department, and other stores that kept the Barbie line in clear sight of Australian consumers (Hosany) and in the forefront of toy sales for many decades (Burnett). This article focusses on a thread of subversion operating alongside the purchase of these Barbie dolls in Australia, when the phenomenon of handmade ‘do-it-yourself’ intersected with the dolls in the second half of the 1960s. Do-It-Yourself ‘Do-it-yourself’ (often expressed as DIY) has been defined as “anything that people did for themselves” (Gelber 283). The history of DIY has been researched in academic disciplines including sociology, cultural studies, musicology, architecture, marketing, and popular culture. This literature charts DIY practice across such domestic production as making clothes, furniture, and toys, growing food, and home improvements including renovating and even building entire houses (Carter; Fletcher) to more externally facing cultural production including music, art, and publications (Spencer). While DIY behaviour can be motivated by such factors as economic necessity or financial benefit, a lack of product availability or its perceived poor quality, and/or a desire for customisation, it can also be linked to the development of personal identity (Wolf and McQuitty; Williams, “A Lifestyle”; Williams, “Re-thinking”). While some mid-century considerations of DIY as a phenomenon were male-focussed (“Do-It”), women and girls were certainly also active at this time in home renovation, house building, and other projects (‘Arona’), as well as more traditionally gendered handicraft activities such as sewing and knitting. Fig. 1: Australian Home Beautiful magazine cover, November 1958, showing a woman physically engaged in home renovation activities. Australia has a long tradition of women crafting (by sewing, knitting, and crocheting, for instance) items of clothing for themselves and their families, as well as homewares such as waggas (utilitarian quilts made of salvaged or other inexpensive materials such as old blankets and grain sacks) and other quilts (Burke; Gero; Kingston; Thomas). This making was also prompted by a range of reasons, including economic or other necessity and/or the pursuit of creative pleasure, personal wellbeing, or political activism (Fletcher; Green; Lord, Vintage). It is unsurprising, then, that many have also turned their hands to making dolls’ clothes from scraps of fabrics, yarns, ribbons, and other domestic materials, as well as creating entire dolls’ houses complete with furniture and other domestic items (Benson). In the late eighteenth and nineteenth centuries, many Australian dolls themselves were handmade, with settlers and migrants importing European traditions of doll-making and clothing with them (Cramer). In the early twentieth century, mass-produced dolls and clothing became more available and accessible, however handmade dolls’ clothes continued to be made and circulated within families (Elvin and Elvin, The Art; Elvin and Elvin, The Australian). An article in the Weekly in 1933 contained instructions for making both cloth dolls and clothes for them (“Home-Made”), with many such articles to follow. While the 1960s saw increased consumer spending in Australia, this research reveals that this handmade, DIY ethos (at least in relation to dolls) continued through this decade, and afterwards (Carter; Wilson). This making is documented in artefacts in museum and private collections and instructions in women’s magazines, newspapers, and other printed materials including commercially produced patterns and kits. The investigation scans bestselling women’s magazine The Australian Women’s Weekly (the Weekly) and other Australian print media from the 1960s that are digitised in the National Library of Australia’s Trove database for evidence of interest in this practice. Do-It-Yourself Barbie Doll Patterns for Barbie clothes appeared in Australian women’s magazines almost immediately after the doll was for sale in Australia, including in the Weekly from 1965. The first feature included patterns for a series of quite elaborate outfits: a casual knitted jumpsuit with hooded jacket, a knitted three-piece suit of skirt, roll-necked jumper and jacket, a crocheted afternoon dress, tied with a ribbon belt and accessorised with a knitted coat and beret, and a crocheted full length evening gown and opera coat (“Glamorous”). A sense of providing the Weekly’s trusted guidance but also a reliance on makers’ individuality was prominent in this article. Although detailed instructions were provided in the feature above, for example, readers were also encouraged to experiment with yarns and decorative elements. Fig. 2: Crocheted and knitted ‘afternoon ensemble’ in “Glamorous Clothes for Teenage Dolls” feature in the Weekly, 1965. Another richly illustrated article published in 1965 focussed on creating high fashion wigs for Barbie at home. The text and photographs guided readers through the process of crafting five differently styled wigs from one synthetic hair piece: a “romantic, dreamy” Jean Shrimpton-style coiffure, deep-fringed Sassoon hairdo, layered urchin cut, low set evening bun, and pair of pigtails (Irvine, “How”). Again, makers were encouraged to express their creativity and individuality in decorating these hairstyles, with suggestions (but not directions) to personalise these styles using ribbons, tiny bows and artificial flowers, coloured pins, seed pearls, and other objects that might be to hand. Fig. 3: Detailed instructions for creating one of the wigs. Three Barbie dolls (identified as ‘teen dolls’ rather than by the brand) were featured on the cover of the Weekly on 5 January 1966, for a story about making dolls’ outfits from handkerchiefs (Irvine, “New”). This was framed as a “novel” way to use the excess of fancy hankies often received at Christmas, promising that the three ensembles could thriftily and cleverly be made from three handkerchiefs in a few hours. The instructions detail how to make a casual two-piece summer outfit accessorised with a headscarf, a smart town ensemble highlighted with flower motifs cut from broderie anglaise, and a lavish evening gown. Readers were assured this would be an engaging, “marvellous fun” as well as creative activity, as each maker needed to individually design each garment in terms of working with the individual features of the handkerchiefs they had, incorporating such elements as floral or other borders, lace edging, and overall patterns such as spots or checks (Irvine, “New”). The long-sleeved evening gown was quite an ambitious project. The gown was not only fashioned from a fine Irish linen, lace-bordered hankie, meaning some of the cutting and sewing required considerable finesse, but the neckline and hemline were then hand-beaded, as were a circlet of tiny pearls to be worn around the doll’s hair. Such delicacy was required for all outfits, with armholes and necklines for Barbie dolls very small, requiring considerable dexterity in cutting, sewing, and finishing. Fig. 4: Cover of The Australian Women’s Weekly of 5 January 1966 featuring three Barbie dolls. Only two issues later, the magazine ran another Barbie-focussed feature, this time about using oddments found around the home to make accessories for Barbie dolls. Again, the activity is promoted as thrifty and creative: “make teen doll outfits and accessories economically—all you need is imagination and a variety of household oddments” (“Turn”). Included in the full coloured article is a ‘hula’ costume made from a short length of green silk fringe and little artificial flowers sewn together, hats fashioned from a bottle top and silk flower decorated with scraps of lace and ribbon, a cardboard surfboard, aluminium foil and ice cream stick skis, and miniature ribbon-wound coat hangers. This article ended with an announcement commonly associated with calls for readers’ recipes: “what clever ideas have you got? … we will award £5 for every idea used” (“Turn”). This was a considerable prize, representing one-third of the average minimum weekly wage for full-time female workers in Australia in 1966 (ABS 320). Fig. 5: Brightly coloured illustrations making the Weekly’s “Turn Oddments into Gay Accessories”, 1966, a joyful read. This story was reinforced with a short ‘behind the scenes’ piece, which revealed the care and energy that went into its production. This reported that, when posing the ‘hulagirl’ on a fountain in Sydney’s Hyde Park, the doll fell in. While her skirt was rescued by drying in front of a fan, the dye from her lei ran and had to be scrubbed off the doll with abrasive sandsoap and the resulting stain then covered up with make-up. After the photographer built the set (inside this time), the shoot was finally completed (“The Doll”). A week later, the Weekly advertised a needlework kit for three new outfits: a beach ensemble of yellow bikini and sundress, red suit with checked blouse, and blue strapless evening gown. The garment components, with indicated gathering, seam, stitching, and cutting lines, were stamped onto a piece of fine cotton. The kit also included directions “simple enough for the young beginner seamstress” (“Teenage Doll’s”). Priced at 8/6 (85¢ in the new decimal currency introduced that year) including postage, this was a considerable saving when compared to the individual Mattel-branded clothing sets which were sold for sums ranging from 13/6 to 33/6 in 1964 (Burnett). Reader demand for these kits was so high that the supplier was overwhelmed and the magazine had to print an apology regarding delays in dispatching orders (“The Weekly”). Fig. 6: Cotton printed with garments to cut out and sew together and resulting outfits from the Weekly’s “Teenage Doll’s Wardrobe” feature, 1966. This was followed by another kit offer later in the year, this time explicitly promoted to both adult and “little girl” needleworkers. Comprising “cut out, ready to sew [material pieces] … and easy-to-follow step-by-step instructions”, this kit made an embroidered white party dress with matching slip and briefs, checked shorts and top set, and long lace and net trimmed taffeta bridesmaid dress and underclothes (“Three”). Again, at $1.60 for the kit (including postage), this was much more economical (and creative) than purchasing such outfits ready-made. Fig. 7: Party dress from “Three Lovely Outfits for Teenage Dolls” article in the Weekly, 1966. Making dolls’ clothes was an educationally sanctioned activity for girls in Australia, with needlecraft and other home economics subjects commonly taught in schools as a means of learning domestic and professionally transferable skills until the curriculum reforms of the 1970s onwards (Campbell; Cramer; Issacs). In Australia in the 1960s, Barbie dolls (and their clothing and furniture) were recommended for girls aged nine-years-old and older (Dyson), while older girls obviously also continued to interact with the dolls. A 1968 article in the Weekly, for example, praised a 13-year-old girl’s efforts in reinterpreting an adult dress pattern that had appeared in the magazine and sewing this for her Barbie (Dunstan; Forde). It was also suggested that the dolls could be used by girls who designed their own clothes but did not have a full-sized dressmaker’s model, with the advice to use a Barbie model to test a miniature of the design before making up a full-sized garment (“Buy”). Making Things for Barbie Dolls By 9 February 1966, the ‘using oddments’ contest had closed and the Weekly filled two pages with readers’ “resourceful” ideas (“Prizewinning”). These used such domestic bits and pieces as string, wire, cord, cotton reels, egg cartons, old socks, toothpicks, dried leaves, and sticky tape to create a range of Barbie accessories including a mob cap from a doily, hair rollers from cut drinking straws and rubber bands, and a suitcase from a plastic soap container with gold foil locks. A party dress and coat were fashioned from an out-of-date man’s tie and a piece of elastic. There was even a pipe cleaner dog and cardboard guitar. A month later, fifty more winning entries were published in a glossy, eight-page colour insert booklet. This included a range of clothing, accessories, and furniture which celebrated that “imagination and ingenuity, rather than dollars and cents” could equip a teen doll “for any occasion” (“50 Things”, 1). Alongside day, casual, and evening outfits, rainwear, underwear, jewellery, hats, sunglasses, footwear, a beauty case, hat boxes, and a shopping trolley and bags, readers submitted a skilfully fashioned record player with records in a stand as well as a barbeque crafted from tiny concrete blocks, sun lounge, and deckchairs. Miniature accessories included a hairdryer and lace tissue holder with tiny tissues and a skindiving set comprising mask, snorkel, and flippers. The wide variety of negligible-cost materials utilised and how these were fashioned for high effect is as interesting as the results are charming. Fig. 8: Cover of insert booklet of the entries of the 50 winners of the Weekly’s making things for Barbie from oddments competition, 1966. That women were eager to learn to make these miniature fashions and other items is evidenced by some Country Women’s Association groups holding handicraft classes on making clothes and accessories for Barbie dolls (“CWA”). That they were also eager to share the results with others is revealed in how competitions to dress teenage dolls in handmade outfits rapidly also became prominent features of Australian fetes, fairs, agricultural shows, club events, and other community fundraising activities in the 1960s (“Best”; “Bourke”; “Convent”; “Fierce”; “Frolic”; “Gala”; “Guide”; “Measles”; “Parish”; “Personal”; “Pet”; “Present”, “Purim”; “Successful”; “School Fair”; “School Fair Outstanding”; “School Fete”; “Weather”; Yennora”). Dressing Barbie joined other traditional categories such as those to dress baby, bride, national, and bed dolls (the last those dolls dressed in elaborate costumes designed as furniture decorations rather than toys). The teenage doll category at one primary school fete in rural New South Wales in 1967 was so popular that it attracted 50 entries, with many entries in this and other such competitions submitted by children (“Primary”). As the dolls became more prominent, the categories using them became more imaginative, with prizes for Barbie doll tea parties (“From”), for example. The category of dressing Barbie also became segmented with separate prizes for Barbie bride dolls, both sewn and knitted outfits (“Hobby and Pet”) and day, evening, and sports clothes (“Church”). There is no evidence from the sources surveyed that any of this making concentrated on producing career-focussed outfits for Barbie. Do-It-Yourself Ethos A do-it-yourself ethos was evident across the making discussed above. This refers to the possession of attitudes or philosophies that encourage undertaking activities or projects that involve relying on one’s own skills and resources rather than consuming mass-produced goods or using hired professionals or their services. This draws on, and develops, a sense of self-reliance and independence, and uses and enhances problem-solving skills. Creativity is central in terms of experimentation with new ideas, repurposing materials, or finding unconventional solutions to challenges. While DIY projects are often pursued independently and customised to personal preferences, makers also often collaboratively draw on, and share, expertise and resources (Wilson). It is important to note that the Weekly articles discussed above were not disguised advertorials for Barbie dolls or other Mattel products with, throughout the 1960s, the Barbies illustrated in the magazine referred to as ‘teen dolls’ or ‘teenage dolls’. However, despite this and the clear DIY ethos at work, women in Australia could, and did, make such Barbie-related items as commercial ventures. This included local artisanal dressmaking businesses that swiftly added made-to-measure Barbie doll clothes to their ranges (“Arcade”). Some enterprising women sold outfits and accessories they had made through various non-store venues including at home-based parties (“Hobbies”), in the same way as Tupperware products had been sold in Australia since 1961 (Truu). Other women sought sewing, knitting, or crocheting work specifically for Barbie doll clothes in the ‘Work wanted’ classified advertisements at this time (‘Dolls’). Conclusion This investigation has shown that the introduction of the Barbie doll unleashed more than consumer spending in Australia. Alongside purchases of the branded doll, clothes, and associated merchandise, Australians (mostly, but not exclusively, women and girls) utilised (and developed) their skills in sewing, knitting, crochet, and other crafts to make clothes for Barbie. They also displayed significant creativity and ingenuity in using domestic oddments and scraps to craft fashion accessories ranging from hats and bags to sunglasses as well as furniture and many of the other accoutrements of daily life in the second half of the 1960s in Australia. This making appears to have been prompted by a range of motivations including thrift and the real pleasures gained in crafting these miniature garments and objects. While the reception of these outfits and other items is not recorded in the publications sourced during this research, this scan of the Weekly and other publications revealed that children did love these dolls and value their wardrobes. In a description of the effects of a sudden, severe flood which affected her home south of Cairns in North Queensland, for instance, one woman described how amid the drama and terror, one little girl she knew packed up only “her teenage doll and its clothes” to take with her (Johnstone 9). The emotional connection felt to these dolls and handcrafted clothes and other objects is a rich area for research which is outside the scope of this article. Whether adult production was all ultimately intended to be gifted (or purchased) for children, or whether some was the work of early adult Barbie collectors, is also outside the scope of the research conducted for this project. As most of the evidence for this article was sourced from The Australian Women’s Weekly, a similarly close study of other magazines during the 1960s, and of whether any DIY clothing for Barbie also included career-focussed outfits, would add more information and nuance to these findings. This investigation has also concentrated on what happened in Australia during the second half of the 1960s, rather than in following decades. It has also not examined the DIY phenomenon of salvaging and refurbishing damaged Barbie dolls or otherwise altering and customising their appearance in the Australian context. These topics, as well as a full exploration of how women used Barbie dolls in their own commercial ventures, are all rich fields for further research both in terms of practice in Australia and how they were represented in popular and other media. Alongside the global outpouring of admiration for Barbie as a global icon and the success of the recent live action Barbie movie (Aguirre; Derrick), significant scholarship and other commentary have long criticised what Barbie has presented, and continues to present, to the world in terms of her body shape, race, activities, and career choices (Tulinski), as well as the pollution generated by the production and disposal of these dolls (“Feminist”; Pears). An additional line of what can be identified as resistance to the consumer-focussed commercialism of Barbie, in terms of making her clothes and accessories, seems to be connected to do-it-yourself culture. The exploration of handmade Barbie doll clothes and accessories in this article reveals, however, that what may at first appear to reflect a simple anti-commercial, frugal, ‘make do’ approach is more complex in terms of how it intersects with real people and their activities. 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Truu, Maani. “The Rise and Fall of Tupperware’s Plastic Empire and the Die-Hard Fans Desperate to Save It.” ABC News 16 Apr. 2023. 7 Apr. 2024 <https://www.abc.net.au/news/2023-04-16/tupperware-plastic-container-inspired-generations-of-fans/102224914>. Tulinski, Hannah. “Barbie as Cultural Compass: Embodiment, Representation, and Resistance Surrounding the World’s Most Iconized Doll.” Hons. Diss. Worchester: College of the Holy Cross, 2017. “Turn Oddments into Gay Accessories.” The Australian Women’s Weekly 19 Jan. 1966: 3. “Weather Crowns Tenth Lock Show Success.” Port Lincoln Times 29 Sep. 1966: 15. Williams, Colin C. “A Lifestyle Choice? Evaluating the Motives of Do-It-Yourself (DIY) Consumers.” International Journal of Retail & Distribution Management 32.5 (2004): 270–78. ———. “Re-Thinking The Motives of Do-It-Yourself (DIY) Consumers.” The International Review of Retail, Distribution and Consumer Research 18.3 (2008): 311–23. Wilson, Katherine. Tinkering: Australians Reinvent DIY Culture. Clayton: Monash UP, 2017. Wolf, Marco, and Shaun McQuitty. “Understanding the Do-It-Yourself Consumer: DIY Motivations and Outcomes.” Academy of Market Science Review 1 (2011): 154–70. “Yennora Pupils’ Show Results.” The Broadcaster 25 Jul. 1967: 2.

Special Care NoticeThis article discusses trauma and violence inflicted upon the Indigenous peoples of Tasmania through the processes of colonisation. Content within this article may be distressing to some readers. IntroductionThis article looks briefly at the collection, consultation, and digital sharing of stories essential to the histories of the First Nations peoples of Australia. Focusing on materials held in Sydney, New South Wales two case studies—the object known as the Proclamation Board and the George Augustus Robinson Papers—explore how materials can be shared with Aboriginal peoples of the region now known as Tasmania. Specifically, the authors of this article (a Palawa man and an Australian woman of European descent) ask how can the idea of the privileging of Indigenous voices, within Eurocentric cultural collections, be transformed from rhetoric to reality? Moreover, how can we navigate this complex work, that is made even more problematic by distance, through the utilisation of knowledge networks which are geographically isolated from the collections holding stories crucial to Indigenous communities? In seeking to answer these important questions, this article looks at how cultural, emotional, and intellectual ownership can be divested from the physical ownership of a collection in a way that repatriates—appropriately and sensitively—stories of Aboriginal Australia and of colonisation. Holding Stories, Not Always Our OwnCultural institutions, including libraries, have, in recent years, been drawn into discussions centred on the notion of digital disruption and “that transformative shift which has seen the ongoing realignment of business resources, relationships, knowledge, and value both facilitating the entry of previously impossible ideas and accelerating the competitive impact of those same impossible ideas” (Franks and Ensor n.p.). As Molly Brown has noted, librarians “are faced, on a daily basis, with rapidly changing technology and the ways in which our patrons access and use information. Thus, we need to look at disruptive technologies as opportunities” (n.p.). Some innovations, including the transition from card catalogues to online catalogues and the provision of a wide range of electronic resources, are now considered to be business as usual for most institutions. So, too, the digitisation of great swathes of materials to facilitate access to collections onsite and online, with digitising primary sources seen as an intermediary between the pillars of preserving these materials and facilitating access for those who cannot, for a variety of logistical and personal reasons, travel to a particular repository where a collection is held.The result has been the development of hybrid collections: that is, collections that can be accessed in both physical and digital formats. Yet, the digitisation processes conducted by memory institutions is often selective. Limited resources, even for large-scale digitisation projects usually only realise outcomes that focus on making visually rich, key, or canonical documents, or those documents that are considered high use and at risk, available online. Such materials are extracted from the larger full body of records while other lesser-known components are often omitted. Digitisation projects therefore tend to be devised for a broader audience where contextual questions are less central to the methodology in favour of presenting notable or famous documents online only. Documents can be profiled as an exhibition separate from their complete collection and, critically, their wider context. Libraries of course are not neutral spaces and this practice of (re)enforcing the canon through digitisation is a challenge that cultural institutions, in partnerships, need to address (Franks and Ensor n.p.). Indeed, our digital collections are as affected by power relationships and the ongoing impacts of colonisation as our physical collections. These power relationships can be seen through an organisation’s “processes that support acquisitions, as purchases and as the acceptance of artefacts offered as donations. Throughout such processes decisions are continually made (consciously and unconsciously) that affect what is presented and actively promoted as the official history” (Thorpe et al. 8). While it is important to acknowledge what we do collect, it is equally important to look, too, at what we do not collect and to consider how we continually privilege and exclude stories. Especially when these stories are not always our own, but are held, often as accidents of collecting. For example, an item comes in as part of a larger suite of materials while older, city-based institutions often pre-date regional repositories. An essential point here is that cultural institutions can often become comfortable in what they collect, building on existing holdings. This, in turn, can lead to comfortable digitisation. If we are to be truly disruptive, we need to embrace feeling uncomfortable in what we do, and we need to view digitisation as an intervention opportunity; a chance to challenge what we ‘know’ about our collections. This is especially relevant in any attempts to decolonise collections.Case Study One: The Proclamation BoardThe first case study looks at an example of re-digitisation. One of the seven Proclamation Boards known to survive in a public collection is held by the Mitchell Library, State Library of New South Wales, having been purchased from Tasmanian collector and photographer John Watt Beattie (1859–1930) in May 1919 for £30 (Morris 86). Why, with so much material to digitise—working in a program of limited funds and time—would the Library return to an object that has already been privileged? Unanswered questions and advances in digitisation technologies, created a unique opportunity. For the First Peoples of Van Diemen’s Land (now known as Tasmania), colonisation by the British in 1803 was “an emotionally, intellectually, physically, and spiritually confronting series of encounters” (Franks n.p.). Violent incidents became routine and were followed by a full-scale conflict, often referred to as the Black War (Clements 1), or more recently as the Tasmanian War, fought from the 1820s until 1832. Image 1: Governor Arthur’s Proclamation to the Aborigines, ca. 1828–1830. Image Credit: Mitchell Library, State Library of New South Wales, Call No.: SAFE / R 247.Behind the British combatants were various support staff, including administrators and propagandists. One of the efforts by the belligerents, behind the front line, to win the war and bring about peace was the production of approximately 100 Proclamation Boards. These four-strip pictograms were the result of a scheme introduced by Lieutenant Governor George Arthur (1784–1854), on the advice of Surveyor General George Frankland (1800–38), to communicate that all are equal under the rule of law (Arthur 1). Frankland wrote to Arthur in early 1829 to suggest these Proclamation Boards could be produced and nailed to trees (Morris 84), as a Eurocentric adaptation of a traditional method of communication used by Indigenous peoples who left images on the trunks of trees. The overtly stated purpose of the Boards was, like the printed proclamations exhorting peace, to assert, all people—black and white—were equal. That “British Justice would protect” everyone (Morris 84). The first strip on each of these pictogram Boards presents Indigenous peoples and colonists living peacefully together. The second strip shows “a conciliatory handshake between the British governor and an Aboriginal ‘chief’, highly reminiscent of images found in North America on treaty medals and anti-slavery tokens” (Darian-Smith and Edmonds 4). The third and fourth strips depict the repercussions for committing murder (or, indeed, any significant crime), with an Indigenous man hanged for spearing a colonist and a European man hanged for shooting an Aboriginal man. Both men executed in the presence of the Lieutenant Governor. The Boards, oil on Huon pine, were painted by “convict artists incarcerated in the island penal colony” (Carroll 73).The Board at the State Library of New South Wales was digitised quite early on in the Library’s digitisation program, it has been routinely exhibited (including for the Library’s centenary in 2010) and is written about regularly. Yet, many questions about this small piece of timber remain unanswered. For example, some Boards were outlined with sketches and some were outlined with pouncing, “a technique [of the Italian Renaissance] of pricking the contours of a drawing with a pin. Charcoal was then dusted on to the drawing” (Carroll 75–76). Could such a sketch or example of pouncing be seen beneath the surface layers of paint on this particular Board? What might be revealed by examining the Board more closely and looking at this object in different ways?An important, but unexpected, discovery was that while most of the pigments in the painting correlate with those commonly available to artists in the early nineteenth century there is one outstanding anomaly. X-ray analysis revealed cadmium yellow present in several places across the painting, including the dresses of the little girls in strip one, uniform details in strip two, and the trousers worn by the settler men in strips three and four (Kahabka 2). This is an extraordinary discovery, as cadmium yellows were available “commercially as an artist pigment in England by 1846” and were shown by “Winsor & Newton at the 1851 Exhibition held at the Crystal Palace, London” (Fiedler and Bayard 68). The availability of this particular type of yellow in the early 1850s could set a new marker for the earliest possible date for the manufacture of this Board, long-assumed to be 1828–30. Further, the early manufacture of cadmium yellow saw the pigment in short supply and a very expensive option when compared with other pigments such as chrome yellow (the darker yellow, seen in the grid lines that separate the scenes in the painting). This presents a clearly uncomfortable truth in relation to an object so heavily researched and so significant to a well-regarded collection that aims to document much of Australia’s colonial history. Is it possible, for example, the Board has been subjected to overpainting at a later date? Or, was this premium paint used to produce a display Board that was sent, by the Tasmanian Government, to the 1866 Intercolonial Exhibition in Melbourne? In seeking to see the finer details of the painting through re-digitisation, the results were much richer than anticipated. The sketch outlines are clearly visible in the new high-resolution files. There are, too, details unable to be seen clearly with the naked eye, including this warrior’s headdress and ceremonial scarring on his stomach, scars that tell stories “of pain, endurance, identity, status, beauty, courage, sorrow or grief” (Australian Museum n.p.). The image of this man has been duplicated and distributed since the 1830s, an anonymous figure deployed to tell a settler-centric story of the Black, or Tasmanian, War. This man can now be seen, for the first time nine decades later, to wear his own story. We do not know his name, but he is no longer completely anonymous. This image is now, in some ways, a portrait. The State Library of New South Wales acknowledges this object is part of an important chapter in the Tasmanian story and, though two Boards are in collections in Tasmania (the Tasmanian Museum and Art Gallery, Hobart and the Queen Victoria Museum and Art Gallery, Launceston), each Board is different. The Library holds an important piece of a large and complex puzzle and has a moral obligation to make this information available beyond its metropolitan location. Digitisation, in this case re-digitisation, is allowing for the disruption of this story in sparking new questions around provenance and for the relocating of a Palawa warrior to a more prominent, perhaps even equal role, within a colonial narrative. Image 2: Detail, Governor Arthur’s Proclamation to the Aborigines, ca. 1828–1830. Image Credit: Mitchell Library, State Library of New South Wales, Call No.: SAFE / R 247.Case Study Two: The George Augustus Robinson PapersThe second case study focuses on the work being led by the Indigenous Engagement Branch at the State Library of New South Wales on the George Augustus Robinson (1791–1866) Papers. In 1829, Robinson was granted a government post in Van Diemen’s Land to ‘conciliate’ with the Palawa peoples. More accurately, Robinson’s core task was dispossession and the systematic disconnection of the Palawa peoples from their Country, community, and culture. Robinson was a habitual diarist and notetaker documenting much of his own life as well as the lives of those around him, including First Nations peoples. His extensive suite of papers represents a familiar and peculiar kind of discomfort for Aboriginal Australians, one in which they are forced to learn about themselves through the eyes and words of their oppressors. For many First Nations peoples of Tasmania, Robinson remains a violent and terrible figure, but his observations of Palawa culture and language are as vital as they are problematic. Importantly, his papers include vibrant and utterly unique descriptions of people, place, flora and fauna, and language, as well as illustrations revealing insights into the routines of daily life (even as those routines were being systematically dismantled by colonial authorities). “Robinson’s records have informed much of the revitalisation of Tasmanian Aboriginal culture in the twentieth century and continue to provide the basis for investigations of identity and deep relationships to land by Aboriginal scholars” (Lehman n.p.). These observations and snippets of lived culture are of immense value to Palawa peoples today but the act of reading between Robinson’s assumptions and beyond his entrenched colonial views is difficult work.Image 3: George Augustus Robinson Papers, 1829–34. Image Credit: Mitchell Library, State Library of New South Wales, A 7023–A 7031.The canonical reference for Robinson’s archive is Friendly Mission: The Tasmanian Journals and Papers of George Augustus Robinson, 1829–1834, edited by N.J.B. Plomley. The volume of over 1,000 pages was first published in 1966. This large-scale project is recognised “as a monumental work of Tasmanian history” (Crane ix). Yet, this standard text (relied upon by Indigenous and non-Indigenous researchers) has clearly not reproduced a significant percentage of Robinson’s Tasmanian manuscripts. Through his presumptuous truncations Plomley has not simply edited Robinson’s work but has, quite literally, written many Palawa stories out of this colonial narrative. It is this lack of agency in determining what should be left out that is most troubling, and reflects an all-too-familiar approach which libraries, including the State Library of New South Wales, are now urgently trying to rectify. Plomley’s preface and introduction does not indicate large tranches of information are missing. Indeed, Plomley specifies “that in extenso [in full] reproduction was necessary” (4) and omissions “have been kept to a minimum” (8). A 32-page supplement was published in 1971. A new edition, including the supplement, some corrections made by Plomley, and some extra material was released in 2008. But much continues to be unknown outside of academic circles, and far too few Palawa Elders and language revival workers have had access to Robinson’s original unfiltered observations. Indeed, Plomley’s text is linear and neat when compared to the often-chaotic writings of Robinson. Digitisation cannot address matters of the materiality of the archive, but such projects do offer opportunities for access to information in its original form, unedited, and unmediated.Extensive consultation with communities in Tasmania is underpinning the digitisation and re-description of a collection which has long been assumed—through partial digitisation, microfilming, and Plomley’s text—to be readily available and wholly understood. Central to this project is not just challenging the canonical status of Plomley’s work but directly challenging the idea non-Aboriginal experts can truly understand the cultural or linguistic context of the information recorded in Robinson’s journals. One of the more exciting outcomes, so far, has been working with Palawa peoples to explore the possibility of Palawa-led transcriptions and translation, and not breaking up the tasks of this work and distributing them to consultants or to non-Indigenous student groups. In this way, people are being meaningfully reunited with their own histories and, crucially, given first right to contextualise and understand these histories. Again, digitisation and disruption can be seen here as allies with the facilitation of accessibility to an archive in ways that re-distribute the traditional power relations around interpreting and telling stories held within colonial-rich collections.Image 4: Detail, George Augustus Robinson Papers, 1829–34. Image Credit: Mitchell Library, State Library of New South Wales, A 7023–A 7031.As has been so brilliantly illustrated by Bruce Pascoe’s recent work Dark Emu (2014), when Aboriginal peoples are given the opportunity to interpret their own culture from the colonial records without interference, they are able to see strength and sophistication rather than victimhood. For, to “understand how the Europeans’ assumptions selectively filtered the information brought to them by the early explorers is to see how we came to have the history of the country we accept today” (4). Far from decrying these early colonial records Aboriginal peoples understand their vital importance in connecting to a culture which was dismantled and destroyed, but importantly it is known that far too much is lost in translation when Aboriginal Australians are not the ones undertaking the translating. ConclusionFor Aboriginal Australians, culture and knowledge is no longer always anchored to Country. These histories, once so firmly connected to communities through their ancestral lands and languages, have been dispersed across the continent and around the world. Many important stories—of family history, language, and ways of life—are held in cultural institutions and understanding the role of responsibly disseminating these collections through digitisation is paramount. In transitioning from physical collections to hybrid collections of the physical and digital, the digitisation processes conducted by memory institutions can be—and due to the size of some collections is inevitably—selective. Limited resources, even for large-scale and well-resourced digitisation projects usually realise outcomes that focus on making visually rich, key, or canonical documents, or those documents considered high use or at risk, available online. Such materials are extracted from a full body of records. Digitisation projects, as noted, tend to be devised for a broader audience where contextual questions are less central to the methodology in favour of presenting notable documents online, separate from their complete collection and, critically, their context. Our institutions carry the weight of past collecting strategies and, today, the pressure of digitisation strategies as well. Contemporary librarians should not be gatekeepers, but rather key holders. In collaborating across sectors and with communities we open doors for education, research, and the repatriation of culture and knowledge. We must, always, remember to open these doors wide: the call of Aboriginal Australians of ‘nothing about us without us’ is not an invitation to collaboration but an imperative. Libraries—as well as galleries, archives, and museums—cannot tell these stories alone. Also, these two case studies highlight what we believe to be one of the biggest mistakes that not just libraries but all cultural institutions are vulnerable to making, the assumption that just because a collection is open access it is also accessible. Digitisation projects are more valuable when communicated, contextualised and—essentially—the result of community consultation. Such work can, for some, be uncomfortable while for others it offers opportunities to embrace disruption and, by extension, opportunities to decolonise collections. For First Nations peoples this work can be more powerful than any simple measurement tool can record. Through examining our past collecting, deliberate efforts to consult, and through digital sharing projects across metropolitan and regional Australia, we can make meaningful differences to the ways in which Aboriginal Australians can, again, own their histories.Acknowledgements The authors acknowledge the Palawa peoples: the traditional custodians of the lands known today as Tasmania. The authors acknowledge, too, the Gadigal people upon whose lands this article was researched and written. We are indebted to Dana Kahabka (Conservator), Joy Lai (Imaging Specialist), Richard Neville (Mitchell Librarian), and Marika Duczynski (Project Officer) at the State Library of New South Wales. Sincere thanks are also given to Jason Ensor of Western Sydney University.ReferencesArthur, George. “Proclamation.” The Hobart Town Courier 19 Apr. 1828: 1.———. Proclamation to the Aborigines. Graphic Materials. Sydney: Mitchell Library, State Library of New South Wales, SAFE R / 247, ca. 1828–1830.Australian Museum. “Aboriginal Scarification.” 2018. 11 Jan. 2019 <https://australianmuseum.net.au/about/history/exhibitions/body-art/aboriginal-scarification/>.Brown, Molly. “Disruptive Technology: A Good Thing for Our Libraries?” International Librarians Network (2016). 26 Aug. 2018 <https://interlibnet.org/2016/11/25/disruptive-technology-a-good-thing-for-our-libraries/>.Carroll, Khadija von Zinnenburg. Art in the Time of Colony: Empires and the Making of the Modern World, 1650–2000. Farnham, UK: Ashgate Publishing, 2014.Clements, Nicholas. The Black War: Fear, Sex and Resistance in Tasmania. St Lucia, U of Queensland P, 2014.Crane, Ralph. “Introduction.” Friendly Mission: The Tasmanian Journals and Papers of George Augustus Robinson, 1829-1834. 2nd ed. Launceston and Hobart: Queen Victoria Museum and Art Gallery, and Quintus Publishing, 2008. ix.Darian-Smith, Kate, and Penelope Edmonds. “Conciliation on Colonial Frontiers.” Conciliation on Colonial Frontiers: Conflict, Performance and Commemoration in Australia and the Pacific Rim. Eds. Kate Darian-Smith and Penelope Edmonds. New York: Routledge, 2015. 1–14.Edmonds, Penelope. “‘Failing in Every Endeavour to Conciliate’: Governor Arthur’s Proclamation Boards to the Aborigines, Australian Conciliation Narratives and Their Transnational Connections.” Journal of Australian Studies 35.2 (2011): 201–18.Fiedler, Inge, and Michael A. Bayard. Artist Pigments, a Handbook of Their History and Characteristics. Ed. Robert L. Feller. Cambridge: Cambridge UP, 1986. 65–108. Franks, Rachel. “A True Crime Tale: Re-Imagining Governor Arthur’s Proclamation Board for the Tasmanian Aborigines.” M/C Journal 18.6 (2015). 1 Feb. 2019 <http://journal.media-culture.org.au/index.php/mcjournal/article/view/1036>.Franks, Rachel, and Jason Ensor. “Challenging the Canon: Collaboration, Digitisation and Education.” ALIA Online: A Conference of the Australian Library and Information Association, 11–15 Feb. 2019, Sydney.Kahabka, Dana. Condition Assessment [Governor Arthur’s Proclamation to the Aborigines, ca. 1828–1830, SAFE / R247]. Sydney: State Library of New South Wales, 2017.Lehman, Greg. “Pleading Robinson: Reviews of Friendly Mission: The Tasmanian Journals and Papers of George Augustus Robinson (2008) and Reading Robinson: Companion Essays to Friendly Mission (2008).” Australian Humanities Review 49 (2010). 1 May 2019 <http://press-files.anu.edu.au/downloads/press/p41961/html/review-12.xhtml?referer=1294&page=15>. Morris, John. “Notes on A Message to the Tasmanian Aborigines in 1829, popularly called ‘Governor Davey’s Proclamation to the Aborigines, 1816’.” Australiana 10.3 (1988): 84–7.Pascoe, Bruce. Dark Emu. Broome: Magabala Books, 2014/2018.Plomley, N.J.B. Friendly Mission: The Tasmanian Journals and Papers of George Augustus Robinson, 1829–1834. Hobart: Tasmanian Historical Research Association, 1966.Robinson, George Augustus. Papers. Textual Records. Sydney: Mitchell Library, State Library of NSW, A 7023–A 7031, 1829–34. Thorpe, Kirsten, Monica Galassi, and Rachel Franks. “Discovering Indigenous Australian Culture: Building Trusted Engagement in Online Environments.” Journal of Web Librarianship 10.4 (2016): 343–63.

In Ireland today, we eat more pigmeat per capita, approximately 32.4 kilograms, than any other meat, yet you very seldom if ever see a pig (C.S.O.). Fat and flavour are two words that are synonymous with pig meat, yet scientists have spent the last thirty years cross breeding to produce leaner, low-fat pigs. Today’s pig professionals prefer to use the term “pig finishing” as opposed to the more traditional “pig fattening” (Tuite). The pig evokes many themes in relation to cuisine. Charles Lamb (1775-1834), in his essay Dissertation upon Roast Pig, cites Confucius in attributing the accidental discovery of the art of roasting to the humble pig. The pig has been singled out by many cultures as a food to be avoided or even abhorred, and Harris (1997) illustrates the environmental effect this avoidance can have by contrasting the landscape of Christian Albania with that of Muslim Albania.This paper will focus on the pig in Irish cuisine and culture from ancient times to the present day. The inspiration for this paper comes from a folklore tale about how Saint Martin created the pig from a piece of fat. The story is one of a number recorded by Seán Ó Conaill, the famous Kerry storyteller and goes as follows:From St Martin’s fat they were made. He was travelling around, and one night he came to a house and yard. At that time there were only cattle; there were no pigs or piglets. He asked the man of the house if there was anything to eat the chaff and the grain. The man replied there were only the cattle. St Martin said it was a great pity to have that much chaff going to waste. At night when they were going to bed, he handed a piece of fat to the servant-girl and told her to put it under a tub, and not to look at it at all until he would give her the word next day. The girl did so, but she kept a bit of the fat and put it under a keeler to find out what it would be.When St Martin rose next day he asked her to go and lift up the tub. She lifted it up, and there under it were a sow and twelve piglets. It was a great wonder to them, as they had never before seen pig or piglet.The girl then went to the keeler and lifted it, and it was full of mice and rats! As soon as the keeler was lifted, they went running about the house searching for any hole that they could go into. When St Martin saw them, he pulled off one of his mittens and threw it at them and made a cat with that throw. And that is why the cat ever since goes after mice and rats (Ó Conaill).The place of the pig has long been established in Irish literature, and longer still in Irish topography. The word torc, a boar, like the word muc, a pig, is a common element of placenames, from Kanturk (boar’s head) in West Cork to Ros Muc (headland of pigs) in West Galway. The Irish pig had its place in literature well established long before George Orwell’s English pig, Major, headed the dictatorship in Animal Farm. It was a wild boar that killed the hero Diarmaid in the Fenian tale The Pursuit of Diarmaid and Gráinne, on top of Ben Bulben in County Sligo (Mac Con Iomaire). In Ancient and Medieval Ireland, wild boars were hunted with great fervour, and the prime cuts were reserved for the warrior classes, and certain other individuals. At a feast, a leg of pork was traditionally reserved for a king, a haunch for a queen, and a boar’s head for a charioteer. The champion warrior was given the best portion of meat (Curath Mhir or Champions’ Share), and fights often took place to decide who should receive it. Gantz (1981) describes how in the ninth century tale The story of Mac Dathó’s Pig, Cet mac Matach, got supremacy over the men of Ireland: “Moreover he flaunted his valour on high above the valour of the host, and took a knife in his hand and sat down beside the pig. “Let someone be found now among the men of Ireland”, said he, “to endure battle with me, or leave the pig for me to divide!”It did not take long before the wild pigs were domesticated. Whereas cattle might be kept for milk and sheep for wool, the only reason for pig rearing was as a source of food. Until the late medieval period, the “domesticated” pigs were fattened on woodland mast, the fruit of the beech, oak, chestnut and whitethorn, giving their flesh a delicious flavour. So important was this resource that it is acknowledged by an entry in the Annals of Clonmacnoise for the year 1038: “There was such an abundance of ackornes this yeare that it fattened the pigges [runts] of pigges” (Sexton 45). In another mythological tale, two pig keepers, one called ‘friuch’ after the boars bristle (pig keeper to the king of Munster) and the other called ‘rucht’ after its grunt (pig keeper to the king of Connacht), were such good friends that the one from the north would bring his pigs south when there was a mast of oak and beech nuts in Munster. If the mast fell in Connacht, the pig-keeper from the south would travel northward. Competitive jealousy sparked by troublemakers led to the pig keepers casting spells on each other’s herds to the effect that no matter what mast they ate they would not grow fat. Both pig keepers were practised in the pagan arts and could form themselves into any shape, and having been dismissed by their kings for the leanness of their pig herds due to the spells, they eventually formed themselves into the two famous bulls that feature in the Irish Epic The Táin (Kinsella).In the witty and satirical twelfth century text, The Vision of Mac Conglinne (Aisling Mhic Conglinne), many references are made to the various types of pig meat. Bacon, hams, sausages and puddings are often mentioned, and the gate to the fortress in the visionary land of plenty is described thus: “there was a gate of tallow to it, whereon was a bolt of sausage” (Jackson).Although pigs were always popular in Ireland, the emergence of the potato resulted in an increase in both human and pig populations. The Irish were the first Europeans to seriously consider the potato as a staple food. By 1663 it was widely accepted in Ireland as an important food plant and by 1770 it was known as the Irish Potato (Mac Con Iomaire and Gallagher). The potato transformed Ireland from an under populated island of one million in the 1590s to 8.2 million in 1840, making it the most densely populated country in Europe. Two centuries of genetic evolution resulted in potato yields growing from two tons per acre in 1670 to ten tons per acre in 1800. A constant supply of potato, which was not seen as a commercial crop, ensured that even the smallest holding could keep a few pigs on a potato-rich diet. Pat Tuite, an expert on pigs with Teagasc, the Irish Agricultural and Food Development Authority, reminded me that the potatoes were cooked for the pigs and that they also enjoyed whey, the by product of both butter and cheese making (Tuite). The agronomist, Arthur Young, while travelling through Ireland, commented in 1770 that in the town of Mitchelstown in County Cork “there seemed to be more pigs than human beings”. So plentiful were pigs at this time that on the eve of the Great Famine in 1841 the pig population was calculated to be 1,412,813 (Sexton 46). Some of the pigs were kept for home consumption but the rest were a valuable source of income and were shown great respect as the gentleman who paid the rent. Until the early twentieth century most Irish rural households kept some pigs.Pork was popular and was the main meat eaten at all feasts in the main houses; indeed a feast was considered incomplete without a whole roasted pig. In the poorer holdings, fresh pork was highly prized, as it was only available when a pig of their own was killed. Most of the pig was salted, placed in the brine barrel for a period or placed up the chimney for smoking.Certain superstitions were observed concerning the time of killing. Pigs were traditionally killed only in months that contained the letter “r”, since the heat of the summer months caused the meat to turn foul. In some counties it was believed that pigs should be killed under the full moon (Mahon 58). The main breed of pig from the medieval period was the Razor Back or Greyhound Pig, which was very efficient in converting organic waste into meat (Fitzgerald). The killing of the pig was an important ritual and a social occasion in rural Ireland, for it meant full and plenty for all. Neighbours, who came to help, brought a handful of salt for the curing, and when the work was done each would get a share of the puddings and the fresh pork. There were a number of days where it was traditional to kill a pig, the Michaelmas feast (29 September), Saint Martins Day (11 November) and St Patrick’s Day (17 March). Olive Sharkey gives a vivid description of the killing of the barrow pig in rural Ireland during the 1930s. A barrow pig is a male pig castrated before puberty:The local slaughterer (búistéir) a man experienced in the rustic art of pig killing, was approached to do the job, though some farmers killed their own pigs. When the búistéirarrived the whole family gathered round to watch the killing. His first job was to plunge the knife in the pig’s heart via the throat, using a special knife. The screeching during this performance was something awful, but the animal died instantly once the heart had been reached, usually to a round of applause from the onlookers. The animal was then draped across a pig-gib, a sort of bench, and had the fine hairs on its body scraped off. To make this a simple job the animal was immersed in hot water a number of times until the bristles were softened and easy to remove. If a few bristles were accidentally missed the bacon was known as ‘hairy bacon’!During the killing of the pig it was imperative to draw a good flow of blood to ensure good quality meat. This blood was collected in a bucket for the making of puddings. The carcass would then be hung from a hook in the shed with a basin under its head to catch the drip, and a potato was often placed in the pig’s mouth to aid the dripping process. After a few days the carcass would be dissected. Sharkey recalls that her father maintained that each pound weight in the pig’s head corresponded to a stone weight in the body. The body was washed and then each piece that was to be preserved was carefully salted and placed neatly in a barrel and hermetically sealed. It was customary in parts of the midlands to add brown sugar to the barrel at this stage, while in other areas juniper berries were placed in the fire when hanging the hams and flitches (sides of bacon), wrapped in brown paper, in the chimney for smoking (Sharkey 166). While the killing was predominantly men’s work, it was the women who took most responsibility for the curing and smoking. Puddings have always been popular in Irish cuisine. The pig’s intestines were washed well and soaked in a stream, and a mixture of onions, lard, spices, oatmeal and flour were mixed with the blood and the mixture was stuffed into the casing and boiled for about an hour, cooled and the puddings were divided amongst the neighbours.The pig was so palatable that the famous gastronomic writer Grimod de la Reyniere once claimed that the only piece you couldn’t eat was the “oink”. Sharkey remembers her father remarking that had they been able to catch the squeak they would have made tin whistles out of it! No part went to waste; the blood and offal were used, the trotters were known as crubeens (from crúb, hoof), and were boiled and eaten with cabbage. In Galway the knee joint was popular and known as the glúiníns (from glún, knee). The head was roasted whole or often boiled and pressed and prepared as Brawn. The chitterlings (small intestines) were meticulously prepared by continuous washing in cool water and the picking out of undigested food and faeces. Chitterlings were once a popular bar food in Dublin. Pig hair was used for paintbrushes and the bladder was occasionally inflated, using a goose quill, to be used as a football by the children. Meindertsma (2007) provides a pictorial review of the vast array of products derived from a single pig. These range from ammunition and porcelain to chewing gum.From around the mid-eighteenth century, commercial salting of pork and bacon grew rapidly in Ireland. 1820 saw Henry Denny begin operation in Waterford where he both developed and patented several production techniques for bacon. Bacon curing became a very important industry in Munster culminating in the setting up of four large factories. Irish bacon was the brand leader and the Irish companies exported their expertise. Denny set up a plant in Denmark in 1894 and introduced the Irish techniques to the Danish industry, while O’Mara’s set up bacon curing facilities in Russia in 1891 (Cowan and Sexton). Ireland developed an extensive export trade in bacon to England, and hams were delivered to markets in Paris, India, North and South America. The “sandwich method” of curing, or “dry cure”, was used up until 1862 when the method of injecting strong brine into the meat by means of a pickling pump was adopted by Irish bacon-curers. 1887 saw the formation of the Bacon Curers’ Pig Improvement Association and they managed to introduce a new breed, the Large White Ulster into most regions by the turn of the century. This breed was suitable for the production of “Wiltshire” bacon. Cork, Waterford Dublin and Belfast were important centres for bacon but it was Limerick that dominated the industry and a Department of Agriculture document from 1902 suggests that the famous “Limerick cure” may have originated by chance:1880 […] Limerick producers were short of money […] they produced what was considered meat in a half-cured condition. The unintentional cure proved extremely popular and others followed suit. By the turn of the century the mild cure procedure was brought to such perfection that meat could [… be] sent to tropical climates for consumption within a reasonable time (Cowan and Sexton).Failure to modernise led to the decline of bacon production in Limerick in the 1960s and all four factories closed down. The Irish pig market was protected prior to joining the European Union. There were no imports, and exports were subsidised by the Pigs and Bacon Commission. The Department of Agriculture started pig testing in the early 1960s and imported breeds from the United Kingdom and Scandinavia. The two main breeds were Large White and Landrace. Most farms kept pigs before joining the EU but after 1972, farmers were encouraged to rationalise and specialise. Grants were made available for facilities that would keep 3,000 pigs and these grants kick started the development of large units.Pig keeping and production were not only rural occupations; Irish towns and cities also had their fair share. Pigs could easily be kept on swill from hotels, restaurants, not to mention the by-product and leftovers of the brewing and baking industries. Ed Hick, a fourth generation pork butcher from south County Dublin, recalls buying pigs from a local coal man and bus driver and other locals for whom it was a tradition to keep pigs on the side. They would keep some six or eight pigs at a time and feed them on swill collected locally. Legislation concerning the feeding of swill introduced in 1985 (S.I.153) and an amendment in 1987 (S.I.133) required all swill to be heat-treated and resulted in most small operators going out of business. Other EU directives led to the shutting down of thousands of slaughterhouses across Europe. Small producers like Hick who slaughtered at most 25 pigs a week in their family slaughterhouse, states that it was not any one rule but a series of them that forced them to close. It was not uncommon for three inspectors, a veterinarian, a meat inspector and a hygiene inspector, to supervise himself and his brother at work. Ed Hick describes the situation thus; “if we had taken them on in a game of football, we would have lost! We were seen as a huge waste of veterinary time and manpower”.Sausages and rashers have long been popular in Dublin and are the main ingredients in the city’s most famous dish “Dublin Coddle.” Coddle is similar to an Irish stew except that it uses pork rashers and sausage instead of lamb. It was, traditionally, a Saturday night dish when the men came home from the public houses. Terry Fagan has a book on Dublin Folklore called Monto: Murder, Madams and Black Coddle. The black coddle resulted from soot falling down the chimney into the cauldron. James Joyce describes Denny’s sausages with relish in Ulysses, and like many other Irish emigrants, he would welcome visitors from home only if they brought Irish sausages and Irish whiskey with them. Even today, every family has its favourite brand of sausages: Byrne’s, Olhausens, Granby’s, Hafner’s, Denny’s Gold Medal, Kearns and Superquinn are among the most popular. Ironically the same James Joyce, who put Dublin pork kidneys on the world table in Ulysses, was later to call his native Ireland “the old sow that eats her own farrow” (184-5).The last thirty years have seen a concerted effort to breed pigs that have less fat content and leaner meat. There are no pure breeds of Landrace or Large White in production today for they have been crossbred for litter size, fat content and leanness (Tuite). Many experts feel that they have become too lean, to the detriment of flavour and that the meat can tend to split when cooked. Pig production is now a complicated science and tighter margins have led to only large-scale operations being financially viable (Whittemore). The average size of herd has grown from 29 animals in 1973, to 846 animals in 1997, and the highest numbers are found in counties Cork and Cavan (Lafferty et al.). The main players in today’s pig production/processing are the large Irish Agribusiness Multinationals Glanbia, Kerry Foods and Dairygold. Tuite (2002) expressed worries among the industry that there may be no pig production in Ireland in twenty years time, with production moving to Eastern Europe where feed and labour are cheaper. When it comes to traceability, in the light of the Foot and Mouth, BSE and Dioxin scares, many feel that things were much better in the old days, when butchers like Ed Hick slaughtered animals that were reared locally and then sold them back to local consumers. Hick has recently killed pigs for friends who have begun keeping them for home consumption. This slaughtering remains legal as long as the meat is not offered for sale.Although bacon and cabbage, and the full Irish breakfast with rashers, sausages and puddings, are considered to be some of Ireland’s most well known traditional dishes, there has been a growth in modern interpretations of traditional pork and bacon dishes in the repertoires of the seemingly ever growing number of talented Irish chefs. Michael Clifford popularised Clonakilty Black Pudding as a starter in his Cork restaurant Clifford’s in the late 1980s, and its use has become widespread since, as a starter or main course often partnered with either caramelised apples or red onion marmalade. Crubeens (pigs trotters) have been modernised “a la Pierre Kaufman” by a number of Irish chefs, who bone them out and stuff them with sweetbreads. Kevin Thornton, the first Irish chef to be awarded two Michelin stars, has roasted suckling pig as one of his signature dishes. Richard Corrigan is keeping the Irish flag flying in London in his Michelin starred Soho restaurant, Lindsay House, where traditional pork and bacon dishes from his childhood are creatively re-interpreted with simplicity and taste.Pork, ham and bacon are, without doubt, the most traditional of all Irish foods, featuring in the diet since prehistoric times. Although these meats remain the most consumed per capita in post “Celtic Tiger” Ireland, there are a number of threats facing the country’s pig industry. Large-scale indoor production necessitates the use of antibiotics. European legislation and economic factors have contributed in the demise of the traditional art of pork butchery. Scientific advancements have resulted in leaner low-fat pigs, many argue, to the detriment of flavour. Alas, all is not lost. There is a growth in consumer demand for quality local food, and some producers like J. Hick & Sons, and Prue & David Rudd and Family are leading the way. The Rudds process and distribute branded antibiotic-free pig related products with the mission of “re-inventing the tastes of bygone days with the quality of modern day standards”. Few could argue with the late Irish writer John B. Keane (72): “When this kind of bacon is boiling with its old colleague, white cabbage, there is a gurgle from the pot that would tear the heart out of any hungry man”.ReferencesCowan, Cathal and Regina Sexton. Ireland's Traditional Foods: An Exploration of Irish Local & Typical Foods & Drinks. Dublin: Teagasc, 1997.C.S.O. Central Statistics Office. Figures on per capita meat consumption for 2009, 2010. Ireland. http://www.cso.ie.Fitzgerald, Oisin. "The Irish 'Greyhound' Pig: an extinct indigenous breed of Pig." History Ireland13.4 (2005): 20-23.Gantz, Jeffrey Early Irish Myths and Sagas. New York: Penguin, 1981.Harris, Marvin. "The Abominable Pig." Food and Culture: A Reader. Eds. Carole Counihan and Penny Van Esterik. New York: Routledge, 1997. 67-79.Hick, Edward. Personal Communication with master butcher Ed Hick. 15 Apr. 2002.Hick, Edward. Personal Communication concerning pig killing. 5 Sep. 2010.Jackson, K. H. Ed. Aislinge Meic Con Glinne, Dublin: Institute of Advanced Studies, 1990.Joyce, James. The Portrait of the Artist as a Young Man, London: Granada, 1977.Keane, John B. Strong Tea. Cork: Mercier Press, 1963.Kinsella, Thomas. The Táin. Oxford: Oxford University Press, 1970.Lafferty, S., Commins, P. and Walsh, J. A. Irish Agriculture in Transition: A Census Atlas of Agriculture in the Republic of Ireland. Dublin: Teagasc, 1999.Mac Con Iomaire, Liam. Ireland of the Proverb. Dublin: Town House, 1988.Mac Con Iomaire, Máirtín and Pádraic Óg Gallagher. "The Potato in Irish Cuisine and Culture."Journal of Culinary Science and Technology 7.2-3 (2009): 1-16.Mahon, Bríd. Land of Milk and Honey: The Story of Traditional Irish Food and Drink. Cork:Mercier, 1998.Meindertsma, Christien. PIG 05049 2007. 10 Aug. 2010 http://www.christienmeindertsma.com.Ó Conaill, Seán. Seán Ó Conaill's Book. Bailie Átha Cliath: Bhéaloideas Éireann, 1981.Sexton, Regina. A Little History of Irish Food. Dublin: Gill and Macmillan, 1998.Sharkey, Olive. Old Days Old Ways: An Illustrated Folk History of Ireland. Dublin: The O'Brien Press, 1985.S.I. 153, 1985 (Irish Legislation) http://www.irishstatutebook.ie/1985/en/si/0153.htmlS.I. 133, 1987 (Irish Legislation) http://www.irishstatuebook.ie/1987/en/si/0133.htmlTuite, Pat. Personal Communication with Pat Tuite, Chief Pig Advisor, Teagasc. 3 May 2002.Whittemore, Colin T. and Ilias Kyriazakis. Whitmore's Science and Practice of Pig Production 3rdEdition. Oxford: Wiley-Blackwell, 2006.

Introduction The decline of marriage in the West has been extensively researched over the last three decades (Carmichael and Whittaker; de Vaus; Coontz; Beck-Gernshein). Indeed, it was fears that the institution would be further eroded by the legalisation of same sex unions internationally that provided the impetus for the Australian government to amend the Marriage Act (1961). These amendments in 2004 sought to strengthen marriage by explicitly defining, for the first time, marriage as a legal partnership between one man and one woman. The subsequent heated debates over the discriminatory nature of this definition have been illuminating, particularly in the way they have highlighted the ongoing social significance of marriage, even at a time it is seen to be in decline. Demographic research about partnering practices (Carmichael and Whittaker; Simons; Parker; Penman) indicates that contemporary marriages are more temporary, fragile and uncertain than in previous generations. Modern marriages are now less about a permanent and “inescapable” union between a dominant man and a submissive female for the purposes of authorised sex, legal progeny and financial security, and more about a commitment between two social equals for the mutual exchange of affection and companionship (Croome). Less research is available, however, about how couples themselves reconcile the inherited constructions of romantic love as selfless and unending, with trends that clearly indicate that romantic love is not forever, ideal or exclusive. Civil marriage ceremonies provide one source of data about representations of love. Civil unions constituted almost 70 per cent of all marriages in Australia in 2010, according to the Australian Bureau of Statistics. The civil marriage ceremony has both a legal and symbolic role. It is a legal contract insofar as it prescribes a legal arrangement with certain rights and responsibilities between two consenting adults and outlines an expectation that marriage is voluntarily entered into for life. The ceremony is also a public ritual that requires couples to take what are usually private feelings for each other and turn them into a public performance as a way of legitimating their relationship. Consistent with the conventions of performance, couples generally customise the rest of the ceremony by telling the story of their courtship, and in so doing they often draw upon the language and imagery of the Western Romantic tradition to convey the personal meaning and social significance of their decision. This paper explores how couples construct the idea of love in their relationship, first by examining the western history of romantic love and then by looking at how this discourse is invoked by Australians in the course of developing civil marriage ceremonies in collaboration with the author. A History of Romantic Love There are many definitions of romantic love, but all share similar elements including an intense emotional and physical attraction, an idealisation of each other, and a desire for an enduring and unending commitment that can overcome all obstacles (Gottschall and Nordlund; Janowiak and Fischer). Romantic love has historically been associated with heightened passions and intense almost irrational or adolescent feelings. Charles Lindholm’s list of clichés that accompany the idea of romantic love include: “love is blind, love overwhelms, a life without love is not worth living, marriage should be for love alone and anything less is worthless and a sham” (5). These elements, which invoke love as sacred, unending and unique, perpetuate past cultural associations of the term. Romantic love was first documented in Ancient Rome where intense feelings were seen as highly suspect and a threat to the stability of the family, which was the primary economic, social and political unit. Roman historian Plutarch viewed romantic love based upon strong personal attraction as disruptive to the family, and he expressed a fear that romantic love would become the norm for Romans (Lantz 352). During the Middle Ages romantic love emerged as courtly love and, once again, the conventions that shaped its expression grew out of an effort to control excessive emotions and sublimate sexual desire, which were seen as threats to social stability. Courtly love, according to Marilyn Yalom, was seen as an “irresistible and inexhaustible passion; a fatal love that overcomes suffering and even death” (66). Feudal social structures had grounded marriage in property, while the Catholic Church had declared marriage a sacrament and a ceremony through which God’s grace could be obtained. In this context courtly love emerged as a way of dealing with the conflict between the individual and family choices over the martial partner. Courtly love is about a pure ideal of love in which the knight serves his unattainable lady, and, by carrying out feats in her honour, reaches spiritual perfection. The focus on the aesthetic ideal was a way to fulfil male and female emotional needs outside of marriage, while avoiding adultery. Romantic love re-appeared again in the mid-eighteenth century, but this time it was associated with marriage. Intellectuals and writers led the trend normalising romantic love in marriage as a reaction to the Enlightenment’s valorisation of reason, science and materialism over emotion. Romantics objected to the pragmatism and functionality induced by industrialisation, which they felt destroyed the idea of the mysterious and transcendental nature of love, which could operate as a form of secular salvation. Love could not be bought or sold, argued the Romantics, “it is mysterious, true and deep, spontaneous and compelling” (Lindholm 5). Romantic love also emerged as an expression of the personal autonomy and individualisation that accompanied the rise of industrial society. As Lanz suggests, romantic love was part of the critical reflexivity of the Enlightenment and a growing belief that individuals could find self actualisation through the expression and expansion of their “emotional and intellectual capacities in union with another” (354). Thus it was romantic love, which privileges the feelings and wishes of an individual in mate selection, that came to be seen as a bid for freedom by the offspring of the growing middle classes coerced into marriage for financial or property reasons. Throughout the 19th century romantic love was seen as a solution to the dehumanising forces of industrialisation and urbanisation. The growth of the competitive workplace—which required men to operate in a restrained and rational manner—saw an increase in the search for emotional support and intimacy within the domestic domain. It has been argued that “love was the central preoccupation of middle class men from the 1830s until the end of the 19th century” (Stearns and Knapp 771). However, the idealisation of the aesthetic and purity of love impacted marriage relations by casting the wife as pure and marital sex as a duty. As a result, husbands pursued sexual and romantic relationships outside marriage. It should be noted that even though love became cemented as the basis for marriage in the 19th century, romantic love was still viewed suspiciously by religious groups who saw strong affection between couples as an erosion of the fundamental role of the husband in disciplining his wife. During the late 19th and early 20th centuries romantic love was further impacted by urbanisation and migration, which undermined the emotional support provided by extended families. According to Stephanie Coontz, it was the growing independence and mobility of couples that saw romantic love in marriage consolidated as the place in which an individual’s emotional and social needs could be fully satisfied. Coontz says that the idea that women could only be fulfilled through marriage, and that men needed women to organise their social life, reached its heights in the 1950s (25-30). Changes occurred to the structure of marriage in the 1960s when control over fertility meant that sex was available outside of marriage. Education, equality and feminism also saw women reject marriage as their only option for fulfilment. Changes to Family Law Acts in western jurisdictions in the 1970s provided for no-fault divorce, and as divorce lost its stigma it became acceptable for women to leave failing marriages. These social shifts removed institutional controls on marriage and uncoupled the original sexual, emotional and financial benefits packaged into marriage. The resulting individualisation of personal lifestyle choices for men and women disrupted romantic conventions, and according to James Dowd romantic love came to be seen as an “investment” in the “future” that must be “approached carefully and rationally” (552). It therefore became increasingly difficult to sustain the idea of love as a powerful, mysterious and divine force beyond reason. Methodology In seeking to understand how contemporary partnering practices are reconstituting romantic love, I draw upon anecdotal data gathered over a nine-year period from my experiences as a marriage celebrant. In the course of personalising marriage ceremonies, I pose a series of questions designed to assist couples to explain the significance of their relationship. I generally ask brides and grooms why they love their fiancé, why they want to legalise their relationship, what they most treasure about their partner, and how their lives have been changed by their relationship. These questions help couples to reflexively interrogate their own relationship, and by talking about their commitment in concrete terms, they produce the images and descriptions that can be used to describe for guests the internal motivations and sentiments that have led to their decision to marry. I have had couples, when prompted to explain how they know the other person loves them say, in effect: “I know that he loves me because he brings me a cup of coffee every morning” or “I know that she loves me because she takes care of me so well.” These responses are grounded in a realism that helps to convey a sense of sincerity and authenticity about the relationship to the couple’s guests. This realism also helps to address the cynicism about the plausibility of enduring love. The brides and grooms in this sample of 300 couples were a socially, culturally and economically diverse group, and they provided a wide variety of responses ranging from deeply nuanced insights into the nature of their relationship, to admissions that their feelings were so private and deeply felt that words were insufficient to convey their significance. Reoccurring themes, however, emerged across the cases, and it is evident that even as marriage partnerships may be entered into for a variety of reasons, romantic love remains the mechanism by which couples talk of their feelings for each other. Australian Love and Marriage Australians' attitudes to romantic love and marriage have, understandably, been shaped by western understandings of romantic love. It is evident, however, that the demands of late modern capitalist society, with its increased literacy, economic independence and sexual equality between men and women, have produced marriage as a negotiable contract between social equals. For some, like Carol Pateman, this sense of equality within marriage may be illusory. Nonetheless, the drive for individual self-fulfilment by both the bride and groom produces a raft of challenges to traditional ideas of marriage as couples struggle to find a balance between independence and intimacy; between family and career; and between pursuing personal goals and the goals of their partners. This shift in the nature of marriage has implications for the “quest for undying romantic love,” which according to Anthony Giddens has been replaced by other forms of relationship, "each entered into for its own sake, for what can be derived by each person from a sustained association with another; and which is continued only in so far as it is thought by both parties to deliver enough satisfactions for each individual to stay within it” (qtd. in Lindholm 6). The impact of these social changes on the nature of romantic love in marriage is evident in how couples talk about their relationship in the course of preparing a ceremony. Many couples describe the person they are marrying as their best friend, and friendship is central to their commitment. This description supports research by V.K. Oppenheimer which indicates that many contemporary couples have a more “egalitarian collaborative approach to marriage” (qtd. in Carmichael and Whittaker 25). It is also standard for couples to note in ceremonies that they make each other happy and contented, with many commenting upon how their partners have helped to bring focus and perspective to their work-oriented lives. These comments tend to invoke marriage as a refuge from the isolation, competition, and dehumanising elements of workplaces. Since emotional support is central to the marriage contract, it is not surprising that care for each other is another reoccurring theme in ceremonies. Many brides and grooms not only explicitly say they are well taken care of by their partner, but also express admiration for their partner’s treatment of their families and friends. This behaviour appears to be seen as an indicator of the individual’s capacity for support and commitment to family values. Many couples admire partner’s kindness, generosity and level of personal self-sacrifice in maintaining the relationship. It is also not uncommon for brides and grooms to say they have been changed by their love: become kinder, more considerate and more tolerant. Honesty, communication skills and persistence are also attributes that are valued. Brides and grooms who have strong communication skills are also praised. This may refer to interpersonal competency and the willingness to acquire the skills necessary to negotiate the endless compromises in contemporary marriage now that individualisation has undermined established rules, rituals and roles. Persistence and the ability not to be discouraged by setbacks is also a reoccurring theme, and this connects with the idea that marriage is work. Many couples promise to grow together in their marriage and to both take responsibility for the health of their relationship. This promise implies awareness that marriage is not the fantasy of happily ever after produced in romantic popular culture, but rather an arrangement that requires hard work and conscious commitment, particularly in building a union amidst many competing options and distractions. Many couples talk about their relationship in terms of companionship and shared interests, values and goals. It is also not uncommon for couples to say that they admire their partner for supporting them to achieve their life goals or for exposing them to a wider array of lifestyle choices and options like travel or study. These examples of interdependence appear to make explicit that couples still see marriage as a vehicle for personal freedom and self-realisation. The death of love is also alluded to in marriage ceremonies. Couples talk of failed past relationships, but these are produced positively as a mechanism that enables the couple to know that they have now found an enduring relationship. It is also evident that for many couples the decision to marry is seen as the formalisation of a preexisting commitment rather than the gateway to a new life. This is consistent with figures that show that 72 per cent of Australian couples chose to cohabit before marriage (Simons 48), and that cohabitation has become the “normative pathway to marriage” (Penman 26). References to children also feature in marriage ceremonies, and for the couples I have worked with marriage is generally seen as the pre-requisite for children. Couples also often talk about “being ready” for marriage. This seems to refer to being financially prepared. Robyn Parker citing the research of K. Edin concludes that for many modern couples “rushing into marriage before being ‘set’ is irresponsible—marrying well (in the sense of being well prepared) is the way to avoid divorce” (qtd. in Parker 81). From this overview of reoccurring themes in the production of Australian ceremonies it is clear that romantic love continues to be associated with marriage. However, couples describe a more grounded and companionable attachment. These more practical and personalised sentiments serve to meet both the public expectation that romantic love is a precondition for marriage, while also avoiding the production of romantic love in the ceremony as an empty cliché. Grounded descriptions of love reveal that attraction does not have to be overwhelming and unconquerable. Indeed, couples who have lived together and are intimately acquainted with each other’s habits and disposition, appear to be most comfortable expressing their commitment to each other in more temperate, but no less deeply felt, terms. Conclusion This paper has considered how brides and grooms constitute romantic love within the shifting partnering practices of contemporary Australia. It is evident “in the midst of significant social and economic change and at a time when individual rights and freedom of choice are important cultural values” marriage remains socially significant (Simons 50). This significance is partially conveyed through the language of romantic love, which, while freighted with an array of cultural and historical associations, remains the lingua franca of marriage, perhaps because as Roberto Unger observes, romantic love is “the most influential mode of moral vision in our culture” (qtd. in Lindholm 5). It is thus possible to conclude, that while marriage may be declining and becoming more fragile and impermanent, the institution remains important to couples in contemporary Australia. Moreover, the language and imagery of romantic love, which publicly conveys this importance, remains the primary mode of expressing care, affection and hope for a partnership, even though the changed partnering practices of late modern capitalist society have exposed the utopian quality of romantic love and produced a cynicism about the viability of its longevity. It is evident in the marriage ceremonies prepared by the author that while the language of romantic love has come to signify a broader range of more practical associations consistent with the individualised nature of modern marriage and demystification of romantic love, it also remains the best way to express what Dowd and Pallotta describe as a fundamental human “yearning for communion with and acceptance by another human being” (571). 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