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Gummadi, Sarada, e Jonathan Glass. "Therapeutic Response to Granulocyte Colony-Stimulating Factor in a Case of Selective IgA Deficiency (SIgAD) with Chronic Neutropenia." Blood 114, n. 22 (20 novembre 2009): 4512. http://dx.doi.org/10.1182/blood.v114.22.4512.4512.

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Abstract Abstract 4512 Introduction Neutropenia is a frequent occurrence in some immunodeficiency syndromes such as IgA deficiency, Hyper IgM syndrome, and common variable immunodeficiency1. We present a case of an IgA-deficient patient with neutropenia treated with pegfilgrastim. Case Report A 23-year-old Caucasian female was referred for evaluation of chronic neutropenia diagnosed at age 18 and a postpartum DVT. The patient had a history of recurrent pharyngitis since age 13 and MSSA septicemia during pregnancy. Evaluation for chronic neutropenia included negative ANA, Hepatitis panel and HIV with a normal bone marrow biopsy and no anti-granulocyte antibodies. She was found to have Protein S deficiency during her first pregnancy with no other coagulation abnormalities and was started on prophylactic doses of LMWH antepartum. Patient quit taking LMWH after delivery, had a DVT 3 weeks postpartum, and was restarted on LMWH. Quantitative immunoglobulins revealed IgA < 5 mg/dl. Peripheral blood flow cytometry showed no evidence of lymphoproliferative disorder. Bone marrow biopsy was repeated and showed a hypercellular bone marrow with no cytogenetic abnormalities. Patient was diagnosed with secondary Autoimmune neutropenia (AIN) in association with IgA deficiency. After a single dose of 6 mg pegfilgrastim, neutropenia resolved and subsequent anti-granulocyte antibodies remained negative. Patient is currently on 6mg pegfilgrastim every 2 weeks with resolution of neutropenia. Repeat Protein S level is pending. Discussion AIN is defined as a (chronic) neutropenia in which autoantibodies against neutrophil autoantigens can be detected by leukoagglutination, neutrophil immunofluorescence, and/or monoclonal antibody immobilization of neutrophil antigens2. Primary AIN is rare. Infections start 1 to 15 months after birth and recovery is spontaneous in 7 to 73 months. Neutrophil-specific autoantibodies are detectable in most patients, and are directed to NA1 or sometimes NA2. Treatment is usually not necessary. Infections are treated with antibiotics and with high-dose IVIG or G-CSF2. Secondary AIN with an associated hematopoietic or systemic autoimmune disorder or with combined immunodeficiency is more frequent in adults, peaking at age 40 to 60 years is known as adult autoimmune neutropenia. Only in a few cases of adult AIN are neutrophil-antigen-specific autoantibodies found including anti-NA1, NB1, pan-Fc_RIIIb, and CD11b/CD18 (CR3) antibodies. With infections appropriate antibiotics together with G-CSF is the treatment of choice. An important effect of G-CSF is that with an increased mass of neutrophils, the autoantibodies are absorbed to the neutrophils and leading to their disappearance from the circulation2. Conclusions We present a case of secondary AIN associated with IgA deficiency without demonstrable anti-neutrophil antibodies that was treated with pegfilgrastim with resolution of neutropenia. There are no published cases of IgA-deficient patients with neutropenia who received G- CSF and G-CSF may be helpful in these patients. Disclosures: Off Label Use: Off label use of pegfilgrastim for treatment of autoimmune neutropenia in selective IgA deficiency..
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Fernando, S., S. K. Tadakamadla, M. Bakr, P. A. Scuffham e N. W. Johnson. "Indicators of Risk for Dental Caries in Children: A Holistic Approach". JDR Clinical & Translational Research 4, n. 4 (30 aprile 2019): 333–41. http://dx.doi.org/10.1177/2380084419834236.

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Background Dental caries in children is a major public health problem worldwide, with a multitude of determinants acting upon children to different degrees in different communities. The objective of this study was to determine maternal, environmental, and intraoral indicators of dental caries experience in a sample of 6- to 7-y-old children in South East Queensland, Australia. Methods: A total of 174 mother-child dyads were recruited for this cross-sectional study from the Griffith University Environments for Healthy Living birth cohort study. Maternal education, employment status, and prepregnancy body mass index were maternal indicators, and annual household income was taken as a proxy for environmental indicators. These were collected as baseline data of the study. Clinical data on children’s dental caries experience, saliva characteristics of buffering capacity, stimulated flow rate, and colony-forming units per milliliter of salivary mutans streptococci were collected for the oral health substudy. Univariate analysis was performed with 1-way analysis of variance and chi-square tests. Caries experience was the outcome, which was classified into 4 categories based on the number of carious tooth surfaces. Ordinal logistic regression was used to explore the association of risk indicators with caries experience. Results: Age ( P = 0.021), low salivary buffering capacity ( P = 0.001), reduced levels of salivary flow rate ( P = 0.011), past caries experience ( P = 0.001), low annual household income; <$30,000 (P = 0.050) and <$60,000 (P = 0.033) and maternal employment status ( P = 0.043) were associated with high levels of dental caries. Conclusion These data support the evidence of associations between maternal, environmental, and children’s intraoral characteristics and caries experience among children in a typical Western industrialized country. All of these need to be considered in preventative strategies within families and communities. Knowledge Transfer Statement: The results of this study can be used by clinicians, epidemiologists, and policy makers to identify children who are at risk of developing dental caries. With consideration of costs for treatment for the disease, this information could be used to plan cost-effective and patient-centered preventive care.
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Hiwatari, Mitsuteru, Masafumi Seki, Ryosuke Matsuno, Kenichi Yoshida, Takeshi Nagasawa, Aiko Sato-Otsubo, Shohei Yamamoto et al. "Abstract 6734: Identification of the novel TENM3-ALK fusion in an AYA case with ALK rearranged neuroblastoma". Cancer Research 83, n. 7_Supplement (4 aprile 2023): 6734. http://dx.doi.org/10.1158/1538-7445.am2023-6734.

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Abstract Neuroblastoma is the most common extracranial solid tumor that occurs in childhood and the most common cancer in infancy. Fewer than 5% of neuroblastomas occur in adolescents and young adults (AYAs), for whom the disease has an indolent and fatal course. Chen et al. previously reported that missense mutations in the protein- tyrosine kinase domain of anaplastic lymphoma kinase (ALK) occur in approximately 10% of cases of sporadic neuroblastoma, and these missense mutations result in the activation of the ALK protein kinase domain, which plays a key role in the tumorigenic process as seen in ALK fusion proteins. Since the initial discovery of the NPM-ALK fusion protein in human anaplastic lymphoma cell lines, more than 24 different ALK fusion proteins have been discovered in various malignancies. Till date, ALK-containing chimeric proteins have not been reported in neuroblastoma. In this study, a translocation within chromosome 2p and 4q was found to bring about the formation of an in-frame fusion gene that was composed of portions of the teneurin transmembrane protein 3 (TENM3) gene and ALK gene in tumor cells from an AYA patient with neuroblastoma. The patient was 19-year-old female diagnosed with stage 4 neuroblastoma (unfavorable histology, poorly differentiated subtype, MYCN DNA not amplified). Computed tomography revealed a mass in the left adrenal gland with bone, spine, liver, and lung metastasis. ALK rearrangement was confirmed via FISH analysis. Crizotinib resulted in no disease progression for 5 months, except for metastatic spinal disease, but it did not exhibit high efficacy compared with its effects against lymphoma and lung cancer. This 5′ in-frame fusion partner gene in neuroblastoma has not yet been identified, and its role is not well-known in oncogenesis. We generated the cell line with the expression of the full length TENM3-ALK cDNA in NIH-3T3 cells led to the formation of a fusion protein. A cell-based evaluation of this predicted ALK protein variant revealed activation of downstream targets-STAT3, AKT and ERK- and ALK inhibitors, crizotinib or lorlatinib, treatment inhibited the growth of xenograft tumors with stable TENM3-ALK expression. We determined whether TENM3-ALK affects transformation and proliferation using a soft agar colony formation assay. As expected, the cells that expressed an empty vector and wild type ALK line did not produce a considerable number of colonies, whereas TENM3-ALK transfected cells showed anchorage-independent growth, resulting in the production of a higher number of colonies. The evidence for the role of ALK receptor signaling in stimulating neuroblastoma tumor cell growth and the demonstrated in vitro and in vivo efficacy of the ALK selective inhibitors in this study provide biological and clinical justification for the further exploration of this combination and testing in patients with recurrent or refractory neuroblastoma. Citation Format: Mitsuteru Hiwatari, Masafumi Seki, Ryosuke Matsuno, Kenichi Yoshida, Takeshi Nagasawa, Aiko Sato-Otsubo, Shohei Yamamoto, Motohiro Kato, Kentaro Watanabe, Masahiro Sekiguchi, Satoru Miyano, Seishi Ogawa, Junko Takita. Identification of the novel TENM3-ALK fusion in an AYA case with ALK rearranged neuroblastoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6734.
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Crees, Logan, Jessene Aquino-Thomas, Ellen Lake, Paul Madeira e Melissa Smith. "First report of a predatory mite in association with Floracarus perrepae (Acariformes: Eriophyidae), a biological control agent for Old World climbing fern in Florida". Florida Entomologist 107, s1 (2 gennaio 2024). http://dx.doi.org/10.1515/flaent-2024-0026.

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Abstract Floracarus perrepae Knihinicki & Boczek (Acariformes: Eriophyidae) is a gall-forming mite that is used as a biological control agent for the invasive weed Old World climbing fern, Lygodium microphyllum (Cav.) R.Br. (Lygodiaceae). The United States Department of Agriculture, Agricultural Research Service, Invasive Plant Research Laboratory in Fort Lauderdale, Florida, has mass reared and released over 49 million mites since 2014. Recently, a predatory mite has been observed in the mass-rearing and release colony. Preliminary field studies have revealed that the predatory mite is found within F. perrepae galls throughout south Florida. Molecular analysis was conducted and identified the predatory mite as Amblyseius tamatavensis Blommers (Acari: Phytoseiidae).
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Bertagnolli, Mariane, Katryn Paquette, Megan Sutherland, Marie-Amelie Lukaszewski, Ying He, Anik Cloutier, Rong Wu et al. "Abstract 045: Endothelial Colony Forming Cells Dysfunction Relates to Cardiovascular Alterations in Preterm Born Adults". Hypertension 68, suppl_1 (settembre 2016). http://dx.doi.org/10.1161/hyp.68.suppl_1.045.

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Endothelial colony-forming cell (ECFC), a subtype of endothelial progenitor cells with high clonogenic and proliferative capacity, is present in cord and peripheral blood, participating in neovessel formation and regeneration. Cord blood ECFCs have impaired bioactivity in pregnancy complications and preterm (PT) birth. Dysfunction of cord blood ECFC is also related to complications of prematurity such as bronchopulmonary dysplasia. Although cardiovascular alterations, such as high blood pressure (BP) and left ventricular (LV) dysfunction, occur in PT subjects during adulthood, whether ECFC dysfunction beyond the neonatal period relates to such alterations is not known. OBJECTIVE: We aim in this study to assess if ECFC function relates to cardiovascular alterations in PT born adults. METHODS: Peripheral blood mononuclear cells from 30 young adults (21-28 years old) born very PT (<29 weeks gestation) and 30 at term (T, ≥37 weeks gestation) were separated by density gradient and cultured to ECFC colony formation. ECFC proliferative and angiogenic function were assessed in vitro by modified thymidine analogue (EdU) incorporation and tube formation in Matrigel. BP was measured by 24h monitor and LV mass index (g/cm 2 ) by ultrasound imaging. All analyses were performed blind; correlations were significant when p<0.05. RESULTS: The proportion of early (<15 days) and late (≥15 days) time for ECFC colony formation was different between PT and T, with a higher frequency for late growth or no colony in the PT born group. Time to colony formation inversely correlated with ECFC proliferation rate (r=-0.57, r 2 =0.32) and tube formation (r=-0.57, r 2 =0.33) in PT, which shows ECFC dysfunction in those PT subjects with late colony formation, with no significant correlations in T. Additionally, time to colony formation has positively related to systolic BP (r=0.54, r 2 =0.29) and LV mass index (r=0.49, r 2 =0.24) in PT born subjects. CONCLUSION: Our findings demonstrate, for the first time, an association between dysfunctional circulating ECFCs and cardiovascular alterations in adults born PT. We also show that ECFC dysfunction, in PT adults, significantly relates to important cardiovascular risk factors such as high BP and increased LV mass.
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Zhyhun, Snizhana. "The Space Modeling in the Ukrainian Detective Story of the Second Half of the 20th century". Synopsis: Text Context Media, n. 3 (2019). http://dx.doi.org/10.28925/2311-259x.2019.3.1.

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The relevance of the study is due to the underestimation of the influence of entertainment literature on the formation of ideas about the world in the reader. Therefore, the purpose of the presented article is to demonstrate how the spatial structures of the Soviet detective determine the creation of values, forming collective strategies. The subject of research is the ratio of the foreign and Soviet spaces, as well as local space and imperial space, which was the Soviet one. The main research method is structuralist analysis, and the interpretation of the results obtained with its help was made in the context of the ideas of postcolonial criticism. It defines the novelty of the study, which is to consider the detective texts of the Soviet period as carriers of not only political ideology but also a colonial view. As a result of the research it is found out that modeling of space in the Ukrainian detective story of the 1950s–1980s is defined by a ratio of world and imperial spaces, provided with ethical estimates as well as imperial and local spaces which create the system of knowledge of the world. At the same time, the space of the Ukrainian detective story of this period is significantly narrowed if compared with the detective of the 1920s or the Russian detective of the 1950s–1980s. The described space is often devoid of national features or they are not focused. Instead, attention is focused on the achievements of the power: construction of new buildings, re-equipment of old ones, industrial facilities. The “entertaining” text fixed the replicated by mass media narrative of the civilization mission of the Soviet power and its successes. The urban space is usually determined by production and trade, often illegal. And it is the trade that becomes the core of the image of Moscow, the capital of the Union. There is a hidden rejection of the metropolis in its representation as a center of stolen things selling to foreigners. But the image of Kyiv as an averaged “regional center demonstrates colonial mimicry and assimilation strategy. The space mystification, characteristic of texts about crimes with ideological mechanics, destroyed the association of responsibility for them with specific cities. Instead, memory places accentuated the losses incurred in the fight against the external enemy, and raised the emotional value of the Ukrainian SSR within the Union. Thus, the analyzed texts demonstrate unambiguous relations between the world and the empire, and complex relations between the empire and the colony. In the prospect of research it is advisable to compare the image of space in Russian detectives (metropolitan and regional authors), as well as in detectives of other republics and countries of the Warsaw Pact.
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Coull, Kim. "Secret Fatalities and Liminalities: Translating the Pre-Verbal Trauma and Cellular Memory of Late Discovery Adoptee Illegitimacy". M/C Journal 17, n. 5 (26 ottobre 2014). http://dx.doi.org/10.5204/mcj.892.

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I was born illegitimate. Born on an existential precipice. My unwed mother was 36 years old when she relinquished me. I was the fourth baby she was required to give away. After I emerged blood stained and blue tinged – abject, liminal – not only did the nurses refuse me my mother’s touch, I also lost the sound of her voice. Her smell. Her heart beat. Her taste. Her gaze. The silence was multi-sensory. When they told her I was dead, I also lost, within her memory and imagination, my life. I was adopted soon after but not told for over four decades. It was too shameful for even me to know. Imprinted at birth with a psychological ‘death’, I fell, as a Late Discovery Adoptee (LDA), into a socio-cultural and psychological abyss, frozen at birth at the bottom of a parturitive void from where, invisible within family, society, and self I was unable to form an undamaged sense of being.Throughout the 20th century (and for centuries before) this kind of ‘social abortion’ was the dominant script. An adoptee was regarded as a bastard, born of sin, the mother blamed, the father exonerated, and silence demanded (Lynch 28-74). My adoptive mother also sinned. She was infertile. But, in taking me on, she assumed the role of a womb worthy woman, good wife, and, in her case, reluctant mother (she secretly didn’t want children and was privately overwhelmed by the task). In this way, my mother, my adoptive mother, and myself are all the daughters of bereavement, all of us sacrificed on the altar of prejudice and fear that infertility, sex outside of marriage, and illegitimacy were unspeakable crimes for which a price must be paid and against which redemptive protection must be arranged. If, as Thomas Keneally (5) writes, “original sin is the mother fluid of history” then perhaps all three of us all lie in its abject waters. Grotevant, Dunbar, Kohler and Lash Esau (379) point out that adoption was used to ‘shield’ children from their illegitimacy, women from their ‘sexual indiscretions’, and adoptive parents from their infertility in the belief that “severing ties with birth family members would promote attachment between adopted children and parents”. For the adoptee in the closed record system, the socio/political/economic vortex that orchestrated their illegitimacy is born out of a deeply, self incriminating primal fear that reaches right back into the recesses of survival – the act of procreation is infested with easily transgressed life and death taboos within the ‘troop’ that require silence and the burial of many bodies (see Amanda Gardiner’s “Sex, Death and Desperation: Infanticide, Neonaticide, and Concealment of Birth in Colonial Western Australia” for a palpable, moving, and comprehensive exposition on the links between 'illegitimacy', the unmarried mother and child murder). As Nancy Verrier (24) states in Coming Home to Self, “what has to be understood is that separation trauma is an insidious experience, because, as a society, we fail to see this experience as a trauma”. Indeed, relinquishment/adoption for the baby and subsequent adult can be acutely and chronically painful. While I was never told the truth of my origins, of course, my body knew. It had been there. Sentient, aware, sane, sensually, organically articulate, it messaged me (and anyone who may have been interested) over the decades via the language of trauma, its lexicon and grammar cellular, hormonal, muscular (Howard & Crandall, 1-17; Pert, 72), the truth of my birth, of who I was an “unthought known” (Bollas 4). I have lived out my secret fatality in a miasmic nebula of what I know now to be the sequelae of adoption psychopathology: nausea, physical and psychological pain, agoraphobia, panic attacks, shame, internalised anger, depression, self-harm, genetic bewilderment, and generalised anxiety (Brodzinsky 25-47; Brodzinsky, Smith, & Brodzinsky 74; Kenny, Higgins, Soloff, & Sweid xiv; Levy-Shiff 97-98; Lifton 210-212; Verrier The Primal Wound 42-44; Wierzbicki 447-451) – including an all pervading sense of unreality experienced as dissociation (the experience of depersonalisation – where the self feels unreal – and derealisation – where the world feels unreal), disembodiment, and existential elision – all characteristics of Post Traumatic Stress Disorder (PTSD). In these ways, my body intervened, acted out, groaned in answer to the social overlay, and from beyond “the dermal veil” tried to procure access, as Vicky Kirby (77) writes, to “the body’s opaque ocean depths” through its illnesses, its eloquent, and incessantly aching and silent verbosities deepened and made impossibly fraught because I was not told. The aim of this paper is to discuss one aspect of how my body tried to channel the trauma of my secret fatality and liminality: my pre-disclosure art work (the cellular memory of my trauma also expressed itself, pre-disclosure, through my writings – poetry, journal entries – and also through post-coital glossolalia, all discussed at length in my Honours research “Womb Tongues” and my Doctoral Dissertation “The Womb Artist – A Novel: Translating Pre-verbal Late Discovery Adoption Trauma into Narrative”). From the age of thirty onwards I spent twelve years in therapy where the cause of my childhood and adult psychopathology remained a mystery. During this time, my embodied grief and memories found their way into my art work, a series of 5’ x 3’ acrylic paintings, some of which I offer now for discussion (figures 1-4). These paintings map and express what my body knew but could not verbalise (without language to express my grief, my body found other ways to vent). They are symptom and sign of my pre-verbal adoption trauma, evidence that my body ‘knew’ and laboured ceaselessly and silently to find creative ways to express the incarcerated trauma. Post disclosure, I have used my paintings as artefacts to inform, underpin, and nourish the writing of a collection of poetry “Womb Tongues” and a literary novel/memoir “The Womb Artist” (TWA) in an ongoing autoethnographical, performative, and critical inquiry. My practice-led research as a now conscious and creative witness, fashions the recontextualisation of my ‘self’ into my ‘self’ and society, this time with cognisant and reparative knowledge and facilitates the translation of my body’s psychopathology and memory (explicit and implicit) into a healing testimony that explores the traumatised body as text and politicizes the issues surrounding LDAs (Riley 205). If I use these paintings as a memoirist, I use them second hand, after the fact, after they have served their initial purpose, as the tangible art works of a baby buried beneath a culture’s prejudice, shame, and judgement and the personal cries from the illegitimate body/self. I use them now to explore and explain my subclinical and subterranean life as a LDA.My pre-disclosure paintings (Figures 1-4) – filled with vaginal, fetal, uterine, and umbilical references – provide some kind of ‘evidence’ that my body knew what had happened to me as if, with the tenacity of a poltergeist, my ‘spectral self’ found ways to communicate. Not simply clues, but the body’s translation of the intra-psychic landscape, a pictorial and artistic séance into the world, as if my amygdala – as quasar and signal, homing device and history lesson (a measure, container, and memoir) – knew how to paint a snap shot or an x-ray of the psyche, of my cellular marrow memories (a term formulated from fellow LDA Sandy McCutcheon’s (76) memoir, The Magician’s Son when he says, “What I really wanted was the history of my marrow”). If, as Salveet Talwar suggests, “trauma is processed from the body up”, then for the LDA pre-discovery, non-verbal somatic signage is one’s ‘mother tongue’(25). Talwar writes, “non-verbal expressive therapies such as art, dance, music, poetry and drama all activate the sub-cortical regions of the brain and access pre-verbal memories” (26). In these paintings, eerily divinatory and pointed traumatic, memories are made visible and access, as Gussie Klorer (213) explains in regard to brain function and art therapy, the limbic (emotional) system and the prefrontal cortex in sensorimotor integration. In this way, as Marie Angel and Anna Gibbs (168) suggest, “the visual image may serve as a kind of transitional mode in thought”. Ruth Skilbeck in her paper First Things: Reflections on Single-lens Reflex Digital Photography with a Wide-angled Lens, also discusses (with reference to her photographic record and artistic expression of her mother’s death) what she calls the “dark matter” – what has been overlooked, “left out”, and/or is inexplicable (55) – and the idea of art work as the “transitional object” as “a means that some artists use, conceptually and yet also viscerally, in response to the extreme ‘separation anxiety’ of losing a loved one, to the void of the Unknown” (57). In my case, non-disclosure prevented my literacy and the evolution of the image into language, prevented me from fully understanding the coded messages left for me in my art work. However, each of my paintings is now, with the benefit of full disclosure, a powerful, penetrating, and comprehensible intra and extra sensory cry from the body in kinaesthetic translation (Lusebrink, 125; Klorer, 217). In Figure 1, ‘Embrace’, the reference to the umbilical is palpable, described in my novel “The Womb Artist” (184) this way; “two ropes tightly entwine as one, like a dark and dirty umbilical cord snaking its way across a nether world of smudged umbers”. There is an ‘abject’ void surrounding it. The cord sapped of its colour, its blood, nutrients – the baby starved of oxygen, breath; the LDA starved of words and conscious understanding. It has two parts entwined that may be seen in many ways (without wanting to reduce these to static binaries): mother/baby; conscious/unconscious; first person/third person; child/adult; semiotic/symbolic – numerous dualities could be spun from this embrace – but in terms of my novel and of the adoptive experience, it reeks of need, life and death, a text choking on the poetic while at the same time nourished by it; a text made ‘available’ to the reader while at the same narrowing, limiting, and obscuring the indefinable nature of pre-verbal trauma. Figure 1. Embrace. 1993. Acrylic on canvas.The painting ‘Womb Tongues’ (Figure 2) is perhaps the last (and, obviously, lasting) memory of the infinite inchoate universe within the womb, the umbilical this time wrapped around in a phallic/clitorial embrace as the baby-self emerges into the constrictions of a Foucauldian world, where the adoptive script smothers the ‘body’ encased beneath the ‘coils’ of Judeo-Christian prejudice and centuries old taboo. In this way, the reassigned adoptee is an acute example of power (authority) controlling and defining the self and what knowledge of the self may be allowed. The baby in this painting is now a suffocated clitoris, a bound subject, a phallic representation, a gagged ‘tongue’ in the shape of the personally absent (but socially imposing) omni-present and punitive patriarchy. Figure 2. Womb Tongues. 1997. Acrylic on canvas.‘Germination’ (Figure 3) depicts an umbilical again, but this time as emerging from a seething underworld and is present in TWA (174) this way, “a colony of night crawlers that writhe and slither on the canvas, moving as one, dozens of them as thin as a finger, as long as a dream”. The rhizomic nature of this painting (and Figure 4), becomes a heaving horde of psychosomatic and psychopathological influences and experiences, a multitude of closely packed, intense, and dendridic compulsions and symptoms, a mass of interconnected (and by nature of the silence and lie) subterranean knowledges that force the germination of a ‘ghost baby/child/adult’ indicated by the pale and ashen seedling that emerges above ground. The umbilical is ghosted, pale and devoid of life. It is in the air now, reaching up, as if in germination to a psychological photosynthesis. There is the knot and swarm within the unconscious; something has, in true alien fashion, been incubated and is now emerging. In some ways, these paintings are hardly cryptic.Figure 3. Germination.1993. Acrylic on canvas.In Figure 4 ‘The Birthing Tree’, the overt symbolism reaches ‘clairvoyant status’. This could be read as the family ‘tree’ with its four faces screaming out of the ‘branches’. Do these represent the four babies relinquished by our mother (the larger of these ‘beings’ as myself, giving birth to the illegitimate, silenced, and abject self)? Are we all depicted in anguish and as wraithlike, grotesquely simplified into pure affect? This illegitimate self is painted as gestating a ‘blue’ baby, near full-term in a meld of tree and ‘self’, a blue umbilical cord, again, devoid of blood, ghosted, lifeless and yet still living, once again suffocated by the representation of the umbilical in the ‘bowels’ of the self, the abject part of the body, where refuse is stored and eliminated: The duodenum of the damned. The Devil may be seen as Christopher Bollas’s “shadow of the object”, or the Jungian archetypal shadow, not simply a Judeo-Christian fear-based spectre and curmudgeon, but a site of unprocessed and, therefore, feared psychological material, material that must be brought to consciousness and integrated. Perhaps the Devil also is the antithesis to ‘God’ as mother. The hell of ‘not mother’, no mother, not the right mother, the reluctant adoptive mother – the Devil as icon for the rich underbelly of the psyche and apophatic to the adopted/artificial/socially scripted self.Figure 4. The Birthing Tree. 1995. Acrylic on canvas.These paintings ache with the trauma of my relinquishment and LDA experience. They ache with my body’s truth, where the cellular and psychological, flesh and blood and feeling, leak from my wounds in unspeakable confluence (the two genital lips as the site of relinquishment, my speaking lips that have been sealed through non-disclosure and shame, the psychological trauma as Verrier’s ‘primal wound’) just as I leaked from my mother (and society) at birth, as blood and muck, and ooze and pus and death (Grosz 195) only to be quickly and silently mopped up and cleansed through adoption and life-long secrecy. Where I, as translator, fluent in both silence and signs, disclose the baby’s trauma, asking for legitimacy. My experience as a LDA sets up an interesting experiment, one that allows an examination of the pre-verbal/pre-disclosure body as a fleshed and breathing Rosetta Stone, as an interface between the language of the body and of the verbalised, painted, and written text. As a constructed body, written upon and invented legally, socially, and psychologically, I am, in Hélène Cixous’s (“To Live the Orange” 83) words, “un-forgetting”, “un-silencing” and “unearthing” my ‘self’ – I am re-writing, re-inventing and, under public scrutiny, legitimising my ‘self’. I am a site of inquiry, discovery, extrapolation, and becoming (Metta 492; Poulus 475) and, as Grosz (vii) suggests, a body with “all the explanatory power” of the mind. I am, as I embroider myself and my LDA experience into literary and critical texts, authoring myself into existence, referencing with particular relevance Peter Carnochan’s (361) suggestion that “analysis...acts as midwife to the birth of being”. I am, as I swim forever amorphous, invisible, and unspoken in my mother’s womb, fashioning a shore, landscaping my mind against the constant wet, my chronic liminality (Rambo 629) providing social landfall for other LDAs and silenced minorities. As Catherine Lynch (3) writes regarding LDAs, “Through the creation of text and theory I can formulate an intimate space for a family of adoptive subjects I might never know via our participation in a new discourse in Australian academia.” I participate through my creative, self-reflexive, process fuelled (Durey 22), practice-led enquiry. I use the intimacy (and also universality and multiplicity) and illegitimacy of my body as an alterative text, as a site of academic and creative augmentation in the understanding of LDA issues. The relinquished and silenced baby and LDA adult needs a voice, a ‘body’, and a ‘tender’ place in the consciousness of society, as Helen Riley (“Confronting the Conspiracy of Silence” 11) suggests, “voice, validation, and vindication”. Judith Herman (3) argues that, “Survivors challenge us to reconnect fragments, to reconstruct history, to make meaning of their present symptoms in the light of past events”. I seek to use the example of my experience – as Judith Durey (31) suggests, in “support of evocative, creative modes of representation as valid forms of research in their own right” – to unfurl the whole, to give impetus and precedence for other researchers into adoption and advocate for future babies who may be bought, sold, arranged, and/or created by various means. The recent controversy over Gammy, the baby boy born with Down Syndrome in Thailand, highlights the urgent and moral need for legislation with regard to surrogacy (see Kajsa Ekis Ekman’s Being and Being Bought: Prostitution, Surrogacy and the Split Self for a comprehensive examination of surrogacy issues). Indeed, Catherine Lynch in her paper Doubting Adoption Legislation links the experiences of LDAs and the children of born of surrogacy, most effectively arguing that, “if the fate that closed record adoptees suffered was a misplaced solution to the question of what to do with children already conceived how can you justify the deliberate conception of a child with the intention even before its creation of cruelly removing that child from their mother?” (6). Cixous (xxii) confesses, “All I want is to illustrate, depict fragments, events of human life and death...each unique and yet at the same time exchangeable. Not the law, the exception”. I, too, am a fragment, an illustration (a painting), and, as every individual always is – paradoxically – a communal and, therefore, deeply recognisable and generally applicable minority and exception. In my illegitimacy, I am some kind of evidence. Evidence of cellular memory. Evidence of embodiment. Evidence that silenced illegitimacies will manifest in symptom and non-verbal narratives, that they will ooze out and await translation, verification, and witness. This paper is offered with reverence and with feminist intention, as a revenant mouthpiece for other LDAs, babies born of surrogacy, and donor assisted offspring (and, indeed, any) who are marginalised, silenced, and obscured. It is also intended to promote discussion in the psychological and psychoanalytic fields and, as Helen Riley (202-207) advocates regarding late discovery offspring, more research within the social sciences and the bio-medical field that may encourage legislators to better understand what the ‘best interests of the child’ are in terms of late discovery of origins and the complexity of adoption/conception practices available today. As I write now (and always) the umbilical from my paintings curve and writhe across my soul, twist and morph into the swollen and throbbing organ of tongues, my throat aching to utter, my hands ready to craft latent affect into language in translation of, and in obedience to, my body’s knowledges. It is the art of mute witness that reverses genesis, that keeps the umbilical fat and supple and full of blood, and allows my conscious conception and creation. Indeed, in the intersection of my theoretical, creative, psychological, and somatic praxis, the heat (read hot and messy, insightful and insistent signage) of my body’s knowledges perhaps intensifies – with a ripe bouquet – the inevitably ongoing odour/aroma of the reproductive world. ReferencesAngel, Maria, and Anna Gibbs. “On Moving and Being Moved: The Corporeality of Writing in Literary Fiction and New Media Art.” Literature and Sensation, eds. Anthony Uhlmann, Helen Groth, Paul Sheehan, and Stephan McLaren. Newcastle upon Tyne, UK: Cambridge Scholars Publishing, 2009: 162-172. Bollas, Christopher. The Shadow of the Object: Psychoanalysis of the Unthought Known. New York: Columbia UP, 1987. Brodzinsky, David. “Adjustment to Adoption: A Psychosocial Perspective.” Clinical Psychology Review 7 (1987): 25-47. doi: 10.1016/0272-7358(87)90003-1.Brodzinsky, David, Daniel Smith, and Anne Brodzinsky. Children’s Adjustment to Adoption: Developmental and Clinical Issues. 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