Structural, chemical, and magnetic investigation of a graphene/cobalt/platinum multilayer system on silicon carbide.

We investigate the magnetic interlayer coupling and domain structure of ultra-thin ferromagnetic (FM) cobalt (Co) layers embedded between a graphene (G) layer and a platinum (Pt) layer on a silicon carbide (SiC) substrate (G/Co/Pt on SiC). Experimentally, a combination of x-ray photoemission electron microscopy with x-ray magnetic circular dichroism has been carried out at the Co L-edge. Furthermore, structural and chemical properties of the system have been investigated using low energy electron diffraction (LEED) and x-ray photoelectron spectroscopy (XPS).In situLEED patterns revealed the crystalline structure of each layer within the system. Moreover, XPS confirmed the presence of quasi-freestanding graphene, the absence of cobalt silicide, and the appearance of two silicon carbide surface components due to Pt intercalation. Thus, the Pt-layer effectively functions as a diffusion barrier. The magnetic structure of the system was unaffected by the substrate's step structure. Furthermore, numerous vortices and anti-vortices were found in all samples, distributed all over the surfaces, indicating Dzyaloshinskii-Moriya interaction. Only regions with a locally increased Co-layer thickness showed no vortices. Moreover, unlike in similar systems, the magnetization was predominantly in-plane, so no perpendicular magnetic anisotropy was found.

Extremely long-range, high-temperature Josephson coupling across a half-metallic ferromagnet.

The Josephson effect results from the coupling of two superconductors across a spacer such as an insulator, a normal metal or a ferromagnet to yield a phase coherent quantum state. However, in junctions with ferromagnetic spacers, very long-range Josephson effects have remained elusive. Here we demonstrate extremely long-range (micrometric) high-temperature (tens of kelvins) Josephson coupling across the half-metallic manganite La0.7Sr0.3MnO3 combined with the superconducting cuprate YBa2Cu3O7. These planar junctions, in addition to large critical currents, display the hallmarks of Josephson physics, such as critical current oscillations driven by magnetic flux quantization and quantum phase locking effects under microwave excitation (Shapiro steps). The latter display an anomalous doubling of the Josephson frequency predicted by several theories. In addition to its fundamental interest, the marriage between high-temperature, dissipationless quantum coherent transport and full spin polarization brings opportunities for the practical realization of superconducting spintronics, and opens new perspectives for quantum computing.

Impact of seed-applied fungicide and insecticide on Azospirillum brasilense survival and wheat growth-promoting ability.

The use of Azospirillum brasilense as a crop inoculant has increased in recent years. Thus, the compatibility of the inoculation technology with seed treatments using pesticides needs to be evaluated. In this study, we evaluated the effect of an insecticide and fungicide formulation on A. brasilense strain FP2 population by culturing and culture-independent approaches. In addition, we evaluated the impact of these pesticides on the ability of A. brasilense to promote plant growth by monitoring biometric traits (root and shoot dry mass and length) of wheat grown in Greenhouse conditions. Seed pesticide dressings, mainly fungicide, led to a significant mortality of A. brasilense over time. The ability of A. brasilense to promote wheat growth also decreased due to pesticide treatments combined with sowing delay. Considering that pesticides confer fitness advantages to the wheat in field condition, our results suggest that sowing within the first 4 h after inoculation maintain the beneficial effects of A. brasilense on wheat growth promotion. Furthermore, we conclude that inoculation and treatment of seeds with pesticides may be compatible techniques when carried out immediately before sowing.

Influence of environmental factors on the tropical peatlands diazotrophic communities from the Southern Brazilian Atlantic Rain Forest.

The tropical peatlands of southern Brazil are essential for the maintenance of the Atlantic Rain Forest, one of the 25 hotspots of biodiversity in the world. Although diazotrophic micro-organisms are essential for the maintenance of this nitrogen limited ecosystem, so far studies have focused only on micro-organisms involved in the carbon cycle. In this work, peat samples were collected from three tropical peatland regions during dry and rainy seasons and their chemical and microbial characteristics were evaluated. Our results showed that the structure of the diazotrophic communities in the Brazilian tropical peatlands differs in the evaluated seasons. The abundance of the genus Bradyrhizobium showed to be affected by rainfall and peat pH. Despite the shifts of the nitrogen-fixing population in the tropical peatland caused by seasonality it showed to be constantly dominated by α-Proteobacteria followed by Cyanobacteria. In addition, more than 50% of nifH gene sequences have not been classified, indicating the necessity for more studies in tropical peatland, since the reduction of N supply in the peatlands stimulates the recalcitrant organic matter decomposition performed by peatland micro-organisms, influencing the C stock.

Mechanism of Néel Order Switching in Antiferromagnetic Thin Films Revealed by Magnetotransport and Direct Imaging.

We probe the current-induced magnetic switching of insulating antiferromagnet-heavy-metal systems, by electrical spin Hall magnetoresistance measurements and direct imaging, identifying a reversal occurring by domain wall (DW) motion. We observe switching of more than one-third of the antiferromagnetic domains by the application of current pulses. Our data reveal two different magnetic switching mechanisms leading together to an efficient switching, namely, the spin-current induced effective magnetic anisotropy variation and the action of the spin torque on the DWs.

Ferroelectric Control of Interface Spin Filtering in Multiferroic Tunnel Junctions.

The electronic reconstruction occurring at oxide interfaces may be the source of interesting device concepts for future oxide electronics. Among oxide devices, multiferroic tunnel junctions are being actively investigated as they offer the possibility to modulate the junction current by independently controlling the switching of the magnetization of the electrodes and of the ferroelectric polarization of the barrier. In this Letter, we show that the spin reconstruction at the interfaces of a La_{0.7}Sr_{0.3}MnO_{3}/BaTiO_{3}/La_{0.7}Sr_{0.3}MnO_{3} multiferroic tunnel junction is the origin of a spin filtering functionality that can be turned on and off by reversing the ferroelectric polarization. The ferroelectrically controlled interface spin filter enables a giant electrical modulation of the tunneling magnetoresistance between values of 10% and 1000%, which could inspire device concepts in oxides-based low dissipation spintronics.

Clinical and Epidemiologic Description of Orofacial Clefts in Bogota and Cali, Colombia, 2001-2015.

OBJECTIVES: Among congenital craniofacial anomalies, orofacial clefts (OFCs) are the most common. Global prevalence is 2 in 1000 and in Colombia, 1 in 700. Our goal was to describe cleft palate (CP) prevalence and cleft lip with or without cleft palate (CL±P) from 2001 to 2015 in Bogota and Cali, Colombia. METHOD: Using the ECLAMC case-control design method, information was obtained from the Congenital Anomalies Monitoring and Surveillance Programs in Bogota and Cali. We describe the prevalence of cases classified into the following groups: isolated, polymalformed, and syndromic. The proportion of cases and controls was 1:4. Data were analyzed using frequency distribution and Student t test to compare means and 95% confidence intervals (CIs). RESULTS: We identified 529 OFC cases and 2116 controls from 448,930 births: a rate of 11.8 per 10,000 (CI = 10.80-12.83). From the total cases, 73% were identified with CL/CP compared to 27% with CP. Males had higher CL±P (59%) prevalence, whereas the highest neonatal mortality was observed among polymalformed cases (7%). The most common anomaly identified among our cases was cleft lip without isolated cleft palate (58%). We found that OFCs are linked to birthweight, size, and gestational age and higher parity with statistically significant differences in all variables compared to controls. CONCLUSIONS: OFC is a highly prevalent anomaly in Colombia, with a range of maternal and infant differences across case subgroups. The identification of important OFC subgroups that follow certain patterns of prevalence may prove useful to primary and tertiary care facilities with the goal of reducing further disability.

Electric-field control of magnetic order above room temperature.

Controlling magnetism by means of electric fields is a key issue for the future development of low-power spintronics. Progress has been made in the electrical control of magnetic anisotropy, domain structure, spin polarization or critical temperatures. However, the ability to turn on and off robust ferromagnetism at room temperature and above has remained elusive. Here we use ferroelectricity in BaTiO3 crystals to tune the sharp metamagnetic transition temperature of epitaxially grown FeRh films and electrically drive a transition between antiferromagnetic and ferromagnetic order with only a few volts, just above room temperature. The detailed analysis of the data in the light of first-principles calculations indicate that the phenomenon is mediated by both strain and field effects from the BaTiO3. Our results correspond to a magnetoelectric coupling larger than previous reports by at least one order of magnitude and open new perspectives for the use of ferroelectrics in magnetic storage and spintronics.

Thermodynamic analysis of framework deformation in Na,Cs-RHO zeolite upon CO2 adsorption.

Fully dehydrated and partially sodium-cesium containing RHO zeolite (Na,Cs-RHO) shows a genuine inflection in the CO2 isotherms in the temperature range 293-333 K that can be attributed to a sorbate-induced framework deformation from an acentric (A) to a centric (C) phase due to a partial cation rearrangement. This peculiar sorption pattern can be captured by the formulation of thermodynamic isotherms, providing a direct enthalpic and entropic signature of the CO2 adsorption-desorption process during deformation. Using this formulation, the energy barrier between the acentric and centric phases for CO2 adsorption-desorption was estimated in the range 4.7-9.6 J g(-1) of solid (15-32 kJ mol(-1)), reflecting a higher CO2 affinity for the acentric phase, whereas the elastic energy involved during framework distortion was estimated in the range 6-12 J g(-1) of solid (19-39 kJ mol(-1)) with a relative maximum at 303 K and showing a dominant entropic contribution.

Contrasting effects of geographical separation on the genetic population structure of sympatric species of mites in avocado orchards.

Oligonychus punicae and Oligonychus perseae (Acari: Tetranychidae) are the most important mite species affecting avocado orchards in Mexico. Here we used nucleotide sequence data from segments of the nuclear ribosomal internal transcribed spacers (ITS1 and ITS2) and mitochondrial cytochrome oxidase subunit I (COI) genes to assess the phylogenetic relationships between both sympatric mite species and, using only ITS sequence data, examine genetic variation and population structure in both species, to test the hypothesis that, although both species co-occur, their genetic population structures are different in both Michoacan state (main producer) and Mexico state. Phylogenetic analysis showed a clear separation between both species using ITS and COI sequence information. Haplotype network analysis done on 24 samples of O. punicae revealed low genetic diversity with only three haplotypes found but a significant geographical population structure confirmed by analysis of molecular variance (AMOVA) and Kimura-2-parameter (K2P) analyses. In addition, a Mantel test revealed that geographical isolation was a factor responsible for the genetic differentiation. In contrast, analyses of 22 samples of O. perseae revealed high genetic diversity with 15 haplotypes found but no geographical structure confirmed by the AMOVA, K2P and Mantel test analyses. We have suggested that geographical separation is one of the most important factors driving genetic variation, but that it affected each species differently. The role of the ecology of these species on our results, and the importance of our findings in the development of monitoring and control strategies are discussed.

Phase-dependent generation and transmission of time information by the KaiABC circadian clock oscillator through SasA-KaiC interaction in cyanobacteria.

Circadian clocks allow organisms to predict environmental changes of the day/night cycle. In the cyanobacterial circadian clock machinery, the phosphorylation level and ATPase activity of the clock protein KaiC oscillate with a period of approximately 24 h. The time information is transmitted from KaiC to the histidine kinase SasA through the SasA autophosphorylation-enhancing activity of KaiC, ultimately resulting in genome-wide transcription cycles. Here, we showed that SasA derived from the thermophilic cyanobacterium Thermosynechococcus elongatus BP-1 has the domain structure of an orthodox histidine kinase and that its C-terminal domain, which contains a phosphorylation site at His160, is responsible for the autophosphorylation activity and the temperature- and phosphorylation state-dependent trimerization / hexamerization activity of SasA. SasA and KaiC associate through their N-terminal domains with an affinity that depends on their phosphorylation states. Furthermore, the SasA autophosphorylation-enhancing activity of KaiC requires the C-terminal ATPase catalytic site and depends on its phosphorylation state. We show that the phosphotransfer activity of SasA is essential for the generation of normal circadian gene expression in cyanobacterial cells. Numerical simulations suggest that circadian time information (free phosphorylated SasA) is released mainly by unphosphorylated KaiC during the late subjective night.

[Surgical margins as prognostic factor in pelvis chondrosarcoma. Cohort study in a sarcoma unit]. / Márgenes quirúrgicos como factor pronóstico del condrosarcoma de pelvis. Estudio de cohorte en una unidad de sarcomas.

INTRODUCTION: chondrosarcoma is the second most common primary malignant tumor, constitutes approximately one quarter of all primary bone sarcomas. Surgical margins in pelvic chondrosarcoma have a direct impact as a prognostic factor, both on overall survival and on recurrence-free survival of this disease. OBJECTIVES: to analyze the impact of surgical margins as a prognostic factor in pelvic chondrosarcoma. MATERIAL AND METHODS: a retrospective database cohort with prospective follow-up of sarcomas in patients diagnosed with primary pelvic chondrosarcoma who underwent surgical treatment. Clinical-demographic variables were obtained, a descriptive analysis of each variable was performed, and these were contrasted with the outcome variables. RESULTS: seventeen patients were included, of which nine were female. The median age was 41 years, ranging from 23 to 65 years. The average tumor size was 20.9 cm (range 5 to 46 cm). The average surgical margin was 5.3 mm, ranging from 1 to 30 mm, with 58% positive margins. The average overall survival was 64 months (range 7 to 108 months). The distribution of pelvic involvement was as follows: zone I in nine patients (52.9%), zone II in two (11.8%), a combination of zones I-III in two (11.8%), I+II in one (5.9%), II+III in one (5.9%), I-III plus sacrum in one (5.9%) and I plus sacrum in one (5.9%). Tumor grades were classified as low in seven patients (41.2%), intermediate in sven (41.2%), high in two (11.8%), and dedifferentiated in one (5.9%). Regarding the type of resection, 12 patients (70.6%) underwent internal hemipelvectomy and five (29.4%) external hemipelvectomy. Recurrence was recorded in five cases (29.4%), metastasis in three (17.6%), and mortality in four (23.5%). CONCLUSIONS: this series represents the largest cohort reported in Latin America of primary pelvic chondrosarcomas. A more favorable prognosis was observed in patients with surgical margins greater than 1 mm. The presence of chondrosarcoma in multiple pelvic zones was associated with a worse oncological prognosis. Additionally, a higher incidence of positive surgical margins and local recurrence rates were identified in pelvic chondrosarcomas compared to those located in the extremities.

INTRODUCCIÓN: el condrosarcoma (CS), el segundo tumor maligno óseo primario más común, constituye aproximadamente una cuarta parte de todos los sarcomas óseos primarios. Los márgenes quirúrgicos en el condrosarcoma pélvico tienen un impacto directo como factor pronóstico, tanto en la supervivencia global como en la supervivencia libre de recurrencia de esta enfermedad. OBJETIVOS: analizar el impacto de los márgenes quirúrgicos como factor pronóstico en el condrosarcoma de la pelvis. MATERIAL Y MÉTODOS: cohorte de base de datos retrospectiva con seguimiento prospectivo de sarcomas de pacientes con diagnóstico de condrosarcoma primario de la pelvis que fueron sometidos a tratamiento quirúrgico. Se obtuvieron variables clínico-demográficas, se realizó un análisis descriptivo de cada variable y se contrastaron con las variables desenlace. RESULTADOS: se incluyeron 17 pacientes, de los cuales nueve eran mujeres. La mediana de edad fue de 41 años (rango de 23 a 65 años). El tamaño promedio del tumor fue de 20.9 cm (rango de 5 a 46 cm). El margen quirúrgico promedio fue de 5.3 mm, variando entre 1 y 30 mm, con 58% de márgenes positivos. La supervivencia global promedio fue de 64 meses (rango de 7 a 108 meses). La distribución de la afectación pélvica fue: zona I en nueve pacientes (52.9%), zona II en dos (11.8%), combinación de zonas I-III en dos (11.8%), I+II en uno (5.9%), II+III en uno (5.9%), I-III más sacro en uno (5.9%) y I más sacro en uno (5.9%). Los grados tumorales se clasificaron en bajo en siete pacientes (41.2%), intermedio en siete (41.2%), alto en dos (11.8%) y desdiferenciado en uno (5.9%). Respecto al tipo de resección, 12 pacientes (70.6%) se sometieron a hemipelvectomía interna y cinco (29.4%) a hemipelvectomía externa. Se registró recurrencia en cinco casos (29.4%), metástasis en tres (17.6%) y mortalidad en cuatro (23.5%). CONCLUSIONES: esta serie representa la cohorte más extensa reportada en Latinoamérica de condrosarcomas primarios de la pelvis. Se observó un pronóstico más favorable en pacientes con márgenes quirúrgicos superiores a 1 mm. La presencia de condrosarcoma en múltiples zonas pélvicas se asoció con un peor pronóstico oncológico. Además, se identificó una mayor incidencia de márgenes quirúrgicos positivos y tasas de recurrencia local en condrosarcomas de la pelvis en comparación con aquellos ubicados en las extremidades.

Interface-induced room-temperature multiferroicity in BaTiO3.

Multiferroic materials possess two or more ferroic orders but have not been exploited in devices owing to the scarcity of room-temperature examples. Those that are ferromagnetic and ferroelectric have potential applications in multi-state data storage if the ferroic orders switch independently, or in electric-field controlled spintronics if the magnetoelectric coupling is strong. Future applications could also exploit toroidal moments and optical effects that arise from the simultaneous breaking of time-reversal and space-inversion symmetries. Here, we use soft X-ray resonant magnetic scattering and piezoresponse force microscopy to reveal that, at the interface with Fe or Co, ultrathin films of the archetypal ferroelectric BaTiO3 simultaneously possess a magnetization and a polarization that are both spontaneous and hysteretic at room temperature. Ab initio calculations of realistic interface structures provide insight into the origin of the induced moments and bring support to this new approach for creating room-temperature multiferroics.

Magnetic frustration, phase competition, and the magnetoelectric effect in NdFe3(BO3)4.

We present an element selective resonant magnetic x-ray scattering study of NdFe3(BO3)4 as a function of temperature and applied magnetic field. Our measurements show that the magnetic order of the Nd sublattice is induced by the Fe spin order. When a magnetic field is applied parallel to the hexagonal basal plane, the helicoidal spin order is suppressed and a collinear ordering, where the moments are forced to align in a direction perpendicular to the applied magnetic field, is stabilized. This result excludes a noncollinear spin order as the origin of the magnetically induced electric polarization in this compound. Instead our data imply that magnetic frustration results in a phase competition, which is the origin of the magnetoelectric response.

Superconducting imprint of magnetic textures in ferromagnets with perpendicular magnetic anisotropy.

Research on proximity effects in superconductor/ferromagnetic hybrids has most often focused on how superconducting properties are affected-and can be controlled-by the effects of the ferromagnet's exchange or magnetic fringe fields. The opposite, namely the possibility to craft, tailor and stabilize the magnetic texture in a ferromagnet by exploiting superconducting effects, has been more seldom explored. Here we show that the magnetic flux trapped in high-temperature superconducting YBa2Cu3O7-δ microstructures can be used to modify the magnetic reversal of a hard ferromagnet-a cobalt/platinum multilayer with perpendicular magnetic anisotropy-and to imprint unusual magnetic domain distributions in a controlled manner via the magnetic field history. The domain distributions imprinted in the superconducting state remain stable, in absence of an external magnetic field, even after increasing the temperature well above the superconducting critical temperature, at variance to what has been observed for soft ferromagnets with in-plane magnetic anisotropy. This opens the possibility of having non-trivial magnetic configuration textures at room temperature after being tailored below the superconducting transition temperature. The observed effects are well explained by micromagnetic simulations that demonstrate the role played by the magnetic field from the superconductor on the nucleation, propagation, and stabilization of magnetic domains.

Quadratic X-ray magneto-optical effect upon reflection in a near-normal-incidence configuration at the M edges of 3d-transition metals.

We have observed a quadratic x-ray magneto-optical effect in near-normal-incidence reflection at the M edges of iron. The effect appears as the magnetically induced rotation of approximately 0.1 degrees of the polarization plane of linearly polarized x-ray radiation upon reflection. A comparison of the measured rotation spectrum with results from x-ray magnetic linear dichroism data demonstrates that this is the first observation of the Schäfer-Hubert effect in the x-ray regime. Ab initio density-functional theory calculations reveal that hybridization effects of the 3p core states necessarily need to be considered when interpreting experimental data. The discovered magneto-x-ray effect holds promise for future ultrafast and element-selective studies of ferromagnetic as well as antiferromagnetic materials.

A local view of the laser induced magnetic domain dynamics in CoPd stripe domains at the picosecond time scale.

The dynamics of the magnetic structure in a well ordered ferromagnetic CoPd stripe domain pattern has been investigated upon excitation by femtosecond infrared laser pulses. Time-resolved x-ray magnetic circular dichroism in photoemission electron microscopy (TR-XMCD-PEEM) is used to perform real space magnetic imaging with 100 ps time resolution in order to show local transformations of the domains structures. Using the time resolution of the synchrotron radiation facility of the Helmholtz-Zentrum Berlin, we are able to image the transient magnetic domains in a repetitive pump and probe experiment. In this work, we study the reversible and irreversible transformations of the excited magnetic stripe domains as function of the laser fluence. Our results can be explained by thermal contributions, reducing the XMCD amplitude in each stripe domain below a threshold fluence of 12 mJ cm-2. Above this threshold fluence, irreversible transformations of the magnetic domains are observed. Static XMCD-PEEM images reveal the new partially ordered stripe domain structures characterized by a new local magnetic domain distribution showing an organized pattern at the micrometer scale. This new arrangement is attributed to the recovery of the magnetic anisotropy during heat dissipation under an Oersted field.

Splenic abscess after arterial embolization: a rare cause of acute abdomen.

Splenic abscess is a rare disease and a diagnostic challenge for the medical team. Attributable to its high mortality, prompt diagnosis and treatment are essential. A high degree of clinical awareness is required in conjunction with aggressive treatment, as misleading symptoms may delay treatment and worsen the patient's prognosis. The management of splenic abscess is based on medical therapy, antibiotics and splenectomy or percutaneous drainage. We present the case of a 58-year-old patient presented with a splenic abscess after arterial embolization. He underwent surgery and completely recovered.

Neurocognitive reorganization of emotional processing following a socio-cognitive intervention in Colombian ex-combatants.

Ex-combatants often exhibit atypical Emotional Processing (EP) such as reduced emphatic levels and higher aggressive attitudes. Social Cognitive Training (SCT) addressing socio-emotional components powerfully improve social interaction among Colombian ex-combatants. However, with narrow neural evidence, this study offers a new testimony. A sample of 28 ex-combatants from Colombian illegal armed groups took part in this study, split into 15 for SCT and 13 for the conventional program offered by the Governmental Reintegration Route. All of them were assessed before and after the intervention with a protocol that included an EP task synchronized with electroencephalographic recordings. We drew behavioral scores and brain connectivity (Coherency) metrics from task performance. Behavioral scores yielded no significant effects. Increased post-intervention connectivity in the delta band was observed during negative emotional processing only SCT group. Positive emotions exposed distinctive gamma band connectivity that differentiate groups. These results suggest that SCT can trigger covert neurofunctional reorganization in ex-combatants embarked on the reintegration process even when overt behavioral improvements are not yet apparent. Such covert functional changes may be the neural signature of compensatory mechanisms necessary to reshape behaviors adaptively. This novel framework may inspire cutting-edge translational research at the crossing of neuroscience, sociology, and public policy-making.

The experiences of dentists in the management planning of oral health services in Lesotho, Africa.

INTRODUCTION: Health sector reforms motivated by the need for efficiency, effectiveness and equity in the delivery of services have interested authorities in the planning competencies of managers, because planning sets the stage for the effective management of health systems. The huge public and private cost of oral health makes planning an important dimension for health authorities when considering the allocation of funds. Productivity in the oral health service sector is not often reported on, despite the cost involved in rendering oral health services. This study explores and describes the management planning experiences of oral health managers in the public sector in Lesotho, Africa, which consists of clinics in 10 districts serving hundreds of rural and remote mountainous communities. METHODS: The study used a qualitative research design. Of the purposive sample of 14 public sector dentists then available, seven dentists (2 female and 5 male) met the criteria for participation (> or = 1 year of experience in district oral health planning), and consented to and were available for participation. Data were collected by in-depth, one-on-one interviews with 6 participants, and textual data were collected from the seventh. Interviews were audiotaped and transcribed verbatim. Data were organised and analysed using the Tesch method, with themed topics coded and categorised by a researcher and an independent coder for analysis. RESULTS: One major theme emerged (the management planning of oral health services were experienced as inefficient) and four sub-themes: (1) the need to plan carefully to provide efficient clinical services; (2) constraints to promoting expansion of community based dental services; (3) a breakdown in communication hampered service delivery; and (4) internal and external stakeholder issues impacted strongly on management planning. CONCLUSION: The inefficiency (failure of the community to derive maximum curative, preventive and rehabilitative benefits from public expenditure on oral health in Lesotho), as described by participants, arose from factors that impair careful planning; constrained the expansion of community based oral health services; caused a breakdown in communication between dentists and their authorities leading to poor services delivery; and was impacted strongly by internal and external stakeholder issues.