Why federal intervention in Portland shouldn’t be a shock

For several months, protests have been ongoing in Portland, Oregon, following the police killings of Breonna Taylor and George Floyd. Aaron Roussell and Gisela Rodriguez Fernandez examine the intentional misconceptions which have developed to delegitimize the protests in Portland and elsewhere, writing that despite sentiments that such tactics are ‘not American’, the use of police violence and federal agents against protests in US cities is nothing new

Latin America and the Caribbean: Assessment of the Advances in Public Health for the Achievement of the Millennium Development Goals

To improve health and economy of the world population, the United Nations has set up eight international goals, known as Millennium Development Goals (MDGs), that 192 United Nations member states and at least 23 international organizations have agreed to achieve by the year 2015. The goals include: (1) eradicating extreme poverty and hunger; (2) achieving universal primary education; (3) promoting gender equality; (4) reducing child mortality; (5) improving maternal health; (6) combating HIV/AIDS, malaria and other diseases; (7) ensuring environmental sustainability; and (8) developing a global partnership for development. Having been in the midway from the 2015 deadline, the UN Secretary-General urges countries to engage constructively to review progress towards the MDGs. This paper aims to evaluate advances in public health, with special reference to gender inequalities in health, health sector reform, global burden of disease, neglected tropical diseases, vaccination, antibiotic use, sanitation and safe water, nutrition, tobacco and alcohol use, indicators of health, and disease prevention in Latin America and the Caribbean region (LAC). The paper also identifies areas of deficits for the achievement of MDGs in LAC

The effect of early life events on glucose levels in first-episode psychosis

First episode of psychosis (FEP) patients display a wide variety of metabolic disturbances at onset, which might underlie these patients’ increased morbidity and early mortality. Glycemic abnormalities have been previously related to pharmacological agents; however, recent research highlights the impact of early life events. Birth weight (BW), an indirect marker of the fetal environment, has been related to glucose abnormalities in the general population over time. We aim to evaluate if BW correlates with glucose values in a sample of FEP patients treated with different antipsychotics. Two hundred and thirty-six patients were included and evaluated for clinical and metabolic variables at baseline and at 2, 6, 12, and 24 months of follow-up. Pearson correlations and linear mixed model analysis were conducted to analyze the data. Antipsychotic treatment was grouped due to its metabolic risk profile. In our sample of FEP patients, BW was negatively correlated with glucose values at 24 months of follow-up [r=-0.167, p=0.037]. BW showed a trend towards significance in the association with glucose values over the 24-month period (F=3.22; p=0.073) despite other confounders such as age, time, sex, body mass index, antipsychotic type, and chlorpromazine dosage. This finding suggests that BW is involved in the evolution of glucose values over time in a cohort of patients with an FEP, independently of the type of pharmacological agent used in treatment. Our results highlight the importance of early life events in the later metabolic outcome of patients

Gene co-expression architecture in peripheral blood in a cohort of remitted first-episode schizophrenia patients

A better understanding of schizophrenia subtypes is necessary to stratify the patients according to clinical attributes. To explore the genomic architecture of schizophrenia symptomatology, we analyzed blood co-expression modules and their association with clinical data from patients in remission after a first episode of schizophrenia. In total, 91 participants of the 2EPS project were included. Gene expression was assessed using the Clariom S Human Array. Weighted-gene co-expression network analysis (WGCNA) was applied to identify modules of co-expressed genes and to test its correlation with global functioning, clinical symptomatology, and premorbid adjustment. Among the 25 modules identified, six modules were significantly correlated with clinical data. These modules could be clustered in two groups according to their correlation with clinical data. Hub genes in each group showing overlap with risk genes for schizophrenia were enriched in biological processes related to metabolic processes, regulation of gene expression, cellular localization and protein transport, immune processes, and neurotrophin pathways. Our results indicate that modules with significant associations with clinical data showed overlap with gene sets previously identified in differential gene-expression analysis in brain, indicating that peripheral tissues could reveal pathogenic mechanisms. Hub genes involved in these modules revealed multiple signaling pathways previously related to schizophrenia, which may represent the complex interplay in the pathological mechanisms behind the disease. These genes could represent potential targets for the development of peripheral biomarkers underlying illness traits in clinical remission stages after a first episode of schizophrenia

Post-intervention Status in Patients With Refractory Myasthenia Gravis Treated With Eculizumab During REGAIN and Its Open-Label Extension

OBJECTIVE: To evaluate whether eculizumab helps patients with anti-acetylcholine receptor-positive (AChR+) refractory generalized myasthenia gravis (gMG) achieve the Myasthenia Gravis Foundation of America (MGFA) post-intervention status of minimal manifestations (MM), we assessed patients' status throughout REGAIN (Safety and Efficacy of Eculizumab in AChR+ Refractory Generalized Myasthenia Gravis) and its open-label extension. METHODS: Patients who completed the REGAIN randomized controlled trial and continued into the open-label extension were included in this tertiary endpoint analysis. Patients were assessed for the MGFA post-intervention status of improved, unchanged, worse, MM, and pharmacologic remission at defined time points during REGAIN and through week 130 of the open-label study. RESULTS: A total of 117 patients completed REGAIN and continued into the open-label study (eculizumab/eculizumab: 56; placebo/eculizumab: 61). At week 26 of REGAIN, more eculizumab-treated patients than placebo-treated patients achieved a status of improved (60.7% vs 41.7%) or MM (25.0% vs 13.3%; common OR: 2.3; 95% CI: 1.1-4.5). After 130 weeks of eculizumab treatment, 88.0% of patients achieved improved status and 57.3% of patients achieved MM status. The safety profile of eculizumab was consistent with its known profile and no new safety signals were detected. CONCLUSION: Eculizumab led to rapid and sustained achievement of MM in patients with AChR+ refractory gMG. These findings support the use of eculizumab in this previously difficult-to-treat patient population. CLINICALTRIALSGOV IDENTIFIER: REGAIN, NCT01997229; REGAIN open-label extension, NCT02301624. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that, after 26 weeks of eculizumab treatment, 25.0% of adults with AChR+ refractory gMG achieved MM, compared with 13.3% who received placebo

Minimal Symptom Expression' in Patients With Acetylcholine Receptor Antibody-Positive Refractory Generalized Myasthenia Gravis Treated With Eculizumab

The efficacy and tolerability of eculizumab were assessed in REGAIN, a 26-week, phase 3, randomized, double-blind, placebo-controlled study in anti-acetylcholine receptor antibody-positive (AChR+) refractory generalized myasthenia gravis (gMG), and its open-label extension

Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (VT). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients.OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference.DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries.MAIN OUTCOME MEASURES: Women and men were compared with respect to use of LTVV, defined as VT of 8 ml kg-1 or less predicted bodyweight (PBW). A VT was deemed 'default' if the set VT was a round number. A mediation analysis assessed which factors may explain the sex difference in use of LTVV during intra-operative ventilation.RESULTS: This analysis includes 9864 patients, of whom 5425 (55%) were women. A default VT was often set, both in women and men; mode VT was 500 ml. Median [IQR] VT was higher in women than in men (8.6 [7.7 to 9.6] vs. 7.6 [6.8 to 8.4] ml kg-1 PBW, P < 0.001). Compared with men, women were twice as likely not to receive LTVV [68.8 vs. 36.0%; relative risk ratio 2.1 (95% CI 1.9 to 2.1), P < 0.001]. In the mediation analysis, patients' height and actual body weight (ABW) explained 81 and 18% of the sex difference in use of LTVV, respectively; it was not explained by the use of a default VT.CONCLUSION: In this worldwide cohort of patients receiving intra-operative ventilation during general anaesthesia for surgery, women received a higher VT than men during intra-operative ventilation. The risk for a female not to receive LTVV during surgery was double that of males. Height and ABW were the two mediators of the sex difference in use of LTVV.TRIAL REGISTRATION: The study was registered at Clinicaltrials.gov, NCT01601223

\u3ci\u3eReproduciendo Otros Mundos\u3c/i\u3e: Indigenous Women\u27s Struggles Against Neo-Extractivism and the Bolivian State

Latin America is in a political crisis, yet Bolivia is still widely recognized as a beacon of hope for progressive change. The radical movements at the beginning of the 21st century against neoliberalism that paved the road for the election of Bolivia\u27s first indigenous president, Evo Morales, beckoned a change from colonial rule towards a more just society. Paradoxically, in pursuing progress through economic growth, the Bolivian state led by President Morales has replicated the colonial division of labor through a development model known as neo-extractivism. Deeply rooted tensions have also emerged between indigenous communities and the Bolivian state due to the latter\u27s zealous economic bond with the extractivist sector. Although these paradoxes have received significant attention, one substantial aspect that remains underexplored and undertheorized is how such tensions affect socio-political relations at the intersections of class, race and gender where indigenous women in Bolivia occupy a unique position. To address this research gap, this qualitative study poses the following research questions: 1. How does neo-extractivism affect the lives of indigenous women? 2. How does the state shape relations between neo-extractivism and indigenous women? 3. How do indigenous women organize to challenge the impact of state-led extractivism on their lives and their communities? To answer these questions, I conducted a multi-sited ethnographic study between October 2017 and June 2018 in Oruro, Bolivia, an area that is heavily affected by mining contamination. By analyzing processes of social reproduction, I argue that neo-extractivism leads to water contamination and water scarcity, becoming the epicenter of the deterioration of subsistence agriculture and the dispossession of indigenous ways of life. Because indigenous women are subsistence producers and social reproducers whose activities depend on water, the dispossession of water has a dire effect on them, which demonstrates how capitalism relies on and exacerbates neo-colonial and patriarchal relations. To tame dissent to these contradictions, the Bolivian and self-proclaimed indigenist state defines and politicizes ethnicity in order to build a national identity based on indigeneity. This state-led ethnic inclusion, however, simultaneously produces class exclusions of indigenous campesinxs (peasants) who are not fully engaged in market relations. In contrast to the government\u27s inclusive but rigidly-defined indigeneity, indigenous communities embrace a fluid and dual indigeneity: one that is connected to territories, yet also independent from them; a rooted indigeneity based on the praxis of what it means to be indigenous. Indigenous women and their communities embrace this fluid and rooted indigeneity to build alliances across gender, ethnic, and geographic lines to organize against neo-extractivism. Moreover, the daily responsibilities of social reproduction within the context of subsistence agriculture, which are embedded in Andean epistemes of reciprocity, duality, and complementarity, have allowed indigenous women to build solidarity networks that keep the social fabric within, and between, communities alive. These solidarity networks are sites of everyday resistances that represent a threat and an alternative to capitalist, colonial and patriarchal mandates

Reproduciendo Otros Mundos: Indigenous Women’s Struggles against Neo-Extractivism and the Bolivian State

Latin America is in a political crisis, yet Bolivia is still widely recognized as a beacon of hope for progressive change. The radical movements at the beginning of the 21st century against neoliberalism that paved the road for the election of Bolivia’s first indigenous president, Evo Morales, beckoned a change from colonial rule towards a more just society. Paradoxically, in pursuing progress through economic growth, the Bolivian state led by President Morales has replicated the colonial division of labor through a development model known as neo-extractivism. Deeply rooted tensions have also emerged between indigenous communities and the Bolivian state due to the latter’s zealous economic bond with the extractivist sector. Although these paradoxes have received significant attention, one substantial aspect that remains underexplored and undertheorized is how such tensions affect socio-political relations at the intersections of class, race and gender where indigenous women in Bolivia occupy a unique position. To address this research gap, this qualitative study poses the following research questions: 1. How does neo-extractivism affect the lives of indigenous women? 2. How does the state shape relations between neo-extractivism and indigenous women? 3. How do indigenous women organize to challenge the impact of state-led extractivism on their lives and their communities? To answer these questions, I conducted a multi-sited ethnographic study between October 2017 and June 2018 in Oruro, Bolivia, an area that is heavily affected by mining contamination. By analyzing processes of social reproduction, I argue that neo-extractivism leads to water contamination and water scarcity, becoming the epicenter of the deterioration of subsistence agriculture and the dispossession of indigenous ways of life. Because indigenous women are subsistence producers and social reproducers whose activities depend on water, the dispossession of water has a dire effect on them, which demonstrates how capitalism relies on and exacerbates neo-colonial and patriarchal relations. To tame dissent to these contradictions, the Bolivian and self-proclaimed “indigenist state” defines and politicizes ethnicity in order to build a national identity based on indigeneity. This state-led ethnic inclusion, however, simultaneously produces class exclusions of indigenous campesinxs (peasants) who are not fully engaged in market relations. In contrast to the government’s inclusive but rigidly-defined indigeneity, indigenous communities embrace a fluid and dual indigeneity: one that is connected to territories, yet also independent from them; a rooted indigeneity based on the praxis of what it means to be indigenous. Indigenous women and their communities embrace this fluid and rooted indigeneity to build alliances across gender, ethnic, and geographic lines to organize against neo-extractivism. Moreover, the daily responsibilities of social reproduction within the context of subsistence agriculture, which are embedded in Andean epistemes of reciprocity, duality, and complementarity, have allowed indigenous women to build solidarity networks that keep the social fabric within, and between, communities alive. These solidarity networks are sites of everyday resistances that represent a threat and an alternative to capitalist, colonial and patriarchal mandates

The effect of early life events on glucose levels in first-episode psychosis.

Peer reviewed: TrueFirst episode of psychosis (FEP) patients display a wide variety of metabolic disturbances at onset, which might underlie these patients' increased morbidity and early mortality. Glycemic abnormalities have been previously related to pharmacological agents; however, recent research highlights the impact of early life events. Birth weight (BW), an indirect marker of the fetal environment, has been related to glucose abnormalities in the general population over time. We aim to evaluate if BW correlates with glucose values in a sample of FEP patients treated with different antipsychotics. Two hundred and thirty-six patients were included and evaluated for clinical and metabolic variables at baseline and at 2, 6, 12, and 24 months of follow-up. Pearson correlations and linear mixed model analysis were conducted to analyze the data. Antipsychotic treatment was grouped due to its metabolic risk profile. In our sample of FEP patients, BW was negatively correlated with glucose values at 24 months of follow-up [r=-0.167, p=0.037]. BW showed a trend towards significance in the association with glucose values over the 24-month period (F=3.22; p=0.073) despite other confounders such as age, time, sex, body mass index, antipsychotic type, and chlorpromazine dosage. This finding suggests that BW is involved in the evolution of glucose values over time in a cohort of patients with an FEP, independently of the type of pharmacological agent used in treatment. Our results highlight the importance of early life events in the later metabolic outcome of patients