Pathways as "signatures in landscape": towards an ethnography of mobility among the Mbya-Guaraní (Northeastern Argentina)

RefereedProcesses of spatial mobility among the Mbya are of interest in anthropological and ethnobiological studies, as these processes are related to transformations in the landscape and the environment. Despite this, ethnographic literature usually focuses itself on the mobility of Guaraní communities from the perspective of population dynamics on a regional scale. Our research among two Mbya-Guaraní communities in the Argentinean province of Misiones has enabled us to recognize patterns of mobility on a micro-scale. Certainly, the mobility of adult members of these communities as they perform hunting and gathering activities delimit spaces of individual use. We consider the different pathways as "signatures in landscape", resulting from processes of spatial mobility inherent to those activities Taking into account the gathering and circulation of medicinal plants for treatment of gastrointestinal illnesses, we have been able to identify different pathways inherent in their search, towards the monte or other spaces away from de settlement. The design and construction of the pathways is determined by the specific personal knowledge of individuals who search for these valuable resources. Using both strategies of direct observation – as members of the community manipulate different resources during these search and gathering trips – and interviews, we have been able to gather and interpret significant information on the strategies used by the Mbya to domesticate the monte areas. As a consequence of our approach we suggest that the landscape design resulting from these trips should not be considered a consensual or collective strategy of the whole community; it is rather the result of the daily strategies of individuals, which involves the selection of resources mainly based on each individual's knowledge and interests.Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET)Universidad Nacional de La Plat

Cardiovascular Efficacy and Safety of Bococizumab in High-Risk Patients

Bococizumab is a humanized monoclonal antibody that inhibits proprotein convertase subtilisin- kexin type 9 (PCSK9) and reduces levels of low-density lipoprotein (LDL) cholesterol. We sought to evaluate the efficacy of bococizumab in patients at high cardiovascular risk. METHODS In two parallel, multinational trials with different entry criteria for LDL cholesterol levels, we randomly assigned the 27,438 patients in the combined trials to receive bococizumab (at a dose of 150 mg) subcutaneously every 2 weeks or placebo. The primary end point was nonfatal myocardial infarction, nonfatal stroke, hospitalization for unstable angina requiring urgent revascularization, or cardiovascular death; 93% of the patients were receiving statin therapy at baseline. The trials were stopped early after the sponsor elected to discontinue the development of bococizumab owing in part to the development of high rates of antidrug antibodies, as seen in data from other studies in the program. The median follow-up was 10 months. RESULTS At 14 weeks, patients in the combined trials had a mean change from baseline in LDL cholesterol levels of -56.0% in the bococizumab group and +2.9% in the placebo group, for a between-group difference of -59.0 percentage points (P<0.001) and a median reduction from baseline of 64.2% (P<0.001). In the lower-risk, shorter-duration trial (in which the patients had a baseline LDL cholesterol level of ≥70 mg per deciliter [1.8 mmol per liter] and the median follow-up was 7 months), major cardiovascular events occurred in 173 patients each in the bococizumab group and the placebo group (hazard ratio, 0.99; 95% confidence interval [CI], 0.80 to 1.22; P = 0.94). In the higher-risk, longer-duration trial (in which the patients had a baseline LDL cholesterol level of ≥100 mg per deciliter [2.6 mmol per liter] and the median follow-up was 12 months), major cardiovascular events occurred in 179 and 224 patients, respectively (hazard ratio, 0.79; 95% CI, 0.65 to 0.97; P = 0.02). The hazard ratio for the primary end point in the combined trials was 0.88 (95% CI, 0.76 to 1.02; P = 0.08). Injection-site reactions were more common in the bococizumab group than in the placebo group (10.4% vs. 1.3%, P<0.001). CONCLUSIONS In two randomized trials comparing the PCSK9 inhibitor bococizumab with placebo, bococizumab had no benefit with respect to major adverse cardiovascular events in the trial involving lower-risk patients but did have a significant benefit in the trial involving higher-risk patients