Refazendo Corpos para os Mortos: As Efígies Mortuárias Kalapalo (Alto Xingu, Brasil)

The Quarup is an Upper Xinguan ritual in which at least one deceased nobleman is remembered in the form of an effigy, a temporary body made out of the wood of a special tree trunk. In this paper I analyze how the notions of body, trunk, soul and chief are related to the concept akuãpütelü (“to homage” or “to substitute”), by which the Kalapalo describe the Quarup. I argue that effigies work at restoring the conditions necessary for the production of kinship, and discuss why the ritualization of relations of enmity with other Xinguans is necessary for this process. O Quarup é um ritual alto-xinguano no qual pelo menos um nobre falecido é lembrado sob a forma de uma efígie, um corpo temporário feito do tronco de uma árvore especial. Neste trabalho analiso como as noções de corpo, tronco, alma e chefe estão relacionadas no conceito de akuãpütelü, pelo qual os Kalapalo descrevem este processo, e que traduzem geralmente como “homenagear” ou “substituir”. Argumento que as efígies atuam na reposição das condições para a produção do parentesco, e discuto porque sua condição é a ritualização de relações de inimizade com outros xinguanos. Le Quarup est un rituel du Haut Xingu dans lequel au moins un noble décédé est remémoré sous la forme d’une effigie, c’est-à-dire d’un corps temporaire fait du tronc d’un arbre spécial. Dans cet article, j’analyse comment les notions de corps, tronc, âme et chef sont liés au concept akuãpütelü, par lequel les Kalapalo décrivent ce processus, qui se traduit habituellement par « honorer » ou « remplacer ». J’affirme que les effigies aident au rétablissement des conditions permettant la reproduction de la parenté, et défend l’idée que la production de la parenté dépend de la ritualisation des relations d’hostilité avec d’autres Xinguanos

Rare coding variants in PLCG2, ABI3, and TREM2 implicate microglial-mediated innate immunity in Alzheimer's disease

We identified rare coding variants associated with Alzheimer’s disease (AD) in a 3-stage case-control study of 85,133 subjects. In stage 1, 34,174 samples were genotyped using a whole-exome microarray. In stage 2, we tested associated variants (P<1×10-4) in 35,962 independent samples using de novo genotyping and imputed genotypes. In stage 3, an additional 14,997 samples were used to test the most significant stage 2 associations (P<5×10-8) using imputed genotypes. We observed 3 novel genome-wide significant (GWS) AD associated non-synonymous variants; a protective variant in PLCG2 (rs72824905/p.P522R, P=5.38×10-10, OR=0.68, MAFcases=0.0059, MAFcontrols=0.0093), a risk variant in ABI3 (rs616338/p.S209F, P=4.56×10-10, OR=1.43, MAFcases=0.011, MAFcontrols=0.008), and a novel GWS variant in TREM2 (rs143332484/p.R62H, P=1.55×10-14, OR=1.67, MAFcases=0.0143, MAFcontrols=0.0089), a known AD susceptibility gene. These protein-coding changes are in genes highly expressed in microglia and highlight an immune-related protein-protein interaction network enriched for previously identified AD risk genes. These genetic findings provide additional evidence that the microglia-mediated innate immune response contributes directly to AD development

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure &lt;= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

A novel Alzheimer disease locus located near the gene encoding tau protein

This is the author accepted manuscript. The final version is available from the publisher via the DOI in this recordAPOE ε4, the most significant genetic risk factor for Alzheimer disease (AD), may mask effects of other loci. We re-analyzed genome-wide association study (GWAS) data from the International Genomics of Alzheimer's Project (IGAP) Consortium in APOE ε4+ (10 352 cases and 9207 controls) and APOE ε4- (7184 cases and 26 968 controls) subgroups as well as in the total sample testing for interaction between a single-nucleotide polymorphism (SNP) and APOE ε4 status. Suggestive associations (P<1 × 10-4) in stage 1 were evaluated in an independent sample (stage 2) containing 4203 subjects (APOE ε4+: 1250 cases and 536 controls; APOE ε4-: 718 cases and 1699 controls). Among APOE ε4- subjects, novel genome-wide significant (GWS) association was observed with 17 SNPs (all between KANSL1 and LRRC37A on chromosome 17 near MAPT) in a meta-analysis of the stage 1 and stage 2 data sets (best SNP, rs2732703, P=5·8 × 10-9). Conditional analysis revealed that rs2732703 accounted for association signals in the entire 100-kilobase region that includes MAPT. Except for previously identified AD loci showing stronger association in APOE ε4+ subjects (CR1 and CLU) or APOE ε4- subjects (MS4A6A/MS4A4A/MS4A6E), no other SNPs were significantly associated with AD in a specific APOE genotype subgroup. In addition, the finding in the stage 1 sample that AD risk is significantly influenced by the interaction of APOE with rs1595014 in TMEM106B (P=1·6 × 10-7) is noteworthy, because TMEM106B variants have previously been associated with risk of frontotemporal dementia. Expression quantitative trait locus analysis revealed that rs113986870, one of the GWS SNPs near rs2732703, is significantly associated with four KANSL1 probes that target transcription of the first translated exon and an untranslated exon in hippocampus (P≤1.3 × 10-8), frontal cortex (P≤1.3 × 10-9) and temporal cortex (P≤1.2 × 10-11). Rs113986870 is also strongly associated with a MAPT probe that targets transcription of alternatively spliced exon 3 in frontal cortex (P=9.2 × 10-6) and temporal cortex (P=2.6 × 10-6). Our APOE-stratified GWAS is the first to show GWS association for AD with SNPs in the chromosome 17q21.31 region. Replication of this finding in independent samples is needed to verify that SNPs in this region have significantly stronger effects on AD risk in persons lacking APOE ε4 compared with persons carrying this allele, and if this is found to hold, further examination of this region and studies aimed at deciphering the mechanism(s) are warranted

Radiopacity evaluation of root canal sealers containing calcium hydroxide and MTA

The purpose of this study was to evaluate the radiopacity of root canal sealers containing calcium hydroxide and MTA (Acroseal, Sealer 26, Sealapex, Endo CPM Sealer, Epiphany and Intrafill). Five disc-shaped specimens (10 x 1 mm) were fabricated from each material, according to the ISO 6876/2001 standard. After setting of the materials, radiographs were taken using occlusal film and a graduated aluminum stepwedge varying from 2 to 16 mm in thickness. The dental X-ray unit (GE1000) was set at 50 kVp, 10 mA, 18 pulses/s and distance of 33.5 cm. The radiographs were digitized and the radiopacity compared to that of the aluminum stepwedge using VIXWIN-2000 software (Gendex). The data (mmAl) were analyzed statistically by ANOVA and Tukey's test at the 5% significance level. Epiphany and Intrafill presented the highest radiopacity values (8.3 mmAl and 7.5 mmAl respectively, p < 0.05) followed by Sealer 26 (6.3 mmAl), Sealapex (6.1 mmAl) and Endo CPM Sealer (6 mmAl). Acroseal was the least radiopaque material (4 mmAl, p < 0.05). In conclusion, the calcium hydroxide- and MTA-containing root canal sealers had different radiopacities. However, all materials presented radiopacity values above the minimum recommended by the ISO standard

Unequal burden of Zika-associated microcephaly among populations with public and private healthcare in Salvador, Brazil

This study was supported by Oswaldo Cruz Foundation; Secretariat of Health Surveillance; Brazilian Ministry of Health; Wellcome Trust, Grant/Award Number: 102330/Z/13/Z; NSF-NIH, Grant/Award Number: 5 R01 AI052473, 5 U01 AI088752, 1 R25 TW009338, 1 R01 AI121207, F31 AI114245, R01 AI052473, U01 AI088752, R01 TW009504, and R25 TW009338. Fogarty International Center (R25 TW009338). Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) projects 2016/08727-5 and National Council for Scientific and Technological Development – CNPq. Fundação de Amparo à Pesquisa do Estado da Bahia (FAPESB) projeto (PET0021/2016)Yale School of Public Health. New Haven, USAHospital Aliança. Salvador, BA, BrazilYale School of Public Health. New Haven, USAFundação Oswaldo Cruz. Salvador, BA, BrazilSecretária da Saúde do Estado da Bahia. Hospital Geral Roberto Santos. Salvador, BA, BrazilUniversidade Federal da Bahia. Instituto da Saúde Coletiva. Hospital Universitário Professor Edgard Santos. Faculdade de Medicina da Bahia. Salvador, BA, BrazilSecretária da Saúde do Estado da Bahia. Hospital Geral Roberto Santos. Salvador, BA, BrazilSecretária da Saúde do Estado da Bahia. Hospital Geral Roberto Santos. Salvador, BA, BrazilSecretária da Saúde do Estado da Bahia. Hospital Geral Roberto Santos. Salvador, BA, BrazilSecretária da Saúde do Estado da Bahia. Hospital Geral Roberto Santos. Salvador, BA, BrazilUniversidade Federal da Bahia. Instituto da Saúde Coletiva. Hospital Universitário Professor Edgard Santos. Faculdade de Medicina da Bahia. Salvador, BA, BrazilFundação Oswaldo Cruz. Salvador, BA, BrazilSecretária da Saúde do Estado da Bahia. Hospital Geral Roberto Santos. Salvador, BA, BrazilUniversidade Federal da Bahia. Faculdade de Medicina. Programa de Pós-graduação em Ciências da Saude. Salvador, BA, BrazilFundação Oswaldo Cruz. Salvador, BA, BrazilMinistério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, BrasilMinistério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, BrasilMinistério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Ananindeua, PA, BrasilUniversidade Federal da Bahia. Instituto da Saúde Coletiva. Hospital Universitário Professor Edgard Santos. Faculdade de Medicina da Bahia. Salvador BA, BrazilFundação Oswaldo Cruz. Salvador, BA, BrazilFundação Oswaldo Cruz. Salvador, BA, BrazilSecretária da Saúde do Estado da Bahia. Hospital Geral Roberto Santos. Salvador, BA, Brazil / King’s College Hospital. Harris Birthright Center for Fetal Medicine. London, UK / Universidade Federal da Bahia. Instituto da Saúde Coletiva. Hospital Universitário Professor Edgard Santos. Faculdade de Medicina da Bahia. Salvador, BA, BrazilSecretária da Saúde do Estado da Bahia. Hospital Geral Roberto Santos. Salvador, BA, Brazil / Escola Paulista de Medicina. São Paulo, SP, BrazilSecretária da Saúde do Estado da Bahia. Hospital Geral Roberto Santos. Salvador, BA, BrazilFundação Oswaldo Cruz. Salvador, BA, BrazilYale School of Public Health. New Haven, USA / Fundação Oswaldo Cruz. Salvador, BA, Brazil / Universidade Federal da Bahia. Instituto da Saúde Coletiva. Hospital Universitário Professor Edgard Santos. Faculdade de Medicina da Bahia. Salvador, BA, BrazilYale School of Public Health. New Haven, USAYale School of Public Health. New Haven, USA / Universidade Federal da Bahia. Salvador, BA, BrazilObjectives: To describe the differences in clinical presentation and relative disease burden of congenital Zika syndrome (CZS)-associated microcephaly at 2 large hospitals in Salvador, Brazil that serve patients of different socioeconomic status (SES). Methods: Clinical and serologic data were collected prospectively from pregnant women and their infants, who delivered at 2 study centers during the 2015–2016 Zika virus (ZIKV) epidemic in Salvador, Brazil. Results: Pregnant women from Salvador, Brazil delivering in a low SES hospital had 3 times higher ZIKV exposure rate than women at a high SES hospital. However, different SES hospitals had similar prevalence of infants with CZS-associated microcephaly (10% vs 6%, p = 0.16) after controlling for ZIKV exposure in their mothers. Conclusions: Our study supports the positive association between low SES, high maternal ZIKV exposure, and high rates of CZS-associated microcephaly