Translating environments

Far from being inert materials activated by human ingenuity, natural resources come to be made and unmade through ongoing processes of translation, through which they acquire new potentialities and meanings. In this introduction, we review the key concept of translation for anthropology and explore some of its multiple analytical possibilities in the context of human-environment relations. Based on insights offered by the articles in this collection, we propose a twofold definition of environments as both translating subjects and objects of translation. In grounding our analytical definition, we focus on the enactment of material transformations (as the result of both relations of mutual determination with humans and processes of objectification of the environment), the implications of incommensurability and erasure in processes of (attempted) translation, and the indeterminacy that accompanies (re)configurations of materials, relations and values

Decreased Cerebrospinal Fluid Flow Is Associated With Cognitive Deficit in Elderly Patients

Background: Disruptions in cerebrospinal fluid (CSF) flow during aging could compromise protein clearance from the brain and contribute to the etiology of Alzheimer’s Disease (AD).Objective: To determine whether CSF flow is associated with cognitive deficit in elderly patients (>70 years).Methods: We studied 92 patients admitted to our geriatric unit for non-acute reasons using phase-contrast magnetic resonance imaging (PC-MRI) to calculate their ventricular and spinal CSF flow, and assessed their global cognitive status, memory, executive functions, and praxis. Multivariable regressions with backward selection (criterion p < 0.15) were performed to determine associations between cognitive tests and ventricular and spinal CSF flow, adjusting for depression, anxiety, and cardiovascular risk factors.Results: The cohort comprised 71 women (77%) and 21 (33%) men, aged 84.1 ± 5.2 years (range, 73–96). Net ventricular CSF flow was 52 ± 40 μL/cc (range, 0–210), and net spinal CSF flow was 500 ± 295 μL/cc (range, 0–1420). Ventricular CSF flow was associated with the number of BEC96 figures recognized (β = 0.18, CI, 0.02–0.33; p = 0.025). Spinal CSF flow was associated with the WAIS Digit Span Backward test (β = 0.06, CI, 0.01–0.12; p = 0.034), and categoric verbal fluency (β = 0.53, CI, 0.07–0.98; p = 0.024) and semantic verbal fluency (β = 0.55, CI, 0.07–1.02; p = 0.024).Conclusion: Patients with lower CSF flow had significantly worse memory, visuo-constructive capacities, and verbal fluency. Alterations in CSF flow could contribute to some of the cognitive deficit observed in patients with AD. Diagnosis and treatment of CSF flow alterations in geriatric patients with neurocognitive disorders could contribute to the prevention of their cognitive decline

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms

A História da Alimentação: balizas historiográficas

Os M. pretenderam traçar um quadro da História da Alimentação, não como um novo ramo epistemológico da disciplina, mas como um campo em desenvolvimento de práticas e atividades especializadas, incluindo pesquisa, formação, publicações, associações, encontros acadêmicos, etc. Um breve relato das condições em que tal campo se assentou faz-se preceder de um panorama dos estudos de alimentação e temas correia tos, em geral, segundo cinco abardagens Ia biológica, a econômica, a social, a cultural e a filosófica!, assim como da identificação das contribuições mais relevantes da Antropologia, Arqueologia, Sociologia e Geografia. A fim de comentar a multiforme e volumosa bibliografia histórica, foi ela organizada segundo critérios morfológicos. A seguir, alguns tópicos importantes mereceram tratamento à parte: a fome, o alimento e o domínio religioso, as descobertas européias e a difusão mundial de alimentos, gosto e gastronomia. O artigo se encerra com um rápido balanço crítico da historiografia brasileira sobre o tema

Carcinome bronchique à petites cellules (survie et facteurs pronostiques)

Introduction : Le cancer bronchique à petites cellules est une tumeur agressive qui représente 15 à 20 % de l'ensemble des cancers bronchiques. Son pronostic est sombre puisque la médiane de survie sans traitement est de 2 à 3 mois et de 9 à 11 mois après traitement, stades localisés et diffus groupés. Patients et Méthodes : Nous avons réalisé une étude rétrospective multicentrique en Picardie menée sur 195 patients atteints d'un cancer bronchique à petites cellules. L'objectif principal était la survie globale, les objectifs secondaires étaient la survie sans progression, les facteurs pronostiques de survie globale et sans progression, la réponse tumorale et les toxicités des traitements. Résultats : Parmi les 195 patients inclus (162 hommes) âgés en moyenne de 64 ans au moment du diagnostic, 179 étaient fumeurs (91,8 %), 70 présentaient des antécédents cardio-vasculaires (40 %) à type d'artériopathie oblitérante des membres inférieurs ou d'arythmie cardiaque par fibrillation auriculaire, et 40 recevaient un traitement anti-agrégant plaquettaire (20,5 %). La néoplasie était la plupart du temps découverte à l'occasion d'une altération de l'état général (40,5 %) et diagnostiquée par fibroscopie bronchique (77,9 %). Plus de la moitié des patients étaient atteints d'un stade diffus de la maladie (56,9 %). Les stades localisés recevaient principalement un traitement par association radiothérapie et chimiothérapie (69 %), et les stades diffus, une chimiothérapie seule par cisplatine et étoposide (81 %). Le taux de réponse tumorale (réponse complète et partielle) après la première ligne était de 43,4 %. Aucune réponse partielle ou complète n'est observée à partir de la deuxième ligne. La médiane de survie globale était de 229 jours IC 95 % [193 - 265] et la médiane de survie sans progression de 185 jours IC 95 % [162 - 208]. En analyse univariée, les facteurs de mauvais pronostic de la survie globale était l'âge supérieur ou égal à 70 ans (p=0,009), l'indice de performance de l'OMS supérieur ou égal à 2 (p<0,00001), les antécédents d'artériopathie oblitérante des membres inférieurs (p=0,0308), l'altération de l'état général (p=0,0079), le stade diffus de la néoplasie (p=0,0104), le taux d'hémoglobine inférieur à 12 g/dL (p=0,05), le taux sérique du marqueur Cyfra 21-1 anormalement élevé (p=0,0216), l'absence de réponse objective après la première ligne de traitement (p<0,00001) et le passage en réanimation au cours de l'évolution de la néoplasie (p=0,0083). En analyse multivariée selon le modèle de Cox, 5 facteurs pronostiques de survie globale indépendants ont été mis en évidence : 2 facteurs de bon pronostic qui sont le stade localisé du cancer bronchique à petites cellules (HR 0,487, [0,332-0,716] p<0,00001) et le chiffre d'hémoglobine supérieur ou égal à 12 g/dL (HR 0,653, [0,429-0,993] p=0,046) et 3 facteurs de mauvais pronostic qui sont un indice de performance de l'OMS supérieur ou égal à 2 (HR 2,435, [1,621-3,659] p<0,00001), la présence d'une altération de l'état général (HR 1,670, [1,145-2,435] p=0,008), et le passage en réanimation (HR 2,435, [1,209-4,904] p=0,013). Conclusion : La connaissance des facteurs pronostiques de cette néoplasie au pronostic sombre peut permettre au clinicien d'adapter de façon optimale la thérapeutique au patient afin d'allonger la survie tout en maintenant une qualité de vie correcteAMIENS-BU Santé (800212102) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Trends in guideline implementation: an updated scoping review

Abstract: Background: Guidelines aim to support evidence-informed practice but are inconsistently used without implementation strategies. Our prior scoping review revealed that guideline implementation interventions were not selected and tailored based on processes known to enhance guideline uptake and impact. The purpose of this study was to update the prior scoping review. Methods: We searched MEDLINE, EMBASE, AMED, CINAHL, Scopus, and the Cochrane Database of Systematic Reviews for studies published from 2014 to January 2021 that evaluated guideline implementation interventions. We screened studies in triplicate and extracted data in duplicate. We reported study and intervention characteristics and studies that achieved impact with summary statistics. Results: We included 118 studies that implemented guidelines on 16 clinical topics. With regard to implementation planning, 21% of studies referred to theories or frameworks, 50% pre-identified implementation barriers, and 36% engaged stakeholders in selecting or tailoring interventions. Studies that employed frameworks (n=25) most often used the theoretical domains framework (28%) or social cognitive theory (28%). Those that pre-identified barriers (n=59) most often consulted literature (60%). Those that engaged stakeholders (n=42) most often consulted healthcare professionals (79%). Common interventions included educating professionals about guidelines (44%) and information systems/technology (41%). Most studies employed multi-faceted interventions (75%). A total of 97 (82%) studies achieved impact (improvements in one or more reported outcomes) including 10 (40% of 25) studies that employed frameworks, 28 (47.45% of 59) studies that pre-identified barriers, 22 (52.38% of 42) studies that engaged stakeholders, and 21 (70% of 30) studies that employed single interventions. Conclusions: Compared to our prior review, this review found that more studies used processes to select and tailor interventions, and a wider array of types of interventions across the Mazza taxonomy. Given that most studies achieved impact, this might reinforce the need for implementation planning. However, even studies that did not plan implementation achieved impact. Similarly, even single interventions achieved impact. Thus, a future systematic review based on this data is warranted to establish if the use of frameworks, barrier identification, stakeholder engagement, and multi-faceted interventions are associated with impact. Trial registration: The protocol was registered with Open Science Framework (https://osf.io/4nxpr) and published in JBI Evidence Synthesis