Love and hate among the people without things : the social and economic relations of the Enxet people of Paraguay

This thesis examines the social and economic relations of the Enxet indigenous people of the Paraguayan Chaco region who place a high value on egalitarianism, generosity and personal autonomy. However, during the twentieth century their land has been colonized by cattle ranchers and they have been obliged to enter the market economy. While anthropologists have proposed a range of theories to explain indigenous social and economic relations, the main concern of this thesis is to examine how the Enxet themselves explain their social behaviour. The Enxet make salient use of "emotion words" when discussing their social and economic practices. For instance, a fundamental dichotomy in Enxet thought is between "love" and "hate" and much of their discourse centres on these two concepts. The Enxet seek to create "good/beautiful" people who know how to act appropriately. In certain contexts they should practise "love" while in other contexts "hate" is acceptable. Enxet social organization should not be understood as a structure but as a process, as something that is being continually created. I will consider different aspects of this process through an examination of kinship, co-residence, marital relations, "brideservice" and inter-community contact, and I will describe how economic transactions are key elements in the generation of "loving" social relations. However, self-centred practices create many challenges to a harmonious community life and I will consider how the Enxet strive to overcome them. Of particular interest will be demand sharing which responds, in part, to a strongly-held egalitarian ethic but can also provoke disharmony and discomfort in community life. I will also discuss commodity relations within Enxet communities and challenge the common assumption that money is necessarily destructive of indigenous social relations. I will conclude that the overriding goal of the Enxet is the attainment of tranquillity in both their personal and social lives. For the Enxet, economic relations are not about gaining material wealth but about living well with other people. They recognize that personal affective comfort is dependent on engendering tranquillity in other people. Therefore, the "emotion words" they use to explain their social behaviour should not be regarded as merely referring to "feelings" but as encompassing an aesthetics of social behaviour

A case-study amongst the Enxet of the Paraguayan Chaco

An explanatory model of religious change in small-scale subsistence societies is developed, in which it is argued that the relative balance of domination between neighbouring societies is a crucial factor in the development of stimuli for religious change. Societies which retain control over their productive resources exhibit relative satisfaction with their well-being and change is usually restricted to diffusion. However, in a colonial situation the well-being of the dominated people is threatened and they enter a crisis. This is characterized by a realization that their ritual practices no longer adequately control the superempirical universe, and by a reduction in their sense of self-worth and prestige. A common response is religious transformation and the resultant conversion movements can be conceived of as active constructions of more satisfying cultures in which attempts are made to re-impose control over the mystical universe and to regain prestige and self- worth. The mechanism used is intercultural sociality: the dominated people look to the colonizers for the secret of their perceived success but the difficulties of intercultural communication result in frequent misinterpretation. The model is used to explain religious change amongst the Enxet Indians of the Paraguayan Chaco. Prior to colonialism, change amongst the Enxet was limited to diffusion. However, post-1885 their land was invaded by the white man, plunging them into a crisis. Two independent conversion movements are examined and successfully explained by reference to the theoretical model. However, a third movement, conversion to Anglicanism, illustrates the influence of culturally-specific factors on the character of a movement. The Enxet, as immediate return hunter- gatherers, viewed the Anglican church as a "foraging resource" and the adoption of Anglicanism by a minority of Enxet was little more than a technique of gaining access to the economic benefits available

Lawrence Head Volcanics and Dunnage Mélange, Newfoundland Appalachians: Origin by Ordovician Ridge Subduction or in Back-Arc Rift?

This paper reviews the geological setting and reports new geochemical trace element data from the Ordovician Lawrence Head Volcanics (LHV) and the underlying gabbro sills in the Exploits Group. In combination with existing published analyses and ages of these rocks, the volcanic rocks and sills are indistinguishable in composition and age, and the data are consistent with the hypothesis that they represent the same (mostly E-MORB composition) magmatic event in the early–mid Darriwilian (~465 ± 2 Ma). The LHV and their enclosing strata show regional evidence for: 1) upward decline of volume and grain size of arc-derived volcaniclastic materials over the uppermost interval of turbidite sedimentary strata below the LHV; 2) change to shallow marine conditions locally by the end of the LHV event, followed immediately by significant subsidence, and 3) no evidence of coarse-grained clastic input, nor of normal faulting, during or immediately after LHV magmatism. Ridge–trench interaction (ridge subduction) at a subduction system is consistent with all of these features and spatial distribution of related elements, but a rift (back-arc) origin over a subduction zone can only accommodate the compositions, and is inconsistent with the geological evidence. The Dunnage Mélange (DM) has been interpreted either as olistostromal in a developing back-arc rift basin, or as a subduction accretionary prism. Peraluminous intrusions in the mélange (Coaker Porphyry ― CP) are more readily explained by ridge subduction, and a previously reported zircon age (469 ± 4 Ma) is consistent with the age of the LHV and gabbro sills, also interpreted as products of ridge subduction. Localization of the CP in the eastern area of DM, and of most of the large LHV-derived volcanic blocks in the western DM, suggests a slightly younger age, and perhaps a different mechanism, for the origin of the western DM.SOMMAIRECet article passe en revue le contexte géologique et présente de nouvelles données géochimiques d’éléments traces des roches volcaniques ordoviciennes de Lawrence Head (LHV) et des filons-couches de gabbro sous-jacents du Groupe Exploits.  Considérant la combinaison des données d’analyse publiées et des datations de ces roches, les roches volcaniques et les filons-couches sont indiscernables tant en composition qu’en âge, et les données sont compatibles avec l’hypothèse selon laquelle ils représentent le même événement magmatique (principalement E-MORB) du Darriwilien précoce à moyen (~465 ± 2 Ma).  Les LHV ainsi que les strates de l’encaissant renferment des indices régionaux qui montrent : 1) que le volume et la granulométrie des matériaux volcanoclastiques d’arc diminuent vers le haut dans l’intervalle supérieur des strates de turbidites sédimentaires sous les LHV; 2) que le changement vers des milieux marins peu profonds localement vers la fin de l’événement des LHV a été suivi immédiatement par une subsidence importante, et 3) qu’il n’existe pas d’indices d’apports clastiques à gros grains, non plus que de formation de failles normales, durant ou immédiatement après le magmatisme des LHV.  L’interaction crête-fosse (subduction de la crête) au lieu d’un système de subduction concorde avec toutes ces caractéristiques et la répartition spatiale des éléments reliés, alors qu’une origine de crête (arrière-arc) au-dessus d’une zone de subduction ne peut expliquer que les compositions et qu’elle est incompatible avec l’évidence géologique.  Le Dunnage Mélange (DM) a été interprété soit comme un olistostome dans un bassin d’arrière-arc en développement, ou comme un prisme d’accrétion de subduction.  Les intrusions hyperalumineuses dans le mélange (Porphyre Coaker — CP), s’explique plus facilement par une subduction de crête, et un âge de datation sur zircon de (469 ± 4 Ma) correspond à l’âge des LHV et des filons-couche de gabbro, aussi interprétés comme produits d’une subduction de crête.  La localisation du CP dans la portion orientale du DM, et de la majeure partie des grands blocs volcaniques dérivés des LHV de la portion ouest du DM, suggère un âge légèrement plus jeune, et peut-être un mécanisme différent, pour l’origine de la portion ouest du DM

Strategic Leadership Competencies

The strategic leadership literature in both the academic and military contexts is replete with long lists of the knowledge, skills, and abilities. Unfortunately, long comprehensive lists are problematic. Looking across the literature on strategic leadership, current Army strategic leader competencies, and the future environment, six meta-competencies can be derived: identity, mental agility, cross-cultural savvy, interpersonal maturity, world-class warrior, and professional astuteness.https://press.armywarcollege.edu/monographs/1785/thumbnail.jp

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

The FANCM:p.Arg658* truncating variant is associated with risk of triple-negative breast cancer

Abstract: Breast cancer is a common disease partially caused by genetic risk factors. Germline pathogenic variants in DNA repair genes BRCA1, BRCA2, PALB2, ATM, and CHEK2 are associated with breast cancer risk. FANCM, which encodes for a DNA translocase, has been proposed as a breast cancer predisposition gene, with greater effects for the ER-negative and triple-negative breast cancer (TNBC) subtypes. We tested the three recurrent protein-truncating variants FANCM:p.Arg658*, p.Gln1701*, and p.Arg1931* for association with breast cancer risk in 67,112 cases, 53,766 controls, and 26,662 carriers of pathogenic variants of BRCA1 or BRCA2. These three variants were also studied functionally by measuring survival and chromosome fragility in FANCM−/− patient-derived immortalized fibroblasts treated with diepoxybutane or olaparib. We observed that FANCM:p.Arg658* was associated with increased risk of ER-negative disease and TNBC (OR = 2.44, P = 0.034 and OR = 3.79; P = 0.009, respectively). In a country-restricted analysis, we confirmed the associations detected for FANCM:p.Arg658* and found that also FANCM:p.Arg1931* was associated with ER-negative breast cancer risk (OR = 1.96; P = 0.006). The functional results indicated that all three variants were deleterious affecting cell survival and chromosome stability with FANCM:p.Arg658* causing more severe phenotypes. In conclusion, we confirmed that the two rare FANCM deleterious variants p.Arg658* and p.Arg1931* are risk factors for ER-negative and TNBC subtypes. Overall our data suggest that the effect of truncating variants on breast cancer risk may depend on their position in the gene. Cell sensitivity to olaparib exposure, identifies a possible therapeutic option to treat FANCM-associated tumors

Case Reports1. A Late Presentation of Loeys-Dietz Syndrome: Beware of TGFβ Receptor Mutations in Benign Joint Hypermobility

Background: Thoracic aortic aneurysms (TAA) and dissections are not uncommon causes of sudden death in young adults. Loeys-Dietz syndrome (LDS) is a rare, recently described, autosomal dominant, connective tissue disease characterized by aggressive arterial aneurysms, resulting from mutations in the transforming growth factor beta (TGFβ) receptor genes TGFBR1 and TGFBR2. Mean age at death is 26.1 years, most often due to aortic dissection. We report an unusually late presentation of LDS, diagnosed following elective surgery in a female with a long history of joint hypermobility. Methods: A 51-year-old Caucasian lady complained of chest pain and headache following a dural leak from spinal anaesthesia for an elective ankle arthroscopy. CT scan and echocardiography demonstrated a dilated aortic root and significant aortic regurgitation. MRA demonstrated aortic tortuosity, an infrarenal aortic aneurysm and aneurysms in the left renal and right internal mammary arteries. She underwent aortic root repair and aortic valve replacement. She had a background of long-standing joint pains secondary to hypermobility, easy bruising, unusual fracture susceptibility and mild bronchiectasis. She had one healthy child age 32, after which she suffered a uterine prolapse. Examination revealed mild Marfanoid features. Uvula, skin and ophthalmological examination was normal. Results: Fibrillin-1 testing for Marfan syndrome (MFS) was negative. Detection of a c.1270G > C (p.Gly424Arg) TGFBR2 mutation confirmed the diagnosis of LDS. Losartan was started for vascular protection. Conclusions: LDS is a severe inherited vasculopathy that usually presents in childhood. It is characterized by aortic root dilatation and ascending aneurysms. There is a higher risk of aortic dissection compared with MFS. Clinical features overlap with MFS and Ehlers Danlos syndrome Type IV, but differentiating dysmorphogenic features include ocular hypertelorism, bifid uvula and cleft palate. Echocardiography and MRA or CT scanning from head to pelvis is recommended to establish the extent of vascular involvement. Management involves early surgical intervention, including early valve-sparing aortic root replacement, genetic counselling and close monitoring in pregnancy. Despite being caused by loss of function mutations in either TGFβ receptor, paradoxical activation of TGFβ signalling is seen, suggesting that TGFβ antagonism may confer disease modifying effects similar to those observed in MFS. TGFβ antagonism can be achieved with angiotensin antagonists, such as Losartan, which is able to delay aortic aneurysm development in preclinical models and in patients with MFS. Our case emphasizes the importance of timely recognition of vasculopathy syndromes in patients with hypermobility and the need for early surgical intervention. It also highlights their heterogeneity and the potential for late presentation. Disclosures: The authors have declared no conflicts of interes

Evaluating the Effects of SARS-CoV-2 Spike Mutation D614G on Transmissibility and Pathogenicity.

Global dispersal and increasing frequency of the SARS-CoV-2 spike protein variant D614G are suggestive of a selective advantage but may also be due to a random founder effect. We investigate the hypothesis for positive selection of spike D614G in the United Kingdom using more than 25,000 whole genome SARS-CoV-2 sequences. Despite the availability of a large dataset, well represented by both spike 614 variants, not all approaches showed a conclusive signal of positive selection. Population genetic analysis indicates that 614G increases in frequency relative to 614D in a manner consistent with a selective advantage. We do not find any indication that patients infected with the spike 614G variant have higher COVID-19 mortality or clinical severity, but 614G is associated with higher viral load and younger age of patients. Significant differences in growth and size of 614G phylogenetic clusters indicate a need for continued study of this variant

State of the climate in 2018

In 2018, the dominant greenhouse gases released into Earth’s atmosphere—carbon dioxide, methane, and nitrous oxide—continued their increase. The annual global average carbon dioxide concentration at Earth’s surface was 407.4 ± 0.1 ppm, the highest in the modern instrumental record and in ice core records dating back 800 000 years. Combined, greenhouse gases and several halogenated gases contribute just over 3 W m−2 to radiative forcing and represent a nearly 43% increase since 1990. Carbon dioxide is responsible for about 65% of this radiative forcing. With a weak La Niña in early 2018 transitioning to a weak El Niño by the year’s end, the global surface (land and ocean) temperature was the fourth highest on record, with only 2015 through 2017 being warmer. Several European countries reported record high annual temperatures. There were also more high, and fewer low, temperature extremes than in nearly all of the 68-year extremes record. Madagascar recorded a record daily temperature of 40.5°C in Morondava in March, while South Korea set its record high of 41.0°C in August in Hongcheon. Nawabshah, Pakistan, recorded its highest temperature of 50.2°C, which may be a new daily world record for April. Globally, the annual lower troposphere temperature was third to seventh highest, depending on the dataset analyzed. The lower stratospheric temperature was approximately fifth lowest. The 2018 Arctic land surface temperature was 1.2°C above the 1981–2010 average, tying for third highest in the 118-year record, following 2016 and 2017. June’s Arctic snow cover extent was almost half of what it was 35 years ago. Across Greenland, however, regional summer temperatures were generally below or near average. Additionally, a satellite survey of 47 glaciers in Greenland indicated a net increase in area for the first time since records began in 1999. Increasing permafrost temperatures were reported at most observation sites in the Arctic, with the overall increase of 0.1°–0.2°C between 2017 and 2018 being comparable to the highest rate of warming ever observed in the region. On 17 March, Arctic sea ice extent marked the second smallest annual maximum in the 38-year record, larger than only 2017. The minimum extent in 2018 was reached on 19 September and again on 23 September, tying 2008 and 2010 for the sixth lowest extent on record. The 23 September date tied 1997 as the latest sea ice minimum date on record. First-year ice now dominates the ice cover, comprising 77% of the March 2018 ice pack compared to 55% during the 1980s. Because thinner, younger ice is more vulnerable to melting out in summer, this shift in sea ice age has contributed to the decreasing trend in minimum ice extent. Regionally, Bering Sea ice extent was at record lows for almost the entire 2017/18 ice season. For the Antarctic continent as a whole, 2018 was warmer than average. On the highest points of the Antarctic Plateau, the automatic weather station Relay (74°S) broke or tied six monthly temperature records throughout the year, with August breaking its record by nearly 8°C. However, cool conditions in the western Bellingshausen Sea and Amundsen Sea sector contributed to a low melt season overall for 2017/18. High SSTs contributed to low summer sea ice extent in the Ross and Weddell Seas in 2018, underpinning the second lowest Antarctic summer minimum sea ice extent on record. Despite conducive conditions for its formation, the ozone hole at its maximum extent in September was near the 2000–18 mean, likely due to an ongoing slow decline in stratospheric chlorine monoxide concentration. Across the oceans, globally averaged SST decreased slightly since the record El Niño year of 2016 but was still far above the climatological mean. On average, SST is increasing at a rate of 0.10° ± 0.01°C decade−1 since 1950. The warming appeared largest in the tropical Indian Ocean and smallest in the North Pacific. The deeper ocean continues to warm year after year. For the seventh consecutive year, global annual mean sea level became the highest in the 26-year record, rising to 81 mm above the 1993 average. As anticipated in a warming climate, the hydrological cycle over the ocean is accelerating: dry regions are becoming drier and wet regions rainier. Closer to the equator, 95 named tropical storms were observed during 2018, well above the 1981–2010 average of 82. Eleven tropical cyclones reached Saffir–Simpson scale Category 5 intensity. North Atlantic Major Hurricane Michael’s landfall intensity of 140 kt was the fourth strongest for any continental U.S. hurricane landfall in the 168-year record. Michael caused more than 30 fatalities and $25 billion (U.S. dollars) in damages. In the western North Pacific, Super Typhoon Mangkhut led to 160 fatalities and$6 billion (U.S. dollars) in damages across the Philippines, Hong Kong, Macau, mainland China, Guam, and the Northern Mariana Islands. Tropical Storm Son-Tinh was responsible for 170 fatalities in Vietnam and Laos. Nearly all the islands of Micronesia experienced at least moderate impacts from various tropical cyclones. Across land, many areas around the globe received copious precipitation, notable at different time scales. Rodrigues and Réunion Island near southern Africa each reported their third wettest year on record. In Hawaii, 1262 mm precipitation at Waipā Gardens (Kauai) on 14–15 April set a new U.S. record for 24-h precipitation. In Brazil, the city of Belo Horizonte received nearly 75 mm of rain in just 20 minutes, nearly half its monthly average. Globally, fire activity during 2018 was the lowest since the start of the record in 1997, with a combined burned area of about 500 million hectares. This reinforced the long-term downward trend in fire emissions driven by changes in land use in frequently burning savannas. However, wildfires burned 3.5 million hectares across the United States, well above the 2000–10 average of 2.7 million hectares. Combined, U.S. wildfire damages for the 2017 and 2018 wildfire seasons exceeded $40 billion (U.S. dollars)

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication