Objective: To examine associations between potentially inappropriate medication, use and the risk of falls, unplanned hospitalization and death in older patients receiving initial care in a geriatric day hospital due to acute conditions. Methods: Cohort study with older adults referred to a geriatric day hospital from 2014 to 2017 due to acute conditions. Patients were submitted to comprehensive geriatric assessment. Use of medications was analyzed according to Beers Criteria 2019. Outcome assessment was based on monthly follow-up telephone calls made over the course of one year. Results: In this sample, 40.6% of patients had been prescribed at least one potentially inappropriate medication, particularly proton pump inhibitors (66.5%). Over the course of follow-up, 44.7% of patients receiving potentially inappropriate medications sustained at least one fall (p=0.0043) and 70% visited the emergency department (p=0.0452). These outcomes were more common among patients using two or more of drugs. Use of potentially inappropriate medication was associated with a 64% increase in the odds of unplanned hospitalization and a two-fold increase in risk of death. Conclusion: Associations between potentially inappropriate medication use and unfavorable outcomes such as falls and unplanned hospitalizations within one year of admission to a geriatric day hospital support the application of Beers Criteria and emphasize the importance of periodic prescription review, deprescription and rational use of these drugs whenever possible.

A special correspondent for the leading Egyptian newspaper al-Ahram wrote from Alexandria on 28 May 1936: “One of the effects of the Al-Bosfur nightclub murder in Cairo is that its circumstances have led to an interest in the problem of ‘al-futuwwat’ [sing., al-futuwwa] and how much power and influence (al-sat˙wa) they have in the capital and in other Egyptian cities.” The murder referred to was that of a popular singer and dancer, Imtithal Fawzi, by a band of assassins led by failed businessman and weight-trainer Fuad al-Shami. I argue here that this murder can be read as an instance of a larger event, which might be inscribed in the following way: a moment that irrevocably branded the public figure of futuwwa with the additional meanings of thug, mobster, and nefarious villain—bal ˙tagi. This is not the conventional way of registering this moment; indeed, the modern transformation of al-futuwwa is rarely considered as a historical event. It is not my aim here to affirm or deny the outcome of this transformation, nor am I suggesting that the normative conception of al-futuwwa as an Islamic ideal of masculinity had never before had any negative connotations. Rather, I posit—and want to interrogate—a changed historical relationship in the constitution of al-futuwwa, in which the nature of history itself was radically transformed and contributed to the formation of a new politics and a new subject of politics. As part of the hegemonic rise of this field of politics and its subject, history typically shows, or simply presumes, that other life-worlds, like that of the futuwwat and their particular form of power, were rendered exceptional and ultimately obsolete. In a larger project from which this article is drawn, I explored the gendered constitution of that new cultural and political hegemony. I labeled the gender norm that emerged at the intersection of colonial modernity and nationalism as effendi (bourgeois) masculinity, which I located in a new constellation of practices and discourses around the desirable, modern body. The present essay is in part an effort to de-center this bourgeois figure and the terms of its narration, which I unwittingly reproduced in the original study by rendering the event of the futuwwa's transformation as a bit part within a larger story of ostensibly greater national and historical import.

Dementia is more prevalent in Blacks than in Whites, likely due to a combination of environmental and biological factors. Paradoxically, clinical studies suggest an attenuation of APOE ϵ4 risk of dementia in African ancestry (AFR), but lack of neuropathological data preclude the interpretation of the biological factors underlying these findings, including the association between APOE ϵ4 risk and Alzheimer's disease (AD) pathology, the most frequent cause of dementia. We investigated the interaction between African ancestry, AD-related neuropathology, APOE genotype, and functional cognition in a postmortem sample of 400 individuals with a range of AD pathology severity and lack of comorbid neuropathology from a cohort of community-dwelling, admixed Brazilians. Increasing proportions of African ancestry (AFR) correlated with a lower burden of neuritic plaques (NP). However, for individuals with high levels of NP and neurofibrillary tangles (NFT), AFR proportion was associated with worse Clinical Dementia Rating sum of boxes (CDR-SOB). Among APOE ϵ4 carriers, the association between AFR proportion and CDR-SOB disappeared. APOE local ancestry inference of a subset of 309 individuals revealed that, in APOE ϵ4 noncarriers, non-European APOE background associated with lower NP burden, but with worst cognitive outcomes compared to European APOE when adjusting by the similar NP burden. Finally, APOE ϵ4 was associated with worse AD neuropathological burden only in a European APOE background. APOE genotype and its association with AD neuropathology and clinical pattern are highly influenced by ancestry, with AFR associated with lower NP burden and attenuated APOE ϵ4 risk compared to European ancestry.

It is true that gender and religion have always been interrelated; also true is the fact that the relationship as such did not exist until around the nineteenth century. This formulation is neither a paradox nor a historical puzzle given the outpouring of genealogical analyses of such discursive formations in the wake of Michel Foucault's interventions over three decades ago. The organising power and analytical value of what were once regarded as merely descriptive terms are now self-evident to many scholars. That an epistemological rupture, or, less radically, a shift in 'the order of things', occurred between the seventeenth and nineteenth centuries is accepted as truth, no matter one's view of the relationship between knowledge, power and the human. 1 Some of the silences generated by that historical truth, particularly the common presupposition of a liberal political order and sovereign subject, have been productively engaged by scholars working on the intersection of gender, sexuality and race in the context of empire or gender, religion and politics in postcolonial times. 2 In short, these studies conclude that the power of discursive categories and biopolitical apparatuses are historically and geographically variable such that attending to older conceptions of political hegemony and economic dominance is still necessary to establish the specificity of their operations in particular places as well as their limits. 3 In this article, I examine a problematic very central to the rise of modern states and the liberal regime of rights: sovereignty. The question of sovereignty, rarely considered in histories of colonial contexts except in terms of anti-colonial nationalism, has tremendous importance to the geographically differentiated formations of gender and religion that were produced in the nineteenth century. However, rather than argue that European imperialism and colonial rule brought new political notions to the rest of the world, the story of the Muslim Hadhrami Alawis in India examined below reveals a far more complex and interrelated process of delimiting the terms of a new global dispensation centred around sovereignty. In order to avoid confusing this with claims

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ABSTRACT. Clinical trials of the effects of physical activity have reported improvements in symptoms and quality of life in patients with Parkinson's disease (PD). Additionally, morphological brain changes after exercising were reported in PD animal models. However, these lifestyle-related changes were not evaluated in postmortem brain tissue. Objective: We aimed to evaluate, by immunohistochemistry, astrocytes, tyrosine hydroxylase (TH) and structural proteins expression (neurofilaments and microtubules — MAP2) changes in postmortem brain samples of individuals with Lewy body pathology. Methods: Braak PD stage≥III samples, classified by neuropathology analysis, from The Biobank for Aging Studies were classified into active (n=12) and non-active (n=12) groups, according to physical activity lifestyle, and paired by age, sex and Braak staging. Substantia nigra and basal ganglia were evaluated. Results: Groups were not different in terms of age or gender and had similar PD neuropathological burden (p=1.00). We observed higher TH expression in the active group in the substantia nigra and the basal ganglia (p=0.04). Astrocytes was greater in the non-active subjects in the midbrain (p=0.03) and basal ganglia (p=0.0004). MAP2 levels were higher for non-active participants in the basal ganglia (p=0.003) and similar between groups in the substantia nigra (p=0.46). Neurofilament levels for non-active participants were higher in the substantia nigra (p=0.006) but not in the basal ganglia (p=0.24). Conclusion: Active lifestyle seems to promote positive effects on brain by maintaining dopamine synthesis and structural protein expression in the nigrostriatal system and decrease astrogliosis in subjects with the same PD neuropathology burden.

Objective: Reports show that LGBT+ people may face several struggles during their endof-life (EOF) preparations, reporting higher rates, for example, of harassment and fear of feeling pain during these moments. We thus aimed to investigate variables related to EOF preparations among LGBT+ people and compare them with heterosexual cisgender individuals. Methods: This is a cross-sectional study in which Brazilians aged 50 or older were invited to answer an anonymous online survey between August 2019 and January 2020. The survey was widely distributed in neighbourhood associations, nongovernmental organizations, and social media. Those who identified as homosexual, bisexual, pansexual, non-heterosexual, transgender, travesti, or non-binary were grouped as LGBT+; cisgender and heterosexual participants were grouped as non-LGBT+. Results: The questionnaire was answered by 6693 participants with a median age of 60 years. Out of all respondents, 1332 were LGBT+ (19.90%) and 5361 were non-LGBT+ (80.10%). Compared to their non-LGBT+ peers, LGBT+ people reported higher rates of loneliness (25.30% vs 16.32%, p < 0.001), fear of dying alone (15.69% vs 9.79%, p < 0.001) or in pain (35.21% vs 25.74%, p < 0.001), and less social support (19.44% vs 13.48%, p < 0.001). Conclusions: Being LGBT+ was associated with challenges and inequalities regarding EOF preparations and discussions. Sexuality and diversity should be addressed in palliative training programs to address the needs of the LGBT+ population and to provide them with a dignified death.