Morphometrics and Phylogenomics of Coca (Erythroxylum spp.) Illuminate Its Reticulate Evolution, With Implications for Taxonomy.

South American coca (Erythroxylum coca and E. novogranatense) has been a keystone crop for many Andean and Amazonian communities for at least 8,000 years. However, over the last half-century, global demand for its alkaloid cocaine has driven intensive agriculture of this plant and placed it in the center of armed conflict and deforestation. To monitor the changing landscape of coca plantations, the United Nations Office on Drugs and Crime collects annual data on their areas of cultivation. However, attempts to delineate areas in which different varieties are grown have failed due to limitations around identification. In the absence of flowers, identification relies on leaf morphology, yet the extent to which this is reflected in taxonomy is uncertain. Here, we analyze the consistency of the current naming system of coca and its four closest wild relatives (the "coca clade"), using morphometrics, phylogenomics, molecular clocks, and population genomics. We include name-bearing type specimens of coca's closest wild relatives E. gracilipes and E. cataractarum. Morphometrics of 342 digitized herbarium specimens show that leaf shape and size fail to reliably discriminate between species and varieties. However, the statistical analyses illuminate that rounder and more obovate leaves of certain varieties could be associated with the subtle domestication syndrome of coca. Our phylogenomic data indicate extensive gene flow involving E. gracilipes which, combined with morphometrics, supports E. gracilipes being retained as a single species. Establishing a robust evolutionary-taxonomic framework for the coca clade will facilitate the development of cost-effective genotyping methods to support reliable identification.

Inside ILSI: How Coca-Cola, Working through Its Scientific Nonprofit, Created a Global Science of Exercise for Obesity and Got It Embedded in Chinese Policy (1995-2015).

CONTEXT: Industry influence on health science and policy is a critical issue of our day. In 2015 the New York Times revealed that Coca-Cola paid scientists to form a Global Energy Balance Network promoting the notion that exercise, not dietary restraint, is the solution to the obesity epidemic-a claim few accept. This article examines the organizational dynamics and policy process behind Coke's efforts to sway obesity policy-globally and in China, a critical market-during 1995-2015. METHODS: In-depth, qualitative research during 2013-18 involved 10 weeks of fieldwork in Beijing, interviews with 25 leading experts, analysis of newsletters documenting all major obesity-related activities in China, interviews with 10 Euro-American experts, and extensive internet research on all major actors. FINDINGS: This article tells two intertwined stories (institutional dynamics, science making and policy making) at global and local-Chinese levels. Coke succeeded in redirecting China's obesity science and policy to emphasize physical activity. Key to its success was the industry-funded global nonprofit International Life Sciences Institute (ILSI). Beneath ILSI's public narrative of unbiased science and no policy advocacy lay a maze of hidden channels companies used to advance their interests. Working through those channels, Coca-Cola influenced China's science making and policy making during every phase in the policy process, from framing the issues to drafting official policy. CONCLUSIONS: Though China is exceptional, ILSI promoted exercise globally, suggesting potentially significant impacts in other ILSI-branch countries.

Evaluating Coca-Cola's attempts to influence public health 'in their own words': analysis of Coca-Cola emails with public health academics leading the Global Energy Balance Network.

OBJECTIVE: We evaluate the extent to which Coca-Cola tried to influence research in the Global Energy Balance Network, as revealed by correspondence between the company and leading public health academics obtained through Freedom-of-Information (FOI) requests. DESIGN: US state FOI requests were made in the years 2015-2016 by US Right to Know, a non-profit consumer and public health group, obtaining 18 030 pages of emails covering correspondence between The Coca-Cola Company and public health academics at West Virginia University and University of Colorado, leading institutions of the Global Energy Balance Network. We performed a narrative, thematic content analysis of 18 036 pages of Coca-Cola Company's emails, coded between May and December 2016, against a taxonomy of political influence strategies. RESULTS: Emails identified two main strategies, regarding information and messaging and constituency building, associated with a series of practices and mechanisms that could influence public health nutrition. Despite publications claiming independence, we found evidence that Coca-Cola made significant efforts to divert attention from its role as a funding source through diversifying funding partners and, in some cases, withholding information on the funding involved. We also found documentation that Coca-Cola supported a network of academics, as an 'email family' that promoted messages associated with its public relations strategy, and sought to support those academics in advancing their careers and building their affiliated public health and medical institutions. CONCLUSIONS: Coca-Cola sought to obscure its relationship with researchers, minimise the public perception of its role and use these researchers to promote industry-friendly messaging. More robust approaches for managing conflicts of interest are needed to address diffuse and obscured patterns of industry influence.

Influence of the Coca-Cola Drinks on the Overall Color of Glazed or Polished Porcelain Veneers Fabricated from Different Materials and Thicknesses: An In Vitro Study.

AIM: The aim of the current study is to assess the influence of Coca-Cola drinks on the overall color of glazed or polished porcelain veneers fabricated of three different porcelain systems and two different thicknesses. MATERIALS AND METHODS: A total of 96 ceramic disk specimens were fabricated. The ceramic veneers were prepared to a standardized thickness of 1.0 mm ± 0.025 mm and 0.6 ± 0.025 (48 samples each group) using the following ceramic systems: Zircon, E-max press, and E-max CAD/CAM. Veneer samples from each system were divided into two subgroups (n = 8). First subgroup samples were glazed according to the manufacturer's instructions, and the other subgroup samples were adjusted with diamond burs then polished with ceramic polishing kit. Color was measured with Vita Easyshade spectrophotometer. Then all samples immersed with Cola drink, for 4 weeks, in a thermocycling machine and then the color were measured again and color change was recorded. RESULTS: Significant differences in color change were noticed before and after immersing with Coca-Cola and thermocycling for all materials and thicknesses used (p < 0.01). Significant differences in color changes were noticed between glazed and polished samples (p < 0.001). No significant differences in color change were noticed when using different thicknesses for all materials used (p < 0.05). CONCLUSION: Different porcelain materials have shown significant color changes after immersing and thermocycling in Coca-Cola drinks. The color changes of polished porcelain specimens were more considerable than those of polished specimens for all porcelain materials and thicknesses used. This suggests reglazing of all esthetic restoration after any adjustments might be performed and before final cementation in an attempt to maintain the color stability in oral environment. CLINICAL SIGNIFICANCE: To achieve a perfect color stability of ceramic veneers, clinicians should take into consideration the possible color deviations that might result after any adjustment followed by polishing procedures to the ceramic surface. And, it is always preferable to do reglazing of porcelain restorations after any surface treatments and before final cementation.

Erythroxylum in Focus: An Interdisciplinary Review of an Overlooked Genus.

The genus Erythroxylum contains species used by indigenous people of South America long before the domestication of plants. Two species, E. coca and E. novogranatense, have been utilized for thousands of years specifically for their tropane alkaloid content. While abuse of the narcotic cocaine has impacted society on many levels, these species and their wild relatives contain untapped resources for the benefit of mankind in the form of foods, pharmaceuticals, phytotherapeutic products, and other high-value plant-derived metabolites. In this review, we describe the current state of knowledge of members within the genus and the recent advances in the realm of molecular biology and biochemistry.

Coca-Cola - a model of transparency in research partnerships? A network analysis of Coca-Cola's research funding (2008-2016).

OBJECTIVE: To (i) evaluate the extent to which Coca-Cola's 'Transparency Lists' of 218 researchers that it funds are comprehensive; (ii) map all scientific research acknowledging funding from Coca-Cola; (iii) identify those institutions, authors and research topics funded by Coca-Cola; and (iv) use Coca-Cola's disclosure to gauge whether its funded researchers acknowledge the source of funding. DESIGN: Using Web of Science Core Collection database, we retrieved all studies declaring receipt of direct funding from the Coca-Cola brand, published between 2008 and 2016. Using conservative eligibility criteria, we iteratively removed studies and recreated Coca-Cola's transparency lists using our data. We used network analysis and structural topic modelling to assess the structure, organization and thematic focus of Coca-Cola's research enterprise, and string matching to evaluate the completeness of Coca-Cola's transparency lists. RESULTS: Three hundred and eighty-nine articles, published in 169 different journals, and authored by 907 researchers, cite funding from The Coca-Cola Company. Of these, Coca-Cola acknowledges funding forty-two authors (<5 %). We observed that the funded research focuses mostly on nutrition and emphasizes the importance of physical activity and the concept of 'energy balance'. CONCLUSIONS: The Coca-Cola Company appears to have failed to declare a comprehensive list of its research activities. Further, several funded authors appear to have failed to declare receipt of funding. Most of Coca-Cola's research support is directed towards physical activity and disregards the role of diet in obesity. Despite initiatives for greater transparency of research funding, the full scale of Coca-Cola's involvement is still not known.

Operational impact of canine teams in the fight against drug trafficking in Colombia: review of their contribution, strategies and recent trends. / Impacto operacional de los equipos caninos en la lucha contra el narcotráfico en Colombia: una revisión de la contribución, estrategias y tendencias recientes.

As part of national and international cooperation to fight the drug-trafficking system, the Colombian National Police (PNC) has created institutional operational synergy to combat organised armed groups. To this end, it uses police service dog and handler teams which are distributed across Colombia in 75 canine units and which are specialised in different policing tasks. The focus of canine teams is to counter actions that undermine peaceful co-existence and citizen security by checking for explosive substances around coca, marijuana and poppy fields. In 2016, these teams discovered 16% of the 12,500 kg of improvised explosive devices, anti-personnel mines and unexploded ordnance (conventional guns and grenades) that were seized by the PNC. In addition, dogs have detected 19% of all controlled substances (cocaine, marijuana, heroin, coca paste and synthetic drugs) seized at ports, airports, land terminals and highways, striking a blow at drug-trafficking structures at all stages, from the illicit cultivation of drugs, through to their production, distribution, sale and use, countering small-scale dealing and the factors associated with drug-related social disorder. It is the responsibility of the PNC Police Service Dog and Handler Training School (ESGAC) to provide a framework for academic endeavour and technological advances aimed at achieving defined strategic roles for dog and handler teams. This involves the genetic selection and breeding of candidate detection dogs, assessment, training, operant conditioning, odour-discrimination during searches, certification, dog/ handler relationship, the dogs' living environment, and animal health, production and welfare management. All of the above is designed to achieve real, effective and successful outcomes when policing with dogs, enshrined within the national government's Vision 2030 project for safe and peaceful communities.

Dans le cadre de la coopération nationale et internationale contre les réseaux de trafic de stupéfiants, la police nationale de Colombie a mis en place une synergie opérationnelle institutionnelle contre les groupes armés organisés. Pour ce faire, elle recourt à des binômes d'intervention (un maître-chien et un chien) répartis en 75 unités cynotechniques sur tout le territoire colombien, spécialisés dans différentes tâches opérationnelles. La contribution des équipes cynotechniques consiste à neutraliser les activités qui menacent la cohabitation et la sécurité des citoyens, en détectant la présence de substances explosives aux alentours des champs de culture de cocaïne, cannabis et pavot, celles-ci ayant représenté 16 % des engins explosifs improvisés, mines antipersonnel et munitions non explosées (fusils et grenades conventionnelles) saisis par la police colombienne en 2016 sur un total de 12 500 kg. De surcroît, les chiens ont détecté 19 % du total des saisies de substances illicites (cocaïne, cannabis, héroïne, dérivés de cocaïne et drogues de synthèse) dans les ports, aéroports, gares routières et routes. Ceci atteint les structures du narcotrafic depuis les cultures illicites jusqu'à la production, la distribution, la commercialisation et la consommation tout en neutralisant le microtrafic ainsi que d'autres facteurs liés à la décomposition sociale due aux drogues. L'École de maîtres-chiens et de dressage de chiens de la Police colombienne prend en charge les efforts de formation ainsi que la recherche technologique afin que les fonctions stratégiques attribuées aux binômes soient réalisées avec succès. Ceci requiert la prise en compte de plusieurs aspects : la sélection génétique, la reproduction, les chiens potentiellement candidats pour être formés à la détection de drogue, l'évaluation, la formation, la gestion comportementale opérationnelle, la capacité de discriminer entre les odeurs lors des recherches, la certification, la relation entre le maître-chien et son chien, l'habitat, la gestion sanitaire et zootechnique ainsi que la protection du bien-être animal. Ces différents aspects sont destinés à garantir l'efficience et l'efficacité des résultats concrets obtenus par les services de la police cynophile dans le cadre de la stratégie institutionnelle 2030 « Pour des communautés sûres et en paix ¼.

En el marco de la cooperación nacional e internacional contra el sistema del narcotráfico, la policía nacional de Colombia (PNC) establece una sinergia operacional institucional contra los grupos armados organizados (GAO). Para ello, emplea binomios (guía-perro), distribuidos en forma de 75 unidades caninas por todo el territorio colombiano, especializadas en diferentes tareas del servicio. La contribución de los equipos caninos consiste en contrarrestar las acciones que afectan a la convivencia y seguridad ciudadana, controlando sustancias explosivas alrededor de los cultivos de cocaína, marihuana y amapola, en los cuales se ha logrado hallar un 16% de artefactos explosivos improvisados, minas antipersona y munición sin explotar (fusiles y granadas convencionales) de un total de 12 500 kg incautados por la PNC (año 2016). Además, los perros han detectado un 19% del total de las incautaciones de sustancias controladas (cocaína, marihuana, heroína, bazuco y drogas sintéticas) en puertos, aeropuertos, terminales terrestres y carreteras, golpeando así las estructuras narcotraficantes desde los cultivos ilícitos, la producción, la distribución, la comercialización y el consumo, y contrarrestando el microtráfico y los factores asociados a la descomposición social de las drogas. Son responsabilidad de la Escuela de Guías y Adiestramiento Canino de la institución los esfuerzos académicos y avances tecnológicos que propenden a lograr roles estratégicos definidos para los binomios, para los cuales son necesarios la selección genética, la cría, los perros detectores aspirantes, la evaluación, la formación, el manejo comportamental operativo, la discriminación de olores durante la búsqueda, la certificación, la relación guía perro, su hábitat, y el manejo sanitario, zootécnico y relativo al bienestar animal. Todo lo anterior va destinado a lograr resultados efectivos, eficientes y eficaces en el servicio de policía con caninos en el marco de la visión institucional 2030 «Comunidades Seguras y en Paz¼.

[A 67-year old man with epigastric pain]. / 67-jähriger Patient mit epigastrischen Schmerzen.

A 67-year-old man suffering from epigastric pain showed a phytobezoar in the endoscopy. Therapy with Coca Cola® and enzymes was initiated. The (partial) lysis led to a migration of the bezoar into the ileum, resulting in a small bowel obstruction. After removal of the remaining bezoar via ileotomy a secondary pneumatosis intestinalis occurred. As a rare finding the (phyto-)bezoar should be considered as a differential diagnosis of abdominal pain - especially considering the rising numbers of bariatric surgery, which is a potential risk factor. Furthermore, intestinal obstruction after migration has to be considered as a relevant complication of treatment.

Archaeological, radiological, and biological evidence offer insight into Inca child sacrifice.

Examination of three frozen bodies, a 13-y-old girl and a girl and boy aged 4 to 5 y, separately entombed near the Andean summit of Volcán Llullaillaco, Argentina, sheds new light on human sacrifice as a central part of the Imperial Inca capacocha rite, described by chroniclers writing after the Spanish conquest. The high-resolution diachronic data presented here, obtained directly from scalp hair, implies escalating coca and alcohol ingestion in the lead-up to death. These data, combined with archaeological and radiological evidence, deepen our understanding of the circumstances and context of final placement on the mountain top. We argue that the individuals were treated differently according to their age, status, and ritual role. Finally, we relate our findings to questions of consent, coercion, and/or compliance, and the controversial issues of ideological justification and strategies of social control and political legitimation pursued by the expansionist Inca state before European contact.

De-demonizing the VRAEM: A Peruvian-Cocalero Area.

BACKGROUND: The valley of the rivers Apurímac, Ene, and Mantaro (VRAEM) is the main center of coca production in Peru. This is a jungle area located between southern highland regions, and is notorious for the presence of drug-trafficking and the last remnants of Shining Path guerrillas. As a result, it occupies a central place in security policies in Peru, and has been "demonized" in the national imaginary. OBJECTIVE: This article explores the current situation, recent history, and most important collectives of the VRAEM, challenging stereotypes about it. METHODS: The article is based on short-term fieldwork undertaken in the VRAEM in March 2008, and long-term research conducted in Ayacucho in 2008-2009; and it is contextualized in relation to the literature on coca producing areas and drug policies. RESULTS: The negative image of the VRAEM started in the context of the 1980s-1990s coca boom and Peruvian armed conflict. State policies in the area since then have been mainly based on militarization and repression, contributing to maintain that negative image, which differs of a complex and nuanced local reality. A coca eradication campaign started in 2014, bringing major changes. CONCLUSIONS: The negative image of the VRAEM is largely unfair, and has been mainly based on stereotypes and prejudices. This negative stereotyping contributes to justify and maintain inefficient and pernicious state policies in the area, and to criminalize local people. There is an urgent need for fieldwork-based studies in the area to counteract those negative stereotypes and monitor current events.

Coca: High Altitude Remedy of the Ancient Incas.

The use of coca leaf for medicinal purposes is a centuries-old tradition of the native peoples of South America. Coca products are thought by many laypersons to provide risk-free benefits to users participating in strenuous activities at high altitude. Physiologic studies of coca have increased understanding of its possible mechanism of action as well as its potential impact on high altitude activities. This present work explores the role of coca throughout the history of the Andean peoples and explores whether this ancient remedy has a place in modern medicine. A focused summary of research articles with particular relevance to the field of wilderness medicine is also included to better provide the reader with lessons not only from history but also from another culture.

Coca-Cola consumption vs fragmentation in the management of patients with phytobezoars: A prospective randomized controlled trial.

BACKGROUND: Gastric phytobezoars (GPBs) are very common in northern China. Combined therapy involving carbonated beverage consumption and endoscopic lithotripsy has been shown to be effective and safe. Existing studies on this subject are often case reports highlighting the successful dissolution of phytobezoars through Coca-Cola consumption. Consequently, large-scale prospective investigations in this domain remain scarce. Therefore, we conducted a randomized controlled trial to examine the effects of Coca-Cola consumption on GPBs. AIM: To evaluate the impact of Coca-Cola on GPBs, including the dissolution rate, medical expenses, ulcer rate, and operation time. METHODS: A total of 160 consecutive patients diagnosed with GPBs were allocated into two groups (a control group and an intervention group) through computer-generated randomization. Patients in the intervention group received a Coca-Cola-based regimen (Coca-Cola 2000-4000 mL per day for 7 d), while those in the control group underwent emergency fragmentation. RESULTS: Complete dissolution of GPBs was achieved in 100% of the patients in the intervention group. The disparity in expenses between the control group and intervention group (t = 25.791, P = 0.000) was statistically significant, and the difference in gastric ulcer occurrence between the control group and intervention group (χ2 = 6.181, P = 0.013) was also statistically significant. CONCLUSION: Timely ingestion of Coca-Cola yields significant benefits, including a complete dissolution rate of 100%, a low incidence of gastric ulcers, no need for fragmentation and reduced expenses.

Has Coca-Cola treatment become the first-line therapy for gastric bezoars, both in general and specifically for western countries?

Phytobezoars is a rare disease and less common in Western countries. The stomach is the primary site for these formations, and endoscopic treatment involving fragmentation and extraction has traditionally been the most effective approach. However, medical treatments using enzymatic and chemical agents, such as cellulase and Coca-Cola, aimed at dissolving the bezoars, have also been utilized, showing varying degrees of resolution success. Notably, the oral dissolution treatment with Coca-Cola has emerged as a promising, simpler, and more cost-effective method. The study by Liu et al represents an important step in clinical research on this topic, despite some limitations that need addressing for a more comprehensive understanding of its findings. Key considerations for future research include sample size calculation, endoscopic procedure details, outpatient vs. inpatient treatment, and detailed cost calculations. The study's exclusions, such as patients with upper gastric surgery, phytobezoars older than 14 d, and cases of gastroparesis, limit its applicability to broader populations, especially in Western countries. Given the promising outcomes of the Coca-Cola treatment, it's advocated as a first-line therapy for phytobezoars. Nonetheless, further research is essential to overcome these limitations. However special situations such as perforation or small bowel obstruction will require surgical treatment.

Pollen identification of three notorious illicit drug plants and its potential applications in forensic practice.

Opium poppy, coca and cannabis are raw materials for three notorious illicit drugs. For a long time, drug lords have been growing and smuggling these drugs in a variety of ways and channels and are continually finding new ways of trafficking their wares, which has led to the increasing difficulty of global drug enforcement. In the present paper, we propose an innovative pollen identification system for these important drug plants, which provides a tool for screening and detection of the drugs to aid in drug enforcement. By utilizing the characteristics of these fine particles, their abundant production, and high resistance to decay, we believe this tool could be applied in the following scenarios: detecting and dynamically monitoring drug cultivation activities; determining whether a suspect has been to fields of drug plants and determining whether the site has ever been planted with a drug plant and/or was involved in drug production. In the future, combined with microscope automatic image acquisition technology and intelligent image recognition technology, this pollen identification system is expected to be used to screen three notorious illicit drug plants, thus enhancing the efficiency of drug related crime investigations.

Effect of Coca-Cola on the Dissolution of Persimmon-Related Phytobezoar in a Tertiary Care Hospital.

Introduction Bezoars, masses of indigestible foreign bodies formed in the gastrointestinal tract, pose challenges in their management. Phytobezoars are particularly problematic due to their difficult diagnosis and resilience towards treatment. Recently, Coca-Cola has emerged as a potential solution due to its acidic composition and mucolytic properties. However, existing evidence is limited, highlighting the need for comprehensive studies. This research explores the efficacy of Coca-Cola in dissolving persimmon-related phytobezoars, aiming to contribute valuable insights to non-invasive treatment options. Material and methods Conducted as a descriptive case series, this study employed gastric cola lavage using non-probability purposive sampling. Patients aged 18-70 with persimmon-related phytobezoars were included. Two nasogastric tubes were inserted for cola lavage over 12 hours, utilizing three liters of cola until the disappearance of symptoms. When the bezoar disappeared, it was considered as complete success to the treatment. Results Out of 31 patients, 45.2% were male and 54.8% were female, with a mean age of 56.77 ± 9.01 years. Efficacy was noted in 54.8% of cases. Age less than 50 and no history of diabetes mellitus were associated with higher chances of treatment success (p-value ≤0.05). Conclusion Ingestion of Coca-Cola was highly effective, safe, and reliable for the dissolution of persimmon-related phytobezoars, as the frequency of efficacy was high in our study. Coca-Cola ingestion is a non-invasive and cost-effective mode of phytobezoar dissolution that should be taken as a first-line initial treatment option to attain desired outcomes.

Electrochemical and statistical study of Nickel ion assessment in daily children intake samples relying on magnesium aluminate spinel nanoparticles.

Lately, children's daily consumption of some products, such as cereals and candies, has been rising, which provides a compelling rationale for determining any metallic substances that may be present. Monitoring the concentration of certain metals, like nickel, in these products is necessary due to medical issues in humans when consumed regularly. So, in this work, a novel and highly selective carbon paste as a Ni(II) ion-selective sensor was prepared and investigated using ceramic magnesium aluminum spinel nanoparticles as the ionophore and tritolyl phosphate (TOCP) as a plasticizer. A modified co-precipitation method was used to synthesize the spinel nanoparticles. X-ray diffraction, scanning electron microscope with EDAX, transmission electron microscope, and BET surface area were used to determine the phase composition, microstructure, pores size, particle size, and surface area of the synthesized nanoparticles. The spinel nanoparticle was found to have a nano crystallite size with a cubic crystal system, a particle size ranging from 17.2 to 51.52 nm, mesoporous nature (average pore size = 8.72 nm), and a large surface area (61.75 m2/g). The composition ratio of graphite carbon as a base: TOCP as binder: spinal as ionophore was 67.3:30.0:2.7 (wt%) based on potentiometric detections over concentrations from 5.0 × 10-8 to 1.0 × 10-2 mol L-1 with LOD of 5.0 × 10-8 mol L-1. A measurement of 29.22 ± 0.12 mV decade-1 over pH 2.0-7.0 was made for the Nernstian slope. This sensor demonstrated good repeatability over nine weeks and a rapid response of 8 s. A good selectivity was shown for Ni(II) ions across many interferents, tri-, di-, and monovalent cations. The Ni(II) content in spiked real samples, including cocaine, sweets, coca, chocolate, carbonated drinks, cereals, and packages, were measured. The results obtained indicated no significant difference between the proposed potentiometric method and the officially reported ICP method according to the F- and t-test data. In addition to utilizing ANOVA statistical analysis, validation procedures have been implemented, and the results exceed the ICP-MS methodology.

Caring for coca, living with chemicals: Towards ecological harm reduction.

In this paper, we show how the materialisation of chemical harms linked to the cultivation of coca and its processing into coca paste reside in a wider politics of structural violence which is also situated ecologically. Drawing on the qualitative interview accounts of coca farmers in Putumayo, Colombia, we attend to practices of care in the field and in the laboratory. We look first at chemicals used in coca's cultivation (herbicides, fertilizers, pesticides), and second at chemicals (such as sulphuric acid, sodium carbonate, magnesium permanganate) used in the processing of coca leaf into paste (before the paste is sold on for refinement into cocaine). Our analysis highlights the tensions which inevitably arise in the balance and multiplicities of care - for crops, livelihood, and environment. We trace how farmers' narratives of the neutralisation of chemical risks habituate chemical harms as mundane, even uneventful, in an economic imperative to 'carry on as normal' in the coca economy. We emphasise health and harm as matters of care which not only affect humans but living environments. Accounts of 'risk environment' can give insufficient attention to Nature, and this leads us to consider 'ecological harm reduction'.

Successful Dissolution of a Large Gastric Phytobezoar Through Nonsurgical and Nonendoscopic Fragmentation.

A phytobezoar is the result of poorly digestible vegetable matter that accumulates in the gastrointestinal tract often forming a hard mass in the stomach. We present a case of a phytobezoar in a patient without predisposing risk factors, resulting in significant stomach distension initially believed to require high-risk surgical intervention but which ultimately resolved after 3 days of conservative treatment with prokinetic agents. The patient was discharged uneventfully and was recommended a low-fiber diet indefinitely while undergoing further workup for motility disorders.

Multivariate Base Rates of Low Score on Neuropsychological Tests of Individuals with Coca Paste Use Disorder.

OBJECTIVE: The aim of this study was to determine the prevalence of low scores on eight commonly used neuropsychological tests to evaluate learning and memory, language, and executive functions in individuals with coca paste use disorders (CPUD) and to identify the differences with respect to a group of healthy nonconsuming subjects (HCs). METHODS: 162 Colombian adults with CPUD and a group of 162 Colombian adult HCs participated in this comparative study. Eight tests (eighteen test scores) were grouped into three categories: learning and memory, language, and executive functions. Each participant was categorized based on the number of low scoring tests in specific percentile cut-off groups (25th, 16th, 10th, 5th, and 2nd). RESULTS: In the learning and memory domain, 89.5% of individuals with CPUD and 55.6% of HCs scored below the 25th percentile on at least one of the five test scores, in the language domain, 80.7% of individuals with CPUD and 58% of HCs and in the executive function domain, 92% of individuals with CPUD and 67.3% of HCs. Having two or more scores below the 10th percentile or 10 or more at the 5th percentile shows an optimal cut-off for determining the sensitivity and specificity for discriminating between the two groups. CONCLUSIONS: The individuals with CPUD had a higher percentage of low scores than the HCs in the domains of learning and memory, language, and executive function. It is important for clinicians to be aware of low scores in individuals with CPUD to avoid false-positive diagnoses of cognitive impairment.