Il Novecento è davvero finito : considerazioni sull'urbanistica

Un profondo cambiamento segna l’urbanistica e l’architettura di questi ultimi due decenni e si esprime come lontananza dal progetto moderno, apertura di nuovi problemi, modifiche di linguaggi e tecniche. Al cambiare di tutto o quasi si sovrappone un discorso critico che non è mai sembrato così disarmato, poco attento ad osservare ciò che l’urbanistica fa, il modo in cui argomenta ciò che fa, in cui interpreta problemi, chiarisce intenzioni, produce giustificazioni, cambia linguaggi. Manca una migliore descrizione dell’urbanistica e del suo progetto che sia anche un tornare a descrivere, osservare, interpretare i temi del discorso urbanistico; chiarire ed esplicitare i modi messi in atto per ordinare il mondo sensibile esercitando un’azione politica al di là degli aspetti normativi e della ricostruzione del negoziato. In mancanza di un tale atteggiamento è fin troppo facile parlare di difficoltà, sconfitta, impoverimento. Scopo di questo libro è provare a descrivere alcuni aspetti dell’urbanistica italiana di questi ultimi venti anni. Al di fuori da un atteggiamento nostalgico, di perdita e al di fuori da una entusiastica accettazione delle condizioni contemporanee. Un tale compito si giustifica con la convinzione che en-tro una situazione difficile permangano importanti spiragli di conoscenza e azione, che lo sfondo disegnato da coloro che pensano ad un impoverimento sia realistico, ma non racconti tutto. Che in esso si possa riallacciare un’azione affermativa: una certa libertà di movimento e di pensiero

Corpi. Tra spazio e progetto

Il corpo è “canale di transito” tra lo spazio e il progetto: il tramite con il quale il progetto manipola lo spazio. Questa è la tesi del libro. Il progetto allude sempre ad uno spazio che è riempito di corpi, svuotato di corpi. Di corpi nella loro materiale finitezza. Di relazioni: di corpi che si ignorano, si cercano. Di antagonismi. Di alleanze. Non è la perfezione dell’analogia organica (sfidata solo dall’imperfezione di Frankenstein), ma la materiale concretezza del corpo che si rende visibile, respira, si muove, rimane fermo, parla o sta in silenzio. Si espone. Manifesta la propria intimità, le piccole abitudini, il sapere del corpo nei suoi rapporti con altri corpi e con lo spazio: il suo essere “operatore delicatissimo” nella relazione tra spazio e progetto. Entro questa angolazione il testo osserva alcune figure di architetti, urbanisti, paesaggisti del Novecento, nella tradizione europea: autori che hanno espresso posizioni significative entro un ragionamento sulla città e l’architettura, alludendo in modo diretto o indiretto al tema del corpo. Richard Neutra, Clair e Michel Corajoud, Alexander Klein, John Habracken, Paola Viganò e Bernardo Secchi, John Turner

Cytoprotective Effect of Idebenone through Modulation of the Intrinsic Mitochondrial Pathway of Apoptosis in Human Retinal Pigment Epithelial Cells Exposed to Oxidative Stress Induced by Hydrogen Peroxide

Idebenone is a ubiquinone short-chain synthetic analog with antioxidant properties, which is believed to restore mitochondrial ATP synthesis. As such, idebenone is investigated in numerous clinical trials for diseases of mitochondrial aetiology and it is authorized as a drug for the treatment of Leber’s hereditary optic neuropathy. Mitochondria of retinal pigment epithelium (RPE) are particularly vulnerable to oxidative damage associated with cellular senescence. Therefore, the aim of this study was to explore idebenone’s cytoprotective effect and its underlying mechanism. We used a human-RPE cell line (ARPE-19) exposed to idebenone pre-treatment for 24 h followed by conditions inducing H2O2 oxidative damage for a further 24 h. We found that idebenone: (a) ameliorated H2O2-lowered cell viability in the RPE culture; (b) activated Nrf2 signaling pathway by promoting Nrf2 nuclear translocation; (c) increased Bcl-2 protein levels, leaving unmodified those of Bax, thereby reducing the Bax/Bcl-2 ratio; (d) maintained the mitochondrial membrane potential (ΔΨm) at physiological levels, preserving the functionality of mitochondrial respiratory complexes and counteracting the excessive production of ROS; and (e) reduced mitochondrial cytochrome C-mediated caspase-3 activity. Taken together, our findings show that idebenone protects RPE from oxidative damage by modulating the intrinsic mitochondrial pathway of apoptosis, suggesting its possible role in retinal epitheliopathies associated with mitochondrial dysfunction

Successful CAR-T cell therapy in a refractory MCL patient with bacterial, fungal and COVID-19 infection: a case report

BackgroundThe COVID-19 pandemic has had a significant impact on the management and care of onco-hematological patients, particularly those with lymphoproliferative disorders who are at higher risk for COVID-19 associated bacterial and fungal superinfections.Case presentationWe present the successful treatment of a 44-year-old male patient with refractory mantle cell lymphoma treated with chimeric antigen receptor T (CAR-T) cell therapy, despite concurrent COVID-19 infection. The patient developed grade II cytokine release syndrome, requiring admission to the intensive care unit. The CAR-T cells expanded effectively, and the patient achieved complete metabolic remission. During the treatment course, the patient experienced complications including COVID-19-associated pulmonary aspergillosis and a co-infection with Stenotrophomonas maltophilia and the SARS-CoV-2 omicron variant. Prompt antifungal and antibacterial therapy, along with appropriate COVID-19 treatment, led to the resolution of these infections. Dexamethasone was also administered to reduce inflammation and aid hematologic recovery. Despite the presence of multiple infections, the patient achieved complete remission of lymphoma, highlighting the effectiveness of CAR-T cell therapy in this high-risk patient.ConclusionDespite the challenges posed by concurrent infections, the decision to proceed with CAR-T cell therapy in this patient proved to be successful, resulting in complete remission of lymphoma. Early initiation of supportive therapies and the use of dexamethasone contributed to the resolution of complications. This case underscores the importance of individualized decision-making and the potential benefits of CAR-T cell therapy in similar high-risk patients

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 ± 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys

Cognitive neuroscience of delusions in aging

Assessments and clinical understanding of late-onset delusions in the elderly are inconsistent and often incomplete. In this review, we consider the prevalence, neurobehavioral features, and neuroanatomic correlations of delusions in elderly persons – those with documented cognitive decline and those with no evidence of cognitive decline. Both groups exhibit a common phenotype: delusions are either of persecution or of misidentification. Late-onset delusions show a nearly complete absence of the grandiose, mystical, or erotomanic content typical of early onset psychoses. Absent also from both elderly populations are formal thought disorders, thought insertions, and delusions of external control. Neuroimaging and behavioral studies suggest a frontotemporal localization of delusions in the elderly, with right hemispheric lateralization in delusional misidentification and left lateralization in delusions of persecution. We propose that delusions in the elderly reflect a common neuroanatomic and functional phenotype, and we discuss applications of our proposal to diagnosis and treatment

Territoires Partagés.

L’individualisation est destinée à demeurer parmi nous, mais elle est de plus en plus compromise par le partage. Nombreux sont les épisodes qui montrent le renforcement des liens horizontaux sur une base rigoureusement individualiste, construite sur l’exaltation de la subjectivité au sens moderne du terme: des associationnismes de différents types, des actions collectives pas forcément durables, un être-en-commun peu intentionné, des rencontres dans ces lieux qui sont étrangers à l’idée courante d’espace public. Ce livre vise à saisir les implications spatiales d’un « fait social formé dans l’espace » qui a d’importantes retombées sur l’espace puisqu’il transforme, récrit, renforce, colonise, dans l’acte même de se donner ; en définitive, il construit les lieux au sein desquels il se donne. Pusieurs cas européens (Genève, Turin, Berlin, Milan, Breda, Bruxelles, Lyon) servent de prétexte à une remontée théorique qui vient à questionner l’urbanisme. Texxtes de Cristina Bianchetti, Massimo Briccoli, Emanuel Giannotti, Isabella Inti, Ota de Leonardis, Angelo Sampieri, Paola Savoldi, Anna Todros. Préface de Thierry Paquot