From the criminal to the sinthome: Lacan's ethics of psychoanalysis and contemporary life

This thesis examines the continuity and the changes in Lacan's elaboration of psychoanalytic ethics. It focuses in particular on the shift from Lacan's classic formulation of psychoanalytic ethics in relation to the criminal figures of Sade and Antigone in Seminar VII, to his later formulation of a psychoanalytic ethics based on a re-elaboration of the concept of symptom - the sinthome - in the 1970s. By illustrating the way in which psychoanalytic ethics is constantly, from Freud to Lacan, defined against a critique of civilization, and by engaging with a number of contemporary clinical readings of Lacan's work, this thesis argues that the development of Lacan's understanding of psychoanalytic ethics should be seen as an attempt to adapt the practice of psychoanalysis to a major change in the structure of contemporary civilization. In this way, this thesis also insists on the importance of maintaining a distinction between Lacan's theory of ethics and, on the other hand, the ethical effects of psychoanalytic practice, and aims to explore the dialogue, the exchanges and the tensions between psychoanalytic practice and contemporary culture

Crystal nucleation from solution: design and modelling of detection time experiments

Crystal nucleation is the process responsible for the appearance of a thermodynamically stable phase from a metastable parent solution. Given its activated nature, nucleation is affected by stochasticity which, despite originating at the molecular level, affects heavily also the macroscopic behaviour of the system. Being far too small to be observed directly, nuclei are detected by indirect methods, which correlate the formation of the new phase with a measurable change in a property of the system, hence a model linking nuclei formation and crystals detection is always needed. We have previously presented a model describing nucleation in macroscopic systems as a stochastic Poisson process. The model, despite its general character, can describe industrially relevant processes, e.g. batch cooling at different operating conditions. The different scales influenced by the stochastic nature of nucleation demand appropriate theoretical and experimental investigations, particularly for applying the model to industrial scale-up, optimisation, and control. Using statistical tools, we have looked into the issue of estimating stochastic processes by collecting a representative, but limited number of data, produced from a homogeneous set. Moreover, using our model, we analysed the sensitivity of crystallising systems on initial and boundary conditions, with particular emphasis on the effect of supersaturation, temperature and detection conditions. Finally, in light of the stochastic nature of nucleation, we also applied statistical meta-analysis to assess the agreement between the fitting and its parameters and experiments, to gain further insight into the quality of the model. Experimentally, we have first investigated the conditions to perform homogeneous and reproducible measurements, necessary to understand the fundamental physical features and ultimately to estimate reliable kinetic parameters. A second aspect we have explored concerned the size of the crystallising systems. Since in macroscopic reactors various phenomena occur simultaneously (nucleation, growth, breakage, agglomeration) we chose to work with two main system sizes, 1-3 mL reactors (mesoscale) and 1-60 nL reactors (microscale, i.e. microscopic droplets), where at least some of such phenomena could be decoupled. In the mesoscale crystallisers, one can perform experiments where temperature and transmissivity could be measured online, hence monitoring the appearance and disappearance of crystals. Additionally, the influence of fluid-dynamics, typically turbulent in these reactors, was investigated. In the microfluidic chips, on the other hand, a very high through-put (thousands of replicas of the same reactor) can be potentially achieved and, thanks to their very small size, high supersaturations, outside of usual experimental reach, could be explored. Additionally, within the microscopic droplets the fluid motion is generally diffusive or laminar convective, hence hindering breakage and agglomeration. One could thus observe systems where nucleation and growth of single crystals (or of few crystals) occur unperturbed. Nevertheless, some main challenges, which we have been addressing, must be tackled before performing reliable crystallisation experiments: the characterisation and the reproducibility of shape and size of the droplets and their stability (i.e. the loss of mass due to evaporation and perspiration through the chip). In conclusion, we demonstrate that, even if the data are reproducible and reliable, robust probability estimations can be obtained only with a sufficiently large number of experiments, which require careful design to avoid sensitivity regions and data processing to reject the non-homogeneous data. The different sizes investigated have permitted to gain a better insight into the fundamental phenomena occurring in a crystallising system between the first formation of nuclei until crystal detection, which is of utmost importance for understanding the design of the experiments at an industrially relevant scale. Moreover, appropriate mathematical tools allowed to assess the reliability of the fitting obtained from independent measurements of the same system at different conditions

Injectable bone-graft substitute for in vivo tissue regeneration

We have demonstrated that using growth factors we can induce the proliferation of human primary osteoblasts but it isn’t enough to form new bone that need also the differentiation of the proliferated osteoblasts [1]. Being these two steps regulated by different pathways and different stimuli, in the same work we have found the combination of a proliferating growth factor (FGF2) with a differentiating stimulus (1,25Vit D3) as an optimal solution. With the aim to develop an injectable medicated scaffold which speeds bone formation in sinus lift augmentation, in bony void and in fracture repair, we have tested in vitro osteoblasts’ behavior in a 3D jelly collagen model (1mg/ml) using soluble native collagen prepared from rat tail tendons [2]. We have seen an osteoblasts’ Rho-kinase mediated contraction of the collagen that causes an approach of bone fragments within a week of culture with the formation of a fibrous bone tissue within 3 weeks of culture. FGF2 addition to the collagen fastened this result by increasing cell proliferation rate while the addition of 1,25Vit D3 to collagen at a concentration of 0,1 mg/mL that shows at HPLC analysis a release of 0,26 mcg/ ml/day during the incubation time studied, favors the mineralization of the new formed tissue that shows also increased tensile strenght. We think that this combination of factors could be used in vivo to accelerate bone growth and fracture healing

Older Adults' Access to Care during the COVID-19 Pandemic: Results from the LOckdown and LifeSTyles (LOST) in Lombardia Project

: The COVID-19 pandemic disproportionally affected older people in terms of clinical outcomes and care provision. We aimed to investigate older adults' changes in access to care during the pandemic and their determinants. We used data from a cross-sectional study (LOST in Lombardia) conducted in autumn 2020 on a representative sample of 4400 older adults from the most populated region in Italy. Lifestyles, mental health, and access to healthcare services before and during the pandemic were collected. To identify factors associated with care delays, reduction in emergency department (ED) access, and hospitalisations, we estimated prevalence ratios (PR) and 95% confidence intervals (CI) using multivariable log-binomial regression models. During the pandemic, compared to the year before, 21.5% of the study population increased telephone contacts with the general practitioner (GP) and 9.6% increased self-pay visits, while 22.4% decreased GP visits, 12.3% decreased outpatient visits, 9.1% decreased diagnostic exams, 7.5% decreased ED access, and 6% decreased hospitalisations. The prevalence of care delays due to patient's decision (overall 23.8%) was higher among men (PR 1.16, 95% CI 1.05-1.29), subjects aged 75 years or more (PR 1.12, 95% CI 1.00-1.25), and those with a higher economic status (p for trend < 0.001). Participants with comorbidities more frequently cancelled visits and reduced ED access or hospitalisations, while individuals with worsened mental health status reported a higher prevalence of care delays and ED access reductions. Access to care decreased in selected sub-groups of older adults during the pandemic with likely negative impacts on mortality and morbidity in the short and long run

A real world analysis of COVID-19 impact on hospitalizations in older adults with chronic conditions from an Italian region

Healthcare delivery reorganization during the COVID-19 emergency may have had a significant impact on access to care for older adults with chronic conditions. We investigated such impact among all adults with chronic conditions aged >= 65 years, identified through the electronic health databases of two local health agencies-ATS Brianza and ATS Bergamo-from the Lombardy region, Italy. We considered hospitalizations for 2020 compared to the average 2017-2019 and quantified differences using rate ratios (RRs). Overall, in 2017-2019 there were a mean of 374,855 older adults with >= 1 chronic condition per year in the two ATS and 405,371 in 2020. Hospitalizations significantly decreased from 84,624 (225.8/1000) in 2017-2019 to 78,345 (193.3/1000) in 2020 (RR 0.86). Declines were reported in individuals with many chronic conditions and for most Major Diagnostic Categories, except for diseases of the respiratory system. The strongest reductions were observed in hospitalizations for individuals with active tumours, particularly for surgical ones. Hospitalization rates increased in individuals with diabetes, likely due to COVID-19-related diseases. Although determinants of the decrease in demand and supply for care among chronic older adults are to be further explored, this raises awareness on their impacts on chronic patients' health in the medium and long run

Technology Diffusion, Abatement Cost and Transboundary Pollution

This paper studies countries' incentives to develop advanced pollution abatement technology when technology may spillover across countries and pollution abatement is a global public good. We are motivated in part by the problem of global warming: a solution to this involves providing a global public good, and will surely require the development and implementation of new technologies. We show that at the Nash equilibrium of a simultaneous-move game with R&D investment and emission abatement, whether the free rider effect prevails and under-investment and excess emissions occur depends on the degree of technology spillovers and the effect of R&D on the marginal abatement costs. There are cases in which, contrary to conventional wisdom, Nash equilibrium investments in emissions reductions exceed the first-best case

Genomic instability analysis in DNA from Papanicolaou test provides proof-of-principle early diagnosis of high-grade serous ovarian cancer

Late diagnosis and the lack of screening methods for early detection define high-grade serous ovarian cancer (HGSOC) as the gynecological malignancy with the highest mortality rate. In the work presented here, we investigated a retrospective and multicentric cohort of 250 archival Papanicolaou (Pap) test smears collected during routine gynecological screening. Samples were taken at different time points (from 1 month to 13.5 years before diagnosis) from 113 presymptomatic women who were subsequently diagnosed with HGSOC (pre-HGSOC) and from 77 healthy women. Genome instability was detected through low-pass whole-genome sequencing of DNA derived from Pap test samples in terms of copy number profile abnormality (CPA). CPA values of DNA extracted from Pap test samples from pre-HGSOC women were substantially higher than those in samples from healthy women. Consistently with the longitudinal analysis of clonal pathogenic TP53 mutations, this assay could detect HGSOC presence up to 9 years before diagnosis. This finding confirms the continual shedding of tumor cells from fimbriae toward the endocervical canal, suggesting a new path for the early diagnosis of HGSOC. We integrated the CPA score into the EVA (early ovarian cancer) test, the sensitivity of which was 75% (95% CI, 64.97 to 85.79), the specificity 96% (95% CI, 88.35 to 100.00), and the accuracy 81%. This proof-of-principle study indicates that the early diagnosis of HGSOC is feasible through the analysis of genomic alterations in DNA from endocervical smears

Technology Transfer in the Non-Traded Sector as a Means to Combat Global Warming

The paper considers a situation where two countries - the North and the South - use a non-traded polluting input to produce the goods for final consumption. The North is more efficient in both, production and abatement processes. The study compares the effects of the transfer of abatement technology by the North to the South under autarky with the free trade situation, assuming that the North pre-commits to an international protocol to keep the global pollution under a fixed level. The conditions under which either full or partial technology is transferred in autarky are determined. It is shown that under free trade no such transfer is possible. With trade even though the North wants a complete transfer of technology, the South refuses it

Sexual Orientation and Household Decision Making: Same-Sex Couples' Balance of Power and Labor Supply Choices

I estimate how intra-household bargaining affects gay and lesbian couples' labor supplies, investigating their similarity to heterosexual decision-making, in a collective household framework. Data from the 2000 US Census show that couples of all types exhibit a significant response to bargaining power shifts, as measured by differences between partners in age or non-labor income. In gay, lesbian, and heterosexual cohabiting couples, a relatively young or rich partner has more bargaining power and hence supplies less labor, the opposite holding for his/her mate. Married couples value the older spouse instead, or the richer. No effects are found for same-sex roommates

The Relationship between Environmental Efficiency and Manufacturing Firm's Growth

This paper investigates the empirical link between emission intensity and economic growth, using a very large data set of 61,219 Italian manufacturing firms over the period 2000-2004. As a measure of lagged environmental performance (efficiency) at firm level we exploit NAMEA sector for CO2, NOx, SOx data over 1990-1999. The paper tests the extent to which (past) environmental efficiency/intensity, which is driven by structural features and firm strategic actions, including responses to policies, influences firms growth. Our results show, first, a typical trade off generally appearing for the three core environmental emissions we analyse: lower environmentally efficiency in the recent past allows higher degrees of freedom to firms and relax the constraints for growth, at least in this short/medium term scenario. Nevertheless, the size of the estimated coefficients is not large. Trade offs are significant for two emission indicators out of two, but quite negligible in terms of impacts, besides the case of CO2. For example, growth is reduced by far less than 0.1% in association to a 1% increase of environmental efficiency. In addition, non-linearity seems to characterise the economic growth-environmental performance relationship. Signals of inverted U shape appear: this may be a signal that both firm strategies and recent policy efforts are affecting the dynamic relationship between environmental efficiency and economic productivity, turning it from an usual trade off to a possible joint complementary/co-dynamics