Trans-anal irrigation in patients with multiple sclerosis: Efficacy in treating disease-related bowel dysfunctions and impact on the gut microbiota: A monocentric prospective study

Background: Constipation and faecal incontinence are not so uncommon in patients with multiple sclerosis, impairing quality of life. The gut microbiota is altered in multiple sclerosis patients and likely contributes to disease pathogenesis. Trans-anal irrigation has been proven to allow treatment of neurogenic bowel dysfunction and may affect gut microbiota. Objectives: The primary outcome was trans-anal irrigation effectiveness on constipation and faecal incontinence. The secondary outcome was gut microbiota profiling compared to healthy subjects and during trans-anal irrigation adoption. Methods: We conducted a prospective cohort study on multiple sclerosis patients, screened with Patient Assessment of Constipation Quality of Life questionnaire before undergoing constipation and faecal incontinence scoring, abdomen X-ray for intestinal transit time, compilation of food and evacuation diaries and faecal sample collection for gut microbiota analysis before and after 4 weeks of trans-anal irrigation. Results and Conclusions: Eighty patients were screened of which nearly half had intestinal symptoms. The included population (n = 37) was predominantly composed of women with significantly longer disease duration, higher mean age and disability than the excluded one (p < 0.05). Twelve patients completed the trans-anal irrigation phase, which led to significant improvement of bowel dysfunction symptom-related quality of life, increase in gut microbiota diversity and reduction of the proportions of pro-inflammatory taxa (p < 0.05). Trans-anal irrigation was safe, satisfactory and could help counteract multiple sclerosis-related dysbiosis

The Function of Bachelardian Epistemology in the Post-colonial Project of Mohammed ‘Abed al-Jabri

This paper explores the function of historical epistemology in the thought of Gaston Bachelard (1884–1962) and Mohammed ‘Abed al-Jabri (1935–2010). Attributing thought with a particular function challenges our tendency to explain the development of thought in other socio-historical contexts in terms of mere conceptual influence. Available English-language literature on al-Jabri commonly references Bachelard’s concept of epistemological rupture as a source of inspiration. Though the reference is astute, this term remains poorly understood and has long been overshadowed by Thomas Kuhn’s notion of ‘paradigm shift’. The broader function of Bachelard’s thought as a renegotiation of time, place, subject, and reason in the natural sciences has been largely neglected in historiographies of the philosophy of science outside of France. This paper emphasizes the level of insight and ingenuity with which al-Jabri employs the function of Bachelard’s epistemology by re-interpreting it within the framework of his own socio-historical context. Far from reducing al-Jabri’s thought to a mere programmatic reproduction of French thought, I suggest that al-Jabri was among the most astute interpreters of this long-misunderstood theorist

The Janus head of Bachelard’s phenomenotechnique: from purification to proliferation and back

The work of Gaston Bachelard is known for two crucial concepts, that of the epistemological rupture and that of phenomenotechnique. A crucial question is, however, how these two concepts relate to one another. Are they in fact essentially connected or must they be seen as two separate elements of Bachelard's thinking? This paper aims to analyse the relation between these two Bachelardian moments and the significance of the concept of phenomenotechnique for today. This will be done by examining certain historical uses of the concepts of Bachelard have been used from the 1960s on. From this historical perspective, one gets the impression that these two concepts are relatively independent from each other. The Althusserian school has exclusively focused on the concept of 'epistemological break', while scholars from Science & Technology Studies (STS), such as Bruno Latour, seem to have only taken up the concept of phenomenotechnique. It in fact leads to two different models of how to think about science, namely the model of purification and the model of proliferation. The former starts from the idea that sciences are rational to the extent that they are purified and free from (epistemological) obstacles. Scientific objectivity, within this later model, is not achieved by eradicating all intermediaries, obstacles and distortions, but rather exactly by introducing as many relevant technical mediators as possible. Finally, such a strong distinction will be criticized and the argument will be made that both in Bachelard's and Latour's thought both concepts are combined. This leads to a janus-headed view on science, where both the element of purification (the epistemological break) and the element of proliferation (phenomenotechnique) are combine

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Commentary on Anastasios Brenner's 'Epistemology Historicized'

By starting from a reflection on the article by Anastasios Brenner which precedes mine in this edited book, I discuss the 'difficult' relation of history and philosophy, and draw examples from the tradition of historical epistemology. On this basis, I evaluate the current status of history of philosophy of science, and I conclude with the defence of a truly historical approach to philosophy of science and of the philosopher's reflexivity

Constructing narratives and reading texts: Approaches to history and power struggles between philosophy and emergent disciplines in inter-war France

In inter-war France, history of philosophy was a very important academic discipline, but nevertheless its practitioners thought it necessary to defend its identity, which was threatened by its vicinity to many other disciplines, and especially by the emergent social sciences and history of science. I shall focus on two particular issues that divided traditional historians of philosophy from historians of science, ethnologists and sociologists, and that became crucial in the definition of the identity of their disciplines: the conception of history and the interpretation of texts. By analysing representative discussions and positions, I shall show that traditional historians of philosophy needed to reassert their own approach to history, which, borrowing the term from Bergson, I define as ‘snapshot’. This approach is focused on a particular idea or text rather than a narrative. I shall also show that history of philosophy, in its traditional form, would have been undermined both intellectually and institutionally by the opposite ‘narrative’ approach of history of science and of the social sciences. Social scientists openly attacked history of philosophy’s methods and, in the eyes of traditional philosophers, its existence as an academic discipline. The same opposition is to be found in evaluation of past texts, which for traditional historians of philosophy were to be read as timeless documents, while for historians of science, ethnologists and sociologists were to be considered as documents exhibiting a particular mentality. However, between these alternatives there were intermediate positions. I shall in particular consider that of Léon Brunschvicg: he embraced a narrative approach and considered texts as documents of different ways of thinking, but at the same time carried on employing philosophical methods and defending the institutional position of philosophy. I shall argue that this was possible partly because of the considerable amount of power he enjoyed at the Sorbonne

Fully amorphous atactic and isotactic block copolymers and their self-assembly into nano- and microscopic vesicles

Data underlying the figures in the publication “Fully amorphous atactic and isotactic block copolymers and their self-assembly into nano- and microscopic vesicles”, published in Polym. Chem., 2021, 12, 5377-5389. https://pubs.rsc.org/en/content/articlelanding/2021/PY/D1PY00952D Table of contents: 1. Figure 1: Zip archive containing the experimental data (NMR spectra) for the kinetics of the PBO syntheses (Figure 1c) and the PBO-b-PEEGE syntheses (Figure 1d). 2. Figure 2: Zip archive containing the experimental data for Figure 2. Structural characterisation of the (S)-BCP (S)-PBO27-b-(S)-PG14 by 1H-NMR spectroscopy in methanol-d4. 3. Figure 3: Zip archive containing the experimental data for Figure 3. Chiral characterisation of the atactic and isotactic BCPs. 4. Figure 4: Zip archive containing the experimental data for Figure 4. TEM and Cryo-TEM characterisation of the SUVs formed by (a) (R/S)-PBO26-b-(R/S)-PG14, (b) (R)-PBO26-b-(R)-PG14 and (c) (S)-PBO27-b-(S)-PG14. 5. Figure 5: Zip archive containing the CLSM images for Figure 5. 6. Figure 6: Zip archive containing the images for Figure 6. Snapshots of the enzyme reaction within the cavity of (R/S)-BCP GUVs (b) with and (c) without reconstituted membrane protein OmpF, recorded by CLSM at different time points 7. Figure 7: Excel file containing the experimental data for Figure 7. Fluorescence intensity development of (a) (R/S)-BCP and (b) PDMS25-b-PMOXA10 GUVs resulting from the reaction of resorufin β-D-galactopyranoside (RGP) with β-galactosidase (β-Gal) to yield fluorescent resorufin. 8. Table 1: Zip archive containing the experimental data for Table 1. 9. Table 2: Zip archive containing the experimental data for Table 2

Management of complex pelvic floor dysfunctions: Combined versus single surgical procedure in a multidisciplinary approach. A prospective study

Objectives: The management of pelvic floor dysfunction (PFD) is challenging because of high failure rates after surgery. The objective of this study was to compare the combined surgical treatment for complex PFD versus single procedures to improve the outcome. Materials and Methods: A prospective series of consecutive patients (n=30) undergoing single pelvic procedure (SP group) was compared to patients (n=30) operated with combined procedure (CP group) over a 24-month period in a tertiary referral university center in Italy. The primary outcome was the overall rate of PFD recurrence and “de novo” PFD at 24-months after surgery. Secondary outcomes included postoperative complications, functional outcomes, quality of life, and patient satisfaction. Results: At 24-months after surgery, we observed more recurrences in the SP group compared to CP group (6.7% vs 3.3%). De novo defects occurred more frequently in the SP group than in CP group (30% vs 6.7%; p=0.022). Ten percent of women of SP group underwent further surgery, compared to 3% in the CP group. Minor complications occurred in 33.3% of women in SP group and 43.3% in CP group. Postoperative improvement of pelvic prolapse was better in CP group (p=0.009). PFDI and PFQI questionnaires revealed significant postoperative clinical and quality-of-life improvement (p<0.0001) in both groups. Defecatory symptoms improved significantly in CP group (p=0.049). Minor fecal incontinence worsened in CP group while urinary symptomatology resulted improved in both groups. Patient satisfaction was very good in both groups. Conclusion: The combined surgical approach to PFD is effective and safe