Antologie e necrologi del Mar Mediterraneo. Violenza e violazioni nel Mediterraneo: Pratiche ed esperienze psicosociali di trasformazione del ricordo in memoria e di elaborazione culturale delle morti di migranti «irregolarizzati»

La tesi si occupa della dimensione traumatica e della memoria delle morti o delle scomparse di migranti senza documenti (morti legate alle frontiere o morti di persone in movimento, anche morti di migranti “illegalizzati”) alle frontiere europee, in particolare nel Mar Mediterraneo, cioè al confine meridionale dell’Europa e nel canale di Sicilia. Di fatto, più di 40.000 persone migranti hanno perso la vita nelle frontiere mondiali sempre più esternalizzate, securitarie e militarizzate. In questo scenario mortale, la frontiera meridionale dell’Europa, il Mar Mediterraneo (diviso in Mediterraneo occidentale, centrale e orientale) si è trasformato nella rotta più pericolosa e mortale. Un cimitero sommerso, un sarcofago acquatico, o l’espressione più evidente del regime della “Fortezza Europa” attraverso il quale si applica una necropolitica violenta, emergono crimini di pace e solidarietà e si materializzano forme eterogenee di violazioni. Così, la ricerca si propone un’analisi socioculturale e psicosociale critica sui dati empirici raccolti attraverso un lavoro etnografico nelle zone di confine, in particolare nell’isola italiana di Lampedusa, e attraverso interviste narrative semi-strutturate con attivisti/artivisti italiani ed europei. L’obiettivo è quello di analizzare come le pratiche di costruzione e memorizzazione del trauma, come esperienze simboliche/liminali personali e collettive di creazione di significato, affrontino la dimensione razziale, coloniale e violenta delle politiche europee manifesta in una concezione di frontiera che non si riduce ad una linea geografica materiale. Il lavoro si articola nei seguenti punti: • Una breve panoramica sugli studi sulle migrazioni da una prospettiva storica e sociale: cause, dinamiche e normative che inquadrano l’eterogeneità delle migrazioni. L’attenzione sarà posta principalmente sulla situazione europea/italiana; • Un focus dettagliato sui “migranti illegalizzati” o migranti privi di documentazione regolare, che sono persone in movimento che prendono rotte di confine pericolose e rischiano la vita nell’attraversarle. Utilizzando dati provenienti da diverse fonti, la dimensione numerica del fenomeno sarà affrontata e discussa criticamente. • Uno schema dettagliato sugli studi di frontiera, memoria e trauma da una prospettiva transdisciplinare e dalla prospettiva specifica della psicologia socioculturale. • Una descrizione dell’impianto metodologico impiegato dalla ricerca. • Due capitoli di analisi, distinti lungo una linea geografica: zone di confine (Lampedusa) ed esperienze transfrontaliere. • In conclusione, saranno evidenziati i limiti e le linee di direzione future.The thesis deals with the traumatic and memory dimension of undocumented migrants’ deaths (border-related deaths or people-on-the-move deaths, also ‘illegalized’ migrants’ deaths) at the European borders, specifically in the Mediterranean Sea, i.e. the southern European border. As a matter of fact, more than 40,000 people-on-the-move have lost their lives in worldwide increasing externalized, securitized, and militarized borders. In such a deadly scenario, the European southern border, the Mediterranean Sea (divided in West, Central, and East Mediterranean route) has turned into the most perilous and deadliest route. A submerged cemetery, the European ‘sarcophagi’, or the most evident expression of the ‘Fortress Europe’ regime through which necropolitics are applied, ‘crimes of peace/solidarity’ emerge, and heterogeneous forms of violence/violation materialize. Thus, the book proposes a sociocultural and critical psychosocial analysis on empirical data collected through ethnographic work in border-zones, specifically in the Italian island of Lampedusa, and through semi-structured narrative interviews with European activist/’artivist’. The aim is to analyse how practices of trauma construction and memorialization, as personal and collective symbolic/liminal experiences of meaning-making, engage racial, colonial, and violent European policies. A brief overview over migration studies from a historical and social perspective: causes, dynamics, and normative that frame migration heterogeneity. The attention will mainly put on European/Italian situation. The thesis is further structured in the following sections: • A detailed focus over ‘illegalized migrants’ or undocumented migrants which are people-on-the-move who take perilous border routes and risk their lives in crossing them. Using data from different sources, the numeric dimension of the phenomenon will be addressed and critically discussed. • A detailed outline on border, memory, and trauma studies from a transdisciplinary perspective and from the specific perspective of sociocultural psychology. • A methodological/methods description of the research. • Two chapter of analysis, distinguished along a geographical line: border-zones (Lampedusa) and cross-borders experiences. In conclusion, limits and future lines of direction will be highlighted

Exploring the psychosocial experiences of Afghan refugees in Italy: A qualitative study

The Taliban restored their government in Afghanistan in August 2021, following an international agreement and a rapid offensive throughout the country. Consequently, many Afghans who collaborated with the United States­-NATO coalition were forced to leave the country. Forced migration events expose people to a wide breadth of sudden stressful changes, conventionally assumed as trauma. This article proposes another point of view of forced migration considering the turning points to understand negative impact and resilience trajectories, exploring the life stories of 34 Afghan refugees who were evacuated from Afghanistan to Italy. Grounded theory and a thematic analysis method were used to infer themes. The results show three themes: the shock for the taking of Kabul, a tragic possibility, gaining a sense of mastery. The last theme, gaining a sense of mastery, displays a form of suffering but also various forms of resilience and new modes of engagement. Overall, our results foreground the deep role played by the social and historical bonds in forging both suffering and resilience in the identified turning points. From these insights, practical implications for community-based psychosocial interventions can be drawn.

A Clinical Decision Support System based on fuzzy rules and classification algorithms for monitoring the physiological parameters of type-2 diabetic patients

The use of different types of Clinical Decision Support Systems (CDSS) makes possible the improvement of the quality of the therapeutic and diagnostic efficiency in health field. Those systems, properly implemented, are able to simulate human expert clinician reasoning in order to suggest decisions on treatment of patients. In this paper, we exploit fuzzy inference machines to improve the quality of the day-by-day clinical care of type-2 diabetic patients of Anti-Diabetes Centre (CAD) of the Local Health Authority ASL Naples 1 (Naples, Italy). All the designed functionalities were developed thanks to the experience on the field, through different phases (data collection and adjustment, Fuzzy Inference System development and its validation on real cases) executed by an interdisciplinary research team comprising doctors, clinicians and IT engineers. The proposed approach also allows the remote monitoring of patients' clinical conditions and, hence, can help to reduce hospitalizations

Modeling SARS-CoV-2 spike/ACE2 protein–protein interactions for predicting the binding affinity of new spike variants for ACE2, and novel ACE2 structurally related human protein targets, for COVID-19 handling in the 3PM context

Aims The rapid spread of new SARS-CoV-2 variants has highlighted the crucial role played in the infection by mutations occurring at the SARS-CoV-2 spike receptor binding domain (RBD) in the interactions with the human ACE2 receptor. In this context, it urgently needs to develop new rapid tools for quickly predicting the affinity of ACE2 for the SARS-CoV-2 spike RBD protein variants to be used with the ongoing SARS-CoV-2 genomic sequencing activities in the clinics, aiming to gain clues about the transmissibility and virulence of new variants, to prevent new outbreaks and to quickly estimate the severity of the disease in the context of the 3PM. Methods In our study, we used a computational pipeline for calculating the interaction energies at the SARS-CoV-2 spike RBD/ACE2 protein–protein interface for a selected group of characterized infectious variants of concern/interest (VoC/ VoI). By using our pipeline, we built 3D comparative models of the SARS-CoV-2 spike RBD/ACE2 protein complexes for the VoC B.1.1.7-United Kingdom (carrying the mutations of concern/interest N501Y, S494P, E484K at the RBD), P.1- Japan/Brazil (RBD mutations: K417T, E484K, N501Y), B.1.351-South Africa (RBD mutations: K417N, E484K, N501Y), B.1.427/B.1.429-California (RBD mutations: L452R), the B.1.141 (RBD mutations: N439K), and the recent B.1.617.1- India (RBD mutations: L452R; E484Q) and the B.1.620 (RBD mutations: S477N; E484K). Then, we used the obtained 3D comparative models of the SARS-CoV-2 spike RBD/ACE2 protein complexes for predicting the interaction energies at the protein–protein interface. Results Along SARS-CoV-2 mutation database screening and mutation localization analysis, it was ascertained that the most dangerous mutations at VoC/VoI spike proteins are located mainly at three regions of the SARS-CoV-2 spike “boat-shaped” receptor binding motif, on the RBD domain. Notably, the P.1 Japan/Brazil variant present three mutations, K417T, E484K, N501Y, located along the entire receptor binding motif, which apparently determines the highest interaction energy at the SARS-CoV-2 spike RBD/ACE2 protein–protein interface, among those calculated. Conversely, it was also observed that the replacement of a single acidic/hydrophilic residue with a basic residue (E484K or N439K) at the “stern” or “bow” regions, of the boat-shaped receptor binding motif on the RBD, appears to determine an interaction energy with ACE2 receptor higher than that observed with single mutations occurring at the “hull” region or with other multiple mutants. In addition, our pipeline allowed searching for ACE2 structurally related proteins, i.e., THOP1 and NLN, which deserve to be investigated for their possible involvement in interactions with the SARS-CoV-2 spike protein, in those tissues showing a low expression of ACE2, or as a novel receptor for future spike variants. A freely available web-tool for the in silico calculation of the interaction energy at the SARS-CoV-2 spike RBD/ACE2 protein–protein interface, starting from the sequences of the investigated spike and/or ACE2 variants, was made available for the scientific community at: https:// www. mitoa irm. it/ covid 19aff​initi es. Conclusion In the context of the PPPM/3PM, the employment of the described pipeline through the provided webservice, together with the ongoing SARS-CoV-2 genomic sequencing, would help to predict the transmissibility of new variants sequenced from future patients, depending on SARS-CoV-2 genomic sequencing activities and on the specific amino acid replacement and/or on its location on the SARS-CoV-2 spike RBD, to put in play all the possible counteractions for preventing the most deleterious scenarios of new outbreaks, taking into consideration that a greater transmissibility has not to be necessarily related to a more severe manifestation of the disease

Assessment of Sexual Dysfunction in Cervical Cancer Patients after Different Treatment Modality: A Systematic Review

Background and Objectives: Cervical cancer is a leading cause of mortality among women. Chemo-radiation followed by interventional radiotherapy (IRT) is the standard of care for stage IB-IVA FIGO. Several studies have shown that image-guided adaptive IRT resulted in excellent local and pelvic control, but it is associated with vaginal toxicity and intercourse problems. The purpose of this review is to evaluate the dysfunctions of the sexual sphere in patients with cervical cancer undergoing different cervix cancer treatments. Materials and Methods: We performed a comprehensive literature search using Pub med, Scopus and Cochrane to identify all the full articles evaluating the dysfunctions of the sexual sphere. ClinicalTrials.gov was searched for ongoing or recently completed trials, and PROSPERO was searched for ongoing or recently completed systematic reviews. Results: One thousand three hundred fifty-six women included in five studies published from 2016 to 2022 were analyzed. The median age was 50 years (range 46-56 years). The median follow-up was 12 months (range 0-60). Cervical cancer diagnosis and treatment (radiotherapy, chemotherapy and surgery) negatively affected sexual intercourse. Sexual symptoms such as fibrosis, strictures, decreased elasticity and depth and mucosal atrophy promote sexual dysfunction by causing frigidity, lack of lubrication, arousal, orgasm and libido and dyspareunia. Conclusions: Physical, physiological and social factors all contribute to the modification of the sexual sphere. Cervical cancer survivors who were irradiated have lower sexual and vaginal function than the normal population. Although there are cures for reducing discomfort, effective communication about sexual dysfunctions following treatment is essential

Protective effect of resin adsorption on septic plasma-induced tubular injury

Introduction: A pro-apoptotic effect of circulating mediators on renal tubular epithelial cells has been involved in the pathogenesis of sepsis-associated acute kidney injury (AKI). Adsorption techniques have been showed to efficiently remove inflammatory cytokines from plasma. The aim of this study was to evaluate the efficiency of the hydrophobic resin Amberchrom CG161 M to adsorb from septic plasma soluble mediators involved in tubular injury. Methods: We enrolled in the study 10 critically ill patients with sepsis-associated AKI and we evaluated the effects of their plasma on granulocyte adhesion, apoptosis and functional alterations of cultured human kidney tubular epithelial cells. We established an in vitro model of plasma adsorption and we studied the protective effect of unselective removal of soluble mediators by the Amberchrom CG161 M resin on septic plasma-induced tubular cell injury. Results: Plasma from septic patients induced granulocyte adhesion, apoptosis and altered polarity in tubular cells. Plasma adsorption significantly decreased these effects and abated the concentrations of several soluble mediators. The inhibition of granulocyte adhesion to tubular cells was associated with the down-regulation of ICAM-1 and CD40. Resin adsorption inhibited tubular cell apoptosis induced by septic plasma by down-regulating the activation of caspase-3, 8, 9 and of Fas/death receptor-mediated signalling pathways. The alteration of cell polarity, morphogenesis, protein reabsorption and the down-regulation of the tight junction molecule ZO-1, of the sodium transporter NHE3, of the glucose transporter GLUT-2 and of the endocytic receptor megalin all induced by septic plasma were significantly reduced by resin adsorption. Conclusions: Septic plasma induced a direct injury of tubular cells by favouring granulocyte adhesion, by inducing cell apoptosis and by altering cell polarity and function. All these biological effects are related to the presence of circulating inflammatory mediators that can be efficiently removed by resin adsorption with a consequent limitation of tubular cell injury

The real-time multiparametric network of Campi Flegrei and Vesuvius

Volcanic processes operate over a wide range of time scale that requires different instruments and techniques to be monitored. The best approach to survey a volcanic unrest is to jointly monitor all the geophysical quantities that could vary before an eruption. The monitoring techniques are sometimes peculiar for each volcano, which has its own behavior. The simultaneous investigation of all the geophysical and geochemical parameters improves the sensibility and the understanding of any variation in the volcanic system. The Osservatorio Vesuviano is the INGV division charged of the Campi Flegrei and Vesuvius monitoring, two of the highest risk volcanic complexes in the world due to the large number of people living on or close to them. Each of them have peculiarities that increase the monitoring challenge: Campi Flegrei has high anthropic noise due to people living within its numerous craters; Vesuvius has a sharp topography that complicates the data transmission and analysis. The real time monitoring of the two areas involves several geophysical fields and the data are transmitted by a wide data-communication wired or radio infrastructure to the Monitoring Centre of Osservatorio Vesuviano: - The seismic network counts of 20 station sites in Campi Flegrei and 23 in Vesuvius equipped with velocimetric, accelerometric and infrasonic sensors. Some of them are borehole stations. - The GPS network counts of 25 stations operating at Campi Flegrei caldera and 9 stations at Vesuvius volcano. All the procedures for remote stations managing (raw data downloading, data quality control and data processing) take place automatically and the computed data are shown in the Monitoring Centre. - The mareographic network counts of 4 stations in the Campi Flegrei caldera coast and 3 close to the Vesuvius that transmit to the Monitoring Centre where the data are elaborated. - The tiltmetric network consist of 10 stations distributed around Pozzuoli harbor, the area of maximum ground uplift of Campi Flegrei, evidenced since 2005, and 7 stations distributed around the Vesuvius crater. Each tiltmetric station is also equipped with a temperature and magnetic sensor. The signals recorded are sent to the Monitoring Centre. - The 4 marine multiparametric stations installed in the Pozzuoli gulf send accelerometric, broad band, hydrophonic and GPS data to the Monitoring Centre. - The geochemical network counts of 4 multiparametric stations in the fumarolic areas of Campi Flegrei and 2 stations in the Vesuvius crater (rim and bottom) with data transmission to the Monitoring Centre. They collect soil CO2 flux, temperature gradient and environmental and meteorological parameters and transmit them directly to the Monitoring Centre. - The permanent thermal infrared surveillance network (TIRNet) is composed of 6 stations distributed among Campi Flegrei and Vesuvius. The stations acquire IR scenes at night-time of highly diffuse degassing areas. IR data are processed by an automated system of IR analysis and the temperatures values are sent to the Monitoring CentrePublishedVienna, Austria1IT. Reti di monitoraggio e sorveglianz

Third-line sorafenib after sequential therapy with sunitinib and mTOR inhibitors in metastatic renal cell carcinoma

Background: Sunitinib and everolimus have been approved for first- and second-line treatment, respectively, in metastatic renal cell carcinoma (mRCC). The role of sorafenib, which is approved for second-line treatment after cytokines failure, is presently to be defined. Objective: To determine whether third-line sorafenib after sequential use of sunitinib and mammalian target of rapamycin inhibitors (everolimus or temsirolimus) is feasible and effective. Design, setting, and participants: One hundred fifty medical records of patients with mRCC treated with first-line sunitinib between January 2006 and January 2010 were reviewed at four participating centers. Data regarding patients treated with the sequence sunitinib-everolimus or temsirolimus-sorafenib were extracted. Central analysis of radiographic images was performed using RECIST criteria to determine progression-free survival (PFS) and overall response rate (oRR) to sorafenib treatment. Measurements: PFS and oRR to sorafenib were the primary end points. Secondary outcomes were safety and overall survival (OS). Results and limitations: Thirty-four patients were eligible for the study. A median PFS of 4 mo (range: 3-6 mo) and a median OS of 7 mo since sorafenib treatment (range: 6-10 mo) were reported. Of the patients, 23.5% showed response to sorafenib, with an overall disease control rate (complete responses plus partial responses plus stable disease) of 44%. Selection bias, data incompleteness, and absence of study design are inevitable limitations of the study, although central review can strengthen the quality of presented data. Conclusions: Third-line sorafenib appears to be active and well tolerated in mRCC after first-line sunitinib and second-line everolimus or temsirolimus, with no patients interrupting sorafenib because of toxicity or lack of compliance. Prospective, placebo-controlled trials are completely lacking and are required in this setting