Filosofia della smart city: la cura del luogo e il luogo della cura

Al centro di questo saggio vi è il tema della relazione tra essere umano e luogo. Sulla base di un’originale prospettiva filosofica ed etico-politica, che tiene conto di alcune importanti ricerche di Sennett, Heidegger, Casey, Spinoza, Foucault, viene esaminato il progetto delle smart-cities e il mutamento del rapporto tra le città e coloro che le abitano e attraversano. Proprio sulla scorta di queste riflessioni, è riconosciuta la necessità di confrontarsi non solo con gli studi che si occupano del luogo come oggetto della cura, ma anche di quelli che si interrogano sulle modalità in cui il luogo stesso può influenzare la vita, la politica e la società. L’assunto che guida l’intero contributo è infatti il seguente: non si possono dare “città-intelligenti”, senza una “partecipazione-intelligente” e senza la presa in carico dei bisogni dei “cittadini intelligenti”. At the centre of this essay is the theme of the relationship between human being and place. On the basis of an original philosophical and ethical-political perspective, which takes into account some important research by Sennett, Heidegger, Casey, Spinoza and Foucault, the smart-cities project and the changing relationship between cities and those who inhabit and pass through them are examined. On the basis of these reflections, it is recognised that there is a need to confront not only those studies that deal with place as an object of care, but also those that question the ways in which place itself can influence life, politics and society. In fact, the assumption guiding the entire contribution is the following: there can be no 'smart-cities' without 'smart-participation' and without addressing the needs of 'smart citizens'

Cyber security e spazi di sovranità: implicazioni geografico-politiche e globalizzazione digitale

L'articolo si propone di definire il rapporto tra sovranità spaziale e sovranità digitale, analizzando le implicazioni che la sovrapposizione dei due tipi di sovranità produce in termini di risposta degli stati nazionali alle domande di sicurezza che i cittadini pongono

Lo spazio digitale: una prospettiva eterotopica della memoria nell’era di Byung-Chul Han

The purpose of this paper is to provide elements for theoretical reflection about the space of the digital as a site of memory starting from the Foucauldian concept of heterotopia and in relation to Han's theses about cyberspace. The concept of heterotopia, deeply anchored in the structuralist approach, has exerted an undoubted influence in the social sciences and in the field of so-called memory studies. Heterotopias, which take the form of concretely realized utopias, subvert the traditional process of hierarchization of social space insofar as they are able to juxtapose – within a single real place – other places and spaces which are typically incompatible with each other. This process also takes place in relation to the temporal datum and through a breach of the traditional conception of time: think, by way of example, of cemeteries as a heterotopic – and, indeed, heterochronic – place where the opposite poles of ‘death’ and ‘eternity’ are reunited. Nowadays, the advent of information technologies and the pervasive spread of the digital in our lives have had a deep impact on what were traditionally considered the places of memory. For this reason, it appears necessary to question the space of memory within and in relation to the digital environment. Equally evident appears to be the role played by the French philosopher in the development of Han's thought. Starting with a reconstruction of the concept of heterotopia and its potential application in the digital sphere, this essay proposes a reading of cyberspace as a potential heterotopic place capable of fostering the construction of shared collective memories. Moreover, by breaking down the barriers of space and time, the digital becomes a place where humans can learn information, stories and past events in a manner not dissimilar (or even enhanced) to what other heterotopic places allow, acting in favour of that attribute of memory that Kant, in Anthropology from a Pragmatic Point of View, defines as ‘active/productive’, since it is able to make the past voluntarily present

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Surgical treatment with Ligasure® Precise of schwannoma of brachial plexus: case report

We present a case of bulky schwannoma arising from the brachial plexus treated by a new surgical device. A 38-year-old man presented with a slow-growing left-sided supraclavicular mass and complained paresthesia of the third and forth fingers of the hand and forearm weakness. Physical examination revealed Tinel’s sign. A CT-scan revealed a solid mass situated in the left profound supraclavicular fossa. The tumour was resected with the utilization of bipolar vessel sealing system (Ligasure® Precise). This device is very useful in suturless removal of masses localized in deep supraclavicular fossa. During the operation, care was taken to preserve the nerve functio

Heterogeneous Characteristics of Patients with Inflammatory Abdominal Aortic Aneurysm. Systematic Review of Therapeutic Solutions

Background: Endovascular repair of Inflammatory Abdominal Aortic Aneurysms (IAAA) has emerged as an alternative to open surgery, but direct comparisons are limited. The aim of the study was to compare clinical outcomes of endovascular and open repair for IAAA according with specific clinical characteristics. Materials: We performed a literature review of reports describing patients who had open or endovascular repair for IAAA . A literature search was performed in June 2022 by two investigators who conducted a review of papers reported in Pub Med, EMBASE, MEDLINE and Cochrane Database. The strings "Inflammatory aneurysm", "Abdominal Aortic Aneurysms" were used. There was no language restriction and screened reports were published from March 1972 to December 2021 We identified 2062 patients who had open (1586) or endovascular repair (476) for IAAA. Primary outcomes were operative mortality and morbidity. Secondary outcomes were complications during follow-up (mean follow-up 48 months). Propensity score matching was performed between patients who had open or endovascular surgery. Results: In Western countries, propensity-weighted post-operative mortality (in-hospital) (1.5% endovascular versus 6% open) and morbidity rates (6% versus 18%) were significantly lower in patients who had endovascular repair (p<0.0001); patients with larger aneurysm (more than 7 cm diameter), signs of active inflammation, and retroperitoneal rupture of the aneurysm had better outcomes after endovascular repair than after open surgery.. Hydronephrosis was present in 20% of the patients. Hydronephrosis regressed in most patients when signs of active inflammation were present suggesting an acute onset of the hydronephrosis itself (fever, elevated serum C Reactive Protein) either after endovascular or open surgery. Long standing hydronephrosis as suggested by the absence of signs of active inflammation rarely regressed after endovascular surgery despite associated steroid therapy. During a mean follow-up of 48 months, propensity-weighted graft-related complications were more common in patients who had endovascular repair (20% versus 8%). For patients from Asia, short and medium-term results were similar after open and endovascular repair. IAAA related with aortitis were more common in Asia. In Western countries IAAA were commonly associated with atherosclerosis. Conclusions: Patients with IAAA represent a heterogeneous population, suggesting biological differences from continent to continent; conservative therapy, endovascular or open surgery should be chosen according to the patient clinical condition. Endovascular repair presents advantages in patients with signs of active inflammation, contained rupture of the IAAA and larger aneurysms. Hydronephrosis, without signs of active inflammation, rarely regresses after endovascular repair associated with steroid therapy. Further studies are needed to establish the long-term results of endovascular repair