Adriana Cavarero und die italienischen Denkerinnen der Differenz

Die Diplomarbeit „Adriana Cavarero und die italienischen Denkerinnen der Differenz“ stellt die zeitgenössische feministische Strömung des pensiero della differenza, der philosophischen Auseinandersetzung der italienischen Theoretikerinnen der sexuellen Differenz, dar. Sie zeichnet die Grundlinien der italienischen Frauenbewegung seit ihren Anfängen nach und stellt die philosophische Praxis der 1984 gegründeten DIOTIMA-Gemeinschaft dar, deren radikale praktische und theoretische Umsetzung von Luce Irigarays Forderung nach einer Symbolik der weiblichen Differenz auch im internationalen feministischen Diskurs als bemerkenswerte Alternative zum akademischen Diskurs angesehen wird. Die theoretische Auseinandersetzung DIOTIMAs basiert fundamental auf der Praxis der weiblichen Beziehungen und auf den Lebenserfahrungen der Denkerinnen. Der Fokus dieser Arbeit liegt jedoch auf der autonomen Denkerin Adriana Cavarero, die als Mitbegründerin der Gruppe einen sehr ähnlichen Zugang zur Theorie der sexuellen Differenz verfolgt, wie DIOTIMA. Einer meiner Untersuchungsschwerpunkte beleuchtet Cavareros Trennung von DIOTIMA. Meine diesbezügliche Darstellung basiert auf einem Interview, das ich mit Cavarero führte. Anders als DIOTIMA, denkt Cavarero die Differenz hauptsächlich im Zusammenhang mit der Philosophie Hannah Arendts. Sie erweitert Arendts Gedanken der Erscheinung und der menschlichen Einzigartigkeit um den Aspekt der körperlichen Sexuiertheit und übernimmt Arendts Kritik an der Ausrichtung der abendländischen Philosophie auf das Paradigma des Todes. Im Zentrum von Cavareros Theorien steht die Auseinandersetzung mit weiblichen Stereotypen. Cavarero arbeitet bevorzugt mit den Mitteln der Narration. Meine Diplomarbeit unternimmt den Versuch, die Linie des „literarischen Theoretisierens“ in ihrem Werk nachzuzeichnen. Neben ihren wichtigsten theoretischen Texten stehen "Nonostante Platone" und "Tu che mi guardi, tu che mi racconti" im Zentrum meiner Untersuchungen

Landscape response to tectonic deformation and cyclic climate change since ca. 800 ka in the southern Central Andes

heory suggests that the response time of alluvial channel long-profiles to perturbations in climate is related to the magnitude of the forcing and the length of the system. Shorter systems may record a higher frequency of forcing compared to longer systems. Empirical field evidence that system length plays a role in the climate periodicity preserved within the sedimentary record is, however, sparse. The Toro Basin in the Eastern Cordillera of NW Argentina provides an opportunity to test these theoretical relationships as this single source-to-sink system contains a range of sediment deposits, located at varying distances from the source. A suite of eight alluvial fan deposits is preserved along the western flanks of the Sierra de Pascha. Farther downstream, a flight of cut-and-fill terraces have been linked to eccentricity-driven (100-kyr) climate cycles since ca. 500 ka. We applied cosmogenic radionuclide (10Be) exposure dating to the fan surfaces to explore (1) how channel responses to external perturbations may or may not propagate downstream, and (2) the differences in landscape response to forcing frequency as a function of channel length. We identified two generations of fan surfaces: the first (G1) records surface activity and abandonment between ca. 800 and 500 ka and the second (G2) within the last 100 kyr. G1 fans record a prolonged phase of net incision, which has been recognised throughout the Central Andes, and was likely triggered by enhanced 100-kyr global glacial cycles following the Mid-Pleistocene Transition. Relative fan surface stability followed, while 100-kyr cut-and-fill cycles occurred downstream, suggesting a disconnect in behaviour between the two channel reaches. G2 fans record higher frequency climate forcing, possibly the result of precessional forcing of climate (ca. 21/40-kyr timescales). The lack of a high-frequency signal farther downstream provides field support for theoretical predictions of a filtering of high-frequency climate forcing with increasing channel length. We show that multiple climate periodicities can be preserved within the sedimentary record of a single basin. Differences in the timing of alluvial fan and fluvial terrace development in the Toro Basin appears to be associated with how channel length affects fluvial response times to climate forcing as well as local controls on net incision, such as tectonic deformation

Setting up child health and mortality prevention surveillance in Ethiopia

Background: Mortality rates for children under five years of age, and stillbirth risks, remain high in parts of sub-Saharan Africa and South Asia. The Child Health and Mortality Prevention Surveillance (CHAMPS) network aims to ascertain causes of child death in high child mortality settings (>50 deaths/1000 live-births). We aimed to develop a “greenfield” site for CHAMPS, based in Harar and Kersa, in Eastern Ethiopia. This very high mortality setting (>100 deaths/1000 live-births in Kersa) had limited previous surveillance capacity, weak infrastructure and political instability. Here we describe site development, from conception in 2015 to the end of the first year of recruitment. Methods: We formed a collaboration between Haramaya University and the London School of Hygiene & Tropical Medicine and engaged community, national and international partners to support a new CHAMPS programme. We developed laboratory infrastructure and recruited and trained staff. We established project specific procedures to implement CHAMPS network protocols including; death notifications, clinical and demographic data collection, post-mortem minimally invasive tissue sampling, microbiology and pathology testing, and verbal autopsy. We convened an expert local panel to determine cause-of-death. In partnership with the Ethiopian Public Health Institute we developed strategies to improve child and maternal health. Results: Despite considerable challenge, with financial support, personal commitment and effective partnership, we successfully initiated CHAMPS. One year into recruitment (February 2020), we had received 1173 unique death notifications, investigated 59/99 MITS-eligible cases within the demographic surveillance site, and assigned an underlying and immediate cause of death to 53 children. Conclusions: The most valuable data for global health policy are from high mortality settings, but initiating CHAMPS has required considerable resource. To further leverage this investment, we need strong local research capacity and to broaden the scientific remit. To support this, we have set up a new collaboration, the “Hararghe Health Research Partnership”

Causes of stillbirth and death among children younger than 5 years in eastern Hararghe, Ethiopia: a population-based post-mortem study

Background Child mortality is high in Ethiopia, but reliable data on the causes of death are scarce. We aimed to gather data for the contributory causes of stillbirth and child deaths in eastern Ethiopia. Methods In this population-based post-mortem study, we established a death-notification system in health facilities and in the community in Kersa (rural), Haramaya (rural) and Harar (urban) in eastern Ethiopia, at a new site of the Child Health and Mortality Prevention Surveillance (CHAMPS) network. We collected ante-mortem data, did verbal autopsies, and collected post-mortem samples via minimally invasive tissue sampling from stillbirths (weighing at least 1000 g or with an estimated gestational age of at least 28 weeks) and children who died younger than 5 years. Children—or their mothers, in the case of stillbirths and deaths in children younger than 6 months—had to have lived in the catchment area for the past 6 months to be included. Molecular, microbiological, and histopathological analyses were done in collected samples. Cause of death was established by an expert panel on the basis of these data and classified as underlying, comorbid, or immediate separately for stillbirths, neonatal deaths (deaths aged 0–27 days), and child deaths (aged 28 days to <5 years). Findings Between Feb 4, 2019, and Feb 3, 2021, 312 deaths were eligible for inclusion, and the families gave consent in 195 (63%) cases. Cause of death was established in 193 (99%) cases. Among 114 stillbirths, the underlying cause of death was perinatal asphyxia or hypoxia in 60 (53%) and birth defects in 24 (21%). Among 59 neonatal deaths, the most common underlying cause was perinatal asphyxia or hypoxia (17 [29%]) and the most common immediate cause of death was neonatal sepsis, which occurred in 27 (60%). Among 20 deaths in children aged 28 days to 59 months, malnutrition was the leading underlying cause (15 [75%]) and infections were common immediate and comorbid causes. Pathogens were identified in 19 (95%) child deaths, most commonly Klebsiella pneumoniae and Streptococcus pneumoniae. Interpretation Perinatal asphyxia or hypoxia, infections, and birth defects accounted for most stillbirths and child deaths. Most deaths could have been prevented with feasible interventions, such as improved maternity services, folate supplementation, and improved vaccine uptake. Funding Bill & Melinda Gates Foundation

The Impact of Interventions to Prevent Neonatal Healthcare-associated Infections in Low- and Middle-income Countries: A Systematic Review.

BACKGROUND: Clinically suspected and laboratory-confirmed bloodstream infections are frequent causes of morbidity and mortality during neonatal care. The most effective infection prevention and control interventions for neonates in low- and middle-income countries (LMIC) are unknown. AIM: To identify effective interventions in the prevention of hospital-acquired bloodstream infections in LMIC neonatal units. METHODS: Medline, PUBMED, the Cochrane Database of Systematic Reviews, EMBASE and PsychInfo (January 2003 to October 2020) were searched to identify studies reporting single or bundled interventions for prevention of bloodstream infections in LMIC neonatal units. RESULTS: Our initial search identified 5206 articles; following application of filters, 27 publications met the inclusion and Integrated Quality Criteria for the Review of Multiple Study Designs assessment criteria and were summarized in the final analysis. No studies were carried out in low-income countries, only 1 in Sub-Saharan Africa and just 2 in multiple countries. Of the 18 single-intervention studies, most targeted skin (n = 4) and gastrointestinal mucosal integrity (n = 5). Whereas emollient therapy and lactoferrin achieved significant reductions in proven neonatal infection, glutamine and mixed probiotics showed no benefit. Chlorhexidine gluconate for cord care and kangaroo mother care reduced infection in individual single-center studies. Of the 9 studies evaluating bundles, most focused on prevention of device-associated infections and achieved significant reductions in catheter- and ventilator-associated infections. CONCLUSIONS: There is a limited evidence base for the effectiveness of infection prevention and control interventions in LMIC neonatal units; bundled interventions targeting device-associated infections were most effective. More multisite studies with robust study designs are needed to inform infection prevention and control intervention strategies in low-resource neonatal units

Causes of stillbirth and death among children younger than 5 years in eastern Hararghe, Ethiopia: a population-based post-mortem study

BACKGROUND: Child mortality is high in Ethiopia, but reliable data on the causes of death are scarce. We aimed to gather data for the contributory causes of stillbirth and child deaths in eastern Ethiopia. METHODS: In this population-based post-mortem study, we established a death-notification system in health facilities and in the community in Kersa (rural), Haramaya (rural) and Harar (urban) in eastern Ethiopia, at a new site of the Child Health and Mortality Prevention Surveillance (CHAMPS) network. We collected ante-mortem data, did verbal autopsies, and collected post-mortem samples via minimally invasive tissue sampling from stillbirths (weighing at least 1000 g or with an estimated gestational age of at least 28 weeks) and children who died younger than 5 years. Children-or their mothers, in the case of stillbirths and deaths in children younger than 6 months-had to have lived in the catchment area for the past 6 months to be included. Molecular, microbiological, and histopathological analyses were done in collected samples. Cause of death was established by an expert panel on the basis of these data and classified as underlying, comorbid, or immediate separately for stillbirths, neonatal deaths (deaths aged 0-27 days), and child deaths (aged 28 days to <5 years). FINDINGS: Between Feb 4, 2019, and Feb 3, 2021, 312 deaths were eligible for inclusion, and the families gave consent in 195 (63%) cases. Cause of death was established in 193 (99%) cases. Among 114 stillbirths, the underlying cause of death was perinatal asphyxia or hypoxia in 60 (53%) and birth defects in 24 (21%). Among 59 neonatal deaths, the most common underlying cause was perinatal asphyxia or hypoxia (17 [29%]) and the most common immediate cause of death was neonatal sepsis, which occurred in 27 (60%). Among 20 deaths in children aged 28 days to 59 months, malnutrition was the leading underlying cause (15 [75%]) and infections were common immediate and comorbid causes. Pathogens were identified in 19 (95%) child deaths, most commonly Klebsiella pneumoniae and Streptococcus pneumoniae. INTERPRETATION: Perinatal asphyxia or hypoxia, infections, and birth defects accounted for most stillbirths and child deaths. Most deaths could have been prevented with feasible interventions, such as improved maternity services, folate supplementation, and improved vaccine uptake. FUNDING: Bill & Melinda Gates Foundation

Human impact on the transport of terrigenous and anthropogenic elements to peri-alpine lakes (Switzerland) over the last decades

Terrigenous (Sc, Fe, K, Mg, Al, Ti) and anthropogenic (Pb and Cu) element fluxes were measured in a new sediment core from Lake Biel (Switzerland) and in previously well-documented cores from two upstream lakes (Lake Brienz and Lake Thun). These three large peri-alpine lakes are connected by the Aare River, which is the main tributary to the High Rhine River. Major and trace element analysis of the sediment cores by inductively coupled plasma mass spectrometry (ICP-MS) shows that the site of Lake Brienz receives three times more terrigenous elements than the two other studied sites, given by the role of Lake Brienz as the first major sediment sink located in the foothills of the Alps. Overall, the terrigenous fluxes reconstructed at the three studied sites suggest that the construction of sediment-trapping reservoirs during the twentieth century noticeably decreased the riverine suspended sediment load at a regional scale. In fact, the extensive river damming that occurred in the upstream watershed catchment (between ca. 1930 and 1950 and up to 2300 m a.s.l.) and that significantly modified seasonal suspended sediment loads and riverine water discharge patterns to downstream lakes noticeably diminished the long-range transport of (fine) terrigenous particles by the Aare River. Concerning the transport of anthropogenic pollutants, the lowest lead enrichment factors (EFs Pb) were measured in the upstream course of the Aare River at the site of Lake Brienz, whereas the metal pollution was highest in downstream Lake Biel, with the maximum values measured between 1940 and 1970 (EF Pb >3). The following recorded regional reduction in aquatic Pb pollution started about 15 years before the actual introduction of unleaded gasoline in 1985. Furthermore, the radiometric dating of the sediment core from Lake Biel identifies three events of hydrological transport of artificial radionuclides released by the nuclear reactor of Mühleberg located at more than 15 km upstream of Lake Biel for the time period 1970 to 200

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries