Sul significato dell’argomento aπὸ τοῦ νοεῖν del De ideis di Aristotele (Alex. Aphrod. in Metaph. 81, 25-82, 6)

Nel presente contributo si discute l\u2019argomento del \u3a0\u3b5\u3c1\u1f76 \u1f30\u3b4\u3b5\u1ff6\u3bd aristotelico noto come \uabargomento dal pensare\ubb (\u1f00\u3c0\u1f78 \u3c4\u3bf\u1fe6 \u3bd\u3bf\u3b5\u1fd6\u3bd), vale a dire l\u2019argomento che afferma che le forme esistono perch\ue9 possiamo pensare cose che sono e non sono particolari anche dopo che si sono corrotte. Si mostra qui come Aristotele muova non una, ma due obiezioni a tale argomento. Tali obiezioni si fondano su un significato di \u3bd\u3bf\u3b5\u1fd6\u3bd differente da quello attribuito ai platonici. Questo, infatti, prevede capacit\ue0 di astrazione, mentre le critiche di Aristotele si limitano al pensiero di individui. Gail Fine ha distinto un significato broad del verbo \u3bd\u3bf\u3b5\u1fd6\u3bd (i.e. il pensiero genericamente inteso) da un significato high del verbo (i.e. la forma pi\uf9 alta di pensiero in senso tecnico). Su questa base ha sostenuto che l\u2019argomento attribuito ai platonici sia diverso dal secondo degli \uabargomenti dalle scienze\ubb perch\ue9 adotta un significato broad di \u3bd\u3bf\u3b5\u1fd6\u3bd. Io sostengo invece che l\u2019argomento \u1f00\u3c0\u1f78 \u3c4\u3bf\u1fe6 \u3bd\u3bf\u3b5\u1fd6\u3bd \ue8 differente dal secondo degli \uabargomenti dalle scienze\ubb, nonostante adotti un significato high di \u3bd\u3bf\u3b5\u1fd6\u3bd. Infine, si prende in esame la connessione tra la memoria e le forme attribuita da Aristotele ai platonici, mostrando come si tratti verosimilmente di un argomento extra e intra-academico non attribuibile direttamente a Platone.On the meaning of the argument of Aristotle's De ideis (Alex Aphrod in Metaph. 81, 25-82, 6) In my paper I aim to discuss the so-called \uabargument from the thought\ubb (\u1f00\u3c0\u1f78 \u3c4\u3bf\u1fe6 \u3bd\u3bf\u3b5\u1fd6\u3bd) exposed in Aristotle\u2019s \u3a0\u3b5\u3c1\u1f76 \u1f30\u3b4\u3b5\u1ff6\u3bd, i.e. the argument according to which the Forms exist because we are able to think things that exist and that are not particulars after they get corrupted as well. In my paper I argue that Aristotle offers not just a single but instead a twofold refutation of this argument. Furthermore, Aristotle\u2019s criticism is based on a different meaning of \u3bd\u3bf\u3b5\u1fd6\u3bd from the one which is ascribed to the Platonists by Aristotle himself. Indeed, Plato\u2019s use implies the ability to abstract non-particular items, whereas Aristotle\u2019s criticism is based on the understanding of the act of thinking as thinking of individuals. Gail Fine operates a distinction between a broad meaning of \u3bd\u3bf\u3b5\u1fd6\u3bd (i.e. the act of thinking unspecifically understood) and a high-level meaning (i.e. the higher form of thought in a rather technical, speculative sense). On this basis she claims that the argument ascribed to the Platonists is different from the second of the \uabarguments from the sciences\ubb because it is based on a broad meaning of \u3bd\u3bf\u3b5\u1fd6\u3bd. In my opinion, however, the argument \u1f00\u3c0\u1f78 \u3c4\u3bf\u1fe6 \u3bd\u3bf\u3b5\u1fd6\u3bd is different from the second among the \uabarguments from the sciences\ubb despite its being based on a high-level meaning of \u3bd\u3bf\u3b5\u1fd6\u3bd. In the final part of my paper, I shall discuss the connection between the Forms and the memory, something which is attributed by Aristotle to the Platonists: my aim is to show that this was most probably both an intra- and an extra-Academic argument, although it cannot be attributed directly to Plato

What is a philosophical peira? : Some reflections on Plato's Seventh Letter 340b-341b

The aim of this chapter is to discuss lines 340b-341b of Plato\u2019s Seventh Letter, which describe the meeting between the philosopher and Dionysius II at the time of his last trip to Syracuse. Plato had good reasons to embark on this journey and to test Dionysius II\u2019s love of philosophy: several people worthy of esteem (Dion, Archytas, others from Tarentum, some Athenians) had attested to the fact that the young tyrant was sincerely passionate about philosophy. Plato himself was confident of the possibility that \u201ca young man of native intelligence who has accidentally heard some talk of lofty matters shoul

Dose intensity and efficacy of the combination of everolimus and exemestane (EVE/EXE) in a real-world population of hormone receptor-positive (ER+/PgR+), HER2-negative advanced breast cancer (ABC) patients: a multicenter Italian experience

Aim: This retrospective analysis focused on the effect of treatment with EVE/EXE in a real-world population outside of clinical trials. We examined the efficacy of this combination in terms of PFS and RR related to dose intensity (5 mg daily versus 10 mg daily) and tolerability. Methods: 163 HER2-negative ER+/PgR+ ABC patients, treated with EVE/EXE from May 2011 to March 2016, were included in the analysis. The primary endpoints were the correlation between the daily dose and RR and PFS, as well as an evaluation of the tolerability of the combination. Secondary endpoints were RR, PFS, and OS according to the line of treatment. Patients were classified into three different groups, each with a different dose intensity of everolimus (A, B, C). Results: RR was 29.8% (A), 27.8% (B) (p = 0.953), and not evaluable (C). PFS was 9 months (95% CI 7–11) (A), 10 months (95% CI 9–11) (B), and 5 months (95% CI 2–8) (C), p = 0.956. OS was 38 months (95% CI 24–38) (A), median not reached (B), and 13 months (95% CI 10–25) (C), p = 0.002. Adverse events were stomatitis 57.7% (11.0% grade 3–4), asthenia 46.0% (6.1% grade 3–4), hypercholesterolemia 46.0% (0.6% grade 3–4), and hyperglycemia 35.6% (5.5% grade 3–4). The main reason for discontinuation/interruption was grade 2–3 stomatitis. Conclusions: No correlation was found between dose intensity (5 vs. 10 mg labeled dose) and efficacy in terms of RR and PFS. The tolerability of the higher dose was poor in our experience, although this had no impact on efficacy

The role of sentinel node tumor burden in modeling the prognosis of melanoma patients with positive sentinel node biopsy: an Italian melanoma intergroup study (N = 2,086)

Background The management of melanoma patients with metastatic melanoma in the sentinel nodes (SN) is evolving based on the results of trials questioning the impact of completion lymph node dissection (CLND) and demonstrating the efficacy of new adjuvant treatments. In this landscape, new prognostic tools for fine risk stratification are eagerly sought to optimize the therapeutic path of these patients. Methods A retrospective cohort of 2,086 patients treated with CLND after a positive SN biopsy in thirteen Italian Melanoma Centers was reviewed. Overall survival (OS) was the outcome of interest; included independent variables were the following: age, gender, primary melanoma site, Breslow thickness, ulceration, sentinel node tumor burden (SNTB), number of positive SN, non-sentinel lymph nodes (NSN) status. Univariate and multivariate survival analyses were performed using the Cox proportional hazard regression model. Results The 3-year, 5-year and 10-year OS rates were 79%, 70% and 54%, respectively. At univariate analysis, all variables, except for primary melanoma body site, were found to be statistically significant prognostic factors. Multivariate Cox regression analysis indicated that older age (P < 0.0001), male gender (P = 0.04), increasing Breslow thickness (P < 0.0001), presence of ulceration (P = 0.004), SNTB size (P < 0.0001) and metastatic NSN (P < 0.0001) were independent negative predictors of OS. Conclusion The above results were utilized to build a nomogram in order to ease the practical implementation of our prognostic model, which might improve treatment personalization

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Improved risk stratification of patients with atrial fibrillation: an integrated GARFIELD-AF tool for the prediction of mortality, stroke and bleed in patients with and without anticoagulation.

OBJECTIVES: To provide an accurate, web-based tool for stratifying patients with atrial fibrillation to facilitate decisions on the potential benefits/risks of anticoagulation, based on mortality, stroke and bleeding risks. DESIGN: The new tool was developed, using stepwise regression, for all and then applied to lower risk patients. C-statistics were compared with CHA2DS2-VASc using 30-fold cross-validation to control for overfitting. External validation was undertaken in an independent dataset, Outcome Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). PARTICIPANTS: Data from 39 898 patients enrolled in the prospective GARFIELD-AF registry provided the basis for deriving and validating an integrated risk tool to predict stroke risk, mortality and bleeding risk. RESULTS: The discriminatory value of the GARFIELD-AF risk model was superior to CHA2DS2-VASc for patients with or without anticoagulation. C-statistics (95% CI) for all-cause mortality, ischaemic stroke/systemic embolism and haemorrhagic stroke/major bleeding (treated patients) were: 0.77 (0.76 to 0.78), 0.69 (0.67 to 0.71) and 0.66 (0.62 to 0.69), respectively, for the GARFIELD-AF risk models, and 0.66 (0.64-0.67), 0.64 (0.61-0.66) and 0.64 (0.61-0.68), respectively, for CHA2DS2-VASc (or HAS-BLED for bleeding). In very low to low risk patients (CHA2DS2-VASc 0 or 1 (men) and 1 or 2 (women)), the CHA2DS2-VASc and HAS-BLED (for bleeding) scores offered weak discriminatory value for mortality, stroke/systemic embolism and major bleeding. C-statistics for the GARFIELD-AF risk tool were 0.69 (0.64 to 0.75), 0.65 (0.56 to 0.73) and 0.60 (0.47 to 0.73) for each end point, respectively, versus 0.50 (0.45 to 0.55), 0.59 (0.50 to 0.67) and 0.55 (0.53 to 0.56) for CHA2DS2-VASc (or HAS-BLED for bleeding). Upon validation in the ORBIT-AF population, C-statistics showed that the GARFIELD-AF risk tool was effective for predicting 1-year all-cause mortality using the full and simplified model for all-cause mortality: C-statistics 0.75 (0.73 to 0.77) and 0.75 (0.73 to 0.77), respectively, and for predicting for any stroke or systemic embolism over 1 year, C-statistics 0.68 (0.62 to 0.74). CONCLUSIONS: Performance of the GARFIELD-AF risk tool was superior to CHA2DS2-VASc in predicting stroke and mortality and superior to HAS-BLED for bleeding, overall and in lower risk patients. The GARFIELD-AF tool has the potential for incorporation in routine electronic systems, and for the first time, permits simultaneous evaluation of ischaemic stroke, mortality and bleeding risks. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier for GARFIELD-AF (NCT01090362) and for ORBIT-AF (NCT01165710)

Two-year outcomes of patients with newly diagnosed atrial fibrillation: results from GARFIELD-AF.

AIMS: The relationship between outcomes and time after diagnosis for patients with non-valvular atrial fibrillation (NVAF) is poorly defined, especially beyond the first year. METHODS AND RESULTS: GARFIELD-AF is an ongoing, global observational study of adults with newly diagnosed NVAF. Two-year outcomes of 17 162 patients prospectively enrolled in GARFIELD-AF were analysed in light of baseline characteristics, risk profiles for stroke/systemic embolism (SE), and antithrombotic therapy. The mean (standard deviation) age was 69.8 (11.4) years, 43.8% were women, and the mean CHA2DS2-VASc score was 3.3 (1.6); 60.8% of patients were prescribed anticoagulant therapy with/without antiplatelet (AP) therapy, 27.4% AP monotherapy, and 11.8% no antithrombotic therapy. At 2-year follow-up, all-cause mortality, stroke/SE, and major bleeding had occurred at a rate (95% confidence interval) of 3.83 (3.62; 4.05), 1.25 (1.13; 1.38), and 0.70 (0.62; 0.81) per 100 person-years, respectively. Rates for all three major events were highest during the first 4 months. Congestive heart failure, acute coronary syndromes, sudden/unwitnessed death, malignancy, respiratory failure, and infection/sepsis accounted for 65% of all known causes of death and strokes for <10%. Anticoagulant treatment was associated with a 35% lower risk of death. CONCLUSION: The most frequent of the three major outcome measures was death, whose most common causes are not known to be significantly influenced by anticoagulation. This suggests that a more comprehensive approach to the management of NVAF may be needed to improve outcome. This could include, in addition to anticoagulation, interventions targeting modifiable, cause-specific risk factors for death. CLINICAL TRIAL REGISTRATION: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Forme, linguaggio, sostanze : il dibattito sulle idee nell&#8217;Academia antica

L'Academia di Platone \ue8 stata la pi\uf9 libera scuola filosofica del mondo greco e, con ogni probabilit\ue0, dell'intera tradizione occidentale. Questo aspetto non \ue8 per\uf2 sufficiente per giustificare un fatto scandaloso: dopo Platone, nessuno dei suoi allievi diretti e dei pi\uf9 autorevoli membri della scuola ha conservato quella che \ue8 convenzionalmente indicata come la sua pi\uf9 importante teoria, quella delle idee. La presente ricerca indaga il dibattito che ha animato l'Academia in un periodo compreso tra la composizione del "Parmenide", l'unico dialogo di Platone dedicato espressamente alle idee, e di uno scritto polemico di Aristotele noto solo indirettamente grazie al commentario di Alessandro di Afrodisia alla "Metafisica": il "Peri ideon". Attraverso un'analisi scrupolosa dei testi e un ampio confronto con la letteratura secondaria, questo libro mira a offrire un quadro storicamente fondato e filosoficamente pregnante di un dibattito indispensabile per lo sviluppo della filosofia europea