Academic literature on the topic 'Rottura progressiva'

La politica delle alleanze nella transizione italianaL'emergere di una competizione tra coalizioni partitiche rappresenta una delle principali conseguenze delle regole per l'elezione dei due rami del parlamento, dei consigli regionali e degli organismi amministrativi di comuni e province adottate in Italia fra il 1993 e il 19951. Nell'operatività dei nuovi sistemi elettorali, la scelta dell'aggregazione fa capo agli aspetti maggioritari del meccanismo di voto (l'elezione dei deputati e dei senatori nei collegi uninominali, l'attribuzione del premio di maggioranza nei consigli regionali, l'elezione del sindaco e del presidente della provincia), ancorati, con maggiore o minore forza cogente, allo scopo di «votare per eleggere un governo»2. In tal modo, la politica delle alleanze si è affermata come un elemento permanente del processo elettorale, decisivo ai fini del risultato e non privo di implicazioni sull'evoluzione strutturale del sistema partitico. La formazione delle coalizioni e la progressiva ridefinizione dell'offerta coalizionale, in effetti, hanno cadenzato fin qui i passaggi elettorali della transizione italiana. La forza aggregativa del Pds e la sua capacità di attivare una logica di schieramento si rivelarono determinanti, in assenza di coalizioni alternative, per il successo della sinistra negli importanti test elettorali locali dell'estate e dell'autunno 1993. La formula inventata da Silvio Berlusconi per colmare il deficit di offerta sul fronte moderato – il cartello elettorale a geografia variabile che vedeva la sua nuova formazione politica alleata al Nord con la Lega e al Sud con il Msi-An – consentì alle destre di vincere le elezioni politiche del marzo 1994. Nella fase successiva, il vincolo delle alleanze ha determinato la rottura del polo di centro e il riequilibrio coalizionale che ne è scaturito ha favorito, alle elezioni regionali dell'aprile 19953, il dispiegarsi di una competizione tendenzialmente bipolare tra due schieramenti di analoga forza.

The contribution starts with a status quaestionis which concerns its title about the hermeneutics of Vatican ii, well based in historical background. The roots are grounded in the difference between “event” and “occurrence” – in italian “evento” e “avvenimento”. This is linked with the change in the perspective of historiography realized in the first part of the last century. The vision of continuity (see “Annales”) was put aside, introducing the one of “events”, which are linked with “ruptures” and not continuity in the course of history. With this frame we can understand that in the one of the Church there must be consideration for the hermeneutics expressed finally in the formula of the title closed by a question mark, that is: D.H.: rupture or reform and renewal in the continuity of the unique subject the Church? The answer is: no rupture in discontinuity but reform and renewal. The initial input of the contribution are the speeches of Pope Francis in the U.S.A. and U.N., an answer to the actual Sitz im Leben as far as religious freedom in nowadays society, 50 years after D.H., in a moment in which more attention is given to the texts of Vatican ii, concretely avoiding to consider “the Council of the Press” (Pope Benedict) instead of the one “of the conciliar Fathers” (= participants). The procedure of the author is certainly inspired by the volume Vatican ii. La liberté religieuse, ed. by J. Hamer and Y. Congar. The first point of attention therefore in the analysis is “homogeneous evolution of the pontifical doctrine on the matter”. It is a fundamental vision which allows even a dogmatic evolution, if it is homogeneous. In fact, the Declaration represented a development of the doctrine, a step forward in the progress of civilization, a progress in the catholic doctrine but in the line of no contradiction. And at this point the thoughts of the two fundamental pillars allowing this step forward are presented; they are J. Courtney Murray and P. Pavan. Very important is the Courtney’s statement in this regard, the following: “The doctrine of D.H. is in plenitude traditional, but it is also new, in the sense that tradition is always a developing and progressive tradition”. The author presents later on some essential elements of the right to religious freedom, with the most important and solemn affirmation in the text (N. 2): This Vatican Council declares that the human person has the right to religious freedom. It is truly an historical affirmation in the life of the Church and also for the human family. It follows the study of the relation between religious freedom and the public powers and the illustration of the education to exercise freedom under the light of the Revelation. In the final part of the essay the author analyses…some consequences of D.H. without forgetting a judgment about the actual situation of religious freedom in the world which is becoming always more serious and worrying. Here two citations of Archbishop Paul R. Gallagher, Secretary of the Relations with the States of the Papal Secretariat, are exemplary, that is: “Unfortunately we have to admit that for years the question of the violence against Christians was not taken in serious consideration. – He concluded: Even if we cannot speak of persecution in the old continent [Europe] nevertheless we must not underestimate the rather alarming phenomenon of the intolerance of religious character”.

Questo articolo esamina la rottura del modello occupazionale che sosteneva il sistema di Welfare della seconda metà del XX secolo. Il focus del capitolo è il lento ma al contempo progressivo smantellamento delle tutele del lavoro avvenuto negli ultimi decenni, smantellamento che nell'ipotesi qui proposta ha svolto anche un ruolo cruciale nel facilitare la nascita delle piattaforme digitali. Così, se da un lato la perdita delle tutele può essere correlata ai limiti che avevano le tradizionali regolazioni del lavoro, soprattutto nell'inclusione di donne, migranti e altri lavoratori generalmente considerati più "marginali"; dall'altro essa è un prodotto diretto della nuova divisione globale del lavoro e del modo in cui le tecnologie sono oggi utilizzate per esternalizzare il lavoro. Questi sviluppi vengono successivamente ampliati dalla crescente "piattaformizzazione" dell'economia che si sta diffondendo in tutti i settori di produzione basati su attività direttamente controllate dagli algoritmi. Nonostante la nascita di nuove forme sindacali, capaci di intercettare le istanze e difendere gli interessi dei gig worker, il paper si conclude evidenziando come quest'ultime non possano rappresentare da sole una soluzione definitiva e come occorra puntare a un nuovo set di diritti universali dei lavoratori.

Abstract Abstract 3391 Poster Board III-279 BACKGROUND: We previously reported on the outcome of unrelated donor nonmyeloablative hematopoietic cell transplantation (HCT) in 24 patients (pts) with poor-risk multiple myeloma treated by Seattle Consortium Centers (Georges et al BBMT 2007). Here we update our observation to 43 pts with a median follow up of 3.3 years after allografting. PATIENTS: Pts with stage II-III MM (n=43) received AlloHCT at 9 centers between May 2000 and September 2008. Forty pts (93%) were matched with their donors for 10 of 10 HLA alleles, and 3 (7%) had single HLA-C allele-level mismatches. Median age at allotransplant was 53 (range 35–67) years. Median number of prior treatments was 2 (1–3), and median number of prior treatment cycles was 8 (5–22). All pts but 2 received at least 1 (range 1-3) high dose-Autograft regimen. Fifteen pts (35%) received planned tandem Auto/AlloHCT as consolidation to first line therapy. Allogeneic conditioning was with 2 Gy TBI plus fludarabine 90 mg/m2 and post allografting immunosuppression was with mycophenolate mofetil (MMF) and cyclosporine or tacrolimus. Disease status at allogeneic HCT included complete remission (CR, 6 pts, 14%), very good partial remission (VGPR, 12 pts, 28%), partial remission (PR, 14 pts, 33%) and refractory disease (RD, 11 pts, 26%). RESULTS: All pts had sustained donor engraftment. Twenty-eight (65%) developed grade 2 to 4 acute graft-versus-host-disease (GVHD) and 6 pts (14%) developed 3 to 4 acute GVHD. Twenty-six pts (60%) had extensive chronic GVHD. The overall response rate was 86%, with 18 pts (42%) achieving CR, 14 (33%) VGPR and 5 (12%) PR. With a median follow-up of 3.3 (0.3–8.1) years from allografting, median time to progression was 1.1 years. Median overall survival (OS) has not been reached. Median progression-free survival (PFS) was 1.5 years. Five-year estimated OS and PFS were 51% and 21% respectively. Cumulative incidence of nonrelapse mortality (NRM) at 100 days, 1 and 5 years were 2%, 16% and 19% respectively. The subgroup of 15 pts receiving upfront tandem Auto/AlloHCT had five-year estimated OS and PFS of 72% and 37%, respectively. These results are similar to the outcomes we observed in a series of 102 patients with MM who received upfront tandem Auto/AlloHCT from HLA-identical sibling donor (Rotta et al, Blood 2009) where five-year OS and PFS were 64% and 36%, respectively. CONCLUSION: The use of unrelated donors leads to sustained donor engraftment and is associated with a low 1-year NRM (16%). As consolidation of first remission, Tandem Auto/Allo HCT leads to similar 5-year outcomes as HCT from HLA-identical sibling donors. Disclosures: No relevant conflicts of interest to declare.

BackgroundImmune checkpoint inhibitor therapy, or ICI, is currently the most successful treatment option for patients with renal cell carcinoma (RCC). However, only 20% of patients have a durable response,1 driving a significant need to improve treatment outcomes. The tumor microbiome has recently been shown to play a role in chemotherapy-based treatment outcomes, but, to our knowledge, no study has explored its role in response to ICIs.2–4MethodsTumor samples were collected from 22 patients with RCC as a part of the Total Cancer Care program at The Ohio State University Comprehensive Cancer Center. Raw RNA-seq reads from these biopsies, as well as data on the responses to ICI therapy were collected. Response evaluation was based on RECIST v1.1 criteria with complete or partial response, or stable disease classified as ”Responders,”, and progressive disease classified as ”Non-responsders”. The RNA-seq reads were processed through a pipeline developed by the Spakowicz lab, known as ExoTIC (Exogenous sequences in Tumor and Immune Cells), to carefully identify exogenous sequences.5 6 Reads that don’t align to the human reference genome are meticulously filtered of (1) common laboratory contaminants, (2) taxa that inversely correlate with input RNA quantity, and (3) taxa commonly found in the negative controls of microbiome experiments. DESeq2 was used to perform a differential abundance analysis on the comparison groups at every taxonomic level.ResultsThe 22 patients with RCC range from 22 to 74 years of age at diagnosis, are 72.7% male, and 54.5% responded to ICIs. Exogenous taxa are identified in the tumor RNAseq, including bacteria, fungi, and viruses (figure 1). Within the tumors responsive to immunotherapy, there was found to be a significant enrichment of certain microbial species, including Bacillus thuringiensis, Comamonas testosteroni, Colletotrichum higginsianum, and Elaeis guineesis. Comparatively, the cohort of non-responsive tumors was found to have a significant enrichment of Candidatus Promineofilum breve, Clostridioides difficile, Nocardia cyriacigeorgica, Streptomyces sp. CdTB01, and Streptomyces venezuelae (figure 2).Abstact 942 Figure 1Relative abundances of exogenous taxa found in tumor RNAseq are shown in a stacked bar plotAbstact 942 Figure 2Differential abundance analysis of taxa found within tumor RNAseq data by the exotic pipeline. Colored points represent significantly (pvalue < 0.05) enriched taxa with a high (>2.5) fold-difference in abundance between the groupsConclusionsWe found that prior to ICI treatment the tumor microbiome of patients with RCC whose tumors responded to immunotherapy vary from those that did not respond to treatment. This implies that a therapeutic target to modify the tumor microbiome to improve treatment outcomes. Future research will evaluate whether these correlations are causally associated with outcomes and will evaluate their effect on the tumor microenvironment including immune cell infiltration.AcknowledgementsThe authors acknowledge the support and resources of the Ohio Supercomputing Center (PAS1695).ReferencesCiccarese C, Di Nunno V, Iacovelli R, Massari F. Future perspectives for personalized immunotherapy in renal cell carcinoma. Expert opinion on biological therapy. Taylor & Francis. 2017;17(9):1049–1052.Geller LT, Barzily-Rokni M, Danino T, Jonas OH, Shental N, Nejman D, Gavert N, Zwang Y, Cooper ZA, Shee K, Thaiss CA, Reuben A, Livny J, Avraham R, Frederick DT, Ligorio M, Chatman K, Johnston SE, Mosher CM, Brandis A, Fuks G, Gurbatri C, Gopalakrishnan V, Kim M, Hurd MW, Katz M, Fleming J, Maitra A, Smith DA, Skalak M, Bu J, Michaud M, Trauger SA, Barshack I, Golan T, Sandbank J, Flaherty KT, Mandinova A, Garrett WS, Thayer SP, Ferrone CR, Huttenhower C, Bhatia SN, Gevers D, Wargo JA, Golub TR, Straussman R. Potential role of intratumor bacteria in mediating tumor resistance to the chemotherapeutic drug gemcitabine. Science 2017 September 15;357(6356):1156–1160. PMID: 28912244.Nejman D, Livyatan I, Fuks G, Gavert N, Zwang Y, Geller LT, Rotter-Maskowitz A, Weiser R, Mallel G, Gigi E, Meltser A, Douglas GM, Kamer I, Gopalakrishnan V, Dadosh T, Levin-Zaidman S, Avnet S, Atlan T, Cooper ZA, Arora R, Cogdill AP, Khan MAW, Ologun G, Bussi Y, Weinberger A, Lotan-Pompan M, Golani O, Perry G, Rokah M, Bahar-Shany K, Rozeman EA, Blank CU, Ronai A, Shaoul R, Amit A, Dorf-man T, Kremer R, Cohen ZR, Harnof S, Siegal T, Yehuda-Shnaidman E, Gal-Yam EN, Shapira H, Baldini N, Langille MGI, Ben-Nun A, Kaufman B, Nissan A, Golan T, Dadiani M, Levanon K, Bar J, Yust-Katz S, Barshack I, Peeper DS, Raz DJ, Segal E, Wargo JA, Sandbank J, Shental N, Straussman R. The human tumor microbiome is composed of tumor type–specific intracellular bacteria. Science 2020 May 29;368(6494):973–980.Poore GD, Kopylova E, Zhu Q, Carpenter C, Fraraccio S, Wandro S, Kosciolek T, Janssen S, Metcalf J, Song SJ, Kanbar J, Miller-Montgomery S, Heaton R, Mckay R, Patel SP, Swafford AD, Knight R. Microbi-ome analyses of blood and tissues suggest cancer diagnostic approach. Nature 2020;579(7800):567–574. PMID: 32214244.Malalur, Pannaga, Mo, Xiaokui, Hoyd, Rebecca, Hays, John, Carbone, David, Spakowicz, Daniel. Investigating intra-tumor microbes, blood microbes, and CEA for development of non-invasive biomarkers in colorectal cancer. Journal of Clinical Oncology 2021;39(15_suppl): 3551–3551.Malalur PG, Mo X, Hoyd R, Carbone DP, Spakowicz D. Intra-tumoral microbes and overall survival in colorectal cancer patients. Journal of Clinical Oncology 2020;38(15_suppl):4083–4083.Ethics ApprovalData were obtained through an IRB-approved Honest Broker protocol (2015H0185) supporting the Total Cancer Care protocol 2013H0199.

Nel nostro Ser.D., in linea con il trend registrato in Italia, si rileva un progressivo aumento degli accessi di adolescenti gi&agrave; "complessi" (policonsumo di sostanze psicoattive, comportamenti devianti, aggressivi e di rottura con il contesto familiare ed educativo di riferimento). Sono altres&igrave; presenti componenti di malessere pi&ugrave; profondo, che coinvolgono anche la sfera del disagio psichico, affettivo e relazionale. Gli adolescenti "complessi" sono resistenti ad affidarsi ai servizi, ai familiari e agli operatori. Infatti, si registrano problemi legati al rispecchiamento positivo e alla capacit&agrave; di innescare meccanismi di risonanza con l'"altro", rendendo laboriosi sia l'aggancio, sia la ritenzione in trattamento, soprattutto laddove la presa in carico &egrave; frammentata e multipla. La pratica clinica suggerisce l'importanza della presa in carico globale e multidimensionale e la necessit&agrave; di creare un virtuoso circuito del sistema di continuit&agrave; delle cure per gli adolescenti "complessi" che transitano dalla minore alla maggiore et&agrave;, i quali spesso percepiscono attorno a loro un "vuoto assistenziale" da parte dei sevizi deputati al loro sostegno.La ricerca (settembre 2015-Dicembre 2016) ha consentito di osservare e analizzare come la "complessit&agrave; socio-sanitaria" ha influito sulla gestione clinica e operativa dei casi all'interno di un determinato servizio e come questo si sia organizzato al fine di fornire risposte pertinenti ed efficaci ai nuovi bisogni emergenti.

Social and cultural pressures play a significant role in the development of depressive disorders. Women are at a greater risk of experiencing depressive disorders because they always become the subject of social and cultural pressure. This paper presents the case study of a 23-year-old female who developed symptoms of Major Depressive Disorder (MDD) due to cultural constraints. Initial pre-testing and therapist observation of the client’s verbal and non-verbal attitude / behavior confirmed the diagnosis of MDD. Diagnosis was made according to DSM-5. After initial intake interview, psychological tests including House-tree-person (HTP), Thematic Apprehension Test (TAT), Rotter Incomplete Sentence Blank (RISB), Beck Depression Inventory (BDI), Raven Standard Progressive Matrices (SPM) and Clinical Structured Interview (CIS-R) were administered on the client. After exploring the causal factors of her problem and conducting diagnostic sessions, therapeutic sessions were also conducted. Some techniques of cognitive behavioral therapy were selected for the client based on the strong empirical evidence available that advocates for their use in effectively treating depressive disorders. After achieving the goals of psychotherapy set at the first session with the help of the client as well as gaining satisfactory results of post-testing and therapist observation of the client’s progress, psychotherapy was terminated. Follow up sessions were conducted to monitor the progress of the client. Our research study has clinical and community implications.