BackgroundBeta thalassemia major is a severe inherited form of hemolytic anemia that results from ineffective erythropoiesis. Allogenic hematopoietic stem cell transplantation (HSCT) remains the only potentially curative therapy. Unfortunately, the subgroup of adult thalassemia patients with hepatomegaly, portal fibrosis and a history of irregular iron chelation have an elevated risk for transplantation-related mortality that is currently estimated to be about 29 percent.DiscussionThalassemia patients may be faced with a difficult choice: they can either continue conventional transfusion and iron chelation therapy or (...) accept the high mortality risk of HSCT in the hope of obtaining complete recovery.Throughout the decision making process, every effort should be made to sustain and enhance autonomous choice. The concept of conscious consent becomes particularly important. The patient must be made fully aware of the favourable and adverse outcomes of HSCT. Although it is the physician's duty to illustrate the possibility of completely restoring health, considerable emphasis should be put on the adverse effects of the procedure. The physician also needs to decide whether the patient is eligible for HSCT according to the "rule of descending order". The patient must be given full details on self-care and fundamental lifestyle changes and be fully aware that he/she will be partly responsible for the outcome.SummaryOnly if all the aforesaid conditions are satisfied can it be considered reasonable to propose unrelated HSCT as a potential cure for high risk thalassemia patients. (shrink)

The informed consent process is the legal embodiment of the fundamental right of the individual to make decisions affecting his or her health., and the patient’s permission is a crucial form of respect of freedom and dignity, it becomes extremely important to enhance the patient’s understanding and recall of the information given by the physician. This statement acquires additional weight when the medical treatment proposed can potentially be detrimental or even fatal. This is the case of thalassemia patients pertaining to (...) class 3 of the Pesaro classification where Allogenic hematopoietic stem cell transplantation remains the only potentially curative treatment. Unfortunately, this kind of intervention is burdened by an elevated transplantation-related mortality risk , equal to 30% according to published reports. In thalassemia, the role of the patient in the informed consent process leading up to HSCT has not been fully investigated. This study investigated the hypothesis that information provided by physicians in the medical scenario of HSCT is not fully understood by patients and that misunderstanding and communication biases may affect the clinical decision-making process. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Image and SilenceGiorgio AgambenTranslated by Leland de la Durantaye (bio)[End Page 94]In the Roman pantheon there is a goddess named Angerona, represented with her mouth bound and sealed (ore obligato signatoque).1 Her finger is raised to her lips as if to command silence. Scholars claim that she represents, in the context of pagan mystery cults, the power of silence, although there is no consensus among them as to how (...) to understand this power. Etymologically speaking, myein, the root of the Greek word mysterion, means “to close the mouth, to silence.” At the beginning of the sacred rites in Eleusis a herald “commanded silence” (epittatei tēn siōpen). It is said that that the initiates into these Eleusinian mysteries were required to maintain absolute silence concerning what they had seen and heard during their initiation. Our question is how to understand this silence. Was it a prohibition aimed at keeping a secret doctrine from the uninitiated? Or did it concern, instead, something truly impossible to say?To begin we might ask what sense there might have been in the obligation to remain silent given that it was possible for anyone—including slaves, and thus, potentially, the entire population of Athens—to be initiated into the mysteries. In his early work, “On Philosophy,” Aristotle affirmed that, “the initiates do not need to learn something (mathein ti), but, instead, to be disposed to something, to experience and to undergo something (pathein kai diatethēnai).”2 It would therefore be possible that in the ancient mystery cults the initiate did not learn a doctrine that could be expressed in words (yet had to remain secret), but, instead, experienced something essentially silent, something impossible to say. “A great awe in face of the gods,” we read in the Homeric ode to Demeter, “silences the voice.”3The impossibility of speaking—and the power of silence—has two forms, one joyful and the other disturbing. In myth muteness is often associated with rape. The Romans tell the story of Lara who was punished for her inclination to gossip by being rendered mute and who was then raped in a sacred wood by Mercury (who took advantage of her impossibility of speaking). Before being transformed into a swallow Philomela was raped by Tereus, who cut off her tongue to prevent her from recounting his misdeed. Persephone, raped, kidnapped, and conducted to Hades, remained there silent as the dead. In every one of these cases silence is the painful experience of a privation of speech, of being unable to say what one wishes to say.In Gnostic mythology, the preexisting, eternal, uncreated God contains within himself a female figure which is his silence, Sigē. From his union with Silence Thought is born. “Sigē,” we read in a Valentinian text, “is the mother of all the beings that have emerged from the Abyss. He who has failed to say the unsayable has silenced it; he who was understood the unsayable, has declared it unsayable.”4 Here too silence appears as the experience of an impossibility of saying, as a privation. It is in opposition to this abyssal figure of silence that the church fathers affirmed the primacy of the logos in which God is revealed. Nevertheless, of the power of silence Heidegger would write: “This primordial silence is more powerful than any human potentiality. No one, on his or her own, has ever invented language—that is, has been strong enough to break the power of this silence.”5 [End Page 95]In Kafka’s parable on Ulysses, we are told that the silence of the Sirens is more perilous than their song, and that Ulysses—who realized, as his ship neared them, that the Sirens were silent—put on an act to protect himself from this silence, plugging his ears with wax and having his men tie him to the mast.6 In Kafka’s retelling of the tale, the silence of the Sirens represents a zero degree of song and, following a stubborn tradition that sees in absence the most extreme form of presence, also represents an at once zero and ultimate degree of reality. In this sense Heidegger could write... (shrink)

Recent literature highlights that the use of smartphones during meals increases the number of calories ingested in young people. Although the distraction interferes with physiological signals of hunger and satiety, a social facilitation effect has also been suggested. Cognition is a pivotal component in regulating food intake, and activities requiring high perceptual demands should be discouraged during meals.

L'eclissi della politica è cominciata da quando essa ha omesso di confrontarsi con le trasformazioni che ne hanno svuotato categorie e concetti. Accade così che paradigmi genuinamente politici vadano ora cercati in esperienze e fenomeni che di solito non sono considerati politici: la vita naturale degli uomini restituita al centro della polis; il campo di concentramento; il rifugiato; il linguaggio come luogo politico per eccellenza, oggetto di una contesa e di una manipolazione senza precedenti; la sfera dei mezzi puri o (...) dei gesti, ossia dei mezzi che, pur restando tali, si emancipano dalla loro relazione a un fine. Il libro cerca di ripensare le categorie della politica in una nuova realtà. (shrink)

1. Dioniso, Apollo, Eleusi, Orfeo, Museo, Iperborei, Enigma -- 2. Epimenide, Ferecide, Talete, Anassimandro, Annassimene, Onomacrito (2. ed., 1994) -- 3. Eraclito (2a ed., 1982).

Los conceptos de evolución y cambio evolutivo son a la vez laxos y polisémicos: se aplican a fenómenos muy diferentes y no siempre se definen con precisión. La aplicación extendida del paradigma neo-darwinista clásico, además, suele imponer un esquema adaptacionista al análisis de los hechos evolutivos, en el cual las funciones juegan un papel lógicamente anterior a los rasgos y sus formas. En este artículo proponemos, como etapa previa a la formulación de hipótesis sobre las causas del cambio, un modelo (...) de espacio forma-función que pueda responder a preguntas como cuándo se da un cambio en los rasgos de una arquitectura biológica y de qué tipo son estos cambios. Un modelo de este tipo nos permite ver claramente cuándo se da un cambio en la forma o en la función y qué alcance evolutivo tiene. (shrink)

Les trois études rassemblent des réflexions du philosophe sur trois problèmes de méthode spécifiques : le concept de paradigme, la théorie des signatures et la relation entre histoire et archéologie.

La ricerca può essere effettuata anche con parole non complete. Per esempio - per la ricerca dell'autore 'Gerardus van der Leeuw' può bastare l'inserimento della parola 'lee' o di altre parti del nome o del cognome. Questa possibilità facilita la ricerca di parole difficili o di cui non è semplice memorizzare la trascrizione. Se invece si inserisce nella ricerca, oltre al cognome dell'autore, anche il nome ed il titolo del libro, o almeno alcune parole significative del titolo, il risultato della (...) ricerca sarà più selettivo. (shrink)

La creatività è una capacità orientata: non solo una dote innata, ma qualcosa che va coltivato, sviluppato e fatto crescere sfruttando tutte le opportunità (e tutte le casualità) offerte dall'intorno. La creatività nasce dall'integrazione di pensiero logico e pensiero analogico. Il primo procede per sequenze lineari: cause ed effetti, premesse e conseguenze. Coinvolge essenzialmente l'emisfero cerebrale sinistro, dove si trovano i centri del linguaggio. Il secondo procede in modo non sequenziale ma per somiglianze - analogie, appunto - e differenze, simmetrie (...) e asimmetrie. Coinvolge in prevalenza l'emisfero cerebrale destro, dove si trovano i centri della visione. Ma il pensiero creativo consiste, prima di tutto, nel farsi domande e nell'affrontare problemi o quesiti a partire da solide conoscenze, adottando però nuove prospettive, con l'obiettivo di trovare soluzioni innovative ed efficaci. Questo stile di pensiero si esprime in un processo che ha andamenti non sempre lineari, e consiste nel raccogliere, selezionare e riconfigurare le informazioni utili tra tutte quelle disponibili, individuando connessioni atte a generare conclusioni nuove"--Back cover. (shrink)

C'est au tournant du XIXe siècle que les représentations de la jeunesse féminine italienne commencent à se croiser autour de nouveaux concepts et de nouvelles disciplines.Cet article décrit l'émergence des multiples visages de la « nouvelle jeune fille » italienne à partir des codes d'appellation et d'une plus grande mobilité dans l'appartenance aux classes d'âge juvéniles. C'est la convergence de plusieurs éléments de transformation socio-culturelle qui, dans les années 1920, est à l'origine de la naissance de la « Jeunesse féminine (...) catholique » italienne, que l'auteur examine comme lieu emblématique, entre traditions et innovations, des modèles et des normes de la formation des signorine italiennes. (shrink)

El proyecto del ‘Darwinismo Formal’ de Alan Grafen propone una formulación matemática de la teoría de Darwin que pretende demostrar que la selección natural moldea los rasgos fenotípicos a través de la maximización de la eficacia. El proyecto de Grafen reposa sobre tres premisas: la selección natural es la única fuerza que moldea los fenotipos; la eficacia es la única medida de le evolución; y el diseño biológico surge como resultado de un proceso de optimización selectiva. En este trabajo argumentamos (...) que estas tres premisas limitan la aplicabilidad del modelo a los hechos evolutivos más simples. Esto se debe a que Grafen implícitamente presupone un concepto de eficacia que es a la vez causa y efecto de las novedades fenotípicas; lo que, por un lado, vacía la teoría de Darwin de poder explicativo y, por el otro, lleva a ignorar la potencial contribución de fuerzas evolutivas no selectivas en la configuración de la complejidad biológica. Para superar estos escollos del proyecto de del Darwinismo Formal - que son además comunes a todos los modelos formales adaptacionistas - proponemos sustituir el concepto causal de eficacia por el de robustez, definiendo así el diseño biológico como forma y función en lugar de como maximización de la eficacia. (shrink)

C'est au tournant du XIXe siècle que les représentations de la jeunesse féminine italienne commencent à se croiser autour de nouveaux concepts et de nouvelles disciplines.Cet article décrit l'émergence des multiples visages de la « nouvelle jeune fille » italienne à partir des codes d'appellation et d'une plus grande mobilité dans l'appartenance aux classes d'âge juvéniles. C'est la convergence de plusieurs éléments de transformation socio-culturelle qui, dans les années 1920, est à l'origine de la naissance de la « Jeunesse féminine (...) catholique » italienne, que l'auteur examine comme lieu emblématique, entre traditions et innovations, des modèles et des normes de la formation des signorine italiennes. (shrink)

La causa e la colpa -- Crimen e karman -- Le aporie della volontà -- Al di là dell'azione.

Certaines applaudiront le titre, d'autres pas. Je suis de celles qui applaudissent. Dans le frontispice, la hiérarchie typographique distingue « Les Femmes », majuscules et gras, du diptyque de la ligne suivante « les silences » / « l'Histoire », en caractères plus petits, comme une frisure. Cette décomposition rend encore plus évidente la surdétermination thématique, un « sexe à part entière », sans autre discussion et distinction. Il y a de la passion dans ce titre, non de l'arroganc...

The paper illustrates the evolution of the territorial system of government in Italy. A traditionally centralized state is turning into a quasifederation. The reasons underpinning this transformation are the growing insatisfaction with the inefficiency of the central government, the quest for autonomy by the fastest growing regions and the opposition by the latter to the interterritorial redistribution of resources made by the central government with the use of nontransparent and inefficient instruments.A substantial degree of subnational tax autonomy has been reintroduced. (...) The powers of subnational governments have been expanded. The main impact on decentralization derives, however, from the direct, popular, election of mayors and of presidents of regional and provincial governments.The transformation is far from complete. The central government is still reluctant to relinquishing its powers. The increased local tax autonomy did not yet introduce substantial tax competition. More precisely, tax rates were not reduced, but rather increased, due to the fiscal stringency of the whole public sector.L’article illustre l’évolution du système territorial de gouvernement en Italie. Un Etat traditionnellement centralisé est en train de devenir quasi-fédéral. Les raisons fondamentales de cette transformation sont l’insatisfaction croissante vis-à-vis de l’inefficacité du gouvernement central, la quête de plus d’autonomie de la part des régions à croissance rapide et l’opposition de ces dernières à la redistribution interterritoriale des ressources qu’opère le gouvernement central en utilisant des instruments opaques et inefficaces.Un degré substantiel d’autonomie fiscale subnationale a été réintroduit. Les pouvoirs des gouvernements subnationaux ont été étendus. L’impact principal de la décentralisation provient, cependant, de l’élection, directe et populaire, des maires et des présidents de gouvernements régionaux et provinciaux.La transformation est loin d’être complète. Le gouvernement central reste réticent à abandonner ses pouvoirs. L’autonomie croissante des impôts locaux n’a pas introduit pour le moment de concurrence fiscale. Plus précisément, les taux d’imposition n’ont pas été réduits, mais plutôt augmentés, en raison de la rigueur budgétaire de l’ensemble du secteur public. (shrink)

Riassunto Attraverso le pagine di Celso e di Origene vediamo delinearsi due Weltanschauungen contrapposte. La prima esclude un intervento attivo di Dio nel mondo, ipostatizza l’ordine di cose esistente, privilegia rigorosamente la cura dell’anima, nega che l’uomo possa far affidamento sul corpo per raggiungere la meta cui deve tendere, irride come irragionevoli e blasfeme sia la credenza nell’incarnazione sia quella nella resurrezione. La seconda è decisamente più sfaccettata. Il corpo per un verso sembra costituire un gravame, se è vero che (...) le creature razionali cadono in un soma a seguito della trasgressione originaria cui le conduce l’esercizio del libero arbitrio; per l’altro è anch’esso un portato della creazione divina e dall’inizio il Figlio pervade il mondo nella sua consistenza materiale, sino a che si produce il decisivo evento dell’incarnazione; alla fine dei tempi avrà luogo senza dubbio la resurrezione che chiama in causa una volta di più il corpo, in quanto l’esistere creaturale sembra inseparabile da una dotazione corporea. A partire da questo quadro complesso e almeno in parte aporetico si profila – all’interno della seconda Weltanschauung qui considerata attraverso la lente di Origene – una linea di tendenza, che cerca di sciogliere i nodi problematici persistenti negando essere la materia causa del male e rivendicando al corpo nato dalla vergine la capacità di salvare l’umanità. (shrink)

Semblanza de G. Tagliacozzo a través de las distintas voces que, desde su infancia hasta su muerte, lo llamaron en su vida: las primeras vocaciones de grandeza , las voces de la academia , la voz de América , la impelente voz de Vico , la voz de los caminos que la naturaleza recorre .Semblance of G. Tagliacozzo through the voices that he followed from his younger age to his death: the first calls for greatness , the voices of academy (...) , the voice of America , the impelling voice of Vico , and the voice of the ways that nature runs. (shrink)