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In this article, we argue that modes of labour and value extraction have been under-researched and under-theorised in critical geographical research on migration, asylum and refugee humanitarianism. We examine data production, voluntary work programmes and financialised asylum housing as key sites through which value is extracted from asylum-seekers’ unpaid and reproductive activities. We argue that specific forms of migrant carcerality are, firstly, grounded in migrants’ and asylum-seekers’ carceral conditions and exclusion from paid work. Secondly, we argue that subtle forms of coercion and conditionality at work in asylum hosting require asylum-seekers’ invisible and unpaid labour. Thirdly, we show how financialised real estate firms further capitalise on government contracts for asylum housing, rendering accommodation as another site of value extraction. We thereby expand conceptualisations of carceral economies of migration control beyond detention and confinement and elaborate the specific forms of labour and value extraction emerging from migration, asylum and refugee governance.

This article advances the notion of “extractive humanitarianism” to designate the role played by data extraction and knowledge extraction operations in refugee governmentality. It argues that extractive operations rely on refugees’ active participation to their own governmentality—what I define as participatory confinement. The piece engages with feminist literature on unpaid labor and shows that participatory confinement implies that refugees perform unpaid labor activities, which are disguised as voluntary work. It moves on by conceptualizing participatory confinement through the lens of the invitation to governmentality. In order to develop this, the article focuses on two modes of participatory confinement: unpaid labor that asylum seekers do as “voluntary” activities and knowledge and data extraction. It concludes by questioning extractive humanitarianism in light of the subtle coercion and invisible exploitation that asylum seekers are exposed to.

This article investigates the fragmented knowledges that migrants need to deal with in order to get access to asylum, and the related effects of disorientation it generates on them. The piece argues that disorientation is as a constitutive political technology of refugee governance and develops this argument by focusing on the Greek asylum system. It starts by drawing attention to the multiple technological steps and forced digital intermediations that asylum seekers in Greece need to navigate, focusing in particular on the Cash Assistance Programme, and it shows how asylum seekers need to deal with dispersed knowledges. The article moves on by analysing how the governing through disorientation underpin the asylum legal system in Greece and how this ends up in debilitating asylum seekers and hampering them from accessing rights and humanitarian support. The final section explores how asylum seekers are racialised and treated as deceitful subjects, and argues that not only their speech but also their conduct and behaviour are assumed to be deceptive, and therefore their knowledge turns out to be pointless. It concludes by challenging claims for more transparency and more knowledge as a response to the governing through disorientation.

Background Nipple adenoma is a very uncommon, benign neoplasm that involves the nipple. A palpable mass of the nipple associated with nipple discharge and erosion or ulceration is the common clinical presentation. Generally, complete surgical excision of the nipple is the main treatment, alternative therapeutic methods such as Mohs micrographic surgery, nipple splitting enucleation, and cryotherapy can be considered. Disorders of the breast in young women are generally benign. Even if the management during pregnancy is usually conservative and surgical excision is reserved for very strong malignancy suspicion, benign lesions can cause the impossibility to breastfeed after giving birth when involving the nipple. Case presentation We present the case of a 28-year-old female, who was referred to the Breast Unit of the University Hospital of Modena (Italy) in May 2020 with a 12-months history of enlargement of the left nipple with associated erythema, serohemorrhagic discharge, and pain in the left nipple region. The diagnostic assessment came out in favor of a nipple adenoma. After surgical treatment was recommended, the patient got pregnant. Taking into account the major risks of surgery during pregnancy, a multidisciplinary discussion was conducted, to consider whether to proceed with surgery or postpone it after pregnancy. Because of the volume and the position of the adenoma, the indication for surgical excision was confirmed, to allow regular lactation and breastfeeding immediately after giving birth and to avoid potential obstructive complications. Surgical excision of nipple adenoma without complete resection of the nipple was performed after her first trimester of pregnancy under local anesthesia. A histopathological examination confirmed the diagnosis. No recurrence occurred after 12 months. The patient gave birth, had no deficit in lactation, and successfully breastfed. Conclusions Therefore, we consider that nipple adenoma enucleation might be a safe treatment even during pregnancy. Moreover, conservative local treatment of nipple adenomas can preserve the nipple aesthetically and functionally, thus allowing regular lactation and breastfeeding in young women.

Surgery for breast cancer has changed in the last few decades in favor of more conservative approaches, without compromising loco‐regional control and survival. Common immediate complications fol ‐lowing breast surgery are hematoma, seroma, and wound infection.1Traditionally, surgeons have implemented the use of closed‐suction drains in this setting with the aim of preventing these complications, which can cause discomfort, morbidity, increased follow‐up visits,and possible delay in the beginning of adjuvant therapies.2 On the other hand, potential benefits of performing breast procedures without using a drain have been increasingly considered.3 There is lack of modern and official guidelines on use of drains in breast sur ‐gery, with no consensus regarding their management and the appro‐priate use of antibiotics in this setting. Almost all reports agree withthe use of drains after breast procedures, especially if they are asso‐ciated with reconstruction or axillar lymph node dissection (ALND), but an extreme variability is reported regarding practice patterns.4A national survey regarding the management of drains afterbreast cancer surgery was sent by email on January 2018 to all Breast Centers (BC) registered with Senonetwork Italia. Data col ‐lected by the administrative office of Senonetwork were de‐iden‐tified and exported for statistical analysis. A Steering Committeecomposed of general surgeons and plastic surgeons was appointedto coordinate the survey, which consisted of 22 multiple choicequestions, designed to inquire about surgeons' demographics, use of drains after breast procedures with and without reconstructionand/or ALND, antibiotic use and to characterize drain managementin their clinical practice.

This article investigates how the security-humanitarian rationale that underpins migration governmentality has been restructured by and inflected in light of hygienic-sanitary borders which enforce racialised confinement in the name of both migrants' and citizens' safety from infection by Covid-19. Focusing on the politics of migration containment along EUrope's frontiers, examining in particular border reinforcements carried out by Italy, Malta and Greece, we interrogate how the pandemic has been exploited to enact deterrence through hygienic-sanitary border enforcements. These enforcements are underpinned by an ambivalent security-humanitarian narrative that crafts migrants as subjects who cannot be protected by EU member states from the pandemic if allowed inside, and, at once, as potential vehicles of contagion - ‘Corona spreaders’ - and thus as dangers on a bacterial-hygienic level. Our article demonstrates that these EUropean border measures are more than temporary responses to an unprecedented health crisis. Rather, the pandemic has been seized as an opportunity to strengthen existing deterrence measures and hamper migrants' access to asylum through biopolitical and spatial tactics that aim to restructure the border regime. While emphasising the historical trajectories and continuities underwriting these current developments, we contend that the pandemic functions as an accelerator of dynamics of migrant incarceration and containment.

Introduction: Spider bites are common worldwide. Frequently symptoms resolve without any adverse outcome, but in rare cases the bite can cause severe morbidity. The most typical presentation of Mediterranean recluse spider (Loxosceles Rufescens) bite is a dermatonecrotic lesion of the skin (skin loxoscelism). When the only manifestation of a spider bite is an ulcerated skin lesion, clinical suspicion and differential diagnosis strongly depend on its site. We present the case of an ulcerated wound of the breast, diagnosed as a Mediterranean recluse spider bite. Case presentation: A 79-year-old woman presented a 10cm-wide soft tissue ulceration of her left breast. At first, the diagnostic hypothesis of an ulcerated cancer was ruled out. Two family members revealed a recent history of Mediterranean recluse spider bite and the same clinical diagnosis was made for our patient. A wide excision was performed, with complete resolution of symptoms. Discussion: No specific diagnostic criteria for spider bites are available. Diagnosis is usually clinical. Skin loxoscelism could be easily mistaken for cellulitis, various types of skin infections, cutaneous anthrax, vasculitis, scorpion sting, pyoderma gangrenosum, erythema migrans of Lyme disease or prurigo nodularis. A thorough anamnestic interview is fundamental to raise the diagnostic hypothesis. When possible, a biopsy is recommended and it is extremely important when the ulcer can mimic a cancer, as is the case in breast tissue. Conclusion: We recommend a wide excision of the wound after failure of conservative treatment, in order to obtain local control and to perform histological examination on a more representative specimen.

Background: Nipple Adenoma is a very uncommon, benign neoplasm that involves the nipple. Generally, complete surgical excision of the nipple is the main treatment, alternative therapeutic methods such as Mohs micrographic surgery, nipple splitting enucleation, and cryotherapy can be considered. Benign disorders of the breast generally occur in the breast of young women. Even if the management during pregnancy is usually conservative and surgical excision is reserved for very strong malignancy suspicion, benign lesions can cause the impossibility to breastfeed after giving birth when involving the nipple. Case Presentation: Here, we report a case of a 28-year-old woman with a 12-month history of progressive enlargement of the left nipple associated with erythema and intermittent serous-haematic discharge. The diagnostic assessment came out in favor of a nipple adenoma. After surgical treatment was recommended, the patient got pregnant. Surgical excision of nipple adenoma without complete resection of the nipple was performed after her first trimester of pregnancy under local anesthesia. A histopathological examination confirmed the diagnosis. No recurrence occurred after 12 months. The patient gave birth, had no deficit in lactation, and successfully breastfed. Conclusions: Therefore, we consider that nipple adenoma enucleation might be a safe treatment even during pregnancy. Moreover, conservative local treatment of nipple adenomas can preserve the nipple aesthetically and functionally, thus allowing regular lactation and breastfeeding in young women.

This article deals with the technologies and apps that asylum seekers need to navigate as forced hindered techno-users in order to get access to asylum and financial support. With a focus on the Greek refugee system, it discusses the multiple technological intermediations that asylum seekers face when dealing with the cash assistance programme and how asylum seekers are obstructed in accessing asylum and financial support. It explores the widespread disorientation that asylum seekers experience as they navigate un-legible techno-scripts that change over time. The article critically engages with the literature on the securitization and victimization of refugees, and it argues that asylum seekers are not treated exclusively as potential threats or as victims, but also as forced hindered subjects; that is, they are kept in a condition of protracted uncertainty during which they must find out the multiple technological and bureaucratic steps they are requested to comply with. In the final section, the article illustrates how forced technological mediations actually reinforce asylum seekers’ dependence on humanitarian actors and enhance socio-legal precarity.

This paper argues that COVID-19 has triggered a multiplication of heterogeneous bordering mechanisms that, far from stopping movement as such, have enhanced hierarchies of mobility. In particular, it shows that a confinement continuum has been put in place in the name of the “contain to protect” principle: migrants have been subjected to protracted lockdown measures in the name of their own protection. The piece concludes by interrogating how to rearticulate critique in COVID times in light of the enforcement of discriminatory “passports to freedom” (COVID-19 travel certificates).

This article advances a genealogy of migrant struggles and citizens solidarity practices, with a focus on the French-Italian migrant passage. It contends that scholarship has mainly mobilised a spatial approach to migrant struggles, while the temporality of solidarity and the collective memory of struggles have remained under-theorised. Then, the article moves on by focusing on the French-Italian Alpine border and it analyses the longstanding history of migrants’ passages there and, jointly, the mobilisations that took place in that area over the last decades exploring how these sedimented a citizen collective memory of solidarity practices. The final section deals with the history of mountain rescue at the French-Italian Alpine border and shows how migrants were saved by volunteers. The piece concludes by arguing that an insight into the memory of migrant struggles and solidarity practices enables foregrounding the transversal alliances which have been built between migrants and citizens and unsettling binary opposition between the former and the latter.

Coordinated and Edited by: N De Genova, M Tazzioli Co-Authored by: Claudia Aradau, Brenna Bhandar, Manuela Bojadzijev, Josue David Cisneros, N De Genova, Julia Eckert, Elena Fontanari, Tanya Golash-Boza, Jef Huysmans, Shahram Khosravi, Clara Lecadet, Patrisia Macias-Rojas, Federica Mazzara, Anne McNevin, Peter Nyers, Stephan Scheel, Nandita Sharma, Maurice Stierl, Vicki Squire, M Tazzioli, Huub van Baar and William Walters

Ewing’s Sarcoma Family Tumors (ESFT) include classic Ewing’s sarcoma of bone, extra-skeletal Ewing’s sarcoma (EES), malignant small cell tumor of the chest wall (Askin tumor), and soft tissue-based Peripheral Primitive Neuroectodermal tumors (pPNET). The t(11;22)(q24;q12) translocation is associated with 85% of tumors and leads to EWS-FLI-1 (Ewing’s Sarcoma–Friend Leukemia Integration-1) formation. This is a potent transforming gene that encodes a chimeric protein that plays a role in the genesis of Ewing’s Sarcoma and Primitive Neuroectodermal Tumors. The breast location of ESFT remains exceptional. The prognosis is among the poorest of all subtypes of breast cancer and even poorer than other extraosseous Ewing’s sarcomas. We describe the case report of a 23-year-old patient with a growing breast lump, who required an accurate and challenging diagnostic estimation and who ultimately resulted in a peripheral primary neuroectodermal tumor (pPNET). Through this case description and a brief narrative review of the literature, we aim to highlight the rarity of ESFT located in the breast. Histopathological confirmation is mandatory for all growing masses of the breast to reach a conclusive diagnosis and plan the correct treatment. Patients with rare diagnoses should always be centralized in breast units, conducting multidisciplinary meetings and, when necessary, the diagnosis should be shared through wider national or international registries.

BACKGROUND/AIM: Extraordinary restrictions aimed to limit Sars-CoV-2 spreading; they imposed a total reorganization of the health-system. Oncological treatments experienced a significant slowdown. The aim of our multicentric retrospective study was to evaluate screening suspension and surgical treatment delay during COVID-19 and the impact on breast cancer presentation. PATIENTS AND METHODS: All patients who underwent breast surgery from March 11, 2020 to May 30, 2020 were evaluated and considered as the Lockdown group. These patients were compared with similar patients of the previous year, the Pre-Lockdown group. RESULTS: A total of 432 patients were evaluated; n=223 and n=209 in the Lockdown and Pre-lockdown-groups, respectively. At univariate analysis, waiting times, lymph-nodes involvement and cancer grading, showed a statistically significant difference (p

Highlights • SARS-CoV-2 cause a wide spectrum of clinical manifestations including acute respiratory distress syndrome (ARDS) manifestation. • Continuous positive airway pressure, or non-invasive ventilation, and invasive ventilatory support are often required to manage the acute respiratory failure in COVID-19 patients. • Temperature >38 °C, LDH > 250 U/L and d-dimer >1000 ng/ml resulted to be indipendent risk factors for non invasive/invasive ventilator support requirement. • An early inflammatory screening should be warranted in order to stratify the illness severity and provide an appropriate treatment., Objectives To investigate risk factors for non-invasive/invasive-ventilatory support (NI/I-VS) in Coronavirus diseases 2019 (COVID-19) patients. Methods All consecutive patients admitted, from February 25 to April 25, 2020, to the Infectious Diseases Unit and Intensive Care Unit of Santa Maria Annunziata Hospital (Florence, Italy) with confirmed COVID-19 diagnosis were enrolled in this retrospective cohort study. NI/I-VS was defined as need for continuous positive airway pressure (CPAP) or bilevel positive pressure non-invasive ventilation (BPAP) or mechanical ventilation (MV) than low-flow systems oxygen-therapy as Venturi Mask (VM) or nasal cannula. Results Ninety-seven patients were enrolled; 61,9% (60/97) were male, median age was 64 years; intra-hospital mortality was 9.3%. Thirty five out of 97 (36%) patients required ICU admission and 94.8% (92/97) were prescribed oxygen-therapy: 10.8% (10/92) with nasal cannula, 44.5% (41/92) with VM, 31.5% (29/92) with CPAP, 2.2% (2/92) with BPAP and 10.8% (10/92) underwent intubation for MV. Patients with body mass index >30, type II diabetes mellitus and presenting at the admission with dyspnoea, asthenia, SOFA score ≥2 points, PaO2/FiO2 38 °C, increased levels of lactate dehydrogenase (LDH), alanine aminotransferase, C-reactive protein and a d-dimer >1000 ng/ml underwent more frequently NI/I-VS at the univariate analysis. Multivariate logistic regression analysis confirmed temperature >38 °C (odds ratio [OR] 21.2, 95% confidential interval [95%CI] 3.5-124.5, p = 0.001), LDH > 250 U/L (OR 15.2, 95%CI 1.8-128.8, p = 0.012) and d-dimer >1000 ng/ml (OR 4.5, 95%CI 1.2-17.3, p = 0.027) as significantly associated with NI/I-VS requirement. A non-significant trend (p = 0.051) was described for PaO2/FiO2 38 °C, LDH > 250 U/L and d-dimer >1000 ng/ml resulted to be indipendent risk factors for NI/I-VS in COVID-19 patients. In order to quickly recognize patients likely at risk to develop a critical illness, inflammatory markers assessment should be warranted upon hospital admission.

Background: Achieving a reliable venous access in a particular subset of patients and/or in emergency settings can be challenging and time-consuming. Furthermore, many hospitalized patients do not meet the criteria for central venous catheter positioning, unless an upgrade of the treatment is further needed. The mini-midline catheter has already showed to be reliable and safe as a stand-alone device, since it is easily and rapidly inserted and can indwell up to 1 month. Methods: In this further case series, we retrospectively evaluated data from 63 patients where a previously inserted mini-midline catheter was upgraded to a central venous catheter (the devices inserted in the arm replaced by peripherally inserted central catheter and others inserted “off-label” in the internal jugular replaced by single lumen centrally inserted central catheter), being used as introducer for the Seldinger guidewire. Results: The guidewire replacement was been made even early (after 1 day) or late (more than 10 days), usually following a need for an upgrade in treatment. No early or late complications were reported. Conclusion: According to the preliminary data we collected, this converting procedure seems to be feasible and risk-free, since neither infectious nor thrombotic complications were reported.

This article deals with the political legacy of migrants’ spaces across Europe that are the outcome of border enforcement policies but that are also shaped by migrants’ struggles and movements. It interrogates what is left, after their vanishing forced eviction, at the level of spatial-political traces, as well as in the collective memory of the citizens of those places. The main argument of the piece is that in order to come to grips with these spaces beyond their ephemeral dimension, we need to consider the temporality of migrant struggles and of solidarity practices – between migrants and citizens. The article focuses, first, on the French-Italian Alpine border, and analyses how the sedimented memory of the struggles in that valley has been reactivated in the present to support the migrants in transit. Then, the article moves on by developing the notion of transversal alliances through an insight into the Gilets Noirs movement in France, a collective of undocumented migrants which mobilised towards getting to permit to stay and accommodation, while at the same time framing their struggle as a broader battle against precarity and exploitation. The piece concludes suggesting that by bringing in the genealogy of struggles and solidarity practices, migrants’ spaces appear as part of a precarious mobile common in the making.

Risk-reducing-salpingo-oophorectomy (RRSO) inevitably leads BRCA mutation carriers to premature menopause.To evaluate the existing evidence for use of postmenopausal hormone therapy (HT) in BRCAmc, after RRSO or menopause occurring naturally, for both breast cancer (BC) survivors and those without BC.All BC survivors are excluded from any HT treatment: in other BRCAmc, before 51 years of age the benefits of HT overcome the risks after RRSO and/or premature ovarian insufficiency (POF). After 51 years of age, it is important to treat only women with important vasomotor symptoms, after the failure of alternative therapies. Estrogens-only therapy plays a key role in hysterectomized women (HW). In the case of an intact uterus (UW), associations with the lowest dose of progestins/natural progesterone derivatives have to be preferred, as progestins has been shown to play an important role in BC transformation, especially in BRCA1mc. No studies have been performed in BRCAmc with regard to 'progestin-free' HT, in particular the old tibolone (both in HW and UW) and the new tissue-selective estrogen complex (in UW). However, preliminary data obtained from the general population are reassuring about the use of these 'progestin-free' preparations and BC safety.

This article identifies and analyses the tactic of kidnapping migrants that is increasingly deployed by states to disrupt, decelerate, and block migrants’ mobility. Kidnapping, we argue, is one of the political technologies of capture used by state authorities in their efforts to reassert control over migratory movements. This analysis contributes to a new understanding of the politics of border enforcement through strategies aimed at the containment of migration. The article focuses on the U.S.–Mexico border and the European border in the Mediterranean Sea as crucial sites where states have increasingly engaged in heterogenous modes of kidnapping.It also considers migrant struggles against these diverse kidnapping tactics. Through a focus on kidnapping, the article expands how we understand border violence and interrogates accounts of the biopolitics and necropolitics of borders that rely on the overly reductive formula of ‘making live/letting die’. The article concludes by highlighting how the critical examination of kidnapping migrants allows us to trace affinities and partial continuities among various historical modes of racialised subjugation that have affected both contemporary migrants and previously colonised populations.

This article develops an alternative definition of a migrant that embraces the perspective of mobility. Starting from the observation that the term ‘migrant’ has become a stigmatizing label that problematizes the mobility or the residency of people designated as such, we in-vestigate the implications of nation-state centered conceptions of migration which define migration as movement from nation-state A to nation-state B. By asking ‘Who is a migrant in Europe today?’ we show that nation-state centered understandings of migration rest on a deeply entrenched methodological nationalism and implicate three epistemological traps that continue to shape much of the research on migration: first, the naturalization of the in-ternational nation-state order that results, secondly, in the ontologisation of ‘migrants’ as ready-available objects of research, while facilitating, thirdly, the framing of migration as problem of government. To overcome these epistemological traps, we develop an alternative conception of migration that, inspired by the autonomy of migration approach, adopts the perspective of mobility while highlighting the constitutive role that nation-states’ bordering practices play in the enactment of some people as migrants. Importantly, this definition al-lows to turn the study of instances of migrantisation into an analytical lens for investigating transformations in contemporary border and citizenship regimes.

Triple-negative breast cancer (TNBC) patients who do not obtain pathologic complete response (pCR) after neoadjuvant chemotherapy (NACT) present higher rate of relapse and worse overall survival. Risk factors for relapse in this subset of patients are poorly characterized. This study aimed to identify predictive factors for relapse in TNBC patients without pCR after NACT. Women with TNBC treated with NACT from January 2008 to May 2020 at the Modena Cancer Center were included in the analysis. We identified 142 patients with median follow-up of 55 months. After NACT, 62 patients obtained pCR (43.9%). Young age at diagnosis (< 50 years) and high ki-67 (>20%) were significantly associated to pCR. Lack of pCR after NACT resulted in worse 5-year EFS and OS. Factors independently predicting EFS in patients without pCR were the presence of multifocal disease (HR 3.22; 95% CI, 1.28–8.11; P 0.01) and Residual Cancer Burden (RCB) III (HR 3.8; 95% CI, 1.12–12; P 0.03). These data can be used to stratify patients and potentially guide treatment decision-making, identifying appropriate candidates for treatment intensification especially in neo/adjuvant setting.

Rebel groups govern significant parts of territory worldwide. They often deliver crucial public goods and services to populations under their control. Scholarship on rebel governance commonly explains this with the need for armed groups to generate local and international legitimacy. We argue that this understanding of rebel governance as an instrumental means to power is insufficient. Instead, we propose a novel conceptualization of rebel governance as competing biopolitics. Tracing biopolitical technologies of rebel rule reveals the productive functions of war-time social orders for molding populations into imagined communities in direct opposition to the existing nation state. We develop this perspective by mobilizing Foucault's work in conjunction with Chatterjee's postcolonial understanding of governmentality in contexts of postcolonial state- and nation-formation, and empirical research on the Pat Jasan in northern Myanmar. Linked to the Kachin rebellion, this movement has fought against a devastating narcotics crisis with biopolitical interventions that form the Kachin nation body amidst protracted ethnonational conflict. Beyond shedding light on one of the world's longest running but least-researched civil wars, this offers three distinct contributions to international studies: exploring non-state armed groups as actors of public health, theorizing the sociological underpinnings of rebel governance, and developing the concept of biopolitics beyond the nation state.

Background/Aim: Despite the large amount of clinical data available of Coronavirus-19 (COVID-19), not many studies have been conducted about the psychological toll on Health Care Workers (HCWs). Patients and Methods: In this multicentric descriptive study, surveys were distributed among 4 different Breast Cancer Centers (BCC). BCCs were distinguished according to COVID-19 tertiary care hospital (COVID/No-COVID) and district prevalence (DP) (High vs. Low). DASS-21 score, PSS score and demographic data (age, sex, work) were evaluated. Results: A total of 51 HCWs were analyzed in the study. Age, work and sex did not demonstrate statistically significant values. Statistically significant distribution was found between DASS-21-stress score and COVID/No-COVID (p=0.043). No difference was found in the remaining DASS-21 and PSS scores, dividing the HCWs according to COVID-19-hospital and DP. Conclusion: Working in a COVID-19-hospital represents a factor that negatively affects psychosocial well-being. However, DP seems not to affect the psychosocial well-being of BCC HCWs. During the outbreak, psychological support for low risk HCWs should be provided regardless DP.

Background Fat tissue is strongly involved in BC tumorigenesis inducing insulin resistance, chronic inflammation and hormonal changes. Computed tomography (CT) imaging instead of body mass index (BMI) gives a reliable measure of skeletal muscle mass and body fat distribution. The impact of body composition parameters (BCPs) on chemosensitivity is still debated. We examined the associations between BCPs and tumor response to neoadjuvant chemotherapy (NC) in patients treated for operable breast cancer (BC). Methods A retrospective review of BC patients treated with NC in Modena Cancer Center between 2005 and 2017 was performed. BCPs, such as subcutaneous fat area (SFA), visceral fat area (VFA), lumbar skeletal muscle index (LSMI) and liver-to-spleen (L/S) ratio were calculated by Advance workstation (General Electric), software ADW server 3.2 or 4.7. BMI and BCPs were correlated with pathological complete response (pCR) and survival outcomes. Results 407 patients were included in the study: 55% with BMI < 25 and 45% with BMI ≥ 25. 137 of them had pre-treatment CT scan imagines. Overweight was significantly associated with postmenopausal status and older age. Hormonal receptor positive BC was more frequent in overweight patients (p

Background The optimal time interval between the end of neoadjuvant systemic therapy (NST) and breast surgery is still unclear. It is not known if a delay in surgery might influence the benefit of primary chemotherapy. The aim of this study is to evaluate the relationship between time to surgery (TTS) and survival outcomes. Patients and methods According to TTS, women with diagnosis of BC treated with NST were divided into two cohorts: group A = 21 days or fewer and group B = longer than 21 days. OS and RFS were estimated and compared according to TTS and known prognostic factors. Results A total of 319 patients were included in the study: 61 in group A and 258 in group B. Median TTS was 34 days. No association between clinical stage, nuclear grade, type of chemotherapy, type of surgery and TTS was detected. OS and RFS were significantly worse for group B compared with group A, with a hazard ratio of 3.1 (95% CI, 1.1–8.6 p = 0.03) and 3.1 (95% CI, 1.3–7.1 p = 0.008) respectively. Multivariate analysis confirmed that TTS was an independent prognostic factor in term of OS (p = 0.03) and RFS (p = 0.01). Even in the subgroup of patients with pCR, TTS continued to be an independent prognostic factor for both OS and RFS (p = 0.05 and p = 0.03). Conclusions TTS after NST seems to influence survival outcomes. BC patients underwent surgery within 21 days experienced maximal benefit from previous treatment: this advantage is consistent and maintained over time.

L’articolo analizza, prendendo la prospettiva di una storia dei fuggitivi, gli attuali transiti dei migranti attraverso le Alpi. Si interroga sulle tracce lasciate dalla presenza fuggevole dei migranti al confine alpino tra la Francia e l’Italia, leggendole in connessione sia con la memoria delle mobilita del passato sia con le pratiche del soccorso alpino e delle reti di solidarieta che hanno toccato queste stessi valli. L’articolo inizia con una parte sulle infrastrutture mobili di solidarieta dispiegate al confine alpino franco-italiano, tracciandone la loro breve storia e mettendola in parallelo con la memoria sedimentata delle lotte in Val di Susa. L’articolo continua approfondendo la storia del soccorso alpino al confine franco-italiano, indicando come gli stranieri cosi come gli “emigranti clandestini” italiani siano stati salvati in questa stessa zona in passato. Infine, si conclude proponendo il concetto di “storia dei fuggitivi” in montagna come quadro teorico che permette una lettura politica dell’attraversamento delle Alpi da parte dei migranti.

Alterations in the human microbiome have been observed in a variety of conditions such has asthma, gingivitis, dermatitis and cancer, and much remains to be learned about the links between the microbiome and human health. The fusion of artificial intelligence with rich microbiome datasets can offer an improved understanding of the microbiome’s role in our health. To gain actionable insights it is essential to consider both the predictive power and the transparency of the models by providing explanations for the predictions.We combine the effort of collecting a corpus of leg skin microbiome samples of two healthy cohorts of women with the development of an explainable artificial intelligence (EAI) approach that provides accurate predictions of phenotypes and explanations. The explanations are expressed in terms of variations in the abundance of key microbes that drive the predictions.We predict skin hydration, subject’s age, pre/post-menopausal status and smoking status from the leg skin microbiome. The key changes in microbial composition linked to skin hydration can accelerate the development of personalised treatments for healthy skin, while those associated with age may offer insights into the skin aging process. The leg microbiome signatures associated with smoking and menopausal status are consistent with previous findings from oral/respiratory tract microbiomes and vaginal microbiomes respectively. This suggests that easily accessible microbiome samples could be used to investigate health-related phenotypes, offering potential for non-invasive diagnosis and condition monitoring.Our EAI approach sets the stage for new work focused on understanding the complex relationships between microbial communities and phenotypes. Our approach can be applied to predict any conditions from microbiome samples and has the potential to accelerate the development of microbiome-based personalised therapeutics and non-invasive diagnostics.

Highlights • Pancreatic trauma with complete wirsung transection in man treated with pancreaticogastrostomy reconstruction in emergency. • High risk of complications like postoperative pancreatic fistula (POPF). • The need of protocols for correct manage of this patients in emergency surgery shared by surgeons., Introduction Due to its retroperitoneal location and its proximity to major vascular structures and other organs, isolated pancreatic injuries are rare. The optimal management for pancreatic injuries of grades III and IV, where a main ductal transection is present, remains controversial. Isolated complete traumatic transection of the pancreatic neck is uncommon, but this condition is associated with some peculiar technical aspects that allow more conservative treatments. Presentation of the case A closed abdominal blunt trauma in a young patient underwent emergency surgery for suspect hemoperitoneum. Intraoperatively evidence of complete traumatic transection of the pancreatic neck treated with pancreas tissue debridement, suture of the cephalic stump and pancreaticogastrostomy reconstruction. Discussion Preservation of pancreatic volume and avoidance of adjacent organ resection is associated with lesser mortality and morbidity rate. The advantages of conservative treatments are related to reductions in the postoperative exocrine and endocrine insufficiencies. Conclusion In selected cases of complete neck transection with preserved pancreatic parenchyma in a stable patient, parenchymal-sparing interventions should be considered. Pancreaticogastrostomy offers an easier to learn and faster technique also suited for less experienced surgeons.

In this paper we examine the increasing criminalisation by states and the EU of citizen networks that have mobilised across Europe for supporting migrants in transit. Through these transnational solidarity practices a sort of infrastructure of migrant support has been built. The paper focuses on ‘crimes of solidarity’ that have taken place in France and in Italy and argues that the criminalisation of individuals which build solidarity connections across borders paradoxically constitutes a radical challenge to Europe’s principles of citizens’ solidarity across borders. The infrastructure of migrant support enacts a form of Europeanisation of citizens’ practices that states and local authorities try instead to undermine. The paper moves on by focusing on the ambivalences of the expression ‘smuggling activities’, which is increasingly being used to name individuals who help migrants to cross or to stay without making any economic profit from that. The essay considers the frictions between local, national and European authorities in tolerating or criminalising citizens that act in solidarity with the migrants, bringing humanitarian help and building material channels for safe passages. The final part of the paper reads the moment of crimes of solidarity in terms of a genealogy of European borders. It argues that one consequence of the criminalisation of solidarity is that new hybrid forums concerning migration, citizenship and borders questions are emerging. These arise, for example, when citizens are prosecuted for acts of assistance. Their trials have potential to become public scenes and spaces of counter-politics where it is not only the citizen but Europe that is in the dock. While some have argued that criminalisation and humanitarianism closes down the politics of European borders, we argue that it may allow for unexpected political opportunities.