Paesaggio, cinema e fantasia: trent’anni di Italia nei film

Dal nord al sud, città e campagne italiane sono set cinematografici che ci restituiscono le immagini di un’Italia molteplice e variegata. Il database IMDb (Internet Movie Database) raccoglie ben 13.550 film girati in Italia dal 1989 ad oggi. Nella finzione cinematografica non tutti sono ambientati in Italia, ma lo è la maggior parte. Il nostro contributo parte da questi luoghi e dall’analisi del database che li raccoglie e ha un duplice obiettivo. In primo luogo desidera esaminare la geografia e la localizzazione della produzione cinematografica che ha avuto come sfondo l’Italia e, in seconda battuta, analizzare il ruolo svolto dal paesaggio nell’ambito della narrazione cinematografica, attraverso un focus specifico su alcuni film ambientati a Siena e nei dintorni. Lo studio dopo un breve paragrafo di carattere introduttivo su paesaggio e cinema (§ 2), presenta l’analisi spaziale del database IMDb (§3), affronta il tema del paesaggio italiano in relazione ai film selezionati e ai generi (§ 4), proponendo, infine, alcune riflessioni sull’impatto concreto che i film hanno nel determinare una maggiore attrattività dei luoghi che ospitano i set cinematografici (§ 5

Continuous vs Intermittent Meropenem Administration in Critically Ill Patients With Sepsis

Importance: Meropenem is a widely prescribed β-lactam antibiotic. Meropenem exhibits maximum pharmacodynamic efficacy when given by continuous infusion to deliver constant drug levels above the minimal inhibitory concentration. Compared with intermittent administration, continuous administration of meropenem may improve clinical outcomes. Objective: To determine whether continuous administration of meropenem reduces a composite of mortality and emergence of pandrug-resistant or extensively drug-resistant bacteria compared with intermittent administration in critically ill patients with sepsis. Design, setting, and participants: A double-blind, randomized clinical trial enrolling critically ill patients with sepsis or septic shock who had been prescribed meropenem by their treating clinicians at 31 intensive care units of 26 hospitals in 4 countries (Croatia, Italy, Kazakhstan, and Russia). Patients were enrolled between June 5, 2018, and August 9, 2022, and the final 90-day follow-up was completed in November 2022. Interventions: Patients were randomized to receive an equal dose of the antibiotic meropenem by either continuous administration (n = 303) or intermittent administration (n = 304). Main outcomes and measures: The primary outcome was a composite of all-cause mortality and emergence of pandrug-resistant or extensively drug-resistant bacteria at day 28. There were 4 secondary outcomes, including days alive and free from antibiotics at day 28, days alive and free from the intensive care unit at day 28, and all-cause mortality at day 90. Seizures, allergic reactions, and mortality were recorded as adverse events. Results: All 607 patients (mean age, 64 [SD, 15] years; 203 were women [33%]) were included in the measurement of the 28-day primary outcome and completed the 90-day mortality follow-up. The majority (369 patients, 61%) had septic shock. The median time from hospital admission to randomization was 9 days (IQR, 3-17 days) and the median duration of meropenem therapy was 11 days (IQR, 6-17 days). Only 1 crossover event was recorded. The primary outcome occurred in 142 patients (47%) in the continuous administration group and in 149 patients (49%) in the intermittent administration group (relative risk, 0.96 [95% CI, 0.81-1.13], P = .60). Of the 4 secondary outcomes, none was statistically significant. No adverse events of seizures or allergic reactions related to the study drug were reported. At 90 days, mortality was 42% both in the continuous administration group (127 of 303 patients) and in the intermittent administration group (127 of 304 patients). Conclusions and relevance: In critically ill patients with sepsis, compared with intermittent administration, the continuous administration of meropenem did not improve the composite outcome of mortality and emergence of pandrug-resistant or extensively drug-resistant bacteria at day 28. Trial registration: ClinicalTrials.gov Identifier: NCT03452839

La clausola di supremazia statale nel Ddl di revisione costituzionale: si scrive “interesse nazionale”, si legge “indirizzo politico-governativo”

La clausola di supremazia statale prevista nell’art. 31 del progetto di revisione in esame è espressione, in astratto, di un’esigenza costituzionalmente rilevante e, per certi versi, doverosa. Tuttavia, cercheremo di mostrare come, in concreto, sia fondato il rischio per cui la clausola in oggetto, da strumento volto alla tutela dell’unità giuridica ed economica e dell’interesse nazionale, possa debordare dai fini per i quali è stata prefigurata e tramutarsi in meccanismo per il perseguimento dell’indirizzo politico-governativo.The State supremacy clause established by art. 31 of the Italian Constitution’s revision project now under discussion in the Italian Parliament, is an expression of a significant and compelling constitutional need: the economic and juridical unity of the Italian State. Nevertheless, this paper aims to show the risks connected to the use of the supremacy clause, particularly its transformation into an instrument to pursue the political aims of the Government rather than as a defense of the juridical-economical unity and, more broadly, the national interest