Editorial

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A legal and economic assessment of the EMU’s common principles and alternative routes of budget constraints

Defence date: 20 July 2018Examining Board: Professor Stefan Grundmann, European University Institute; Professor Klaus Heine, Erasmus University Rotterdam; Professor Giorgio Monti, European University Institute; Professor Pietro Sirena, Università commerciale Luigi BocconiIn the past 20 years, the European integration process has been mostly successful at establishing a single European market. However, no such success can be attributed to the establishment of an economic and monetary union. The recent financial and sovereign debt crisis dramatically exposed all the flaws and weaknesses of this ambitious project, which led the European Union into a deep economic and political crisis. In this context, the task of scholars and academics should be to explore new effective and efficient alternative in order to strengthen and create “a more perfect union”. On these premises and considerations, the present research will analyze the current legal framework of the European Monetary Union in order to assess and understand its success, and explore possible alternative institutional designs which could be more effective in achieving its objectives and, at the same time, be potentially more efficient and legittimate. More in details, after examining in the first chapter, the origin and evolution of the economic and monetary integration from its very foundation, and, in the second chapter, the current legal structure of the economic union; the last and third chapter represents the normative claim of thesis. In an attempt to reconcile both law and economics, this normative part will involve a balancing exercise between the economic concepts of effectiveness and efficiency, and the legal concepts of legitimacy. The analysis will first understand and assess the effectiveness of the present governance structure. We will argue that the fundamental problem of the present governance structure is given by its many internal inconsistencies. On these premises, we will claim that it is possible to design an alternative regime which could potentially solve such issues and thus be more effective. The resulting three different alternative regimes will then be compared and evaluated in terms of their efficiency, according to the new institutional economics approach. The purpose of the efficiency evaluation is not to identify the single most efficient system of governance, but rather to understand the distinctive strenghts and weaknesses of the various alternatives in comparison with the current structure. Ultimately, the chapter will also evaluate the current EMU structure under a legitimacy standpoint. In particular, it will try to assess and understand whether these potentially more effective and efficient alternative arrangements would also improve the EMU under a legitimacy standpoint

Management of Allogeneic Stem Cell Transplant Recipients with Hepatic Veno-Occlusive Disease

Hepatic veno-occlusive disease (VOD) or sinusoidal obstruction syndrome (SOS) is one the major limiting factor for the successful outcome of patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT), with a reported mortality rate of up to 50%. VOD/SOS is thought to result from an endothelial damage and occurs with a highly variable incidence ranging from 8% to 14%. Management of patients with VOD/SOS is based on both prevention and treatment, which rely on non-pharmacological approaches, for instance the control of additional risk factors, and pharmacologic treatments. Herein we provide a review of the current understanding for the management of patients with VOD/SOS after allogeneic HSCT

Prophylaxis and treatment of invasive fungal infections in hematological patients

The evidence from the literature strongly support antifungal prophylaxis in high risk haematological patients, such as patients with AML during remission induction chemotherapy and alloHSCT patients. Current antifungal prophylaxis guidelines for high risk patients recommend azoles (fluconazole, posaconazole, voriconazole) and echinocandins (micafungin) with the strongest level of evidence. In terms of treatment, the choice between empiric therapy (or fever driven) and pre-emptive therapy (or diagnostic driven) is still debated. Not a single therapeutic strategy is appropriate in every patients, in particular empirical antifungal therapy may be recommended in patients at very high risk, while a pre-emptive approach may be advised for those at standard risk. In order to exploit the synergistic and/or additive effect of two antifungal drugs it's possible to combine two agents that work with different mechanisms of action (e.g. echinocandins + azoles or polyenes). Once the treatment has been initiated we should consider the therapeutic drug monitoring (TDM) of the drugs, especially when the pharmacokinetic variability is high and the dose-concentration effect relationships is not predictable (e.g. for itraconazole, voriconazole and posaconazole)

Conversion of Lignin to Chemical Intermediates:a Study of Pyrolysis of Kraft Lignin

Experiments of pyrolysis of commercial Kraft lignin have been realized in the 250-550 °C range. Product analyses have been performed by FTIR, GC-MS, EDX analyses. The main goal of the work is to optimize the experiments in terms of liquid yield, reduction of oxygen content in the resulting biochar, and removal of sulfur, found mainly in the gas phase. It has been concluded that the amount of the starting lignin charged in the reactor must be limited to be fully positioned in the heating chamber also during high temperature treatment. Sulfur may be partially removed in the gas phase as H2S and CH3SH mainly, by a pre-treatment at 250 °C. The maximum amount of liquid product, mainly constituted by methoxy- and alkyl-methoxy-phenols, and the maximum solid deoxygenation are both obtained at 550 °C

Iron Overload in Patients Receiving Allogeneic Hematopoietic Stem Cell Transplantation

Iron overload has been associated to a variety of post-transplant complications, including infections, sinusoidal obstructive syndrome and it is conceivable that increased hepatic iron may mimic the clinical picture of GVHD or even may contribute to the worsening of hepatic GVHD. Objectives and Methods: aim of present review was to summarize the current knowledge about diagnosis and treatment strategies of iron overload following HSCT. Results: serum ferritin may be considered as surrogate marker of iron overload and is widely used as an indicator of body iron status; however other noninvasive diagnostic methods, namely SQUID and MRI, may provide more precise information on iron burden in specific organs, such as liver and heart. Since there are not physiological tools to remove efficiently the excess of iron, it is of particular importance to consider iron depleting therapy. Phlebotomy should be considered as the first line treatment of iron overload, while iron chelators, such as deferasirox, may represent an alternative option for patients with an inadequate hematological recovery. Discussion: additional prospective studies are mandatory to investigate the relationship between iron overload and the outcome of patients receiving an allogeneic stem cell transplantation

Posttransplantation chronic renal damage in nonrenal transplant recipients

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