Send in the clowns. Humor and power in Italian political, social and cultural life

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Cardiovascular abnormalities and impaired exercise performance in adolescents with congenital adrenal hyperplasia

Context: Patients with classic Congenital Adrenal Hyperplasia (CAH) are treated with lifelong glucocorticoids (GCS). Cardiovascular (CV) and metabolic effects of such therapy in adolescents have never been quantified. Objective: To investigate left ventricular (LV) morphology, function and exercise performance in adolescents with CAH. Design and Setting: cross-sectional and controlled study conducted at a tertiary referral centre. Patients: Twenty patients with classic CAH (10 females) aged 13.6±2.5 years and 20 healthy controls comparable for sex and pubertal status were enrolled in the study and compared to a group of 18 patients without CAH receiving a similar dose of GCS for Juvenile Idiopathic Arthritis (JIA). Main Outcomes Measures: Echocardiographic assessment and symptom-limited exercise testing were performed. Anthropometric, hormonal and biochemical parameters were also measured. Results: Compared to healthy controls, patients with CAH exhibited an increased BMI (p<0.001), waist-to-height ratio (p<0.001), percentage of body fat (p<0.001) as well as higher insulin concentrations and HOMA index even after adjustment for BMI (p=0.03 and p=0.05, respectively). Moreover, CAH patients exhibited an impaired exercise capacity as shown by reduced peak workload (99±27 vs 126±27 W, p<0.01) and higher systolic blood pressure response at peak (156±18 vs 132±11 mmHg, p<0.01; Δ=45±24 vs 22±10 mmHg, p=0.05) with respect to healthy controls. CAH males displayed mild LV diastolic dysfunction as documented by significant prolongation of both isovolumic relaxation time (IRT) (118±18 vs 98±11ms, p<0.05) and mitral deceleration time (MDT) (138±25 vs 111±15 ms, p<0.01). No significant differences in CV function were found between CAH and JIA patients. Conclusion: Adolescents with CAH exhibit impaired exercise performance and enhanced systolic blood pressure response during exercise. In our population, such abnormalities appear related to GCS therapy rather than CAH per se. CAH males, but no females, present mild LV diastolic dysfunction that correlates with testosterone concentrations suggesting a sex hormone related difference

IL RAPPORTO DI AGENZIA, UNA PROSPETTIVA GIUSLAVORISTICA

L’elaborato tratta il rapporto di agenzia in un’ottica giuslavoristica. La prima parte dello scritto insiste sull’inquadramento normativo prendendo in considerazione lo sviluppo della normativa sia convenzionale che legale. In particolare si è valutato se vi fosse una possibile analogia tra l’efficacia degli AEC e quella dei CCNL rispetto al contratto individuale. Successivamente si sono analizzate figure simili all’agente come il procacciatore d’affari o il promoter finanziario per evidenziarne le differenze tale da non poter definire l’agente mero lavoratore autonomo. In seguito si sono rilevate le analogia con il rapporto di lavoro subordinato in particolare sull’applicazione delle clausole generali inerenti lo svolgimento del rapporto medesimo come la buona fede e la diligenza. Infine particolari analogie si sono riscontrate nell’aspetto conclusivo del rapporto. innegabili, se non nelle conseguenze almeno nelle cause. Da ultimo sono state trattate le analogie sia nell’aspetto previdenziale che processuale. L’elaborato ha voluto ricercare la voluntas regulandi del legislatore nel disciplinare il rapporto di agenzia il quale si presta ad essere utilizzato sia da imprese di capitali sia da singole persone fisiche. La ricerca effettuata ha fatto dedurre che il legislatore abbia voluto tutelare, nel caso dell’agente persona fisica, non solo interessi economici ma anche i diritti della persona mutuando, in quest’ultimo caso, la disciplina del diritti del lavoro.The paper discusses the relationship of agency labor law perspective . The first part of the paper insists on the regulatory framework taking into account the development of both conventional and legal regulations . In particular, we examined whether there was a possible analogy between the effectiveness of the ERM and that of the national collective bargaining agreement with respect to the individual contract . Subsequently, we analyzed similar figures to the agent as the intermediary or financial promoter to highlight the differences that they can not define the agent merely self-employed. Then are recognized the analogy with the employment relationship , in particular, on the application of general clauses relating to the conduct of the relationship itself as the good faith and diligence . Finally the particular similarities were found in the appearance of the final report. undeniable , if not in the consequences at least in the cases . Finally, the similarities were treated both in social security that reason . The paper wanted to search the voluntas regulandi of the legislature in regulating the agency relationship which lends itself to be used by businesses of capital from both individual natural persons . The research did conclude that the legislature intended to protect, in the case of the agent individual, not only economic interests but also the rights of the person borrowing , in the last case , the regulation of labor rights

Sucrose metabolism: Anabaena sucrose-phosphate synthase and sucrose-phosphate phosphatase define minimal functional domains shuffled during evolution

Based on the functional characterization of sucrose biosynthesis related proteins [SBP: sucrose-phosphate synthase (SPS), sucrose-phosphate phosphatase (SPP), and sucrose synthase (SuS)] in Anabaena sp. PCC7120 and sequence analysis, we have shown that SBP are restricted to cyanobacterium species and plants, and that they are multidomain proteins with modular architecture. Anabaena SPS, a minimal catalytic SPS unit, defines a glucosyltransferase domain present in all SPSs and SuSs. Similarly, Anabaena SPP defines a phosphohydrolase domain characteristic of all SPPs and some SPSs. Phylogenetic analysis points towards the evolution of modern cyanobacterial and plant SBP from a bidomainal common ancestral SPS-like gene.Fil: Cumino, Andrea Carina. Fundación para Investigaciones Biológicas Aplicadas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Curatti, Leonardo. Fundación para Investigaciones Biológicas Aplicadas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Giarrocco, Laura Estela. Fundación para Investigaciones Biológicas Aplicadas; ArgentinaFil: Salerno, Graciela Lidia. Fundación para Investigaciones Biológicas Aplicadas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Overdiagnosis and overimaging: an ethical issue for radiological protection

Aims and objectives: This study aimed to analyse the key factors that influence the overimaging using X-ray such as self-referral, defensive medicine and duplicate imaging studies and to emphasize the ethical problem that derives from it. Materials and methods: In this study, we focused on the more frequent sources of overdiagnosis such as the total-body CT, proposed in the form of screening in both public and private sector, the choice of the most sensitive test for each pathology such as pulmonary embolism, ultrasound investigations mostly of the thyroid and of the prostate and MR examinations, especially of the musculoskeletal system. Results: The direct follow of overdiagnosis and overimaging is the increase in the risk of contrast media infusion, radiant damage, and costs in the worldwide healthcare system. The theme of the costs of overdiagnosis is strongly related to inappropriate or poorly appropriate imaging examination. Conclusions: We underline the ethical imperatives of trust and right conduct, because the major ethical problems in radiology emerge in the justification of medical exposures of patients in the practice. A close cooperation and collaboration across all the physicians responsible for patient care in requiring imaging examination is also important, balancing possible ionizing radiation disadvantages and patient benefits in terms of care

Interfacial Morphology Addresses Performance of Perovskite Solar Cells Based on Composite Hole Transporting Materials of Functionalized Reduced Graphene Oxide and P3HT

The development of novel hole transporting materials (HTMs) for perovskite solar cells (PSCs) that can enhance device's reproducibility is a largely pursued goal, even to the detriment of a very high efficiency, since it paves the way to an effective industrialization of this technology. In this work, we study the covalent functionalization of reduced graphene oxide (RGO) flakes with different organic functional groups with the aim of increasing the stability and homogeneity of their dispersion within a poly(3-hexylthiophene) (P3HT) HTM. The selected functional groups are indeed those recalling the two characteristic moieties present in P3HT, i.e., the thienyl and alkyl residues. After preparation and characterization of a number of functionalized RGO@P3HT blends, we test the two containing the highest percentage of dispersed RGO as HTMs in PSCs and compare their performance with that of pristine P3HT and of the standard Spiro-OMeTAD HTM. Results reveal the big influence of the morphology adopted by the single RGO flakes contained in the composite HTM in driving the final device performance and allow to distinguish one of these blends as a promising material for the fabrication of highly reproducible PSCs