Prime riflessioni sul decreto “trasparenza” (D.Lgs. n. 104/2022) modificato dal decreto “lavoro” (D.L. n. 48/2023)

Il contributo fornisce una prima lettura del c.d. “trasparenza” (d.lgs. n. 104/2022), che ha dato attuazione alla direttiva (UE) 2019/1152, da un lato ampliando, rispetto alla disciplina del 1997, le informazioni sul rapporto di lavoro che il datore di lavoro deve fornire al lavoratore all’atto dell’assunzione, dall’altro lato dettando alcune prescrizioni minime relative alle condizioni di lavoro, il tutto accompagnato dalle misure a tutela del lavoratore che reclami l’osservanza dell’obbligo d’informativa. L’analisi, condotta in costante confronto con la direttiva (UE) 2019/1152 onde evidenziarne eventuali scostamenti o distonie, tende ad individuare l’impatto che la nuova disciplina ha sulla regolamentazione del rapporto di lavoro

Trasparenza e attività di cura nei contratti di lavoro. Commentario ai decreti legislativi n. 104 e n. 105 del 2022

La produzione legislativa dell’ultimo quarto di secolo (a partire dalla c.d. riforma Treu del 1997, poi con la c.d. riforma Biagi del 2003 e col c.d. Jobs Act del 2015) ha dato l’avvio ad una proficua riflessione scientifica plurale, esplicatasi mediante la pubblicazione di più Commentari dello stesso provvedimento legislativo. Al riguardo, non si condivide il pensiero di chi ritenga (o abbia eventualmente ritenuto) tale genere giuridico-letterario come un prodotto connotato di per sé da scarso approfondimento e, quindi, di basso contenuto scientifico. Viceversa, sul piano dei risultati, l’analisi di molti, che trovano più agevolmente voce in questo tipo di opere, soprattutto quando caratterizzati da background differenti, contribuisce all’arricchimento del dibattito scientifico almeno quanto l’analisi di pochi, pur se navigati studiosi della materia. I Commentari, come progetti editoriali, rappresentano una preziosa occasione per far crescere i giovani studiosi, specie in un momento di scomparsa, e comunque di ridimensionamento, del tradizionale modello di Scuole. Fatta tale premessa, all’indomani della pubblicazione dei d.lgs. n. 104 e n. 105 del 2022, ai curatori del volume, diversi per estrazione accademica ed impostazioni di ricerca, ma convergenti sulla bontà di un’iniziativa aperta soprattutto ai giovani, è apparso utile promuovere una riflessione su due provvedimenti, che si ha motivo di ritenere possano incidere in modo significativo sulla disciplina del rapporto di lavoro e sulle relazioni industriali, in quanto ridisegnano taluni obblighi a “latere datoris” e taluni diritti a “latere praestatoris” alla luce dell’evoluzione dei modi di produrre e di lavorare. Emerge, infatti, una progressiva destrutturazione del tempo e del luogo, che incide per un verso sul potere organizzativo del datore di lavoro, e per altro verso sulla conciliazione dei tempi di vita e dei tempi di lavoro, il che consente di cogliere il nesso che lega i due decreti oggetto di analisi

Flexicurity e mercati transizionali del lavoro. Una nuova stagione per il diritto del mercato del lavoro?

Nel corso degli ultimi anni l’ambito di studi riconducibile all’area, ancora poco esplorata, del c.d. “diritto del mercato del lavoro” è stato oggetto di un progressivo allargamento e di una diversificazione delle metodologie e dei temi affrontati. Se nella prima fase della sua evoluzione la riflessione sulle “tutele nel mercato” si è sostanzialmente sovrapposta al paradigma europeo della flexicurity, condividendone luci ed ombre, ben presto ulteriori contributi sviluppati prevalentemente dalla letteratura economica e sociologica internazionale (dalla teoria delle capabilities a quella dei transitional labour markets) hanno aperto la strada a nuove riflessioni e prospettive anche nell’ambito della riflessione giuridica sulle trasformazioni del lavoro. Tale differenziazione e ampliamento degli orizzonti offre oggi ai giuristi del lavoro l’opportunità per un ripensamento e soprattutto per un rilancio del filone di studi ascrivibile al diritto del mercato del lavoro nella prospettiva di un rinnovamento complessivo della nostra disciplina. Obiettivo dei contributi qui raccolti è quello di approfondire come tale ambito di indagine stia evolvendo in risposta alle dirompenti trasformazioni determinate dalla transizione digitale, ecologica e demografica. Trasformazioni che impongono di allargare obiettivi e ambiti di analisi oltre quelli consegnatici dalla tradizione giuslavoristica, superando una rigida ripartizione interna tra aree di specializzazione

I.S.Mu.L.T - Rotator cuff tears guidelines

Despite the high level achieved in the field of shoulder surgery, a global consensus on rotator cuff tears management is lacking. This work is divided into two main sessions: in the first, we set questions about hot topics involved in the rotator cuff tears, from the etiopathogenesis to the surgical treatment. In the second, we answered these questions by mentioning Evidence Based Medicine. The aim of the present work is to provide easily accessible guidelines: they could be considered as recommendations for a good clinical practice developed through a process of systematic review of the literature and expert opinion, in order to improve the quality of care and rationalize the use of resources

Comparison of site sensitivity of crop models using spatially variable field data from Precision Agriculture

Site conditions and soil properties have a strong influence on impacts of climate change on crop production. Vulnerability of crop production to changing climate conditions is highly determined by the ability of the site to buffer periods of adverse climatic situations like water scarcity or excessive rainfall.  Therefore, the capability of models to reflect crop responses and water and nutrient dynamics under different site conditions is essential to assess climate impact even on a regional scale. To test and improve sensitivity of models to various site properties such as soil variability and hydrological boundary conditions, spatial variable data sets from precision farming of two fields in Germany and Italy were provided to modellers. For the German 20 ha field soil and management data for 60 grid points for 3 years (2 years wheat, 1 year triticale) were provided. For the Italian field (12 ha) information for 100 grid points were available for three growing seasons of durum wheat. Modellers were asked to run their models using a) the model specific procedure to estimate soil hydraulic properties from texture using their standard procedure and use in step b) fixed values for field capacity and wilting point derived from soil taxonomy. Only the phenology and crop yield of one grid point provided for a basic calibration. In step c) information for all grid points of the first year (yield, soil water and mineral N content for Germany, yield, biomass and LAI for Italy) were provided. First results of five out of twelve participating models are compared against measured state variables analysing their site specific response and consistency across crop and soil variables.(Main text to be published in a peer-reviewed journal

Comparison of site sensitivity of crop models using spatially variable field data from Precision Agriculture

Site conditions and soil properties have a strong influence on impacts of climate change on crop production. Vulnerability of crop production to changing climate conditions is highly determined by the ability of the site to buffer periods of adverse climatic situations like water scarcity or excessive rainfall.  Therefore, the capability of models to reflect crop responses and water and nutrient dynamics under different site conditions is essential to assess climate impact even on a regional scale. To test and improve sensitivity of models to various site properties such as soil variability and hydrological boundary conditions, spatial variable data sets from precision farming of two fields in Germany and Italy were provided to modellers. For the German 20 ha field soil and management data for 60 grid points for 3 years (2 years wheat, 1 year triticale) were provided. For the Italian field (12 ha) information for 100 grid points were available for three growing seasons of durum wheat. Modellers were asked to run their models using a) the model specific procedure to estimate soil hydraulic properties from texture using their standard procedure and use in step b) fixed values for field capacity and wilting point derived from soil taxonomy. Only the phenology and crop yield of one grid point provided for a basic calibration. In step c) information for all grid points of the first year (yield, soil water and mineral N content for Germany, yield, biomass and LAI for Italy) were provided. First results of five out of twelve participating models are compared against measured state variables analysing their site specific response and consistency across crop and soil variables.(Main text to be published in a peer-reviewed journal

Imagine a world without cancer

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.Abstract Background Since the War on Cancer was declared in 1971, the United States alone has expended some $300 billion on research, with a heavy focus on the role of genomics in anticancer therapy. Voluminous data have been collected and analyzed. However, in hindsight, any achievements made have not been realized in clinical practice in terms of overall survival or quality of life extended. This might be justified because cancer is not one disease but a conglomeration of multiple diseases, with widespread heterogeneity even within a single tumor type. Discussion Only a few types of cancer have been described that are associated with one major signaling pathway. This enabled the initial successful deployment of targeted therapy for such cancers. However, soon after this targeted approach was initiated, it was subverted as cancer cells learned and reacted to the initial treatments, oftentimes rendering the treatment less effective or even completely ineffective. During the past 30 plus years, the cancer classification used had, as its primary aim, the facilitation of communication and the exchange of information amongst those caring for cancer patients with the end goal of establishing a standardized approach for the diagnosis and treatment of cancers. This approach should be modified based on the recent research to affect a change from a service-based to an outcome-based approach. The vision of achieving long-term control and/or eradicating or curing cancer is far from being realized, but not impossible. In order to meet the challenges in getting there, any newly proposed anticancer strategy must integrate a personalized treatment outcome approach. This concept is predicated on tumor- and patient-associated variables, combined with an individualized response assessment strategy for therapy modification as suggested by the patients own results. As combined strategies may be outcome-orientated and integrate tumor-, patient- as well as cancer-preventive variables, this approach is likely to result in an optimized anticancer strategy. Summary Herein, we introduce such an anticancer strategy for all cancer patients, experts, and organizations: Imagine a World without Cancer

Sigh in patients with acute hypoxemic respiratory failure and acute respiratory distress syndrome: the PROTECTION pilot randomized clinical trial

Background: Sigh is a cyclic brief recruitment manoeuvre: previous physiological studies showed that its use could be an interesting addition to pressure support ventilation to improve lung elastance, decrease regional heterogeneity and increase release of surfactant. Research question: Is the clinical application of sigh during pressure support ventilation (PSV) feasible? Study design and methods: We conducted a multi-center non-inferiority randomized clinical trial on adult intubated patients with acute hypoxemic respiratory failure or acute respiratory distress syndrome undergoing PSV. Patients were randomized to the No Sigh group and treated by PSV alone, or to the Sigh group, treated by PSV plus sigh (increase of airway pressure to 30 cmH2Ofor 3 seconds once per minute) until day 28 or death or successful spontaneous breathing trial. The primary endpoint of the study was feasibility, assessed as non-inferiority (5% tolerance) in the proportion of patients failing assisted ventilation. Secondary outcomes included safety, physiological parameters in the first week from randomization, 28-day mortality and ventilator-free days. Results: Two-hundred fifty-eight patients (31% women; median age 65 [54-75] years) were enrolled. In the Sigh group, 23% of patients failed to remain on assisted ventilation vs. 30% in the No Sigh group (absolute difference -7%, 95%CI -18% to 4%; p=0.015 for non-inferiority). Adverse events occurred in 12% vs. 13% in Sigh vs. No Sigh (p=0.852). Oxygenation was improved while tidal volume, respiratory rate and corrected minute ventilation were lower over the first 7 days from randomization in Sigh vs. No Sigh. There was no significant difference in terms of mortality (16% vs. 21%, p=0.342) and ventilator-free days (22 [7-26] vs. 22 [3-25] days, p=0.300) for Sigh vs. No Sigh. Interpretation: Among hypoxemic intubated ICU patients, application of sigh was feasible and without increased risk

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection