L'amministrazione di sostegno come possibile surrogato del testamento biologico?

L'amministrazione di sostegno, istituto di protezione giuridica per i soggetti deboli, può essere utilizzato quale sostituto, in mancanza di legge apposita, del testamento biologico? La risposta viene cercata in questa trattazione andando ad analizzare vari casi giuridici in cui si fa uso di strumenti di protezione per sostituire la volontà del beneficiario in campo medico. Dal controverso caso Englaro si passa a una serie di decreti riguardanti l'amministrazione di sostegno per poi analizzare le opinioni della dottrina giuridica. Viene poi proposta una specifica analisi della questione della nomina preventiva in caso di futura incapacità che rappresenta il nodo più importante per avvicinare l'amministrazione di sostegno al testamento biologico. Infine ci si sofferma su un eventuale intervento normativo, ponendo un analisi sul tentativo, arenatosi nel 2011, del decreto Calabrò

A CFD-based virtual test-rig for rotating heat exchangers

Rotating heat exchangers are used in steel industry, air conditioning and thermal power plants to pre-heat air used in steam generators or for waste heat recovery. Here we focus on a rotating heat exchanger on a so-called Ljungström arrangement operated in thermal power plants to pre-heat the air fed to the steam generators. In these devices the heat exchange between two fluids is achieved through a rotating matrix that gets in contact alternatively with the two fluid streams and acts as a thermal accumulator. To increase the heat capacity and the overall exchange surface, the rotating matrix is filled by a series of folded metal sheets. In the paper we de-scribe a methodology to account for the effects of the Ljungström in a virtual test-rig implemented in a Computational Fluid Dynamics environment. To this aim, a numerical model based on the work of Molinari and Cantiano was derived and implemented in the OpenFOAM library. RANS numerical results were compared with those of a mono-dimensional tool used by ENEL to design Ljungström heat exchangers and validated against available measurements in a real configuration of a thermal power plant

Sexual Victimization Experience Predicting Empathy with an Unspecified or Date Rape Victim

The purpose of this study was to examine empathy with a rape victim in two experimental conditions (date rape; unspecified rape) based on personal sexual victimization experience (nonvictim; date victim; nondate victim). Undergraduate women (n = 212) completed the Sexual Experiences Survey (Koss, Gidycz, & Wisniewski, 1987), and one of two versions of the Rape Victim Empathy Scale (Smith & Frieze, 2003). Results showed that all victims reported greater empathy than nonvictims, and a potential interaction (p \u3c .10); date victims tended to report greater empathy with a date rape victim than an unspecified rape victim, but nondate victims tended to report greater empathy with an unspecified rape victim than a date rape victim. Similarity in experience may influence empathy

Pandemic Vibrio cholerae shuts down site-specific recombination to retain an interbacterial defence mechanism

Vibrio cholerae is an aquatic microbe that can be divided into three subtypes: harmless environmental strains, localised pathogenic strains, and pandemic strains causing global cholera outbreaks. Each type has a contact-dependent type VI secretion system (T6SS) that kills neighbouring competitors by translocating unique toxic effector proteins. Pandemic isolates possess identical effectors, indicating that T6SS effectors may affect pandemicity. Here, we show that one of the T6SS gene clusters (Aux3) exists in two states: a mobile, prophage-like element in a small subset of environmental strains, and a truncated Aux3 unique to and conserved in pandemic isolates. Environmental Aux3 can be readily excised from and integrated into the genome via site-specific recombination, whereas pandemic Aux3 recombination is reduced. Our data suggest that environmental Aux3 acquisition conferred increased competitive fitness to pre-pandemic V. cholerae, leading to grounding of the element in the chromosome and propagation throughout the pandemic clade

Tibial tuberosity derotation: a surgical procedure for realignment of the patellofemoral mechanism

We retrospectively reviewed the clinical outcomes of 22 patients (9 men and 13 women) aged 17–42 years, and affected with anterior knee pain. These patients underwent surgical derotation of the tibial tuberosity in the period between September 1992 and December 1993. We describe the details of this new surgical technique to correct a torsional abnormality that has perhaps been underestimated in the past, as a possible cause of anterior knee pain. Follow-up clinical and radiographic controls (average follow-up, 78 months; range 72–87 months) allowed us to document the efficacy of this new procedure as a treatment for anterior knee pain resistant to conservative therapy, in young patients with external hypertorsion of the proximal tibial metaphysis and without significant chondropathology

Local treatment with electrochemotherapy of superficial angiosarcomas: Efficacy and safety results from a multi-institutional retrospective study

Background: Angiosarcoma is an aggressive vascular neoplasm with a high propensity for local recurrence. Electrochemotherapy is an emerging skin-directed therapy, exerting prominent cytotoxic activity, and antivascular effects. Its efficacy in angiosarcoma has not been investigated. Methods: This multicenter retrospective analysis reviewed patients who underwent electrochemotherapy from 2007 to 2014 for superficial advanced angiosarcomas. Bleomycin was administered intravenously and delivered within tumors by means of percutaneously applied electric pulses, according to the European Standard Operating Procedures for Electrochemotherapy. Tumor assessment was performed using RECIST (version 1.1). Toxicity (CTCAE, v4.0) and local progression-free survival (LPFS) were also evaluated. Results: Nineteen patients (13 with locally advanced and 6 with metastatic angiosarcomas) were treated. Tumor sites were: scalp (n¼5), breast(n¼8), other skin sites (n¼3), and soft tissue (n¼3). Target lesions (n¼54) ranged in size from 1.5 to 2.5 cm (median, 2 cm). Treatment was well tolerated. After 2 months, an objective response was observed in 12/19 (63%) patients, complete in 8 (42%). One-year LPFS within treatment field was 68%. Local symptom improvement included palliation of bleeding (5/19 patients) and pain relief (6/19 patients). Conclusions: Electrochemotherapy may represent a new locoregional treatment for selected patients with superficial angiosarcomas

When the pandemic opts for the lockdown: Secretion system evolution in the cholera bacterium

Vibrio cholerae, the causative agent of the diarrheal disease cholera, is a microbe capable of inhabiting two different ecosystems: chitinous surfaces in brackish, estuarine waters and the epithelial lining of the human gastrointestinal tract. V. cholerae defends against competitive microorganisms with a contact-dependent, contractile killing machine called the type VI secretion system (T6SS) in each of these niches. The T6SS resembles an inverted T4 bacteriophage tail and is used to deliver toxic effector proteins into neighboring cells. Pandemic strains of V. cholerae encode a unique set of T6SS effector proteins, which may play a role in pathogenesis or pandemic spread. In our recent study (Santoriello et al. (2020), Nat Commun, doi: 10.1038/s41467-020-20012-7), using genomic and molecular biology tools, we demonstrated that the T6SS island Auxiliary Cluster 3 (Aux3) is unique to pandemic strains of V. cholerae. We went on to show that Aux3 is related to a phage-like element circulating in environmental V. cholerae strains and that two genetic domestication events formed the pandemic Aux3 cluster during the evolution of the pandemic clone. Our findings support two main conclusions: (1) Aux3 evolution from phage-like element to T6SS cluster offers a snapshot of phage domestication in early T6SS evolution and (2) chromosomal maintenance of Aux3 was advantageous to the common ancestor of V. cholerae pandemic strains