Principio di precauzione e diritto alla salute tra responsabilità del privato e della Pubblica Amministrazione

2009-2010Sempre più forte è l’esigenza, nella società attuale, di un punto di equilibrio tra il progresso, momento essenziale nella vita della comunità, e un ambiente vivibile, protetto da alterazioni. Il problema, anche quando sembra riferirsi esclusivamente alla tutela dell’ambiente – cui la riflessione giuridica moderna è particolarmente sensibile – riguarda il fondamentale diritto alla salute e interessa una molteplicità di discipline, scientifiche sociali ed economiche. Il diritto alla salute, infatti, inteso nell’accezione accolta nel Preambolo della Costituzione dell’Organizzazione Mondiale della Sanità, vale a dire non soltanto come mera assenza di malattie, bensì come stato di benessere fisio-psichico della persona, non può essere disgiunto dal diritto ad un ambiente salubre. Rispondere al quesito se il diritto debba intervenire in ambiti in cui all’elevata utilità per l’uomo si accompagna il sospetto di un rischio per la sua salute, quali il trasporto di energia elettrica, la radiotelefonia, l’immissione sul mercato di organismi geneticamente modificati, farmaci sperimentali, nanotecnologie, e così via, significa rispondere preliminarmente al quesito se – e secondo quali criteri – il diritto debba disciplinare ambiti in cui vi sia l’incertezza scientifica. La medesima Corte Costituzionale ha più volte ribadito che l’incertezza scientifica non è sufficiente per escludere provvedimenti volti alla salvaguardia della salute umana ex art. 32 Cost. Da più parti si invoca la necessità di adottare misure cautelative dinanzi a rischi di danni gravi e irreversibili all’ambiente e alla salute. L’incertezza non può giustificare l’immobilismo giuridico dinanzi ai mutamenti, soprattutto nell’ambito scientifico-tecnologico, dove la scienza contempla una pluralità di previsioni e asserzioni, in alcuni casi opposte. Emerge, così, l’ulteriore interrogativo di come il diritto possa disciplinare situazioni in cui gli effetti, soprattutto se a lungo termine, non siano prevedibili con sufficiente sicurezza. Ad esso si aggiunge il problema delle modalità con cui dare attuazione alla norma. Tali esigenze si traducono nell’elaborazione, nel diritto internazionale, prima, e in quello comunitario, poi, del principio di precauzione, che impone di assumere come esistente la situazione più pericolosa per la salute umana e di adottare misure di cautela anche qualora il rischio che si realizzi un danno grave o irreversibile all’ambiente sia meramente sospettato. [a cura dell'autore]IX n.s

Developing a new approach for machine learning explainability combining local and global model-agnostic approaches

The last couple of past decades have seen a new flourishing season for the Artificial Intelligence, in particular for Machine Learning (ML). This is reflected in the great number of fields that are employing ML solutions to overcome a broad spectrum of problems. However, most of the last employed ML models have a black-box behavior. This means that given a certain input, we are not able to understand why one of these models produced a certain output or made a certain decision. Most of the time, we are not interested in knowing what and how the model is thinking, but if we think of a model which makes extremely critical decisions or takes decisions that have a heavy result on people’s lives, in these cases explainability is a duty. A great variety of techniques to perform global or local explanations are available. One of the most widespread is Local Interpretable Model-Agnostic Explanations (LIME), which creates a local linear model in the proximity of an input to understand in which way each feature contributes to the final output. However, LIME is not immune from instability problems and sometimes to incoherent predictions. Furthermore, as a local explainability technique, LIME needs to be performed for each different input that we want to explain. In this work, we have been inspired by the LIME approach for linear models to craft a novel technique. In combination with the Model-based Recursive Partitioning (MOB), a brand-new score function to assess the quality of a partition and the usage of Sobol quasi-Montecarlo sampling, we developed a new global model-agnostic explainability technique we called Global-Lime. Global-Lime is capable of giving a global understanding of the original ML model, through an ensemble of spatially not overlapped hyperplanes, plus a local explanation for a certain output considering only the corresponding linear approximation. The idea is to train the black-box model and then supply along with it its explainable version

Engineering Transport via Collisional Noise: a Toolbox for Biology Systems

The study of noise assisted transport in quantum systems is essential in a wide range of applications from near-term NISQ devices to models for quantum biology. Here, we study a generalised XXZ model in the presence of stochastic collision noise, which allows to describe environments beyond the standard Markovian formulation. Our analysis through the study of the local magnetization, the inverse participation ratio (IPR) or its generalisation, the Inverse Ergodicity Ratio (IER), showed clear regimes where the transport rate and coherence time can be controlled by the dissipation in a consistent manner. In addition, when considering several excitations, we characterize the interplay between collisions and system interactions identifying regimes in which transport is counterintuitively enhanced when increasing the collision rate, even in the case of initially separated excitations. These results constitute an example of the essential building blocks for the understanding of quantum transport in structured noisy and warm disordered environments.Comment: 18 pages, 6 figure

C2238/αANP modulates apolipoprotein E through Egr-1/miR199a in vascular smooth muscle cells in vitro

Subjects carrying the T2238C ANP gene variant have a higher risk to suffer a stroke or myocardial infarction. The mechanisms through which T2238C/αANP exerts detrimental vascular effects need to be fully clarified. In the present work we aimed at exploring the impact of C2238/αANP (mutant form) on atherosclerosis-related pathways. As a first step, an atherosclerosis gene expression macroarray analysis was performed in vascular smooth muscle cells (VSMCs) exposed to either T2238/αANP (wild type) or C2238/αANP. The major finding was that apolipoprotein E (ApoE) gene expression was significantly downregulated by C2238/αANP and it was upregulated by T2238/αANP. We subsequently found that C2238/αANP induces ApoE downregulation through type C natriuretic peptide receptor (NPR-C)-dependent mechanisms involving the upregulation of miR199a-3p and miR199a-5p and the downregulation of DNAJA4. In fact, NPR-C knockdown rescued ApoE level. Upregulation of miR199a by NPR-C was mediated by a reactive oxygen species-dependent increase of the early growth response protein-1 (Egr-1) transcription factor. In fact, Egr-1 knockdown abolished the impact of C2238/αANP on ApoE and miR199a. Of note, downregulation of ApoE by C2238/αANP was associated with a significant increase in inflammation, apoptosis and necrosis that was completely rescued by the exogenous administration of recombinant ApoE. In conclusion, our study dissected a novel mechanism of vascular damage exerted by C2238/αANP that is mediated by ApoE downregulation. We provide the first demonstration that C2238/αANP downregulates ApoE in VSMCs through NPR-C-dependent activation of Egr-1 and the consequent upregulation of miR199a. Restoring ApoE levels could represent a potential therapeutic strategy to counteract the harmful effects of C2238/αANP

Fate of lead and other heavy metals during pyrolysis of lignocellulosic biomass

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Il benessere educativo: validazione di un questionario sul benessere a scuola

The article presents a part of the trial results of a questionnaire for the detection of Educational well-being in some middle school students in the cities of Rome and Moscow.Educational well-being is defined as a positive perception of the school environment, which includes the sense of satisfaction with what happens at school, the positive perception of the school climate, the psychological safety and reduction of discomfort factors. The research was conducted on two samples of Italian and Russian students.The article presents the psychometric properties of the questionnaire and of the results of the Italian sample of the research.L’articolo presenta una parte dei risultati della sperimentazione di un questionario per la rilevazione del Benessere educativo in alcuni studenti di scuola secondaria di primo grado delle città di Roma e di Mosca. Il benessere educativo è definito come una percezione positiva dell’ambiente scolastico, che comprende il senso di soddisfazione per quanto avviene a scuola, la percezione positiva del clima scolastico, la sicurezza psicologica e la riduzione dei fattori di disagio.La ricerca è stata condotta su due campioni di giudizio italiano e russo. Vengono presentate le proprietà psicometriche dello strumento e parte dei risultati del campione italiano della ricerca

Reduced brain UCP2 expression mediated by microRNA-503 contributes to increased stroke susceptibility in the high-salt fed stroke-prone spontaneously hypertensive rat

UCP2 maps nearby the lod score peak of STR1-stroke QTL in the SHRSP rat strain. We explored the potential contribution of UCP2 to the high-salt diet (JD)-dependent increased stroke susceptibility of SHRSP. Male SHRSP, SHRSR, two reciprocal SHRSR/SHRSP-STR1/QTL stroke congenic lines received JD for 4 weeks to detect brain UCP2 gene/protein modulation as compared with regular diet (RD). Brains were also analyzed for NF-κB protein expression, oxidative stress level and UCP2-targeted microRNAs expression level. Next, based on knowledge that fenofibrate and Brassica Oleracea (BO) stimulate UCP2 expression through PPARα activation, we monitored stroke occurrence in SHRSP receiving JD plus fenofibrate versus vehicle, JD plus BO juice versus BO juice plus PPARα inhibitor. Brain UCP2 expression was markedly reduced by JD in SHRSP and in the (SHRsr.SHRsp-(D1Rat134-Mt1pa)) congenic line, whereas NF-κB expression and oxidative stress level increased. The opposite phenomenon was observed in the SHRSR and in the (SHRsp.SHRsr-(D1Rat134-Mt1pa)) reciprocal congenic line. Interestingly, the UCP2-targeted rno-microRNA-503 was significantly upregulated in SHRSP and decreased in SHRSR upon JD, with consistent changes in the two reciprocal congenic lines. Both fenofibrate and BO significantly decreased brain microRNA-503 level, upregulated UCP2 expression and protected SHRSP from stroke occurrence. In vitro overexpression of microRNA-503 in endothelial cells suppressed UCP2 expression and led to a significant increase of cell mortality with decreased cell viability. Brain UCP2 downregulation is a determinant of increased stroke predisposition in high-salt-fed SHRSP. In this context, UCP2 can be modulated by both pharmacological and nutraceutical agents. The microRNA-503 significantly contributes to mediate brain UCP2 downregulation in JD-fed SHRSP

Beneficial Effects of Citrus Bergamia Polyphenolic Fraction on Saline Load-Induced Injury in Primary Cerebral Endothelial Cells from the Stroke-Prone Spontaneously Hypertensive Rat Model

High salt load is a known noxious stimulus for vascular cells and a risk factor for cardiovascular diseases in both animal models and humans. The stroke-prone spontaneously hypertensive rat (SHRSP) accelerates stroke predisposition upon high-salt dietary feeding. We previously demonstrated that high salt load causes severe injury in primary cerebral endothelial cells isolated from SHRSP. This cellular model offers a unique opportunity to test the impact of substances toward the mechanisms underlying high-salt-induced vascular damage. We tested the effects of a bergamot polyphenolic fraction (BPF) on high-salt-induced injury in SHRSP cerebral endothelial cells. Cells were exposed to 20 mM NaCl for 72 h either in the absence or the presence of BPF. As a result, we confirmed that high salt load increased cellular ROS level, reduced viability, impaired angiogenesis, and caused mitochondrial dysfunction with a significant increase in mitochondrial oxidative stress. The addition of BPF reduced oxidative stress, rescued cell viability and angiogenesis, and recovered mitochondrial function with a significant decrease in mitochondrial oxidative stress. In conclusion, BPF counteracts the key molecular mechanisms underlying high-salt-induced endothelial cell damage. This natural antioxidant substance may represent a valuable adjuvant to treat vascular disorders

Functional Role of Natriuretic Peptides in Risk Assessment and Prognosis of Patients with Mitral Regurgitation

The management of mitral valve regurgitation (MR), a common valve disease, represents a challenge in clinical practice, since the indication for either surgical or percutaneous valve replacement or repair are guided by symptoms and by echocardiographic parameters which are not always feasible. In this complex scenario, the use of natriuretic peptide (NP) levels would serve as an additive diagnostic and prognostic tool. These biomarkers contribute to monitoring the progression of the valve disease, even before the development of hemodynamic consequences in a preclinical stage of myocardial damage. They may contribute to more accurate risk stratification by identifying patients who are more likely to experience death from cardiovascular causes, heart failure, and cardiac hospitalizations, thus requiring surgical management rather than a conservative approach. This article provides a comprehensive overview of the available evidence on the role of NPs in the management, risk evaluation, and prognostic assessment of patients with MR both before and after surgical or percutaneous valve repair. Despite largely positive evidence, a series of controversial findings exist on this relevant topic. Recent clinical trials failed to assess the role of NPs following the interventional procedure. Future larger studies are required to enable the introduction of NP levels into the guidelines for the management of MR

Cardiovascular disease risk in liver transplant recipients transplanted due to chronic viral hepatitis

Background: Cardiovascular disease (CVD) is a major cause of morbidity and mortality after liver transplantation, mostly in patients transplanted for nonalcoholic steatohepatitis, obesity and diabetes. Few data exist on cardiovascular diseases among patients transplanted for viral hepatitis. Objective: Our aim is to clarify the cardiovascular risk and subclinical vascular damage among liver transplant recipients for chronic viral hepatitis (i.e. hepatits C virus, hepatis B virus and hepatitis D virus infection). Methods: Adult patients (age ≥ 18 years) with orthotopic liver transplants (OLT) due to viral hepatitis who signed informed consent, and were admitted for a routine follow-up between June 2019 and September 2020 at the Infectious Disease outpatient clinic of the University of Campania Luigi Vanvitelli, Naples, Italy, were prospectively enrolled. An estimation of cardiovascular risk was assessed using three main risk charts, echocolor-Doppler of epiaortic vessels was performed to assess subclinical Intima-Media changes. Results: A total of 161 patients were evaluated; of these 15 were excluded because not affected by viral hepatitis. 146 patients were considered. 83 patients (56.8%) were considered at high cardiovascular risk according to Framingham, 54 patients (36.9%) to American Heart Association Arteriosclerotic Cardiovascular Disease (ASCVD) score and 19 (13.0%) to Heart Score. Only 8 patients (5.4%) showed a normal carotid ultrasound, while 52 patients (35.6%) had a carotid artery Intima-Media Thickness (IMT) and 86 (58.9%) an atherosclerotic plaque. Conclusions: Liver transplant recipients for virus-related associated liver disease are, in light of the high percentage of carotid lesions, at high risk of CVD. Risk charts compared to subclinical carotid lesions which represent damage already established and a real localization of the disease, seem to underestimate the cardiovascular risk. A chronic inflammatory status, could play a key role. It's important to raise the awareness of cardiovascular risk in liver transplant patients to prevent cardiovascular diseases and improve the timing of early diagnosis of premature vascular lesions