LA COOPERAZIONE MANCATA: SOPRAVVENUTA IMPOSSIBILITA' DELLA PRESTAZIONE E IMPUTABILITA' DELL'INADEMPIMENTO

Una ricostruzione dei temi dell’inadempimento e della responsabilità contrattuale che muove dal pensiero di Emilio Betti e che pone in evidenza l’attualità del suo insegnamento a cinquant’anni dalla scomparsa. Dal ruolo assunto dalle nozioni di buona fede e di correttezza nella configurazione della fattispecie dell’inadempimento, alla funzione degli obblighi di protezione, alla critica dell’“apparente antinomia” tra gli artt. 1218 e 1176 c.c. e del concetto di impossibilità soggettiva, all’individuazione dei limiti della diligenza nell’adempimento nei diversi tipi di cooperazione dovuta, alla “relativizzazione” della nozione di impossibilità oggettiva sulla base del concreto rapporto obbligatorio e della sua fonte. Le critiche mosse da Giuseppe Osti nel 1954 appaiono il frutto di una incomprensione del pensiero bettiano, che invece è volto a contestare con decisione il principio della colpa ed a teorizzare un modello oggettivo di imputazione nel campo della responsabilità da inadempimento. Da qui l’individuazione di molteplici elementi di convergenza nel pensiero di Betti, Osti e Mengoni, che poi saranno oggetto di ricezione da parte della migliore giurisprudenza delle Sezioni Unite. Il superamento della partizione tra obbligazioni “di mezzi” e “di risultato” induce a prospettare una disciplina unitaria dell’inadempimento che consente di applicare i principi di “vicinanza della prova” e di “presunzione della persistenza del diritto” anche in tema di adempimento inesatto. La ricostruzione dell’inadempimento sulla base del pensiero di questi esimi Autori permette di contestare un recente orientamento della Terza Sezione della Cassazione che, ponendosi in evidente contrasto con i dicta di due fondamentali decisioni delle SS.UU. (n. 13533 del 2001; n. 577 del 2008) e operando un’indebita confusione tra la struttura e la disciplina delle responsabilità contrattuale e delittuale (art. 2043 c.c.), tra inadempimento e colpa, tra causalità “giuridica” e “materiale”, accolla al creditore il rischio della causa ignota anche in tema di responsabilità contrattuale. Tale indirizzo rappresenta un regresso rispetto alla stessa giurisprudenza sulle prestazioni c.d. routinarie e, oltre a violare l’art. 1218 c.c., disattende la riforma della responsabilità sanitaria (l. n. 24 del 2017) la quale ha inteso collocare in ambito extracontrattuale la sola responsabilità dell’ausiliare del debitore, ma in ambito contrattuale la responsabilità della struttura sanitaria pubblica o privata, concedendo anzi al creditore danneggiato un’azione diretta nei riguardi dell’assicuratore del debitore

Networks as mediating variables: a Bayesian latent space approach

The use of network analysis to investigate social structures has recently seen a rise due to the high availability of data and the numerous insights it can provide into different fields. Most analyses focus on the topological characteristics of networks and the estimation of relationships between the nodes. We adopt a different perspective by considering the whole network as a random variable conveying the effect of an exposure on a response. This point of view represents a classical mediation setting, where the interest lies in estimating the indirect effect, that is, the effect propagated through the mediating variable. We introduce a latent space model mapping the network into a space of smaller dimension by considering the hidden positions of the units in the network. The coordinates of each node are used as mediators in the relationship between the exposure and the response. We further extend mediation analysis in the latent space framework by using Generalised Linear Models instead of linear ones, as previously done in the literature, adopting an approach based on derivatives to obtain the effects of interest. A Bayesian approach allows us to get the entire distribution of the indirect effect, generally unknown, and compute the corresponding highest density interval, which gives accurate and interpretable bounds for the mediated effect. Finally, an application to social interactions among a group of adolescents and their attitude toward substance use is presented

Effect of pre-weaning solid feed and milk intake on caecal content characteristics and performance of rabbits around weaning

The aim of this study is to know the effect of different solid feed and milk intake during suckling on performance around weaning and on caecal content characteristics at weaning. In order to obtain different intakes of milk and solid feed, 13 litters of pregnant females (PF) inseminated the day after delivery and 14 litters of non-pregnant females (NPF) were compared. At birth the litters were equalized at eight pups and during lactation dead pups were replaced by pups of the same age from nursing does. Compared to the PF group, rabbits in the NPF group had a higher milk intake (26.0 versus 21.4 g/day; P < 0.01) and lower solid feed intake (9.1 versus 11.5 g/day; P < 0.01) between 20 and 28 days of age. No significant difference was observed between the two groups in weight gain before and post-weaning (28-49 days). At weaning, the rabbits in group PF showed higher values in caecal content (g 26.3 versus 22.6; P < 0.05) and volatile fatty acids (mmol/l 52.2 versus 43.6; P < 0.01) and lower values in empty caecal weight (g 7.18 versus 7.78; P < 0.05), C3 (6.4 versus 9.3%; P < 0.01) and C3/C4 ratio (0.39 versus 0.63; P < 0.01) than the group NPF. On the basis of the above results, it may be concluded that the quantity of solid feed and milk intake before weaning influenced the charac- teristics of the caecal content, but not the performance of rabbits around weaning

Feed intake, milk composition and cheese-making properties in Girgentana grazing goats with different genotype at as1-casein and k-casein

Milk ability for cheese manufacturing depends on both animals utilization of dietary nutrients and genetic polymorphism of caseins. It is well known that strong alleles associated with high content of as1-casein increase cheese-making properties of goat milk, whereas there is little information about effect of genetic variants of κ-casein. The aim of this experiment was to investigate the effect of some composite as1-casein and κ-casein genotypes n changing feeding behavior at pasture and milk yield and properties of Girgentana goats. Forty goats were genotyped at as1, as2, b and κ-casein loci using specific PCR protocols at DNA level and IEF technique at milk protein level. Twelve goats, differing only for as1-casein and κ-casein genotype and averaging 136±5 days in milk and 38±6 kg of live weight, were selected and divided equally into 3 groups according to their genotypes: WA, with weak alleles (FF) for as1-casein and AIEF for κ-casein; SA, with strong alleles (AA) for s1-casein and AIEF for κ-casein; SB, with strong alleles (AA) for as1-casein and BIEF for κ-casein. No goats with weak alleles for as1-casein and BIEF for κ-casein were found. Over a 5 weeks period in spring, goats were allowed to graze daily an Italian ryegrass and berseem clover mixture, and supplied with 500g/d of barley. Measurements, sampling and analyses of individual milk and forage selected by goats were performed weekly. Forage intake of goats at pasture was assessed by n-alkane technique. Data were analysed by MIXED procedure of SAS 9.1.3, using a model with genotype as fixed effect and goat as random effect. The genotype did not influence the goats intake of DM (1180,1137, 1250 g/d DM for WA, SA, SB), net energy, crude protein and NDF, and milk yield (994, 1104, 1130 g/d for WA, SA, SD). Milk casein increased passing from WA to SA and SB genotypes (2.66, 2.93, 3.33%; P<0.01), similarly to casein/fat ratio (0.66, 0.74, 0.79%; P<0.05). the genotype associated with high as1-casein was responsible of a reduction in whey protein (0.71, 0.49, 0.55% for WA, SA, SB; P<0.01) and an increase in the casein N/NT ratio (71, 79, 80 for WA, SA, SB; P<0.001). The values of casein N/N intake ratio (109, 143, 158 g/kg for WA, SA, SB; P<0.001) indicate an effect of strong alleles of as1-casein in improving the efficiency of dietary N utilization for milk casein synthesis. Milk from WA genotype showed higher pH (6.70, 6.63, 6.58; P<0.05) and lower titratable acidity (3.15, 3.55, 3.76 °SH/50ml; P<0.05) than SB milk, with intermediate values for SA genotype. Clotting time (r) (10.7, 10.5, 9.3 min for WA, SA, SB; P<0.05) and curd firming time (k20) (1.56, 1.56, 1.24 min for WA, SA, SB; P<0.001) were lower in milk from goats with BIEF for κ-casein than in milk from goats with AIEF, regardless of as1-casein alleles. Curd firmness (a30) was improved by strong alleles than weak alleles of as1-casein, and more by BIEF than AIEF for κ-casein (41.8, 51.1, 59.8 mm for WA, SA, SB; P<0.001). These first results suggest that the strong alleles of as1-casein could act at metabolic level by increasing the efficiency of dietary nitrogen utilization and, consequently, the milk casein synthesis, and evidence the additional role of BIEF alleles of κ-casein in increasing casein content and improving coagulation properties of goats milk, but require further investigation to be confirmed

The combination of laser-assisted surgery with PRP for the treatment of BRONJ in cancer patient. A pilot study

Aim. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a well-known potential complication of bisphosphonates (BPs) therapy and its treatment could reckon on different approaches. Recently, encouraging results for BRONJ were showed from some clinical studies using Er, Cr: YSGG laser-assisted surgery. Platelet-Rich Plasma (PRP), a new approach to promote tissue regeneration and healing, may be a promising complementary therapy. The aim of this pilot study is to study the effectiveness, in terms of clinical healing, of a combined treatment (laserassisted surgery and topical PRP) for BRONJ in a group of cancer patients. Methods. Ten oncological patients (3 males, 7 females; aged 69-89 years, mean age 76.2±5.8) with BRONJ were consecutively recruited. BRONJ was classified (T0) according to. All patients underwent pre- and peri-operatory antibiotic prophylaxis, and preparation of autologous PRP; the following combined surgical protocol was applied: i) exposure of the surgical area, through the creation of surgical edges; ii) courettage of the necrotic bone and, if present, sequestrectomy, by using a Er, Cr: YSGG laser; iii) application of autologous PRP over the entire bone cavity; iiii) suture of surgical flaps. All patients performed a CT after 3 months from surgery (T1) in order to re-stage of the disease. Successful treatments were considered the complete healing and the radiological improvement (transition from a higher stage to a lower one). Results. At T0 6/10 patients were stage IB, 2/10 were stage IIA and 2/10 were stage IIB. At T1, 3/10 (30%) cases (2 cases IB and 1 case IIB) showed no clinical and radiological signs of BRONJ relapse; 5/10 (50%) cases (4 cases IB and 1 case IIB) showed clinical improvement, whereas 2/10 (20%) (both IIA) showed no-improvement. Conclusion. The association of laser-assisted surgery and topical PRP, firstly investigated in this study, seems useful in BRONJ healing among cancer patients. Further investigation is necessary in order to validate these preliminary result

Conservative Surgical Treatment of Bisphosphonate-Related Osteonecrosis of the Jaw with Er,Cr:YSGG Laser and Platelet-Rich Plasma: A Longitudinal Study

Abstract Introduction: The management of bisphosphonate-related osteonecrosis of the jaw (BRONJ), with no evidence-based guidelines, remains controversial. We aimed to evaluate the efficiency of a conservative surgical treatment combining Er,Cr:YSGG laser and platelet-rich plasma (PRP) for the treatment of BRONJ in cancer patients.Methods:We performed a longitudinal cohort study. Inclusion criteria were (1) age 65 18 years; (2) cancer diagnosis; (3) treatment with NBP because of the underlying cancer. Results:We consecutively recruited ten patients diagnosed with BRONJ in stage I or II. These patients underwent a surgical laser-assisted therapy together with autologous PRP. At the latest follow-up at 12 months, clinical improvement was observed in eight patients. Registration Number is IRCT20180329039159N1. Conclusion:We could successfully manage the BRONJ utilizing this combined protocol to heal the 30% of surgically treated sites and to improve the 50% of patients' lesions clinically. Our findings suggest that a surgical approach combined with Er,Cr:YSGG laser and PRP benefit cancer patients with general health issues

Relationships between dietary factors and milk urea nitrogen level in goats grazing herbaceous pasture

This investigation aimed to individuate the dietary factors affecting the milk urea nitrogen (MUN) concentration in goats grazing herbaceous pasture and, particularly, to verify the relationship linking the diet crude protein (CP) content to MUN. A total of 205 individual observations regarding dietary and milk variables of 37 Girgentana goats involved in two experiments were used. Goats, averaging 154±14 days in milk and 38.1±5.4 kg of live weight, grazed on swards and received 500 g/d of barley meal. Sward biomass, herbage selected by goats and individual milk yield were measured and sampled weekly. The herbage intake and diet digestibility were estimated by the n-alkane method. Milk urea content was determined by an enzymatic method and transformed in MUN (MUN=urea*0.4665). The MUN concentration (9.7-35.4 mg/dl) was positively correlated with diet CP content (13.7-26.0% of dry matter (DM); r=0.76; P<0.001), pasture allowance (39-151 kg DM/goat; r=0.42; P<0.001), diet net energy for lactation concentration (NEL) (1.5-1.9 Mcal/kg DM; r=0.37; P<0.001) and milk yield (320- 2250 g/d; r=0.25; P<0.001), and negatively related with NDF (18.7-37.4% DM; r=-0.69; P<0.001) and diet digestibility (72.6-92.5%; r=-0.33; P< 0.001). The stepwise selection from dietary variables and milk yield showed dietary CP percentage to be the single variable explaining the most variation in MUN (R2=0.56; P< 0.0001). The other variables entering into the model were diet NDF, 3.5% fat-corrected milk (FCM), DM intake and NDF intake (total R2=0.66). Including the CP/NEL and CP/NDF ratios of diet in the stepwise regression model, the CP/NDF ratio alone explained 60.1% of MUN variability, followed by barley proportion in the diet, FCM and diet CP concentration, absorbing an extra 4.6% of MUN variability. A linear regression, fitting mean feeding treatment per time data of MUN and dietary CP concentration (n=28)[CP(% of DM)=6.91±1.42+0.61±0.06*MUN (mg/dl); R²=0.79; P<0.0001], suggests that MUN could be used for predicting the CP content of the diet, as a tool for developing feeding strategies aimed at balancing the rations of grazing goats through adequate supplementation. Further data from experiments on grazing goats in different environmental conditions are required in order to define a more robust relationship by which to predict the dietary CP content by MUN

Effects of diet on casein and fatty acid profiles of milk from goats differing in genotype for αS1-casein synthesis

This study investigated the interactions between nutrition and the genotype at αS1-CN loci (CSN1S1) in goats, evaluating the impact of fresh forage-based diets and an energy supplement on the casein and fatty acid (FA) profiles of milk from Girgentana goats. Twelve goats were selected for having the same genotype at the αS2-CN, β- CN, and κ-CN loci and differing in the CSN1S1 genotype: homozygous for strong alleles (AA) or heterozygous for strong and weak alleles (AF). Goats of each genotype were divided into three groups and, according to a 3 × 3 Latin square design, fed ad libitum three diets: sulla fresh forage (SFF), SFF plus 800 g/day of barley (SFB), and mixed hay plus 800 g/day of barley (MHB). The SFB diet led to higher-energy intake and milk yield. The energy-supplemented diets (SFB, MHB) reduced milk fat and urea and increased coagulation time. The fresh forage diets (SFF, SFB) increased dry matter (DM) and crude protein (CP) intake and milk β-CN. Diet had a more pronounced effect than CSN1S1 genotype on milk FA profile, which was healthier from goats fed the SFF diet, due to the higher content of rumenic acid, polyunsaturated, and omega-3 FAs. The AA milk had longer coagulation time and higher curd firmness, higher short- and medium-chain FAs (SMFA), and lower oleic acid than AF milk. Significant diet by genotype interactions indicated the higher milk yield of AA goats than AF goats with the higher-energy SFB diet and the lower synthesis of SMFA in AF than in AA goats with the SFF diet