ASPETTI GIURIDICI E MEDICO-LEGALI NELLA VALUTAZIONE DELL'IMPATTO SULLA SALUTE DEL LAVORO A TURNI E NOTTURNO

Epidemiological and clinical studies point out shiftwork as a risk factor for human health and well being, starting from a disruption of biological circadian rhythms. This thesis aims to critically review the current knowledge about shiftwork and cardiovascular desease from epidemiological evidence to causal pathways. It is also focused on european and italian working-time legislation and on medico-legal aspects involved in litigations

Algal biomass and macroinvertebrate dynamics in intermittent braided rivers: new perspectives from instream pools

Perennial streams and rivers are now largely subjected to fragmentation and lentification processes due to flow reduction, which creates a number of lateral habitats with different degrees of hydrological connectivity. These habitats have environmental conditions and biotic interactions that can be far divergent than those of main channel habitats. However, they remain largely unexplored, especially in temperate regions. We here focused on studying algal dynamics and their interactions with aquatic invertebrates across mesohabitats (i.e., main channel, secondary channel, pools) in streambeds under both normal and low flow conditions. We selected four watercourses in the Po Plain (northern Italy), where we detected the main dynamics and drivers of algal and invertebrate communities by applying mixed effect modelling. A clear algal growth trend was detected in summer, and was similar for all mesohabitats, but with temporal decoupling and doubled values in pools. Mesohabitat and time were central factors in driving benthic algae dynamics that, in turn, negatively affected aquatic invertebrates. Hydrology and algae seemed to have a mutually reinforcing effect on macroinvertebrates by reducing almost all the investigated metrics. By considering future projections on further regime shifts in lotic systems, loss of biodiversity driven by algal blooms could become a major concern, and also for potential cascade impacts on other biotic compartments of river networks

LFR safety approach and main ELFR safety analysis results

This paper summarizes the approach to safety for the LFR systems, developed on the basis of the recommendations of the Generation IV International Forum (GIF) Risk and Safety Working Group (RSWG) and taking into account the fundamental safety objectives and the Defence-in-Depth approach, as described by IAEA Safety Guides, as well as the Safety quantitative objectives reported in the European Utilities Requirements (EUR). LEADER project activities are focused on the resolution of the key issues as they emerged from the 6th FP ELSY project attempting to reach a new industrial size European Lead-cooled Fast Reactor (ELFR) configuration. Apart from the safety approach, the main results of the ELFR safety transient analysis, where the most important design basis condition (DBC) and design extension condition (DEC) transient initiators were re-analyzed using the system codes RELAP5 (ENEA), TRACE-FRED (PSI), SIM-LFR (KIT) and SIMMER (CIRTEN), are summarized

Identification and categorisation of safety issues for ESNII reactor concepts. Part I: Common phenomena related to materials

International audience; With the aim to develop a joint proposal for a harmonised European methodology for safety assessment of advanced reactors with fast neutron spectrum, SARGEN-IV (Safety Assessment for Reactors of Gen IV) Euratom coordination action project gathered together twenty-two partners' safety experts from twelve EU Member States. The group consisted of eight European Technical Safety Organisations involved in the European Technical Safety Organisation Network (ETSON), European Commission's Joint Research Centre (JRC), system designers, industrial vendors as well as research and development (RandD) organisations. To support the methodology development, key safety features of four fast neutron spectrum reactor concepts considered in Deployment Strategy of the Sustainable Nuclear Energy Technology Platform (SNETP) were reviewed. In particular, outcomes from running European Sustainable Nuclear Industrial Initiative (ESNII) system projects and related Euratom collaborative projects for Sodium-cooled Fast Reactors, Lead-cooled Fast Reactors, Gas-cooled Fast Reactors, and the lead-bismuth eutectic cooled Fast Spectrum Transmutation Experimental Facility were gathered and critically assessed. To allow a consistent build-up of safety architecture for the ESNII reactor concepts, the safety issues were further categorised to identify common phenomena related to materials. Outcomes of the present work also provided guidance for the identification and prioritisation of further RandD needs respective to the identified safety issues. © 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-NDlicense

Ventilatory associated barotrauma in COVID-19 patients: A multicenter observational case control study (COVI-MIX-study)

Background: The risk of barotrauma associated with different types of ventilatory support is unclear in COVID-19 patients. The primary aim of this study was to evaluate the effect of the different respiratory support strategies on barotrauma occurrence; we also sought to determine the frequency of barotrauma and the clinical characteristics of the patients who experienced this complication. Methods: This multicentre retrospective case-control study from 1 March 2020 to 28 February 2021 included COVID-19 patients who experienced barotrauma during hospital stay. They were matched with controls in a 1:1 ratio for the same admission period in the same ward of treatment. Univariable and multivariable logistic regression (OR) were performed to explore which factors were associated with barotrauma and in-hospital death. Results: We included 200 cases and 200 controls. Invasive mechanical ventilation was used in 39.3% of patients in the barotrauma group, and in 20.1% of controls (p<0.001). Receiving non-invasive ventilation (C-PAP/PSV) instead of conventional oxygen therapy (COT) increased the risk of barotrauma (OR 5.04, 95% CI 2.30 - 11.08, p<0.001), similarly for invasive mechanical ventilation (OR 6.24, 95% CI 2.86-13.60, p<0.001). High Flow Nasal Oxygen (HFNO), compared with COT, did not significantly increase the risk of barotrauma. Barotrauma frequency occurred in 1.00% [95% CI 0.88-1.16] of patients; these were older (p=0.022) and more frequently immunosuppressed (p=0.013). Barotrauma was shown to be an independent risk for death (OR 5.32, 95% CI 2.82-10.03, p<0.001). Conclusions: C-PAP/PSV compared with COT or HFNO increased the risk of barotrauma; otherwise HFNO did not. Barotrauma was recorded in 1.00% of patients, affecting mainly patients with more severe COVID-19 disease. Barotrauma was independently associated with mortality. Trial registration: this case-control study was prospectively registered in clinicaltrial.gov as NCT04897152 (on 21 May 2021)

L'autopsia in tema di eventi avversi in radiologia interventistica : il punto di vista medico-legale

La recente amplificazione dell'approccio radiologico-interventistico a fini diagnostici e terapeutici, \ue8 interessante stimolo di riflessione medico-legale. Gli Autori, dopo un preliminare inquadramento della materia inerente la principali applicazioni e complicanze, si soffermano sulle procedure irrinunciabili per una completa indagine autoptica

Forensic aspects of laparoscopic surgery

There has been a substantial increase in the use of laparoscopic surgery over the years as a result of the proven advantages it offers in terms of reduced hospital stay, reduced costs, and better esthetic results compared to traditional surgery. As regards the issue of professional liability, this kind of procedure calls for analysis of major aspects such as indications, the obtaining of informed consent, execution, and postoperative course

Reliability assessment of passive safety systems for nuclear energy applications: State‐of‐the‐art and open issues

Passive systems are fundamental for the safe development of Nuclear Power Plant (NPP) technology. The accurate assessment of their reliability is crucial for their use in the nuclear industry. In this paper, we present a review of the approaches and procedures for the reliability assessment of passive systems. We complete the work by discussing the pending open issues, in particular with respect to the need of novel sensitivity analysis methods, the role of empirical modelling and the integration of passive safety systems assessment in the (static/dynamic) Probabilistic Safety Assessment (PSA) framework

L&#8217;infanticidio a Milano tra 1862 e 1930 : analisi di 65 dispositivi di sentenza

Gli Autori affrontano il tema del reato di infanticidio nel periodo storico compreso tra l\u2019unit\ue0 d\u2019Italia e l\u2019emanazione del Codice Rocco (1930), con particolare riferimento al territorio milanese. Introdotta l\u2019evoluzione della normativa vigente in Italia dopo il 1861 e riportate le statistiche giudiziarie nazionali circa il reato di infanticidio tra XIX e XX secolo, si procede con l\u2019analisi dettagliata di 65 dispositivi di sentenza della Corte d\u2019Assise di Milano e di Busto Arsizio conservati presso l\u2019Archivio di Stato di Milano in volumi suddivisi per anno, i quali sono stati fotografati e quindi studiati direttamente dal supporto digitale. Dai dati ricavati, si traccia quindi un quadro della situazione milanese caratterizzando l\u2019infanticidio e ponendo particolare attenzione all\u2019autore del reato, alla distribuzione nel territorio, alla modalit\ue0 lesiva impiegata, alle pene comminateAuthors study infanticide during the age between the unification of Italy and the issue of Codice Rocco (1930), in particular around Milan. They introduce the evolution of Italian laws after 1861 and quote national legal statistics about infanticide between XIX and XX century; they particularly analyze 65 executive judgements pronounced by Corte d\u2019Assise in Milan and Busto Arsizio that are kept in Archivio di Stato in Milan in volumes divided into years, and that were photographed and studied on digital images. From data, authors drawn the situation in Milan characterizing infanticide and pointing on the author of the crime, the distribution in the country, the kind of injuries, the length of punishments