La regolamentazione finanziaria nel contesto globale: nuovi obiettivi e futuro modello

La crisi finanziaria internazionale ha fatto emergere la necessità di regolare e monitorare i rischi finanziari a livello macro. Da ciò deriva l’adozione, dopo la crisi, di un nuovo approccio regolativo che assume come obiettivo chiave della regolamentazione e della supervisione delle istituzioni e dei mercati finanziari la tradizionale stabilità finanziaria, intesa però nella rinnovata e più ampia prospettiva di “stabilità sistemica”. In questa nuova ottica, il modello di regolamentazione finanziaria che presumibilmente si delineerà su scala mondiale al fine di migliorare la governance dei mercati finanziari integrati e, dunque, la “resilienza” di questi ultimi nei confronti di crisi finanziarie future sarà quello in grado di trovare un giusto e soprattutto fattibile equilibrio tra regolamentazione nazionale e regolamentazione internazionale

Sostenibilità e innovazione: come la regolamentazione sulla finanza sostenibile può supportare la crescita dell'economia contemporanea

Per uscire dalla recessione e favorire una crescita “smart” (trainata dall’innovazione, di lungo periodo), inclusiva (con meno disuguaglianza) e sostenibile (da un punto di vista ambientale e sociale), occorre incrementare lo sforzo dei sistemi finanziari nell’investimento in progetti industriali innovativi a contenuto tecnologico. La natura di “beni intangibili” di tali progetti, tuttavia, ostacola l’apporto di risorse finanziarie per la loro realizzazione, con conseguente impatto negativo sulla crescita della produttività. Si pone, pertanto, la necessità di indurre e/o incentivare il mondo della finanza a sostenere il mondo delle idee, ergo dell’innovazione; cosa che implica uno sforzo e un’azione congiunta, collaborativa e convergente dello Stato, degli operatori del mercato e delle Autorità di regolazione e vigilanza. In tale prospettiva, nel presente contributo dapprima si evidenziano i fattori che ostacolano gli investimenti in settori ad elevata intensità di intangibili e le misure di policy che potrebbero essere adottate per rimuovere tali ostacoli ed incentivare l’apporto di risorse finanziarie all’innovazione. Successivamente, l’indagine si concentra sulla governance dei finanziamenti, pubblici o privati, destinati agli intangibili. Ed è qui che entra in gioco il principio di sostenibilità, come declinato nella regolamentazione in materia di finanza sostenibile, nel ruolo di possibile parametro di riferimento per lo sviluppo di modelli di governance diretti ad indirizzare, gestire e controllare tali finanziamenti in modo efficace ed efficiente; là dove l’efficacia e l’efficienza si misura in termini sia di idoneità a prevenire ed evitare le distorsioni nell’uso delle risorse erogate e a superare i problemi di azzardo morale derivanti dalla presenza di garanzie statali, sia di adeguatezza ad orientare i processi decisionali degli investitori/operatori pubblici e privanti e a monitorare la concreta realizzazione dei progetti innovativi finanziati. In order to emerge from the recession and foster a smart (innovation-driven, long-term), inclusive (with less inequality) and sustainable (both environmentally and socially) growth, the effort of financial systems in investing in innovative industrial projects with technological content must be boosted. The “intangible” nature of such projects, however, hampers the provision of financial resources for their realisation, which has a negative impact on productivity growth. The need therefore arises to induce and/or incentivise the world of finance to support the world of ideas and innovation, which implies a joint, collaborative, and convergent effort and action by the state, market operators and regulatory and supervisory authorities. With this in mind, this paper first highlights the factors hindering investment in intangible-intensive sectors and the policy measures that could be adopted to remove these obstacles and to stimulate the provision of financial resources to innovation. Next, the investigation focuses on the governance of funding, public or private, for intangibles. And this is where the principle of sustainability, as declined in the regulation on sustainable finance, comes into play in the role of a possible benchmark for the development of governance models aimed at directing, managing and controlling such funding effectively and efficiently, where efficiency and effectiveness are measured in terms of both suitability to prevent and avoid distortions in the use of the resources provided and to overcome moral hazard problems arising from the presence of state guarantees, and suitability to guide the decision-making processes of public and private investors/operators and to monitor the actual implementation of the innovative projects financed

L'enforcement della disciplina in materia di tutela del contraente debole nei mercati finanziari

Il contributo riproduce la relazione introduttiva al seminario su «Risoluzione Stragiudiziale delle Controversie in ambito bancario e finanziario» (Siena, 12 aprile 2019). Preso atto della specificità che la figura del “consumatore” assume in campo finanziario in termini di ampiezza e varietà e della copiosità delle regole settoriali poste a tutela del medesimo, viene sottolineata la problematicità della loro applicazione concreta e posta in forma interlocutoria la questione della effettività ed efficacia del modello di enforcement a tal fine adottato dal legislatore europeo

Con la MiFID II nuovi obblighi informativi per l'intermediario a tutela dell'investitore

La riforma del framework regolamentare a tutela dell’investitore in strumenti finanziari realizzata a livello europeo (nel c.d. pacchetto MiFID) è intervenuta tra l’altro sulla disciplina della valutazione di adeguatezza degli investimenti finanziari e dei connessi obblighi di informativa alla clientela, imponendo requisiti di contenuto e di forma più rigorosi rispetto al passato. Ciò non potrà non avere conseguenze significative sulla direzione che prenderanno le future decisioni della giurisprudenza civile e delle procedure di risoluzione alternative (i.e. Arbitro per le Controversie Finanziarie) finalizzate ad assicurare l’enforcement della nuova disciplina, ergo la protezione in concreto dell’investitore

3D Microfluidic model for evaluating immunotherapy efficacy by tracking dendritic cell behaviour toward tumor cells

Immunotherapy efficacy relies on the crosstalk within the tumor microenvironment between cancer and dendritic cells (DCs) resulting in the induction of a potent and effective antitumor response. DCs have the specific role of recognizing cancer cells, taking up tumor antigens (Ags) and then migrating to lymph nodes for Ag (cross)-presentation to naïve T cells. Interferon-α-conditioned DCs (IFN-DCs) exhibit marked phagocytic activity and the special ability of inducing Ag-specific T-cell response. Here, we have developed a novel microfluidic platform recreating tightly interconnected cancer and immune systems with specific 3D environmental properties, for tracking human DC behaviour toward tumor cells. By combining our microfluidic platform with advanced microscopy and a revised cell tracking analysis algorithm, it was possible to evaluate the guided efficient motion of IFN-DCs toward drug-treated cancer cells and the succeeding phagocytosis events. Overall, this platform allowed the dissection of IFN-DC-cancer cell interactions within 3D tumor spaces, with the discovery of major underlying factors such as CXCR4 involvement and underscored its potential as an innovative tool to assess the efficacy of immunotherapeutic approaches

Percutaneous Edge-to-Edge Mitral Valve Repair with the Mitraclip System in Barlow's Disease

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APPLICATION OF A FLOW CHART TO EVALUATE PLACEMENT OF UMBILICAL VENOUS CATHETERS ON FRONTAL RADIOGRAM IN RADIOLOGIST RESIDENT

We tried in young resident radiologist the impact of a simplified flow-chart for evaluating umbilical venous catheters (UVC) placement

Effect of initial levothyroxine dose on neurodevelopmental and growth outcomes in children with congenital hypothyroidism

We designed a multicentre open prospective randomized trial to evaluate the risk-benefit profile of two different initial treatment schemes with levothyroxine (L-T4), 10-12.5 μg/kg/day vs 12.6-15 μg/kg/day, on growth and neurodevelopmental outcomes in children with congenital hypothyroidism (CH) detected by neonatal screening to identify the best range dose to achieve optimal neurocognitive development

Real-world Outcomes of Relapsed/Refractory Diffuse Large B-cell Lymphoma Treated With Polatuzumab Vedotin-based Therapy

: After FDA and EMA approval of the regimen containing polatuzumab vedotin plus rituximab and bendamustine (PolaBR), eligible relapsed/refractory diffuse large B-cell lymphoma (DLBCL) patients in Italy were granted early access through a Named Patient Program. A multicentric observational retrospective study was conducted focusing on the effectiveness and safety of PolaBR in everyday clinical practice. Fifty-five patients were enrolled. There were 26 females (47.3%), 32 patients were primary refractory and 45 (81.8%) resulted refractory to their last therapy. The decision to add or not bendamustine was at physician's discretion. Thirty-six patients underwent PolaBR, and 19 PolaR. The 2 groups did not differ in most of baseline characteristics. The final overall response rate was 32.7% (18.2% complete response rate), with a best response rate of 49.1%. Median disease-free survival was reached at 12 months, median progression-free survival at 4.9 months and median overall survival at 9 months, respectively. Overall, 88 adverse events (AEs) were registered during treatment in 31 patients, 22 of grade ≥3. Eight cases of neuropathy occurred, all of grades 1-2 and all related to polatuzumab. The two groups of treatment did not differ for effectiveness endpoints but presented statistically significant difference in AEs occurrence, especially in hematological AEs, in AEs of grade equal or greater than 3 and in incidence of neuropathy. Our data add useful information on the effectiveness of Pola(B)R in the setting of heavily pretreated DLBCL and may also suggest a better tolerability in absence of bendamustine without compromise of efficacy

A multicenter randomized phase 4 trial comparing sodium picosulphate plus magnesium citrate vs. polyethylene glycol plus ascorbic acid for bowel preparation before colonoscopy. The PRECOL trial

Background: Adequate bowel preparation before colonoscopy is crucial. Unfortunately, 25% of colonoscopies have inadequate bowel cleansing. From a patient perspective, bowel preparation is the main obstacle to colonoscopy. Several low-volume bowel preparations have been formulated to provide more tolerable purgative solutions without loss of efficacy. Objectives: Investigate efficacy, safety, and tolerability of Sodium Picosulphate plus Magnesium Citrate (SPMC) vs. Polyethylene Glycol plus Ascorbic Acid (PEG-ASC) solutions in patients undergoing diagnostic colonoscopy. Materials and methods: In this phase 4, randomized, multicenter, twoarm trial, adult outpatients received either SPMC or PEG-ASC for bowel preparation before colonoscopy. The primary aims were quality of bowel cleansing (primary endpoint scored according to Boston Bowel Preparation Scale) and patient acceptance (measured with six visual analogue scales). The study was open for treatment assignment and blinded for primary endpoint assessment. This was done independently with videotaped colonoscopies reviewed by two endoscopists unaware of study arms. A sample size of 525 patients was calculated to recognize a difference of 10% in the proportion of successes between the arms with a two-sided alpha error of 0.05 and 90% statistical power. Results: Overall 550 subjects (279 assigned to PEG-ASC and 271 assigned to SPMC) represented the analysis population. There was no statistically significant difference in success rate according to BBPS: 94.4% with PEG-ASC and 95.7% with SPMC (P = 0.49). Acceptance and willing to repeat colonoscopy were significantly better for SPMC with all the scales. Compliance was less than full in 6.6 and 9.9% of cases with PEG-ASC and SPMC, respectively (P = 0.17). Nausea and meteorism were significantly more bothersome with PEG-ASC than SPMC. There were no serious adverse events in either group. Conclusion: SPMC and PEG-ASC are not different in terms of efficacy, but SPMC is better tolerated than PEG-ASC. SPMC could be an alternative to lowvolume PEG based purgative solutions for bowel preparation