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The Italian insolvency and pre-insolvency frameworks have been reformed recently (2019, due to enter into force in September 2021 but now probably in 2022). This article recalls the intense period of reforms in Italian insolvency law, started in 2005 and culminated with the new ‘Code of enterprise crisis and of insolvency’. The Code introduces new rules for court-confirmed debt restructuring agreements (similar to schemes of arrangement) and judicial composition with creditors, as well as with regard to new rules for insolvency of groups, international jurisdiction and directors’ liability. The article addresses these novelties pointing out some unresolved issues. Finally, the article touches upon the compatibility of the new law with the Directive on restructuring and insolvency (Directive 2019/1023). Autonomy of sport, Private International Law, Public-private Governance, Corruption, Transnational Legal Order, Sports Economy, Legal Status of Sporting Organisations, Audit, Managerial Transparency, Economic Monitoring, International Sporting Convention

In the outbreak of Covid-19, healthcare systems needed to reinvent the provision of good care to outpatients. The doctor-patient’s relationship, even if at a distance, has been established to be a strikingly important factor to both monitor patient’s clinical conditions and to provide reassurance avoiding sense of abandonment. Digital innovation opened up to new solutions and possibilities that haven’t being considered before, particularly in the heavily test-based-evaluation field of ophthalmology. In this scarcely explored field, the role and cooperation of patients became central and essential. Patients need to become active actors in the management of their own health, teaming up with clinicians throughout a process of empowerment. A digital teleophthalmology platform, TreC-Ophthalmology, has been designed and created by a multidisciplinary team including actors from the local Healthcare Trust, the Autonomous Province of Trento, the Bruno Kessler Foundation and the competence center on digital health (TrentinoSalute4.0). The digital system, which is prescribed and activated directly by the clinician, allows the direct involvement of patients, autonomously collecting and safely providing information to the clinician allowing a better remote evaluation of patient’s sight. Several self-administer tests have been selected and loaded on the platform, tutorials have been created and training sessions have been performed. Throughout the platform, patients and clinicians have had the chance to communicate, either asynchronously and real-time, via an encrypted chat and a video-meeting channel.Feedback both from patients and clinicians were collected at the end of a testing phase showing an overall appreciation for the system and the remote interaction from both sides. Participants feedback allowed also to plan ameliorations and new development of the platform (e.g. tele-cooperation setting, devices integration, etc.), supporting new protocols and work organization. 92 patients have had the possibility to use this service so far. Particularly during the extraordinary containment measures imposed at a national level, TreC-Ophthalmology allowed the remote communication between patients and healthcare professionals in a proactive way while preventing the spread of the virus. This experience represents a successful attempt towards the innovation of the health care system, supported by digital solutions and the active involvement of its actors, such as patients and clinicians. Thanks to the novelty of the protocol and the characteristics of the platform, which is created by public stakeholders for the local public healthcare, other regional healthcare providers have decided to start using TreC-Ophthalmology platform, validating its efficiency.

Anomalous origin of the pulmonary arteries from the ascending aorta is a rare, but severe clinical entity necessitating a scrupulous evaluation. Either the right or the left pulmonary arteries can arise directly from the ascending aorta while the other pulmonary artery retains its origin from the right ventricular outflow tract. Such a finding can be isolated or can coexist with several congenital heart lesions. Direct intrapericardial aortic origin, however, must be distinguished with origin through a persistently patent arterial duct. In the current era, clinical manifestations usually become evident in the newborn rather than during infancy, as used to be the case. They include respiratory distress or congestive heart failure due to increased pulmonary flow and poor feeding. The rate of survival has now increased due to early diagnosis and prompt surgical repair, should now be expected to be at least 95%. We have treated four neonates with this lesion over the past 7 years, all of whom survived surgical repair. Right ventricular systolic pressure was significantly decreased at follow-up. Our choice of treatment was to translocate the anomalous pulmonary artery in end-to-side fashion to the pulmonary trunk. Our aim in this report is to update an Italian experience in the diagnosis and treatment of anomalous direct origin of one pulmonary artery from the aorta, adding considerations on the lessons learned from our most recent review of the salient literature.

Background: The COVID-19 pandemic had a significant impact on the population’s ability to be physically active. Purpose: Evaluate the effect of the COVID-19 mitigation measures on exercise tolerance in patients with congenital heart disease (CHD). Materials and methods: All subjects (880, 6–18 years old) who performed a stress test at our hospital from October 2020 to February 2021 and had a similar test one year earlier were enrolled. A questionnaire on the degree of physical activity carried out in 2020 concerning the period prior to the pandemic was compiled. Exercise tolerance and the main anthropometric parameters between the first and second tests were compared. Results: 110 subjects (11.9 ± 4.1 years) were included in the study. The percentage of patients engaged in regular physical activity (RPA) decreased significantly during the pandemic (p &lt, 0.001), and BMI increased significantly (p &lt, 0.001), except among the subjects who began RPA during the lockdown, whereas test duration did not decrease significantly overall but increased in this last subgroup (p &lt, 0.05) Conclusions: The COVID-19 lockdown led to a less active lifestyle with a significant increase in BMI in our group of CHD. These data could have negative effects on the risk profile of this population. RPA practiced at home seems to be effective in counteracting such effects.

Aim of these revised recommendations for the general management of Kawasaki disease is to encourage its prompter recognition and warrant the most appropriate therapy, based on ascertained scientific data, raising awareness of the complications related to misdiagnosis or delayed treatment. A set of 20 synthetic operative statements is herein provided, including the definition of Kawasaki disease, its protean presentations, clinical course and seminal treatment modalities of all disease phases. The application of these recommendations should improve prognosis of Kawasaki disease and prevent the progression to permanent vascular abnormalities, thereby diminishing morbidity and mortality.

The Italian insolvency framework makes several restructuring tools available to firms and their creditors, so that distress does not necessarily lead to liquidation. This paper analyses two such instruments: debt restructuring agreements (DRAs) and compositions with creditors (CCs), both commonly used to reorganize distressed firms and preserve their continuity. These procedures typically involve large firms, particularly in the case of DRAs where judicial control over negotiations is milder. Firms using DRAs are in less critical economic conditions when they file for restructuring, but they do so after longer periods of distress. Despite their declared aim, the effectiveness of these instruments in terms of business continuity is limited: many firms that use them end up exiting the market, in particular in DRAs. Firms that survive display only partial recovery, which is relatively more intense in CCs. However, the apparently superior performance of CCs is overshadowed by the long duration of restructuring, which may prevent us from observing definitive outcomes.

Though now possible, no European state is competing for incorporations, and this is unlikely to happen in a general fashion. In this article I argue, however, that the possibility of one state competing for one specific segment of the market for incorporations should not be ruled out altogether. As happened with Nevada in the US, a state could seek to attract companies that are looking for a very protective legal environment for their directors, officers and shareholders or for the company itself. Given the importance of enforcement, I argue that states could compete by capitalising on the inefficiency of their courts, rather than by changing the law on the books. The fact that no investment is necessary would change the perspective on incentives for states to compete: a very small incentive will be needed if the costs are negligible. I also consider the possible drawbacks of such competition and the possible reactions from other states.

On the 21st May 2019, the University of Florence awarded Michele Casalini an honorary degree for his dedication and his important contribution in the field of Library and Archival Sciences. The ceremony, which was held in the Rectorate's Aula Magna in Florence, represents the first recognition of merit for modern library science and the second for library and archival sciences to ever be granted by an Italian university. The text features the complete speeches by Luigi Dei, Rector, by Andrea Zorzi, Director of the SAGAS Department, the Laudatio by Mauro Guerrini, president of the Degree in Library and Archival Sciences and the Lectio Doctoralis by Michele Casalini, entitled La centralita delle biblioteche per il progresso e la democrazia. All the texts are published in Italian and English.Il 21 maggio 2019 Michele Casalini ha ricevuto dall’Universita di Firenze la Laurea ad honorem per la sua dedizione e il suo importante contributo nel campo della Biblioteconomia e delle Scienze archivistiche. La cerimonia, che si e tenuta a Firenze nell’Aula Magna del Rettorato, rappresenta in assoluto il primo riconoscimento per merito in Biblioteconomia moderna e il secondo in Scienze biblioteconomiche e archivistiche mai assegnato da parte di un’universita italiana. Il testo comprende gli interventi integrali di Luigi Dei, Magnifico Rettore, di Andrea Zorzi, Direttore del Dipartimento SAGAS, la Laudatio di Mauro Guerrini, presidente del Corso di studi in Scienze archivistiche e biblioteconomiche e la Lectio Doctoralis di Michele Casalini, dal titolo La centralita delle biblioteche per il progresso e la democrazia. Tutti i testi sono pubblicati in lingua italiana e inglese.

The paper was written as part of the preliminary research for the Human Centred Business Model Project, a project developed within the Global Forum on Law, Justice and Development and now supported by the OECD Development Centre. In a preliminary fashion, the paper skims the surface of ‘social’ businesses, in the broadest sense, around the world, identifying some general trends and commonalities and some differences. The paper covers jurisdictions from North and South America, Europe, Asia and Australia and describes the organisations that can be used to carry out social business.

In companies with a controlling shareholder the agency relationship between controlling shareholders and minority shareholders poses significant issue. Managers may pursue, rather than the interests of the company as a whole, the interest of the controlling shareholder. When there is a controlling shareholder, independent directors may not prove sufficient to monitor the management behaviour, given that they are ultimately appointed by the same controlling shareholder whose possible opportunistic behaviour they are meant to constrain. Therefore, minority shareholders may be given appointment rights to the board: directors elected by minority shareholders may work as a corporate governance mechanism that fosters the board’s willingness and ability to monitor managers’ behaviour, on the assumption that managers are appointed by the controlling shareholder. This paper examines empirically whether having a minority-elected director on corporate boards increases the ability of the board to monitor management behaviour. Using a sample of the largest listed Italian companies in years 2008-2017, we find that minority-elected directors have a positive and statistically significant effect on board monitoring tasks. We also document that this effect is higher when they are elected by institutional investors. Our results have important implications for policy makers and, more generally, corporate governance best practice in all contexts in which companies have a concentrated ownership structure.

The primary purpose of these practical guidelines related to Kawasaki disease (KD) is to contribute to prompt diagnosis and appropriate treatment on the basis of different specialists’ contributions in the field. A set of 40 recommendations is provided, divided in two parts: the first describes the definition of KD, its epidemiology, etiopathogenetic hints, presentation, clinical course and general management, including treatment of the acute phase, through specific 23 recommendations. Their application is aimed at improving the rate of treatment with intravenous immunoglobulin and the overall potential development of coronary artery abnormalities in KD. Guidelines, however, should not be considered a norm that limits treatment options of pediatricians and practitioners, as treatment modalities other than those recommended may be required as a result of peculiar medical circumstances, patient’s condition, and disease severity or complications.

Urban conflicts are a main historiographical field which study has been often conditioned by prejudices and misconceptions that prevented an appropriate knowledge of the development and consequences of their social, political, anthropological and cultural manifestations. In Italian cities, the so-called weigh of the political values from the Ancient world that would have been transferred to the Western civilization, has burdened our perception of the historical reality. Particularly regarding conflicts: an aspect that did not fit the ideal political virtues of the Italian comune. In the Castilian case, the main problem is the excessive political prominence attributed to royal power and its institutional and legal system, an approach that was reinforced in the 80’s when it was linked to the origins of the «Modern State». These perspectives have limited the study of urban conflicts in a complex political society that also managed the control of violence. The article proves that, by putting aside some of the mentioned perspectives, it is possible to achieve new findings regarding conflicts, social behavior in urban history., La conflictividad en los medios urbanos sigue siendo un tema de interés historiográfico de primer orden que en ocasiones se ha estudiado desde concepciones y apriorismos condicionantes, lo cual ha impedido conocer el desarrollo y el alcance de sus manifestaciones sociales, políticas, antropológicas y culturales. En las ciudades italianas el pretendido peso de los valores políticos heredados del mundo clásico y transferidos a la civilización occidental ha lastrado la percepción de su realidad histórica y en particular de una conflictividad, que encajaba mal con el compendio de las supuestas virtudes políticas del comune italiano. Para las ciudades castellanas el prisma de deformación sería el excesivo protagonismo político otorgado al poder monárquico y a su aparato institucional y normativo. Interpretación que se vio reforzada, en la década de los ochenta del siglo pasado, al conectarla con el origen del «estado moderno». Ese enfoque también ha limitado el estudio de la conflictividad urbana, en el marco de una sociedad política compleja, que también había gestionado el control de la violencia. Pero, tal y como se señala en el trabajo, el estudio de la conflictividad con menos condicionantes interpretativos puede arrojar mucha luz sobre cuestiones relevantes del funcionamiento social y de la historia urbana.

An optimal active-can lead configuration during implantable cardioverter defibrillator (ICD) placement is important to obtain an adequate defibrillation safety margin. The purpose of this multicenter study was to evaluate the rate of the first shock success at defibrillation testing according to the type of lead implant (single vs. dual coil) and shock polarity (cathodal and anodal) in a large series of consecutive patients who received transvenous ICDs.This was a multicenter study enrolling 469 consecutive patients. Single- versus dual-coil leads and cathodal versus anodal polarity were evaluated at defibrillation testing. In all cases, the value of the energy for the first shock was set to 20 J less than the maximum energy deliverable from the device.A total of 469 patients underwent defibrillation testing: 158 (34 %) had dual-coil and 311 (66 %) had single-coil lead systems configuration, 254 (54 %) received anodal shock and 215 (46 %) received cathodal shock. In 35 (7.4 %) patients, the shock was unsuccessful. No significant differences in the outcome of defibrillation testing using single- versus dual-coil lead were observed but the multivariate analysis showed an increased risk of shock failure using cathodal shock polarity (OR 2.37, 95 % CI 1.12-5.03).Both single- and dual-coil transvenous ICD lead systems were associated with high rates of successful ICD implantation, and we found no significant differences in ventricular arrhythmias interruption between the two ICD lead systems configuration. Instead, anodal defibrillation was more likely to be successful than cathodal defibrillation.

Transcatheter creation or enlargement of an atrial septal defect has been used to promote adequate blood flow and mixing in some forms of congenital heart defects or as a relief valve in right or left atrial hypertension, resulting in better cardiac output and/or systemic saturation. We report a case of a 4-year-old male affected by complex congenital heart disease who was admitted for management of severe cyanosis following a staged pericardial fenestrated Fontan procedure. Transoesophageal echocardiogram showed a wide fenestration of 9 mm in size with a severely dilated pericardial Fontan system. To avoid a new surgical procedure and as part of a compassionate use programme, we decided to implant an atrial flow regulator device (4 mm in diameter) with percutaneous approach with the goal of reducing the right-to-left shunt and increasing the pulmonary flow. Preprocedural oxygen saturation was 75%, whereas after 2 months of follow-up, we observed a progressive increase of up to 95% with significant reduction in the pericardial Fontan system dimensions at echocardiography.

Many point to the virtues and benefits of physical activity for human health, but we feel it is important to broaden this thinking to include the urban space of our towns and cities as a support which can either favour or inhibit the adoption of healthier and more active life styles. This paper argues that sport represents a potential factor for social and urban development, even though many statistics indicates that large numbers of people in Italy take no part in any physical activity. On the other hand, spaces for sport in our towns and cities seem to have become more closed and confined, being relegated increasingly to ‘specialist places’. It is therefore useful, as many cases demonstrate, to rethink the diffuse practice of sport in urban space outside dedicated facilities.

Kawasaki disease (KD) is a systemic vasculitis that mainly affects coronary arteries in children, and requires regular follow-up from the time of diagnosis.To evaluate the feasibility of 64-slice CT angiography (CTA) for follow-up of patients with KD using previously performed invasive catheter coronary angiography (CCA) as reference standard.The study group comprised 12 patients (age 17.6 ± 2.9 years, mean ± SD) with a diagnosis of KD and a previously performed CCA (interval, 32.6 ± 13.5 months) who underwent 64-slice cardiac CTA. The quality of the images for establishing the presence of coronary abnormalities was determined by two observers. The CTA findings were compared with those from the prior CCA.Adequate image quality was obtained in all patients. Mean effective dose for CTA was 6.56 ± 0.95 mSv. CTA allowed accurate identification, characterization and measurement of all coronary aneurysms (n = 32), stenoses (n = 3) and occlusions (n = 9) previously demonstrated by CCA. One patient with disease progression went on to have percutaneous coronary intervention.Coronary lesions were reliably evaluated by 64-slice CTA in the follow-up of compliant patients with KD, reducing the need for repeated diagnostic invasive CCA. Hence, in an adequately selected patient population, the role of CCA could be limited almost only to therapeutic procedures.

Tetralogy of Fallot associated with the atrioventricular canal defect has been usually reported in association with Down syndrome. The aim of the present study was to describe the cardiac aspects and the genetic anomalies in children with this association of heart defects. We identified 64 patients with atrioventricular canal defect tetralogy of Fallot. All children underwent complete cardiovascular, clinical phenotypic and genetic evaluation. A genetic syndrome or extracardiac anomalies were found in 56 patients (87.5%). Down syndrome (43 patients, 67.2%) was the most frequent genetic diagnosis. Other syndromes were 8p deletion, trisomy 13, duplication 5p, cranio-cerebello-cardiac syndrome, Cantrell syndrome, CHARGE association, VACTERL association, and DiGeorge syndrome related to maternal diabetes. No patients in our series had 22q11 deletion. Tetralogy of Fallot with extreme dextroposition of the aorta was found in seven patients (only one with Down syndrome). Additional cardiac malformations were present in 23 patients (only 11 with Down syndrome). The association between atrioventricular canal defect and tetralogy of Fallot represents a cardiac phenotype with strong genetic characteristics. For this reason, a careful genetic examination is required. Our study confirms the high prevalence of Down syndrome, but also reveals a significant genetic heterogeneity. Additional cardiac defects are prevalent in patients without Down syndrome.

OBJECTIVESWe sought to evaluate if angiographic dye videointensity of the risk area during percutaneous transluminal coronary angioplasty (PTCA) of the infarct-related artery (IRA) relates to remodeling.BACKGROUNDPoor reflow after myocardial infarction (MI) predicts worse ventricular remodeling.METHODSFifty-three patients with a first anterior MI and isolated disease of the left anterior descending (LAD), who underwent “primary” (n = 14), “rescue” (n = 7) or “late” (after 10 ± 4 days, n = 32) PTCA, were retrospectively selected. In 10 patients prospectively collected, we assessed Doppler flow velocities and Doppler flow reserve (DFR), relating them to the videointensity technique. Coronary stenosis and TIMI flow were determined, and echocardiographic volumes (end-diastolic and end-systolic volume indexes) and regional asynergy were computed before hospital discharge (baseline) and at six months. Assuming higher peak videointensity reflects greater myocardial blood volume, a 1- to 5-point (poor-optimal) perfusion scale was devised.RESULTSThe correlation of Doppler peak velocity and DFR with videointensity was significant (r = 0.58, p = 0.007 and r = 0.71, p < 0.001, respectively). Patients were subdivided into group A (increased videointensity post-PTCA ≥1.5 points, n = 29) and group B (unchanged videointensity, n = 24). Analysis of variance showed a time-group interaction for end-diastolic volume index (−4.6 ± 23% vs. +22 ± 22%, p = 0.003) and end-systolic volume index (−3.05 ± 11.1% vs. +4.1 ± 12.5%, p = 0.027). There was no interaction for changes in LAD stenosis (p = 0.39) and TIMI flow after PTCA (p = 0.27), or regional asynergy at six months (p = 0.31).CONCLUSIONSAngiographic dye videointensity in the risk area correlates with Doppler peak velocity and DFR, and its increase after PTCA of IRA has a limiting effect on ventricular volumes, independent of coronary stenosis resolution, changes in Thrombolysis In Myocardial Infarction (TIMI) flow or extent of regional asynergy.

Current American Heart Association guidelines indicate that patients with Kawasaki disease and no coronary artery abnormalities on echocardiography at any stage of illness may be discharged from cardiologic follow-up 1 year after onset of illness.To determine whether coronary artery dimensions in patients with Kawasaki disease whose vessels are classified as "normal" by Japanese Ministry of Health criteria have a distribution similar to expected population norms when adjusting for body surface area, we studied 125 patients during 4 intervals from onset of illness: (1) 10 days or less, (2) 2 weeks (11 to 21 days), (3) 6 weeks (22 days to 3 months), and (4) 1 year (4 months to 1.5 years). Using two-dimensional echocardiography, we measured the internal lumen diameter of the left main, proximal left anterior descending, and proximal right coronary arteries. Mean body surface area-adjusted dimensions of the proximal left anterior descending and right coronary arteries were significantly larger (P.01) in patients with Kawasaki disease than those in subjects in all periods, except for a marginal difference at 6 weeks for the proximal right coronary artery (P = .02); for the left main coronary artery, this difference achieved statistical significance in the period of 10 days or less, with a trend at 2 weeks (P = .02). Among patients classified as having normal coronary arteries on all echocardiograms by the Japanese Ministry of Health criteria, 27% had at least 1 body surface area-adjusted coronary dimension more than 2 standard deviations above the expected mean.Coronary artery dilation in Kawasaki disease is thus more prevalent than previously reported, highlighting the need for systematic long-term surveillance of this population.