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Under what conditions can artificial intelligence contribute to political processes without undermining their legitimacy? Thanks to the ever-growing availability of data and the increasing power of decision-making algorithms, the future of political institutions is unlikely to be anything similar to what we have known throughout the last century, possibly with parliaments deprived of their traditional authority and public decision-making processes largely unaccountable. This paper discusses and challenges these concerns by suggesting a theoretical framework under which algorithmic decision-making is compatible with democracy and, most relevantly, can offer a viable solution to counter the rise of populist rhetoric in the governance arena. Such a framework is based on three pillars: (1) understanding the civic issues that are subjected to automated decision-making; (2) controlling the issues that are assigned to AI; and (3) evaluating and challenging the outputs of algorithmic decision-making.

This article aims to discuss the impact of the expansion of the country of origin principle to video-sharing digital platforms, and how this contributes to a new paradigm of centralized governance of online media content in Europe. Compared to other jurisdictional regimes in the fields of data protection, intellectual property and personality rights, where other country of receipt and targeting tests are utilized, the case of the Audiovisual Media Services Directive (AVMSD) demonstrates the emergence of a split governance model between individual rights and public interests, which fails to protect adequately local cultural and social specificities in the media sphere.

Objective: The emergency operations center (EOC) is an essential component of modern emergency management. Traditionally understood as a place where officials communicate with the public, support coordination, manage operations, craft policy, gather information, and host visitors; there has been little recent research on their structure, operations, or work procedures. EOCs may in fact be, as we argue here, places where emergency managers come to find workarounds, delegate tasks, and find new sources of expertise in order to make sense, make meaning, and make decisions. However, despite their status as a symbol of emergency management and recipients of large amounts of funding, there has been relatively little scientific research into the EOC. With this paper, we synthesize the existing research and propose a variety of research questions to accelerate the process of inquiry into the EOC.Design: Informed by an extensive literature review, this article presents a comprehensive look at the existing state of knowledge surrounding EOCs.Interventions: Research questions to support investigation of the EOC are suggested.Conclusions: The EOC is an underexplored setting ripe for development and discovery by researchers and emergency managers seeking to influence the field of emergency management.

The European Union’s (EU) strategy to address the spread of disinformation, and most notably the Code of Practice on Disinformation and the forthcoming Digital Services Act, tasks digital platforms with a range of actions to minimise the distribution of issue-based and political adverts that are verifiably false or misleading. This article discusses the implications of the EU’s approach with a focus on its categorical approach, specifically what it means to conceptualise disinformation as a form of advertisement and by what standards digital platforms are expected to assess the truthful or misleading nature of the content that they distribute because of this categorisation. The analysis will show how the emerging EU anti-disinformation framework marks a departure from the European Court of Human Rights’ consolidated standards of review for public interest and commercial speech and the tests utilised to assess their accuracy.

The EU Code of Conduct on hate speech requires online platforms to set standards to regulate the blocking or removal of undesirable content. The standards chosen can be analysed for four variables: the scope of protection, the form of speech, the nature of harm, and the likelihood of harm. Comparing the platforms' terms of use against existing legal standards for hate speech reveals that the scope of speech that may be removed increases significantly under the Code's mechanism. Therefore, it is legitimate to consider the platforms as substantive regulators of speech. However, the Code is only the latest example in a global trend of platforms' activities affecting both the substantive regulation of speech and its governance. Meanwhile, States' authority to set standards of acceptable speech wanes.

The emergency operations center (EOC) is an essential component of modern emergency management. Traditionally understood as a place where officials communicate with the public, support coordination, manage operations, craft policy, gather information, and host visitors; there has been little recent research on their structure, operations, or work procedures. EOCs may in fact be, as we argue here, places where emergency managers come to find workarounds, delegate tasks, and find new sources of expertise in order to make sense, make meaning, and make decisions. However, despite their status as a symbol of emergency management and recipients of large amounts of funding, there has been relatively little scientific research into the EOC. With this paper, we synthesize the existing research and propose a variety of research questions to accelerate the process of inquiry into the EOC.Informed by an extensive literature review, this article presents a comprehensive look at the existing state of knowledge surrounding EOCs.Research questions to support investigation of the EOC are suggested.The EOC is an underexplored setting ripe for development and discovery by researchers and emergency managers seeking to influence the field of emergency management.

This article claims that the practices undertaken by digital platforms to counter disinformation, under the EU Action Plan against Disinformation and the Code of Practice, mark a shift in the governance of news media content. While professional journalism standards have been used for long, both within and outside the industry, to assess the accuracy of news content and adjudicate on media conduct, the platforms are now resolving to different fact-checking routines to moderate and curate their content. The article will demonstrate how fact-checking organisations have different working methods than news operators and ultimately understand and assess ‘accuracy’ in different ways. As a result, this new and enhanced role for platforms and fact-checkers as curators of content impacts on how content is distributed to the audience and, thus, on media freedom. Depending on how the fact-checking standards and working routines will consolidate in the near future, however, this trend offers an actual opportunity to improve the quality of news and the right to receive information.

This latest book by Eric Barendt is at the same time an in-depth study of a complex topic and an engaging and pleasant-to-read excursus on the various meanings that societies have attached to the v...

Case C‑18/18 Eva Glawischnig-Piesczek v Facebook Ireland Limited, Judgement of the Court of Justice of the European Union (Third Chamber) of 3 October 2019Article 15(1) of the E-Commerce Directive does not preclude a court of a Member State from: ordering a host provider to remove or block access to information identical to the content of information previously declared unlawful; ordering a host provider to remove or block access to information equivalent to information previously declared unlawful, provided that the content remains essentially unchanged and the differences in the wording are not such as to require the host provider to carry out an independent assessment beyond the elements specified in the injunction; ordering a host provider to remove or block access to information covered by the injunction worldwide within the framework of the relevant international law.Recitals 6, 7, 9, 10, 40, 41, 45 to 48, 52, 58 and 60; Articles 14, 15(1) and 18(1) of Directive 2000/31 of the European Parliament and of the Council of 8 June 2000 on certain legal aspects of information society services, in particular electronic commerce, in the Internal Market (‘Directive on electronic commerce’) [2000] OJ L 178/1

Article 15(1) of the E-Commerce Directive does not preclude a court of a Member State from: ordering a host provider to remove or block access to information identical to the content of information previously declared unlawful; ordering a host provider to remove or block access to information equivalent to information previously declared unlawful, provided that the content remains essentially unchanged and the differences in the wording are not such as to require the host provider to carry out an independent assessment beyond the elements specified in the injunction; ordering a host provider to remove or block access to information covered by the injunction worldwide within the framework of the relevant international law.

Public participation in environmental management, and more specifically in hazard mitigation planning, has received much attention from scholars and practitioners. A shift in perspective now sees the public as a fundamental player in decision-making rather than simply as the final recipient of a policy decision. Including the public in hazard mitigation planning brings widespread benefits. First, communities gain awareness of the risks they live with, and thus, this is an opportunity to empower communities and improve their resilience. Second, supported by a collaborative participation process, emergency managers and planners can achieve the ultimate goal of strong mitigation plans. Although public participation is highly desired as an instrument to improve hazard mitigation planning, appropriate participation techniques are context dependent and some trade-offs exist in the process design (such as between representativeness and consensus building). Designing participation processes requires careful planning and an all-around consideration of the representativeness of stakeholders, timing, objectives, knowledge, and ultimately desired goals to achieve. Assessing participation also requires more consistent methods to facilitate policy learning from diverse experiences. New decision-support tools may be necessary to gain widespread participation from laypersons lacking technical knowledge of hazards and risks.

The rise of a number of initiatives, at both the national and supranational levels, to go beyond economic metrics of societal progress such as the gross domestic production is sparking a growing interest worldwide. Such a shift would generate a number of effects on the policymaking process and traditional strategic narratives about the interplay between community and society, the functioning of the public debate and the roles of civil society, government and the state at large. Introducing indicators of holistic quality of life would impact the policymaking process and require to abandon the current “rational-instrumental” model of policymaking in favour of the alternative “constructivist” or “interactionist” models. Furthermore, this would shake the very foundations of Western constitutionalism by challenging consolidated assumptions of what are considered to be the traditional aims and responsibilities of a state, the functioning of the media sphere and the public debate, and eventually raising a case f...

Intestinal endometriosis is an uncommon clinical entity that is rarely seen by general surgeons. It traditionally requires laparoscopy for diagnosis and an open laparotomy procedure for the treatment. Herein, we report a rare case of colonic endometriosis involving the ileocecal region and left adnexal region. The management was totally laparoscopic: an ileocecal resection of the lesions was successfully performed. Endometriosis was not suspected preoperatively; however, it became a differential diagnosis during the operation and then confirmed by the histopathologic examination. We discuss the investigation process, surgical management, and prognosis related to ectopic endometriosis.

Endogenous ligands of cannabinoid receptors have been discovered recently and include some N -acylethanolamines (NAEs; e.g., N- arachidonoylethanolamine) and some 2-acylglycerols (e.g., sn -2-arachidonoylglycerol). Previously, we found these compounds to be active biologically when administered per os in large quantities to mice. In the present work, piglets were fed diets with and without 20:4 n −6 and 22:6 n −3 fatty acid precursors of NAEs, in levels similar to those found in porcine milk, during the first 18 days of life, and corresponding brain NAEs were assessed. In piglets fed diets containing 20:4 n −6 and 22:6 n −3, there were increases in several biologically active NAEs in brain homogenates—20:4 n −6 NAE (4-fold), 20:5 n −3 NAE (5-fold), and 22:5 n −3 and 22:6 n −3 NAE (9- to 10-fold). These results support a mechanism we propose for dietary long-chain polyunsaturated fatty acids influences on brain biochemistry with presumed functional sequelae. This paradigm will enable targeted investigations to determine whether and why specific populations such as infants, elderly, or persons suffering from certain clinical conditions may benefit from dietary long-chain polyunsaturated fatty acids.

A new dimeric isoquinoline alkaloid, jorumycin (3), has been isolated from the skin and the mucus of the Pacific nudibranch Jorunna funebris. The structure has been fully elucidated on the grounds of ESMS data and of an extensive 2D NMR analysis. The cytotoxicity of 3 was evaluated against various human cancer cell lines and was found to be slightly less potent than Et 743 (2).

Two new scalaranes (1 and 2) have been isolated from the dorid nudibranch Glossodoris atromarginata and its prey. The structures were deteremined by spectral techniques and confirmed by chemical methods. Compounds 1 and 3 showed selective cytotoxic activity against human thyroid carcinoma.

Several phase III clinical trials demonstrated that hepatic arterial chemotherapy for unresectable colorectal liver metastases is able to provide significantly higher response rates than those obtained by systemic route: in more than 500 patients collected from 6 randomized trials, the median values of objective response rates were 55% after fluoxuridine (FUdR) continuous hepatic arterial infusion (HAI) vs. 18.5% after FUdR or 5-fluorouracil (5-FU) intravenous (i.v.) chemotherapy. Furthermore, the majority of those studies reported that median survival increased in the patient subgroups treated with intrahepatic chemotherapy, even if not always statistically significant [1-6]. Certainly, FUdR can be recognized as the first drug, among those regionally given, able to modify the natural history of colorectal liver metastases: it results from both the highest rates of objective responses ever reported in literature and the almost constant notice of unusual sites of extrahepatic metastases [7-10].

Gastrointestinal stromal tumors are malignancies originating from stromal/mesenchymal tissues, most commonly in the stomach and small intestine, although they can be located everywhere in the gastrointestinal tract. Diagnosis is based on histological and immunohistochemical examination, and these rare tumors are characterized by c-kit (CD117) staining. Complete removal of the tumor is often curative in localized gastrointestinal stromal tumors and is always recommended. Clinically, their behavior is difficult to predict, and mitotic count and tumor size seem to be the most effective prognostic factors. We performed a retrospective analysis of clinical presentation and course, surgical management and pathological features of patients with gastrointestinal stromal tumors treated in our institution from 1995 to 2003. Twenty-two patients were enrolled in the study, and all of them underwent surgery. There were two perioperative deaths, and global morbidity was about 13%. Nineteen patients were followed (mean, 31 months): 4 patients had disease progression/recurrence and died, and one patient experienced a local recurrence and was reoperated with a curative intent; 14 patients were disease free. Our experience shows that histological and immunohistochemical examinations are fundamental for a definitive diagnosis and to assess the risk of aggressive behavior. Moreover, our results confirm that in stromal tumors complete surgical resection remains the mainstay of treatment in localized gastrointestinal stromal tumors, although the recurrence rate is relatively high. It is conceivable that treatment and prognosis of metastatic and non-resectable gastrointestinal stromal tumors, as well as the adjuvant treatment of high-risk, radically excised gastrointestinal stromal tumors will be strongly impacted by the c-kit target therapy.

Laparoscopy is not generally accepted as an effective, advantageous alternative to formal laparotomy for abdominal emergencies. Its use in patients with previous surgery and intestinal obstruction is often debatable. A retrospective study was performed to analyse the results of the laparoscopic approach for acute small-bowel obstruction in terms of efficacy and safety. From January 2000 to December 2003, 44 non-consecutive patients underwent laparoscopic surgery for radiologically documented small-bowel obstruction. Thirty-nine (89%) had undergone previous abdominal operations (mean number of laparotomies: 2; range 1-5). Twelve were men and 32 women (mean age: 57 years; range 13-91). We retrospectively reviewed the patient data, analysing operative time, need for accessory incision or conversion, length of hospital stay, and intraoperative and postoperative morbidity and mortality. The aetiology was established in 40 patients (91%), and the procedures were completed laparoscopically in 28/44. Mean operative time was 58 min (range 25-160). Six patients required an accessory target incision and 10 patients were converted to formal laparotomy. The reasons for conversion were extent of adhesions (n = 3), problems with laparoscopic view (n = 2), gangrenous bowel (n = 2), locally advanced colon cancer (n = 1), haemoperitoneum (n = 1), and diffuse peritonitis (n = 1). The mean hospital stay was 6 days (range 2-28). Postoperative mortality and morbidity were 2% and 16%, respectively. In conclusion, this study suggest that laparoscopy should be considered early in the clinical course of patients presenting with acute small-bowel obstruction. In most patients definitive treatment is possible, effective and safe, thus justifying the early laparoscopic approach.

The aim of this retrospective study was to assess the feasibility, safety and efficacy of the laparoscopic approach in the management of perforated peptic ulcers. From January 1997 to December 2002, all patients referred to our community hospital for abdominal surgical emergencies were routinely managed by laparoscopic surgery. A review was carried out on 39 consecutive patients suffering from perforated peptic ulcers with or without generalised peritonitis. The study population comprised 24 male and 15 female patients, aged 30 to 94 years (mean age: 62 +/- 18). Laparoscopic repair was attempted in all patients. Laparoscopy afforded the correct diagnosis in all cases. Laparoscopic peritoneal washout (irrigation and suction of the entire abdominal cavity) with simple suture of the perforation proved successful in 34 patients. An additional omental patching was performed in 15 of these cases. Conversion to conventional open surgery was necessary in 5 patients. The morbidity and mortality rates were 13% and 10%, respectively. The mean operative time was 77 minutes (range: 40-120) and the mean hospital stay 9 days (range: 3-22). Laparoscopic repair of perforated ulcers is technically feasible but requires sound experience in laparoscopic abdominal emergencies. This study shows that the mini-invasive procedure is safe and effective, offering a valid alternative to traditional laparotomy.

The classification of colon cancer proposed by Dukes, 1 and subsequently modified by Astler and Coller 2 is considered prognostically reliable and has acquired wide clinical use since its formulation. Nevertheless, during the last two decades, interest has been directed to additional variables to predict the survival of patients and to improve case selection for adjuvant chemotherapy. 3 Despite these efforts, however, the presence of nodal metastasis is still the most important prognostic indicator of survival, and the quality of both surgical and pathologic procedures has been recently enhanced to provide the best information about the lymphatic spreading of colorectal cancer. 4–8 The exact number of lymph nodes to be dissected by the surgeon and the modality of the pathologic exam are still a matter of debate. 6–8 Since 1990, when it was first proposed to examine at least 12 lymph nodes to properly stage colorectal cancer as N0, 9 the suggested number of nodes to be examined has varied from 6 to 17, 4–8 until Goldstein et al. 6 suggested to pick up as many nodes as possible during curative resections for colon cancer. In the recent Guidelines for therapy of colon cancer 10 it is stressed that, “For adjuvant trial, a minimum of one lymph node must be examined for entry into a trial. For surgical trials or for entry into a colon adjuvant trial in which the lymph node are negative for disease, a minimum of 12 nodes must be examined. The TNM staging system should be used for all colorectal cancer trials. Level of evidence: III-IV. Grade of recommendation: C.” The quality and the extent of lymphadenectomy, besides the diagnostic importance, have rarely been related to long-term outcome and a clear demonstration of their impact on survival has not yet been given. There are limitations to these studies. First, they are retrospective and based on small series of patients; and second, they seldom analyze the extent of lymphadenectomy in relationship to the long-term outcome. So far, only one large-scale trial (published in abstract form 11) is available and has concluded that aggressive lymphadenectomy may improve overall survival. In this study we present the surgical data of two INTACC (National Intergroup for Adjuvant Therapy on Colon Cancer) trials on the adjuvant treatment of resected colon cancer. The aim of this study was to determine, in patients operated on for stage B and C colon cancer, if the extent of lymphadenectomy (number of recovered lymph nodes) is associated with long-term outcome.