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(1) Background: to retrospectively evaluate safety and efficacy of combined microwave ablation (MWA) and bilateral expandable titanium SpineJack (SJ) implants followed by vertebroplasty (VP) for the treatment of painful thoracolumbar pathological vertebral compression fracture. (2) Methods: from July 2017 to October 2022, twenty-eight patients (13 women and 15 men; mean age 68 ± 11 years) with a history of primary neoplasm and thirty-six painful vertebral metastases with vertebral compression fracture underwent combined MWA and bilateral expandable titanium SpineJack implants with vertebroplasty. We analyzed safety through complications rate, and efficacy through vertebral height restoration and pain decrease, evaluated using a visual analogue scale (VAS), and Functional Mobility Scale (FMS), and local tumor control. Contrast-enhanced CT scans were performed at 1, 3, and 6 months and a contrast-enhanced spine MRI at 6 months after the procedure. (3) Results: Technical success rate was 100%. No procedure-related major complications or death occurred. Vertebral height restoration was observed in 22 levels (58%), with a mean anterior height restoration of 2.6 mm ± 0.6 and a mean middle height restoration of 4.4 mm ± 0.6 (p < 0.001). Mean VAS score of pain evaluation on the day before treatment was 6.3 ± 1.5 (range 4–9). At the 6-month evaluation, the median VAS score for pain was 0.4 ± 0.6 (range 0–2) with a mean reduction of 93.65% (6.8 ± 0.7 vs. 0.4 ± 0.6; p < 0.000) compared with baseline evaluation. Contrast-enhanced CT scans were performed at 1, 3, and 6 months and a contrast-enhanced spine MRI was performed at 6 months after the procedure, showing no local recurrence, implant displacement, or new fractures in the treated site. (4) Conclusions: combined microwave ablation and bilateral expandable titanium SpineJack implants with vertebroplasty is a safe and effective procedure for the treatment of pathological compressive vertebral fractures. The vertebral stabilization achieved early and persistent pain relief, increasing patient mobility, improving recovery of walking capacity, and providing local tumor control.

In this paper, we aim at establishing some clear guidelines on which configuration of the interbank net can be most effective in limiting the banks’ default contagion risk. More specifically, based on real banks’ balance sheet data, we analyzed how the exposure concentration on specific counterparts can limit or enhance contagion, and which characteristics (variables) of the counterparts induce these differences. The analysis performed here is based on interbank exposures data, which only represent one of the contagion channels, but the same perspective can be generalized when considering, instead of the direct interbank exposures, the asymmetrical effects of a systemic crisis on the considered bank soundness (similar to what happens for the effect of interbank credit losses on a specific bank), or of the considered bank crisis to the whole system’s soundness (similar to the case of interbank default of the considered bank). Moreover, the simulation model as it is can be applied to both listed and nonlisted banks, since it is based purely on balance sheet data. Results suggest that, if we consider the whole interbank market, a high concentration of exposures can enhance contagion, and that, with reference to specific bank-to-bank exposures, the case in which small banks lend to larger and riskier banks is the most threatening for the system’s stability. These results can help regulators and supervisors keep the banking and financial system safe.

Since their liberalization, the electricity markets are characterized by a rather high volatility, which includes price spikes as one of the stylized and specific characteristics of this market. In this paper, we investigate the factors and mechanisms determining these spikes. Based on the Italian electricity market data, we perform a specific analysis of the auctions mechanisms and of the hourly bid and offer of electricity characteristics, for determining how and why do price spikes occur.

The global financial crisis of 2008 proved that what initially appeared to be relatively small losses in the financial system can be magnified to systemic ones. The European Union debt crisis has thus revived interest in the interdependence across different markets, especially sovereign debt markets and the banking sector, and in the interlinkages among idiosyncratic and common shocks. This paper analyzes the evolution over time of the incidence of common shocks on the main Italian banking groups starting from the period of European Central Bank’s Quantitative Easing program. Results show that the banking sector is no longer perceived by the markets as a common risk source, overcoming the negative picture coming from the financial crisis of 2008–2009. The analysis also suggests that the common risk is broadly affected by the ECB monetary policy, and the idiosyncratic risk is linked to the recapitalization processes.

Purpose: Cryoablation (CrA) is a minimally invasive treatment that can be used in primary and metastatic liver cancer. The purpose of this study was to assess the effectiveness of CrA in patients with hepatocellular carcinoma (HCC) and liver metastases. Methods: We retrospectively evaluated the patients who had CrA for HCC or liver metastases between 2015 and 2020. Technical success, complete ablation, CrA-related complications, local tumor progression, local recurrences, and distant metastases were evaluated in the study population. In patients with HCC, the median survival was also estimated. Results: Sixty-four liver tumors in 49 patients were treated with CrA (50 metastases and 14 HCC). The mean tumor diameter was 2.15 cm. The mean follow-up was 19.8 months. Technical success was achieved in the whole study population. Complete tumor ablation was observed after one month in 92% of lesions treated with CrA (79% and 96% in the HCC Group and metastases Group, respectively, p < 0.001). Local tumor progression occurred in 12.5 of lesions, with no difference between the study groups (p = 0.105). Sixteen patients (33%) developed local recurrence (45% and 29% in the HCC Group and metastases Group, respectively, p = 0.477). Seven patients (14%) developed distant metastases in the follow-up period. Ten patients (20.8%) underwent redo CrA for local recurrence or incomplete tumor ablation. Minor complications were observed in 14% of patients. In patients with HCC, the median survival was 22 months. Conclusions: CrA can be safely used for treatment of HCC and liver metastases not amenable of surgical resection. Further studies are necessary to better define the role of CrA in the multidisciplinary treatment of liver malignancies.

The discussion on the necessity of a larger volume of very highly quality liquid assets (VHQLA) in the euro area has been very extensive. The debate on expanding the pool of comparable euro area assets focuses on &ldquo, safe assets&rdquo, often on various combinations of government bonds, most of which would not entail a strong increase in euro VHQLA. This paper explores a different option, complementary to the existing ones, based on the creation of a safe European asset backed by fully private assets. The paper proposes the issuance of supra-covered bonds by a central European institution. The latter are bonds issued by the central issuer and backed by covered bonds, which banks would have created using their mortgages as their cover pool. The aim is to increase substantially the outstanding amount of euro VHQLA. Such an asset would also be very beneficial during crisis periods, such as the current COVID19 crisis, by allowing banks to transform mortgages into very high quality liquid assets that can be used for funding and as a collateral in operations with the Eurosystem, thus enhancing the possible credit to sustain small and medium-sized enterprises (SMEs). This paper assesses the main effects of such a proposal on banks under different possible scenarios.

Purpose of Review: This paper is aimed at describing the main malignant hematolymphoid disorders and their most frequent imaging appearance. Recent Findings: Hematological malignancies are a heterogeneous group of neoplasms, including leukemia, lymphoma, and multiple myeloma that may involve the bone marrow as a primary or metastatic disease. Imaging has a pivotal role in the assessment of bone involvement, staging, and evaluation of treatment response and detection of complications. Summary: Radiologist should be aware of most frequent findings of hematological malignant diseases, in order to perform an earlier diagnosis as well as assess an adequate clinical-therapeutic pathway.

The recent financial crisis offered an interesting opportunity to analyze the markets&rsquo, behavior in a high-volatility framework. In this paper, we analyzed the price discovery process of the Italian banks&rsquo, Credit Default Swap (CDS) spreads through the Merton model, extended with the inclusion of a redenomination risk proxy, as to say, the risk that Italy could leave the eurozone. This paper contributes to the literature by integrating the classic Merton model with a political-sensitive market variable able to explain the greatest variance in the Italian banks&rsquo, CDS spreads during the most relevant and commonly recognized periods of socio-political and financial distress. Results show that the redenomination risk is progressively becoming the main driver of the process during crises, in particular for the sovereign debt crisis and in 2018.

The discussion on the necessity of a larger volume of very highly quality (VHQLA) and liquid asset in the euro area has been very extensive. The debate on expanding the pool of comparable euro area assets focuses on “safe assets”, often on various combinations of government bonds, most of which would not entail a strong increase in euro VHQLA. This paper explores a different option, complementary to the existing ones, based on the creation of a safe European asset backed by fully private assets. The idea proposed in this paper is the issuance of supra-covered bonds by a central European institution. The latter are bonds issued by the central issuer and backed by covered bonds, which banks would have created using their mortgages as their cover pool. The aim is to increase substantially the outstanding amount of euro VHQLA. Such an asset would be very beneficial also during crisis periods, like the current COVID-19 crisis, by allowing banks to transform mortgages into very high quality and liquid assets that can be used for funding and as a collateral in operations with the Eurosystem, thus enhancing the possible credit sustain to the SMEs. This paper assesses the main effects of such proposal on banks under different possible scenarios.

One of the major problems related to the use of renewable energy sources (RES) relies in the mismatching between renewable energy production and consumption curves. With reference to this problem, it is interesting to note that as wind blows differently in different sites, wind-based productions are differentiated in their production timing. The aim of this position paper is to show that these differences, when properly considered, can be useful for reducing the differences between RES production and energy consumption, thus to maximize the share of RES. The way these differences can be used for optimizing the hourly profile come from finance, where portfolio selection techniques are used, in the aim of combining some risky assets, so to obtain a more stable trend for the whole portfolio. Evidently, when dealing with energy, this strategy must be adapted, as in this case the goal is not a stabilization of results, but the production adaptation to the consumption request. In this way, the contribution of production from renewable sources can be effectively increased: in a test on the Sardinia region, in Italy, on the average hourly profile, we verified that the RES production actual characteristics only allows for a theoretical maximum coverage of 79% while it can go to 94% if the whole production were reorganized on the base of each plant production curves, based on the same techniques coming from finance, and adequately adapted.

Over the past seven years, the financial system has undergone an unprecedented crisis, which has caused important changes in the structure and business models of banks. This paper explores the main changes in the structure of Italian banks’ assets in 2007-2013, by size and category, as a result of the financial crisis and of regulatory and business models changes. The analysis shows that the effects of the crisis were very different on different categories, and that business models have changed, pushing the different banking categories to business models and balances increasingly similar.

In this paper we develop an in-depth analysis of the systemic risk and contagion determinants through the differential effects of excluding one bank on the banking system. The measure allows for splitting the contribution of individual banks into systemic risk as the sum of two components—the stand-alone bank risk and the contagion risk—and measuring the role of assets, riskiness, capitalization, and interconnectedness as determinants of each of the two components. Results show that the variables determining the stand-alone risk component are different from those determining the contagion risk component, so that a bank which is relatively safe with respect to stand-alone risk, can be an important contagion vehicle, or vice versa. Results also show that crisis severity significantly affects results, so that the severity of different crises results in different weights for the input variables and different contributions for the banks considered. These results add highly significant information for macroprudential regulation, not only from the cross-sectional point of view, but also with reference to the time dimension.

One of the main issues in the recent Chinese financial reform is aimed at effectively measuring systemic risk and taking appropriate measures to ensure its sustainability and prevent new crises. In this paper, we firstly introduced the present macro-prudential policies implied in China and pointed out the existing problems. Secondly, we analyzed the banks&rsquo, assets riskiness and the banks&rsquo, probability to default, then, by means of a leave-one-out model, we measured each commercial bank systemic risk contribution. Thirdly, based on comprehensive empirical results and theoretical analysis, we provided some references for macro-prudential regulation and supervision. Results show that systemic risk is increasing in 2013&ndash, 2017, in particular with reference to contagion risk, with a specific concentration within joint-stock commercial banks, suggesting a specific attention of regulators and supervisors for this category.

Gold and Oil have always had a central role within the international economy, and meet the interests of many investors, and in particular, speculators. The Euro introduction (1999) has added the Euro-Dollar exchange rate as a further main variable that the operators, investing on these commodities, have to consider when implementing their strategies. This paper analyzes the mutual relationship between commodities prices (gold and oil) and the Euro/Dollar exchange rate, within the time frame from 2004 to 2014, so to find which specific variable can give significant information on the expected variation of other variables and on which time horizon. This can support the of investors’ choices on taking more effective speculative positions. Results obtained by means of a VAR model show some significant statistical relationship between the three variables on the short term (i.e. when considering daily data), but also some possible relationship on a longer term (monthly data), suggesting that oil prices can give significant information on the expected value of the Euro/Dollar exchange rate.

This paper analyzes the “surprise effect” of some macroeconomic indicators on the US and Germany stock indexes options implied volatility, by means of a VAR model and IRFs between the two volatility indexes. Results show a significant influence of some specific macroeconomic “surprise effects” so that the US volatility has a positive influence on the German one, but not vice versa. With reference to the first considered period, January 2008-May 2012, characterized by higher volatility, the German market analysis shows a direct link between the “surprise effect” of the IFO Business Climate Index and the VDAX-NEW index changes. As regard the second time period (June 2012-December 2014), characterized by lower volatility, the significant macro “surprise effects” are related to the industrial sector (US Retail Sales, German Producer Price) and the job market (US Non-Farm Payroll). These results on the linkages between the macro “surprise effects” and the volatility indexes can be useful for implementing more effective short-term speculative and hedging strategies, based on the “surprise effect” direction and his link with the volatility index.

In December 2013 the European Commissioner Barnier, presenting the Single Resolution Mechanism for the resolution and recovery of banking crises, said it will "break the vicious circle between banks and their sovereigns". But is there any vicious circle? And if so, will resolution tools be able to break it? In literature, the circular nature of the relationship between banking and sovereign debt crises has not yet been properly addressed. Indeed, most papers exclusively focus on one channel of transmission, either quantifying the effects that banking crises have on public finances or analyzing when banking crises may cause sovereign debt crises (or vice-versa). In this paper we propose a computational approach to quantify the effects of this circular relationship and to highlight how sovereign and bank riskiness may increase because of their interconnection. We quantify the effects of bank distress on the banking system itself, passing through the higher public deficit induced by State support, and the subsequent haircut in government bonds. We then test the effectiveness of the bail-in tool proposed in the Single Resolution Mechanism context. The method is tested on four European countries. Results show that, while limited crises tend to be absorbed by the system, serious crises tend to exacerbate at each turn, so that it becomes impossible to stop them without external intervention. Moreover, results show that a bail-in of 8 % of total bank balance sheet can be really effective in breaking the vicious circle and preventing contagion between banks and public finances. This finding supports the bail-in as a valid instrument to avoid taxpayers paying the bill of banking crises.

Italian Abstract: Gli interventi di incentivazione agli investimenti, ed in particolare alla nascita di imprese, sono uno strumento importante per il riequilibrio del differenziale di sviluppo nelle aree a minore vocazione imprenditoriale.La verifica dei risultati ottenuti con tali interventi pone tuttavia diversi problemi di misurazione e valutazione.In primo luogo si pone la necessita di verificare il risultato in termini diretti, ossia se le imprese incentivate siano "vive e vitali". Ma e altrettanto importante verificare in quale modo l’intervento incida sul tessuto produttivo locale, ossia se il sostegno alle nuove imprese indebolisca le imprese gia presenti, togliendo spazio di mercato, ovvero lo rafforzi, completando il mosaico produttivo e trasmettendo fiducia al sistema.In questo studio si intende proporre un metodo di misura sia per il risultato diretto che per l’impatto sul sistema locale, verificato sui dati relativi ad un intervento comunale realizzato in Sardegna a partire dal 2000.English Abstract: Public interventions to encourage investment, and in particular the creation of new firms, are an important tool for the rebalancing of the differential development in areas at lower entrepreneurial vocation.Verifying results obtained with these interventions, however, poses several problems of measurement and evaluation.First there is the need to verify the result in direct terms, so to see if the incentivized companies are "alive and vital." But it is equally important to check how the intervention affects the local production, ie whether the support for new businesses weakens the firms already present, reducing residual market shares, or it strengthens the system, completing the economic framework and transmitting confidence to the system.This study intends to propose a method of measurement for both the direct result that the impact on the local system, tested on a municipal intervention made in Sardinia starting from the year 2000.

The last financial crisis has shown that large banking crises not only pose a highly dangerous risk to financial systems, but also to both the real economy and public finances. Reducing that risk has become a priority for regulators and governments. Still, the debate is open on what the systemic risk is, and how to measure the contribution of each single bank.Market based measures have almost partially failed this goal, as the markets were not able to adequately signal the system riskiness before the crisis start.In this paper we propose an alternative approach for measuring risk contributions, based on balance sheet data, developed on the idea that the contribution of each bank to the system can be captured by the variation of the expected shortfall of the banking system when excluding the considered bank. We thus refer to it as the Leave-One-Out contribution to systemic risk.This measure can be split as the sum of two components, namely the idiosyncratic bank risk (the value of expected losses of the bank when not linked to the system), and the systemic component, defined as the system expected loss variation due to the bank linkages to the system.Results show that the distinction in idiosyncratic and systemic contribution is relevant, as the two components affects the bank riskiness in different ways, and the balance sheet variables related to each component are different. This consciousness of how linkages affect the system riskiness can relevantly contribute to macroprudential regulation.Moreover, we proof that thresholds set for computing the ES relevantly affect results, so that some banks can have a barrier effect in small crises while having a positive contribution in larger crises.Analyzing the evolution of the European financial system riskiness from 2007 to 2013, differently from the market based measures, we find a huge drop in the systemic component between 2011 and 2013, when the system experienced a strong recapitalization, leading the system to a much more reliable stability than what registered for 2007.Finally, comparing the Leave-One-Out outcome to the Shapley values on a small sample of nine French banks, we proof that the two measures are really highly correlated (more than 99.9%), but as LOO doesn’t suffer the computational limits, it is also feasible.

Italian Abstract: Nel corso degli ultimi sette anni il sistema finanziario ha registrato una elevata instabilita, a motivo di una crisi finanziaria senza precedenti, che ha provocato importanti sconvolgimenti nella struttura e nelle modalita di gestione degli intermediari.Questo lavoro esplora le principali variazioni intervenute nella struttura degli attivi bancari degli intermediari italiani nel periodo 2007-2013 in conseguenza sia della crisi finanziaria che dell'evoluzione della regolamentazione e dei modelli di business, con effetti diversi a seconda delle diverse dimensioni bancarie e delle diverse categorie di intermediari: i grandi gruppi sono stati soprattutto colpiti dalla crisi del debito sovrano 2011, mentre quelli piu piccoli sono stati per lo piu esposti alla crisi del 2008.In questi anni i modelli di business sono cambiati, in modo di reagire a tale quadro, ridurre l'esposizione al rischio, ed evitare impatti eccessivi sulla stabilita bancaria.Cio ha comportato una riduzione di valore e la selezione maggiore nei nuovi prestiti di emissione, aumentando la stabilita del sistema bancario, ma riducendo il sostegno alla crescita dell'economia reale.L’evoluzione ha, inoltre, ridotto la diversificazione che prima della crisi caratterizzava il sistema Italiano, riportando le diverse componenti verso modelli ed equilibri sempre piu simili.English Abstract: Over the past seven years, the financial system has recorded a high instability, due to an unprecedented financial crisis, which has caused major upheavals in the structure and business models of banks.This paper explores the main changes in the assets composition of Italian banks in 2007-2013 as a result of the financial crisis and of regulatory and business models. Depending on the different sizes and different banking categories of intermediaries, different effects were induced: the large groups have been particularly affected by the sovereign debt crisis in 2011, while the smaller ones were for the most exposed to the crisis of 2008.In recent years the business models have changed, so to react to this framework, reduce exposure to risk, and avoid excessive impacts on banking stability.This led to a reduction in value and higher selection in new loans, increasing the stability of the banking system, but reducing support for growth of the real economy.Evolution has also reduced the diversification that before the crisis characterized the Italian system, bringing the different components into patterns and balances increasingly similar.

During the recent financial crisis the linkages between banks, public finances and the real economy were one of the important issues. The feedback and cross effects have shown their importance, and evidenced the need for more complete models that include circular feedbacks, cross linkages and side effects. In this paper we have developed a comprehensive simulation model for testing if these “secondary” effects have a relevant impact on the system, so that a more holistic approach can lead to more effective evaluations. The model includes indirect correlation and contagion between banks and public finances, and the sensitivity of both to the real economy variations. Results show that neglecting these indirect effects is misleading, and substantially underestimates the crisis effects. The method is tested on the main banking groups in the EBA panel.

The question of additional taxes on banking institutions has recently been debated.At the same time, financial regulation in the banking sector is undergoing many changes aimed at strengthening financial stability. This paper uses SYMBOL, a micro-simulation model of the banking system, to estimate contributions to systemic risk of individual banks under various future regulatory scenarios and compares them to their potential tax liabilities under alternative designs of Financial Activity Taxes and Bank Levies. The results show that when contagion is not avoided, all taxes perform about the same way. However, when contagion is avoided, bank levies outperform FATs.

The recent financial crisis highlighted that interconnectedness between banks has a crucial role, and can push the effects of bank defaults to extreme levels. Interconnectedness in banking systems can be modelled trough the interbank market structure. As only data on interbank credits and debts aggregated at bank level are publicly available, one common hypothesis is to assume that banks maximise the dispersion of their interbank credits and debts, so that the interbank matrix is approximated by its maximum entropy realisation.

During the recent financial crisis the linkages between banks, public finances and the real economy were one of the important issues. The feedback and cross effects have shown their importance, and evidenced the need for more complete models that include circular feedbacks, cross linkages and side effects.In this paper we have developed a comprehensive simulation model for testing if these “secondary” effects have a relevant impact on the system, so that a more holistic approach can lead to more effective evaluations. The model includes some connecting aspects, as like indirect correlation and contagion between banks and public finances, and their sensitivity of both to the real economy variations.For verifying if results are model sensitive, the simulations are performed according to two different models. Results show that neglecting these indirect effects is misleading, and substantially underestimates the crisis effects.

The recent financial crisis highlighted how the interconnection between banks and sovereign risk could translate a banking crisis into a sovereign crisis. Theoretical and empirical literature has examined both the transmission mechanisms between banks and sovereigns (and viceversa), looking also at how different types of crises occur and combine (the so-called 'twin crises' literature). Indeed, most papers exclusively focus on one channel of transmission, either quantifying the effects that banking crises have on public finances or analyzing when banking crises may cause sovereign debt crises (or viceversa). Still, the circular nature of the relationship between banking and sovereign debt crises has not been deeply addressed. In this paper a numerical approach is proposed to quantify the effects of this relationship and to highlight how sovereign and bank distresses may worsen each other because of their interconnection. We quantify the effects of banks' distress on the banking system itself, passing through the higher public deficit induced by State support, and a subsequent haircut in government bonds. The method is tested on four countries. Results show that, while limited crises tends to be absorbed by the system, serious crises tend to exacerbate at each turn, so that it's not possible to stop them without external interventions.

This paper extends the existing literature on deposit insurance by proposing a new approach for the estimation of the loss distribution of a Deposit Insurance Scheme (DIS) that is based on the Basel 2 regulatory framework. In particular, we generate the distribution of banks’ losses following the Basel 2 theoretical approach and focus on the part of this distribution that is not covered by capital (tail risk). We also refine our approach by considering two major sources of systemic risks: the correlation between banks’ assets and interbank lending contagion. The application of our model to 2007 data for a sample of Italian banks shows that the target size of the Italian deposit insurance system covers up to 98.96% of its potential losses. Furthermore, it emerges that the introduction of bank contagion via the interbank lending market could lead to the collapse of the entire Italian banking system. Our analysis points out that the existing Italian deposit insurance system can be assessed as adequate only in normal times and not in bad market conditions with substantial contagion between banks. Overall, we argue that policy makers should explicitly consider the following when estimating DIS loss distributions: first, the regulatory framework within which banks operate such as (Basel 2) capital requirements; and, second, potential sources of systemic risk such as the correlation between banks’ assets and the risk of interbank contagion.