General anesthesia is a complex drug-induced state of consciousness, amnesia, analgesia and immobility. General anesthesia causes changes to physiological, cardiovascular, and respiratory status. This chapter discusses the techniques for induction of general anesthesia, airway assessment/management, and the ASA difficult airway algorithm.

Chapter 12 discusses the EU’s new pilot regime for DLT market infrastructures, as laid out in the Pilot Regulation (PilotR). Section 12.2 covers its scope, including activities and entities in scope, size limits, the interface towards the Settlement Finality Directive (SFD), geographic scope, and the EU passporting rules. Section 12.3 explains the procedure under PilotR, beginning with the fundamental requirement to appoint an operator that applies for specific permission to run the DLT market infrastructure – in contrast to the decentralised nature of DLT. Then, we outline how PilotR provides exemptions from MiFID/MiFIR and CSDR along with the associated conditions and compensatory measures – and the supervisory framework under PilotR. Section 12.4 discusses the governance of DLT market infrastructures based on the Business Plan Approach, by which the operator proposes the rules for its own operations – to be approved by the competent authority. Section 12.5 concludes.

DLT and cryptoassets are a digital solution to the perennial issue of how to establish a single source of truth. Because digital data entries can easily be altered or copied, we have relied on trusted third parties to keep a master copy of any digital asset registry – until DLT enabled digital equivalents to physical cash and bearer instruments. Instead of a trusted record keeper, DLT relies on a distributed network of nodes that each hold a copy of the ledger. The data are typically stored in a time-stamped sequence of blocks, i.e., a blockchain. Different types of consensus mechanisms exist to keep each copy of the ledger synchronised and to prevent malicious actors from altering the registered information. This technology is democratising the privilege of running a trusted asset registry, thus facilitating new business models in so-called decentralised finance (DeFi) which emulate conventional financial processes with software replacing middlemen, such as banks, depositories, and exchanges. This has resulted in so-called token offerings and more than 10,000 different cryptoassets worth more than USD 1 trillion in aggregate.

This chapter analyse if and how new technologies, and the distributed ledger technology (DLT), could really represent an opportunity, and not a threat, for the banking industry. Through the illustration of the Spunta DLT project, we illustrate how the Italian Banking Association has concretely brought the permissioned blockchain in the Italian banking sector, through an infrastructure for banks operating in Italy that in the future may host other applications. The chapter then dwells on the possibility that the ECB could issue a CBDC, and ABI’s position is presented. In this context, considering the experience gained on DLT, an experimental path related to the digital Euro is illustrated. This project was launched by ABI in December 2020 with the aim of actively contributing to the public debate and supporting Italian banks in the process of preparation for the future scenario, in the case the ECB decides to issue a digital Euro. The chapter concludes with an update on the current scenario that foresees the Eurosystem working on a possible functional design based on and prototyping the digital Euro. In the description of the current scenario, we wish to emphasise that, to effectively compete with comparable instruments offered by private entities or other foreign central banks, it is desirable that the digital Euro enable exchanges beyond the mere transfer of money. Moreover, for the digital Euro to be successful, it must enable the provision of value-added services, thereby supporting competition without displacing private initiatives, primarily around digital payments and avoiding the risk of disintermediation.

Despite the benefits that banks could get from implementing distributed ledger technologies (DLTs), few banks have focused on making full use of it. According to operational experience, DLTs – which are blockchain based in this case – are frequently employed at the level of cryptocurrencies but are seldom used when it comes to banking applications. This chapter aims to provide an overview of the current state of the academic literature on implementing DLT in the banking sector. By providing a comprehensive overview of DLT adoption in the banking sector, this study can contribute to the development of a better understanding of DLT and its potential to transform the banking industry.

This contribution discusses some critical aspects of the upcoming Markets in Crypto-assets (MiCA) Regulation. There is already extensive and comprehensive literature on the MiCA proposal, and the scope of these brief notes is to consider some – necessarily not all – of the issues that MiCA (as it stands in the original proposal) raises, and that might be considered in the next steps of the legislative process. In particular, we discuss the relationship between MiCA and MiFID-Prospectus rules, the issues raised by DeFI, tokenisation of assets, and some general commercial and civil law aspects.

This chapter provides a fundamental overview of the DLT in banking, emphasising the sectors present issues and fundamental industry shifts. To achieve this, the chapter will examine the principal DLTs projects and implementations in banking, categorising them into two main categories based on the type of need met: (i) products and services designed to meet the needs of financial institutions customers and (ii) internal processes and operations designed to meet the needs of financial intermediaries. As a result, the chapter concentrates on the primary features of the prevalent use cases in the sector, emphasising strengths and weaknesses.

The popularity of digital assets and blockchain solutions is accelerating. This chapter explores the environmental, social, and governance (ESG) impact of digital assets due to increasing institutional and retail investors participation. Blockchain technology can help financial institutions drive favourable enterprise ESG outcomes.