Shifting priorities as a decisive factor: ethics in architectural practice

[EN] Every professional offers a unique, precise and basic service to society. This service is vocational from the exemplary models of their profession, with an enlightened and free execution. In the exercise of the profession, the architect tries to provide solutions to the different functional problems that derive from the ideal way of life proposed by today's society, facing ethical, social, political and legal problems in the search for the satisfaction of needs, sometimes economic interests take precedence over the social function of architecture and the principles of sustainability. Trends and intellectual conceptions change. In any case, it is indisputable that the fundamental key to architecture lies in the creation of a habitable environment. Thus, the architect is called upon to act as a civic leader in his or her professional practice. Based on this, the general objective of this paper is to make an exploratory approach to professional dilemmas in the field of urban planning and urban design. This is done from the perception and experience of the urban architect who carries out his work in the Valencian Community, in Spain. It is a first approach, carried out through conversations with professionals using qualitative techniques of social research, specifically the interview. The profiles interviewed combine the professional role with the teaching role in the university, which allows us to propose keys that can contribute to generating good practices in the professional field of the urban architect, but which are also present in teaching and learning. Among the conclusions highlighted are the disjunctions derived from political, economic and political-economic interests, which sometimes call into question the social function of urban planning as public policy; the necessary break with the elitism that has characterized the profession and the interdisciplinary work in urban planning as a way to act as a civic leader.Sosa Espinosa, A.; Casar Furio, ME. (2023). Shifting priorities as a decisive factor: ethics in architectural practice. Editorial Universitat Politècnica de València. 380-389. https://doi.org/10.4995/VIBRArch2022.2022.1520638038

Precautionary saving and health risk evidence from the Italian households using a time series of cross sections

In this paper we analyse the importance of precautionary saving in Italy. In contrast to previous studies, we focus on two contemporaneous sources of uncertainty, income and health expenditures, to explain the presence of precautionary saving. The major changes occurred in public health care policies from 1985 to 1996 have caused households to pay a larger share of their out-of-the-pocket medical expenditures. These events have caused households to face both a higher expected mean and a larger variance of health expenditures. Moreover, the economic recession occurred in the early ‘90s and the Maastricht requirements led to general worsening of future expectations of income. We therefore expect consumers to react to this uncertainty by generating precautionary saving. We test this prediction using an Euler equation augmented with the presence of the variance of income and health expenditure shocks. By using a time series of cross sections from the ISTAT household budget survey, we find strong support for precautionary saving as a response to health uncertainty

Effects of Acute Recombinant Human TSH on Serum Ghrelin Levels

Recent findings showed the presence of a reciprocal relationship between thyroid hormones and ghrelin, although the exact mechanism is not known. Design: Our study is addressed to evaluate the effect of acute exogenous rhTSH administration on serum ghrelin levels in athyreotic patients on replacement l-thyroxine therapy. The study group included 50 patients (16 males and 34 females) submitted to total thyroidectomy and 131-iodine remnant ablation for differentiated thyroid cancer on l-thyroxine therapy. Mean age was 47.5 ± 16.5 years and mean BMI was 25.6 ± 5.01 kg/m2. rhTSH was administrated at the dosage of 0.9 mg i.m. once daily for two consecutive days. Blood samples were taken between 08.00 and 09.00 after a overnight fasting for measurement of TSH, FT3, FT4, and ghrelin before the first administration of rhTSH and for measurement of TSH and ghrelin 24, 48, 72, and 96 h after the first administration of rhTSH. Results: Mean ± SD values of basal TSH were 0.54 ± 0.77 μU/ml without significant difference between females and males. As expected, after rhTSH administration TSH concentrations increased at 24 and 48 h with peak TSH values ranging from 20.20 to 313 μU/ml (mean ± SD 98.4 ± 66.7 μU/ml). Mean ± SD values of basal ghrelin were 1085 ± 373 pg/ml without significant difference between males and females. After rhTSH administration ghrelin concentrations decreased significantly (p < 0.01) at 24 h (mean ± SD 934 ± 314 pg/ml p < 0.01) and returned to pre-treatment levels at 96 h. Conclusion: Our study demonstrates that acute exogenous TSH administration has a suppressive effect on ghrelin secretion independent from changes in thyroid status

Weight Status Is Related with Gender and Sleep Duration but Not with Dietary Habits and Physical Activity in Primary School Italian Children.

The prevalence of overweight and obesity in children has risen greatly worldwide. Diet and poor physical activity are the two risk factors usually examined, but epidemiological evidence exists suggesting a link between sleep duration and overweight/obesity in children. The aim of this study was to describe the relationship among body mass index (BMI), diet quality, physical activity level, and sleep duration in 690 children attending the 5th grade in primary schools (9-11 years old) in the city of Parma (Italy) involved in the Giocampus educational program. This was achieved through (i) measuring anthropometric data to compute body mass index; (ii) administering a food questionnaire to evaluate adherence to the Mediterranean Diet (KIDMED score); and (iii) administering a lifestyle questionnaire to classify children physical activity level (PAL), sleep duration, and school achievement. A highly significant negative association was found between BMI and sleep hours. Moreover, there was a significant positive association between PAL and KIDMED scores. No evidence was found of association between BMI and PAL, nor between BMI and KIDMED score. Data from this study established that BMI is correlated to gender and sleep duration, defining sleep habits as one of the factors linked to overweight and obesity

Foreign Body Reaction Mimicking Intracranial Abscess following the Use of Oxidized Regenerated Cellulose (SurgicelTM): Case Report and Literature Review

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The use of biomarkers to study the effects of the mixture of diuron and hexazinone on small and large O. niloticus

Pesticides have made possible a safer and plentiful supply of food; however, the ultimate sink for many of these contaminants is the aquatic environment. We analyzed the commercial mixture Velpar K® WG, which is composed of the pesticides diuron (46.8% m/m) and hexazinone (13.2% m/m), as well as inert ingredients (40.0% m/m). The present study aimed to evaluate the effects of the herbicide mixture on Oreochromis niloticus of different sizes. To this end, we analyzed biomarkers in small and large O. niloticus exposed to a mixture of herbicides at 125, 250 and 500 ug L-1 for 72h. EROD increased activity in small fish exposed to the herbicide mixture at 250 and 500 ug L-1. The GST activity and levels of the antioxidant enzymes GPx and CAT remained the same in the treated fish, compared with the control. The level of the antioxidant enzyme SOD measured in the fish gills was changed in animals exposed to the herbicide mixture at 250 ug L-1. MDA analysis did not show lipid peroxidation. The comet assay evidenced widespread DNA damage, but the micronucleus test did not show mutagenicity. Hepatosomatic (HSI) analysis did not indicate any alterations in liver morphology. The biomarkers response in the fish depended on the size of the individuals

Left Atrial Ablation Versus Biatrial Ablation for Persistent and Permanent Atrial Fibrillation A Prospective and Randomized Study

ObjectivesThe aim of this study was to compare—in patients with persistent and permanent atrial fibrillation (AF)—the efficacy and safety of left atrial ablation with that of a biatrial approach.BackgroundLeft atrium-based catheter ablation of AF, although very effective in the paroxysmal form of the arrhythmia, has an insufficient efficacy in patients with persistent and permanent AF.MethodsEighty highly symptomatic patients (age, 58.6 ± 8.9 years) with persistent (n = 43) and permanent AF (n = 37), refractory to antiarrhythmic drugs, were randomized to two different ablation approaches guided by electroanatomical mapping. A procedure including circumferential pulmonary vein, mitral isthmus, and cavotricuspid isthmus ablation was performed in 41 cases (left atrial ablation group). In the remaining 39 patients (biatrial ablation group), the aforementioned approach was integrated by the following lesions in the right atrium: intercaval posterior line, intercaval septal line, and electrical disconnection of the superior vena cava.ResultsDuring follow-up (mean duration 14 ± 5 months), AF recurred in 39% of patients in the left atrial ablation group and in 15% of patients in the biatrial ablation group (p = 0.022). Multivariable Cox regression analysis showed that ablation technique was an independent predictor of AF recurrence during follow-up.ConclusionsIn patients with persistent and permanent AF, circumferential pulmonary vein ablation, combined with linear lesions in the right atrium, is feasible, safe, and has a significantly higher success rate than left atrial and cavotricuspid ablation alone

Management strategies and choice of antithrombotic treatment in patients admitted with acute coronary syndrome - Executive summary for clinical practice

Consensus Document of the Regional Chapters of the Italian National Association of Hospital Cardiologists (ANMCO) and of the Italian Society of Emergency Medicine (SIMEU) This document has been developed by the Lazio regional chapters of two scientific associations, the Italian National Association of Hospital Cardiologists (ANMCO) and the Italian Society of Emergency Medicine (SIMEU), whose members are actively involved in the everyday management of Acute Coronary Syndromes (ACS). The document is aimed at providing a specific, practical, evidence-based guideline for the effective management of antithrombotic treatment (antiplatelet and anticoagulant) in the complex and ever changing scenario of ACS. The document employs a synthetic approach which considers two main issues: the actual operative context of treatment delivery and the general management strategy

Severe exacerbations of chronic obstructive pulmonary disease: management with noninvasive ventilation on a general medicine ward

Introduction: Recent evidence suggests that, with a well-trained staff, severe exacerbations of chronic obstructive pulmonary disease (COPD) with moderate respiratory acidosis (pH > 7.3) can be successfully treated with noninvasive mechanical ventilation (NIMV) on a general respiratory care ward. We conducted an open prospective study to evaluate the efficacy of this approach on a general medicine ward. Material and methods: This study population consisted in 27 patients admitted to a general medicine ward (median nurse:patient ratio 1:12) December 1, 2004 May 31, 2006 for acute COPD exacerbation with hypercapnic respiratory failure and acidosis (arterial pH 45 mmHg). All received assist-mode NIMV (average 12 h / day) via oronasal masks (inspiratory pressure 10-25 cm H2O, expiratory pressure 4-6 cm H2O) to maintain O2 saturation at 90-95%. Treatment was supervised by an experienced pulmonologist, who had also provided specific training in NIMV for medical and nursing staffs (90-day course followed by periodic refresher sessions). Arterial blood pressure, O2 saturation, and respiratory rate were continuously monitored during NIMV. Based on baseline arterial pH, the COPD was classified as moderate (7.25-7.34) or severe (< 7.25). Results: In patients with moderate and severe COPD, significant improvements were seen in arterial pH after 2 (p < 0.05) and 24 h (p< 0.05) of NIMV and in the PaC02 after 24 hours (p < 0.05). Four (15%) of the 27 patients died during the study hospitalization (in-hospital mortality 15%), in 2 cases due to NIMV failure. For the other 23, mean long-term survival was 14.5 months (95% CI 10.2 to 18.8), and no significant differences were found between the moderate and severe groups. Over half (61%) the patients were alive 1 year after admission. Conclusions: NIMV can be a cost-effective option for management of moderate or severe COPD on a general medicine ward. Its proper use requires: close monitoring of ventilated subjects, optimum staff:patient ratio, well-trained staff dedicated to NIMV, and supervision by a pulmonologist with experience in NIMV. The treatment was effective at improving arterial blood gases in both groups of COPD patients. The severity of the COPD did not significantly affect length of hospital stay, in-hospital mortality, or long-term survival

Prevalence and Predictors of Out-of-Target LDL Cholesterol 1 to 3 Years After Myocardial Infarction. A Subanalysis From the EYESHOT Post-MI Registry

Background: There is an incomplete understanding of the prevalence and predictors of attainment of low-density lipoprotein cholesterol (LDL-C) goal after myocardial infarction (MI). Aim: To evaluate the prevalence of achievement of LDL-C goal of 70 mg/dL, to identify the baseline features associated with suboptimal lipid control, and to assess the use of LDL-C-lowering drug therapies (LLT) beyond the first year after MI. Methods: The EYESHOT Post-MI was a prospective, cross-sectional, Italian registry, which enrolled patients presenting to cardiologist 1 to 3 years after MI. In this retrospective post-hoc analysis, patients were categorized in 2 groups according to the achievement or not of the LDL-C goal of 70 mg/dL. Univariable and multivariable logistic regression analyses were performed to identify the baseline features associate with LDL-C &gt;= 70 mg/dL. Results: The study population included 903 patients (mean age 65.5 +/- 11.5 years). Among them, LDL-C was &gt;= 70 mg/dL in 474 (52.5%). Male sex (p = 0.031), hypertension (p = 0.024), prior percutaneous coronary intervention (p = 0.016) and high education level (p = 0.008) were higher in the LDL-C &lt; 70 group. At multivariable analysis, low education level was an independent predictor of LDL-C &gt;= 70 mg/dL (OR:1.582; 95%CI, 1.156-2.165; p = 0.004). Conversely, hypertension increased the probability to achieve the LDL-C goal (OR:0.650; 95%CI, 0.443-0.954; p = 0.028). Among off-target patients, LLT was not modified in the majority of cases (67.3%), intensified in 85 (18.6%), and actually reduced in 63 patients (13.8%). Conclusions: In patients presenting to cardiologists 1 to 3 years from the last MI event, LDL-C is not under control in a large proportion of patients, particularly in those with a low education level or without hypertension. LLT is underused in this very-high-risk setting