Is Left Ventricular Assist Device Deactivation Ethically Acceptable? A Study on the Euthanasia Debate

In the last decades, new technologies have improved the survival of patients affected by chronic illnesses. Among them, left ventricular assist device (LVAD) has represented a viable solution for patients with advanced heart failure (HF). Even though the LVAD prolongs life expectancy, patients' vulnerability generally increases during follow up and patients' request for the device withdrawal might occur. Such a request raises some ethical concerns in that it directly hastens the patient's death. Hence, in order to assess the ethical acceptability of LVAD withdrawal, we analyse and examine an ethical argument, widely adopted in the literature, that we call the "descriptive approach", which consists in giving a definition of life-sustaining treatment to evaluate the ethical acceptability of treatment withdrawal. Focusing attention on LVAD, we show criticisms of this perspective. Finally, we assess every patient's request of LVAD withdrawal through a prescriptive approach, which finds its roots in the criterion of proportionality

Leonardo Drone Contest Autonomous Drone Competition: Overview, Results, and Lessons Learned from Politecnico di Milano Team

In this paper, the Politecnico di Milano solutions proposed for the Leonardo Drone Contest (LDC) are presented. The Leonardo Drone Contest is an annual autonomous drone competition among universities, which has already seen the conclusion of its second edition. In each edition, the participating teams were asked to design and build an autonomous multicopter, capable of accomplishing complex tasks in an indoor urban-like environment. To reach this goal, the designed systems should be capable of navigating in a Global Navigation Satellite System (GNSS)-denied environment with autonomous decision making, online planning and collision avoidance capabilities. In this light, the authors describe the first two editions of the competition, i.e., their rules, objectives and overview of the proposed solutions. While the first edition is presented as relevant for the experience and takeaways acquired from it, the second edition solution is analyzed in detail, providing both the simulation and experimental results obtained

Estrategias de vida de los hogares: perspectiva conceptual y metodológica a través de la encuesta anual de hogares de la ciudad de Buenos Aires

La perspectiva conceptual y metodológica que se presenta en este trabajo se centra en las estrategias de vida entendidas como el conjunto de actividades que llevan a cabo los diferentes miembros del hogar para hacer posible su reproducción cotidiana y generacional en su interacción con diversos procesos (económicos, sociales) e instituciones sociales, en función del lugar que ocupan en la estructura social. Los estudios encuadrados en este enfoque han identificado una gran diversidad de estrategias. entre las cuales se encuentran: la inserción laboral de sus miembros, la reestructuración de la división del trabajo, la ampliación de las redes sociales, los cambios en el tamaño y composición del hogar, las migraciones, las modificaciones en pautas de consumo. La propuesta conceptual y metodológica que se presenta en este trabajo tiene a los hogares como unidad de análisis y elabora una mirada complementaria a los estudios sobre ingresos, con eje en la Ciudad de Buenos Aires. En particular, busca conocer las diversas maneras en las que los hogares despliegan arreglos familiares e individuales a los fines de su manutención e identificar su vinculación con distintos contextos macroeconómicos. Sobre la base de esta propuesta analítica, se propone clasificar las estrategias de manutención según ordenadores conceptuales más amplios, partiendo del bloque temático específico contenido en la Encuesta Anual de Hogares de la Ciudad de Buenos Aires (EAH), y analizar su evolución en el tiempo y su relación con características sociodemográficas de los hogares. La EAH releva información de, aproximadamente, 6.500 viviendas dentro de las cuales se encuestan a todos los hogares y sus miembros. Se trata de una encuesta por muestreo de carácter probabilístico estratificado que proporciona información representativa para el total de la Ciudad y para cada comuna.The conceptual and methodological perspective presented in this paper focuses on the strategies of life, understood as the set of activities carried out by different household members to enable their daily and generational reproduction in its interaction with various processes (economic, social) and social institutions, depending on their place in the social structure. Studies framed in this approach have identified a wide variety of strategies: the employment of its members, the restructuring of the division of labor, the expansion of social networks, changes in household size and composition, migration, changes in consumption patterns, among others. The conceptual and methodological proposal presented in this paper has to households as the unit of analysis and develops a complementary perspective to the studies on income, with axis in the City of Buenos Aires. In particular, it seeks to understand the various ways in which households deploy individual and family arrangements for the purposes of his maintenance and identify its relationship with different macroeconomic contexts. Based on this analytical approach, it is proposed to classify maintenance strategies as broader conceptual computers, based on the specific thematic content block at the Annual Household Survey of the City of Buenos Aires (EAH) and analyze their evolution over time and relationship with sociodemographic characteristics of households. The EAH relieves information about 6.500 dwellings within which all households are surveyed and their members. It is a stratified sample survey of probabilistic nature and provides information representative for the total for each city and municipality.Facultad de Humanidades y Ciencias de la Educació

Nutritional and Plasma Antioxidant Status Assessment in a Group of Old Alzheimer\u2019s Inpatients

This study was carried out to assess the nutritional and plasma antioxidant status of Alzheimer\u2019s inpatients compared to age-matched controls by means of anthropometric measurements, neuropsychological and nutritional tests and plasma biomarkers. Assessment of nutritional biomarkers of prooxidant/antioxidant balance in patients with AD as well as nutritional status and neuropsychological evaluation are important since many studies have demonstrated their association with cognitive impairment. This cross sectional study was carried out in 35 subjects recruited in a geriatric institution in Pavia, Northern Italy. Cases mean Body Mass Index (BMI) was lower than controls\u2019 one as well as mid arm circumference, triceps skinfold and arm muscle circumference. Both inpatients MNA and MMSE mean scores were lower than controls ones. Plasma levels of lutein plus zeaxanthin, beta-cryptoxanthin, lycopene, alfa tocopherol, ascorbic acid were significantly lower (p < 0.05) in AD in patients as well as superoxide desmutase and glutathione peroxidase concentrations, while all the other biochemical markers levels did not differ. Plasma antioxidant levels and activities were decreased in AD and could be biologically predictive of an early mild cognitive decline, suggesting early intervention on dietary antioxidant intake

Combinations of QT-prolonging drugs: towards disentangling pharmacokinetic and pharmaco-dynamic effects in their potentially additive nature.

Background: Whether arrhythmia risks will increase if drugs with electrocardiographic (ECG) QT-prolonging properties are combined is generally supposed but not well studied. Based on available evidence, the Arizona Center for Education and Research on Therapeutics (AZCERT) classification defines the risk of QT prolongation for exposure to single drugs. We aimed to investigate how combining AZCERT drug categories impacts QT duration and how relative drug exposure affects the extent of pharmacodynamic drug–drug interactions. Methods: In a cohort of 2558 psychiatric inpatients and outpatients, we modeled whether AZCERT class and number of coprescribed QT-prolonging drugs correlates with observed rate-corrected QT duration (QTc) while also considering age, sex, inpatient status, and other QTc-prolonging risk factors. We concurrently considered administered drug doses and pharmacokinetic interactions modulating drug clearance to calculate individual weights of relative exposure with AZCERT drugs. Because QTc duration is concentration-dependent, we estimated individual drug exposure with these drugs and included this information as weights in weighted regression analyses. Results: Drugs attributing a ‘known’ risk for clinical consequences were associated with the largest QTc prolongations. However, the presence of at least two versus one QTc-prolonging drug yielded nonsignificant prolongations [exposure-weighted parameter estimates with 95% confidence intervals for ‘known’ risk drugs + 0.93 ms (–8.88;10.75)]. Estimates for the ‘conditional’ risk class increased upon refinement with relative drug exposure and coadministration of a ‘known’ risk drug as a further risk factor. Conclusions: These observations indicate that indiscriminate combinations of QTc-prolonging drugs do not necessarily result in additive QTc prolongation and suggest that QT prolongation caused by drug combinations strongly depends on the nature of the combination partners and individual drug exposure. Concurrently, it stresses the value of the AZCERT classification also for the risk prediction of combination therapies with QT-prolonging drugs