Aggressive Quadrotor Flight through Narrow Gaps with Onboard Sensing and Computing using Active Vision

We address one of the main challenges towards autonomous quadrotor flight in complex environments, which is flight through narrow gaps. While previous works relied on off-board localization systems or on accurate prior knowledge of the gap position and orientation, we rely solely on onboard sensing and computing and estimate the full state by fusing gap detection from a single onboard camera with an IMU. This problem is challenging for two reasons: (i) the quadrotor pose uncertainty with respect to the gap increases quadratically with the distance from the gap; (ii) the quadrotor has to actively control its orientation towards the gap to enable state estimation (i.e., active vision). We solve this problem by generating a trajectory that considers geometric, dynamic, and perception constraints: during the approach maneuver, the quadrotor always faces the gap to allow state estimation, while respecting the vehicle dynamics; during the traverse through the gap, the distance of the quadrotor to the edges of the gap is maximized. Furthermore, we replan the trajectory during its execution to cope with the varying uncertainty of the state estimate. We successfully evaluate and demonstrate the proposed approach in many real experiments. To the best of our knowledge, this is the first work that addresses and achieves autonomous, aggressive flight through narrow gaps using only onboard sensing and computing and without prior knowledge of the pose of the gap

PAMPC: Perception-Aware Model Predictive Control for Quadrotors

We present the first perception-aware model predictive control framework for quadrotors that unifies control and planning with respect to action and perception objectives. Our framework leverages numerical optimization to compute trajectories that satisfy the system dynamics and require control inputs within the limits of the platform. Simultaneously, it optimizes perception objectives for robust and reliable sens- ing by maximizing the visibility of a point of interest and minimizing its velocity in the image plane. Considering both perception and action objectives for motion planning and control is challenging due to the possible conflicts arising from their respective requirements. For example, for a quadrotor to track a reference trajectory, it needs to rotate to align its thrust with the direction of the desired acceleration. However, the perception objective might require to minimize such rotation to maximize the visibility of a point of interest. A model-based optimization framework, able to consider both perception and action objectives and couple them through the system dynamics, is therefore necessary. Our perception-aware model predictive control framework works in a receding-horizon fashion by iteratively solving a non-linear optimization problem. It is capable of running in real-time, fully onboard our lightweight, small-scale quadrotor using a low-power ARM computer, to- gether with a visual-inertial odometry pipeline. We validate our approach in experiments demonstrating (I) the contradiction between perception and action objectives, and (II) improved behavior in extremely challenging lighting conditions

Geometry-aware Compensation Scheme for Morphing Drones

Morphing multirotors, such as the Foldable Drone , can increase the versatility of drones employing in-flight-adaptive-morphology. To further increase precision in their tasks, recent works have investigated stable flight in asymmetric morphologies mainly leveraging the low-level controller. However, the aerodynamic effects embedded in multirotors are only analyzed in fixed shape aerial vehicles and are completely ignored in morphing drones. In this paper, we investigate the effects of the partial overlap between the propellers and the main body of a morphing quadrotor. We perform experiments to characterize such effects and design a morphology-aware control scheme to account for them. To guarantee the right trade-off between efficiency and compactness of the vehicle, we propose a simple geometry-aware compensation scheme based on the results of these experiments. We demonstrate the effectiveness of our approach by deploying the compensation scheme on the Foldable Drone, a quadrotor that can fold its arms around the main body. The same set of experiments are performed and compared against one another by activating and deactivating the compensation scheme offline or during the flight. To the best of our knowledge, this is the first work counteracting the aerodynamic effects of a morphing quadrotor during flight and showing the effects of partial overlap between a propeller and the central body of the drone.Comment: Submitted to IEEE Conference on Intelligent Robots and Systems (IROS) 202

A Real-Time Game Theoretic Planner for Autonomous Two-Player Drone Racing

To be successful in multi-player drone racing, a player must not only follow the race track in an optimal way, but also compete with other drones through strategic blocking, faking, and opportunistic passing while avoiding collisions. Since unveiling one's own strategy to the adversaries is not desirable, this requires each player to independently predict the other players' future actions. Nash equilibria are a powerful tool to model this and similar multi-agent coordination problems in which the absence of communication impedes full coordination between the agents. In this paper, we propose a novel receding horizon planning algorithm that, exploiting sensitivity analysis within an iterated best response computational scheme, can approximate Nash equilibria in real time. We also describe a vision-based pipeline that allows each player to estimate its opponent's relative position. We demonstrate that our solution effectively competes against alternative strategies in a large number of drone racing simulations. Hardware experiments with onboard vision sensing prove the practicality of our strategy

Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register

Diabetes is an increasing global health burden with the highest prevalence (24.0%) observed in elderly people. Older diabetic adults have a greater risk of hospitalization and several geriatric syndromes than older nondiabetic adults. For these conditions, special care is required in prescribing therapies including anti- diabetes drugs. Aim of this study was to evaluate the appropriateness and the adherence to safety recommendations in the prescriptions of glucose-lowering drugs in hospitalized elderly patients with diabetes. Data for this cross-sectional study were obtained from the REgistro POliterapie-Società Italiana Medicina Interna (REPOSI) that collected clinical information on patients aged ≥ 65 years acutely admitted to Italian internal medicine and geriatric non-intensive care units (ICU) from 2010 up to 2019. Prescription appropriateness was assessed according to the 2019 AGS Beers Criteria and anti-diabetes drug data sheets.Among 5349 patients, 1624 (30.3%) had diagnosis of type 2 diabetes. At admission, 37.7% of diabetic patients received treatment with metformin, 37.3% insulin therapy, 16.4% sulfonylureas, and 11.4% glinides. Surprisingly, only 3.1% of diabetic patients were treated with new classes of anti- diabetes drugs. According to prescription criteria, at admission 15.4% of patients treated with metformin and 2.6% with sulfonylureas received inappropriately these treatments. At discharge, the inappropriateness of metformin therapy decreased (10.2%, P < 0.0001). According to Beers criteria, the inappropriate prescriptions of sulfonylureas raised to 29% both at admission and at discharge. This study shows a poor adherence to current guidelines on diabetes management in hospitalized elderly people with a high prevalence of inappropriate use of sulfonylureas according to the Beers criteria

Beta-Blocker Use in Older Hospitalized Patients Affected by Heart Failure and Chronic Obstructive Pulmonary Disease: An Italian Survey From the REPOSI Register

Beta (β)-blockers (BB) are useful in reducing morbidity and mortality in patients with heart failure (HF) and concomitant chronic obstructive pulmonary disease (COPD). Nevertheless, the use of BBs could induce bronchoconstriction due to β2-blockade. For this reason, both the ESC and GOLD guidelines strongly suggest the use of selective β1-BB in patients with HF and COPD. However, low adherence to guidelines was observed in multiple clinical settings. The aim of the study was to investigate the BBs use in older patients affected by HF and COPD, recorded in the REPOSI register. Of 942 patients affected by HF, 47.1% were treated with BBs. The use of BBs was significantly lower in patients with HF and COPD than in patients affected by HF alone, both at admission and at discharge (admission, 36.9% vs. 51.3%; discharge, 38.0% vs. 51.7%). In addition, no further BB users were found at discharge. The probability to being treated with a BB was significantly lower in patients with HF also affected by COPD (adj. OR, 95% CI: 0.50, 0.37-0.67), while the diagnosis of COPD was not associated with the choice of selective β1-BB (adj. OR, 95% CI: 1.33, 0.76-2.34). Despite clear recommendations by clinical guidelines, a significant underuse of BBs was also observed after hospital discharge. In COPD affected patients, physicians unreasonably reject BBs use, rather than choosing a β1-BB. The expected improvement of the BB prescriptions after hospitalization was not observed. A multidisciplinary approach among hospital physicians, general practitioners, and pharmacologists should be carried out for better drug management and adherence to guideline recommendations

Low in‑hospital mortality rate in patients with COVID‑19 receiving thromboprophylaxis: data from the multicentre observational START‑COVID Register

Abstract COVID-19 infection causes respiratory pathology with severe interstitial pneumonia and extra-pulmonary complications; in particular, it may predispose to thromboembolic disease. The current guidelines recommend the use of thromboprophylaxis in patients with COVID-19, however, the optimal heparin dosage treatment is not well-established. We conducted a multicentre, Italian, retrospective, observational study on COVID-19 patients admitted to ordinary wards, to describe clinical characteristic of patients at admission, bleeding and thrombotic events occurring during hospital stay. The strategies used for thromboprophylaxis and its role on patient outcome were, also, described. 1091 patients hospitalized were included in the START-COVID-19 Register. During hospital stay, 769 (70.7%) patients were treated with antithrombotic drugs: low molecular weight heparin (the great majority enoxaparin), fondaparinux, or unfractioned heparin. These patients were more frequently affected by comorbidities, such as hypertension, atrial fibrillation, previous thromboembolism, neurological disease,and cancer with respect to patients who did not receive thromboprophylaxis. During hospital stay, 1.2% patients had a major bleeding event. All patients were treated with antithrombotic drugs; 5.4%, had venous thromboembolism [30.5% deep vein thrombosis (DVT), 66.1% pulmonary embolism (PE), and 3.4% patients had DVT + PE]. In our cohort the mortality rate was 18.3%. Heparin use was independently associated with survival in patients aged ≥ 59 years at multivariable analysis. We confirmed the high mortality rate of COVID-19 in hospitalized patients in ordinary wards. Treatment with antithrombotic drugs is significantly associated with a reduction of mortality rates especially in patients older than 59 years

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Antidiabetic Drug Prescription Pattern in Hospitalized Older Patients with Diabetes

Objective: To describe the prescription pattern of antidiabetic and cardiovascular drugs in a cohort of hospitalized older patients with diabetes. Methods: Patients with diabetes aged 65 years or older hospitalized in internal medicine and/or geriatric wards throughout Italy and enrolled in the REPOSI (REgistro POliterapuie SIMI—Società Italiana di Medicina Interna) registry from 2010 to 2019 and discharged alive were included. Results: Among 1703 patients with diabetes, 1433 (84.2%) were on treatment with at least one antidiabetic drug at hospital admission, mainly prescribed as monotherapy with insulin (28.3%) or metformin (19.2%). The proportion of treated patients decreased at discharge (N = 1309, 76.9%), with a significant reduction over time. Among those prescribed, the proportion of those with insulin alone increased over time (p = 0.0066), while the proportion of those prescribed sulfonylureas decreased (p < 0.0001). Among patients receiving antidiabetic therapy at discharge, 1063 (81.2%) were also prescribed cardiovascular drugs, mainly with an antihypertensive drug alone or in combination (N = 777, 73.1%). Conclusion: The management of older patients with diabetes in a hospital setting is often sub-optimal, as shown by the increasing trend in insulin at discharge, even if an overall improvement has been highlighted by the prevalent decrease in sulfonylureas prescription

The “Diabetes Comorbidome”: A Different Way for Health Professionals to Approach the Comorbidity Burden of Diabetes

(1) Background: The disease burden related to diabetes is increasing greatly, particularly in older subjects. A more comprehensive approach towards the assessment and management of diabetes’ comorbidities is necessary. The aim of this study was to implement our previous data identifying and representing the prevalence of the comorbidities, their association with mortality, and the strength of their relationship in hospitalized elderly patients with diabetes, developing, at the same time, a new graphic representation model of the comorbidome called “Diabetes Comorbidome”. (2) Methods: Data were collected from the RePoSi register. Comorbidities, socio-demographic data, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), and functional status (Barthel Index), were recorded. Mortality rates were assessed in hospital and 3 and 12 months after discharge. (3) Results: Of the 4714 hospitalized elderly patients, 1378 had diabetes. The comorbidities distribution showed that arterial hypertension (57.1%), ischemic heart disease (31.4%), chronic renal failure (28.8%), atrial fibrillation (25.6%), and COPD (22.7%), were the more frequent in subjects with diabetes. The graphic comorbidome showed that the strongest predictors of death at in hospital and at the 3-month follow-up were dementia and cancer. At the 1-year follow-up, cancer was the first comorbidity independently associated with mortality. (4) Conclusions: The “Diabetes Comorbidome” represents the perfect instrument for determining the prevalence of comorbidities and the strength of their relationship with risk of death, as well as the need for an effective treatment for improving clinical outcomes