Ethics in the flesh: formalizing moral values in embodied cognition

Values are beliefs or principles that are deemed significant or desirable within a specific society or culture, serving as the fundamental underpinnings for ethical and socio-behavioral norms. The objective of this research is to explore the domain encompassing moral, cultural, and individual values. To achieve this, we employ an ontological approach to formally represent the semantic relations within the value domain. The theoretical framework employed adopts Fillmore’s frame semantics, treating values as semantic frames. A value situation is thus characterized by the co-occurrence of specific semantic roles fulfilled within a given event or circumstance. Given the intricate semantics of values as abstract entities with high social capital, our investigation extends to two interconnected domains. The first domain is embodied cognition, specifically image schemas, which are cognitive patterns derived from sensorimotor experiences that shape our conceptualization of entities in the world. The second domain pertains to emotions, which are inherently intertwined with the realm of values. Consequently, our approach endeavors to formalize the semantics of values within an embodied cognition framework, recognizing values as emotional-laden semantic frames. The primary ontologies proposed in this work are: (i) ValueNet, an ontology network dedicated to the domain of values; (ii) ISAAC, the Image Schema Abstraction And Cognition ontology; and (iii) EmoNet, an ontology for theories of emotions. The knowledge formalization adheres to established modeling practices, including the reuse of semantic web resources such as WordNet, VerbNet, FrameNet, DBpedia, and alignment to foundational ontologies like DOLCE, as well as the utilization of Ontology Design Patterns. These ontological resources are operationalized through the development of a fully explainable frame-based detector capable of identifying values, emotions, and image schemas generating knowledge graphs from from natural language, leveraging the semantic dependencies of a sentence, and allowing non trivial higher layer knowledge inferences.

Parameters and algorithms to evaluate cardiac mechanics by conductance catheter

This work is structured as follows: In Section 1 we discuss the clinical problem of heart failure. In particular, we present the phenomenon known as ventricular mechanical dyssynchrony: its impact on cardiac function, the therapy for its treatment and the methods for its quantification. Specifically, we describe the conductance catheter and its use for the measurement of dyssynchrony. At the end of the Section 1, we propose a new set of indexes to quantify the dyssynchrony that are studied and validated thereafter. In Section 2 we describe the studies carried out in this work: we report the experimental protocols, we present and discuss the results obtained. Finally, we report the overall conclusions drawn from this work and we try to envisage future works and possible clinical applications of our results. Ancillary studies that were carried out during this work mainly to investigate several aspects of cardiac resynchronization therapy (CRT) are mentioned in Appendix. -------- Ventricular mechanical dyssynchrony plays a regulating role already in normal physiology but is especially important in pathological conditions, such as hypertrophy, ischemia, infarction, or heart failure (Chapter 1,2.). Several prospective randomized controlled trials supported the clinical efficacy and safety of cardiac resynchronization therapy (CRT) in patients with moderate or severe heart failure and ventricular dyssynchrony. CRT resynchronizes ventricular contraction by simultaneous pacing of both left and right ventricle (biventricular pacing) (Chapter 1.). Currently, the conductance catheter method has been used extensively to assess global systolic and diastolic ventricular function and, more recently, the ability of this instrument to pick-up multiple segmental volume signals has been used to quantify mechanical ventricular dyssynchrony. Specifically, novel indexes based on volume signals acquired with the conductance catheter were introduced to quantify dyssynchrony (Chapter 3,4.). Present work was aimed to describe the characteristics of the conductancevolume signals, to investigate the performance of the indexes of ventricular dyssynchrony described in literature and to introduce and validate improved dyssynchrony indexes. Morevoer, using the conductance catheter method and the new indexes, the clinical problem of the ventricular pacing site optimization was addressed and the measurement protocol to adopt for hemodynamic tests on cardiac pacing was investigated. In accordance to the aims of the work, in addition to the classical time-domain parameters, a new set of indexes has been extracted, based on coherent averaging procedure and on spectral and cross-spectral analysis (Chapter 4.). Our analyses were carried out on patients with indications for electrophysiologic study or device implantation (Chapter 5.). For the first time, besides patients with heart failure, indexes of mechanical dyssynchrony based on conductance catheter were extracted and studied in a population of patients with preserved ventricular function, providing information on the normal range of such a kind of values. By performing a frequency domain analysis and by applying an optimized coherent averaging procedure (Chapter 6.a.), we were able to describe some characteristics of the conductance-volume signals (Chapter 6.b.). We unmasked the presence of considerable beat-to-beat variations in dyssynchrony that seemed more frequent in patients with ventricular dysfunction and to play a role in discriminating patients. These non-recurrent mechanical ventricular non-uniformities are probably the expression of the substantial beat-to-beat hemodynamic variations, often associated with heart failure and due to cardiopulmonary interaction and conduction disturbances. We investigated how the coherent averaging procedure may affect or refine the conductance based indexes; in addition, we proposed and tested a new set of indexes which quantify the non-periodic components of the volume signals. Using the new set of indexes we studied the acute effects of the CRT and the right ventricular pacing, in patients with heart failure and patients with preserved ventricular function. In the overall population we observed a correlation between the hemodynamic changes induced by the pacing and the indexes of dyssynchrony, and this may have practical implications for hemodynamic-guided device implantation. The optimal ventricular pacing site for patients with conventional indications for pacing remains controversial. The majority of them do not meet current clinical indications for CRT pacing. Thus, we carried out an analysis to compare the impact of several ventricular pacing sites on global and regional ventricular function and dyssynchrony (Chapter 6.c.). We observed that right ventricular pacing worsens cardiac function in patients with and without ventricular dysfunction unless the pacing site is optimized. CRT preserves left ventricular function in patients with normal ejection fraction and improves function in patients with poor ejection fraction despite no clinical indication for CRT. Moreover, the analysis of the results obtained using new indexes of regional dyssynchrony, suggests that pacing site may influence overall global ventricular function depending on its relative effects on regional function and synchrony. Another clinical problem that has been investigated in this work is the optimal right ventricular lead location for CRT (Chapter 6.d.). Similarly to the previous analysis, using novel parameters describing local synchrony and efficiency, we tested the hypothesis and we demonstrated that biventricular pacing with alternative right ventricular pacing sites produces acute improvement of ventricular systolic function and improves mechanical synchrony when compared to standard right ventricular pacing. Although no specific right ventricular location was shown to be superior during CRT, the right ventricular pacing site that produced the optimal acute hemodynamic response varied between patients. Acute hemodynamic effects of cardiac pacing are conventionally evaluated after stabilization episodes. The applied duration of stabilization periods in most cardiac pacing studies varied considerably. With an ad hoc protocol (Chapter 6.e.) and indexes of mechanical dyssynchrony derived by conductance catheter we demonstrated that the usage of stabilization periods during evaluation of cardiac pacing may mask early changes in systolic and diastolic intra-ventricular dyssynchrony. In fact, at the onset of ventricular pacing, the main dyssynchrony and ventricular performance changes occur within a 10s time span, initiated by the changes in ventricular mechanical dyssynchrony induced by aberrant conduction and followed by a partial or even complete recovery. It was already demonstrated in normal animals that ventricular mechanical dyssynchrony may act as a physiologic modulator of cardiac performance together with heart rate, contractile state, preload and afterload. The present observation, which shows the compensatory mechanism of mechanical dyssynchrony, suggests that ventricular dyssynchrony may be regarded as an intrinsic cardiac property, with baseline dyssynchrony at increased level in heart failure patients. To make available an independent system for cardiac output estimation, in order to confirm the results obtained with conductance volume method, we developed and validated a novel technique to apply the Modelflow method (a method that derives an aortic flow waveform from arterial pressure by simulation of a non-linear three-element aortic input impedance model, Wesseling et al. 1993) to the left ventricular pressure signal, instead of the arterial pressure used in the classical approach (Chapter 7.). The results confirmed that in patients without valve abnormalities, undergoing conductance catheter evaluations, the continuous monitoring of cardiac output using the intra-ventricular pressure signal is reliable. Thus, cardiac output can be monitored quantitatively and continuously with a simple and low-cost method. During this work, additional studies were carried out to investigate several areas of uncertainty of CRT. The results of these studies are briefly presented in Appendix: the long-term survival in patients treated with CRT in clinical practice, the effects of CRT in patients with mild symptoms of heart failure and in very old patients, the limited thoracotomy as a second choice alternative to transvenous implant for CRT delivery, the evolution and prognostic significance of diastolic filling pattern in CRT, the selection of candidates to CRT with echocardiographic criteria and the prediction of response to the therapy.

Scienza della sostenibilita' e regolazione: Il caso studio della politica europea in materia di risparmio energetico

Entro l’approccio concettuale e metodologico transdisciplinare della Scienza della Sostenibilità, la presente tesi elabora un background teorico per concettualizzare una definizione di sostenibilità sulla cui base proporre un modello di sviluppo alternativo a quello dominante, declinato in termini di proposte concrete entro il caso-studio di regolazione europea in materia di risparmio energetico. La ricerca, attraverso un’analisi transdisciplinare, identifica una crisi strutturale del modello di sviluppo dominante basato sulla crescita economica quale (unico) indicatore di benessere e una crisi valoriale. L’attenzione si concentra quindi sull’individuazione di un paradigma idoneo a rispondere alle criticità emerse dall’analisi. A tal fine vengono esaminati i concetti di sviluppo sostenibile e di sostenibilità, arrivando a proporre un nuovo paradigma (la “sostenibilità ecosistemica”) che dia conto dell’impossibilità di una crescita infinita su un sistema caratterizzato da risorse limitate. Vengono poi presentate delle proposte per un modello di sviluppo sostenibile alternativo a quello dominante. Siffatta elaborazione teorica viene declinata in termini concreti mediante l’elaborazione di un caso-studio. A tal fine, viene innanzitutto analizzata la funzione della regolazione come strumento per garantire l’applicazione pratica del modello teorico. L’attenzione è concentrata sul caso-studio rappresentato dalla politica e regolazione dell’Unione Europea in materia di risparmio ed efficienza energetica. Dall’analisi emerge una progressiva commistione tra i due concetti di risparmio energetico ed efficienza energetica, per la quale vengono avanzate delle motivazioni e individuati dei rischi in termini di effetti rebound. Per rispondere alle incongruenze tra obiettivo proclamato dall’Unione Europea di riduzione dei consumi energetici e politica effettivamente perseguita, viene proposta una forma di “regolazione per la sostenibilità” in ambito abitativo residenziale che, promuovendo la condivisione dei servizi energetici, recuperi il significato proprio di risparmio energetico come riduzione del consumo mediante cambiamenti di comportamento, arricchendolo di una nuova connotazione come “bene relazionale” per la promozione del benessere relazionale ed individuale.

La funzione limitatrice dei principi - valori costituzionali nella giurisprudenza costituzionale. Riflessi ed implicazioni sulla legalità penale

La tesi di ricerca si propone di indagare il riflesso che i principi/valori producono sul parametro nel sindacato di legittimità costituzionale, al fine di verificarne le implicazioni sulla legalità, in termini di prevedibilità e certezza. In particolare, delineata la connessione tra principi e valori costituzionali e, ricostruito, secondo la teoria dell'ordinamento, il rapporto tra valori e normatività,si analizzano i riflessi prodotti, sul piano interpretativo, dall’apertura del parametro costituzionale alla logica dei valori, enfatizzandone le ricadute sul controllo di costituzionalità delle leggi. Identificato il nesso tra principi e valori nella capacità funzionale dei primi di realizzare i diritti fondamentali, si è inteso rimarcare come la più estesa realizzazione dei principi-valori costituzionali potrebbe compiersi a spese della legge e della certezza del diritto, in una relazione inversamente proporzionale. Ciò apparirebbe evidente dall’ottica privilegiata della materia penale, per cui una legalità materiale, letta alla luce di criteri di adeguatezza e di ragionevole proporzione, seppur vicina alle esigenze di giustizia del caso concreto, se spinta in eccessi interpretativi rischia di invadere il campo del legislatore, unico deputato a compiere scelte di valore.