Journal articles: 'Supporti alla decisione'

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Puletti, N., A. Floris, G. Scrinzi, F. Chianucci, G. Colle, T. Michelini, N. Pedot, A. Penasa, S. Scalercio, and P. Corona. "CFOR: a spatial decision support system dedicated to forest management in Calabria." Forest@ - Rivista di Selvicoltura ed Ecologia Forestale 14, no. 2 (April 30, 2017): 135–40. http://dx.doi.org/10.3832/efor2363-014.

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Della Spina, Lucia, Raffaele Scrivo, Claudia Ventura, and Angela Viglianisi. "The Culture of Evaluation to Improve the Airport Competitiveness of the Metropolitan City of the Strait: Analysis of Alternative Scenarios of Connection." Advanced Materials Research 1065-1069 (December 2014): 3381–87. http://dx.doi.org/10.4028/www.scientific.net/amr.1065-1069.3381.

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Questo articolo illustra una proposta metodologica e una applicazione combinata di metodo Delphi e un Hierarchy Process nalytic (AHP) . Sono strumenti a supporto delle decisioni - a causa, rispettivamente gli scenari avvicinano e Multicriter ho una decisione Analisi - e hanno lo scopo di affrontare i problemi e processi in cui le scelte hanno una natura complessa e un ambito strategico. Proponiamo un processo di valutazione combinata: Delphi- multicriterio - progettato per superare alcune debolezze degli approcci alla scenari e multi-criteri, mentre il consolidamento e la convalida dall'esperienza empirica e la letteratura. Particolare enfasi è posta sul nodo della partecipazione delle parti interessate nel processo decisionale cruciale, normalmente conferiti momento tecnico e gestito da analista-decisore. Per quanto riguarda l'area di riferimento, per il ragionamento teorico e la sua applicazione ad un caso concreto, ha sarà dato risalto al problema della scelta tra scenari alternativi che collegano il miglioramento dell'aeroporto della Città Metropolitana di (Italia) competitività della Stretto.

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Arjun Nainggolan, Annisa Siregar, and Mesran Mesran. "Sistem Pendukung Keputusan Penilaian Indeks Kinerja Sales Marketing Menerapkan Metode MOORA." Hello World Jurnal Ilmu Komputer 1, no. 3 (October 18, 2022): 121–29. http://dx.doi.org/10.56211/helloworld.v1i3.125.

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PT. ALFA SCORPII is a company that works in the sale of YAMAHA brand motorcycles. In this case PT. ALFA SCORPII requires sales marketing to be able to introduce the company's products. Problems that are often faced by PT. ALFA SCORPII is not optimal in sales marketing work in terms of introducing company products. As a result, the company may experience a decrease in revenue. One way that companies need to be able to increase sales marketing even more is that a decision support system is needed using the MOORA method. The MOORA method is a method that has a level of flexibility and ease that can be understood in separating the subjective part of an evaluation into decision criteria and decision attributes. The MOORA method can make decisions with the resulting model to solve a problem. This method is used because it can take a decision that can assess the performance of sales marketing. If the sales marketing gets the best performance assessment, then the sales marketing will get a bonus from the company. From the results calculated on the Sales Marketing Performance Index assessment, the alternative result A1 with a value of 0.4272 on behalf of Budian Arifin was obtained

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Bianchi, M., G. Bovio, A. Camia, P. Cantiani, P. Corona, F. Ferretti, A. Francesetti, A. Lamonaca, and L. Portoghesi. "“ProgettoBosco”: a decision-support system as educational tool at the University level." Forest@ - Rivista di Selvicoltura ed Ecologia Forestale 3, no. 1 (March 17, 2006): 91–97. http://dx.doi.org/10.3832/efor0341-0030091.

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Rossitti, Marco, and Francesca Torrieri. "Action research for the conservation of architectural heritage in mariginal areas: the role of evaluation / La ricerca azione per la conservazione del patrimonio architettonico in aree marginali: il ruolo della valutazione." Valori e Valutazioni 30 (August 2022): 3–44. http://dx.doi.org/10.48264/vvsiev-20223002.

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The recognition of the key role of architectural heritage for sustainable territorial development has pushed the scientific community to give more importance to the involvement of local communities in conservation choices and practices. However, despite the recognition of the benefits deriving from the active participation of local communities in the field of conservation, in practice, this involvement is still marginal and linked to experiences without institutional support. This phenomenon is due to different causes, such as the lack of a participatory culture in conservation. It finds its roots in a conventional approach to architectural heritage conservation merely based on an “expert knowledge”. Consequently, there is an urgent need for approaches and tools to manage the complexity of decisions about conservation, which require close collaboration between local communities, research, and institutions. In this context, the paper aims to investigate the role of the action-research approach in fostering the participation of local communities in conservation processes, especially in marginal areas, where the demographic shrinking dynamics make even more necessary both the institutions’ intervention and the communities’ engagement. Based on these premises, starting from an analysis of recent experiences, the contribution dwells on the need to support the implementation of action-research approaches for the conservation of architectural heritage in marginal areas, paying particular attention to the role of evaluation. More in detail, in the first part of the paper, a reflection on the importance of community involvement for heritage conservation is proposed based on the main documents on the topic. In the second part, the main features of the action-research approach and its strengths and weaknesses have been analyzed through a literature review of action-research experiences applied to architectural heritage at a global level. The analyses have highlighted how most of these experiences are born from spontaneous initiatives, without institutional and methodological support, in which the role of evaluation is still marginal. Therefore, in the final part, the paper proposes a first methodological framework based on integrating action research with the main evaluation tools developed in the scientific literature to support the different phases of the decision-making process. This framework, suitably declined according to the specificities of the case study treated, can represent a valid support for implementing and transposing the research-action approach for heritage conservation in an institutional context. Il riconoscimento del ruolo chiave del patrimonio architettonico per uno sviluppo territoriale sostenibile ha spinto la comunità scientifica ad attribuire maggiore importanza al coinvolgimento delle comunità locali nelle scelte e pratiche di conservazione. Tuttavia, nonostante il riconoscimento dei benefici derivanti dalla partecipazione attiva delle comunità locali in ambito conservativo, nella pratica tale coinvolgimento risulta ancora marginale e legato ad esperienze prive di supporto istituzionale. Tale fenomeno è ascrivibile a molteplici cause, tra cui la mancanza di una cultura della partecipazione, che affonda le sue radici nell’approccio convenzionale alla conservazione del patrimonio architettonico basato sulla sola “conoscenza esperta”, e la conseguente carenza di approcci e strumenti capaci di gestire la complessità delle scelte legate alla conservazione in cui, invece, si richiede una stretta collaborazione tra comunità locali, mondo della ricerca e istituzioni. Il presente contributo mira ad indagare il ruolo dell’approccio della ricerca azione nel favorire la partecipazione delle comunità locali ai processi di conservazione soprattutto nelle aree marginali, dove le dinamiche di contra- zione demografica in atto rendono ancora più necessario sia l’intervento delle istituzioni, che la partecipazione delle comunità. Sulla scorta di tali premesse, partendo da un’analisi delle esperienze in corso, il contributo si sofferma sulla necessità di supportare l’implementazione di approcci alla ricerca-azione per la conservazione del patrimonio architettonico in aree marginali, ponendo parti- colare attenzione al ruolo della valutazione per il raggiungimento di tale obiettivo. Nello specifico, nella prima parte del contributo si propone una riflessione sull’importanza del coinvolgimento delle comunità per la conservazione del patrimonio sulla base delle principali carte e trattati sul tema. Nella seconda parte sono state, poi, analizzate le principali caratteristiche dell’approccio alla ricerca-azione ed i suoi punti di forze e di debolezza rispetto alle finalità preposte attraverso una literature review delle esperienze di ricerca azione applicate al patrimonio architettonico a livello globale. Le analisi condotte hanno portato ad evidenziare come la maggior parte delle esperienze analizzate nasca da iniziative spontanee, prive di un supporto istituzionale e metodologico, in cui il ruolo della valutazione è ancora marginale. Pertanto, nella parte finale della riflessione si propone una prima proposta di framework metodologico basato sul- l’integrazione della ricerca azione con i principali strumenti di valutazione sviluppati in letteratura al fine di supportare le differenti fasi del processo decisionale. Tale framework, opportunamente declinato secondo le specificità del caso studio trattato, può rappresentare un valido supporto per l’implementazione e la trasposizione in ambito istituzionale dell’approccio alla ricerca-azione per la conservazione del patrimonio.

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Locurcio, Marco, Francesco Paolo Del Giudice, Debora Anelli, Francesco Tajani, and Debora Anelli. "An asset allocation model for defining optimal property portfolios in terms of risk/return." Valori e Valutazioni 29 (January 2022): 41–56. http://dx.doi.org/10.48264/vvsiev-20212905.

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The widespread uncertainty that characterizes the current world economic situation has also influenced the real estate market, leading investors towards generally lower risk profiles and more stable returns. However, in the absence of adequate skills, it is difficult to carefully manage the main risks factors which occur during the decision-making process. The aim of the research is to define and implement an asset allocation evaluation model able to support public and private investors for the identification of the most suitable allocation of limited financial resources for core/core plus real estate investments. The computational logic of goal programming is applied for detecting the optimal composition of property portfolios in terms of risk/return. The proposed model has been implemented to an Italian case study, proving to be a valid support tool in the definition of efficient real estate investment strategies. L’instabile congiuntura economica ha determinato un atteggiamento prudente degli investitori immobiliari pubblici e privati, indirizzandoli verso strategie di allocazione delle risorse caratterizzate da rischi contenuti e da rendimenti costanti. Nonostante ciò, i fattori di rischio che possono influenzare la performance di un portafoglio immobiliare sono molteplici e spesso difficilmente gestibili senza le competenze adeguate. L’obiettivo della presente ricerca riguarda la definizione e la sperimentazione di un asset allocation model che, attraverso la logica e gli algoritmi del Goal Programming, possa supportare il generico investitore – dotato di budget finanziario prestabilito e interessato ad investimenti di tipo core e core-plus - nel complesso processo decisionale finalizzato alla costruzione di portafogli immobiliari “ottimali” in termini di rischio/rendimento. I risultati ottenuti dall’applicazione a un ipotetico caso studio inerente a immobili ubicati nel contesto territoriale italiano, evidenziano le potenzialità del modello proposto, quale valido strumento di supporto alle decisioni nella definizione di strategie d’investimento immobiliare efficienti.

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Morales, Narkis S., Ignacio C. Fernández, Leonardo P. Durán, and Waldo A. Pérez-Martínez. "RePlant Alfa: Integrating Google Earth Engine and R Coding to Support the Identification of Priority Areas for Ecological Restoration." Land 12, no. 2 (January 21, 2023): 303. http://dx.doi.org/10.3390/land12020303.

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Land degradation and climate change are among the main threats to the sustainability of ecosystems worldwide. As a result, the restoration of degraded landscapes is essential to maintaining the functionality of ecosystems, especially those with greater social, economic, and environmental vulnerability. Nevertheless, policymakers are frequently challenged by deciding where to prioritize restoration actions, which usually includes dealing with multiple and complex needs under an always limited budget. If these decisions are not taken based on proper data and processes, restoration implementation can easily fail. In order to help decision-makers take informed decisions on where to implement restoration activities, we have developed a semiautomatic geospatial platform to prioritize areas for restoration activities based on ecological, social, and economic variables. This platform takes advantage of the potential to integrate R coding, Google Earth Engine cloud computing, and GIS visualization services to generate an interactive geospatial decision-maker tool for restoration. Here, we present a prototype version called “RePlant alpha”, which was tested with data from the Central Zone of Chile. This exercise proved that integrating R and GEE was feasible, and that the analysis with at least six indicators for a specific region was also feasible to implement even from a personal computer. Therefore, the use of a virtual machine in the cloud with a large number of indicators over large areas is both possible and practical.

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Monacciani, Fabiana. "Dall'analisi dell'incertezza alla valutazione del rischio di investimento." RIV Rassegna Italiana di Valutazione, no. 46 (April 2011): 69–84. http://dx.doi.org/10.3280/riv2010-046006.

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Valutare correttamente l'incertezza associata alle variabili "critiche" da cui dipende l'esito finale di un investimento pubblico č un problema cruciale in tutti quei casi in cui l'operatore pubblico non sia in grado di controllare, attraverso i consueti strumenti di governo dell'economia, le dinamiche di dette variabili, dinamiche che, invece, dipendono fortemente da comportamenti e scelte di altri operatori. Tale circostanza si presenta comunemente nel caso di valutazione degli investimenti "di sviluppo", per i quali si ha un livello di incertezza molto elevato e con impatti determinanti sull'esito della valutazione, ma una scarsa disponibilitŕ di informazioni relative al comportamento delle variabili aleatorie da cui dipende l'esito finale dell'investimento. In una situazione di questo tipo, il ricorso diretto al metodo di Monte Carlo a supporto dell'analisi di rischio potrebbe portare, a nostro avviso, a conclusioni errate. Piuttosto che rinunciare completamente a tale valutazione, a nostro avviso č necessario svolgere una preventiva analisi dell'incertezza, grazie alla quale sia possibile generare tutte le informazioni necessarie alla successiva analisi del rischio. A tal scopo, il lavoro presenta un possibile percorso valutativo da utilizzare con particolare riferimento per gli investimenti pubblici di sviluppo che, attraverso una serie di passaggi, consenta dapprima di comprendere i margini di incertezza entro cui deve essere presa la decisione di investimento e, successivamente, permetta di pervenire ad una stima del grado di rischio associato, nel suo complesso, alla realizzazione dell'opera, generando inoltre indicazioni utili per definire ulteriori interventi di mitigazione del rischio stesso. Il percorso valutativo si articola in quattro passi disposti a cascata, basati sul ricorso a tecniche differenziate ed articolate in modo tale che, a ciascun passo, si generino nuove informazioni utili per lo svolgimento di quello successivo. Un percorso cosě delineato, consente di ampliare le informazioni generate dal processo valutativo e garantire maggiore trasparenza nel processo decisionale.

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Pajardi, Daniela, Carlo Trionfi, Viviana La Spada, Stephanie Castoldi, Claudia Rubis, and Monia Vagni. "La decisione del giudice di fronte all'alta conflittualità genitoriale: quando ricorrere alla coordinazione genitoriale." MALTRATTAMENTO E ABUSO ALL'INFANZIA, no. 3 (December 2019): 87–98. http://dx.doi.org/10.3280/mal2019-003007.

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Sempre più spesso le separazioni altamente conflittuali richiedono l'intervento del Tribunale per tutelare l'interesse dei minori. La letteratura internazionale, infatti, mostra come l'esposizione ad alti livelli di conflittualità genitoriale sia un fattore di rischio per i figli. Si propongono alcuni indicatori di conflittualità, rischio evolutivo e capacità di cura dei bisogni dei figli, come supporto, per il giudice e gli operatori, nella scelta degli interventi giudiziari e psicosociali più idonei. Si delineano vantaggi e finalità di interventi tradizionali (come la consulenza tecnica d'ufficio e la mediazione) e dell'innovativa pratica della coordinazione genitoriale.

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Puca, Antonio. "Il caso di Nancy Beth Cruzan." Medicina e Morale 41, no. 5 (October 31, 1992): 911–32. http://dx.doi.org/10.4081/mem.1992.1091.

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L'eutanasia costituisce un nodo bioetico "caldo" in un dibattito che si svolge a vari livelli: medico, bioetico, legale, di mass-media. Il presente lavoro affronta, al riguardo, uno dei casi più noti di pratica eutanasica: quello di Nancy Cruzan, la donna statunitense che, in seguito a grave incidente nel 1983, è rimasta in stato vegetativo persistente attaccata alle macchine di supporto vitale, fino alla morte nel 1990 avvenuta in seguito alla decisione di un giudice - su richiesta dei familiari - distaccarla dai citati strumentati. Dopo una premessa storica della vicenda, il lavoro si addentra nell'iter giudiziario che ha preceduto il "caso Cruzan" e prende in esame le affermazioni del magistero cattolico sull'eutanasia ed il dibattito teologico in atto. Lo studio affronta, inoltre, la valutazione etica dell'eutanasia argomentando una serie di quesiti: se staccare i tubi dell'alimentazione/idratazione sia eutanasia; se il proseguirla sia accanimento terapeutico; se l'alimentazione/idratazione siano trattamenti medici o cure; il rapporto costi-benefici; il valore della volontà del paziente ed il ruolo dei familiari; il valore della vita. Il lavoro si conclude con l'affermazione che nel "caso Cruzan" siano state privilegiate l'opinione e l'interesse proprio rispetto alla verità. Segno eloquente il silenzio che è seguito alla morte di Nancy.

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Lozzi, Maurizio. "Dalla cura della reazione alla cultura della prevenzione." FUTURIBILI, no. 1 (May 2009): 176–87. http://dx.doi.org/10.3280/fu2008-001012.

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- The conflictual nature of the contemporary world is being given further momentum by the spiral of violence triggered by the pairing of terrorism and war. The need to design instruments able to prevent violent conflicts is unfortunately based more on the containment of economic costs than that of human and social costs. Yet there are no more serious problems requiring our engagement than those of the prevention of genocide, for which the Italian armed forces and NGOs are considered reliable in theatres of war. A questionnaire used in Belgrade and its surrounding area confirm how much !our way of being good people" is appreciated in the Balkans. Governance and democracy in Europe, by Vincenzo Memoli Current literature on democracy points to a decline in citizens' support for democracy in a number of countries in the European Union. A range of explanations have been offered, and many scholars have identified the performance of governments as the main cause of this democratic deficit. Focusing on fifteen consolidated European democracies, this paper analyses the main government policies and estimates the effects they have on people's democratic support. The principal results highlight that between 2002 and 2005 standards of governance were in decline, and confirm that government decisions have an impact - including in the short term - on people's satisfaction with the functioning of democracy in Europe.

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Glawar, Robert, Fazel Ansari, Zsolt János Viharos, Kurt Matyas, and Wilfried Sihn. "Integrating maintenance strategies in autonomous production control using a cost-based model." ACTA IMEKO 10, no. 3 (September 30, 2021): 156. http://dx.doi.org/10.21014/acta_imeko.v10i3.1070.

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<p class="Abstract">Autonomous production control (APC) is able to deal with challenges, inter alia, high delivery accuracy, shorter planning horizons, increasing product and process complexity, and frequent changes. However, several state-of-the-art approaches do not consider maintenance factors contributing to operational and tactical decisions in production planning and control. The incomprehensiveness of the decision models and related decision support tools cause inefficiency in production planning and thus lead to a low acceptance in the manufacturing enterprises. To overcome this challenge, this paper presents a conceptual cost-based model for integrating different maintenance strategies in autonomous production control. The model provides relevant decision aspects and a cost function for different maintenance strategies using on a market-based approach. The present work thus makes a positive contribution to cope with the high demands on flexibility and response times in planning while at the same time ensuring high plant productivity.</p>

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Zambianchi, Manuela. "Promuovere l'invecchiamento attivo attraverso il modello life skills education. Un progetto di ricerca-intervento per potenziare il pensiero critico ed il decision making." RICERCHE DI PSICOLOGIA, no. 2 (September 2020): 651–72. http://dx.doi.org/10.3280/rip2020-002009.

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L'invecchiamento positivo è definito dal modello sistemico di Rowe & Khan (1997) come la presenza di elevate risorse a livello fisico e cognitivo, le quali consentono di mantenere una partecipazione attiva alla società. Il modello Life Skills Education, proposto dall'OMS (1994) come insieme di competenze tra-sversali utili allo sviluppo positivo dei giovani, è stato qui ipotizzato poter contri-buire anche in età anziana alla salute bio-psico-sociale, con adattamenti nei contenuti e nella metodologia di approccio, per il quale è stato adottato il modello della ricercaazione partecipata di ispirazione lewiniana (Lewin, 1946; Kagan, 2012). Un progetto di ricerca-azione partecipata che ha avuto come riferimento teorico-metodologico i programmi Life Skills Education in età anziana (Zam-bianchi, 2015) centrato su due Life Skills, il pensiero critico ed il decision making si è svolto a Bagnacavallo (RA) con il supporto delle Istituzioni politiche e sanitarie territoriali. Hanno partecipato 16 iscritti (età media = 71.13 a. 13 femmine e 3 maschi) che hanno compilato in ingresso ed in uscita il questionario sulle rappresentazioni sociali della salute, due item sulle credenze della dieta mediterranea e dell'attività fisica per la salute ed il questionario sugli stili decisionali. Dopo il per-corso formativo, i modelli Manova a misure ripetute hanno mostrato modificazioni positive sulle credenze sui comportamenti salutari, sulla rappresentazione della salute e sullo stile decisionale di pianificazione razionale.

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Szafranko, Elżbieta, and Jolanta Harasymiuk. "Modelling of Decision Processes in Construction Activity." Applied Sciences 12, no. 8 (April 9, 2022): 3797. http://dx.doi.org/10.3390/app12083797.

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Construction activity with a huge variety of structures, forms and conditions underlying the implementation of construction projects, require special management approach. Decisions are most often made at the planning and preparation stage of a construction project. The literature on the subject includes descriptions of decision support methods and models, including single-criteria and multi-criteria models, operations research and fuzzy models. Different models can be used in different situations. The article contains an analysis of model approaches proposed in the literature, confronted with decision-making processes in engineering practice. The study covered 34 construction projects and 15 companies operating in the construction industry. Several decision situations have been considered. The research carried out in accordance with the seven-stage research process has shown that although the various methods proposed in the cited sources can be used in the implementation of engineering projects, they require modification to suit the specificity of engineering practice. The results of the research are the decision support models proposed by the authors, adapted to the conditions in which construction projects are implemented. In the case of small and relatively simple construction projects, simplified models are usually used, where the use of the last steps of verifying the results and improving the applied model is limited. Large and more complex construction projects were often accompanied by a decision support system consisting of more stages, and in these cases, it turned out to be important to obtain feedback and to refine the decision model accordingly. Research has shown that in large projects it is important to obtain feedback. This is due to, inter alia, from the fact that the implementation of these projects involves much greater financial resources than in small and medium-sized projects. Decision-makers take much more care to verify the correctness of the model, because the effects of wrongly made decisions can be much more severe than in the case of small and medium-sized enterprises. If it is necessary to make strategic decisions related to the future of a given company, attention was paid to models in which the starting point was to clearly define the goal and collect a complete set of information about the decision-making environment. Various analytical and research methods were used, but feedback was always needed to improve the final solution. The observations obtained during the research helped the authors to develop decision support models dedicated to engineering practice that may be useful in the implementation of construction projects.

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Locurcio, Marco, Francesco Tajani, Debora Anelli, and Rossana Ranieri. "A multi-criteria composite indicator to support sustainable investment choices in the built environment / Un indicatore composito multicriteriale a supporto delle decisioni di investimento sul patrimonio edificato." Valori e Valutazioni 30 (August 2022): 85–100. http://dx.doi.org/10.48264/vvsiev-20223006.

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The economic crisis generated by the current Covid-19 has scratched many of the certainties consolidated in the past, highlighting the fragility of the economic system and the need for a more efficient management of the investments. Extreme events, whether environmental, social, health and economic, trigger off shocks to which it is necessary to promptly react. Starting from these premises, many institutional investors are directing their capitals towards environmental interventions. In the real estate field this translates into promoting initiatives to improve the efficiency of the existing building heritage, in line with the concept of Circular Economy, and avoiding soil sealing. In the present research a composite indicator that allows to analyze the performance of different real estate investments (e.g. new construction, demolition and reconstruction, renovation, etc.) has been proposed. The performance is assessed with respect to the expected profitability, the specific characteristics of the market in which the initiatives are located and the different risk-return profiles that characterize the investors. The case study, relating to two different investments located in Rome (Italy), has allowed to test the effectiveness and the limits of the proposed indicator and the possible application fields. La crisi economica innescata dalla pandemia da Covid-19 ha determinato un diffuso clima di incertezza, evidenziando la fragilità del sistema economico e la necessità di una gestione maggiormente efficiente degli investimenti sul territorio. Eventi estremi (ambientali, sociali, sanitari, economici) generano shock ai quali è necessario reagire prontamente, e per tale ragione molti investitori istituzionali stanno indirizzando i loro capitali verso interventi sostenibili. Nel settore immobiliare questo trend si traduce nella promozione di iniziative finalizzate a migliorare l’efficienza del patrimonio edilizio esistente, coerentemente con i principi dell’economia circolare, e con il contrasto del consumo di suolo. Nella presente ricerca è stato proposto un indicatore composito, che consente di analizzare la performance di diversi investimenti immobiliari (nuove costruzioni, demolizioni e ricostruzioni, ristrutturazioni, ecc.), valutati rispetto alla redditività attesa, alle caratteristiche specifiche del mercato immobiliare di riferimento delle iniziative considerate ed ai diversi profili di rischio-rendimento degli investitori. Il caso studio, relativo a due differenti investimenti localizzati nella città di Roma (Italia), ha permesso di testare l’efficacia ed i limiti dell’indicatore proposto, oltre che i possibili campi di applicazione.

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Bottero, Marta, Caterina Caprioli, Giulia Datola, Alessandra Oppio, and Francesca Torrieri. "Regeneration of Rogoredo railway: a combined approach using multi-criteria and financial analysis [Un approccio integrato per la rigenerazione dello scalo ferroviario di Rogoredo]." Valori e Valutazioni 31 (February 2023): 89–102. http://dx.doi.org/10.48264/vvsiev-20223107.

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Abandoned areas such as neglected railways and urban voids represent a suitable opportunity for the regeneration and requalification of cities, according to the paradigms of sustainability and resilience. Urban transformation and urban regeneration processes are characterized by a high level of complexity, a dynamic behavior over time and interactions between the various actors involved in the process. Within this context, the present paper proposes the application of a combined evaluation framework, based on the integration of Multi-Criteria Decision Analysis (MCDA) with a Financial Analysis (FA) to assess different strategic scenarios for the regeneration of the Rogoredo railways area (Milan, Italy). The purpose of this framework is to take into account the complexity of the decision- making process, considering both the qualitative (social and environmental) and quantitative (economic- financial) aspects. In detail, the railway yards in the Rogoredo area in Milan (Italy) represent an emblematic case. The city of Milan, within the Territory Governance Plan (PGT), has already proposed interventions in this site aimed at reconnecting the infrastructural node and making it an attractive and inclusive pole. The present paper demonstrates the usefulness of evaluation procedures in supporting the entire decision-making process and defining the most suitable scenario considering the initial objective and the stakeholders’ interests. The innovative value provided by this application is represented precisely by the possibility of considering both the developer point of view through FA and the broader public perspective through the support of MCDA. This approach allowed to build and evaluate transformation scenarios capable of both attracting potential investors and promoting sustainable mobility models, social inclusion, eco-sustainable development, improvement of environmental quality through the design of new public areas, green spaces, and services for citizens. I vuoti urbani, quali ex aree industriali ed ex scali ferro- viari, rappresentano oggi un’importante occasione di riconversione delle città, nell’ottica di uno sviluppo in chiave sostenibile, resiliente e circolare. Tuttavia, gli interventi di trasformazione e rigenerazione urbana sono caratterizzati da un elevato grado di complessità e dinamicità, così come da un’elevata interazione tra le diverse componenti urbane, quali gli aspetti economici, ambientali, sociali e tra i diversi attori coinvolti nel processo. In questo contesto, l’approccio metodologico proposto nel presente contributo combina le Analisi- Multicriteri (AMC) con l’analisi Analisi Finanziaria (AF). Questo modello permette di analizzare e supportare il processo decisionale nella sua complessità, considerando sia gli aspetti qualitativi (sociali e ambientali) sia quelli quantitativi (economico- finanziari). Il caso degli scali ferroviari dell’area di Rogoredo a Milano (Italia) rap- presenta un caso emblematico. La stessa città di Milano, già all’interno del Piano di Governo del Territorio (PGT), propone interventi volti alla riconnessione di questo nodo infrastrutturale per renderlo un polo attrattivo e inclusivo. L’obiettivo di questo contributo è quello di applicare le AMC con l’AF per la valutazione di scenari alternativi, volti alla riqualificazione dell’ex scalo ferroviario di Rogoredo. La valutazione diventa, quindi, parte integrante dell’intero processo decisionale, supportandone tutte le fasi, da quella iniziale fino alla definizione dello scenario più idoneo agli obiettivi prefissati e agli interessi degli stakeholder coinvolti. Il valore aggiunto fornito dalla presente applicazione è rappresentato proprio dalla possibilità di considerare sia il punto di vista degli investitori, attraverso l’AF, sia la più ampia prospettiva pubblica, attraverso il supporto delle AMC. In questo modo è stato possibile costruire e valutare scenari di trasformazione in grado di attrarre possibili investitori e al tempo stesso capaci di promuovere modelli di mobilita sostenibile, forme di inclusione sociale, sviluppo eco-sostenibile, miglioramento della qualità ambientale, attraverso la progettazione di nuove aree pubbliche, spazi verdi e servizi per i cittadini. In questo processo, la valutazione assume un ruolo essenziale in quanto consente di mettere in luce i diversi obiettivi perseguiti dall’intervento di rigenerazione e le loro eventuali conflittualità. Inoltre, la loro identificazione può supportare la definizione di scenari alternativi di sviluppo, rendendo partecipati sia il processo progettuale sia quello decisionale.

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Shrivastav, Santosh Kumar, and P. Janaki Ramudu. "Bankruptcy Prediction and Stress Quantification Using Support Vector Machine: Evidence from Indian Banks." Risks 8, no. 2 (May 22, 2020): 52. http://dx.doi.org/10.3390/risks8020052.

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Banks play a vital role in strengthening the financial system of a country; hence, their survival is decisive for the stability of national economies. Therefore, analyzing the survival probability of the banks is an essential and continuing research activity. However, the current literature available indicates that research is currently limited on banks’ stress quantification in countries like India where there have been fewer failed banks. The literature also indicates a lack of scientific and quantitative approaches that can be used to predict bank survival and failure probabilities. Against this backdrop, the present study attempts to establish a bankruptcy prediction model using a machine learning approach and to compute and compare the financial stress that the banks face. The study uses the data of failed and surviving private and public sector banks in India for the period January 2000 through December 2017. The explanatory features of bank failure are chosen by using a two-step feature selection technique. First, a relief algorithm is used for primary screening of useful features, and in the second step, important features are fed into the support vector machine to create a forecasting model. The threshold values of the features for the decision boundary which separates failed banks from survival banks are calculated using the decision boundary of the support vector machine with a linear kernel. The results reveal, inter alia, that support vector machine with linear kernel shows 92.86% forecasting accuracy, while a support vector machine with radial basis function kernel shows 71.43% accuracy. The study helps to carry out comparative analyses of financial stress of the banks and has significant implications for their decisions of various stakeholders such as shareholders, management of the banks, analysts, and policymakers.

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Nicholas Saputra, Akbar, and Tita Agustina. "PERAN AGAMA DALAM MENENTUKAN KEPUTUSAN PERNIKAHAN PADA GENERASI MILLENIAL." Familia: Jurnal Hukum Keluarga 2, no. 1 (December 29, 2021): 35–52. http://dx.doi.org/10.24239/familia.v2i1.24.

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This study aims to examine the role of religion in determining marriage decisions among millennials. The shift in values, roles, and interests among the millennial generation is a problem for him in determining marriage decisions. In this study, the authors took data by filling out a questionnaire with open answers and closed answers using a google form. The object of this research is the millennial generation (born 1997-2003), with a total of 87 participants. The research method used in this study is a qualitative research method with the approach used in this study being an approach to content analysis. Based on the research that the author conducted, the millennial generation is divided into two groups, namely the group that believes marriage accelerates (26.4%) and the group that believes it does not accelerate marriage (73.6%). The results of filling out the questionnaire as many as 96.6% of the millennial generation think that the role of religion in determining marriage decisions is important. In determining the decision to marry, millennials also pay attention to several other factors that support the decision to undergo marriage, such as economic factors, mental readiness, and age factors. Almost all decisions (95.4%) of millennials also think that marriage can increase piety to God Almighty. Based on the results of the research conducted, the authors can conclude that religion has a very important role in making marriage decisions among the millennial generation. Based on religion, the marriage carried out will get the blessing of Allah SWT and the journey in domestic life will get blessings. The role of religion can also lead humans to goodness and be kept away from all damage and can increase faith and piety to Allah swt. Abstrak Penelitian ini bertujuan untuk mengkaji peran agama dalam menentukan keputusan pernikahan di kalangan milenial. Pergeseran nilai, peran, dan kepentingan di kalangan generasi milenial menjadi kendala baginya dalam menentukan keputusan pernikahan. Dalam penelitian ini, penulis mengambil data dengan cara mengisi kuesioner dengan jawaban terbuka dan jawaban tertutup menggunakan google form. Objek penelitian ini adalah generasi milenial (kelahiran 1997-2003), dengan jumlah peserta 87 orang. Metode penelitian yang digunakan dalam penelitian ini adalah metode penelitian kualitatif dengan pendekatan yang digunakan dalam penelitian ini adalah pendekatan analisis isi. Berdasarkan penelitian yang penulis lakukan, generasi milenial terbagi menjadi dua kelompok, yaitu kelompok yang meyakini mempercepat pernikahan (26,4%) dan kelompok yang meyakini tidak mempercepat pernikahan (73,6%). Hasil pengisian kuesioner sebanyak 96,6% generasi milenial berpendapat bahwa peran agama dalam menentukan keputusan pernikahan itu penting. Dalam menentukan keputusan pernikahan, kaum milenial juga memperhatikan beberapa faktor lain yang mendukung keputusan menjalani pernikahan, seperti faktor ekonomi, kesiapan mental, dan faktor usia. Hampir semua keputusan (95,4%) kaum milenial juga berpendapat bahwa pernikahan dapat meningkatkan ketakwaan kepada Tuhan Yang Maha Esa. Berdasarkan hasil penelitian yang dilakukan, penulis dapat disimpulkan bahwa agama memiliki peran yang sangat penting dalam pengambilan keputusan pernikahan di kalangan generasi milenial. Berdasarkan agama, pernikahan yang dilakukan akan mendapatkan ridho Allah SWT dan perjalanan dalam kehidupan rumah tangga akan mendapatkan berkah. Peran agama juga dapat mengantarkan manusia kepada kebaikan dan dijauhkan dari segala kerusakan serta dapat meningkatkan keimanan dan ketakwaan kepada Allah swt.

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Viafora, Corrado. "La dimensione etica all’interno delle istituzioni sanitarie: i comitati di etica clinica." Medicina e Morale 53, no. 5 (October 31, 2004): 903–38. http://dx.doi.org/10.4081/mem.2004.625.

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Il saggio propone una ricognizione del processo di istituzionalizzazione dei Comitati etici per la pratica clinica prendendo in considerazione la prospettiva nord-americana, segnata dall’evoluzione dal paradigma orientato alla difesa dei diritti al paradigma orientato all’etica dell’organizzazione; la prospettiva europea, orientata verso una duplice direzione: Comitati come forum per il dibattito sulle questioni etiche all’interno dell’ospedale o Comitati etici come strutture direttamente di supporto al processo decisionale; la prospettiva italiana, marcata ancora da una situazione di incertezza e fragilità. Partendo dalla convinzione che l’istituzione di Comitati etici per la pratica clinica comporta importanti potenzialità per ravvivare la dimensione etica all’interno delle istituzioni sanitarie, il saggio individua e discute tre modelli attraverso cui potrebbero prendere corpo queste potenzialità. Un primo modello di Comitato si sviluppa in una prospettiva professionale, con la prevalenza delle seguenti funzioni: a. fornire un aiuto alle decisioni per gli operatori sanitari alle prese con problemi etici sempre più complessi; b. istituire uno spazio dedicato all’integrazione delle diverse istanze etico-professionali. Un secondo modello di Comitato etico si sviluppa in prospettiva organizzativa, ed ha le seguenti funzioni: a. fornire all’Amministrazione una consulenza che dia credibilità pubblica a indirizzi e direttive istituzionali che abbiano implicanze etiche; b. sensibilizzare alla dimensione etica, con la speranza di coinvolgere maggiormente la responsabilità diretta di ogni operatore sanitario. Un terzo modello di Comitato etico si sviluppa in prospettiva pubblica, con le funzioni di: a. contribuire a dare pubblicità e profondità al dibattito relativo alle questioni bioetiche e istituire procedure e occasioni di una reale comunicazione tra la società in generale e i gruppi di professionisti coinvolti nella produzione e nell’utilizzazione del nuovo sapere biomedico.

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Foddis, Carlo, Daniele Di Girolamo, Lucio Silingardi, Beatrice Manfredi, and Silvia Mazzoni. "Proposta di un algoritmo decisionale a supporto della procedura di valutazione delle relazioni triadiche di famiglie fragili condotta attraverso il Lausanne Trilogue Play (LTP)." TERAPIA FAMILIARE, no. 125 (June 2021): 107–24. http://dx.doi.org/10.3280/tf2021-125006.

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L'articolo delinea l'architettura di un algoritmo decisionale pensato a supporto di un metodo di scoring informatizzato da applicare alla procedura osservativa semi-strutturata del Lausanne Trilogue Play (LTP). Tale metodo consente l'individuazione del tipo di alleanza familiare prevalente a partire dai punteggi espressi dal clinico nel set delle 15 scale previste dalla procedura Viene pertanto descritto, in maniera dettagliata, il lavoro di operazionalizzazione dei differenti tipi di alleanza familiare, sviluppato con preciso riferimento al manuale di utilizzo del LTP (Sistema FAAS 6.3). Sono presentate, infine, le possibili ricadute cliniche ed organizzative dell'utilizzo dell'algoritmo nella valutazione di sistemi familiari triadici, entro il contesto sanitario pubblico dell'UO di Psicologia Clinica Minori e Famiglie.

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Bignamini, Angelo A. "Evidence-based medicine e linee guida di pratica clinica: soluzione o parte del problema?" Medicina e Morale 50, no. 2 (April 30, 2001): 225–49. http://dx.doi.org/10.4081/mem.2001.719.

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La Evidence-based medicine (EBM) e le linee guida di pratica clinica sono oggi ampiamente utilizzate per prendere decisioni in campo sanitario. Sebbene abbiano il merito di sintetizzare efficacemente la vastissima massa di informazioni cliniche continuamente prodotte nel mondo moderno, e possano portare alla esclusione di procedure chiaramente inutili o dannose, non si possono trascurare i rischi di un loro impiego scorretto. Entrambe soffrono del difetto strutturale di essere limitate quanto a copertura, dato che oggetto di evidenza possono essere solo procedure in linea di principio non necessarie, e limitate in quanto ad applicabilità al caso individuale, dato che la previsione statistica su cui si fondano è applicabile a popolazioni e non a soggetti. Infine, la loro stessa origine può essere soggetta ad errori sistematici. EBM e linee guida possono essere un utile strumento di educazione di chi opera nella sanità e un efficace supporto alla programmazione dell’utilizzo delle risorse sanitarie disponibili. Non possono però prevaricare il diritto di ciascun malato alla migliore terapia disponibile, né il diritto-dovere di ciascun medico di applicare per ciascun paziente l’approccio terapeutico ritenuto più utile per il paziente stesso nelle sue specifiche condizioni. D’altra parte, l’aderenza del medico alle informazioni ricavate dalla EBM e alle raccomandazioni delle linee guida può al più costituire garanzia di evitare errori macroscopici, ma non di avere operato nel migliore interesse del paziente e in maniera appropriata sotto il profilo etico e deontologico.

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Franzina, Pietro. "La disciplina internazionalprivatistica italiana della protezione degli adulti alla luce di una recente pronuncia = A recent decision involving the Italian rules of private international law on the protection of adults." CUADERNOS DE DERECHO TRANSNACIONAL 12, no. 1 (March 5, 2020): 219. http://dx.doi.org/10.20318/cdt.2020.5186.

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Riassunto: Una recente pronuncia del Tribunale di Belluno offre l’occasione per discutere le difficoltà che circondano l’applicazione delle norme italiane di diritto internazionale privato relative alla protezione delle persone maggiorenni che, a causa di un un’infermità o di menomazioni psichiche o fisiche, non sono in grado di provvedere ai propri interessi. Investito di un’istanza per la nomina di un amministratore di sostegno, il Tribunale ha affermato la sussistenza della giurisdizione italiana in ragione del fatto che la beneficiaria della misura di protezione –una cittadina macedone– aveva la propria residenza in Italia; circostanza rilevante, si legge nel provvedimento, tanto ai sensi dell’art. 3 quanto ai sensi dell’art. 9 della legge italiana di diritto internazionale privato (legge n. 218/1995), le norme generali riguardanti, rispettivamente, la giurisdizione contenziosa e quella volontaria. Quanto alla legge applicabile, il Tribunale ha innanzitutto rilevato che l’art. 43 della legge italiana di diritto internazio-nale privato richiama la legge nazionale della persona di cui trattasi, cioè, nella specie, la legge macedone. Si è dunque preoccupato di accertare se le norme macedoni sui conflitti di leggi richiamassero una legge diversa, ed è giunto alla conclusione che queste rinviassero nel caso di specie alla legge italiana. Anche il diritto internazionale privato macedone assoggetta in via ordinaria la protezione degli adulti alla legge del paese di cittadinanza dell’interessato, ma esiste nel sistema macedone una clausola di eccezione di carattere generale che, in un caso come quello considerato, interamente collegato con l’Italia (a parte la cittadinanza della beneficiaria) corregge il richiamo predetto e riconduce la fattispecie sotto il diritto italiano. Da qui, in forza dell’art. 13 della legge italiana di diritto internazionale privato, in tema di rinvio, l’applicabilità del diritto italiano. L’articolata argomentazione che sorregge la pronuncia, in sé convincente, mette in luce le ragioni per le quali l’assetto normativo attuale appare inadeguato a soddisfare gli interessi che oggi dominano la materia, quali risultano in particolare dalla Convenzione delle Nazioni Unite del 2006 sui diritti delle persone con disabilità. La ratifica italiana della Convenzione dell’Aja del 2000 sulla protezione internazionale degli adulti comporterebbe, si sostiene nell’articolo, vantaggi significativi. Parole chiave: disabilità; capacità; supporto nella assunzione di decisioni; competenza giurisdizionale; procedimenti contenziosi e volontari; legge applicabile; rinvio; clausola di eccezione. Abstract: A recent decision by the Tribunal of Belluno provides the opportunity to discuss the difficulties that surround the application of the Italian rules of private international law concerning the protection of adults who, by reason of an impairment or insufficiency of their personal faculties, are not in a position to protect their interests. Seised of a request for the appointment of an “amministratore di sostegno” (a person charged with assisting the adult concerned in the taking of particular decisions), the Tribunal found it had jurisdiction on the ground that the person for whom the protection was sought – a national of Macedonia – resided in Italy. As noted by the Tribunal, this provided a sufficient basis for jurisdiction under both Article 3 and Article 9 of the Italian Statute on Private International (Law No 218 of 1995), concerning jurisdiction over contentious and non-contentious proceedings, respectively. As regards the applicable law, the Tribunal observed at the outset that, pursuant to Article 43 of the Italian Statute, the protection of adults is governed by the law of the State of nationality of the adult concerned, that is, in the circumstances, the law of Macedonia. The Tribunal went on to assess whether the conflictof-laws rules in force in Macedonia refer, in turn, to the law of the different country, and found that they refer the matter back to Italian law. Like the Italian Statute, the Macedonian Statute of Private International Law provides that the protection of adults be governed by the law of nationality of the adult in question. However, the Macedo-nian Statute includes a general exception clause pursuant to which, in the Tribunal’s view, the case must rather be considered to be governed by Italian law, given that the case is con-nected with Italy in all respects, apart from the nationality of the person concerned. Hence, according to Article 13 of the Italian Statute, on renvoi, the application of Italian law. The Tribunal’s complex reasoning, while persuasive in itself, illustrates the reasons why the cur-rent legal landscape hardly suits the interests underlying this area of law, in particular as they result from the United Nations Convention on the rights of persons with disabilities of 2006. The paper argues that the picture would significantly improve if Italy ratified the Hague Convention of 2000 on the international protection of adults. Keywords: disability; capacity; assisted decision-making; jurisdiction; contentious and non-contentious proceedings; applicable law; renvoi; exception clause.

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Horna-Cieślak, Monika. "Zarządzenia wydawane przez sąd opiekuńczy na podstawie art. 109 Kodeksu rodzinnego i opiekuńczego jako forma pomocy rodzinie w świetle badania akt sądowych." Prawo w Działaniu 42 (2020): 38–59. http://dx.doi.org/10.32041/pwd.4202.

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The article presents the results of court files studies related to orders issued by guardianship courts on the basis of Article 109 of the Family and Guardianship Code, as one of forms of supporting the family. The analyses focused on the functioning of a family and its particular members (minors and their parents), guardianship courts and support institutions in situations which are difficult for the family, i.e. in cases of a threat of the child’s best interests. In the course of the studies, it was determined inter alia that, in most cases, the support granted to the family by guardianship courts consisted in appointing a court guardian to supervise the family; that rulings of guardianship courts contained a negligible number of direct references to the child; as well that the decision whether and how guardianship courts should help the family were made mainly based on information passed on by court guardians and only in exceptional cases was the child interviewed and only exceptionally was expert’s supports sought, where said experts were able to provide information on a given family’s deficits and needs, and the most adequate forms of support for the family.

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Torrieri, Francesca, Alessandra Oppio, and Marco Rossitti. "Damage assessment for architectural heritage: the Cavallerizza Reale complex in Turin / La stima dei danni al patrimonio architettonico: il caso della Cavallerizza Reale di Torino." Valori e Valutazioni 30 (August 2022): 71–84. http://dx.doi.org/10.48264/vvsiev-20223005.

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Damage assessment for architectural heritage stands as a relevant issue from an appraisal perspective due to heritage properties’ peculiar technological and building techniques and their complex social values. The specificity of Italian cultural heritage, widespread on the national territory, even in high environmental risk (landslides, earthquakes, and floods) areas, calls for dealing with the damage assessment theme by considering tangible and intangible features. Indeed, architectural heritage value is not limited only to its market or use value but must be expressed as a Total Economic Value, in its tangible and intangible components, that can be destroyed or affected by damages. In this context, the paper provides a relevant case study concerning the assessment of fire, lack of maintenance, and occupation damages for the ‘Pagliere’ buildings, located within the building complex ‘Cavallerizza Reale’ in Turin, which is included in the Unesco World Heritage list. Thanks to the specificities and the historical-architectural significance of the properties under analysis, this case study provided an interesting reflection on the methodological approach for the total damage assessment, given by the sum of its three different components: fire damage, lack of maintenance damage, and abandonment damage. Based on the discussion of the results, the paper proposes some possible insights for future research focusing on assessing architectural heritage damages. La stima dei danni al patrimonio storico-architettonico rappresenta una questione interessante da un punto di vista estimativo in considerazione delle particolari caratteristiche tecnologiche-costruttive dei manufatti in oggetto e dei valori sociali complessi di cui essi sono espressione. La specificità del modello italiano di patrimonio culturale, diffuso sul territorio in modo capillare, anche in aree dove sono presenti alti rischi ambientali (frane, terremoti ed alluvioni), pone il tema della stima dei danni rispetto sia alle componenti tangibili sia a quelle intangibili. Il valore del patrimonio architettonico, pertanto, non si limita ai soli valori di mercato e ai valori d’uso, ma si estende al Valore Economico Totale, nelle sue dimensioni tangibili e intangibili, che possono essere distrutte o compromesse dal danno. In questo quadro, il paper presenta un caso studio di rilevante interesse, relativo alla stima dei danni da incendio, da mancata manutenzione e da abbandono del compendio delle Pagliere, sito all’interno del complesso immobiliare, patrimonio dell’Unesco, della Cavallerizza Reale a Torino. Data la particolarità dell’immobile oggetto di analisi e le caratteristiche storico-architettonico di evidente rilievo, il caso ha sollecitato interessanti riflessioni in merito alla metodologia da adottare per la stima del danno nel suo complesso, nonché alla stima delle sue singole componenti, ossia danno da incendio, occupazione e abbandono. A partire da una discussione dei risultati, il contributo traccia potenziali spunti per avviare ricerche che possano essere di supporto all’esercizio della stima del danno arrecato al patrimonio culturale.

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Baker, Ross I., Grace Gilmore, and Scott McGregor. "Andexanet Alfa Corrects the Interference of Direct Factor Xa Inhibitors on Lupus Anticoagulant Testing." Blood 128, no. 22 (December 2, 2016): 2626. http://dx.doi.org/10.1182/blood.v128.22.2626.2626.

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Abstract Background Direct Factor Xa (FXa) inhibitors (e.g. rivaroxaban or apixaban) are widely used oral anticoagulants and are known to interfere with dilute Russell's viper venom time (dRVVT) and aPTT-based lupus anticoagulant (LA) testing, often yielding false-positive LA results. A false positive LA result might incorrectly diagnose a patient with the anti-phospholipid antibody syndrome and lead to a wrong decision for long-term anticoagulation to prevent recurrent thrombosis. Andexanet alfa is a recombinant modified human FXa decoy protein that has been specifically designed as an antidote to neutralise the effect of the direct and indirect FXa inhibitors. Aim To determine whether the addition of andexanet alfa can overcome the interference of rivaroxaban and apixaban on LA testing in plasma samples from both LA positive and LA negative patients. Methods After written informed consent, citrated blood (20mL) was collected from 12 patients on therapeutic doses of rivaroxaban (n=6) or apixaban (n=6) with previously known LA status (3/6 LA positive in each group). Samples were double centrifuged at 3,000 x g for 10 minutes and aliquots were frozen at -40oC until analysed. Normal pooled plasma and rivaroxaban and apixaban calibrated plasma was obtained from a commercial source (Diagnostica Stago) or control plasma from healthy volunteers, prepared as above. IgG was purified by a Protein G column from a known LA positive patient and a control healthy volunteer. Rivaroxaban (Bayer) and apixaban (Bristol-Myers Squibb) tablets were crushed and dissolved in DMSO. Andexanet alfa (Portola Pharmaceuticals, Inc.) was dissolved in distilled water and aliquots were frozen at -40oC until used. Plasma samples were spiked with varying concentrations of FXa inhibitors and andexanet alfa. LA-sensitive aPTT, PT, TCT, dRVVT (Siemens Healthcare Diagnostics) and anti-FXa level (Diagnostica Stago) were performed with and without andexanet alfa on the Sysmex CS5100 analyser. Andexanet alfa (at a final concentration of 250µg/mL) was added to LA positive and LA negative plasma samples to assess the impact on the dRVVT normalised ratio. Results Andexanet alfa demonstrated a concentration-dependent increase in LA sensitive aPTT and dRVVT clotting times, with negligible impact on PT or TCT. Andexanet alfa was capable of reversing FXa inhibition in a concentration-dependent manner in plasma samples containing rivaroxaban or apixaban. When rivaroxaban is added to normal plasma it significantly prolongs the dRVVT without phospholipid more than with excess phospholipid leading to a false-positive LA ratio at final concentrations >100ng/mL. This level of rivaroxaban is in the therapeutic range. The addition of andexanet alfa reduced the measurable anti-FXa level and returned the normalised dRVVT ratio to LA negative result (<1.25). In contrast, apixaban and andexanet alfa proportionately prolongs the dRVVT with or without excess phospholipid and even at high concentrations, the normalised LA ratio remains negative (<1.25). Andexanet alfa converted the false positive dRVVT rivaroxaban patient plasmas LA ratio to negative. True LA positive patients remained positive after the addition of andexanet alfa. These results were confirmed by adding LA positive and control purified IgG to known concentrations of rivaroxaban and apixaban (200ng/ml) in normal plasma. Conclusion Andexanet alfa corrects the false positive LA ratio in patients on rivaroxaban without affecting the true diagnosis in LA positive patients. Apixaban and andexanet alfa proportionately prolong the dRVVT with and without phospholipid, so the LA ratio remains negative. For this reason true LA positive patients can be diagnosed whilst on apixaban at therapeutic concentrations without the addition of andexanet alfa. Disclosures Baker: Biogen Idec: Membership on an entity's Board of Directors or advisory committees, Research Funding; Novo Nordisk: Other: Conference travel support; Astellas and CSL Behring: Research Funding; Bristol-Myers Squibb: Research Funding; Boehringer Ingelheim: Membership on an entity's Board of Directors or advisory committees, Research Funding; Bayer: Membership on an entity's Board of Directors or advisory committees, Research Funding; Shire: Membership on an entity's Board of Directors or advisory committees, Other: Conference travel support, Research Funding; Daiichi Sankyo: Research Funding; Portola Pharmaceuticals: Research Funding; Pfizer: Membership on an entity's Board of Directors or advisory committees, Research Funding; Amgen: Membership on an entity's Board of Directors or advisory committees, Other: Conference travel support; Biogen Idec: Membership on an entity's Board of Directors or advisory committees; Alexion Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees, Other: Conference travel support, Research Funding; Roche: Other: Conference travel support. McGregor:Gilead: Membership on an entity's Board of Directors or advisory committees; Bristol-Myers Squibb: Equity Ownership, Other: Conference travel support; Pfizer: Other: Conference travel support; Roche: Honoraria; Abbvie: Equity Ownership; Portola Pharmaceuticals: Equity Ownership.

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Goldstein, A., L. Fink, O. Raphaeli, A. Hetzroni, and G. Ravid. "Addressing the ‘Tower of Babel’ of pesticide regulations: an ontology for supporting pest-control decisions." Journal of Agricultural Science 157, no. 6 (August 2019): 493–503. http://dx.doi.org/10.1017/s0021859619000820.

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AbstractFarmers, who have to decide which pesticide to use against a particular crop-damaging pest, need to take into account country-specific regulations (e.g. permitted levels of pesticide residues), application instructions and financial considerations. The fact that these data are stored in different locations, sometimes using different terminology or different languages, makes it difficult to gather these data and requires that farmers are familiar with the variety of terms used, which consequently hampers the efficiency and effectiveness of the decision process. To overcome these challenges, a Web application for pest control is proposed to facilitate the integration of information coming from different Internet sources and representing different terminologies by using an ontology. The application is based on a pest-control ontology (formal representations of domain knowledge that can be interpreted by computers) that accounts for various pesticide regulations of different countries to which the crop is exported. In recent years, ontologies have become a major tool for domain knowledge representation and a core component of many knowledge management systems, decision support systems and other intelligent systems, inter alia, in the context of agriculture. The pest-control ontology developed in the current research includes pest-control concepts that have yet to be covered by existing ontologies. It is demonstrated in the specific case of pepper in Israel. The ontology is expressed using Web Ontology Language (OWL) and thus can be shared on the Web and reused by other ontologies and systems. In addition, a comprehensive method for developing and evaluating agricultural ontologies is presented.

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Steynberg, L. "Distinguishing Between Private Law and Social-Security Law in Deducting Social Grants from Claims for Loss of Support." Potchefstroom Electronic Law Journal/Potchefstroomse Elektroniese Regsblad 14, no. 4 (June 8, 2017): 259. http://dx.doi.org/10.17159/1727-3781/2011/v14i4a2590.

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This article attempts to highlight the potential danger in applying private-law principles to social-security law in deciding whether or not social grants should be deducted from awards for damages. Typically, this issue comes to the fore where a damage-causing event, such as death, sets into motion a system that provides for the payment of social benefits, damages or both. In social-security law, the receipt of more than one social benefit is called "double dipping", whereas in private law the problem of double compensation is addressed by applying the collateral-source rule. In some instances the applicable legislation clearly prescribes the deduction or not of the social benefit, but unfortunately our legislation is not always clear on this issue and this can best be illustrated by two recent conflicting decisions in Makhuvela (SGHC) and Timis (SCA). In Makhuvela the court held that a foster-care grant should be disregarded in calculating the award for damages, inter alia because the child will never have a claim to the grant. In Timis the SCA distinguished the facts from Makhuvela and held that the child-support grants received by the mother after the father's death are directly linked to the death of the father and should therefore be deducted from her claim for loss of support. It is submitted that although the outcome of the Timis decision is correct, the court should have incorporated the means test into the process of deciding if the grant should be deducted from the compensation. A two-phase approach is suggested: first determine if the receipt of the grant is directly linked to the death of the breadwinner, and secondly determine how the grant and the subsequent settlement paid by a wrongdoer will affect the circumstances of a particular individual or family. The objectives in social-security law differ from the objectives in the law of damages and therefore the principles applied in cases of double dipping cannot be equated with those applied in cases of collateral benefits.

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Berger, Markus, Jazmin Campos, Mauro Carolli, Ianna Dantas, Silvia Forin, Ervin Kosatica, Annika Kramer, et al. "Advancing the Water Footprint into an Instrument to Support Achieving the SDGs – Recommendations from the “Water as a Global Resources” Research Initiative (GRoW)." Water Resources Management 35, no. 4 (March 2021): 1291–98. http://dx.doi.org/10.1007/s11269-021-02784-9.

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AbstractThe water footprint has developed into a widely-used concept to examine water use and resulting local impacts caused during agricultural and industrial production. Building on recent advancements in the water footprint concept, it can be an effective steering instrument to support, inter alia, achieving sustainable development goals (SDGs) - SDG 6 in particular. Within the research program “Water as a Global Resource” (GRoW), an initiative of the Federal Ministry for Education and Research, a number of research projects currently apply and enhance the water footprint concept in order to identify areas where water is being used inefficiently and implement practical optimization measures (see imprint for more information). With this paper, we aim to raise awareness on the potential of the water footprint concept to inform decision-making in the public and private sectors towards improved water management and achieving the SDGs.

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Luong, An-Vinh, Diep Nguyen, and Dien Dinh. "Examining the Part-of-speech Features in Assessing the Readability of Vietnamese Texts." Acta Linguistica Asiatica 10, no. 2 (July 30, 2020): 127–42. http://dx.doi.org/10.4312/ala.10.2.127-142.

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The readability of the text plays a very important role in selecting appropriate materials for the level of the reader. Text readability in Vietnamese language has received a lot of attention in recent years, however, studies have mainly been limited to simple statistics at the level of a sentence length, word length, etc. In this article, we investigate the role of word-level grammatical characteristics in assessing the difficulty of texts in Vietnamese textbooks. We have used machine learning models (for instance, Decision Tree, K-nearest neighbor, Support Vector Machines, etc.) to evaluate the accuracy of classifying texts according to readability, using grammatical features in word level along with other statistical characteristics. Empirical results show that the presence of POS-level characteristics increases the accuracy of the classification by 2-4%.

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Frison, Vera. "Knowledge; know-how; skills to be able to live with chronicity, care for it, and cure it. An AMD project to help clinicians overcome therapeutic inertia. Results of the web survey among AMD members." Journal of AMD 25, no. 1 (May 2022): 55. http://dx.doi.org/10.36171/jamd21.24.4.10.

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Scopo della survey è stato quello di esaminare il comportamento ed il vissuto del diabetologo nei confronti dell’inerzia terapeutica, anche alla luce degli ostacoli posti dai modelli assistenziali (ad es.: piani terapeutici, scarso tempo disponibile per dedicare attenzione ai pazienti) ponendo l’attenzione anche sugli aspetti emotivi e culturali che emergono nel corso dell’attività professionale. È stato inviato ai diabetologi dell’Associazione Medici Diabetologi un link per un questionario, a cui rispondere via web, composto da 19 domande. La prima parte del questionario era finalizzata a descrivere il campione dei diabetologi coinvolti (età, sesso, contesto lavorativo, ecc.). La seconda parte ha analizzato invece l’atteggiamento nei confronti di situazioni di “inerzia terapeutica”. All’indagine hanno partecipato 94 medici, 66% donne e 34 % uomini, di età compresa tra i 30 ed i 70 anni, distribuiti in maniera omogenea sul territorio nazionale, 37% al Sud, 36% al Nord e 27% al Centro Italia, con buona esperienza nel settore (l’81 % opera da più di 10 anni), che prestano la loro attività per il 51% presso una struttura ospedaliera, per il 37% presso una struttura ambulatoriale mentre il restante 10% svolge esclusivamente attività libero professionale. Le risposte alle domande hanno evidenziato che l’inerzia terapeutica è un elemento presente, causato da molteplici fattori, che si è acuito a causa della pandemia da COVID-19, ed è connaturato alla complessità della patologia da un lato, e dall’altro ad una articolazione dei trattamenti terapeutici complessa da gestire. Sempre di più, il clinico, oltre alle competenze legate alla gestione della patologia, necessita di un supporto che lo aiuti sia a perfezionare il momento decisionale che a migliorare l’approccio con il paziente per essere capace di coglierne i bisogni e proporre il percorso di cura più adatto, efficace e sicuro, realizzando una vera personalizzazione della terapia. Approcciare la terapia rimane forse la sfida più importante. A questo si aggiunge la problematica dell’accesso ancora limitato alle cure a causa della situazione che le strutture sanitarie stanno affrontando per contrastare la pandemia Covid- 19 e la necessità per il medico di ricollocare la propria persona e la propria professione all’interno di un sistema completamente rinnovato. PAROLE CHIAVE diabete mellito; nuovi ipoglicemizzanti; inerzia terapeutica.

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Goldstein, Anat, Lior Fink, and Gilad Ravid. "A Framework for Evaluating Agricultural Ontologies." Sustainability 13, no. 11 (June 4, 2021): 6387. http://dx.doi.org/10.3390/su13116387.

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An ontology is a formal representation of domain knowledge, which can be interpreted by machines. In recent years, ontologies have become a major tool for domain knowledge representation and a core component of many knowledge management systems, decision-support systems and other intelligent systems, inter alia, in the context of agriculture. A review of the existing literature on agricultural ontologies, however, reveals that most of the studies, which propose agricultural ontologies, are lacking an explicit evaluation procedure. This is undesired because without well-structured evaluation processes, it is difficult to consider the value of ontologies to research and practice. Moreover, it is difficult to rely on such ontologies and share them on the Semantic Web or between semantic-aware applications. With the growing number of ontology-based agricultural systems and the increasing popularity of the Semantic Web, it becomes essential that such evaluation methods are applied during the ontology development process. Our work contributes to the literature on agricultural ontologies by presenting a framework that guides the selection of suitable evaluation methods, which seems to be missing from most existing studies on agricultural ontologies. The framework supports the matching of appropriate evaluation methods for a given ontology based on the ontology’s purpose.

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Madinah, Nabukeera, Bwengye Michael, and Nabaggala Rose. "The Husbands’ Support: The Experiences of off-Campus Married Muslim Student Mothers in Private and Religious Institutions of Higher Learning in Uganda—A Case of Islamic University in Uganda (IUIU)." World Journal of Educational Research 8, no. 2 (March 26, 2021): p69. http://dx.doi.org/10.22158/wjer.v8n2p69.

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While IUIU policies allow students to officially get married the same institution does not allow babies in halls of residence yet it has not put in place the necessary facilities and arrangements on campus to enable them juggle their multiple roles as Married Muslim Student Mothers (MMSM) in completing their academic undertakings. This poses a challenge due to constrained finances that make it difficult due to inability to pay maid thus causing frustrations which later affects their academic performance. The research adopted a Feminism theory and other supporting theories to explore the experiences of married Muslim student mothers, husbands support, institutional policies, challenges and coping strategies. The study was allocated within a qualitative research paradigm and involved semi-structured interviews with a purposive sample of 30 undergraduate university married Muslim student mothers. Key findings were that the married Muslim student mothers’ experiences were child care and excess workload: husbands’ support included emotional and financial support: institutional support comprised of lack of child care support, support from lectures, family and friends: challenges involved time management, lack of support from lecturers, transport costs, excess workload, fixed timetables and lack of social and financial support: coping strategies included time management skills, faith and Allah, assistance with child care, creating extra time and advise. These findings have implications for policy in terms of empowerment, support to enable them to amalgamate competing roles of student mothers. MMSM operate in a family system which influences their decisions hence failure to make independent decisions but rather seek approval from their husbands. If MMSM are to succeed with their endeavors of completing their education while married they should submit to their husband in order to receive emotional and financial support to fulfill their academic dreams and a better future.

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Rosato, Paolo, Raul Berto, and Chiara D'Alpaos. "Risk and returns in real estate development projects at the black swan test [Rendimento e rischio d’investimento immobiliare alla prova del cigno nero]." Valori e Valutazioni 31 (February 2023): 15–31. http://dx.doi.org/10.48264/vvsiev-20223103.

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The real estate market is affected by great uncertainty due to the nexus of various factors: a) the specificity of the assets traded, which are illiquid, unique and very hetherogeneous from each other; b) the ‘structural disequilibrium’ of the market caused by the differences emerging in elasticity of supply with respect to demand; c) the non-competitiveness of the market, which often turns into a bilateral monopoly; d) the great variability of market prices. Since the subprime mortgage crisis that broke out at the end of 2006 in the United States, it has clearly emerged that, in a sector that represents about a third of world wealth, it is necessary, on the one hand, to implement proper and increasingly sophisticated valuation tools, to support the design of effective risk management strategies and, on the other hand, to improve the reliability of real estate data, in order to allow for a more robust verification of the hypotheses on the trend of the cash flows generated by the investment and a more accurate valuation of the investment risk and, consequently, of the project expected rate of return. The main objective of this work is to investigate the accuracy and robustness of the estimates of real estate investors of the expected returns on an urban development project in a medium-sized city representative of the North East of Italy. Using a simulation-based approach, the gap between the observed internal rate of return, estimated ex post on the basis of the actual trend of the parameters that influence investment returns, and the expected internal rate of return, calculated ex ante on the basis of the information available at the time of the investment decision. Firstly, we constructed the time series from 1995 to 2015 of the expected and observed internal rates of return of investments in the residential sector. We obtained the time series of the cash flows generated by the investment under investigation by implementing a simulation-based approach. Starting from the comparison between observed internal rate of return and expected internal rates of return, we identified ex post the risk implicitly assumed by the investor at the time of the decision to undertake the investment. Secondly, the effectiveness of the Capital Asset Pricing Model as a method for estimating the return on a property investment was verified, by comparing the project’s observed (ex post) internal rate of return with its ex ante rate of return, estimated through the Capital Asset Pricing Model. To carry out the above analyses, we constructed the time series of observed and expected internal rate of returns from 1995 to 2015 of investments in the residential sector. The time series of the internal rate of returns of real estate investments were obtained by implementing a simulation-based approach to determine the cash flows of real estate investments representative of the context under investigation and by adopting as model inputs the parameters usually adopted in ex-ante and ex-post real estate valuations. Starting from the comparison between observed and expected internal rate of returns, we identified ex-post the risk implicitly assumed by the developer at the time of the decision to undertake the investment. Finally, by investigating the determinants of the divergence between the investment’s observed and expected internal rate of return and cyclical variables, we identified the factors (i.e., the macroeconomic fundaments) which, in the period under investigation, affected investment risk and, consequently, investment return. Finally, by investigating the relationships that account for the difference between the observed and expected internal rate of return and the economic factors that can determine the current stage in economic cycles, we identified the determinants of invetment risk and returns. Il mercato immobiliare è affetto da grande incertezza dovuta a una concatenazione di diversi fattori: a) la specificità dei beni scambiati che sono illiquidi, unici e molto eterogenei tra loro; b) il “disequilibrio strutturale” del mercato causato dalla diversa elasticità del- l’offerta rispetto alla domanda; c) la non concorrenzialità del mercato che, assume spesso le caratteristiche del monopolio bilaterale; d) la grande variabilità dei prezzi di mercato. A partire dalla crisi dei mutui sub- prime scoppiata alla fine del 2006 negli Stati Uniti, è emerso chiaramente come, in un settore che rappresenta circa un terzo della ricchezza mondiale, sia necessario, da un lato, operare con strumenti valutativi adeguati e sempre più sofisticati, in grado di suppor- tare l’individuazione di strategie efficaci di gestione dei rischi e, dall’altro, migliorare l’affidabilità dei dati immobiliari, in modo da consentire una verifica più ro- busta delle ipotesi sull’andamento dei flussi di cassa generati e una stima più accurata del rischio e, conseguentemente, del tasso di rendimento atteso. Obiettivo principale del presente lavoro è di investigare l’accuratezza delle previsioni effettuate da un ipotetico operatore immobiliare sul rendimento di un investi- mento a sviluppo in una città di medie dimensioni rap- presentativa della provincia dell’Italia settentrionale. Attraverso un approccio basato sulla simulazione, è stato calcolato lo scarto fra il tasso interno di rendimento effettivo, stimato ex post in base all’andamento effettivo dei parametri influenti sul rendimento stesso, e il tasso interno di rendimento atteso, calcolato ex ante sulla base delle informazioni disponibili al mo- mento della decisione d’investimento. In primo luogo, è stata costruita la serie storica dal 1995 al 2015 dei tassi interni di rendimento attesi ed effettivi dell’investi- mento immobiliare residenziale a sviluppo. Le serie storiche sono state ottenute mediante la simulazione dei flussi di cassa di investimenti immobiliari rappresentativi della realtà indagata. A partire dal confronto fra tassi interni di rendimento effettivi e tassi interni di rendimento attesi è stato individuato, ex post, il rischio assunto implicitamente dall’investitore al momento della decisione di intraprendere l’investimento stesso. In secondo luogo, è stata verificata la bontà del Capital Asset Pricing Model come metodo di stima del rendi- mento di un investimento immobiliare a sviluppo, confrontando il tasso interno di rendimento effettivo e il tasso di rendimento ex ante stimato attraverso il Capi- tal Asset Pricing Model stesso. Infine, indagando sulle relazioni che intercorrono fra lo scarto fra tasso di rendimento interno effettivo e atteso e le variabili congiunturali, sono stati individuati i fattori che, nel periodo considerato, hanno maggiormente influito sul rischio al quale si è esposto l’investitore al momento di investire.

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Pravettoni, Gabriella, Sara Gandini, Giuseppe Curigliano, Alessandra Gorini, Ketti Mazzocco, J. Gordon McVie, and Elisabetta Munzone. "ALGA: A cancer patient profiling tool to improve physician-patient communication—An analysis in breast cancer patients." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): 9582. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.9582.

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9582 Background: Considerable improvement of communication between physicians and patients (pts) will need to occur as personalised medicine becomes the norm. An accurate profile of the pt’s cognitive and psychological status should help the physician shape his language and his messages to maximise the pt’s understanding of her management options. To this aim a computerized tool (ALGA questionnaire) has been created and validated. Methods: The validation process produced a questionnaire with 4 main factors: Health State Perception, Psychological, Psychosocial and Cognitive aspects. To test its ability to discriminate between healthy people and pts, ALGA has been administered to 50 newly diagnosed primary Breast Cancer (BC) pts prior to their first visit with the oncologist to discuss their adjuvant treatment, and to 50 healthy women (age range:20-60), using an iPad. Results: A multivariate analysis showed a significant difference between BC pts and healthy women relatively to the four aforementioned broad areas: Psychosocial (F(1,56)=13.42, p<.001), Cognitive (F(1,56)=6.53, p<.01), and Psychological Aspect (F(1,56)=2.77, p=.05). ALGA detected pts with higher levels of anxiety and depression. Pts tended to ruminate more than healthy subjects. Finally, pts showed higher level of positive Health State Perception, suggesting a dissociation between cancer illness and general health. Cognitive and Psychological aspects and Health State Perception interacted with participants’ level of education (respectively: F(1,56)=12.23, p<.001; F(1,56)=4.58, p<.05; F(1,56)=7.9, p<.05). Starting from this results a personal profile for each pt was created. Conclusions: The ALGA confirmed ability to discriminate between healthy people and BC pts, and is a good tool to create a personal pt’s profile with which physicians can empower patient with tailored knowledge. Starting from ALGA questionnaire, a smart environment is being implemented as a decision support infrastructure to help communication, interaction and information delivery process from doctor to patient, influencing patient’s quality of life and satisfaction.

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Beresneva, P. V. "Efficiency Assessment of Economic International Cooperation in Development of Arctic Offshore Oil and Gas Resources." MGIMO Review of International Relations, no. 1(40) (February 28, 2015): 128–36. http://dx.doi.org/10.24833/2071-8160-2015-1-40-128-136.

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The research is focused on efficiency assessment of economic cooperation in development of Arctic offshore oil and gas resources. The author developed an economic model based on cost-benefit analysis (CBA). CBA is used in some countries (EU, USA, Australia) as an analytic tool to make public policy decisions. CBA is based on the method of discounting cash flows associated with costs and benefits of public policy. It is assumed that all public goals are equally important inter alia, hence public bodies should opt for those initiatives that maximize public benefits for every dollar spent from the state budget. There are five stages of economic modeling: 1) the definition of public benefits and costs associated with the public initiative; 2) monetary valuation of costs and benefits; 3) the definition of discounting period and discounting rate; 4) the calculation of net present value of cash flows; 5) the comparison of initiatives' net present values. The model is built with a number of hypotheses assumed. It allows making evaluation of investments into the technology to decrease the cost of Arctic offshore oil and gas development. Moreover, the model has two scenarios describing a public policy to support technology development with international economic cooperation and without it. Under given hypotheses both scenarios return positive net present value of policies which proves that governmental initiative to support Arctic technology development is economically justified. Also the model sows that the scenario with international cooperation is more efficient from economic point of view. It is explained by two factors: the higher speed of technology transfer (due W international cooperation) and the opportunity to use financial leverage (attracting the funds from foreign partners). The model allows closing the existing scientific gap between the theory of CBA method and its practical use in public decision making.

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Zanco, Jasper José, Pedro Boff, Simone Silmara Werner, and Mari Ines Carissimi Boff. "Biophototic in azuki bean seeds treated with ultrahigh dilutions." Research, Society and Development 10, no. 2 (February 14, 2021): e26110212462. http://dx.doi.org/10.33448/rsd-v10i2.12462.

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Seed analysis is usually performed by destructive samples with time-consuming methods. Treatments that improve seed vigor are suggested based on bioassays and protocols for most plants. This includes the use of images to assess quality and pro- vide information that supports decisions. However, instrumental cost has not made these technologies widely used. The objective of this research was to study biophotonic images generated by low cost technologies - cold plasma scanner or gas discharge visualization (GDV) and speckle laser (BSL) - to evaluate the germination of adzuki beans seeds treated with ultrahigh dilutions (UHD). The research was carried out at the EPAGRI Homeopathy and Plant Health Laboratory, with a post-graduate support at the State University of Santa Catarina (UDESC). The images of the seeds were diagnosed mathematically, before and after germination, using “Local Connected Fractal Dimension Analysis” (LCFD) and “Time History Speckle Pattern” (THSP). The results show that the images identify the effects of high dilution - Bryonia alba and Silicea terra, at 6, 12 and 30 CH (centesimal hahnemannian dilution order) - on the seeds of azuki beans. There were statistically differences (p < 1% and p < 5%) of the treatments in relation to the control: water. Only Silicea terra 30CH inhibited seed germination. The signals found in the BSL images of the seeds were superior to the GDV signals, showing an average of 89% correct responses (BSL) against 87% (GDV).

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Ontkóc, Marián, and Veronika Kotradyová. "Participatory Design as a Tool for Sustainable Regional Development." Architecture Papers of the Faculty of Architecture and Design STU 26, no. 2 (June 1, 2021): 24–30. http://dx.doi.org/10.2478/alfa-2021-0010.

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Abstract Globalization changes our world too quick and regions cannot keep up. Copying mechanisms affect crafted products and architecture and create specific signs for each region. Understanding that, we can follow cultural concepts and transform them to fit the current era and sustain local identity within communities. Compared with evolution, community attachment as part of social sustainability has the same self-regulated mechanisms. The adaptation process can be achieved in different ways, but only few are truly sustainable. To restore the sense of community and reconnect local people to their village at a deeper level, the participatory approach was tested. The process and tools well known from urban areas were applied in certain Slovak villages. As compared to participation in cities, in the rural environment, the process is more time-consuming. In theory, this should bring a result that lasts longer than that achieved by standard processes. Methods proposed by us will have several outcomes like networking, open communication and, if successful, can be an inspiration for other villages and activists to adopt the approach. This time-demanding activity can help to support local people and show them how to coordinate themselves in the decision-making process. The bottom-up approach increases self-esteem and by place-making, small public intervention can help with communication with local municipalities. In this process, the designer acts as a facilitator of a multidisciplinary innovation project and must use own creativity to handle many challenges.

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França, Lionel Riou, Robert Launois, Katell Le Lay, Philippe Aegerter, Myriam Bouhassira, Patrick Meshaka, and Bertrand Guidet. "Cost-effectiveness of drotrecogin alfa (activated) in the treatment of severe sepsis with multiple organ failure." International Journal of Technology Assessment in Health Care 22, no. 1 (January 2006): 101–8. http://dx.doi.org/10.1017/s0266462306050896.

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Objectives:The aim of this study was to estimate the expected cost and clinical benefits associated with the use of drotrecogin alfa (activated) (Xigris; Eli Lilly and Company; Indianapolis, IN) in the French hospital setting.Methods:The recombinant human activated PROtein C Worldwide Evaluation in Severe Sepsis (PROWESS) study results (1,271 patients with multiple organ failure) were adjusted to 9,948 hospital stays from a database of Parisian area intensive-care units (ICUs)—the CubRea (Intensive Care Database User Group) database. The analysis features a decision tree with a probabilistic sensitivity analysis.Results:The cost per life year gained (LYG) of drotrecogin treatment for severe sepsis with multiple organ failure (European indication) was estimated to be $11,812. At the hospital level, the drug is expected to induce an additional cost of $7,545 per treated patient. The incremental cost-effectiveness ratio ranges from $7,873 per LYG for patients receiving three organ supports during ICU stay to $17,704 per LYG for patients receiving less than two organ supports.Conclusions:Drotrecogin alfa (activated) is cost-effective in the treatment of severe sepsis with multiple organ failure when added to best standard care. The cost-effectiveness of the drug increases with baseline disease severity, but it remains cost-effective for all patients when used in compliance with the European approved indication.

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Zmyvalova, Ekaterina. "The Impact of the War in Ukraine on the Indigenous Small-numbered Peoples’ Rights in Russia." Arctic Review on Law and Politics 13, no. 2022 (2022): 407. http://dx.doi.org/10.23865/arctic.v13.4058.

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This article discusses how the war in Ukraine, started by Russia, impacts the lives of Russian Indigenous small-numbered peoples. First, one can observe Russia’s growing disregard for its international legal obligations. Second, the Russian State is continuously introducing new sanctions against persons and organizations who do not support the Russian regime. Third, the pressure on Indigenous peoples’ representatives is increasing. Fourth, a significant number of members of Indigenous small-numbered peoples actively participate in the war due to, inter alia, socio-economic problems and lack of reliable and objective information about it. Fifth, there is a decline in international cooperation with the Indigenous small-numbered peoples of Russia. Finally, it is visible that the role of Indigenous peoples, including Russian Indigenous peoples, in international decision-making changes.

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Colantuoni, S., G. Mainiero, and A. Esposito. "A Method to Reduce the Rejection Rate for Low Performance at the Acceptance Test of PWC PT6T-6 Overhauled Power Sections." Journal of Engineering for Gas Turbines and Power 118, no. 2 (April 1, 1996): 229–35. http://dx.doi.org/10.1115/1.2816581.

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Alfa Romeo Avio is involved in the overhaul process of the Pratt & Whitney of Canada PT6T-6 for the helicopter fleet of the Italian Army and civil services. The overhauled power sections suffered from a high rejection rate (about 40 percent) for low performance at the acceptance test. Alfa Romeo Avio R&D investigated the causes and developed a method to reduce the rejection rate. A first contribution to the decision support method for the selection of the optimal engine configuration can be obtained from engine thermodynamic cycle simulation, which gives indications on the behavior of the average overhauled power section. In this paper the authors also describe a statistical model based on a cause/effect correlation between power section assembly variables and performance parameters. A simulation procedure, based on the statistical model, estimates the influence of the configuration assembly data on the power section performance parameters. A careful application of both statistical and thermodynamic models gives predictions on the optimum matching of turbine nozzle size to reach the target performance at the engine acceptance test. The method has been tested on the field during the last two years and a reduction in the rejection rate at the acceptance test to 18 percent has been obtained.

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Colle, Brian A., Rosemary Auld, Kenneth Johnson, Christine O’Connell, Temis G. Taylor, and Joshua Rice. "Improving Communication of Uncertainty and Risk of High-Impact Weather through Innovative Forecaster Workshops." Bulletin of the American Meteorological Society 102, no. 7 (July 2021): E1424—E1430. http://dx.doi.org/10.1175/bams-d-20-0108.1.

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AbstractIt is challenging to communicate uncertainty for high-impact weather events to the public and decision-makers. As a result, there is an increased emphasis and training within the National Weather Service (NWS) for “impact-based decision support.” A Collaborative Science, Technology, And Research (CSTAR) project led by Stony Brook University (SBU) in collaboration with the Alan Alda Center for Communicating Science, several NWS forecast offices, and NWS operational centers held two workshops at SBU on effective forecast communication of probabilistic information for high-impact weather. Trainers in two 1.5-day workshops helped 15–20 forecasters learn to distill their messages, engage audiences, and more effectively communicate risk and uncertainty to decision-makers, media, and the general public. The novel aspect of the first workshop focused on using improvisational techniques to connect with audiences along with exercises to improve communication skills using short, clear, conversational statements. The same forecasters participated in the second workshop, which focused on matching messages to intended audiences and stakeholder interaction. Using a recent high-impact weather event, representatives in emergency management, TV media, departments of transportation, and emergency services provided feedback on the forecaster oral presentations (2–3 min) and a visual slide. This article describes our innovative workshop approach, illustrates some of the techniques used, and highlights participant feedback.

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Acampa, Giovanna, and Claudia Mariaserena Parisi. "Cultural heritage management: optimising procedures and maintenance costs." Valori e Valutazioni 29 (January 2022): 79–102. http://dx.doi.org/10.48264/vvsiev-20212907.

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The management of maintenance activities is an ongoing concern for facility managers in the existing building sector due to its complexity and uncertainty. This applies all the more to cultural heritage as protection, preservation and enhancement are a priority in order to keep the artistic and cultural value of historical assets for future generations. In addition, problems related to the increasingly limited economic resources complicate maintenance management processes. Therefore, it has become a common standard to carry out maintenance activities only when actual emergencies occur, thus causing inefficiencies in the planning of Facility Management activities and an increase in maintenance costs. This paper shows a method to support the management decision-making in maintenance activities through Building Condition Assessment (BCA) processes integrated with Building Information Modeling (BIM) systems. The main objective is to develop a maintenance management strategy and support technicians in identifying maintenance priorities in a practical, simple and automated way in order to optimise procedures and costs. To achieve such a goal, the method proposes a BCA process that uses the following tools: 1) building breakdown structure according to UNI 8290 adapted to historic buildings; 2) a degradation level index and a technological and operational connection matrix to assess opportunity maintenance; 3) field inspections and data collection on Excel spreadsheets acting as external Database; 4) data management in BIM environment using Revit as BIM Authoring Software and Dynamo scripts as visual programming language (VPL) to link external Database to BIM model. The results highlight the important role of BIM in Facility Management of existing buildings and buildings of historical and cultural value by allowing the continuous update of information in a single BIM model for BCA purposes and shows a great potential to support facility managers in managing building maintenance activities and optimising costs. La natura complessa, incerta e dinamica della gestione delle attività di manutenzione è fonte di continua preoccupazione per i facility managers che operano nel settore del patrimonio edilizio esistente. In particolare, nel campo dei beni culturali, la tutela, conservazione e valorizzazione sono una priorità per preservare il valore artistico-culturale dei beni storici alle generazioni future. Purtroppo, alla complessa gestione della manutenzione si aggiungono problemi relativi alle risorse economiche sempre più limitate. In questa situazione infatti, sembra essere diventato uno standard comune intervenire con attività di manutenzione solo quando si presentano effettivi casi di emergenza, causando così inefficienze nella pianificazione delle attività del Facility Management e, conseguentemente, un aumento dei costi della manutenzione. Questo paper espone un metodo per supportare le scelte decisionali dei gestori nelle attività di manutenzione attraverso i processi di Building Condition Assessment (BCA) integrati ai sistemi di Building Information Modeling (BIM). L'obiettivo principale è sviluppare una strategia di gestione della manutenzione, dando ai tecnici il necessario supporto per individuare le priorità di intervento di manutenzione in modo pratico, semplice e automatizzato al fine di ottimizzare procedure e costi della manutenzione. Per raggiungere questo obiettivo, il metodo propone un processo di BCA che utilizza i seguenti strumenti: 1) scomposizione dell’edificio secondo la norma UNI 8290 adattata agli edifici storici; 2) un indice del livello di degrado e una matrice di connessione tecnologica e operativa per valutare manutenzioni di opportunità; 3) ispezioni in situ e raccolta dei dati su fogli di calcolo Excel che fungono da Database esterno; 4) gestione dei dati in ambiente BIM utilizzando Revit come BIM Authoring Software e scripts in Dynamo come linguaggio di programmazione visiva per il collegamento tra Database esterno modello BIM. I risultati della ricerca evidenziano l'importanza del ruolo del BIM nel Facility Management degli edifici esistenti e di pregio storico-culturale consentendo l'aggiornamento permanente delle informazioni in un unico modello BIM ai fini del BCA e mostra un grande potenziale per supportare i facility managers nella gestione delle attività di manutenzione degli edifici e nell’ottimizzazione dei costi.

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Khan, Tabassum, and Suresh G. "Do all shocks produce embedded herding and bubble? An empirical observation of the Indian stock market." Investment Management and Financial Innovations 19, no. 3 (September 27, 2022): 346–59. http://dx.doi.org/10.21511/imfi.19(3).2022.29.

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Herding has a history of igniting large, irrational market ups and downs, usually based on a lack of fundamental support. Intuitively, most herds start with an external shock. This empirical study seeks to detect shock-induced herding and the creation of nascent bubbles in the Indian stock market. Initially, the multifractal form of the detrended fluctuation analysis was applied. Then the Reformulated Hurst exponent for the Bombay stock exchange (BSE) was determined using Kantelhardt’s calibration. The investigation found evidence of high-level herding and a bubble in 2012, with a high value of Hurst Exponent (0.7349). The other years of the research period (2011, 2013, 2016, 2018, 2020–2021) observed mild to significant herding with comparatively lower Hurst values. The results confirm that herding behavior occurs during a crisis and harsh situations emitting shocks. The study concludes that shock-based herding is prevalent in all six shocks: the economic meltdown, commodities and currency devaluation, geo-political problems, the Central Bank’s decision on liquidity management, and the Pandemic. Additionally, the years following the Financial Crisis and the years of the Pandemic are when herding and bubble are prominent. AcknowledgmentsWe thank Dr. Bikramaditya Ghosh (Associate Professor, Symbiosis International University, Bangalore, India) for motivating us in this research. We also thank Dr. Natchimuthu N (Assistant Professor, Commerce, CHRIST (Deemed to be University), Bangalore, India) and Dr. Mahesh E. (Assistant Professor, Economics, CHRIST (Deemed to be University), Bangalore, India) for their support throughout this study.

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Badulescu, Oana Viola, Razvan Tudor, Wilhelm Friedl, Andrei Scripcaru, and Paul Dan Sirbu. "Moroctocog Alfa Efficacy in Hemostasis Management in A Type Hemophilia Patients with Elective Arthroplasty." Revista de Chimie 69, no. 6 (July 15, 2018): 1541–43. http://dx.doi.org/10.37358/rc.18.6.6364.

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Type A haemophilia is a hereditary coagulopathy caused by coagulation factor VIII deficiency as part of the rare, life-threatening and at-risk group of diseases that has been attributed over time a life-saving substitution treatment providing to patients diagnosed with this pathology a hope for life and quality of life similar to that of healthy population. However, substitution treatment is very expensive so that nowadays globally most patients cannot benefit from proper healthcare. The quality of healthcare is dependent on the socio-economic level of each country, being decisively influenced by the power of the National Hemophilia Organizations to generate solidarity and support of decision-makers of each country. One of the bleeding manifestations specific to haemophilia is haemarthrosis. Each haemorrhagic episode causes locally a disorder that predisposes to relapse, with the onset of the main chronic complication of this condition, haemophilic arthropathy. It has a slow evolution throughout the life of the patient and generates in time severe sequelae (ankyloses) that require total arthroplasty. Effective hemostasis is the essential element for performing this type of orthopaedic surgery, due to bleeding risk that is of vital nature, in this category of patients. In this sense, this study aims to underline the efficacy of Moroctocog alfa in the management of haemostasis in haemophiliac patients with total endoprosthesis indication, aimed to reduce joint pain and improve locomotor function.

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Kaiser, Iris. "Collaborative Trend Analysis Using Web 2.0 Technologies." International Journal of Distributed Systems and Technologies 3, no. 4 (October 2012): 14–23. http://dx.doi.org/10.4018/jdst.2012100102.

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Through early trend recognition in the business environment and specific processing within the innovation management, companies can achieve long-term market success. A particular challenge is the systematic identification, gathering, structuration and evaluation of trends. Web 2.0 technologies and especially Wikis, which allow several people to maintain and use content simultaneously, are eminently suitable for an efficient process of continuous collection and analysis of relevant market trends. In this paper, trend management processes are introduced and demonstrated how trends can be collected, structured and communicated within the enterprise using a customized wiki. The trend assessment is carried out inter alia on methods of crowd sourcing, resulting in an extensive evaluation basis. In addition, the presented approach includes a visualization of the trends and its assessment for decision support. A case study of global polymer solutions supplier REHAU AG demonstrates the use of the methodology in practice.

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Brooker, Peter. "Air Traffic Control Separation Minima: Part 2 – Transition to a Trajectory-based System." Journal of Navigation 64, no. 4 (September 12, 2011): 673–93. http://dx.doi.org/10.1017/s0373463311000221.

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Current strategic plans for Air Traffic Management (ATM) envisage a transition from radar control to a trajectory-based system. Part 1 sketched the historical origins of separation minima and then analysed the safety thinking behind current minima and the issues involved in risk modelling. Part 2 examines the future situation. This focuses on the intermediate steps to the final system – upgraded capabilities in a mixed-equipage system. Future traffic mixes two categories of traffic: V aircraft, i.e. vectored traditional ATC-handled, and 4D aircraft, i.e. flying on 4D trajectories. Conflict probe and other decision support tools will need to be in place, inter alia to prevent controller workload from increasing. Conceptually, future risks in the transition period will be the sum of three types of aircraft encounter risk: V/V, 4D/4D and 4D/V. These pose different kinds of problem for ATC, appropriate conflict alerting systems and risk assessment. The numbers of 4D/V encounters increase rapidly with growth in the proportion of 4D aircraft. With reduced minima, airborne collision avoidance systems would be unlikely to resolve higher relative velocity encounters were the ATC system to fail. It would be a difficult decision to reduce markedly ATC separation minima for any category of aircraft encounters during the transition period.

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Giuliani, Céline. "Advancing Peace through Human Rights in UN Peace Operations." Journal of International Peacekeeping 24, no. 1-2 (May 24, 2021): 252–84. http://dx.doi.org/10.1163/18754112-20210006.

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Abstract The integration of human rights in United Nations peace operations has witnessed remarkable progress during the past fifteen years. This article analyzes the evolution of human rights integration in the peace and security architecture in relation to peace operations, focusing on the achievements and shortcomings of Headquarters-led policies and reforms of the last decade, as well as the impact of recent Security Council dynamics. The article reviews the significant realizations on both the substantive and structural fronts and argues that ownership of the human rights agenda and policies, as well as accountability and leadership for their implementation, warrants a greater commitment of the organization. Such commitment should translate into institutionalizing Headquarters’ cooperation mechanisms, creating further space for human rights in decision-making, allocating adequate resources, and strengthening accountability for risk-mitigation policies, inter alia. A stronger political will is equally required to better articulate human rights issues in relation to conflict analysis, prevention and peacebuilding, in support of political objectives of peace operations.

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Mastorakis, Konstantinos, Massimo Continisio, Maria Francesca Siotto, Luca Navarini, Franco Carnevale, Mary Ellen Mac Donald, and Claudia Navarini. "La percezione degli operatori sanitari sulle cure palliative come mezzo per promuovere la qualità di vita dei pazienti e prevenire le richieste eutanasich / Healthcare workers’ perception of palliative care as a means to foster patients' quality of life and to prevent euthanasia requests*." Medicina e Morale 68, no. 1 (April 10, 2019): 25–39. http://dx.doi.org/10.4081/mem.2019.565.

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Nel 2010 è stata emanata in Italia la Legge 38, che punta a migliorare formazione e tirocini nel campo delle cure palliative, sebbene al momento non esista un sistema nazionale di monitoraggio di tali pratiche su scala nazionale. A livello internazionale l’eutanasia si è andata sempre più configurando come trattamento possibile fra le cure di fine vita, mentre in Italia resta formalmente illegale. Esistono alcuni studi italiani sulle prospettive dei pazienti rispetto alle cure palliative e all’eutanasia, ma la letteratura relativa alla percezione degli operatori sanitari palliativisti è esigua. Scopo del presente studio è l’indagine di tali percezioni, sia rispetto alla qualità delle cure palliative sia al potenziale ruolo dell’eutanasia nelle cure di fine vita in Italia. La ricerca è stata condotta in tre hospice romani. È stato sviluppato e somministrato un questionario con 75 item graduati secondo la scala Likert a 5 punti, utilizzando come metodi di analisi l’analisi fattoriale e, per la parte statistica, SPSS. Il questionario è stato completato da 56 soggetti. Nella percezione dei partecipanti, i fattori rilevanti per la qualità delle cure palliative sono risultati sette: sofferenza fisica e sociale, benessere psicologico e spirituale, benessere emozionale, partecipazione alle decisioni, compassione, speranza ed empatia. Inoltre, le cure palliative ridurrebbero il desiderio di morte e di eutanasia. I fattori più importanti che emergono dal lavoro sono la sofferenza o il benessere sociali, fisici e psicologici. Gli operatori sanitari coinvolti nello studio non sostengono l’ipotesi dell’eutanasia e anzi ritengono che le cure palliative riducano il desiderio di ottenerla. ---------- In 2010, the State Law no 38 was enacted in Italy, seeking to improve palliative care education and training. There is currently no national monitoring system for palliative care practices in Italy. Euthanasia has become increasingly available internationally as an alternative amidst end-of-life care options, although in Italy this is not the case, and it is formally illegal. Although there are a few studies regarding patients’ perspectives regarding the issue of palliative care and euthanasia in Italy, there is limited literature focused on the perspectives of palliative care health care professionals. The purpose of this study is to explore the perspectives of hospice workers regarding both the quality of palliative care and the potential role of euthanasia in end-of-life care in Italy. This research was conducted with hospice clinicians in three hospices in Rome. A 75 item 5-point Likert scale questionnaire was developed and administered. Factor analysis was used, and descriptive statistics were performed using SPSS. Fifty-six respondents completed the questionnaire. From participants’ perspectives, there are seven significant factors explaining the quality of palliative care in Italy: social and physical suffering, psychological and spiritual well-being, emotional well-being, participation in decision making, compassion, hope, and empathy in care, while reducing patients’ desire for death and euthanasia. The most important of these factors regard social, physical and psychological suffering and well-being. Hospice workers in this study did not support euthanasia and felt that palliative care decreases the patient’s desire for euthanasia. * The manuscript was presented as an abstract in an International Congress on Palliative Care.

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Manurung, Kosma. "Mencermati Kisah Dipilihnya Matias Dari Spritualitas Kaum Pentakostal." Shalom: Jurnal Teologi Kristen 2, no. 2 (December 31, 2022): 115–31. http://dx.doi.org/10.56191/shalom.v2i2.34.

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Both in organizations and in social life, the existence of a leader is absolutely necessary to ensure the maintenance of order and peace in life. The Bible gives various descriptions of the election of a person to become a leader, for example Joseph who was chosen as a leader because he was able to interpret the dreams of Pharaoh or Saul who became king of Israel by lot. This article intends to reinterpret the story of the choice of Matthias to replace Judas Iscariot in Acts 1:15-26 from the Pentecostal spirituality frame. By using descriptive research methods and support from literature studies, it is hoped that this research will be able to provide a strong explanation of the variety of leadership choices in the biblical picture, the story of the election of Matthias, and the meaning of the Pentecostals related to this story. It was found that for the Pentecostals, the story of the election of Matthias to replace Judas Iscariot was a decision of God whose election was carried out in God's way. This story is also interpreted as God's answer to restore the elect. Abstrak Baik dalam organisasi maupun dalam kehidupan bermasyarakat keberadaan pemimpin mutlak perlu untuk memastikan terjaganya ketertiban dan kedamaian hidup. Alkitab memberikan berbagai gambaran terpilihnya seseorang menjadi pemimpin, seumpama Yusuf yang terpilih jadi pemimpin karena mampu menafsirkan mimpi Firaun ataupun Saul yang menjadi raja Israel lewat undian. Artikel ini bermaksud memaknai ulang kisah dipilihnya Matias mengantikan Yudas Iskariot dalam Kisah Para Rasul 1:15-26 dari bingkai spritualitas Pentakostal. Dengan menggunakan metode penelitian deskripsi dan dukungan dari kajian literatur, penelitian ini dirahapkan mampu memberikan penjelasan yang kuat tentang ragam pemilihan pemimpin dalam gambaran Alkitab, kisah pemilihan Matias, dan pemaknaan kaum Pentakostal terkait kisah ini. Didapati bahwa bagi kaum Pentakostal, kisah dipilihnya Matias mengantikan Yudas Iskariot ini merupakan keputusan Allah yang pemilihannya dilakukan dengan cara Allah. Kisah ini juga dimaknai sebagai jawaban Allah untuk memulihkan umat pilihan.

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Ceglie, Teresa, Berardino Pollio, Irene Ricca, Maria Messina, Claudia Linari, and Mauro Pagliarino. "Impact of Systematic Pharmacokinetic (PK) Profiles in a Cohort of 29 Patients Treated with Conventional and Extended-Half Life (EHL) Products." Blood 134, Supplement_1 (November 13, 2019): 1123. http://dx.doi.org/10.1182/blood-2019-132199.

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Introduction. Prophylaxis with factor concentrates reduces bleeding events and improves quality of life for adults and children with severe hemophilia. However, the optimal dosing and infusion frequency is not yet established. Integration of PK data into decision making is gaining support, in particular at the transition between conventional and EHL products. Here we report about 29 PK data of patients affected by hemophilia treated at our centre since childhood. Improved quality of life was our first aim, supposed that decreasing frequency of infusions or increasing the target through factor level allows a more active life without increased risk of bleeding. Patients' characteristics and methods. 18 patients (62%) were ≤ 18 years of age at PK time. 16 were affected by severe hemophilia A, 5 by moderate hemophilia A, 6 by severe hemophilia B and 2 by moderate hemophilia B. At PK time, 28 patients were on prophylaxis and 1 was on demand with recombinant factor IX. Median age at onset of prophylaxis was 9 years (range 3 months-38 years). Genetic assessment was available in 24 patients. Of these, 37.5% and 62.5% were carriers of null and not null mutations respectively. 4 patients were undergone to PK with standard products (1 Octocog alfa, 1 Simoctocog alfa, 1 Octocog alfa-Kovaltry®, 1 Turoctocog alfa) in order to define timing and dosage of successive infusions, while 25 patients switched to EHL factors (15 Efmoroctocog alfa, 2 Ionoctocog alfa, 7 Albutrepenonacog alfa, 1 Eftrenonacog alfa). In 15 patients a population-based PK (popPK) according to WAPPS-Hemo program was also performed. The annualized bleeding rate (ABR) was counted from patient's home bleeding records for one year before PK until now. Results. According to PK data, 21 patients (75%) decreased infusion frequency (100% hemophilia B and 67% hemophilia A patients). The remaining 7 hemophilia A patients maintained the same timing in order to increase the through factor level. Notably, 1 hemophilia B patient switched from on demand treatment to prophylaxis with EHL product due to the more acceptable schedule. 66% of null mutation patients and 73% of not null mutation patients decreased timing. Of 28 patients available at follow-up, 32%, 50% and 18% decreased, increased and maintained the same annual average factor consumption/kg, respectively. All patients had a good adherence after switch. In particular, the on demand patient started a regular prophylaxis with optimal compliance. ABR displayed a reduction with a median of 0 (range 0-5) after PK analysis compared to 1 (range 0-12) before the switch. Full PK vs popPK data obtained using at least two individual PK sampling points were almost similar. Conclusions. Our results remark the necessity of PK study especially in children due to the inter-individual variability independent of genetic assessment. Regarding factor IX, PK allowed us to propose timing even longer than that recommended by prescribing indications resulting in a better personalized prophylaxis. Moreover, our study demonstrates that a full PK analysis is feasible also in children. However, given similar results, popPK could be more feasible in most patients. Regarding consumption, the reduction of only 32% of patients reflects our aim to maintain a high safety profile in an active pediatric population. Nevertheless, the mean annualized consumption was just 0.6-fold increased in the remaining patients. This approach led us to further reduce ABR and in some cases to obtain a persistent no-bleeding status even with a full active life. Disclosures No relevant conflicts of interest to declare.

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Journal articles on the topic 'Supporti alla decisione'

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