Search results for: Maria Rosa Chitolina
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1126

Search results for: Maria Rosa Chitolina

916 Risk Factors for Maternal and Neonatal Morbidities Associated with Operative Vaginal Deliveries

Authors: Maria Reichenber Arcilla

Abstract:

Objective: To determine the risk factors for maternal and neonatal complications associated with operative vaginal deliveries. Methods: A retrospective chart review of 435 patients who underwent operative vaginal deliveries was done. Patient profiles – age, parity, AOG, duration of labor – and outcomes – birthweight, maternal and neonatal complications - were tabulated and multivariable analysis and logistic regression were performed using SPSS® Statistics Base. Results and Conclusion: There was no significant difference in the incidence of maternal and neonatal complications between those that underwent vacuum and forceps extraction. Among the variables analysed, parity and duration of labor reached statistical significance. The odds of maternal complications were 3 times higher among nulliparous patients. Neonatal complications were seen in those whose labor lasted more than 9 hours.

Keywords: operative vaginal deliveries, maternal, neonatal, morbidity

Procedia PDF Downloads 373
915 Practices Supporting the Wellbeing of Healthcare Staff Post-disaster: Findings from a Narrative Inquiry

Authors: Julaine Allan, Katarzyna Olcon, Padmini Pai, Lynne Keevers, Mim Fox, Maria Mackay, Ruth Everingham

Abstract:

Effective local responses to community needs are grounded in contextual knowledge and build on existing resources. The Stability, Encompassing, Endurance & Direction (SEED) Wellbeing Program was created in 2020 in response to cumulative disasters, bushfires, floods and COVID, experienced by healthcare staff in the Illawarra Shoalhaven Local Health District, NSW Australia. SEED used a participatory action methodology to bring healthcare staff teams together to engage in restorative activities in the workplace. Guided by Practice Theory, this study identified the practices that supported the recovery of healthcare staff.

Keywords: mental health and wellbeing, workplace wellness, healthcare providers, natural disasters, COVID-19, burnout, occupational trauma

Procedia PDF Downloads 44
914 Economic Implications of the Arrival of Syrian Refugees in Jordan

Authors: Ammar Z. Alwrekiat, Sara Ojeda Gonzalez, Maria Jose Miranda Martel, Antonio Mihi-Ramirez

Abstract:

This paper analyses the economic situation in Jordan, which has been the political asylum destination for Syrians since 2011. We analyze the effects of the Jordanian situation through the following indicators: international aid, gross domestic product, remittances, and unemployment. A correlation analysis has been used to identify the main connections of these parameters with the reception of refugees. Although the economic effects of Syrian refugees in Jordan are uncertain, it involves an important challenge in the development of migration policies. Jordan has a special economic situation and limited capacities, but the country has provided humanitarian assistance to Syrian refugees. In this case, the support of the international community is of particular importance, taking an important role in the negotiation of international agreements on refugees.

Keywords: correlation analysis, economic implications, migration, refugees

Procedia PDF Downloads 216
913 Increased Envy and Schadenfreude in Parents of Newborns

Authors: Ana-María Gómez-Carvajal, Hernando Santamaría-García, Mateo Bernal, Mario Valderrama, Daniela Lizarazo, Juliana Restrepo, María Fernanda Barreto, Angélica Parra, Paula Torres, Diana Matallana, Jaime Silva, José Santamaría-García, Sandra Baez

Abstract:

Higher levels of oxytocin are associated with better performance on social cognition tasks. However, higher levels of oxytocin have also been associated with increased levels of envy and schadenfreude. Considering these antecedents, this study aims to explore social emotions (i.e., envy and schadenfreude) and other components of social cognition (i.e. ToM and empathy), in women in the puerperal period and their respective partners, compared to a control group of men and women without children or partners. Control women should be in the luteal phase of the menstrual cycle or taking oral contraceptives as they allow oxytocin levels to remain stable. We selected this population since increased levels of oxytocin are present in both mothers and fathers of newborn babies. Both groups were matched by age, sex, and education level. Twenty-two parents of newborns (11 women, 11 men) and 15 controls (8 women, 7 men) performed an experimental task designed to trigger schadenfreude and envy. In this task, each participant was shown a real-life photograph and a description of two target characters matched in age and gender with the participant. The task comprised two experimental blocks. In the first block, participants read 15 sentences describing fortunate events involving either character. After reading each sentence, participants rated the event in terms of how much envy they felt for the character (1=no envy, 9=extreme envy). In the second block, participants read and reported the intensity of their pleasure (schadenfreude, 1=no pleasure, 9=extreme pleasure) in response to 15 unfortunate events happening to the characters. Five neutral events were included in each block. Moreover, participants were assessed with ToM and empathy tests. Potential confounding variables such as general cognitive functioning, stress levels, hours of sleep and depression symptoms were also measured. Results showed that parents of newborns showed increased levels of envy and schadenfreude. These effects are not explained by any confounding factor. Moreover, no significant differences were found in ToM or empathy tests. Our results offer unprecedented evidence of specific differences in envy and schadenfreude levels in parents of newborns. Our findings support previous studies showing a negative relationship between oxytocin levels and negative social emotions. Further studies should assess the direct relationship between oxytocin levels in parents of newborns and the performance in social emotions tasks.

Keywords: envy, empathy, oxytocin, schadenfreude, social emotions, theory of mind

Procedia PDF Downloads 283
912 Identifying Critical Success Factors for Data Quality Management through a Delphi Study

Authors: Maria Paula Santos, Ana Lucas

Abstract:

Organizations support their operations and decision making on the data they have at their disposal, so the quality of these data is remarkably important and Data Quality (DQ) is currently a relevant issue, the literature being unanimous in pointing out that poor DQ can result in large costs for organizations. The literature review identified and described 24 Critical Success Factors (CSF) for Data Quality Management (DQM) that were presented to a panel of experts, who ordered them according to their degree of importance, using the Delphi method with the Q-sort technique, based on an online questionnaire. The study shows that the five most important CSF for DQM are: definition of appropriate policies and standards, control of inputs, definition of a strategic plan for DQ, organizational culture focused on quality of the data and obtaining top management commitment and support.

Keywords: critical success factors, data quality, data quality management, Delphi, Q-Sort

Procedia PDF Downloads 182
911 Sociological Review of the Implantation of New Religious Movements in Spain

Authors: María Del Mar Ramos-Lorente, Rafael Martínez-Martín

Abstract:

More than 40 years have passed since the Spanish Constitution in force today was approved in 1978. The period prior to that Constitution, which marked the transition to democracy, was marked by National Catholicism, which actively limited the existence of religions other than Catholicism in the national territory. The approval of this norm allowed the opening in many aspects, including the religious one. This work will profusely describe the evolution of the appearance of religious minorities in Spain from the moment of the transition, in which the space for religious freedom appears up to the present. The methodology is twofold. On the one hand, qualitative analysis of the legislation has allowed the religious opening. On the other, the quantitative analysis of the NMRs implemented in Spain. The entire analysis establishes the increase in religious organizations as a result, with notable variations across the territory.

Keywords: new religious movements, religious minorities, sociological analysis, Spain

Procedia PDF Downloads 114
910 Practices Supporting the Wellbeing of Healthcare Staff: Findings From a Narrative Inquiry

Authors: Julaine Allan, Katarzyna Olcon, Padmini Pai, Lynne Keevers, Mim Fox, Maria Mackay, Ruth Everingham, Sue Cutmore, Chris Degeling, Kristine Falzon, Summer Finlay

Abstract:

Effective local responses to community needs are grounded in contextual knowledge and built on existing resources. The SEED Wellbeing Program was created in 2020 in response to cumulative disasters, bushfires, floods and COVID experienced by healthcare staff in the Illawarra Shoalhaven Local Health District, NSW, Australia. SEED used a participatory action methodology to bring healthcare staff teams together to engage in restorative activities in the workplace. Guided by Practice Theory, this study identified the practices that supported the recovery of healthcare staff.

Keywords: mental health and wellbeing, workplace wellness, healthcare providers, natural disasters, COVID-19, burnout, occupational trauma

Procedia PDF Downloads 102
909 Free Convection in a Darcy Thermally Stratified Porous Medium That Embeds a Vertical Wall of Constant Heat Flux and Concentration

Authors: Maria Neagu

Abstract:

This paper presents the heat and mass driven natural convection succession in a Darcy thermally stratified porous medium that embeds a vertical semi-infinite impermeable wall of constant heat flux and concentration. The scale analysis of the system determines the two possible maps of the heat and mass driven natural convection sequence along the wall as a function of the process parameters. These results are verified using the finite differences method applied to the conservation equations.

Keywords: finite difference method, natural convection, porous medium, scale analysis, thermal stratification

Procedia PDF Downloads 291
908 A New Categorization of Image Quality Metrics Based on a Model of Human Quality Perception

Authors: Maria Grazia Albanesi, Riccardo Amadeo

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This study presents a new model of the human image quality assessment process: the aim is to highlight the foundations of the image quality metrics proposed in literature, by identifying the cognitive/physiological or mathematical principles of their development and the relation with the actual human quality assessment process. The model allows to create a novel categorization of objective and subjective image quality metrics. Our work includes an overview of the most used or effective objective metrics in literature, and, for each of them, we underline its main characteristics, with reference to the rationale of the proposed model and categorization. From the results of this operation, we underline a problem that affects all the presented metrics: the fact that many aspects of human biases are not taken in account at all. We then propose a possible methodology to address this issue.

Keywords: eye-tracking, image quality assessment metric, MOS, quality of user experience, visual perception

Procedia PDF Downloads 371
907 Multidimensional Item Response Theory Models for Practical Application in Large Tests Designed to Measure Multiple Constructs

Authors: Maria Fernanda Ordoñez Martinez, Alvaro Mauricio Montenegro

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This work presents a statistical methodology for measuring and founding constructs in Latent Semantic Analysis. This approach uses the qualities of Factor Analysis in binary data with interpretations present on Item Response Theory. More precisely, we propose initially reducing dimensionality with specific use of Principal Component Analysis for the linguistic data and then, producing axes of groups made from a clustering analysis of the semantic data. This approach allows the user to give meaning to previous clusters and found the real latent structure presented by data. The methodology is applied in a set of real semantic data presenting impressive results for the coherence, speed and precision.

Keywords: semantic analysis, factorial analysis, dimension reduction, penalized logistic regression

Procedia PDF Downloads 405
906 Coping Resource Triad, Experiences of Filipina Wives in Japan

Authors: Maria Luisa T. Uayan

Abstract:

This study aims to describe the lived experiences of Filipina migrants married to Japanese and to discuss coping strategies that facilitates positive migration events. It utilizes a qualitative study design with focus group discussion which allows clear details on insights and perspectives based on migration process. The grounding of the coping resource triad is the unique finding of this study. It defines coping resource triad as a set of complex factors that relieves Filipina migrants of the stresses associated in migration and cross-cultural marriage. The results of the stress-coping experiences of Filipina migrants in Japan serves as basis for future studies on cross-cultural marriages and other deeper concerns associated with migration as well as in the formulation of relevant programs on acculturation.

Keywords: coping resource triad, migration, Filipina, cross-cultural marriage

Procedia PDF Downloads 442
905 The Role of the Stud’s Configuration in the Structural Response of Composite Bridges

Authors: Mohammad Mahdi Mohammadi Dehnavi, Alessandra De Angelis, Maria Rosaria Pecce

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This paper deals with the role of studs in the structural response of steel-concrete composite beams. A tri-linear slip-shear strength law is assumed according to literature and codes provisions for developing a finite element (FE) model of a case study of a composite deck. The variation of the strength and ductility of the connection is implemented in the numerical model carrying out nonlinear analyses. The results confirm the utility of the model to evaluate the importance of the studs capacity, ductility and strength on the global response (ductility and strength) of the structures but also to analyze the trend of slip and shear at interface along the beams.

Keywords: stud connectors, finite element method, slip, shear load, steel-concrete composite bridge

Procedia PDF Downloads 106
904 Procedure for Recommendation of Archival Documents

Authors: Marlon J. Remedios, Maria T. Morell, Jesse D. Cano

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Diffusion and accessibility of historical collections is one of the main objectives of the institutions that aim to safeguard archival documents (General Archives). Several countries have Web applications that try to make accessible and public the large number of documents that they guard. Each of these sites has a set of features in order to facilitate access, navigability, and search for information. Different sources of information include Recommender Systems as a way of customizing content. This paper aims at describing a process for the production of archival documents relevant to the user. To comply with this, the characteristics ruling archival description, elements and main techniques that establishes the design of Recommender Systems, a set of rules to follow, and how these rules operate and the way in which take advantage of the domain knowledge are discussed. Finally, relevant issues are discussed in the design of the proposed tests and the results obtained are shown.

Keywords: archival document, recommender system, procedure, information management

Procedia PDF Downloads 482
903 Social Dimension of Air Transport Sustainable Development

Authors: Dimitrios J. Dimitriou, Maria F. Sartzetaki

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Air Transport links markets and individuals, making regions more competitive and promoting social and economic development. The assessment of social contribution is the key objective of this paper, focusing on the definition of the components of social dimension and welfare metrics in the national scale. According to a top-down approach, the key dimensions that affect the social welfare are presented. Conventional wisdom is to provide estimations on added value to social issues caused by the air transport development and present the methodology framework for measuring the contribution of transport development in social value chain. Greece is the case study of this paper, providing results from the contribution of air transport infrastructures in national welfare. The application key findings are essential for managers and decision makers to support actions and plans towards economic recovery of an economy presenting strong seasonal characteristics (because of tourism) and suffering from recession.

Keywords: air transport, social coherence, resilient business development, socioeconomic impact

Procedia PDF Downloads 178
902 The Influence of the Laws of Ergonomics on the Design of High-Rise Buildings

Authors: Valery A. Aurov, Maria D. Bausheva, Elena V. Uliyanova

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The problems of sustainability of contemporary high-rise buildings now demand an altogether new approach, which corresponds with the laws of dialectics. We should imply the principle “going from mega-object to the so called mezzo-object.” So the scientists have arrived at the conclusion that a contemporary “skyscraper” must not increase in height but develop horizontal space axes which unite a complex of high-rise buildings into a single composition. This is necessary both for safety issues and increasing skyscrapers’ functioning qualities. As a result, architects single out a quality unit in a dominating group of high-rise constructions and make a conclusion about the influence of visual fields on the designing parameters of this group.

Keywords: design, high-rise buildings, skyscrapers, sustainability, visual fields, dominating group, regulations, design recommendations

Procedia PDF Downloads 341
901 Emotions Aroused by Children’s Literature

Authors: Catarina Maria Neto da Cruz, Ana Maria Reis d'Azevedo Breda

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Emotions are manifestations of everything that happens around us, influencing, consequently, our actions. People experience emotions continuously when socialize with friends, when facing complex situations, and when at school, among many other situations. Although the influence of emotions in the teaching and learning process is nothing new, its study in the academic field has been more popular in recent years, distinguishing between positive (e.g., enjoyment and curiosity) and negative emotions (e.g., boredom and frustration). There is no doubt that emotions play an important role in the students’ learning process since the development of knowledge involves thoughts, actions, and emotions. Nowadays, one of the most significant changes in acquiring knowledge, accessing information, and communicating is the way we do it through technological and digital resources. Faced with an increasingly frequent use of technological or digital means with different purposes, whether in the acquisition of knowledge or in communicating with others, the emotions involved in these processes change naturally. The speed with which the Internet provides information reduces the excitement for searching for the answer, the gratification of discovering something through our own effort, the patience, the capacity for effort, and resilience. Thus, technological and digital devices are bringing changes to the emotional domain. For this reason and others, it is essential to educate children from an early age to understand that it is not possible to have everything with just one click and to deal with negative emotions. Currently, many curriculum guidelines highlight the importance of the development of so-called soft skills, in which the emotional domain is present, in academic contexts. The technical report “OECD Survey on Social and Emotional Skills”, developed by OECD, is one of them. Within the scope of the Portuguese reality, the “Students’ profile by the end of compulsory schooling” and the “Health education reference” also emphasizes the importance of emotions in education. There are several resources to stimulate good emotions in articulation with cognitive development. One of the most predictable and not very used resources in the most diverse areas of knowledge after pre-school education is the literature. Due to its characteristics, in the narrative or in the illustrations, literature provides the reader with a journey full of emotions. On the other hand, literature makes it possible to establish bridges between narrative and different areas of knowledge, reconciling the cognitive and emotional domains. This study results from the presentation session of a children's book, entitled “From the Outside to Inside and from the Inside to Outside”, to children attending the 2nd, 3rd, and 4th years of basic education in the Portuguese education system. In this book, rationale and emotion are in constant dialogue, so in this session, based on excerpts from the book dramatized by the authors, some questions were asked to the children in a large group, with an aim to explore their perception regarding certain emotions or events that trigger them. According to the aim of this study, qualitative, descriptive, and interpretative research was carried out based on participant observation and audio records.

Keywords: emotions, basic education, children, soft skills

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900 Brazilian Sign Language: A Synthesis of the Research in the Period from 2000 to 2017

Authors: Maria da Gloria Guara-Tavares

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This article reports a synthesis of the research in Brazilian Sign Language conducted from 2000 to 2017. The objective of the synthesis was to identify the most researched areas and the most used methodologies. Articles published in three Brazilian journals of Translation Studies, unpublished dissertations and theses were included in the analysis. Abstracts and the method sections of the papers were scrutinized. Sixty studies were analyzed, and overall results indicate that the research in Brazilian Sign Language has been fragmented in several areas such as linguistic aspects, facial expressions, subtitling, identity issues, bilingualism, and interpretation strategies. Concerning research methods, the synthesis reveals that most research is qualitative in nature. Moreover, results show that the cognitive aspects of Brazilian Sign Language seem to be poorly explored. Implications for a future research agenda are also discussed.

Keywords: Brazilian sign language, qualitative methods, research agenda, synthesis

Procedia PDF Downloads 204
899 Emotion Regulation Mediates the Relationship between Affective Disposition and Depression

Authors: Valentina Colonnello, Paolo Maria Russo

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Studies indicate a link between individual differences in affective disposition and depression, as well as between emotion dysregulation and depression. However, the specific role of emotion dysregulation domains in mediating the relationship between affective disposition and depression remains largely unexplored. In three cross-sectional quantitative studies (total n = 1350), we explored the extent to which specific emotion regulation difficulties mediate the relationship between personal distress disposition (Study 1), separation distress as a primary emotional trait (Study 2), and an insecure, anxious attachment style (Study 3) and depression. Across all studies, we found that the relationship between affective disposition and depression was mediated by difficulties in accessing adaptive emotion regulation strategies. These findings underscore the potential for modifiable abilities that could be targeted through preventive interventions.

Keywords: emotions, mental health, individual traits, personality

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898 iSEA: A Mobile Based Learning Application for History and Culture Knowledge Enhancement for the ASEAN Region

Authors: Maria Visitacion N. Gumabay, Byron Joseph A. Hallar, Annjeannette Alain D. Galang

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This study was intended to provide a more efficient and convenient way for mobile users to enhance their knowledge about ASEAN countries. The researchers evaluated the utility of the developed crossword puzzle application and assessed the general usability of its user interface for its intended purpose and audience of users. The descriptive qualitative research method for the research design and the Mobile-D methodology was employed for the development of the software application output. With a generally favorable reception from its users, the researchers concluded that the iSEA Mobile Based Learning Application can be considered ready for general deployment and use. It was also concluded that additional studies can also be done to make a more complete assessment of the knowledge gained by its users before and after using the application.

Keywords: mobile learning, eLearning, crossword, ASEAN, iSEA

Procedia PDF Downloads 272
897 Experimental Study on the Effect of Water-Cement Ratio and Replacement Ratio to the Capacity of the Recycled Aggregate Concrete

Authors: Feng Fu, Maria Karli

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In this paper, experimental studies were carried out to investigate the behaviour of recycled aggregate concrete (RAC). A number of compressive tests, tensile splitting tests, as well as impact tests were conducted. In the tests, different recycled aggregate replacement ratio, different mix design and different water to cement ratio have been chosen in the investigation. The behavior of the RAC concrete was investigated in detail. The results of the tests show that the water-cement ratio plays an important role in the strength of the concrete and RAC concrete exhibit sufficient strength in comparison to the normal aggregate concrete; the relevant design recommendations are also made.

Keywords: recycled aggregate concrete, compressive test, tensile splitting test, flexural strength test, impact test

Procedia PDF Downloads 349
896 Kinetic Study of Thermal Degradation of a Lignin Nanoparticle-Reinforced Phenolic Foam

Authors: Juan C. Domínguez, Belén Del Saz-Orozco, María V. Alonso, Mercedes Oliet, Francisco Rodríguez

Abstract:

In the present study, the kinetics of thermal degradation of a phenolic and lignin reinforced phenolic foams, and the lignin used as reinforcement were studied and the activation energies of their degradation processes were obtained by a DAEM model. The average values for five heating rates of the mean activation energies obtained were: 99.1, 128.2, and 144.0 kJ.mol-1 for the phenolic foam, 109.5, 113.3, and 153.0 kJ.mol-1 for the lignin reinforcement, and 82.1, 106.9, and 124.4 kJ. mol-1 for the lignin reinforced phenolic foam. The standard deviation ranges calculated for each sample were 1.27-8.85, 2.22-12.82, and 3.17-8.11 kJ.mol-1 for the phenolic foam, lignin and the reinforced foam, respectively. The DAEM model showed low mean square errors (< 1x10-5), proving that is a suitable model to study the kinetics of thermal degradation of the foams and the reinforcement.

Keywords: kinetics, lignin, phenolic foam, thermal degradation

Procedia PDF Downloads 450
895 Comparative Study of Affricate Initial Consonants in Chinese and Slovak

Authors: Maria Istvanova

Abstract:

The purpose of the comparative study of the affricate consonants in Chinese and Slovak is to increase the awareness of the main distinguishing features between these two languages taking into consideration this particular group of consonants. This study determines the main difficulties of the Slovak learners in the process of acquiring correct pronunciation of affricate initial consonants in Chinese based on the understanding of the distinguishing features of Chinese and Slovak affricates in combination with the experimental measuring of VOT values. The software tool Praat is used for the analysis of the recorded language samples. The language samples contain recordings of a Chinese native speaker and Slovak students of Chinese with different language proficiency levels. Based on the results of the analysis in Praat, the study identifies erroneous pronunciation and provide clarification of its cause.

Keywords: Chinese, comparative study, initial consonants, pronunciation, Slovak

Procedia PDF Downloads 113
894 The Reflection of Greek Reality Concerning Taxation from the Perspective of Both Tax Payers and Taxmen

Authors: Evagelia Makri, Maria Tsourela, Dimitris Paschaloudis, Dafni M. Nerantzaki

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One of the biggest financial and social problems, which at the same time constitute one of the greater challenges that Greek society faces today, is the illegal avoidance of tax payments. Tax evasion may negate financial data and community budgets, as well as breed financial chaos. This research seeks to reflect Greek reality concerning tax measures. Also, there will be an effort to record the factors surrounding tax evasion. Greek tax system’s data will be rendered in financial terms. Questionnaires will be handed out to tax payers, and interviews will be conducted to taxmen. The quantitative analysis of the questionnaire answers will define the tax payers’ opinion towards the existence of tax evasion. The qualitative analysis of the interviews will reveal the main reason that boosts tax evasion. At the end, there will be some realistic proposals about how to better collect taxes, through the creation of a strong regulatory mechanism.

Keywords: tax evasion, tax collection measures, insurance recovery measures, Greek tax system

Procedia PDF Downloads 331
893 Human Capital and the Innovation System: A Case Study of the Mpumalanga Province, South Africa

Authors: Maria E. Eggink

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Human capital is one of the essential factors in an innovation system and innovation is the driving force of economic growth and development. Schumpeter focused on the entrepreneur as innovator, but the evolutionary economists shifted the focus to all participants in the innovation system. Education and training institutions are important participants in an innovation system, but there is a gap in literature on competence building as part of the analysis of innovation systems. In this paper the education and training institutions’ competence building role in the innovation system is examined. The Mpumalanga Province of South Africa is used as a case study. It was found that the absence of a university, the level of education, the quality and performance in the education sector and the condition of the education infrastructure have not been conducive to learning.

Keywords: education institutions, human capital, innovation systems, Mpumalanga Province

Procedia PDF Downloads 344
892 Linac Quality Controls Using An Electronic Portal Imaging Device

Authors: Domingo Planes Meseguer, Raffaele Danilo Esposito, Maria Del Pilar Dorado Rodriguez

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Monthly quality control checks for a Radiation Therapy Linac may be performed is a simple and efficient way once they have been standardized and protocolized. On the other hand this checks, in spite of being imperatives, require a not negligible execution times in terms of machine time and operators time. Besides it must be taken into account the amount of disposable material which may be needed together with the use of commercial software for their performing. With the aim of optimizing and standardizing mechanical-geometric checks and multi leaves collimator checks, we decided to implement a protocol which makes use of the Electronic Portal Imaging Device (EPID) available on our Linacs. The user is step by step guided by the software during the whole procedure. Acquired images are automatically analyzed by our programs all of them written using only free software.

Keywords: quality control checks, linac, radiation oncology, medical physics, free software

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891 Experience of Two Major Research Centers in the Diagnosis of Cardiac Amyloidosis from Transthyretin

Authors: Ioannis Panagiotopoulos, Aristidis Anastasakis, Konstantinos Toutouzas, Ioannis Iakovou, Charalampos Vlachopoulos, Vasilis Voudris, Georgios Tziomalos, Konstantinos Tsioufis, Efstathios Kastritis, Alexandros Briassoulis, Kimon Stamatelopoulos, Alexios Antonopoulos, Paraskevi Exadaktylou, Evanthia Giannoula, Anastasia Katinioti, Maria Kalantzi, Evangelos Leontiadis, Eftychia Smparouni, Ioannis Malakos, Nikolaos Aravanis, Argyrios Doumas, Maria Koutelou

Abstract:

Introduction: Cardiac amyloidosis from Transthyretin (ATTR-CA) is an infiltrative disease characterized by the deposition of pathological transthyretin complexes in the myocardium. This study describes the characteristics of patients diagnosed with ATTR-CA from 2019 until present at the Nuclear Medicine Department of Onassis Cardiac Surgery Center and AHEPA Hospital. These centers have extensive experience in amyloidosis and modern technological equipment for its diagnosis. Materials and Methods: Records of consecutive patients (N=73) diagnosed with any type of amyloidosis were collected, analyzed, and prospectively followed. The diagnosis of amyloidosis was made using specific myocardial scintigraphy with Tc-99m DPD. Demographic characteristics, including age, gender, marital status, height, and weight, were collected in a database. Clinical characteristics, such as amyloidosis type (ATTR and AL), serum biomarkers (BNP, troponin), electrocardiographic findings, ultrasound findings, NYHA class, aortic valve replacement, device implants, and medication history, were also collected. Some of the most significant results are presented. Results: A total of 73 cases (86% male) were diagnosed with amyloidosis over four years. The mean age at diagnosis was 82 years, and the main symptom was dyspnea. Most patients suffered from ATTR-CA (65 vs. 8 with AL). Out of all the ATTR-CA patients, 61 were diagnosed with wild-type and 2 with two rare mutations. Twenty-eight patients had systemic amyloidosis with extracardiac involvement, and 32 patients had a history of bilateral carpal tunnel syndrome. Four patients had already developed polyneuropathy, and the diagnosis was confirmed by DPD scintigraphy, which is known for its high sensitivity. Among patients with isolated cardiac involvement, only 6 had left ventricular ejection fraction below 40%. The majority of ATTR patients underwent tafamidis treatment immediately after diagnosis. Conclusion: In conclusion, the experiences shared by the two centers and the continuous exchange of information provide valuable insights into the diagnosis and management of cardiac amyloidosis. Clinical suspicion of amyloidosis and early diagnostic approach are crucial, given the availability of non-invasive techniques. Cardiac scintigraphy with DPD can confirm the presence of the disease without the need for a biopsy. The ultimate goal still remains continuous education and awareness of clinical cardiologists so that this systemic and treatable disease can be diagnosed and certified promptly and treatment can begin as soon as possible.

Keywords: amyloidosis, diagnosis, myocardial scintigraphy, Tc-99m DPD, transthyretin

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890 A Game-Based Methodology to Discriminate Executive Function – a Pilot Study With Institutionalized Elderly People

Authors: Marlene Rosa, Susana Lopes

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There are few studies that explore the potential of board games as a performance measure, despite it can be an interesting strategy in the context of frailty populations. In fact, board games are immersive strategies than can inhibit the pressure of being evaluated. This study aimed to test the ability of gamed-base strategies to assess executive function in elderly population. Sixteen old participants were included: 10 with affected executive functions (G1 – 85.30±6.00 yrs old; 10 male); 6 with executive functions with non-clinical important modifications (G2 - 76.30±5.19 yrs old; 6 male). Executive tests were assessed using the Frontal Assessment Battery (FAB), which is a quick-applicable cognitive screening test (score<12 means impairment). The board game used in this study was the TATI Hand Game, specifically for training rhythmic coordination of the upper limbs with multiple cognitive stimuli. This game features 1 table grid, 1 set of Single Game cards (to play with one hand); Double Game cards (to play simultaneously with two hands); 1 dice to plan Single Game mode; cards to plan the Double Game mode; 1 bell; 2 cups. Each participant played 3 single game cards, and the following data were collected: (i) variability in time during board game challenges (SD); (ii) number of errors; (iii) execution speed (sec). G1 demonstrated: high variability in execution time during board game challenges (G1 – 13.0s vs G2- 0.5s); a higher number of errors (1.40 vs 0.67); higher execution velocity (607.80s vs 281.83s). These results demonstrated the potential of implementing board games as a functional assessment strategy in geriatric care. Future studies might include larger samples and statistical methodologies to find cut-off values for impairment in executive functions during performance in TATI game.

Keywords: board game, aging, executive function, evaluation

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889 A Case Report on the Multidisciplinary Approach on Rectal Adenocarcinoma in Pregnancy

Authors: Maria Cristina B. Cabanag, Elijinese Marie S. Culangen

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Pregnancy is a period in a woman's life wherein the body may undergo different physiological changes. These changes can be attributed to the interplay of hormones in the body but can mask a more sinister type of disease such as malignancy on rare occasions. Colorectal cancer (CRC) in pregnancy is an epidemiologically rare disease worldwide. To our knowledge, no available studies were reported in the Philippines at the time of this writing, posing a dilemma for its appropriate diagnosis and management. Signs and symptoms of colorectal malignancy may camouflage a normal pregnancy and, when overlooked, impedes an appropriate approach. This case of a 38-year-old elderly primigravid who presented with hematochezia on her 25th week of gestation. She was diagnosed with rectal adenocarcinoma later in pregnancy which warranted a predicament regarding her appropriate care and management. This paper explores the repertoire of the different diagnostic and treatment approaches to colorectal cancer in the second trimester of pregnancy, with the least possible maternal and fetal hazards.

Keywords: cancer in pregnancy, chemotherapy in pregnancy, colorectal cancer, hematochezia in pregnancy

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888 The Properties of Risk-based Approaches to Asset Allocation Using Combined Metrics of Portfolio Volatility and Kurtosis: Theoretical and Empirical Analysis

Authors: Maria Debora Braga, Luigi Riso, Maria Grazia Zoia

Abstract:

Risk-based approaches to asset allocation are portfolio construction methods that do not rely on the input of expected returns for the asset classes in the investment universe and only use risk information. They include the Minimum Variance Strategy (MV strategy), the traditional (volatility-based) Risk Parity Strategy (SRP strategy), the Most Diversified Portfolio Strategy (MDP strategy) and, for many, the Equally Weighted Strategy (EW strategy). All the mentioned approaches were based on portfolio volatility as a reference risk measure but in 2023, the Kurtosis-based Risk Parity strategy (KRP strategy) and the Minimum Kurtosis strategy (MK strategy) were introduced. Understandably, they used the fourth root of the portfolio-fourth moment as a proxy for portfolio kurtosis to work with a homogeneous function of degree one. This paper contributes mainly theoretically and methodologically to the framework of risk-based asset allocation approaches with two steps forward. First, a new and more flexible objective function considering a linear combination (with positive coefficients that sum to one) of portfolio volatility and portfolio kurtosis is used to alternatively serve a risk minimization goal or a homogeneous risk distribution goal. Hence, the new basic idea consists in extending the achievement of typical risk-based approaches’ goals to a combined risk measure. To give the rationale behind operating with such a risk measure, it is worth remembering that volatility and kurtosis are expressions of uncertainty, to be read as dispersion of returns around the mean and that both preserve adherence to a symmetric framework and consideration for the entire returns distribution as well, but also that they differ from each other in that the former captures the “normal” / “ordinary” dispersion of returns, while the latter is able to catch the huge dispersion. Therefore, the combined risk metric that uses two individual metrics focused on the same phenomena but differently sensitive to its intensity allows the asset manager to express, in the context of an objective function by varying the “relevance coefficient” associated with the individual metrics, alternatively, a wide set of plausible investment goals for the portfolio construction process while serving investors differently concerned with tail risk and traditional risk. Since this is the first study that also implements risk-based approaches using a combined risk measure, it becomes of fundamental importance to investigate the portfolio effects triggered by this innovation. The paper also offers a second contribution. Until the recent advent of the MK strategy and the KRP strategy, efforts to highlight interesting properties of risk-based approaches were inevitably directed towards the traditional MV strategy and SRP strategy. Previous literature established an increasing order in terms of portfolio volatility, starting from the MV strategy, through the SRP strategy, arriving at the EQ strategy and provided the mathematical proof for the “equalization effect” concerning marginal risks when the MV strategy is considered, and concerning risk contributions when the SRP strategy is considered. Regarding the validity of similar conclusions when referring to the MK strategy and KRP strategy, the development of a theoretical demonstration is still pending. This paper fills this gap.

Keywords: risk parity, portfolio kurtosis, risk diversification, asset allocation

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887 Identifying Organizational Culture to Implement Knowledge Management: Case Study of BKN, Indonesia

Authors: Maria Margaretha, Elin Cahyaningsih, Dana Indra Sensuse Lukman

Abstract:

One of key success an organization can be seen from its culture. Employee, environment, and so on are factors for organization to achieve goals and build a competitive advantage. Type of organizational culture can be a guide to implementing Knowledge Management (KM) in organization especially in BKN. Culture will determine behavior of employees or environment to support KM. This paper describes the process to decide which culture does organization belong and suggestion and creating strategic moves in the future to implement KM. OCAI (Organizational Culture Assessment Instrument) and its framework (Competing Value Framework) were used to decide the type of organizational culture. To implement KM in organization, clan is an appropriate culture, because clan culture represent cultural values and leader type to implement a successful KM. Result of the measurement will be references for BKN to improve organization culture to achieve its goals and organization effectiveness.

Keywords: organizational culture, government, knowledge management, OCAI

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