bluuebunny/crossref_metadata_2025 huggingface dataset:
Biogas production from slaughterhouse wastewaters and use of biofertilizer obtained for biodegradation of aromatic hydrocarbons
Authors: Marder Munique , Konrad Odorico , Ilha Vinicius , Granada Camille Eichelberger
Published: December 2019

The anaerobic digestion of industrial wastes produces a biogas that is an alternative to the use of fossil fuels for energy production. At the end of this process, the stabilized biomass presents high levels of nutrients, which can be used both as biofertilizers in agriculture and for the biodegradation of contaminants in the soil through improvement of the microbiota. Thus, this study aimed to evaluate biogas production by industrial wastes and to use the biofertilizer for the bioremediation of soils previously contaminated with gasoline. The biomass (420 mL) generated approximately 10 liters (L) of methane and 3 L of other gases. Anaerobic incubation reduced total and volatile solids, as well as biochemical oxygen demand, chemical oxygen demand, and the carbon and nitrogen contents of the biomass. The bioremediation experiment showed that 15 days after contamination with gasoline, the addition of the biofertilizer improved the degradation efficiency of monoaromatic hydrocarbons; however, the degradation of polyaromatic hydrocarbons was less time efficient. So, we conclude that the anaerobic incubation of industrial wastes generates a high amount of biogas, and that biofertilizer deposition into contaminated soil does not affect the efficiency of the degradation of aromatic hydrocarbons after 30 days. Novelty or significance: Anaerobic incubation of industrial wastes generates a high calorific value gas, which can be used as an alternative source of energy. And, the resulting biomass, called biofertilizer, can be used to remediate soils contaminated with hydrocarbons.
Acoustic Surveys for Bats are Improved by Taking Habitat Type into Account
Authors: Findlay Stephanie V. , Barclay Robert M. R.
Published: December 2019

Passive monitoring of bat species via acoustics is a growing field and as a result there are various software programs available that allow for species identification. However, accuracy of these programs is variable and creating a local call library is essential when trying to identify acoustically similar species. In Dinosaur Provincial Park, Alberta, Canada, 3 Myotis species are difficult to distinguish acoustically. We created an echolocation call library from known Myotis evotis, M. lucifugus, and M. ciliolabrum flying in open spaces and near clutter to test whether or not recording in the bats' local habitat type improved call library quality and identification accuracy. Bat calls recorded within open spaces (coulees) differed from those recorded near cluttered spaces (tree edges) for M. ciliolabrum and M. lucifugus. Accuracy of species identification also increased when we used models based on bat calls recorded in cluttered habitats. Using a simple model with recordings from different habitat types within a study site, we were able to improve identification accuracy and model performance. © 2019 The Wildlife Society.
Cardiovascular autonomic testing in the work-up of cerebellar ataxia: insight from an observational single center study
Authors: Indelicato Elisabetta , Fanciulli Alessandra , Nachbauer Wolfgang , Eigentler Andreas , Amprosi Matthias , Ndayisaba Jean-Pierre , Granata Roberta , Wenning Gregor , Boesch Sylvia
Published: December 2019

Background

Cerebellar ataxias are a heterogeneous group of disorders of both genetic and non-genetic origin. In sporadic cases, two entities are recognized: multiple system atrophy of cerebellar type (MSA-C) and SAOA (sporadic adult-onset ataxia). The presence of severe cardiovascular autonomic failure reliably distinguishes MSA-C from other ataxias, but it may appear only late in the disease course.

Objective

To evaluate the diagnostic yield of cardiovascular autonomic function tests in the work-up of cerebellar ataxia.

Methods

We applied a cardiovascular autonomic tests battery in consecutive patients with neurodegenerative cerebellar ataxia and matched healthy controls. We recorded the presence of both orthostatic hypotension (OH) and blood pressure falls non-fulfilling the criteria of OH (non-OH BP). Sporadic cases were followed-up for an eventual conversion to MSA-C.

Results

Forty-two patients were recruited, 19 of whom with sporadic disease (2 probable MSA-C, 6 possible MSA-C, 11 SAOA). Sporadic and hereditary cases showed no difference concerning ataxia severity at baseline. At head-up tilt, non-OH BP falls were detected in nine patients, but not in controls. This finding was significantly more frequent in sporadic cases (p = 0.006) and was detected in five out of seven patients that during follow-up converted to possible/probable MSA-C. Findings at standing test were normal in four out of nine cases with non-OH BP falls at head-up tilt.

Conclusions

A complete cardiovascular autonomic battery with head-up tilt can detect early signs of BP dysregulation which may be missed at bed-side tests, thus warranting its application in the first line work-up of cerebellar ataxias.
The relation of work-related factors with ambulatory blood pressure and nocturnal blood pressure dipping among aging workers
Authors: Karelius Saana , Vahtera Jussi , Pentti Jaana , Lindroos Annika S. , Jousilahti Pekka , Heinonen Olli J. , Stenholm Sari , Niiranen Teemu J.
Published: December 2019

Objectives

Individuals with reduced nocturnal blood pressure (BP) dipping are at increased risk of cardiovascular disease compared to persons with normal BP dipping. Although the relation of work-related factors and BP has been studied extensively, very little is known of the association between work-related factors and 24-h BP patterns in aging workers. We examined the cross-sectional relation of work-related risk factors, including occupational status, work-time mode, job demands and job control, with ambulatory BP in aging workers, focusing on nocturnal BP dipping.

Methods

208 workers (mean age 62 ± 3 years; 75% women) from two Finnish population-based cohort studies underwent 24-h ambulatory BP monitoring. Work-related factors were inquired using a questionnaire. Nocturnal BP dipping was calculated as [1 − (asleep BP/awake BP)] × 100.

Results

Shift workers demonstrated a higher nocturnal diastolic BP dipping than regular day workers (19% vs. 17%, p = 0.03) and had a significantly higher systolic awake BP than regular day workers (136.5 mmHg vs. 132.5 mmHg, p = 0.03). Participants with high job demands demonstrated a smaller nocturnal systolic BP dipping than participants with low job demands (14% vs. 16%, p = 0.04). We did not observe significant differences in nocturnal systolic or diastolic BP dipping between groups categorized by occupational status or job control.

Conclusions

Although shift workers have a higher daytime BP than regular daytime workers, they exhibit greater nighttime BP dipping. Participants with high job demand had smaller nighttime BP dipping than participants with low job demand. Job control or occupation did not affect the 24-h ambulatory BP profile of aging workers.
Evaluation of growth, stemness, and angiogenic properties of dental pulp stem cells cultured in cGMP xeno-/serum-free medium
Authors: Qu Chengjuan , Brohlin Maria , Kingham Paul J , Kelk Peyman
Published: December 2019

This study was aimed to investigate the effects of cGMP xeno-/serum-free medium (XSF, Irvine Scientific) on the properties of human dental pulp stem cells (DPSCs). DPSCs, from passage 2, were cultured in XSF or fetal bovine serum (FBS)-supplemented medium, and sub-cultured up to passage 8. Cumulative population doublings (PDs) and the number of colony-forming-units (CFUs) were determined. qRT-PCR, ELISA, and in vitro assays were used to assess angiogenic capacity. Flow cytometry was used to measure CD73, CD90, and CD105 expression. Differentiation into osteo-, adipo-, and chondrogenic cell lineages was performed. DPSCs showed more elongated morphology, a reduced rate of proliferation at later passages, and lower CFU counts in XSF compared with FBS. Expression of angiogenic factors at the gene and protein levels varied in the two media and with passage number, but cells grown in XSF had more in vitro angiogenic activity. The majority of early and late passage DPSCs cultured in XSF expressed CD73 and CD90. In contrast, the percentage of CD105 positive DPSCs in XSF medium was significantly lower with increased passage whereas the majority of cells cultured in FBS were CD105 positive. Switching XSF-cultured DPSCs to medium supplemented with human serum restored the expression of CD105. The tri-lineage differentiation of DPSCs cultured under XSF and FBS conditions was similar. We showed that despite reduced CD105 expression levels, DPSCs expanded in XSF medium maintained a functional MSC phenotype. Furthermore, restoration of CD105 expression is likely to occur upon in vivo transplantation, when cells are exposed to human serum.
Cannabinoid1 (CB-1) receptor antagonists: a molecular approach to treating acute cannabinoid overdose
Authors: Skolnick Phil , Crystal Roger
Published: December 2019

The legalization of cannabis for both recreational and medical use in the USA has resulted in a dramatic increase in the number of emergency department visits and hospital admissions for acute cannabinoid overdose (also referred to as cannabis intoxication and cannabis poisoning). Both “edibles” (often sold as brownies, cookies, and candies) containing large amounts of Δ9-tetrahydrocannabinol and synthetic cannabinoids (many possessing higher potencies and efficacies than Δ9-tetrahydrocannabinol) are responsible for a disproportionate number of emergency department visits relative to smoked cannabis. Symptoms of acute cannabinoid overdose range from extreme lethargy, ataxia, and generalized psychomotor impairment to feelings of panic and anxiety, agitation, hallucinations, and psychosis. Treatment of acute cannabinoid overdose is currently supportive and symptom driven. Converging lines of evidence indicating many of the symptoms which can precipitate an emergency department visit are mediated through activation of cannabinoid1 receptors. Here, we review the evidence that cannabinoid1 receptor antagonists, originally developed for indications ranging from obesity to smoking cessation and schizophrenia, provide a molecular approach to treating acute cannabinoid overdose.
Precious metal recoveries in secondary copper smelting with high-alumina slags
Authors: Avarmaa Katri , O’Brien Hugh , Klemettinen Lassi , Taskinen Pekka
Published: December 2019

Waste electrical and electronic equipment (WEEE) represents a significant urban resource for precious metals. To maximize the recoveries and sustainable use of these metals, their behavior needs to be characterized in the secondary copper smelting of WEEE. The current study experimentally determined the distributions of gold, silver, platinum and palladium between copper alloy and FeOx–SiO2–Al2O3/FeOx–SiO2–Al2O3–CaO slags (LCu/s[M] = [M]Copper/[M]Slag) over the oxygen partial pressure range of 10−5 – 10−10 atm at 1300 °C. In addition, the equilibria of copper alloy, slag and Al–Fe spinel system are presented and discussed. The experiments were conducted employing an equilibration—drop-quenching technique followed by major element analysis with Electron Probe MicroAnalysis (EPMA) and trace element analysis with sensitive Laser Ablation Inductively Coupled Plasma Mass Spectrometry (LA-ICP-MS). The results showed that the distribution coefficient of silver increased from 10 to 103 as a function of decreasing oxygen partial pressure. For gold, platinum and palladium, the distribution coefficients were at minimum 105. Lime addition improved the recovery of silver notably and had a small positive effect on gold recovery into copper. Overall, the precious metals can be recovered very efficiently in copper alloy via secondary copper smelting with alumina-rich iron-silicate slags.
Instituting a national early detection and rapid response program: needs for building federal risk screening capacity
Authors: Marshall Meyers N. , Reaser Jamie K. , Hoff Michael H.
Published: December 2019

The invasive species issue is inherently a matter of risk; what is the risk that an invasive species will adversely impact valued assets? The early detection of and rapid response to invasive species (EDRR) requires that an assessment of risk is conducted as rapidly as possible. We define risk screening as rapid characterization of the types and degree of risks posed by a population of non-native species in a particular spatio-temporal context. Risk screening is used to evaluate the degree to which various response measures are warranted and justifiable. In this paper, we evaluate the US government’s risk screening programs with a view towards advancing national EDRR capacity. Our survey-based findings, consistent with prior analyses, indicate that risk evaluation by federal agencies has largely been a reactive, ad hoc process, and there is a need to improve information sharing, risk evaluation tools, and staff capacity for risk screening. We provide an overview of the US Department of Agriculture’s Tiered Weed Risk Evaluation and US Fish and Wildlife Service’s Ecological Risk Screening Summaries, two relatively new approaches to invasive species risk screening that hold promise as the basis for future work. We emphasize the need for a clearinghouse of risk evaluation protocols, tools, completed assessments and associated information; development of performance metrics and standardized protocols for risk screening; as well as support for complementary, science-based tools to facilitate and validate risk screening.
The Determinants of Subjective Well-Being in a Developing Country: The Ecuadorian Case
Authors: Pontarollo Nicola , Orellana Mercy , Segovia Joselin
Published: December 2019

In this study, we identify some individual and contextual factors potentially affecting subjective well-being in developing countries and check their effect in the Ecuadorian case. Ecuador is an oil country where attempts have been made to overcome deep social and territorial inequalities by placing human well-being at the core of public policy through the National Plan for Good Living. By means of ordinary least squares and ordered logit with clustered standard errors, as well as multilevel ordered logit models, we find that oil-dependent territories negatively affect well-being. Moreover, women and indigenous people report lower well-being, while personal income, education, housing quality, institutional trust, health insurance and social relationships can improve it. From a policy perspective, we find that basic unmet needs still need to be fulfilled to increase well-being, and further improvements of the institutional framework, redistributive system and inclusion policies are required. In this respect, we observe that Good Living-based policy accurately addresses these elements and, therefore, has great potential for application in other countries with similar characteristics.
New Homogeneous Dataset of Solar EUV Synoptic Maps from SOHO/EIT and SDO/AIA
Authors: Hamada A. , Asikainen T. , Mursula K.
Published: December 2019

Synoptic maps of solar EUV intensities have been constructed for many decades in order to display the distribution of the different EUV emissions across the solar surface, with each map representing one Carrington rotation (i.e. one rotation of the Sun). This article presents a new solar EUV synoptic map dataset based on full-disk images from the Solar and Heliospheric Observatory/Extreme Ultraviolet Imaging Telescope (SOHO/EIT) and Solar Dynamics Observatory/Atmospheric Imaging Assembly (SDO/AIA). In order to remove the significant and complicated drift of EIT and AIA EUV intensities due to sensor degradation, we construct the synoptic maps in standardized intensity scale. We describe a method of homogenizing the SOHO/EIT maps with SDO/AIA maps by transforming the EIT intensity histograms to AIA levels. The new maps cover the years from 1996 to 2018 with 307 SOHO/EIT and 116 SDO/AIA synoptic maps, respectively. These maps provide a systematic and homogeneous view of the entire solar surface in four EUV wavelengths, and are well suited, e.g., for studying long-term coronal hole evolution.
Stigmatisation and resilience in inflammatory bowel disease
Authors: Lenti Marco Vincenzo , Cococcia Sara , Ghorayeb Jihane , Di Sabatino Antonio , Selinger Christian P.
Published: December 2019

Inflammatory bowel disease, which includes Crohn’s disease and ulcerative colitis, is an immune-mediated, chronic relapsing disorder characterised by severe gastrointestinal symptoms that dramatically impair patients’ quality of life, affecting psychological, physical, sexual, and social functions. As a consequence, patients suffering from this condition may perceive social stigmatisation, which is the identification of negative attributes that distinguish a person as different and worthy of separation from the group. Stigmatisation has been widely studied in different chronic conditions, especially in mental illnesses and HIV-infected patients. There is a growing interest also for patients with inflammatory bowel disease, in which the possibility of disease flare and surgery-related issues seem to be the most important factors determining stigmatisation. Conversely, resilience represents the quality that allows one to adopt a positive attitude and good adjustments despite adverse life events. Likewise, resilience has been studied in different populations, age groups, and chronic conditions, especially mental illnesses and cancer, but little is known about this issue in patients with inflammatory bowel disease, even if this could be an interesting area of research. Resilience can be strengthened through dedicated interventions that could potentially improve the ability to cope with the disease. In this paper, we focus on the current knowledge of stigmatisation and resilience in patients with inflammatory bowel disease.
Reflections on 40 Years of Applied Economics Research on Agriculture and Water Quality
Authors: Ribaudo Marc , Shortle James
Published: December 2019

Reducing agricultural nonpoint pollution has been an environmental policy issue since the early 1980s. We discuss the evolution and results of federal and state policy, the contributions of applied economic research to improving the effectiveness and efficiency of water pollution control policies for agriculture, elements of policy reforms that are consistent with the Clean Water Act, and the outlook for needed policy innovation.
Introductory Remarks by William S. Dodge
Authors: Dodge William S.
Published: December 2019

Welcome to the Fourth Annual Detlev F. Vagts Roundtable on Transnational Law. The purposes of the Roundtable are to promote scholarship by gifted younger academics, to support exchanges of ideas across jurisdictions, and to maintain connections between scholars and the practicing bar in the field of international and transnational law. The Roundtable is supported by a generous gift from the Vagts family, and I would like to acknowledge Karen Vagts, one of Det's two daughters, who is with us today.
Legal Disaster Risk Reduction Cooperation During Ecuador's Earthquake
Authors: Cahueñas Hugo
Published: December 2019

In 2010, Haiti's 7.0 magnitude earthquake resulted in more than 200,000 deaths and more than one million homeless. This event recaptured the attention of international society regarding disaster-related governmental policies and legislation. In 2011, Resolution 7 of the International Conference of the Red Cross reiterated the urgency for states to be prepared to facilitate and regulate any international disaster assistance, using the Guidelines for the domestic facilitation and regulation of international disaster relief and initial recovery assistance (also known as the “IDRL Guidelines”). The International Conference adopted these guidelines in 2007; nevertheless, several countries did not implement the recommendations of the IDRL guidelines before the Haiti earthquake. Such was the case of Ecuador, which, after 2010, began to work on the implementation of the IDRL guidelines. In the beginning, public officials were very skeptical about the IDRL Guidelines as a tool for mitigating the consequences of disasters.
Dual Hats and Arbitrator Diversity: Goals in Tension
Authors: Crook John R.
Published: December 2019

I want to raise a quandary facing international investment dispute settlement: the tension between the wish to curb “dual hatting” and the wish to increase the diversity of persons appointed as arbitrators.
Overview of Climate Change Litigation
Authors: Gerrard Michael
Published: December 2019

Climate change litigation is a global phenomenon. According to a database maintained by the Sabin Center for Climate Change Law, as of February 4, 2019 a total of 1,297 climate cases had been filed in courts or other tribunals worldwide. Of these, 1,009—78 percent—were from the United States, Australia was a distant second, with ninety-eight, followed by the United Kingdom with forty-seven. No other country had as many as twenty. The cases were filed in twenty-nine countries and six international tribunals, led by the Court of Justice of the European Union, which had forty-one.
Indo-Pacific Economic Architecture: An ASEAN Perspective
Authors: Tundang Ronald Eberhard
Published: December 2019

For over five decades, countries in Southeast Asia and its surroundings in Asia, the Pacific Ocean, and Pacific Rim have enjoyed peace and stability, upon which economic growth and welfare have accumulated. The marvel of uninterrupted development has transformed them into a group of countries that are part of the engines of global economic growth. Over the period of 1967 until 2017, Southeast Asian region recorded growth in gross domestic product (GDP) per capita almost thirty-three times bigger, from USD 122 to USD 4,021. In 2016, the region represented 6.2 percent GDP of the world in 2016, almost doubled the share in 1967 at just 3.2 percent. The period also saw an immense trade growth from USD 9.7 billion to USD 2.2 trillion. Right now the region has become the third largest economy in Asia and the fifth largest in the world.
Enchanted by the Tools? An Enlightenment Perspective
Authors: Koskenniemi Martti
Published: December 2019

“In this context the proposition that tools are prolongations of human organs can be inverted to state that the organs are also prolongations of the tools.”
Du harcèlement sexuel sans conséquence pour la victime? Analyse discursive de la jurisprudence du Tribunal administratif du travail du Québec
Authors: Cox Rachel
Published: December 2019

Cette étude s’intéresse au discours des juges du Tribunal administratif du travail du Québec en matière de harcèlement sexuel à partir d’un échantillon de 12 décisions rendues entre 2014 et 2017. Dans la moitié des décisions analysées, les motifs du juge reposent sur une logique binaire. Des binômes (femmes/hommes; subjectivité/objectivité; émotionnalité/rationalité, etc.) se glissent dans l’appréciation de la preuve, perpétuant des mythes qui banalisent le harcèlement sexuel. Une logique binaire est généralement associée au rejet de la réclamation. En revanche, dans l’autre moitié des décisions, les motifs du juge prennent en compte le contexte ainsi que la complexité du harcèlement sexuel. Nos résultats illustrent comment le discours des juges sert soit à perpétuer, soit à remettre en question les stéréotypes négatifs relatifs au harcèlement sexuel des femmes au travail, et ce, dans un cadre juridique identique.
OP06 Evaluating Public Health Interventions: A Neglected Area In HTA
Authors: Lenoir-Wijnkoop Irene , Stojanovic Jovana , Rodrigo Eva Reviriego , Burton Alexia Campbell , Hampson Grace , Gutiérrez-Ibarluzea Iñaki
Published: December 2019

Introduction

Public health (PH) interventions are crucial for ensuring sustainable healthcare infrastructures. Nevertheless, they represent a neglected area in HTA due to various methodological issues and their complex design that goes beyond clinical setting. Our study provides an environmental scan of HTA initiatives related to the assessment of PH technologies on a global level.

Methods

The Initiative for Public Health Outcomes Research and Measurement (INPHORM) interest group has conducted a survey among European and international societies, health bodies and networks during September 2018. The questionnaire evaluates what kind of PH technologies and/or interventions have been evaluated in the last five years, or are planned for the future.

Results

Our preliminary findings from November 2018 indicate a total of 94 initiated and 44 completed surveys. Among the completed ones, the majority of respondents came from European countries (36%), followed by North (30%) and South America (16%) countries. Sixty-eight percent of institutions reported engagement in any aspect of HTA in the area of PH (N = 30). Medical aspects of the PH technology are considered by 83 percent of the institutions, followed by organizational impact (67%), economic evaluation (60%) and societal consequences (60%). An average of four PH technologies has been evaluated by the responding institutions in the last five years. In reference to methodological aspects, 90 percent of institutions used a classical HTA approach for evaluating PH interventions, while 40 percent used budget impact analyses. Among the barriers for reaching a decision, conflicting stakeholder priorities, lack of data and clear methodological frameworks were most commonly cited.

Conclusions

Data analysis is currently on-going and final results will be presented during the Cologne meeting. This study will allow to raise awareness about the importance of PH interventions in HTA, identify existing gaps and propose future methodological developments.
OP22 Patient-Based Evidence: Its Role In Decision-Making On New Medicines
Authors: Hems Sharon , Taylor Louise , Jones Jan , Holmes Eileen
Published: December 2019

Introduction

The Scottish Medicines Consortium (SMC) advises NHS Scotland on the clinical and cost-effectiveness of new medicines. Since 2014, evidence from patients and carers on end-of-life and orphan medicines has been gathered during Patient and Clinician Engagement (PACE) meetings. The output is a consensus statement which describes the added value of a new medicine from the perspective of the patient/carer and clinician. This study investigates the importance of factors identified through PACE to committee members and how these are used in their decision-making.

Methods

Survey methodology was used to gain an understanding of the factors from the PACE statement that are most likely to influence members (n = 26) in decision-making. The survey instrument was informed by a literature review and observation of PACE and SMC meetings. Likert scale questions were used to determine the relative importance of factors in the PACE statement, including information relating to eight prominent ‘quality of life’ themes (family/carer impact, health benefits, tolerability, psychological benefit, hope, normal life, treatment choice and convenience), that were identified by an earlier thematic analysis of these statements.

Results

Analysis of survey responses will use mainly descriptive techniques to generate percentages and ranges. Correlation analysis will be considered to investigate relationships between members’ demographics, type of medicine (end-of-life, orphan) and the importance of different factors in the PACE statement. Preliminary results indicate that key quality of life themes highly valued by patients/carers are also important to committee members in their decision making. Challenges in assimilating qualitative patient-based evidence from PACE alongside quantitative clinical and economic data were highlighted.

Conclusions

Findings from this survey will provide valuable insight into how PACE evidence is used by SMC decision makers alongside traditional clinical and economic evidence and will help shape future improvements to the PACE methodology.
OP25 Organisational Learning Principles Applied To Information Retrieval
Authors: Macmillan Thomas
Published: December 2019

Introduction

A key discussion point during HTAi's 2018 Meeting was how Health Technology Assessment (HTA) practitioners might borrow ideas from other industries or academic areas. Organisational learning (OL) is the study of how individual knowledge is shared within an organisation to become institutional/group knowledge. There are several models of OL, all focusing on how tacit knowledge (abstract, personalised, hard to define, action-based) is converted to explicit knowledge (definable, concrete, fixed, information-based). Effective knowledge sharing is crucial to leveraging individual knowledge to drive innovation, efficiency and effectiveness. Information retrieval is a knowledge-intensive field, with many processes requiring both tacit and explicit knowledge. Ideas from OL demonstrate ways to improve practice by increasing knowledge sharing.

Methods

Nonaka & Takeuchi's (1994) SECI model describes the cyclical process by which knowledge is shared. The model includes 4 stages: socialisation (tacit-to-tacit), externalisation (tacit-to-explicit), combination (explicit-to-explicit) and internalisation (explicit-to-tacit). Each stage describes how knowledge sharing takes place and highlights ways to ameliorate these processes. Information retrieval involves many elements that require or benefit from knowledge sharing and both tacit and explicit knowledge is required.

Results

In the SECI model the Socialisation stage is characterised by face-to-face learning. Peer reviewing of search strategies, open dialogue and team working are ways of facilitating this stage. The Externalisation stage is crucial to OL. This can be seen as the practice-into-research stage; the results of successful experimentation, for example with search filters. The Combination stage is the easiest to understand. Communities of practice and inter-organisational networks can widen knowledge sharing and help refine or increase detail of best practice. The Internalisation stage is the hardest to conceptualise or measure. The extent to which guidelines become adopted in individual practice is one way to gauge Internalisation.

Conclusions

Information retrieval practitioners could benefit from thinking about ways to improve knowledge sharing. Models of OL can be instructive in this regard.
OP40 Criminal Justice Costs And Benefits Of Mental Health Interventions
Authors: Janssen Luca , Pokhilenko Irina , Drost Ruben , Paulus Aggie , Evers Silvia
Published: December 2019

Introduction

Mental health disorders and their treatments produce costs and benefits in both healthcare and non-healthcare sectors. The latter one is often referred to as inter-sectoral costs and benefits (ICBs). Limited research is available on the inclusion of these inter-sectoral costs and benefits (ICBs) in economic evaluations. In this study, we focus on the identification and classification of ICBs of mental health-related interventions within the criminal justice sector in a broader European context. This study was conducted as part of the PECUNIA-project, which aims to develop new standardized, harmonized and validated methods and tools for the assessment of costs and outcomes in European healthcare systems. The aim of the study is to further conceptualize an internationally applicable list of ICBs of mental health-related interventions in the criminal justice sector. Additionally, we aim to facilitate the inclusion of ICBs in economic evaluations across EU by prioritizing important ICBs.

Methods

Data was collected via a systematic literature search on PubMed and PsychINFO. Additionally, a grey literature search was carried out in six European countries. In order to validate the international applicability of the list and prioritize the ICBs, a survey was conducted with an international group of experts from the criminal justice sector.

Results

The literature search identified ICBs and resulted in a comprehensive list of items. A multi-dimensional list was constructed, distinguishing between costs as consequence of crime, and costs in response to crime. Based on the expert survey, the international applicability of the list was validated and the most important ICBs from the economic perspective were identified.

Conclusions

This study laid further foundations for the inclusion of important societal costs of mental health-related interventions within the criminal justice sector. More research is needed to facilitate the greater use of ICBs in economic evaluations.
OP71 Understanding Hospitals’ Performance Variability: Conceptual Framework
Authors: Cicchetti Americo , Marchetti Marco , Gabutti Irene , Boccia Stefania , Specchia Maria Lucia , Biondi Alessia , Ceccarelli Anna , de Waure Chiara , Grossi Adriano , Hoxhaj Ilda , Cacciatore Pasquale , Carini Elettra , Pezzullo Angelo Maria , Daugbjerg Signe
Published: December 2019

Introduction

Understanding of the role of contextual factors in determining the real value of health technologies is one of the major challenges for the use of Health Technology Assessment (HTA) methodology within hospitals. Moreover, the responsibility of assessing hospital performance is problematic. Although a number of managerial tools are available to appraise outcomes, there is little evidence on the role of contextual variables and how they might contribute to hospital performance.

Methods

Based on three extensive literature reviews, a pragmatic framework has been developed to understand interactions between organizational factors and health technologies on hospitals’ performance. Three main causal relationships emerge: (i) direct relationship between contextual factors and performance; (ii) an effect of contextual factors on the capability of technologies to “produce value”; (iii) an influence of organizational factors on clinical evidence-based decision-making. This pragmatic framework was designed within the IMPACT HTA EU Horizon 2020 Research Project.

Results

The contextual dimensions are ascribable to five domains: organizational structure; managerial accounting tools; information, communication and technology (ICT) tools; human resource management (HRM) tools; hospital-based HTA procedures. The impact of contextual factors on technologies’ ability to produce value is highly overlooked in literature. Some effort in this sense exists only in the analysis of health information technologies. Moreover, among the contextual dimensions, only HRM tools have inspired a lively debate. The definition of hospital performance is amenable to multiple domains: accessibility, appropriateness, efficiency, safety and patient centeredness (continuity of care).

Conclusions

Although hospital performance is a pivotal topic in the healthcare sector, a deep understanding of how contextual factors may affect it is missing. The theoretical framework developed provides a tool to understand the multiple dimensions able to affect hospital performance. On one hand contextual dimensions may provide a direct effect on hospital performance. On the other, they may affect the extent to which technologies are capable of producing value.
OP81 Building Technical Capacity To Promote Patient Involvement In Health Technology Assessment
Authors: Toledo-Chávarri Ana , Pego Yolanda Triñanes , Novella Blanca , Reviriego Eva , Cantero-Muñoz Paula , Gavin Patricia , Alvarez-Perez Yolanda , Perestelo-Perez Lilisbeth , Vicente-Edo Maria Jose
Published: December 2019

Introduction

In December 2017, a patient involvement (PI) Interest Group was created in the Spanish Network of Agencies for Assessing National Health System Technologies and Performance (RedETS) Annual conference. It started as a voluntary group of health technology assessment (HTA) methodologists interested in PI. The objective of the Group is to promote and facilitate PI in HTA. With the support of the Spanish Ministry of Health and the RedETS Council the Interest Group grew to at least one member for each of the eight RedETS regional agencies and units. It currently has 22 members. The PI Interest Group works in periodic online meetings and an annual offline meeting to establish a space for experiences exchange and reach consensus on main issues regarding PI.

Methods

RedETS published a strategy to facilitate effective and efficient PI in HTA processes in 2017. The long-term objective is to mainstream PI in all RedETS products. This strategy was built on a literature review and a qualitative study with semi-structured interviews. The interviews detected capacity building needs for technicians and methodologist in the network to be able to actively engage patients in HTA reports.

Results

Since the kick-off meeting the PI Interest Group has worked in a number of activities. The main lines of action since its creation were: (i) evaluation of PI process in RedETS HTA reports in 2017 and in current reports, (ii) discussion on main methodological and procedural aspects, and feasibility of different patient participation approaches, (iii) development of technical protocols and templates to facilitate PI, (iv) the creation/adaptation of educational materials for patients and (v) translation of the HTAi Glossary for patients to Spanish.

Conclusions

Peer-to-peer learning processes can foster technical capacity of HTA methodologist in the Spanish HTA Network and may favor the implementation of the PI strategy.
OP130 Evidence-Informed Policy For Biologic Medicines In Brazil
Authors: Farinasso Cecilia , Silva Roberta Borges , Rego Daniela , Gomes Dalila , Leite Betânia , de Aguiar Aurelina Aguiar , Gonçalves Lenilson Pereira , Leão Luciana Simões Camara , Sachetti Camile Giaretta
Published: December 2019

Introduction

The Department of Sciences and Technology (Decit) of the Brazilian Government has played a vital role in drafting of the National Policy for Biologic Medicines. Decit has provided methodological support to the working group, conducting a rapid review and a rapid evidence synthesis to subsidize decisions and recommendations.

Methods

We used the Methodological Guidelines for the Elaboration of Evidence Synthesis for Health Policies, which is a product of our own team, based on the SUPporting POlicy relevant Reviews and Trials (SUPPORT) Tools for evidence-informed health Policymaking.

Results

The Decit team participated in the key steps to develop an evidence-informed policy. Our product, “Barriers to Access to Biologic Products: a Rapid Review” was used for the prioritization of health problems and the description of the problem. We then proceeded to the evidence synthesis planning and definition of the research question from an acronym. Together with the coordination of the working group, we decided to tackle the problem of interchangeability of biologic products motivated solely by economic factors in a synthesis of policy evidence. Our evidence synthesis went so far as to describe policy options. The working group used this product to inform a Policy Dialog.

Conclusions

This was the first time that the Decit team provided hands-on methodological assistance the development of a health policy. Not all steps recommended in the SUPPORT Tools were feasible due to time restraints. We observed that rapid evidence synthesis products were helpful to inform decision-making.
OP144 mHealth App Evaluation Framework For Reimbursement Decision-making
Authors: Moshi Magdalena , Tooher Rebecca , Merlin Tracy
Published: December 2019

Introduction

Mobile health (mHealth) applications (app) are being integrated into healthcare by patients and practitioners in Australia. However, there are currently no policies or frameworks available that can be used to conduct a health technology assessment (HTA) on mHealth apps for reimbursement purposes. The aim of the study was to determine what policy changes and assessment criteria are needed to facilitate the development of a system that evaluates mobile medical apps for regulatory and reimbursement purposes in Australia.

Methods

To obtain the information to determine what policy changes are needed and create an evidence-based framework that can evaluate mHealth apps for reimbursement decision-making, four studies were conducted. This research included (i) a policy analysis on international mHealth app regulation; (ii) a case study on American and Australian app regulation; (iii) a methodological systematic review on the suitability of current mHealth evaluation frameworks for reimbursement purposes; and (iv) the identification of HTA pathways and impediments to app reimbursement through stakeholder interviews. An evaluation framework for apps was created by combining and synthesizing the results.

Results

Software changes, connectivity, and cybersecurity need to be considered when evaluating mHealth apps for reimbursement purposes. Additionally, the potential dangers of apps providing misinformation, and poor software reliability in current regulation must be considered. Stakeholders indicated that they trust how traditional medical devices are currently appraised for reimbursement in Australia. They expressed caution around the lack of clarity regarding who is responsible for app quality as well as concerns about the digital literacy of medical practitioners and their patients.

Conclusions

Since stakeholder trust in the current HTA process for medical devices in Australia is high, the process was adapted to create an evaluation framework for mHealth apps. The adaptations included making provisions for cybersecurity, software updates, and compatibility issues. Provisions to address concerns around practitioner responsibility and misinformation were incorporated into the framework.
OP162 Stakeholder Involvement In EUnetHTA Relative Effectiveness Assessments
Authors: González María Sánchez , Imaz-Iglesia Iñaki , Chalco-Orrego Juan Pablo
Published: December 2019

Introduction

Appropriate involvement of stakeholders is one of the founding principles of the European Cooperation on Health Technology Assessment. The European Network for Health Technology Assessment (EUnetHTA) produces Rapid Relative Effectiveness Assessments (REAs) to assess pharmaceutical (PT) or other technologies (OT). Stakeholders essentially participate in the scoping, the draft assessment phase, or both.

Methods

All REAs published since 2013 were reviewed. Stakeholder participation in scoping (project plan) and draft assessment was evaluated. We aggregated categories of stakeholders in four groups (Health Care Providers and Academia, Patients and Consumers, Manufacturers, and Regulators and Payers). Means of collaboration (meetings, comments to project plan and draft assessment, questionnaires, focus groups) are also analyzed. Data is continuously updated with new REAs.

Results

More than 20 REAs have been published at the moment, with a higher number of OT. Health Care Providers and Academia acted as experts in both phases, participating in all REA of OT, and less of PT. Manufacturers participated in all REA in the scoping phase. Regulators and Payers, less involved, participated mainly in the scoping phase. The main methods are providing comments in a standardized form and meetings. Patients' contribution, similar in OT and PT, has increased over the years. Questionnaires or interviews were the main method of involvement, followed by participation in meetings and focus groups. Visibility and transparency have also improved, with a clearer reporting of the stakeholder contribution in the last assessments.

Conclusions

The stakeholder involvement in EUnetHTA REAs is steadily growing, with the different nature of stakeholders’ categories reflected in their contribution to the assessments. EUnetHTA is standardizing stakeholder involvement procedures taking into account the particularities of each group when generating guidance for stakeholder involvement.
PP58 The Alliance Between Health Technology Assessment And Public Health In National Screening Policies
Authors: Varela-Lema Leonor , Puñal-Riobóo Janet , Cantero-Muñoz Paula , Faraldo-Vallés Maria José
Published: December 2019

Introduction

Decision making regarding national population-based prenatal and newborn screening policies is recognized to be highly challenging. This paper aims to describe the formalized collaboration that has been established between the Spanish National Public Health Screening Advisory Committee (PHSAC) and the Spanish Network of Health Technology Assessment (HTA) agencies to support the development of evidence- and consensus-based recommendations to support this process.

Methods

In-depth description and analysis of the strategic and methodological processes that have been implemented within the Spanish National Health System prenatal and newborn screening frameworks, with special emphasis on the role, actions, and responsibilities of HTA agencies.

Results

The role of HTA agencies is threefold: (i) support the PHSAC by providing evidence on safety, effectiveness and cost/effectiveness of the screening tests/strategies, as well as contextualized information regarding costs, organizational, social, legal and ethical issues; (ii) collaborate with the PHSAC in the development of formal evidence- and consensus-based recommendations for defining population screening programs, when required; (iii) analyze real-world data that is generated by piloted programs. This paper will provide real-life examples of how these processes were implemented in practice, with a special focus on the development of the non-invasive prenatal testing (NIPT) policy. Recommendations for NIPT were developed by a multidisciplinary group based on the European network for Health Technology Assessment (EUnetHTA) rapid assessment report and the predictive models that were built using national statistics and other contextualized data.

Conclusions

The current work represents an innovative approach for prenatal and newborn screening policymaking, which are commonly difficult to evaluate due to the low quality of evidence and the confounding public health issues. The paper raises awareness regarding the importance of joint collaborations in areas where evidence is commonly insufficient for decision making.