bluuebunny/crossref_metadata_2025 huggingface dataset:
Premorbid functioning as a predictor of outcome in pediatric brain tumor: An initial examination of the normalcy assumption
Authors: Raghubar Kimberly P. , Rothhaar Maria C. , Yeates Keith Owen , Mahone E. Mark , Grosshans David R. , Scheurer Michael E. , Ris M. Douglas
Published: December 2019

Background

Research on neurodevelopmental outcome in survivors of pediatric brain tumor (BT) is often based on the assumption of normal development up to the onset of overt symptoms. We sought to verify the “normalcy assumption” and to investigate corollary issues including challenges inherent to the measurement of premorbid neurobehavioral functioning.

Procedure

The Brain Radiation Investigative Study Consortium (BRISC) is a prospective longitudinal multisite study of 58 children diagnosed with BT. Premorbid functioning was assessed via retrospective parent report on standardized rating scales and detailed questionnaires. Findings were examined for the sample as a whole and in patients grouped by tumor histology (embryonal and non‐embryonal).

Results

Mean age at diagnosis was 9.84 years (range, 3‐16). The overall sample showed low proportions of pre/postnatal risk factors and delays in development. The proportion of children with clinically significant premorbid attention (18%) problems based on the BASC‐2 exceeded expectation of that in healthy children (6.68%). Similar findings were obtained for somatization (18%) and anxiety (14%). Delays in talking were significantly more common in children with embryonal than non‐embryonal tumors (P = 0.02). The non‐embryonal tumor group had significantly higher overall rates of premorbid psychosocial problems than the embryonal tumor group (P < 0.001).

Conclusions

We describe a rigorous approach to estimating premorbid developmental status in pediatric BT. The findings suggest mixed support for the “normalcy assumption” and highlight the complexity of this concept and need for further investigation. Our results also suggest the need for further study of potential premorbid correlates with tumor histology.
Volitional Change in Adult Attachment: Can People Who Want to Become Less Anxious and Avoidant Move Closer towards Realizing those Goals?
Authors: Hudson Nathan W. , Chopik William J. , Briley Daniel A.
Published: December 2019

People value relationships and want to relate to both friends and romantic partners in a secure and comfortable fashion. But can individuals move towards realizing this goal of their own volition? To address this question, across three studies with a combined total of more than 4000 participants, we developed and validated a new measure of people's desires to change their attachment anxiety and avoidance. In Study 1, we created the new, 16–item Change Goals—Experiences in Close Relationships measure. In Study 2, we replicated the Change Goals—Experiences in Close Relationships’ factor structure and demonstrated that it correlates in theoretically expected ways with criterion variables (e.g. people who were high in undesirable traits such as anxiety or avoidance generally wanted to change those traits; change goals were linked to dissatisfaction with relevant life domains). Finally, in Study 3, we conducted a 16–wave, weekly longitudinal study. Results indicated that goals to change attachment anxiety and avoidance predicted corresponding growth across time (e.g. people who wanted to become less anxious tended to experience declines in attachment anxiety across time). Thus, our research provides a new measure for studying changes in attachment and suggests people may be able to increase in attachment security per their own volition. © 2019 European Association of Personality Psychology
Truth and Wishful Thinking: How Interindividual Differences in Communal Motives Manifest in Momentary Partner Perceptions
Authors: Pusch Sebastian , Schönbrodt Felix D. , Zygar–Hoffmann Caroline , Hagemeyer Birk
Published: December 2019

Although rooted in reality, partner perceptions often reflect wishful thinking due to perceivers’ needs. Dispositional needs, or motives, can differ between persons; however, little is known about their differential associations with everyday partner perception. The present study used data from a 4–week experience sampling study ( N = up to 60942 surveys from 510 individuals nested in 259 couples) to examine the effects of perceivers’ partner–related implicit and explicit communal motives on the perception of (i) global communal partner behaviour and (ii) specific communal and uncommunal partner behaviours. The results of truth and bias models of judgement and quasi–signal detection analyses indicate that strong implicit communal approach motives and strong explicit communal motives are associated with the tendency to overestimate the partner's communal behaviour. Additionally, strong implicit communal approach motives were associated with the tendency to avoid perceptions of uncommunal partner behaviour. Neither implicit nor explicit communal motives had an effect on accuracy in the perception of particularly communal partner behaviour. The results highlight the relevance of both implicit and explicit communal motives for momentary partner perceptions and emphasise the benefits of dyadic microlongitudinal designs for a better understanding of the mechanisms through which individual differences manifest in couples’ everyday lives. © 2019 The Authors. European Journal of Personality published by John Wiley & Sons Ltd on behalf of European Association of Personality Psychology
Modeling protein‐protein, protein‐peptide, and protein‐oligosaccharide complexes: CAPRI 7th edition
Authors: Lensink Marc F. , Nadzirin Nurul , Velankar Sameer , Wodak Shoshana J.
Published: December 2019

We present the seventh report on the performance of methods for predicting the atomic resolution structures of protein complexes offered as targets to the community‐wide initiative on the Critical Assessment of Predicted Interactions. Performance was evaluated on the basis of 36 114 models of protein complexes submitted by 57 groups—including 13 automatic servers—in prediction rounds held during the years 2016 to 2019 for eight protein‐protein, three protein‐peptide, and five protein‐oligosaccharide targets with different length ligands. Six of the protein‐protein targets represented challenging hetero‐complexes, due to factors such as availability of distantly related templates for the individual subunits, or for the full complex, inter‐domain flexibility, conformational adjustments at the binding region, or the multi‐component nature of the complex. The main challenge for the protein‐peptide and protein‐oligosaccharide complexes was to accurately model the ligand conformation and its interactions at the interface. Encouragingly, models of acceptable quality, or better, were obtained for a total of six protein‐protein complexes, which included four of the challenging hetero‐complexes and a homo‐decamer. But fewer of these targets were predicted with medium or higher accuracy. High accuracy models were obtained for two of the three protein‐peptide targets, and for one of the protein‐oligosaccharide targets. The remaining protein‐sugar targets were predicted with medium accuracy. Our analysis indicates that progress in predicting increasingly challenging and diverse types of targets is due to closer integration of template‐based modeling techniques with docking, scoring, and model refinement procedures, and to significant incremental improvements in the underlying methodologies.
The five dimensions of receptor pharmacology exemplified by melatonin receptors: An opinion
Authors: Boutin Jean A. , Legros Céline
Published: December 2019

Receptology has been complicated with enhancements in our knowledge of G‐protein‐coupled‐receptor (GPCR) biochemistry. This complexity is exemplified by the pharmacology of melatonin receptors. Here, we describe the complexity of GPCR biochemistry in five dimensions: (a) receptor expression, particularly in organs/tissues that are only partially understood; (b) ligands and receptor‐associated proteins (interactome); (c) receptor function, which might be more complex than the known G‐protein‐coupled systems; (d) ligand bias, which favors a particular pathway; and (e) receptor dimerization, which might concern all receptors coexpressed in the same cell. Thus, receptor signaling might be modified or modulated, depending on the nature of the receptor complex. Fundamental studies are needed to clarify these points and find new ways to tackle receptor functionality. This opinion article emphasizes the global questions attached to new descriptions of GPCRs and aims to raise our awareness of the tremendous complexity of modern receptology.
Antimicrobial activities of Asian ginseng, American ginseng, and notoginseng
Authors: Wang Lijun , Huang Yang , Yin Guo , Wang Jue , Wang Ping , Chen Zhen‐Yu , Wang Tiejie , Ren Guixing
Published: December 2019

Asian ginseng (Panax ginseng C.A. Meyer), American ginseng (Panax quinquefolius) and notoginseng (Panax notoginseng) are the three most commonly used ginseng botanicals in the world. With the increasing interests on antimicrobial properties of plants, the antimicrobial activities of ginseng species have been investigated by a number of researchers worldwide. This overview interprets our present knowledge of the antimicrobial activities of the three ginseng species and some of their bioactive components against pathogenic bacteria (Pseudomonas aeruginosa, Helicobacter pylori, Staphylococcus aureus, Escherichia coli, Propionibacterium acnes, et al.) and fungi (Candida albicans, Fusarium oxysporum, et al). Ginsenosides, polysaccharides, essential oil, proteins, and panaxytriol are all might responsible for the antimicrobial activities of ginseng. The antimicrobial mechanisms of ginseng components could be summarized to the following points: (a) inhibit the microbial motility and quorum‐sensing ability; (b) affect the formation of biofilms and destroy the mature biofilms, which can weaken the infection ability of the microbes; (c) perturb membrane lipid bilayers, thus causing the formation of pores, leakages of cell constituents and eventually cell death; (d) stimulate of the immune system and attenuate microbes induced apoptosis, inflammation, and DNA damages, which can protect or help the host fight against microbial infections; and (e) inhibit the efflux of antibiotics that can descend the drug resistance of the microbial. The collected information might facilitate and guide further studies needed to optimize the use of ginseng and their components to improve microbial food safety and prevent or treat animal and human infections.
Electrokinetic Scanning Probe
Authors: Ostromohov Nadya , Rofman Baruch , Bercovici Moran , Kaigala Govind
Published: December 2019

The theoretical analysis and experimental demonstration of a new concept are presented for a non‐contact scanning probe, in which transport of fluid and molecules is controlled by electric fields. The electrokinetic scanning probe (ESP) enables local chemical and biochemical interactions with surfaces in liquid environments. The physical mechanism and design criteria for such a probe are presented, and its compatibility with a wide range of processing solutions and pH values are demonstrated. The applicability of the probe is shown for surface patterning in conjunction with localized heating and 250‐fold analyte stacking.
Atomic‐Level Fe‐N‐C Coupled with Fe3C‐Fe Nanocomposites in Carbon Matrixes as High‐Efficiency Bifunctional Oxygen Catalysts
Authors: Sun Xueping , Wei Peng , Gu Songqi , Zhang Jinxu , Jiang Zheng , Wan Jing , Chen Zhaoyang , Huang Li , Xu Yue , Fang Chun , Li Qing , Han Jiantao , Huang Yunhui
Published: December 2019

Highly active and durable bifunctional oxygen electrocatalysts are of pivotal importance for clean and renewable energy conversion devices, but the lack of earth‐abundant electrocatalysts to improve the intrinsic sluggish kinetic process of oxygen reduction/evolution reactions (ORR/OER) is still a challenge. Fe‐N‐C catalysts with abundant natural merits are considered as promising alternatives to noble‐based catalysts, yet further improvements are urgently needed because of their poor stability and unclear catalytic mechanism. Here, an atomic‐level Fe‐N‐C electrocatalyst coupled with low crystalline Fe3C‐Fe nanocomposite in 3D carbon matrix (Fe‐SAs/Fe3C‐Fe@NC) is fabricated by a facile and scalable method. Versus atomically FeNx species and crystallized Fe3C‐Fe nanoparticles, Fe‐SAs/Fe3C‐Fe@NC catalyst, abundant in vertical branched carbon nanotubes decorated on intertwined carbon nanofibers, exhibits high electrocatalytic activities and excellent stabilities both in ORR (E1/2, 0.927 V) and OER (EJ=10, 1.57 V). This performance benefits from the strong synergistic effects of multicomponents and the unique structural advantages. In‐depth X‐ray absorption fine structure analysis and density functional theory calculation further demonstrate that more extra charges derived from modified Fe clusters decisively promote the ORR/OER performance for atomically FeN4 configurations by enhanced oxygen adsorption energy. These insightful findings inspire new perspectives for the rational design and synthesis of economical–practical bifunctional oxygen electrocatalysts.
K2Ti2O5@C Microspheres with Enhanced K+ Intercalation Pseudocapacitance Ensuring Fast Potassium Storage and Long‐Term Cycling Stability
Authors: Zhao Shuoqing , Dong Liubing , Sun Bing , Yan Kang , Zhang Jinqiang , Wan Shuwei , He Fengrong , Munroe Paul , Notten Peter H. L. , Wang Guoxiu
Published: December 2019

Benefiting from the natural abundance and low standard redox potential of potassium, potassium‐ion batteries (PIBs) are regarded as one of the most promising alternatives to lithium‐ion batteries for low‐cost energy storage. However, most PIB electrode materials suffer from sluggish thermodynamic kinetics and dramatic volume expansion during K+ (de)intercalation. Herein, it is reported on carbon‐coated K2Ti2O5 microspheres (S‐KTO@C) synthesized through a facile spray drying method. Taking advantage of both the porous microstructure and carbon coating, S‐KTO@C shows excellent rate capability and cycling stability as an anode material for PIBs. Furthermore, the intimate integration of carbon coating through chemical vapor deposition technology significantly enhances the K+ intercalation pseudocapacitive behavior. As a proof of concept, a potassium‐ion hybrid capacitor is constructed with the S‐KTO@C (battery‐type anode material) and the activated carbon (capacitor‐type cathode material). The assembled device shows a high energy density, high power density, and excellent capacity retention. This work can pave the way for the development of high‐performance potassium‐based energy storage devices.
Improvements to the Water Quality of the Acidic Berkeley Pit Lake due to Copper Recovery and Sludge Disposal
Authors: Gammons Christopher H. , Icopini Gary A.
Published: December 2019

The chemistry and limnology of the Berkeley Pit lake, located in Butte, Montana, have substantially changed during the past 15 years. These changes are due to: (1) a large-scale Cu recovery project in which deep water was pumped to a Cu precipitation plant and returned to the surface of the lake; and (2) in-pit disposal of lime-treatment sludge. As a consequence, the lake has shifted from a meromictic to a holomictic state, over 99% of the dissolved Fe has precipitated as schwertmannite and other ferric solids, the total acidity of the water column has dropped by roughly 35%, and the pH has risen from about 2.5 to near 4.1. Whereas most of the lake was anoxic prior to 2013, the water column now contains > 6 mg/L dissolved oxygen from the lake surface to the deepest levels sampled (> 150 m). Concentrations of several other solutes, including As, P, Cr, and V, have fallen sharply due to adsorption or co-precipitation with Fe, while other species, such as Al, Mg, and Mn, have increased due to dissolution of solids in the sludge. Although the Cu recovery circuit was discontinued in 2013, in-pit disposal of sludge is expected to continue. The pit water is now close to saturation with basaluminite, and the pH should remain poised in the range of 4.1–4.5 for many years as Al precipitates out of the water column. Pumping and treating of pit water is set to commence in 2019, and will continue for the foreseeable future. Continued in-pit disposal of sludge should translate into long term water-quality improvement and a decrease in annual lime-consumption costs. Although the Berkeley Pit still has a long ways to go before it will meet water quality standards, it is heartening to mine-water specialists that the pit lake may not be a problem that is “too big to fix”.
Beyond the flow rate: the importance of thermal range, flow intensity, and distribution for water-efficient showers
Authors: Adeyeye Kemi , She Kaiming , Meireles Inês
Published: December 2019

Studies show that user behaviours have not necessarily changed, despite the prevalence of water-efficient products in the market. One reason is because the technical emphasis for delivering the water use efficiency of products has focused on reducing the flow rate. Therefore, this study was undertaken to examine the physical parameters that define the technical efficiency of showerheads against the experiential performance (and therefore the satisfaction with the showerheads). These parameters were measured in a controlled laboratory environment and the findings were triangulated against user feedback from in-home trials. Synergies between the laboratory data and user feedback were found. Notably, it was found that water spray intensity, distribution, and temperature loss all impact the quality of showering experience. These factors also influence shower duration—and thus the volume of water used in the shower. Significantly, these technical metrics affected the overall experiential performance of such products from the users’ perspective. Therefore, the design of water-efficient showerheads, in addition to delivering water discharge savings, should avoid poor spray distribution, intensity, and heat retention. The implications of the findings are that water efficiency labelling and product standards should extend beyond the emphasis on limiting the flow rates—typically to 9 l per min for showerheads. This study shows good merit for including the spray intensity (pressure), distribution, and degree of heat loss, in addition to the discharge rate, as part of the performance and efficiency considerations of showerheads.
“A Real Bucket of Worms”: Views of People Living with Dementia and Family Members on Supported Decision-Making
Authors: Sinclair Craig , Gersbach Kate , Hogan Michelle , Blake Meredith , Bucks Romola , Auret Kirsten , Clayton Josephine , Stewart Cameron , Field Sue , Radoslovich Helen , Agar Meera , Martini Angelita , Gresham Meredith , Williams Kathy , Kurrle Sue
Published: December 2019

Supported decision-making has been promoted at a policy level and within international human rights treaties as a way of ensuring that people with disabilities enjoy the right to legal capacity on an equal basis with others. However, little is known about the practical issues associated with implementing supported decision-making, particularly in the context of dementia. This study aimed to understand the experiences of people with dementia and their family members with respect to decision-making and their views on supported decision-making. Thirty-six interviews (twenty-one dyadic and fifteen individual) were undertaken with fifty-seven participants (twenty-five people living with dementia and thirty-two family members) across three states in Australia. Interpretative Phenomenological Analysis (IPA) was used as the methodological approach, with relational autonomy as a theoretical perspective. We identified two overarching themes relating to participants’ experiences with decision-making: “the person in relationship over time” and “maintaining involvement.” Participant views on the practical issues associated with supported decision-making are addressed under the themes of “facilitating decision-making,” “supported decision-making arrangements,” “constraints on decision-making,” and “safeguarding decision-making.” While participants endorsed the principles of supported decision-making as part of their overarching strategy of “maintaining involvement” in decision-making, they recognized that progressive cognitive impairment meant that there was an inevitable transition toward greater involvement of, and reliance upon, others in decision-making. Social and contextual “constraints on decision-making” also impacted on the ability of people with dementia to maintain involvement. These themes inform our proposal for a “spectrum approach” to decision-making involvement among people living with dementia, along with recommendations for policy and practice to assist in the implementation of supported decision-making within this population.
A revision of the African genus Mesanthemum (Eriocaulaceae)
Authors: Liang Yuxi , Phillips Sylvia M. , Cheek Martin , Larridon Isabel
Published: December 2019

Mesanthemum is a genus comprising 16 species in the family Eriocaulaceae and is native to Africa and Madagascar. Eriocaulaceae are characterised by a basal tuft or rosette of narrow leaves and small flowers in heads. Mesanthemum can be recognised by diplostemonous flowers and fused glandular pistillate petals. While most Mesanthemum species are large perennial herbs, two small ephemeral species from West Africa, M. albidum and M. auratum differ from the rest of the genus by their shorter life cycle, smaller size, simpler floral structures and different seed surface patterning. A molecular phylogenetic study, morphological comparisons and scanning electron microscope (SEM) examination of seed coat sculpture were carried out to determine whether they should be separated as a new genus. The molecular results indicate that the two ephemeral species are nested in the Mesanthemum clade. However, they are not closely related to each other. All species of Mesanthemum are here revised, including the description of a new species M. alenicola from Equatorial Guinea. An identification key is provided, together with taxonomic descriptions, synonymy and notes. Images of the seeds as seen under SEM are provided where available. Lectotypifications are provided for Mesanthemum albidum, M. bennae, M. pilosum, M. prescottianum, M. pubescens and M. variabile. A neotype is selected for M. rutenbergianum, which is synonymised with M. pubescens.
Soil pH is the primary factor driving the distribution and function of microorganisms in farmland soils in northeastern China
Authors: Wang Cheng-yu , Zhou Xue , Guo Dan , Zhao Jiang-hua , Yan Li , Feng Guo-zhong , Gao Qiang , Yu Han , Zhao Lan-po
Published: December 2019

Purpose

To understand which environmental factors influence the distribution and ecological functions of bacteria in agricultural soil.

Method

A broad range of farmland soils was sampled from 206 locations in Jilin province, China. We used 16S rRNA gene-based Illumina HiSeq sequencing to estimated soil bacterial community structure and functions.

Result

The dominant taxa in terms of abundance were found to be, Actinobacteria, Acidobacteria, Gemmatimonadetes, Chloroflexi, and Proteobacteria. Bacterial communities were dominantly affected by soil pH, whereas soil organic carbon did not have a significant influence on bacterial communities. Soil pH was significantly positively correlated with bacterial operational taxonomic unit abundance and soil bacterial α-diversity (P<0.05) spatially rather than with soil nutrients. Bacterial functions were estimated using FAPROTAX, and the relative abundance of anaerobic and aerobic chemoheterotrophs, and nitrifying bacteria was 27.66%, 26.14%, and 6.87%, respectively, of the total bacterial community. Generally, the results indicate that soil pH is more important than nutrients in shaping bacterial communities in agricultural soils, including their ecological functions and biogeographic distribution.
A Review on Artificial Micro/Nanomotors for Cancer-Targeted Delivery, Diagnosis, and Therapy
Authors: Wang Jiajia , Dong Renfeng , Wu Huiying , Cai Yuepeng , Ren Biye
Published: December 2019

Micro/nanomotors have been extensively explored for efficient cancer diagnosis and therapy, as evidenced by significant breakthroughs in the design of micro/nanomotors-based intelligent and comprehensive biomedical platforms. Here, we demonstrate the recent advances of micro/nanomotors in the field of cancer-targeted delivery, diagnosis, and imaging-guided therapy, as well as the challenges and problems faced by micro/nanomotors in clinical applications. The outlook for the future development of micro/nanomotors toward clinical applications is also discussed. We hope to highlight these new advances in micro/nanomotors in the field of cancer diagnosis and therapy, with the ultimate goal of stimulating the successful exploration of intelligent micro/nanomotors for future clinical applications.
Prospects for New England Agriculture: Farm to Fork
Authors: Werner Samantha , Lemos Scott R. , McLeod Amanda , Halstead John M. , Gabe Todd , Huang Ju-Chin , Liang Chyi Lyi , Shi Wei , Harris Lily , McConnon James
Published: December 2019

This paper summarizes a multi-state, multi-year study assessing the potential for local agriculture in northern New England. While largely rural, this region's agricultural sector differs greatly from the rest of the United States, and demand for locally produced food has been increasing. To assess this unique economic landscape, researchers and Cooperative Extension at the Universities of Maine, New Hampshire, and Vermont investigated four key areas: (1) local food capacities, (2) constraints to agricultural expansion, (3) consumer preferences for local and organic produce, and (4) the role of intermediaries as alternative local food outlets. The project included input from local farmers, Extension members, restaurants, and the general public. We present the four research areas in a sequential, overlapping fashion. The timing of our research was such that each step in the process informed the next and can be used as a template for assessing a region's potential for local agricultural production.
The Urban Pushback: International Law as an Instrument of Cities
Authors: Nijman Janne E.
Published: December 2019

For a start, I would like to thank Veronika Fikfak for the invitation and initiating this panel. In my brief remarks, I aim to do three things. First, I would like to discuss briefly the development of the relationship between “cities and international law” and consequently the formation of a new research field. I will illustrate this formation by mentioning briefly two projects I am leading with friend and colleague Helmut Aust (Berlin): the ILA Study Group on “The Role of Cities in International Law” and a research handbook on the theme of cities and international law. I will end with some remarks regarding a paper I am currently working on: “The Urban Pushback”. The relationship between cities and international law is complex and multi-faceted. For the purpose of this Conference's Panel, my remarks focus on how international law has become an instrument of cities.
What’s in a Wage? A New Approach to the Justification of Pay
Authors: Moriarty Jeffrey
Published: December 2019

In this address, I distinguish and explore three conceptions of wages. A wage is a reward, given in recognition of the performance of a valued task. It is also an incentive: a way to entice workers to take and keep jobs, and to motivate them to work hard. Finally, a wage is a price of labor, and like all prices, conveys valuable information about relative scarcity. I show that each conception of wages has its own normative logic, or appropriate justification, and these logics can come apart. This explains some of the debate about wages and makes the project of justifying a wagesimpliciterdifficult. I identify which logic we should choose, since we must choose, and say what this means for how we should think about the justification of pay.
Rethinking the “Crisis” of Indigenous Mass Imprisonment
Authors: Arbel Efrat
Published: December 2019

InR v Gladue, the Supreme Court of Canada famously remarked that the incarceration of Indigenous people represents a “crisis.” Since Gladue’s release, the language of “crisis” has been used with frequency in Canadian legal discourse. In this article, I analyze how this language has shaped the broader legal understanding of Indigenous mass imprisonment. My focus is not on specific iterations or uses, but on the cumulative impact of the language of “crisis” over the last twenty years. I suggest that however well-meaning these representations may be, their cumulative impact is harmful. In the face of the relentless intensification of Indigenous mass imprisonment, the language of “crisis” has operated to subtly entrench the colonial structures it purports to disrupt. Urging a shift away from its use, I argue that the language of “crisis” is not only ill suited to address the problem, but is part of the problem.
Two genitive constructions of Old Babylonian
Authors: Arkhipov Ilya , Loesov Sergey
Published: December 2019

The paper shows that there is a pattern in the distribution of synthetic (šēp šarrim“the king's foot”) vs. analytical (kaspum ša awīlim“the boss's money”) genitive constructions in Old Babylonian. The choice depends on the lexical feature of head nouns known as (in)alienability. Old Babylonian kinship and body part terms, as well as some other substantives, are “inalienable”, which means they take only the synthetic construction. All other Old Babylonian nouns are “alienable”, which means they admit both the synthetic and the analytical construction (kasap tamkārīandkaspum ša tamkārī“the merchants’ money”). In the latter case, there is no general rule to predict the choice, yet in certain cases the two constructions display a non-random frequency distribution.
Revisiting aNahḍaorigin story:Majmaʿ al-Tahdhīband the Protestant community in 1840s Beirut
Authors: Edwards Anthony
Published: December 2019

This article is a comprehensive evaluation of the first learned society of theNahḍa(Renaissance) in Beirut. I argue thatMajmaʿ al-Tahdhīb(the Refinement Council, est. 1846) was not a learned society but anad hocseminary formed to train converts for itinerant preaching and to build camaraderie among the nascent Protestant confession. In order to unearth the mission ofMajmaʿ al-Tahdhīband amplify the voices of its members – twelve Syrians and two Americans – this essay reconstructs their biographies and the condition of the Protestant community until 1846. This case study explicates the personal and professional entanglements of these fourteen men in terms of social connections, educational opportunities, economic needs, and religious convictions. It contextualizes the early years of several prominentNahḍafigures by highlighting the material and spiritual aspects of their lives in 1840s Beirut.
Re-examining Foresti'sSupplementum Chronicarumand the “Ethiopian” embassy to Europe of 1306
Authors: Krebs Verena
Published: December 2019

A widely reported story in the historiography on medieval Ethiopia relates how, in the year 1306, an “Ethiopian” embassy visited the court of Pope Clement V in Avignon and offered military aid in the fight against Islam to Latin Christianity. This article re-examines the source – Jacopo Filippo Foresti's Supplementum Chronicarum – thought to document an episode of one of the earliest European–African Christian contacts. It investigates Foresti's own sources, their historiographical transmission history, and the feasibility of relating it to the socio-political entity of Solomonic Ethiopia in the Horn of Africa in the early fourteenth century, concluding that Foresti's information was based on Latin Christian texts, such as the Legenda Aurea and the myth of Prester John, only. The ‘Ethiopian’ embassy of 1306 is thus not borne out by sources and should be dismissed in scholarship, resetting the timeline of official Ethiopian–Latin Christian contacts in the late medieval period.
OP18 A Case Study Of Local Context-Dependent Decision-Making In Health Technology Assessment
Authors: Drolet Renée , Asselin Genevieve , Nourissat Alice , Coulombe Martin , Rhainds Marc
Published: December 2019

Introduction

Antibiotics impregnated calcium sulfate (AI-CaSO4) is an innovative practice to ensure local diffusion of antibiotics especially in the treatment of prosthesis or medical implants infections. A recent introduction of AI-CaSO4 at CHU de Québec-Université Laval (CHU de Québec) was followed by a rapid increase in use and costs. A hospital-based health technology assessment (HTA) was then requested to assess the clinical relevance of AI-CaSO4 in surgical site infection (SSI) management.

Methods

A systematic review of the effectiveness and adverse effects of AI-CaSO4 was performed in indexed databases and grey literature. The local context analysis included different methodologies: 1) interviews with pharmacists, surgeons and operating room managers, 2) data extraction from electronic patient records (EPR), 3) procurement database on CaSO4, and 4) interdisciplinary working group including orthopedic and vascular surgeons, pharmacists, infectiologists, and hospital managers.

Results

Available evidence suggest that AI-CaSO4 could contribute in the treatment of osteomyelitis whereas no conclusion can be drawn for other medical indications in both treatment and prevention of SSI. A review of 113 surgical procedures showed that AI-CaSO4 was rapidly adopted after only one year and used for various medical indications in neuromodulation, orthopedic and vascular surgery. Osteomyelitis treatment accounted for less than 3% of cases. AI-CaSO4 was mainly used in prevention of SSI (65%) and surgical revisions (74%). Furthermore, local safety issues were raised by a lack of standardization for the preparation and under recording of antibiotics use with AI-CaSO4.

Conclusions

The current state of knowledge does not support the widespread use AI-CaSO4 at CHU de Québec. This study highlights the importance of adapting HTA approach to the local context to influence decision-making especially in the context of innovating practice in order to insure the relevance, safety and sustainability of care.
OP122 Resource Use Measurement Issues: A Scoping Review
Authors: Janssen Luca , Paulus Aggie , Hollingworth William , Thorn Joanna , Evers Silvia
Published: December 2019

Introduction

Resource use measurement is known to be a challenging and time-consuming, but essential step in economic evaluations of health care interventions. Measuring true quantities of resources utilized is of major importance for generating valid costing estimates. As consequence of the absence of a gold standard and of acknowledged guidelines, the choice of a measurement method is often based on practicality instead of methodological evidence. An overview of resource use measurement issues is currently lacking. Such overview could enhance clearance in the quality of resource use measurement methods in economic evaluations and may facilitate to opt for evidence based measurement methods in the future. This study aims to provide an overview of methodological evidence regarding resource use measurement issues in economic evaluations.

Methods

Literature was searched by three different methods. First, a search strategy was used in six different databases. Second, the Database of Instruments for Resource Use Measurement (DIRUM) was hand-searched. Third, experts from six different European Union countries within the field of health economics were asked to provide relevant studies. Data was analyzed according to the Resource Use Measurement Issues (RUMI-) framework, which was developed for this study.

Results

Of the 3,478 articles provided in the initial search, 77 were fully analyzed. An overview with evidence is provided for every resource use measurement issue. Most research focused around the issue ‘how to measure’, in particular the effect of self-reported data versus administrative data. In contrast, little to no research has been done on issues ‘what to measure’ and ‘for which purpose to measure’.

Conclusions

Results of this study provide insight in the effect of a chosen measurement method. The results stress the importance of measuring the true quantities of resources utilized for generating valid costing estimates. Furthermore, this article highlights the lack of evidence in appropriate resource use measurement methods.
PP34 Costs Of Healthcare-Associated Infections In Latin America
Authors: Bagattini Ângela , Martinez-Silveira Martha , Zara Ana , Stempliuk Valeska , Toscano Cristiana
Published: December 2019

Introduction

Healthcare-associated infections (HAI) are among the most common preventable health adverse event, associated with significant burden globally. Limited data on HAI costs in lower and middle-income countries is available. The aim of this study is to assess the cost, additional length-of-stay (LOS) and extra-mortality of HAI in the Latin American and Caribbean (LAC) Region.

Methods

We searched Medline/PubMed, Embase, Web of Science, Lilacs, Cochrane, National Health Service Economic Evaluation Database, Centre for Reviews and Dissemination, EconLit, and gray literature published in any language without restriction of date till July 2017. We included observational studies addressing the outcomes of interest, in which hospitalized patients with HAI are compared to those without HAI. The following study designs were included: quasi-experimental, controlled before-after, prospective and retrospective comparative cohort, case-control, and cross-sectional studies. We considered the following HAI-sites: surgical site infections (SSI), catheter-associated urinary-tract infections (CA-UTI), ventilator-associated pneumonia (VAP), and central line-associated bloodstream infection (CLA-BSI), as well as cross-infection (CI). Screening of citations, data extraction, and risk of bias assessment were conducted in duplicate by independent reviewers, according to the study protocol registered on PROSPERO. Reported costs were converted to USD considering official exchange rates.

Results

We identified 4,339 citations. After removing duplicates, a total of 3,029 citations were screened for eligibility. A total of 87 studies from 17 countries were included. The majority (27.4 percent) reported on VAP, followed by CLA-BSI (21.2 percent), SSI (16.4 percent), and CA-UTI (14.4 percent). Most studies (46.7 percent) reported on incremental LOS, with an average of 14.8 days (range 0.9-49 days). Costs were reported by 25 percent of studies, with average incremental costs of USD 3,460 (range 49-12,155). Average extra-mortality of 15.6 percent (range -2.8-45.2 percent) was reported by 12.6 percent of studies.

Conclusions

Available evidence from the LAC Region reports significant economic burden of HAI. This information will be useful for cost-effectiveness analysis of interventions aimed at reducing HAI economic and health burden.
PP52 Interim Decision-Making To Address Uncertainty At Early Assessment
Authors: Downes Noreen , Jones Jan , Lee Anne , McGuire Pauline
Published: December 2019

Introduction

Medicines regulation has become increasingly adaptive to support earlier patient access but the immature clinical data is often challenging for health technology assessment decision-makers due to high levels of uncertainty on long term risks and benefits. Scottish Medicines Consortium (SMC) is therefore exploring new, more adaptive approaches to help manage this challenge.

Methods

SMC consulted with key stakeholders including clinicians, the pharmaceutical industry and patient groups on a number of options that would allow the committee to make an interim decision that would be revisited based on later evidence. The ability to collect robust patient level data given data capabilities in National Health Service Scotland (NHSScotland) was an important consideration.

Results

To ensure that additional evidence would be available to inform a re-assessment, the new approach applies to medicines with a Conditional Marketing Authorisation (MA) from the European Medicines Agency (EMA). This obligates the company to provide specified clinical data to the regulator within a pre-set timeframe. For these medicines, the SMC decision-making committee can accept or not recommend the medicine as at present but can also accept the medicine on an interim basis, if the regulator's mandated Specific Obligations are likely to address the uncertainties in the clinical evidence. When the regulator converts the MA from conditional to standard, the company is required to make a further SMC submission to allow a reassessment and a final decision. The company can also provide additional supplementary post-licensing patient level evidence at reassessment.

Conclusions

This new decision option allows SMC to test an approach to managing uncertainty targeted at a small number of promising new medicines where there is unmet patient need, with the reassurance that a final decision will be supported by additional clinical data.
PP124 Smart Capability Building For Effective Patient Involvement
Authors: Davis Claire , Hughes Sophie , Myles Susan
Published: December 2019

Introduction

A new Health Technology Assessment (HTA) agency, Health Technology Wales (HTW), has been established to consider the identification, appraisal, and adoption of non-medicine health technologies. This includes, for example, medical devices, surgical procedures and diagnostics. HTW recognizes the importance of effective patient and public involvement (PPI) and is building smart capabilities.

Methods

HTW consulted with external organizations to identify the first steps toward effective PPI. Public partners were recruited as a priority before working together on a PPI strategy. Building smart capabilities is key to establishing effective PPI and future-proofing. HTW established a PPI Standing Group to inform HTW throughout its work, including the development of processes and procedures.

Results

Knowledge and resources have been shared and future collaborations identified, including events to encourage new topics from patients and the public. The HTW PPI lead has become a member of key PPI groups, locally and internationally. HTW has recruited public partners who are actively contributing as full members of the Assessment Group and the Appraisal Panel; two members on each Committee. The PPI Standing Group has been established. They have provided advice and co-produced PPI tools for piloting.

Conclusions

The PPI Standing Group concluded that PPI methods and approaches should be tailored for each project based on best practice, and should be piloted to allow them to evolve based on impact evaluation. A PPI strategy or framework would be more useful at a later stage. HTW is committed to identifying and following best practice. Future-proofing and building smart capability will be key to ensuring that HTW develops effective PPI that can be dynamic and responsive to the evolving PPI and HTA landscapes.
PP127 Asthma Patient Value Framework: Lessons From Patient Focus Groups
Authors: Kyriopoulos Dionysios , Sogokon Paul , Teale Christopher , Callan Luke
Published: December 2019

Introduction

We sought to examine patients’ perceptions of disease burden and treatment impact, and what patients value over the course of the asthma experience.

Methods

Patient focus groups were conducted in three countries, the USA (n = 8 patients), the United Kingdom (n = 7 patients), and Germany (n = 7 patients), to examine aspects of disease burden and patient experience (physical, emotional, clinical, economic, and social). Cause and effect were also explored. Global Initiative for Asthma guidelines were used to screen patients by severity, based on age, sex, time since diagnosis, number of attacks, oral corticosteroid use, and number of therapies needed to control symptoms. Patients classified and ranked aspects of disease burden, including whether it was continuous or episodic in nature, and discussed the interventions used to manage their asthma.

Results

The overall burden of illness was driven by the combined effect of the disease and treatment burdens. All patients highlighted the negative impact of oral corticosteroids. Patients believed that they were the key actors in their asthma management (not healthcare professionals), and reported the physical and emotional burdens as being the most dominant. Understanding of the terms “attack” or “exacerbation” differed significantly between patients, and did not necessarily match the clinical definitions. Patients considered asthma to be an individualized condition that drives lifestyle changes; disease management drives burden and vice versa. Patients perceived that burden was continuous over time, with specific phases of variable duration—before, during, and after an attack—whereas other stakeholders had a more episodic focus. Patients expected more holistic and personalized approaches for managing their asthma.

Conclusions

The research indicated a misalignment between what patients value and what clinicians, payers, and regulators consider in their assessments and decisions. Greater alignment among the different stakeholders, and more inclusion of patients’ values in decision making, will improve outcomes.
PP155 Demand Side And Supply Side Of Healthcare Supply Chain
Authors: Triulzi Isotta , Di Pasquale Flavia , Trieste Leopoldo , Antonel Andrea , Rossi Ettore , Turchetti Giuseppe
Published: December 2019

Introduction

The re-organization of the supply chain (SC) of medicines and medical devices may improve the efficacy and efficiency of the National Health Service (NHS). The aims of this study were to (i) identify the offers provided by private operators to NHS, and (ii) analyze the organizational model of the public healthcare SC system and its criticalities.

Methods

Two online surveys have been designed. Regarding the first survey, managers of private providers associated with the National Association of Commercial and Logistic Operators (ASSORAM) have been interviewed to identify the offers provided to the NHS. The second has been submitted to managers of local health authorities and university hospitals associated to the Italian Association of Hospitals (FIASO) to gather both organizational/managerial information (warehouse capacity, purchasing, registry, security) and qualitative aspects of the SC. Data was collected in 2015.

Results

On the supply side, 41 providers have been interviewed. More than 70 percent of associates managed mainly hospital products; 67 percent of interviewees delivered less than 30 percent of products to hospitals, and only eight percent delivered about 70 percent of the products to hospitals. The providers’ infrastructure (warehouses, transport, information technology, cold chain, gross domestic product) were adequately regulated and they adopted a wide list of indicators for monitoring performance. Private providers showed high interest in investing in the hospital sector. On the demand side (56 hospitals from 28 regions) the main weaknesses of SC are related to infrastructure, information technology, human resources, a lack of financial resources and inadequate process control.

Conclusions

The study highlighted extremely limited outsourcing in the hospital field to date, weaknesses in the public system and a high interest of private providers in investing in public hospital SC.