bluuebunny/crossref_metadata_2025 huggingface dataset:
Analyses of HIV‐1 integrase gene sequences among treatment‐naive patients in the Eastern Cape, South Africa
Authors: Onoriode Digban Tennison , Chucks Iweriebor Benson , Chikwelu Obi Larry , Nwodo Uchechuwku , Ifeanyi Okoh Anthony
Published: December 2019

Drug resistance has been recognized in all available therapeutic class of medications for the management of human immunodeficiency virus‐1 (HIV‐1) infected patients. This makes the continuous study of HIV drug resistance and new treatment options pertinent to patients and researchers globally. The aim of this study is to analyze the complete HIV‐1 integrase gene for the possible occurrence of resistance mutations or polymorphisms. We performed genetic analyses on 48 treatment‐naive HIV‐1‐infected patients using nested polymerase chain reaction. Integrase drug‐related resistance mutation (DRMs) analysis was performed on all generated sequences according to Stanford HIV drug interpretation program and the International AIDS Society‐USA guidelines while phylogenetic analysis was inferred using MEGA 6. The study revealed no major resistance‐associated mutation. However, E157Q (2.1%), L74M/I (4.2%), and P142T (2.1%) were the observed accessory and polymorphic mutations. Naturally occurring polymorphism observed were E11D, K14R, D25E, V31I, M50I, V72I, P90T, F100Y, L101I, T124A, T125A, K136Q, D167E, V201I, L234I, A265V, A269K, D278A, and S283G. Phylogenetic analysis delineated all the sequences as HIV‐1 subtype C. The study revealed the absence of major integrase inhibitors associated resistance mutations in a setting where integrase inhibitor is administered as salvage therapy in patients developing resistance to first and second‐line antiretroviral treatment. However minor and natural polymorphisms were observed and thus may influence the outcome of each treatment regimen. However, additional studies are required to precisely evaluate the impact of these mutations on integrase inhibitors in the Eastern Cape of South Africa.
Main geometrical features of horizontal buoyant jet fire and associated radiative fraction
Authors: Ab Aziz Nur Shahidah , Kasmani Rafiziana Md. , Samsudin Mohd Dinie Muhaimin , Ahmad Arshad
Published: December 2019

High momentum release of jet fire can be very intense, and the released heat can be very high, depending on the source capacity. One of the key parameters in characterizing the jet fire is the radiative fraction. The previous study has correlated the radiative fraction to the source using a Froude number basis. Nevertheless, the flame mechanism and associated geometrical features gave significant effects on the global radiative heat flux to some extent. Therefore, the characterization of the main geometrical features, particularly on jet flame structures at higher momentum release conditions and its correlation with the radiative fraction, are valuable to be investigated. In this work, propane was used as fuel and released through a 9.8 mm circular nozzle with the exit velocities were set ranging between 27 and 65 m/s. It was found that the liftoff length estimation from this work is in a good agreement with the jet fire release under sub‐atmospheric pressure in a vertical orientation. Furthermore, the flame projected length and height were characterized by momentum‐driven length (L
m) and buoyancy‐driven height (L
b) by the dimensionless characteristics length (Ʌ). The experimental observations indicate that as the Ʌ ≥ 0.0001, the radiative fraction shows a decreasing trend.
An overlapping peak separation algorithm based on multiorder differential method and genetic algorithm for magnetic eddy current signal of a defect cluster
Authors: Xiong Jingyi , Liang Wei , Liang Xiaobin , Zhang Meng
Published: December 2019

Safety assessment plays a vital role in the operation of oil and gas production systems, and data processing is important for the analysis of defects to make correct diagnosis. Therefore, the research to find a reliable data processing method is carried out. The magnetic eddy current signal detected of the defect is generally an abnormal data of “one peak and double valley” type. When the distance between the two defects is close, the leakage magnetic fields of the two defects interfere with each other. In order to facilitate the extraction of the characteristics of such anomalous data, it is necessary to separate the overlapping abnormal data. In this article, the above methods for identifying and processing anomaly detection data of complex defects are studied. The data fitting method is used to find the most suitable fitting function, and the accuracy of overlapping peak separation is optimized by the improved peak separation method based on GA algorithm. The results show that the Gaussian function is most suitable for fitting prediction of the “defective cluster” detection data after separation. The overlapped peak separation result optimized by GA algorithm has less error with the actual data. Therefore, the relevant features of the separated data can accurately reflect the defect related information and effectively improve the pipeline safety assessment.
Investor sophistication and asset prices
Authors: Korniotis George M. , Kumar Alok , Page Jeremy K.
Published: December 2019

We show that geographical variation in the level of investor sophistication influences local asset prices. Investors in less sophisticated regions exhibit stronger trading correlations, and correspondingly, the returns of firms headquartered in less sophisticated areas are more strongly correlated. Furthermore, we show that local economic conditions have a greater ability to predict local stock returns in the U.S. states with less sophisticated retail investors. These asset pricing results are driven by the sophistication of actual local investors, and not by the characteristics of the broader local population.
Keyframe‐based thermal–inertial odometry
Authors: Khattak Shehryar , Papachristos Christos , Alexis Kostas
Published: December 2019

Autonomous navigation of microaerial vehicles in environments that are simultaneously GPS‐denied and visually degraded, and especially in the dark, texture‐less and dust‐ or smoke‐filled settings, is rendered particularly hard. However, a potential solution arises if such aerial robots are equipped with long wave infrared thermal vision systems that are unaffected by darkness and can penetrate many types of obscurants. In response to this fact, this study proposes a keyframe‐based thermal–inertial odometry estimation framework tailored to the exact data and concepts of operation of thermal cameras. The front‐end component of the proposed solution utilizes full radiometric data to establish reliable correspondences between thermal images, as opposed to operating on rescaled data as previous efforts have presented. In parallel, taking advantage of a keyframe‐based optimization back‐end the proposed method is suitable for handling periods of data interruption which are commonly present in thermal cameras, while it also ensures the joint optimization of reprojection errors of 3D landmarks and inertial measurement errors. The developed framework was verified with respect to its resilience, performance, and ability to enable autonomous navigation in an extensive set of experimental studies including multiple field deployments in severely degraded, dark, and obscurants‐filled underground mines.
Spatial and temporal persistence of nearshore kelp beds on the west coast of British Columbia, Canada using satellite remote sensing
Authors: Schroeder Sarah B. , Boyer Leanna , Juanes Francis , Costa Maycira
Published: December 2019

Bull kelp Nereocystis luetkeana is an important foundation species, providing structural habitat and nutrients to the nearshore ecosystems of temperate coastal regions in the Northeast Pacific. Sensitive to environmental conditions, this species thrives in cool, nutrient‐rich water. Reported declines in the extent and distribution of bull kelp may reflect changing oceanic conditions and result in breakdown of important food chains and ecosystem services. This study uses satellite remote sensing to map kelp bed extent from 2004 to 2017 in the Salish Sea on the West Coast of British Columbia, Canada and examines the relationship between trends in kelp persistence with local and global scale environmental conditions. In our study area, we found limited evidence of kelp decline. Local scale effects of current speed, temperature and substrate type may play a role in the spatial and temporal patterns of persistence. Kelp persistence was higher in sites with rocky substrate and lower in areas with low current and gravel or sand substrate. A decline in kelp was recorded from a high in 2015 to a low in 2017; however, a longer and more complete record is needed to distinguish declining trends from natural variability. This work highlights the importance of continued collection of long‐term data for use in time series of kelp abundance as multiple factors can influence the reliability of image interpretation and kelp classification.
Systematics of Tibouchina and allies (Melastomataceae: Melastomateae): A new taxonomic classification
Authors: Guimarães Paulo José Fernandes , Michelangeli Fabián A. , Sosa Karla , de Santiago Gómez Jesús Ricardo
Published: December 2019

Tibouchina (Melastomataceae: Melastomateae) is an exclusively Neotropical genus that currently includes close to 310 species. These were first described or assigned to 16 other genera, a reflection of the complex taxonomic and phylogenetic history of the genus. Previous phylogenetic analyses have shown that the genus is polyphyletic. Here we present an expanded analysis that includes representatives of 28 genera of New World Melastomateae, as well as representatives of Old World Melastomateae and members of the Marcetieae and Microlicieae. Over 300 species were sequenced for nrITS and the plastid spacers accD‐psaI and psbK‐psbL. We recovered a large clade of Neotropical Melastomateae that contains Tibouchina along with at least 13 other Neotropical genera. Moreover, Tibouchina is not recovered as monophyletic because three mostly Central American and five mostly Andean genera are nested within it, albeit each these genera are recovered as monophyletic. Many of the previously recognized sections of Tibouchina are recovered as monophyletic or paraphyletic providing a basis for a new classification. Tibouchina is here re‐circumscribed into four genera that are each monophyletic and easily diagnosable. This results in a narrowly circumscribed Tibouchina and the re‐establishment of Pleroma and Chaetogastra, and the description of a new genus, Andesanthus. Pleroma now also includes Itatiaia, Microlepis and Svitramia. Brachyotum is maintained until its relationship to Chaetogastra can be further examined. This new taxonomic arrangement is more informative and convenient than merging eight other genera into Tibouchina. An identification key, descriptions of genera, and lists of taxa with their current generic assignment and necessary nomenclatural novelties are also presented here.
Dipeptide IF prevents the effects of hypertension‐induced Alzheimer's disease on long‐term memory in the cortex of spontaneously hypertensive rats
Authors: Chang Yung‐Ming , Ashok Kumar K. , Ju Da‐Tong , Ho Tsung‐Jung , Mahalakshmi B. , Lin Wan‐Teng , Day Cecilia H. , Vijaya Padma V. , Liao Po‐Hsiang , Huang Chih‐Yang
Published: December 2019

Hypertension (HTN) is one of the most prevalent chronic conditions; it can damage blood vessels and rupture blood vessels can trap in small vessels. This blockage can prevent blood flow and oxygen delivery to brain cells and can result in Alzheimer's disease (AD). HTN‐ and AD‐mediated long‐time memory loss and its treatment remain poorly understood. Plant‐derived natural compounds are alternative solutions for effectively treating diseases without any side effects. This study revealed that bioactive peptides extracted from potato hydrolysis suppress HTN‐mediated long‐term memory (LTM) loss and cell apoptosis, thus improving memory formation and neuronal cell survival in the spontaneously hypertensive rat (SHR) rat model. SHR rats were treated with bioactive peptide IF (10 mg/kg orally) and angiotensin‐converting enzyme inhibitors (5 mg/kg orally). In this study, we evaluated the molecular expression levels of BDNF‐, GluR1‐, and CREB‐mediated markers protein expression in 24‐week‐old SHR rats. The study result showed that HTN‐induced AD regulated long‐term memory (LTM) loss and neuronal degeneration in the SHR animals. The bioactive peptide‐treated animals showed an elevated level of survival proteins. Bioactive peptide IF activate CREB‐mediated downstream proteins to regulate synaptic plasticity and neuronal survival in the SHR rat model.
Eph receptors: the bridge linking host and virus
Authors: Wang Jia , Zheng Xiang , Peng Qiu , Zhang Xuemei , Qin Zailong
Published: December 2019

Eph (erythropoietin-producing hepatoma) receptors and Ephrin ligands constitute the largest subfamily of receptor tyrosine kinase (RTK), which were first discovered in tumors. Heretofore, Eph protein has been shown to be involved in various tumor biological behaviors including proliferation and progression. The occurrence of specific types of tumor is closely related to the virus infection. Virus entry is a complex process characterized by a series of events. The entry into target cells is an essential step for virus to cause diseases, which requires the fusion of the viral envelope and host cellular membrane mediated by viral glycoproteins and cellular receptors. Integrin molecules are well known as entry receptors for most herpes viruses. However, in recent years, Eph receptors and their Ephrin ligands have been reported to be involved in virus infections. The main mechanism may be the interaction between Eph receptors and conserved viral surface glycoprotein, such as the gH/gL or gB protein of the herpesviridae. This review focuses on the relationship between Eph receptor family and virus infection that summarize the processes of viruses such as EBV, KSHV, HCV, RRV, etc., infecting target cells through Eph receptors and activating its downstream signaling pathways resulting in malignancies. Finally, we discussed the perspectives to block virus infection, prevention, and treatment of viral-related tumors via Eph receptor family.
Detecting cliques in CONGEST networks
Authors: Czumaj Artur , Konrad Christian
Published: December 2019

The problem of detecting network structures plays a central role in distributed computing. One of the fundamental problems studied in this area is to determine whether for a given graph H, the input network contains a subgraph isomorphic to H or not. We investigate this problem for H being a clique $$K_{\ell }$$

K
ℓ

in the classical distributed model, where the communication topology is the same as the topology of the underlying network, and with limited communication bandwidth on the links. Our first and main result is a lower bound, showing that detecting $$K_{\ell }$$

K
ℓ

requires $$\varOmega (\sqrt{n} / {\mathfrak {b}})$$

Ω
(

n

/
b
)

communication rounds, for every $$4 \le \ell \le \sqrt{n}$$

4
≤
ℓ
≤

n

, and $$\varOmega (n / (\ell {\mathfrak {b}}))$$

Ω
(
n
/
(
ℓ
b
)
)

rounds for every $$\ell \ge \sqrt{n}$$

ℓ
≥

n

, where $${\mathfrak {b}}$$
b
is the bandwidth of the communication links. This result is obtained by using a reduction to the set disjointness problem in the framework of two-party communication complexity. We complement our lower bound with a two-party communication protocol for listing all cliques in the input graph, which up to constant factors communicates the same number of bits as our lower bound for $$K_4$$

K
4

detection. This demonstrates that our lower bound cannot be improved using the two-party communication framework.
A 9-year experience study of single-port micro-laparoscopic repair of pediatric inguinal hernia using a simple needle
Authors: Chen R. , Tang S. , Lu Q. , Zhang X. , Zhang W. , Chen Z. , Qi S.
Published: December 2019

Purpose

As laparoscopic techniques and equipments improve, laparoscopic inguinal hernia repair has been gaining popularity. The objective of the study was to summarize 9 years of experience using a single-port micro-laparoscopic approach to repair pediatric inguinal hernias with a simple hernia needle.

Methods

1880 children with inguinal hernias were enrolled using micro-laparoscopic surgery between June 2009 and 2018. All patients underwent high ligation surgery using a single-port micro-laparoscopic technique. The clinical data were retrospectively analyzed.

Results

All micro-laparoscopic surgeries were successfully performed in the 1880 patients, who ranged in age from 2 months to 14 years (3.66 ± 2.96 years) including 1622 males and 258 females. Among them, 1299 cases were unilateral hernias and 581 cases were bilateral hernias. The average operating time was 12.5 ± 3.5 min for a unilateral hernia and 20.5 ± 4.5 min for bilateral hernias. All patients were discharged 1–2 days after surgery, and the average length of their hospital stay was 2–4 days. Complications of knot reaction and pneumoscrotum occurred in 5 cases (0.27%) and 54 cases (2.87%), respectively, but these cases were properly managed, with no major impact on the operational outcomes. All patients were followed up for 3–65 months; there were 13 recurrent cases (0.69%).

Conclusions

Single-port micro-laparoscopic herniorrhaphy in children using a simple hernia needle is a reliable and minimally invasive procedure.
Complement activation in individuals with previous subclinical Lyme borreliosis and patients with previous Lyme neuroborreliosis
Authors: Carlsson Hanna , Sandholm Kerstin , Haddish Haben Woldu , Brudin Lars , Ekdahl Kristina Nilsson , Tjernberg Ivar
Published: December 2019

Lyme borreliosis (LB) is caused byBorrelia burgdorferiand infection may lead to not only a large variety of clinical manifestations but also a subclinical outcome. The aim of the present study was to investigate if there is a constitutional difference in complement activation between individuals with previous subclinical Lyme borreliosis (SB) and patients previously diagnosed with Lyme neuroborreliosis (LNB).

Lepirudin plasma for activation studies was collected from 60 SB individuals and from 22 patients pre-diagnosed with LNB. The plasma was incubated with liveBorreliaspirochetes of two strains (complement sensitiveB. gariniiLu59 and complement resistantB. afzeliiACA1).

Complement factor C3 was measured in non-activated lepirudin plasma with immune-nephelometry and C3a and sC5b-9 generated during complement activation were measured by enzyme-linked immunosorbent assay.

We found that the complement sensitive Lu59 induced higher complement activation than the complement resistant ACA1 when measuring activation products C3a and sC5b-9 in SB and LNB patients,p < 0.0001. No significant difference was found between SB and LNB patients in systemic levels of C3. Furthermore, SB individuals generated a higher activation of C3 cleavage to C3a (C3a/C3 ratio) than LNB patients after activation with ACA1,p < 0.001, but no significant differences were found in response to Lu59. In conclusion, Lu59 induced higher complement activation than ACA1 and individuals with previous SB showed increased generation of C3a compared with patients with previous LNB. In our study population, this mechanism could lead to less elimination of spirochetes in LNB patients and thereby be a factor contributing to the clinical outcome.
Technology innovation: advancing capacities for the early detection of and rapid response to invasive species
Authors: Martinez Barbara , Reaser Jamie K. , Dehgan Alex , Zamft Brad , Baisch David , McCormick Colin , Giordano Anthony J. , Aicher Rebecca , Selbe Shah
Published: December 2019

The2016–2018National Invasive Species Council(NISC)Management Planand Executive Order 13751 call for US federal agencies to foster technology development and application to address invasive species and their impacts. This paper complements and draws on an Innovation Summit, review of advanced biotechnologies applicable to invasive species management, and a survey of federal agencies that respond to these high-level directives. We provide an assessment of federal government capacities for the early detection of and rapid response to invasive species (EDRR) through advances in technology application; examples of emerging technologies for the detection, identification, reporting, and response to invasive species; and guidance for fostering further advancements in applicable technologies. Throughout the paper, we provide examples of how federal agencies are applying technologies to improve programmatic effectiveness and cost-efficiencies. We also highlight the outstanding technology-related needs identified by federal agencies to overcome barriers to enacting EDRR. Examples include improvements in research facility infrastructure, data mobilization across a wide range of invasive species parameters (from genetic to landscape scales), promotion of and support for filling key gaps in technological capacity (e.g., portable, field-ready devices with automated capacities), and greater investments in technology prizes and challenge competitions.
Big Data, Big Waste? A Reflection on the Environmental Sustainability of Big Data Initiatives
Authors: Lucivero Federica
Published: December 2019

This paper addresses a problem that has so far been neglected by scholars investigating the ethics of Big Data and policy makers: that is the ethical implications of Big Data initiatives’ environmental impact. Building on literature in environmental studies, cultural studies and Science and Technology Studies, the article draws attention to the physical presence of data, the material configuration of digital service, and the space occupied by data. It then explains how this material and situated character of data raises questions concerning the ethics of the increasingly fashionable Big Data discourses. It argues that attention should be paid to (1) the vocabulary currently used when discussing the governance of data initiatives; (2) the internal tension between current data initiatives and environmental policies; (3) issues of fair distribution. The article explains how taking into account these aspects would allow for a more responsible behaviour in the context of data storage and production.
Assumptions of authority: the story of Sue the T-rex and controversy over access to fossils
Authors: Jones Elizabeth D.
Published: December 2019

Although the buying, selling, and trading of fossils has been a principle part of paleontological practice over the centuries, the commercial collection of fossils today has re-emerged into a pervasive and lucrative industry. In the United States, the number of commercial companies driving the legal, and sometimes illegal, selling of fossils is estimated to have doubled since the 1980s, and worries from academic paleontologists over this issue has increased accordingly. Indeed, some view the commercialization of fossils as one of the greatest threats to paleontology today. In this article, I address the story of “Sue”—the largest, most complete, and most expensive Tyrannosaurus rex ever excavated—whose discovery incited a series of high-profile legal battles throughout the 1990s over the question of “Who owns Sue?” Over the course of a decade, various stakeholders from academic paleontologists and fossil dealers to Native Americans, private citizens, and government officials all laid claim to Sue. In exploring this case, I argue that assumptions of authority are responsible for initiating and sustaining debates over fossil access. Here, assumptions of authority are understood as assumptions of ownership, or expertise, or in some cases both. Viewing the story from this perspective illuminates the significance of fossils as boundary objects. It also highlights the process of boundary-work by which individuals and groups constructed or deconstructed borders around Sue (specifically) and fossil access (more generally) to establish their own authority. I draw on science studies scholarship as well as literature in the professionalization, commercialization, and valuation of science to examine how assumptions of authority facilitated one of the most divisive episodes in recent paleontological history and the broader debate on the commercial collection of vertebrate fossil material in the United Sates.
Dating and romantic relationships of adolescents with intellectual and developmental disabilities
Authors: Heifetz Marina , Lake Johanna , Weiss Jonathan , Isaacs Barry , Connolly Jennifer
Published: December 2019

Introduction

Adolescents with intellectual and/or developmental disabilities (IDD) are at high risk for sexual exploitation, yet there is a paucity of research on their romantic relationships. The objectives of this study were to examine the romantic understanding and experiences of youth with IDD.

Methods

Thirty‐one adolescents (16–19 years; 21 males and 10 females) with IDD (12 participants with additional diagnosis of ASD) were recruited from a community health clinic. Individual interviews and questionnaires assessed cross‐sectionally these youths’: (1) romantic conceptualizations; (2) romantic awareness (knowledge of: romantic relationships, sexual behaviours, initiating relationships); (3) involvement; (4) social competence; and (5) expectations for autonomy. Parent perspectives on these topics were also captured through questionnaires.

Results

While 85% reported an immediate desire for a romantic relationship, only 35% were currently in a relationship. Qualitative findings indicated that 14% of youth were unable to differentiate between a romantic relationship and a friendship. Among those who could make this distinction, romantic relationships were conceptualized as serious, commitment for life, and primarily for companionship. Adolescents with ASD, compared to those without ASD, showed weaker social competence and lower romantic awareness. Parents were adolescents’ primary source of information about relationships. Finally, parents and adolescents differed in their perception of the age at which they were ready to date.

Conclusions

This study contributes to our understanding of the romantic experiences of youth with IDD. Prevention efforts focused on education may be important to help ensure these youth develop safe and healthy relationships.
The Venezuela Crisis 2019: Use of Lethal Force and Action Short of Force
Authors: O'Connell Mary Ellen
Published: December 2019

These comments briefly address two international legal issues of concern in the Venezuela crisis: the legality of any party resorting to lethal force or taking action short of lethal force. Turmoil in Venezuela moved to a new, more dangerous level, when in January 2019 the leader of the parliament, Juan Guaidó, claimed to be the legitimate president in place of the incumbent, Nicolás Maduro. A variety of parties have taken and have threatened to take action in the wake of Guaidó’s claim. The news media has reported on three categories of action short of lethal force, including economic sanctions, military assistance, and humanitarian assistance. In the second category, lethal force, two examples are most relevant, the use of force against protesters and others not organized to use armed force, and the use of force by, on behalf of, and against groups that are organized to fight.
The Legacy of Colonialism on the Rule of Law in Sub Saharan Africa
Authors: Samuels Joel
Published: December 2019

The impact of the colonial legacy and the decolonization process on the rule of law in sub-Saharan Africa encompasses virtually every component of the rule of law—governance, accountability, transparency, corruption, human rights, gender rights, access to justice, and the assurance of clear, publicized, stable, and just laws. These remarks are intended to provide an overview of some of the consequences of that legacy on the slow and delicate march toward a future where states and their leaders across the region embrace and abide by the rule of law.
Remarks by Daniel Sullivan
Authors: Sullivan Daniel
Published: December 2019

Today, the world is facing the highest numbers of internally displaced persons and refugees since at least World War II. Addressing this crisis involves several challenges regarding the law and politics of displacement. To see how this plays out, it is helpful to zero in on a particular case. The case of the Rohingya minority from Myanmar who have been pushed out into Bangladesh is a particularly acute case, one involving atrocity crimes and ethnic cleansing.
Remarks by Shayak Sarkar
Authors: Sarkar Shayak
Published: December 2019

Lucas Roorda's analysis of the realities and prospects of European liability for corporate defendants is particularly timely in light of the recent U.S. Supreme Court decisions in Kiobel v. Royal Dutch Petroleum1 and Jesner v. Arab Bank2 limiting foreign direct liability (FDL) in American courts. I make three brief points in response to Lucas's thoughtful contribution: the importance of empirical research on the relevance and role of European fora; consideration of litigation as part of a broader strategy by accountability-seeking plaintiffs; and the distinction between intentional and negligence-based torts.
Climate Justice: Holding Governments and Business Accountable for the Climate Crisis
Authors: Casper Kristin
Published: December 2019

People around the world are already experiencing the impacts of climate change, and their human rights are under threat. Greenpeace's Climate Justice and Liability Campaign is collaborating with a growing number of communities to reclaim their rights through strategic climate litigation. Three themes run throughout these efforts. First, the climate breakdown is a human rights crisis. Second, political and business leaders must take immediate action or risk being sued. Third, there is mounting evidence that the fossil fuel industry is significantly responsible for the climate crisis and will ultimately be held accountable. Before exploring these themes, it is useful to understand the origins of Greenpeace International's climate justice efforts.
OP26 Search Approaches In Information Retrieval Presented In HTAi SuRe Info
Authors: Hausner Elke , Waffenschmidt Siw
Published: December 2019

Introduction

It is a challenge to stay up-to-date with the latest developments in information retrieval for health technology assessment (HTA). Summarized Research in Information Retrieval for HTA (SuRe Info) is a well-established open-access website with a selection of up-to-date key papers presented in summarized overviews. SuRe Info is maintained by the HTAi Interest Sub-Group on Information Resources; its main target group are information specialists. SuRe Info is updated twice a year by experienced information specialists. Publications on information retrieval methods are identified by running topic-specific search strategies in relevant databases. Publications fulfilling the SuRe Info inclusion criteria receive a structured abstract together with a brief critical appraisal prepared by one SuRe Info information specialist and checked by another. The key messages from the appraisals are summarized in topic-specific chapters.

Methods

The structure and work of SuRe Info is presented on the basis of the chapter “Value of using different search approaches”.

Results

The chapter “Value of using different search approaches” was last updated in September 2018. It examines various alternative search approaches in bibliographic databases beyond the conventional Boolean search. According to this chapter, the most well-known approach, offering the most evidence, is citation searching (direct or indirect citation relationships). In contrast, little research has so far been conducted on other approaches such as full-text searches, automated retrieval methods or hand searching.

Conclusions

SuRe Info is an important resource for information specialists to keep up-to-date with the literature on information retrieval. In particular when information specialists work alone and not within a larger team, it is necessary to rely on collaboration projects such as SuRe Info.
OP58 Developing An Evaluation Based Taxonomy For mHealth Apps
Authors: Goddard Kate , Erskine Jamie
Published: December 2019

Introduction

Mobile Health (mHealth) apps offer potential to promote greater public engagement in health, improve efficiency and open up new care pathways and models of care. However, the volume and heterogeneity of apps has led to uncertainty and lack of standardization around app definitions. Some mobile apps carry minimal risks to consumers, but others can carry significant risks. Work has been carried out to develop a framework for assessment (for example, for the NHS app library [beta version]). We discuss work helping to inform a preliminary framework of categorizing mHealth apps for proportionate assessment and validation, and the challenges involved.

Methods

A literature review was carried out to identify different types of categorizations used to define health apps and the most important dimensions for their assessment. A taxonomy of apps and a process for routing them towards appropriate methods of evaluation was developed through iterative review, discussion and refinement.

Results

Fourteen types of mHealth apps were established which were categorized by app function and by the potential risk involved with use. Subsequently, this research suggested a method of routing apps towards the most appropriate and proportionate method of evaluation, by using four example dimensions of impact (population size, disease burden, priority of clinical condition, and innovation), and four levels of risk.

Conclusions

The outcome of an evaluation framework should be to enable healthcare professionals and patients to select and use safe and effective mHealth apps with greater confidence. A preliminary taxonomy and method of routing apps towards appropriate assessment are presented. Both need larger scale discussion, iterative testing and refining. This research faced significant challenges, including a high volume of heterogeneous apps with poorly standardized app definitions and associated nomenclature.
OP136 Provision Of A Chimeric Antigen Receptor T-Cell Program: A Rapid Review
Authors: Carey Niamh , Harte Marie , Gorry Claire , McCullagh Laura
Published: December 2019

Introduction

The recent European Medicines Agency (EMA) approval of chimeric antigen receptor (CAR) T-cell therapies, axicabtagene ciloleucel and tisagenlecleucel, means the imminent arrival of health technology assessment (HTA) submissions to HTA agencies. HTA requires identification of all resources and organizational impacts pertaining to an intervention. Rapid review is a form of knowledge synthesis that abbreviates certain methodological aspects of systematic reviews to produce information in a timelier manner. Considering the time-sensitive nature of CAR T-cell HTAs, the aim of this research was to conduct a rapid review to identify the institutional requirements for the provision of a CAR T-cell program.

Methods

A Rapid Review protocol was developed and registered in PROSPERO. Electronic databases, EMBASE and MEDLINE, and grey literature were searched. All study designs published in English after the year 2000 were included. Studies pertained to the use of CAR T-cells in adult and pediatric patients with solid and hematological malignancies. No restrictions were placed on the comparators or study setting. Primary outcomes were organized into two categories: (i) resource use, (ii) processes relating to implementation of CAR T-cell programs. Secondary outcomes included associated costs of implementation and barriers to successful implementation. Screening, review, and extraction of relevant data was conducted by a single reviewer. Extracted data included publication details, population and setting, study characteristics, outcomes and outcome measures, and strengths and limitations of research. Data was synthesized by means of thematic analysis.

Results

Results indicate that the provision of a CAR T-cell program in Ireland will require the establishment of bespoke infrastructural support. This includes additional outpatient facilities, ICU resources, and nursing capacity. Close relationships will need to be formed between hematology, ICU and neurology.

Conclusions

The findings of this Rapid Review will inform the assessment of organizational impacts associated with the introduction of a CAR T-cell program, ensuring a robust HTA assessment.
PP35 Valuing Intersectoral Costs And Benefits Of Interventions
Authors: Drost Ruben , Paulus Aggie , Ruwaard Dirk , Evers Silvia
Published: December 2019

Introduction

There is a lack of knowledge about methods for valuing health intervention-related costs and monetary benefits in the education and criminal justice sectors, also known as ‘inter-sectoral costs and benefits’ (ICBs). The objective of this study was to develop methods for obtaining unit prices for the valuation of ICBs.

Methods

By conducting an exploratory literature study and expert interviews, several generic methods were developed. The methods' feasibility was assessed through application in the Netherlands. Results were validated in an expert meeting, which was attended by policy makers, public health experts, health economists and Health Technology Assessment (HTA) experts, and discussed at several international conferences and symposia.

Results

The study resulted in four methods, including the opportunity cost method and valuation using available unit prices, self-constructed unit prices or hourly labor costs.

Conclusions

The methods developed can be used internationally and are valuable for the broad international field of HTA.
PP57 Outcomes On Transcatheter Aortic Valve Implantation
Authors: Soares dos Santos Augusto Cesar , Horta Maria da Glória Cruvinel , Carvalho Lélia Maria de Almeida , Rodrigues Luíza , Avelar Sandra de Oliveira Sapori , Fernandes Mariana , Scherrer Luciano Rios , Biscione Fernando Martin , Kelles Silvana Marcia
Published: December 2019

Introduction

Severe aortic stenosis with symptoms or left ventricular dysfunction has commonly a poor prognosis and therefore, aortic valve replacement is usually performed for patients aiming at improving their functional class and survival rate.

Methods

This retrospective study evaluated a convenience sample of patients at high risk for open surgery for the correction of aortic valve dysfunction treated with TAVI from 2013 to 2018. Data from a private healthcare organization in Belo Horizonte, Brazil were used to assess all-cause mortality. Continuous variables were expressed as mean and standard deviation. Cox proportional regression model and Log-Rank test were used to adjust the survival curve.

Results

Fifty-two patients were included in the study (mean 83 ± 5.7 years of age, range 67 to 93 years; female 55.8 percent). Patients were characterized by: left ventricular ejection fraction (n = 30; mean 52.9 percent, range 26 to 81 percent); aortic valve area (n = 36; mean 0.68 cm2, range 0.4 to 1.2 cm2); left atrium size (n = 14; range 30 to 61 ml/m2); pulmonary artery pressure (n = 20; mean 53 mmHg, range 31 to 70 mmHg). Death occurred in 19 patients during the follow-up period (mean 8.4 months, range 0 to 60 months). Nine deaths occurred within the first 30 days of follow-up (17.3 percent) and 14 (26.9 percent) in the first year. Stroke occurred in three patients (5.8 percent) in the post-implant period. A pacemaker device was required for nine patients (17.3 percent).

Conclusions

Transcatheter aortic valve implantation (TAVI) has become an alternative to surgical aortic valve replacement for patients at high risk for surgery. Real-world studies might result in a better understanding of the local team expertise on TAVI utilization.
PP70 Identification Of Prostheses With Worse Than Expected Outcomes
Authors: Arias de la Torre Jorge , Martínez Olga , Smith Kayla , Pons-Cabrafiga Miquel , Prieto-Alhambra Daniel , Valderas Jose , Martin Vicente , Evans Jonathan , Marcos Raul , Esteban Marta , Villabrille Susana , Espallargues Mireia
Published: December 2019

Introduction

Monitoring the effectiveness of knee and hip arthroplasties could be useful at the clinical, economic, and patient levels. In Catalonia, there is currently no systematic monitoring of the different prostheses available. The aims of this study were to propose an approach for the systematic identification of knee and hip prostheses with the highest revision rates, and to identify those with the poorest outcomes.

Methods

Data recorded from January 2005 to December 2016 were considered from 53 out of the 61 public hospitals in Catalonia included in the Catalonian Arthroplasty Register (RACat). Specific prostheses were classified by joint, type, fixation, and, in total hip prostheses, the bearing surface. Prostheses with the worst outcomes were identified using a three-step approach, based on previous literature: (i) screening using Poisson models; (ii) comparison of prostheses using adjusted Cox models; and (iii) consensus-based review by a panel of orthopedic surgeons to detect possible sources of bias. After this process, selected prostheses were provisionally labeled as having the poorest outcomes. This process will be repeated periodically within the RACat to definitively classify the prostheses.

Results

After first two steps, ten knee prostheses and eight hip prostheses were identified. After the panel discussion (third step), one knee and one hip prosthesis were excluded from the final list. The knee prosthesis was excluded because it was a unicompartmental implant, while the hip prosthesis was excluded because it was a monoblock implant. Finally, nine knee prostheses and seven hip prostheses were provisionally identified as having the worst results relative to other available prostheses. These results await confirmation in subsequent analyses.

Conclusions

This study contributed to the current need to identify hip and knee prostheses whose outcomes might be worse than expected. This identification could have an impact at the patient, surgeon, industry, and stakeholder levels.
PP131 Omalizumab And Ciclosporin For Chronic Spontaneous Urticaria
Authors: Tan Gloria Wan Hui , Pearce Fiona , Ng Kwong
Published: December 2019

Introduction

Omalizumab and ciclosporin are recommended in international clinical guidelines for treating antihistamine-resistant chronic spontaneous urticaria (CSU). This meta-analysis aimed to evaluate their comparative efficacy and safety to inform local treatment practices in Singapore.

Methods

The PubMed and EMBASE databases were searched for randomized controlled trials (RCTs) published up to October 2018 involving omalizumab or ciclosporin as an add-on therapy to H1-antihistamines for CSU. Key outcomes were changes in weekly Urticaria Activity Score (UAS7), adverse events, and health-related quality of life. Pairwise meta-analysis was conducted for each outcome. Owing to differences in trial designs and patient characteristics across the studies, a random effects model was employed. In the absence of head-to-head trials, the Bucher method of adjusted indirect comparison was used to estimate the comparative effectiveness between omalizumab and ciclosporin, with placebo as the common comparator.

Results

Eight omalizumab and two ciclosporin placebo-controlled RCTs comprising 1,740 patients were selected. The magnitude of treatment effect for omalizumab was dose-dependent across all efficacy outcomes: 300 mg was superior to 150 mg. Omalizumab 300 mg, although statistically significantly better than placebo for all efficacy outcomes at week 12, did not achieve clinical significance for all measures. The mean change in UAS7 was statistically better for ciclosporin than for placebo (one RCT) at week 4. The indirect comparison between omalizumab and ciclosporin showed no statistically significant differences for mean change in UAS7. Omalizumab had a more favorable short-term safety profile than ciclosporin, but long-term safety data were lacking.

Conclusions

Both omalizumab and ciclosporin were effective in treating CSU, compared with placebo. However, results of the indirect comparison should be interpreted with caution. On the basis of limited available evidence, and taking into account the similar place in therapy of omalizumab and ciclosporin, the results may be considered acceptable to confirm the clinical comparability of the drugs an add-on to H1-antihistamines for CSU.
PP148 A Stakeholder-Informed Strategy For Effective Communication
Authors: Elston Lauren , Poole Ruth Louise , Fraser Barbara , Coldwell Ian , Myles Susan
Published: December 2019

Introduction

Effective communication is vital for engaging stakeholders in health technology assessment (HTA), as well as the successful dissemination and adoption of HTA research and guidance. As a relatively new organization, Health Technology Wales (HTW) has an ideal opportunity to take an effective, strategic approach to communication and stakeholder engagement from the outset.

Methods

HTW commissioned Pagoda Public Relations to develop an informed communications strategy and delivery framework. The strategy used OASIS methodology for public relations planning: Objectives, Audience insight, Strategy, Implementation, and Scoring (evaluation). Initial objectives were developed with input from the HTW team and members of the HTW Assessment Group and Appraisal Panel. Stakeholder insights were collected through an online survey and telephone interviews. These insights were used to inform the communications strategy and framework, outlining key audiences, key messages, communication objectives, methods, tactics, and evaluations.

Results

Seven key objectives were identified, each of which were supported by recommended actions. These were underpinned by the key aims and messages reflecting how we will achieve these objectives. National Health Service boards, government, clinicians, the technology and research sector, patients, and the general public were identified as priority audiences. Various different communication channels and activities were identified, aimed at various audiences. These included the website, social media, traditional media, and exhibitions or workshops, as well as targeted e-mail dissemination of guidance. Evaluation of HTW communications will be aligned with the wider HTW evaluation strategy, and evidence will be recorded through OutNav software (Matter of Focus Ltd).

Conclusions

HTW is committed to a strategic, effective approach to communication and engagement. We now have an audience-informed communications strategy and plan that outlines our key objectives, and how to achieve and evaluate these objectives. Successful implementation will raise awareness of and value in profile and outputs of HTW, both in Wales and internationally.