bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transport behaviors of humic acid, kaolin and kaolin–humic acid compound colloids on naphthalene in floating islands with biofilmed fillers
Authors: Yu Sheng , Li Bang-yu , Chen Yi-hu 
Published: December 2019

AbstractAs one of the persistent organic pollutants, the investigations of naphthalene transports with humic acid, kaolin and kaolin–humic acid compound colloids by passing through the floating islands with biofilmed filler matrix pores were checked out. Naphthalene was easily captured onto the biofilmed fillers while it was passing through the floating islands with the filling percentages of 0.0 to 60.0 by absorbing bigger contaminated colloids, reflecting that the naphthalene concentrations in influents were, respectively, decreased from 200 to 57 μg L−1 for the humic acid colloids, to 32 μg L−1 for the kaolin colloids and to 13 μg L−1 for the kaolin–humic acid compound colloids. With the filling percentages of 60.0 to 80.0, the naphthalene concentrations in effluents were maintained at 57 ± 2 μg L−1 for the humic acid colloids, at 32 ± 3 μg L−1 for the kaolin colloids and at 13 ± 3 μg L−1 for the kaolin–humic acid compound colloids, respectively. The naphthalene distribution amounts on the biofilmed fillers were, respectively, from 213 to 96 ng m−1 for the humic acid colloids, from 274 to 96 ng m−1 for the kaolin colloids and from 340 to 83 ng m−1 for the kaolin–humic acid compound colloids. Thus, the biofilmed fillers in the floating islands could decrease the naphthalene concentrations by the captures of the humic acid, kaolin and kaolin–humic acid compound colloids to make the contaminated colloid concentrations reduced and promote the water qualities.
A blood‐based nutritional risk index explains cognitive enhancement and decline in the multidomain Alzheimer prevention trial
Authors: Bowman Gene L. , Dodge Hiroko H. , Guyonnet Sophie , Zhou Nina , Donohue Juliana , Bichsel Aline , Schmitt Jeroen , Hooper Claudie , Bartfai Tamas , Andrieu Sandrine , Vellas Bruno ,   MAPT/DSA Study Group, Vellas Bruno , Guyonnet Sophie , Carrié Isabelle , Brigitte Lauréane , Faisant Catherine , Lala Françoise , Delrieu Julien , Villars Hélène , Combrouze Emeline , Badufle Carole , Zueras Audrey , Andrieu Sandrine , Cantet Christelle , Morin Christophe , Van Kan Gabor Abellan , Dupuy Charlotte , Rolland Yves , Caillaud Céline , Ousset Pierre‐Jean , Lala Françoise 
Published: December 2019

AbstractIntroductionMultinutrient approaches may produce more robust effects on brain health through interactive qualities. We hypothesized that a blood‐based nutritional risk index (NRI) including three biomarkers of diet quality can explain cognitive trajectories in the multidomain Alzheimer prevention trial (MAPT) over 3‐years.MethodsThe NRI included erythrocyte n‐3 polyunsaturated fatty acids (n‐3 PUFA 22:6n‐3 and 20:5n‐3), serum 25‐hydroxyvitamin D, and plasma homocysteine. The NRI scores reflect the number of nutritional risk factors (0–3). The primary outcome in MAPT was a cognitive composite Z score within each participant that was fit with linear mixed‐effects models.ResultsEighty percent had at lease one nutritional risk factor for cognitive decline (NRI ≥1: 573 of 712). Participants presenting without nutritional risk factors (NRI=0) exhibited cognitive enhancement (β = 0.03 standard units [SU]/y), whereas each NRI point increase corresponded to an incremental acceleration in rates of cognitive decline (NRI‐1: β = −0.04 SU/y, P = .03; NRI‐2: β = −0.08 SU/y, P < .0001; and NRI‐3: β = −0.11 SU/y, P = .0008).DiscussionIdentifying and addressing these well‐established nutritional risk factors may reduce age‐related cognitive decline in older adults; an observation that warrants further study.
A roadmap to develop dementia research capacity and capability in Pakistan: A model for low‐ and middle‐income countries
Authors: Leroi Iracema , Chaudhry Nasim , Daniel Anna , Dunne Ross , Eman Saima , Farina Nicolas , Haidry Sana‐e‐Zehra , Husain Nusrat , Jafri Hussain , Karim Salman , Kiran Tayyeba , Khan Murad , Khan Quratulain , Malik Shakil Jehangir , Memon Rakhshi , Rana Mowadat Hussain , Sathish Ambily , Sheikh Saima , Tamizudin Asad , Tofique Sehrish , Zadeh Zainab ,   Pakistan Dementia Research Stakeholder Group (PDRSG), Abbasi Yasser , Eitesam Sadaf , Jafri Mohammed , Khaliq Aysha , Karim Raheel , Nafis Saima , Wasay Mohammad 
Published: December 2019

AbstractObjectiveTo produce a strategic roadmap for supporting the development of dementia research in Pakistan.BackgroundWhile global research strategies for dementia research already exist, none is tailored to the specific needs and challenges of low‐ and middle‐income countries (LMIC) like Pakistan.MethodsWe undertook an iterative consensus process with lay and professional experts to develop a Theory of Change‐based strategy for dementia research in Pakistan. This included Expert Reference Groups (ERGs), strategic planning techniques, a “research question” priority survey, and consultations with Key Opinion Leaders.ResultsWe agreed on ten principles to guide dementia research in Pakistan, emphasizing pragmatic, resource sparing, real‐world approaches to support people with dementia, both locally and internationally. Goals included capacity/capability building. Priority research topics included raising awareness and understanding of dementia, and improving quality of life.ConclusionThis roadmap may be a model for other LMIC health ecosystems with emerging dementia research cultures.
OP29 Building A Global, Public Repository Of Patient Experience Data
Authors: Holliday Catherine 
Published: December 2019

IntroductionThe Patient Experience, Expectations and Knowledge (PEEK) protocol was developed so that a holistic, comprehensive, independent, proactive and systematic approach could be taken to inform decisions made in the context of health technology assessment and other parts of the health sector. Each PEEK study is made publicly available which over time will result in a global repository of patient experience data.MethodsThe PEEK protocol is a single protocol that can be implemented across disease areas and includes a quantitative and qualitative component. The quantitative component is based on a series of validated tools that provide baseline health and demographic data for the study population. The qualitative component is the result of two years of protocol testing to develop a structured interview that solicits comprehensive and holistic patient experience data, and provides participants with the opportunity to provide advice on their future expectations.ResultsPEEK studies in breast cancer, bladder cancer, lung cancer, spinal muscular atrophy, atopic dermatitis, chronic kidney disease, chronic heart failure and mitochondrial disease have been completed in the Australian context (www.cc-dr.org/peek). Holistic patient experience themes are presented commencing with symptoms and diagnosis experience, through to communication, information, treatments experienced and quality of life. Information is also available in relation to participant's expectations of future treatment, care, information and communication. The result is a freely available repository of patient experience data that anyone in the sector can access to complement clinical and economic evidence.ConclusionsThe process of providing patient feedback and real-world evidence in the context of health technology assessment is often ad-hoc. The lack of consistency means that it has been difficult to assess the impact of patient engagement and feedback in the context of health technology assessment. The PEEK protocol and program is an example of a systematic, independent and holistic approach to patient experience and real-world evidence data collection that provides the sector with an opportunity to proactively engage the community in decisions that are made about treatment, care and support.
OP62 Let's Co-design A Tool To Assess Overweight And Obesity Health Apps
Authors: Puig Elisa Puigdomenech , Robles Noemí , Gomez Corpus , Saigí-Rubió Francesc , Zamora Alberto , Moharra Montse , Paluzié Guillem , Balfegó Mariona , Cuatrecasas Guillem , Carrion i Ribas Carme 
Published: December 2019

IntroductionThere are more than 320,000 accessible health apps, with the most downloaded of those related to physical exercise and weight control. However the initiatives for their validation address only partial aspects of the evaluation. The EVALAPPS project aims to develop an assessment tool for overweight and obesity management apps, based on the evaluation of efficacy, effectiveness and safety. In the present phase of the project, the team is co-creating the assessment tool considering both the evidence and the expertise of professionals (co-creation process).MethodsProposed co-creation methodology includes: 1) a modified Delphi process for selecting the assessment criteria. Criteria were identified through a) an exhaustive review of the criteria used by several mHealth assessment tools and b) a systematic review of efficacy, safety and effectiveness criteria used in mHealth interventions that assess overweight and obesity management. 2) a co-creation session using “Design Thinking” techniques for defining the final content and appearance of the tool (November 2018).ResultsTen dimensions and 133 criteria were identified, both in relation to the outputs (Usability, Clinical Effectiveness, Security, Development, etc.) and the outcomes (such as weight loss, number of steps). Of those, 114 were included in the modified Delphi, in which 31 professionals participated. A set of 63 criteria were selected as candidates for being part of the tool. Criteria mainly belonged to Security (22%) and Usability dimensions (14%), followed by Quality (11%), and outcomes related to Activity (11%) and Physical status (11%). Once the co-creation session has been performed, the final tool will be developed.ConclusionsRelevant criteria to evaluate the efficacy and safety of mHealth interventions in the management of overweight and obesity have been identified. Once the tool is developed it will be user tested and piloted on users of overweight and obesity management apps.
OP78 Picturing ELSI+: Mapping Ethical, Legal, Social And Value Issues
Authors: Krahn Murray , Bremner Karen , de Oliveira Claire , Almeida Nisha , Clement Fiona , Lorenzetti Diane , O'Campo Patricia , Pechlivanoglou Petros , Tricco Andrea 
Published: December 2019

IntroductionHealth technology assessment (HTA) is value-laden. Consideration of ethical, legal, and social issues (ELSI), and patient values (ELSI+), is challenged by lack of conceptual clarity and the multi-disciplinary nature of ELSI + . This study used concept mapping to identify key concepts in the ELSI+ domain and their interrelationships.MethodsWe conducted a scoping review using Medline and EMBASE (2000-2016, English language) with search terms related to ethics, legal/law, social/society/patient, “ELSI”, and HTA/technology/assessment. Items from the review and additional items from an expert brainstorming session were consolidated into 80 ELSI+-related statements which were entered into Concept Systems® Global MAX software. Participants (N = 38; 36 percent researchers, 21 percent academics; 42 percent self-identified as HTA experts) sorted the statements into thematic groups that made sense to them, and rated the statements on their importance in decision-making about adoption of technologies in Canada: 1 (not at all important), 5 (extremely important), 2, 3, and 4 (unlabeled). We used Concept Systems® Global MAX software to create and analyze concept maps with four to 16 clusters, which were reviewed by the study team.ResultsWe selected the map with five clusters because its clusters represented different concepts and the statements within each cluster represented the same concept. Based on the concepts, we named these clusters: patient preferences and experiences, patient quality of life and function, patient burden/harm, fairness, and organizational. The highest mean importance ratings were for the statements in the patient burden/harm (3.82) and organizational (3.92) clusters.ConclusionsThis study suggests an alternative approach to conceptualize the domains originally described as “ELSI+”. We identified clusters of relevant concepts that focus on patient perspectives (preferences, experiences, quality of life, function), burden and harm, fairness (individual and societal), and organizational issues. Basing ELSI+ on conceptual consonance, rather than academic disciplines or traditions, provides a framework for coherent consideration of ELSI+ in HTA.
PP36 Inflammatory Bowel Disease: The Disability Costs Among Italian Workers
Authors: Nardone Claudia , Russo Simone , Gazzillo Simone , Migliorini Raffaele , Aurilio Marco Trabucco , Mennini Francesco Saverio 
Published: December 2019

IntroductionThe aim of the study is to estimate the disability insurance costs (social security system in Italy is financed by public expenditure) induced by patients with Inflammatory Bowel Disease (IBD) and specifically for Crohn's disease (CD) and Ulcerative Colitis (UC) between 2009 and 2015.MethodsWe analyzed the database about the disability insurance awards and the mean cost per benefit of the National Institute of Social Security (INPS) for two types of social security benefits: incapacity pensions (IP - for people without workability) and disability benefits (DB - for people with reduced work ability). From this data, we have estimated the total benefit provided and the total costs for each disease. A probabilistic model with a Monte Carlo simulation was developed in order to estimate the total benefits provided and costs.ResultsFor CD, an average of 820 beneficiaries of social security benefits were detected per year (2009-2015): the total expenditure was EUR 50 million, EUR 7 million per year (about EUR 7,900 per patient); for UC, about 1,550 beneficiaries per year were detected and the total expenditure was EUR 93 million, EUR 13 million per year (about EUR 8,600 per patient).ConclusionsThe disability insurance costs related with the management of CD and UC showed a significant impact on the expenditure for the Italian system: the most important costs for disability for CD and UC in Italy in the analyzed period were DB (92 percent for CD and 95 percent for UC). Rapid access to innovative treatments could reduce the costs incurred by the social security system.
PP44 Optimal Use Of Warfarin: Self-Monitoring From A Quebec Perspective
Authors: Bouchard Sylvie , St-Pierre Frederic , Levesque Ann , Turgeon Melanie , Guay Helene , Freitas Adriana , Plante Eric , Carpentier Gabriel , Tardif Mélanie 
Published: December 2019

IntroductionFrequent standard International Normalized Ratio (INR) monitoring by health professionals is one of the major inconveniences reported by warfarin users. However, portable coagulometers are now available to reduce this burden by allowing patients to self-monitor their INR in the comfort of their home, thereby reducing their visiting frequency to a medical clinic. The aim of this work was thus to elaborate recommendations on the use of self-monitoring in the management of warfarin-treated patients in the province of Quebec.MethodsSystematic literature reviews were conducted to retrieve the most up-to-date scientific data from primary studies and pharmacoeconomic evaluations as well as recommendations from published clinical practice guidelines. This information was then triangulated with the experiential knowledge of Quebec experts and clinicians collaborating on the project.ResultsThe scientific, contextual and experiential evidence gathered during this work provided convincing support for the use of self-monitoring for long-term warfarin-treated patients, leading to a more effective treatment than standard monitoring while being safe, cost-effective and potentially improving patients’ quality of life. However, physical and mental limitations can hinder the use of portable coagulometers, outlining the need for caution in the selection and support of self-monitoring patients.ConclusionsThis work led to the development of specific recommendations on the use of self-monitoring along with a clinical tool to help discussion between patients and health professionals leading to a shared decision-making. This work will be part of two optimal usage guides on oral anticoagulant therapy to be published by the Institut national d'excellence en santé et en services sociaux.
PP68 Indicators From The Real World Data To Improve Opioid Use
Authors: Tremblay Eric , Daigle Jean-Marc , Breton Marie-Claude , Bouchard Sylvie 
Published: December 2019

IntroductionOpioids are being used increasingly to treat chronic noncancer pain despite the uncertainty regarding its long-term benefits. This study served to determine if problems are associated with opioid use in Québec for new users from 2006 to 2013 without history of cancer.MethodsA retrospective longitudinal cohort study was conducted using administrative databases stored at the Régie de l'assurance maladie du Québec (RAMQ) to describe the annual proportion of new users to whom at least one of the five indicators of potentially inappropriate opioid use applied was estimated. These indicators are (i) overlapping opioid prescriptions, (ii) overlapping opioid and benzodiazepine prescriptions, (iii) the use of long-acting opioids at the start of treatment, (iv) a high mean daily dose, and (v) a rapid increase in the opioid dose.ResultsThe annual proportion of new users to whom at least one of the five indicators of potentially inappropriate opioid use applied decreased from 15.4 percent in 2006 to 12.3 percent in 2013. It was mainly the following three indicators that contributed the most to these proportions in 2013: (i) overlapping opioid prescriptions (5.8 percent), (ii) overlapping opioid and benzodiazepine prescriptions (8.2 percent), and (iii) the use of long-acting opioids at the start of treatment (1.8 percent).ConclusionsThe vast majority of new users with no history of diagnosed cancer used opioids adequately according to the five indicators of potentially inappropriate opioid use applied. Improvement could still be made to decrease mainly overlapping opioid prescriptions and overlapping opioid and benzodiazepine prescriptions.
PP79 Impact Of Hidradenitis Suppurativa On Healthcare Resource Utilization
Authors: Andrade Larissa de Araujo Costa , Moreira Ricardo , Vitale Vinicius 
Published: December 2019

IntroductionHidradenitis suppurativa (HS) is a debilitating, chronic inflammatory skin disease characterized by painful nodules and abscesses. HS has a strong impact on patient quality of life. In Brazil, the prevalence of HS is estimated at 0.4 percent. Medical and surgical treatments have low effectiveness and disease recurrence is common, which affects health system costs. This study aimed to assess how HS patients utilize medical care (emergency and inpatient care) in Brazil and to describe the all-cause costs.MethodsData were retrieved from a public healthcare claims database (DATASUS), which provides access to information regarding health services and costs. Data from DATASUS were used to perform a cost-identification analysis on patients with HS who used health services over a two-year period. A retrospective bottom-up approach was used to estimate direct costs, multiplying the amount of each medical resource consumed by its unit cost.ResultsOver the two-year period, 90 patients (16%) with HS received inpatient care (151 procedures) at a total cost of BRL 83,520 (USD 21,715). Surgeries were the most frequently performed (73% of total) and expensive procedures, costing BRL 73,122 (USD 19,011; 88% of total costs), followed by clinical treatments (BRL 8,354 [USD 2,172]; 10%), and physician consulting (BRL 1,659 [USD 431]; 2%). For the 500 patients treated in the emergency department (total cost BRL 3,027 [USD 787]), the most frequently received services were physician consulting (34%), nursing care (12%), and minor surgeries (11%). Each patient received, on average, three procedures over the two-year period.ConclusionsHS is a high-burden disease, as demonstrated by the high healthcare resource utilization among patients. Since DATASUS is a public database, the costs presented reflect a government reference price and do not consider local costs, which is a limitation of this study. Health managers should be aware of this finding, although further research is needed to investigate the effect of healthcare utilization on patient outcomes.
PP123 Management of Patients’ Conflicts Of Interest And Of Commitment In Health Technology Assessment
Authors: Roy Marie-Christine , Ganache Isabelle , Pomey Marie-Pascale , Demers-Payette Olivier , Roy Denis 
Published: December 2019

IntroductionHealth technology assessment (HTA) and the development of clinical practice guidelines (CPGs) support important health policy and clinical decisions. Conflicts of interest (COI) and conflicts of commitment (COC) can undermine the credibility and integrity of these processes, that of the actors involved, and, more alarmingly, the health of the population. Thus, management of COI and COC is critical. Although COI among experts participating in HTA and CPG development are increasingly discussed and managed, little is said about COCs and the possible COI and COC associated with patient participation. The aim of our study, which is part of the Institut national d'excellence en santé et services sociaux (INESSS) continuing improvement process for COI and COC management, was to identify best practices in this matter.MethodsWe examined the COI and COC management policies of ten HTA and CPG organizations and performed a review of the relevant academic literature.ResultsThree HTA and CPG organizations had norms regarding the management of patients’ COI and COC, whether they were representatives of patient associations or not. These norms addressed situations such as: when a patient represents a patients’ association; when a patients’ association or an individual patient has important (financial) ties with the pharmaceutical industry; or when an expert or one of his/her family members suffers from the disease related to the HTA or CPG. The declaration of a COI or COC should not necessarily lead to the individual's exclusion from the entire HTA or CPG development process, but it must lead to some evaluation and management. Patients appointed to share their perspectives are not considered to have COI or COC if their mandate is explicit.ConclusionsThe COI and COC of all participants in HTA and CPG development should be managed fairly and transparently. Therefore, the management of COI and COC among patients participating in HTA or CPG development should be based on the same principles as those applied to clinical experts.