bluuebunny/crossref_metadata_2025_split huggingface dataset:
PP422 Including Empowering Community Into Primary Healthcare Team Scope Of Practice – A Technology For Ensuring Universal Healthcare Coverage
Authors: Khozhamkul Rabiga , Kosherbaeva Lyazzat , Bakdaulet Ainur , Izmukhambetov Talapkali , Jurgutis Arnoldas , Tolegenova Saule 
Published: December 2020

IntroductionConsidering the World Health Organization (WHO) Astana Declaration, in order to provide universal healthcare coverage, Kazakhstan through ongoing healthcare reform committed to the promotion of a people-centered Primary Healthcare (PHC) system. Since the implemented top-down policies showed low buy-in from community members and put more constraints on PHC facilities and teams, the Kazakh National Medical University, the Medeo district mayor's office and the WHO European Centre for PHC supported the initiative of a local non-governmental organization “Community health committee” and Outpatient clinic of Almaty State hospital #5, for creation of an integrated plan to develop people-centered PHC through better coverage and engagement of patients with non-communicable disease and enhancing the health literacy of the population above 65 years.MethodsWe used a community-based participatory approach. The process consisted of: forming a steering committee with at least one member from each stakeholder group; two interactive workshops where the community worked jointly with PHC professionals in defining priority health needs and proposing actions to address selected priorities; and, after, joint development by all stakeholders of an action plan for empowerment of the community, and for assessment and review of the scope of practice of PHC teams.ResultsThe interactive workshops identified priority health needs such as low health literacy, low responsibility for health, low engagement of the elderly in prevention and self-management of non-communicable diseases. The main findings of semi-structured interviews were that there are no planning approaches (neither shared planning by a PHC team, or individually by PHC professionals) for addressing defined priority needs of the community, families and/or patients, and that the role of a PHC team in community empowerment is very limited.ConclusionsUsing results of the review on PHC teams’ scope of practice, we will develop, discuss and agree with the national and local stakeholders’ proposal of a conceptual model of PHC service delivery. Further, we will implement and evaluate the results of implementation.
PP459 Healthcare Resource Utilisation Of Anti-Neutrophil Cytoplasmic Antibody Associated Vasculitis Patients: Real-World Data From English Clinical Practice Research Datalink
Authors: de Arellano Serna Antonio Ramirez , Glover Matt , Sammon Cormac , Kuo Tzu-Chun , Spearpoint Philip , Rutherford Peter 
Published: December 2020

IntroductionAnti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) is a rare, serious and often life-threatening disease. The use of available treatments options (immunosuppressants and glucocorticoids (GCs)) improves the prognosis of AAV greatly; however, GC use is associated with significant toxicity related morbidities and the management of AAV is costly. However, information of the costs associated with AAV in the United Kingdom is limited. This study aimed to quantify the burden of AAV using a large England and Wales source of real-world data, the Clinical Practice Research Datalink (CPRD) Hospital Episode Statistics (HES) linked database, to identify healthcare resource utilization and generate estimates of costs.MethodsIncident patients (n = 220) were included if ≥ eighteen years, with diagnosis read codes G754.00/G75A.00; ICD codes M31.3/M31.7 from January 1997 to December 2017. Costs were taken from Unit Costs of Social and Health Care, National Health Service reference costs and electronic drug tariff. Distinction was made between type of consultations, outpatient visits and inpatient admission based on Healthcare Resource Grouping. Costs were summarised as mean per member per year (PMPY) in 2016 prices and presented before and after diagnosis.ResultsIn the year preceding AAV diagnosis, mean costs PMPY were GBP12,012 [USD15,400], (GBP5,339 [USD6,845] inpatient, GBP766 [USD982] outpatient, GBP314 [USD403] GP, GBP5,594 [USD7,172] GP prescribing). In the year of AAV diagnosis (Y0) costs PMPY were GBP28,252 [USD36,220], GBP15,436 [USD19,790] inpatient, GBP1,863 [USD2,388] outpatient, GBP2,407 [USD3,086] GBP8,545 [USD10,956] GP prescribing). Costs in the years post-diagnosis remained higher than pre-diagnosis with a low of GBP22,839 [USD29,281] in Y4. The prescribing costs (GC, methotrexate and azathioprine) were the largest contributor in Y0-Y4 (GBP15,047 [USD19,291] Y1; GBP12,325 [USD15,801] Y4).ConclusionsDiagnosis of AAV is associated with increased healthcare costs, including higher inpatients costs in the year of diagnosis and subsequently higher prescribing costs in the community. Given the incidence (17.2 cases per million) and considering only costs in the year of diagnosis, an additional GBP15.6 million [USD24.6 million] of healthcare resource utilization occurs every year from new diagnoses of AAV. However, this will likely be underestimated due to the lack of secondary care prescribing data in CPRD-HES and prescribing of immunosuppressant treatments in this setting.
PP548 The Design Of Long-term Care Insurance Payment: Base On Pilot Practice In Jingmen
Authors: Du Tiantian , Yang Junting , Li Ying , Zhang Meng , Liu Yuehua 
Published: December 2020

IntroductionWith the aging of population, miniaturization of family size and changes of diseases spectrum, the demand for long-term care of Chinese elderly is increasing, which is challenging the existing long-term care system. China is currently carrying out pilot work for a long-term care insurance system, and Jingmen is one of the pilot cities, however more detailed research on payment is needed. Therefore, this paper draws on case-mixed-adjusted prospective payment system to provide designs for long-term care insurance in pilot cities.MethodsAdopting a case analysis method, this paper focuses on system for payment of Skilled Nursing Facility under Part A of the Medicare program—Patient Driven Payment Model, and discusses the implementation plan of a long-term care insurance in Jingmen City from the perspectives of payment methods, payment grouping and payment standards.ResultsCurrently Jingmen adopts per-diem payment for long-term care insurance, so it is necessary to establish a payment based on population characteristics and demands. So, the patients should be classified into a group for each of the five case-mix adjusted components: physical therapy, occupational therapy, speech therapy, nursing and non-therapy ancillary. In addition, this payment model also includes a “variable per diem adjustment” to account for the changes in patient costs more accurately.ConclusionsThe theoretical system of a long-term care insurance payment method is developed, and a localization plan for case-mixed-adjusted prospective payment system for long-term care insurance is provided. Therefore, Jingmen long-term care insurance payment should adopt “case-mixed adjustment”, strengthening the relationship between individual clinical characteristics and payment.
PP612 Use of Rapid Review Methods In Health Technology Assessment For Central Procurement Decisions: Experience In Ukraine
Authors: Piniazhko Oresta , Rabia Kachveci , Tetyana Dumenko , Leleka Mariya , Masheiko Alona , Serediuk Valeriia 
Published: December 2020

IntroductionThe Health Technology Assessment (HTA) Department of the “State Expert Center of the Ministry of Health of Ukraine” was established in 2019 for conducting assessments and development of recommendations for informing decisions of the Ukrainian Ministry of Health regarding financing of the health technologies. Since 2015, procurement of medicines by the state budget in Ukraine was carried out through international specialized organizations. The central procurement program covers forty-one programs for different disease areas. The list of medicines and medical devices purchased were based of procurement agreements with specialized organizations approved by Cabinet of Ministers Decree of Ukraine № 255 of 13 March 2019.MethodsDescriptive analysis of methodological processes around rapid review methods in HTA used for the procedure of central procurements of medicines. In the process of conducting rapid assessment we use a modern tool based on the HTA Core Model® for Rapid Relative Effectiveness Assessments version (V3.0). HTA Guidance in Ukraine was developed in 2017.ResultsThe list of government programs, for which rapid review methods in HTAhave been conducted, included following diseases: adult and pediatric oncology, juvenile rheumatoid arthritis, hemophilia, and orphan diseases. Reports include an overview of comparative efficacy, effectiveness and safety, as well as analysis of reports from HTA agencies and thresholds, budget impact for informing decisions for development of the central procurement programs in 2019. The HTA Department conducted more than forty reviews in less than 6 months.ConclusionsUse of rapid review methods in HTA in Ukraine for informing decisions for the central procurement programs of medicines is the perspective for rational resource allocation and spending. This increases and improves patients’ access to effective, safe and cost-effective medicines.
Forecasting the final disease size: comparing calibrations of Bertalanffy–Pütter models
Authors: Brunner Norbert , Kühleitner Manfred 
Published: December 2020

Abstract
Using monthly data from the Ebola-outbreak 2013–2016 in West Africa, we compared two calibrations for data fitting, least-squares (SSE) and weighted least-squares (SWSE) with weights reciprocal to the number of new infections. To compare (in hindsight) forecasts for the final disease size (the actual value was observed at month 28 of the outbreak) we fitted Bertalanffy–Pütter growth models to truncated initial data (first 11, 12, …, 28 months). The growth curves identified the epidemic peak at month 10 and the relative errors of the forecasts (asymptotic limits) were below 10%, if 16 or more month were used; for SWSE the relative errors were smaller than for SSE. However, the calibrations differed insofar as for SWSE there were good fitting models that forecasted reasonable upper and lower bounds, while SSE was biased, as the forecasts of good fitting models systematically underestimated the final disease size. Furthermore, for SSE the normal distribution hypothesis of the fit residuals was refuted, while the similar hypothesis for SWSE was not refuted. We therefore recommend considering SWSE for epidemic forecasts.
Biomarkers as diagnostic tools for mycobacterial infections in cattle
Authors: Park Hyun-Eui , Yoo Han Sang 
Published: December 2020

AbstractMycobacterial infections are widely distributed in animals and cause considerable economic losses, especially in livestock animals. Bovine paratuberculosis and bovine tuberculosis, which are representative mycobacterial infections in cattle, are difficult to diagnose using current-generation diagnostics due to their relatively long incubation periods. Thus, alternative diagnostic tools are needed for the detection of mycobacterial infections in cattle. A biomarker is an indicator present in biological fluids that reflects the biological state of an individual during the progression of a specific disease. Therefore, biomarkers are considered a potential diagnostic tool for various diseases. Recently, the number of studies investigating biomarkers as tools for diagnosing mycobacterial infections has increased. In human medicine, many diagnostic biomarkers have been developed and applied in clinical practice. In veterinary medicine, however, many such developments are still in the early stages. In this review, we summarize the current progress in biomarker research related to the development of diagnostic biomarkers for mycobacterial infections in cattle.
Governance by Other Means: Rankings as Regulatory Systems
Authors: Kelley Judith G. , Simmons Beth A. 
Published: December 2020

AbstractThis article takes the challenges of global governance and legitimacy seriously and looks at new ways in which international organizations (IOs) have attempted to ‘govern’ without explicit legal or regulatory directives. Specifically, we explore the growth of global performance indicators as a form of social control that appears to have certain advantages even as states and civil society actors push back against international regulatory authority. This article discusses the ways in which Michael Zürn's diagnosis of governance dilemmas helps to explain the rise of such ranking systems. These play into favored paradigms that give information and market performance greater social acceptance than rules, laws, and directives designed by international organizations. We discuss how and why these schemes can constitute governance systems, and some of the evidence regarding their effects on actors’ behaviors. Zürn's book provides a useful context for understanding the rise and effectiveness of Governance by Other Means: systems that ‘inform’ and provoke competition among states, shaping outcomes without directly legislating performance.
In the midst of theoryandpractice: a foreword
Authors: Peltonen Hannes , Traisbach Knut 
Published: December 2020

AbstractThis foreword frames the Symposium in two ways. It summarises the core themes running through the nine ‘meditations’ inThe Status of Law in World Society. Moreover, it places these themes in the wider context of Kratochwil's critical engagement with how we pursue knowledge of and in the social world and translate this knowledge into action. Ultimately, also his pragmatic approach cannot escape the tensions between theoryandpractice. Instead, we are in the midst of both.
From meditation to action – a research agenda for studying informal global rule-making: remarks on ‘Cosmopolitanism, publicity, and the emergence of a “global administrative law”’
Authors: Westerwinter Oliver 
Published: December 2020

AbstractFriedrich Kratochwil engages critically with the emergence of a global administrative law and its consequences for the democratic legitimacy of global governance. While he makes important contributions to our understanding of global governance, he does not sufficiently discuss the differences in the institutional design of new forms of global law-making and their consequences for the effectiveness and legitimacy of global governance. I elaborate on these limitations and outline a comparative research agenda on the emergence, design, and effectiveness of the diverse arrangements that constitute the complex institutional architecture of contemporary global governance.
The Value of Urban Flood Modeling
Authors: Rosenzweig B. R. , Herreros Cantis P. , Kim Y. , Cohn A. , Grove K. , Brock J. , Yesuf J. , Mistry P. , Welty C. , McPhearson T. , Sauer J. , Chang H. 
Published: December 2020

AbstractFloods are important disturbances to urban socio‐eco‐technical systems and their meteorological drivers are projected to increase through the century due to global climate change. Urban flood models are numerical models that have the capability of representing the features of urban ecosystems and the mechanisms of flooding that impact them. They have the potential to play a critical role in flood risk assessment, operational response, and resilience planning, but existing models remain limited in their capability to represent integrated flooding processes in urban areas and provide the credible quantitative information needed to support risk assessment and resilience practice. Research to advance model development, facilitate intensive watershed monitoring for model parameterization and validation, and support collaboration between researchers and practitioners should be prioritized. This will represent a substantial, expensive effort, but will still be of great value as cities are faced with urgent challenges posed by climate change in coming decades.
Quantifying Nitrous Oxide Cycling Regimes in the Eastern Tropical North Pacific Ocean With Isotopomer Analysis
Authors: Kelly Colette L. , Travis Nicole M. , Baya Pascale A. , Casciotti Karen L. 
Published: December 2020

AbstractNitrous oxide (N2O), a potent greenhouse gas, is produced disproportionately in marine oxygen deficient zones (ODZs). To quantify spatiotemporal variation in N2O cycling in an ODZ, we analyzed N2O concentration and isotopologues along a transect through the eastern tropical North Pacific (ETNP). At several stations along this transect, N2O concentrations reached a near surface maximum that exceeded prior measurements in this region, of up to 226.1 ± 20.5 nM at the coast. Above the σθ = 25.0 kg/m3 isopycnal, Keeling plot analysis revealed two sources to the near‐surface N2O maximum, with different δ15N2Oα and δ15N2Oβ values, but each with a site preference (SP) of 6‰–8‰. Given expected SPs for nitrification and denitrification, each of these sources could be comprised of 17%–26% nitrification (bacterial or archeal), and 74%–83% denitrification (or nitrifier‐denitrification). Below the σθ = 25.0 kg/m3 isopycnal, box model analysis indicated that the observed 46‰–50‰ SPs in the anoxic core of the ODZ cannot be reproduced in a steady state context without an SP for N2O production by denitrification, and may indicate instead a transient net consumption of N2O. Furthermore, time‐dependent model results indicated that while δ15N2Oα and δ18O‐N2O reflect both N2O production and consumption in the anoxic core of the ODZ, δ15N2Oβ predominantly reflects N2O sources. Finally, we infer that the high (N2O) observed at some stations derive from a set of conditions supporting high rates of N2O production that have not been previously encountered in this region.
A Double Disturbed Lunar Plasma Wake
Authors: Rasca A. P. , Fatemi S. , Farrell W. M. , Poppe A. R. , Zheng Y. 
Published: December 2020

AbstractUnder nominal solar wind conditions, a tenuous wake forms downstream of the lunar nightside. However, the lunar plasma environment undergoes a transformation as the Moon passes through the Earth's magnetotail, with hot subsonic plasma causing the wake structure to disappear. We investigate the lunar wake response during a passing coronal mass ejection (CME) on March 8, 2012 while crossing the Earth's magnetotail using both a magnetohydrodynamic (MHD) model of the terrestrial magnetosphere and a three‐dimensional hybrid plasma model of the lunar wake. The CME arrives at 1 AU around 10:30 UT and its impact is first detected inside the geomagnetic tail after 11:10 UT by the Acceleration, Reconnection, Turbulence and Electrodynamics of the Moon's Interaction with the Sun (THEMIS‐ARTEMIS) satellites in lunar orbit. A global magnetospheric MHD simulation using Wind data for upstream conditions with the OpenGGCM model reveals the magnetosheath compression to the lunar position from 11:20–12:00 UT, accompanied by multiple flux rope or plasmoid‐like features developing and propagating tailward. MHD results support plasma changes observed by the THEMIS‐ARTEMIS satellites. Lunar‐scale simulations using the Amitis hybrid code show a short and misaligned plasma wake during the Moon's brief entry into the magnetosheath at 11:20 UT, with plasma expansion into the void being aided by the higher plasma temperatures. Sharply accelerated flow speed and a compressed magnetic field lead to an enhanced electric field in the lunar wake capable of generating sudden changes to the nightside near‐surface electric potential.
Forming Relic Cratered Blocks: Left‐Lateral Shear on Enceladus Inferred From Ice‐Shell Deformation in the Leading Hemisphere
Authors: Leonard E. J. , Yin A. , Pappalardo R. T. 
Published: December 2020

Plain Language SummaryThe southern leading hemisphere of Enceladus contains a unique terrain characterized by blocks of older, cratered material surrounded by areas of younger ridged terrain. In order to, investigate how this terrain formed and its implications for the surface history of Enceladus, we create a structural map of the region, infer a formation mechanism, and apply a simplified analytical model. From the structural map, we draw a comparison to shear zones on Earth where coherent blocks are rotated while the material around them is deformed. This comparison allows us to calculate the heat flux required in the region at the time of formation. We find that the heat flux in the region of the cratered blocks may have been high when the terrain formed, similar to that in the South Polar Terrain of Enceladus today, or involved high stresses.
Identification of Seasonal Streamflow Regimes and Streamflow Drivers for Daily and Peak Flows in Alaska
Authors: Curran Janet H. , Biles Frances E. 
Published: December 2020

AbstractAlaska is among northern high‐latitude regions where accelerated climate change is expected to impact streamflow properties, including seasonality and primary flow drivers. Evaluating changes to streamflow, including flood characteristics, across this large and diverse environment can be improved by identifying the distribution and influence of flow drivers. Using metrics of mean monthly streamflow data from 253 streamgages, seasonal flow regimes were clustered to guide identification of seasonal flow drivers and form hydrologic groups for identification of peak‐flow populations. Nine seasonally distinct subclasses described variability within three classes dominated by (mostly fall) rainfall, (spring) snowmelt, and (summer) high‐elevation melt. The most glacierized basins exclusively grouped into high‐elevation melt subclasses, and less glacierized basins sometimes exhibited seasonal patterns aligned with rainfall‐dominated and snowmelt‐dominated regimes. Peak‐flow populations varied by subclass from dominant rainfall or dominant snowmelt to mixed rainfall–snowmelt or mixed rainfall, snowmelt, and high‐elevation melt. Within subclasses, rainfall generated higher mean peak flows (relative to mean annual flow) than snowmelt or high‐elevation melt. Seasonal flow regimes showed clear but complex associations with basin characteristics, primarily elevation and winter temperature, and with geographic location. These dependencies provided elevation‐based analogies for changes associated with warming and insights for seasonal flow regime prediction and hydrologic region delineation. These results provide a spatially comprehensive perspective on seasonal streamflow drivers across Alaska from historical data and serve as an important historical basis for analysis.
Massiliamide, a cyclic tetrapeptide with potent tyrosinase inhibitory properties from the Gram-negative bacterium Massilia albidiflava DSM 17472T
Authors: Frediansyah Andri , Straetener Jan , Brötz-Oesterhelt Heike , Gross Harald 
Published: December 2020

AbstractA cyclic tetrapeptide, designated massiliamide, was isolated from the liquid culture of the Gram-negative bacterium Massilia albidiflava DSM 17472T. The structure was elucidated through extensive spectroscopic analysis, including HR-MS and 1D and 2D NMR experiments. The absolute configuration was determined using the Marfey´s method. Massiliamide showed potent inhibitory activity towards tyrosinase with an IC50 value of 1.15 µM and no cytotoxicity.