bluuebunny/crossref_metadata_2025_split huggingface dataset:
PP399 Analysis Of Referral Patterns To Specialized Centers In Idiopathic Pulmonary Fibrosis To Define A New Regional Care Pathway
Authors: Di Bidino Rossella , Richeldi Luca , Rogliani Paola , Sebastiani Alfredo , Ricci Alberto , Varone Francesco , Cicchetti Americo 
Published: December 2020

IntroductionIdiopathic pulmonary fibrosis (IPF) is a fatal lung disease. Due to insufficient awareness of the disease, and the lack of specificity of clinical and physiological signs, the diagnosis of IPF is often delayed. In the Lazio Region (Italy) four reference centers manage patients with IPF. The objective of this analysis is to support the definition of a new regional care and therapeutic pathway (Percorso Diagnostico Terapeutico Assistenziale [PDTA]) for IPF to anticipate the moment of diagnosis by reference centers. The delayed referral to specialized centers has clinical consequences both in terms of survival and access to treatments.MethodsA survey collected aggregated evidence on factors associated with referral patterns to specialized centers for IPF. Its content was defined on the basis of a literature search, the experience of involved clinicians, and hospital data sources. The survey considered patients diagnosed with IPF by the network of reference centers from 2014 to 2018. Aggregated data on the pre-diagnosis pathway and evidence on organizational features of each reference center were collected.ResultsPatients with a confirmed diagnosis of IPF increased from 2014 (n = 81) to 2018 (n = 344). A similar trend emerged considering only older patients. Incidence rates reached 11.33 cases per 100,000 residents in 2018. The majority of patients had a diagnosis in time to access to available treatments (87% in 2018). The number of specialists in multidisciplinary teams didn't change in a significant way. GPs, pneumologists, and IPF centers emerged as the pillar of the de-facto PDTA.ConclusionsA new regional care and therapeutic pathway has been proposed to improve treatment of IPF. The first goal is to improve interaction among GPs, pneumologists, and IPF centers along the natural course of the disease. Criteria for referral to IPF centers has been defined (i.e. high-resolution computed tomography) as well as for adoption of a hub-and-spoke approach based on telemedicine.
PP498 Decision Support Tool For Investments In Health Technology Replacement: Experience Of A Public Teaching Hospital In Brazil
Authors: Schlatter Rosane Paixão , Coutinho Ana Paula , Rodrigues João Antonio Paim , Sanches Paulo Roberto Stefani , Ribeiro Luciano , Casella Mauricio Leser , Mahmud Simone Dalla Pozza , Muller André Frota , Tondin Bruno Rodriguez 
Published: December 2020

IntroductionBased on the needs assessment of the medical and non-medical departments, the Investment Committee of the Hospital de Clínicas de Porto Alegre (HCPA), a teaching hospital in Brazil, recommends on which technologies the limited financial resources should be invested. Technology inclusion requests are evaluated by the hospital's technology assessment unit. For technology replacement, we have found models to assess the criticality of medical equipment, but they were insufficient to support the decision, which involves all departments of our hospital. This study aimed to develop an automated tool to support decision making regarding investments in equipment replacement in the hospital.MethodsA working group was set up with professionals from healthcare administration, clinical engineering and research departments. From the hospital's inventory database, we developed the tool using Google SheetsR. We have defined three departments for pilot testing of the tool: hemodynamics, laundry, and basic research. These departments represent the areas of healthcare, support services, and teaching and research in the hospital.ResultsThe criticality of medical equipment is assessed based on the criteria of function, physical risk, impact, remaining equipment life cycle, intensity of use and number of corrective maintenance actions performed. For the equipment in the administrative, support and research areas, the function and physical risk criteria were replaced by the safety and by the risks to the quality of service criteria. The evaluation is carried out by a multidisciplinary team. The tool categorizes the equipment into low, medium and high criticality.ConclusionsThe tool prioritized the equipment based on objective criteria evaluated by the departments’ multidisciplinary team comprising experts who use the equipment in their activities, the department administrator and clinical engineers, and provided transparency regarding the decision-making of the hospital's Investment Committee. In 2019, the limited financial resources were invested only in the replacement of highly critical equipment. We believe the tool can be reproduced in hospitals in low and middle-income countries.
PP502 AQuAS Learnings From Implementing GRADE Approach, Especially The Evidence To Decision Framework And Multidisciplinary Final Consensus
Authors: Giménez Emmanuel , Estrada Maria-Dolors , Garcia Xavier , Castillo Maria Auxiliadora , Varela Leonor , Espallargues Mireia 
Published: December 2020

IntroductionIn recent years, the GRADE system has been adopted internationally to make judgments about evidence and/or recommendations. Recently, the Spanish Network of HTA (RedETS) has promoted among its members the use of the GRADE system, especially the “Evidence to Decision” tool (EtD) where a multidisciplinary panel is involved. The objective is to describe the methodological approach with the first AQuAS experience using this methodology in HTA, focused on inclusion/exclusion of these technologies in the Spanish National Health Service (NHS) portfolio.MethodsThe standard EtD tool was used for clinical and financial decisions. Four multidisciplinary panels were constituted by relevant professionals in clinical practice and, where possible, patients. The four panels discussed on the following four interventions: in two cases, AQuAS prepared preliminary recommendations and participants provided feedback, while in the other two cases, experts received the evidence review and were asked to formulate recommendations. These recommendations were voted on and, in the case of disagreement, adapted and then voted on for a second time. Finally, any discrepancies were noted in the report. Evaluated interventions were: maxillofacial 3D-reconstruction, cataract surgery equipment, non-invasive surgery in obesity and pharmacological treatment in secondary fracture prevention.ResultsEspecially when more than one evaluative question was addressed in the HTA report the EtD and the consensus results required discussion. Consensus was fast but not immediate. Meeting length depended on the number of HTA questions and the amount of original disagreement in the recommendations. The nuances on how to write recommendations also affected the panel duration. All panels were successful in formulating the final recommendations.ConclusionsStandardizing methodologies increased the homogeneity across HTA reports. The GRADE system is a feasible and useful tool because it favors transparency and rigor in drawing up recommendations on the inclusion/exclusion of technologies in the NHS portfolio. The EtD framework complements GRADE tables, which display the relevant evidence in a way that can be used by multidisciplinary groups to reach a consensual recommendation.Although all participants received a short training video, more experience in the use of these methodologies might shorten the duration of the process and facilitate reaching consensus. Some considerations on how to overcome the difficulties and complexity of this methodological approach are discussed.
A cost-effective beam forming structure for global navigation satellite system multipath mitigation and its assessment
Authors: Jia Qiongqiong , Hsu Li-Ta , Xu Bing , Wu Renbiao 
Published: December 2020

AbstractArray antenna beam forming has high potential to improve the performance of the global navigation satellite system (GNSS) in urban areas. However, the widespread application of array antennas for GNSS multipath mitigation is restricted by many factors, such as the complexity of the system, the computation load and conflicts between required performance, cost budget and limited room for the antenna placement. The scope of this work is triplicate. (1) The pre-correlation beam forming structure is first suggested for multipath mitigation to decrease the system complexity. (2) With the pre-correlation structure, the equivalence of adaptive beam forming to quiescent beam forming is revealed. Therefore, the computational load for beam forming is greatly decreased. (3) A theoretical model is established to link the benefits of beam forming with GNSS performance improvement in terms of pseudorange quality. The model can be used by industry to balance the aforementioned restrictions. Numerical results with different array settings are given, and a 2 × 2 rectangle array with $0.4\lambda $ element spacing is suggested as a cost-effective choice in GNSS positioning applications in urban canyon areas.
Temperature and humidity associated with increases in tuberculosis notifications: a time-series study in Hong Kong
Authors: Xu M. , Li Y. , Liu B. , Chen R. , Sheng L. , Yan S. , Chen H. , Hou J. , Yuan L. , Ke L. , Fan M. , Hu P. 
Published: December 2020

Abstract
Previous studies have revealed associations of meteorological factors with tuberculosis (TB) cases. However, few studies have examined their lag effects on TB cases. This study was aimed to analyse nonlinear lag effects of meteorological factors on the number of TB notifications in Hong Kong. Using a 22-year consecutive surveillance data in Hong Kong, we examined the association of monthly average temperature and relative humidity with temporal dynamics of the monthly number of TB notifications using a distributed lag nonlinear models combined with a Poisson regression. The relative risks (RRs) of TB notifications were >1.15 as monthly average temperatures were between 16.3 and 17.3 °C at lagged 13–15 months, reaching the peak risk of 1.18 (95% confidence interval (CI) 1.02–1.35) when it was 16.8 °C at lagged 14 months. The RRs of TB notifications were >1.05 as relative humidities of 60.0–63.6% at lagged 9–11 months expanded to 68.0–71.0% at lagged 12–17 months, reaching the highest risk of 1.06 (95% CI 1.01–1.11) when it was 69.0% at lagged 13 months. The nonlinear and delayed effects of average temperature and relative humidity on TB epidemic were identified, which may provide a practical reference for improving the TB warning system.
Correlation of population mortality of COVID-19 and testing coverage: a comparison among 36 OECD countries
Authors: Wei C. , Lee C. C. , Hsu T. C. , Hsu W. T. , Chan C. C. , Chen S. C. , Chen C. J. 
Published: December 2020

Abstract
Although testing is widely regarded as critical to fighting the COVID-19 pandemic, what measure and level of testing best reflects successful infection control remains unresolved. Our aim was to compare the sensitivity of two testing metrics – population testing number and testing coverage – to population mortality outcomes and identify a benchmark for testing adequacy. We aggregated publicly available data through 12 April on testing and outcomes related to COVID-19 across 36 OECD (Organization for Economic Development) countries and Taiwan. Spearman correlation coefficients were calculated between the aforementioned metrics and following outcome measures: deaths per 1 million people, case fatality rate and case proportion of critical illness. Fractional polynomials were used to generate scatter plots to model the relationship between the testing metrics and outcomes. We found that testing coverage, but not population testing number, was highly correlated with population mortality (rs = −0.79, P = 5.975 × 10−9vs. rs = −0.3, P = 0.05) and case fatality rate (rs = −0.67, P = 9.067 × 10−6vs. rs = −0.21, P = 0.20). A testing coverage threshold of 15–45 signified adequate testing: below 15, testing coverage was associated with exponentially increasing population mortality; above 45, increased testing did not yield significant incremental mortality benefit. Taken together, testing coverage was better than population testing number in explaining country performance and can serve as an early and sensitive indicator of testing adequacy and disease burden.
Species identification and antimicrobial susceptibility testing of non-tuberculous mycobacteria isolated in Chongqing, Southwest China
Authors: Zhang Huizheng , Luo Ming , Zhang Ke , Yang Xin , Hu Kui , Fu Zongqiang , Zhang Liwen , Wu Ping , Wan Dongyong , Han Mei , Wang Xiaoying 
Published: December 2020

Abstract
With the rapid rise in the prevalence of non-tuberculous mycobacteria (NTM) diseases across the world, the microbiological diagnosis of NTM isolates is becoming increasingly important for the diagnosis and treatment of NTM disease. In this study, the clinical presentation, species distribution and drug susceptibility of patients with NTM disease visiting the Chongqing Public Health Medical Centre during March 2016–April 2019 were retrospectively analysed. Among the 146 patients with NTM disease, eight NTM species (complex) were identified. The predominant NTM species in these patients were identified to be Mycobacterium abscessus complex (53, 36.3%), M. intracellulare (38, 26%) and M. fortuitum (17, 11.7%). In addition, two or more species were isolated from 7.5% of the patients. Pulmonary NTM disease (142, 97.3%) showed the highest prevalence among the patients. It was observed that 40.1% of the patients with pulmonary NTM disease had chronic pulmonary obstructive disease and bronchiectasis, while 22.5% had prior tuberculosis. Male patients showed more association with the conditions of cough and haemoptysis than the female patients. In an in vitro antimicrobial susceptibility testing, most of the species showed susceptibility to linezolid, amikacin and clarithromycin, while M. fortuitum exhibited low susceptibility to tobramycin. In conclusion, the prevalence of NTM disease, especially that of the pulmonary NTM disease, is common in Southwest China. Species identification and drug susceptibility testing are thus extremely important to ensure appropriate treatment regimens for patient care and management.
High prevalence of food insecurity, the adverse impact of COVID-19 in Brazilian favela
Authors: Manfrinato Catarina V , Marino Aluízio , Condé Vitória F , Franco Maria do Carmo P , Stedefeldt Elke , Tomita Luciana Y 
Published: December 2020

AbstractObjective:To investigate food insecurity (FI) prevalence in two favelas in Brazil in the early weeks of the social distancing policy, from 27 March 2020 to 1 June 2020.Design:A cross-sectional study using an online questionnaire to elicit information on socio-economic and demographic characteristics, the types of stores visited to buy food, and FI screening. The FI experience was evaluated according to the Brazilian Food Insecurity Scale. Factors associated with moderate or severe FI were investigated using the logistic regression model.Setting:São Paulo city, Brazil.Participants:Totally, 909 householders.Results:Eighty-eight per cent of the households included young women working as cleaners or kitchen assistants and in sales services. One-fifth of the participants were involved in the federal cash transfer programme, called Bolsa Família. There were 92 % households with children. The most frequent experience reported was uncertainty about food acquisition or receiving more (89 %), eating less than one should (64 %), not being able to eat healthy and nutritious food (46 %), and skipping a meal (39 %). Forty-seven per cent of the participants experienced moderate or severe FI. Factors associated with moderate and severe FI were low income, being a Bolsa Família recipient, having a low level of education and living in a household without children.Conclusions:Half of the participants experienced moderate or severe FI, and almost 10 % experienced hunger. Our data suggest that families with children were at a lower risk of moderate to severe FI. It is possible that nationally established social programmes such as Bolsa Família were protecting those families.
Symposium: Authority, legitimacy, and contestation in global governance
Authors: Fioretos Orfeo , Tallberg Jonas 
Published: December 2020

AbstractAs global governance institutions appear increasingly contested by state and non-state actors alike, understanding their origin, operation, and impact is becoming ever more urgent. This symposium uses Michael Zürn's A Theory of Global Governance: Authority, Legitimacy, and Contestation (OUP, 2018) as a springboard to explore the state of global governance theory. A Theory opens new terrain and advances bold and original arguments, including the contention that global governance is itself best understood as a political system. It analyzes a cycle from rising authority beyond the state through the 20th century, to ensuing legitimation problems toward the century's end, to the politicization and contestation triggered by such problems. A book of such ambition inevitably elicits queries within diverse international relations research communities. This symposium features seven articles from diverse traditions in engagement with A Theory's understanding of global contestation, authority, and legitimacy. These are followed by a response from Zürn. An introduction situates A Theory within extant research on global governance, highlights its endogenous theory of global politics, and identifies the stakes of deepening research on the sources of global authority, contestation, and political legitimation.
Sense and sensibility or: remarks on the ‘bounds of (non)sense’
Authors: Peltonen Hannes 
Published: December 2020

AbstractKratochwil's diagnostic approach identifies specific failures in particular, historical contexts in order to prescribe practically realisable remedies under non-ideal conditions. The diagnostic approach compares actual alternatives against each other rather than against some ideal. Yet, the basis for such an identification is unclear. By reinterpreting Kratochwil's approach with the help of Buddha's Four Noble Truths, one can understand Kratochwil's existential worldview and his aims, but the medium Kratochwil uses hinders the attainment of those goals. He tries to communicate in writing something (phronesis) that belongs in the world of experience.
Hope behind the critique of grand narratives of collective salvation: remarks on ‘The power of metaphors and narratives’
Authors: Vasconcelos Vilaça Guilherme 
Published: December 2020

AbstractKratochwil criticizes two important teleological global narratives of universal progress – Luhmannian systems theory andjus cogens– and defends the need for a non-ideal and situated approach to law and politics. Despite the cogency of Kratochwil's analysis, why should we place our hope in his pragmatic program given the complexity of actual decision-making? This paper shows that more needs to be said about the role of hope grounding Kratochwil's account. Which hopes are hopeless, and which warranted? Why should we care and ‘go on’, choosing to be prudential and political rather than focusing on one's inner development or pleasure?
On engagement and distance in social analysis: a reply to my critics
Authors: Kratochwil Friedrich 
Published: December 2020

AbstractThe problem of ‘distance and engagement’ highlights the Weberian paradox that objectivity in the social sciences cannot be based on demonstrative proof; it has to take into account values as the constituents of our ‘interests’. Values should be explicit even if this ‘perspectivity’ cannot satisfy the criteria of necessity and universality. Allegedly, my skeptical approach to ‘social theory’ leaves researchers with insufficient ‘hope’, but one also learns from understanding that something is impossible or conceptually flawed. Moreover, deeper issues of analyzing social action, with existential and moral dimensions, should be considered. These involve our cognitive capacities, experiences, and emotions.
A field day with Fritz: introduction to the Symposium
Authors: Wiener Antje 
Published: December 2020

AbstractThe Status of Law begins with the suspicion ‘that “law” might have become the problem rather than the solution, and this problem requires further analysis’. Given that law is a social construct, Kratochwil invites us to turn to the sites where this construction takes place. To bring the many constitutions and contestations of law to the fore, he conjures theoretical sparring partners to engage in nine meditations. The genius of this Symposium consists of inviting nine colleagues, each engaging with a different meditation, and inviting a tenth colleague to add this introduction as a way to engage the engagement. By doing practice on practice the Symposium does full justice Kratochwil's move towards looking at the practice ‘in the middle of things’. The resulting field day with Fritz is a piece of intellectual mastery compiled by ‘spirited members of the republic of letters’ that carries the reader along on a journey that reveals and addresses Kratochwil's suspicions about the problem with law. In the end, we know more through sharing the problem and partaking in the joy of addressing it.
Bewitching the world: remarks on ‘Inter-disciplinarity, the epistemological ideal of incontrovertible foundations, and the problem of praxis’
Authors: Onuf Nicholas 
Published: December 2020

AbstractKratochwil's magnificent The Status of Law in World Society's first meditation, a philosophical discursus masquerading as a meditation about meditation, addresses how International Law and International Relations deal so differently with their common concerns. Kratochwil treats these concerns with his usual cogency. Yet, critical links are missing. How do we get from speaking as a normative practice to the status of law in today's world? How does language (even more than law) go from an ‘agency-related notion’ to ‘a pervasive force penetrating all social relations’? The bewitchment of the world through language is ontology's greatest mystery, worthy of endless meditation.
Observations of Mirror Mode Structures in the Dawn‐Side Magnetosphere
Authors: Chandler M. O. , Schwartz S. J. , Avanov L. A. , Coffey V. N. , Giles B. L. , Moore T. E. , Pollock C. J. , Burch J. L. , Russell C. T. , Torbert R. B. 
Published: December 2020

AbstractWe present observations of mirror mode structures in the dawn‐side magnetosphere from the Magnetospheric Multiscale Mission. The observations were made during a period of relatively stable northward interplanetary magnetic field conditions. We observed magnetic troughs only with reductions of up to 90% in the magnitude of the local magnetic field. The structures were closely aligned with the local magnetic field and had sizes perpendicular to the magnetic field of the order of 1Re and ion densities up to twice that of the surrounding regions. We used ion, magnetic field, and electric field data to examine the plasma conditions inside and outside of these structures to investigate the stability and evolution of the structures and estimate the magnitude of changes in the ion distributions. Comparing the ion bulk properties to theoretical predictions, we concluded that variations in the parameters with trough depth were due to the spacecraft traversing them at different locations along their length. Our calculations of heating and cooling of the ions at different pitch angles is consistent with theory. We conclude that these troughs were likely long‐lived, bistable structures that originated in the magnetosheath near the nose of the magnetopause and were captured into the magnetosphere by dual‐lobe reconnection.