bluuebunny/crossref_metadata_2025_split huggingface dataset:
PP52 Interim Decision-Making To Address Uncertainty At Early Assessment
Authors: Downes Noreen , Jones Jan , Lee Anne , McGuire Pauline 
Published: December 2019

IntroductionMedicines regulation has become increasingly adaptive to support earlier patient access but the immature clinical data is often challenging for health technology assessment decision-makers due to high levels of uncertainty on long term risks and benefits. Scottish Medicines Consortium (SMC) is therefore exploring new, more adaptive approaches to help manage this challenge.MethodsSMC consulted with key stakeholders including clinicians, the pharmaceutical industry and patient groups on a number of options that would allow the committee to make an interim decision that would be revisited based on later evidence. The ability to collect robust patient level data given data capabilities in National Health Service Scotland (NHSScotland) was an important consideration.ResultsTo ensure that additional evidence would be available to inform a re-assessment, the new approach applies to medicines with a Conditional Marketing Authorisation (MA) from the European Medicines Agency (EMA). This obligates the company to provide specified clinical data to the regulator within a pre-set timeframe. For these medicines, the SMC decision-making committee can accept or not recommend the medicine as at present but can also accept the medicine on an interim basis, if the regulator's mandated Specific Obligations are likely to address the uncertainties in the clinical evidence. When the regulator converts the MA from conditional to standard, the company is required to make a further SMC submission to allow a reassessment and a final decision. The company can also provide additional supplementary post-licensing patient level evidence at reassessment.ConclusionsThis new decision option allows SMC to test an approach to managing uncertainty targeted at a small number of promising new medicines where there is unmet patient need, with the reassurance that a final decision will be supported by additional clinical data.
PP124 Smart Capability Building For Effective Patient Involvement
Authors: Davis Claire , Hughes Sophie , Myles Susan 
Published: December 2019

IntroductionA new Health Technology Assessment (HTA) agency, Health Technology Wales (HTW), has been established to consider the identification, appraisal, and adoption of non-medicine health technologies. This includes, for example, medical devices, surgical procedures and diagnostics. HTW recognizes the importance of effective patient and public involvement (PPI) and is building smart capabilities.MethodsHTW consulted with external organizations to identify the first steps toward effective PPI. Public partners were recruited as a priority before working together on a PPI strategy. Building smart capabilities is key to establishing effective PPI and future-proofing. HTW established a PPI Standing Group to inform HTW throughout its work, including the development of processes and procedures.ResultsKnowledge and resources have been shared and future collaborations identified, including events to encourage new topics from patients and the public. The HTW PPI lead has become a member of key PPI groups, locally and internationally. HTW has recruited public partners who are actively contributing as full members of the Assessment Group and the Appraisal Panel; two members on each Committee. The PPI Standing Group has been established. They have provided advice and co-produced PPI tools for piloting.ConclusionsThe PPI Standing Group concluded that PPI methods and approaches should be tailored for each project based on best practice, and should be piloted to allow them to evolve based on impact evaluation. A PPI strategy or framework would be more useful at a later stage. HTW is committed to identifying and following best practice. Future-proofing and building smart capability will be key to ensuring that HTW develops effective PPI that can be dynamic and responsive to the evolving PPI and HTA landscapes.
PP127 Asthma Patient Value Framework: Lessons From Patient Focus Groups
Authors: Kyriopoulos Dionysios , Sogokon Paul , Teale Christopher , Callan Luke 
Published: December 2019

IntroductionWe sought to examine patients’ perceptions of disease burden and treatment impact, and what patients value over the course of the asthma experience.MethodsPatient focus groups were conducted in three countries, the USA (n = 8 patients), the United Kingdom (n = 7 patients), and Germany (n = 7 patients), to examine aspects of disease burden and patient experience (physical, emotional, clinical, economic, and social). Cause and effect were also explored. Global Initiative for Asthma guidelines were used to screen patients by severity, based on age, sex, time since diagnosis, number of attacks, oral corticosteroid use, and number of therapies needed to control symptoms. Patients classified and ranked aspects of disease burden, including whether it was continuous or episodic in nature, and discussed the interventions used to manage their asthma.ResultsThe overall burden of illness was driven by the combined effect of the disease and treatment burdens. All patients highlighted the negative impact of oral corticosteroids. Patients believed that they were the key actors in their asthma management (not healthcare professionals), and reported the physical and emotional burdens as being the most dominant. Understanding of the terms “attack” or “exacerbation” differed significantly between patients, and did not necessarily match the clinical definitions. Patients considered asthma to be an individualized condition that drives lifestyle changes; disease management drives burden and vice versa. Patients perceived that burden was continuous over time, with specific phases of variable duration—before, during, and after an attack—whereas other stakeholders had a more episodic focus. Patients expected more holistic and personalized approaches for managing their asthma.ConclusionsThe research indicated a misalignment between what patients value and what clinicians, payers, and regulators consider in their assessments and decisions. Greater alignment among the different stakeholders, and more inclusion of patients’ values in decision making, will improve outcomes.
PP155 Demand Side And Supply Side Of Healthcare Supply Chain
Authors: Triulzi Isotta , Di Pasquale Flavia , Trieste Leopoldo , Antonel Andrea , Rossi Ettore , Turchetti Giuseppe 
Published: December 2019

IntroductionThe re-organization of the supply chain (SC) of medicines and medical devices may improve the efficacy and efficiency of the National Health Service (NHS). The aims of this study were to (i) identify the offers provided by private operators to NHS, and (ii) analyze the organizational model of the public healthcare SC system and its criticalities.MethodsTwo online surveys have been designed. Regarding the first survey, managers of private providers associated with the National Association of Commercial and Logistic Operators (ASSORAM) have been interviewed to identify the offers provided to the NHS. The second has been submitted to managers of local health authorities and university hospitals associated to the Italian Association of Hospitals (FIASO) to gather both organizational/managerial information (warehouse capacity, purchasing, registry, security) and qualitative aspects of the SC. Data was collected in 2015.ResultsOn the supply side, 41 providers have been interviewed. More than 70 percent of associates managed mainly hospital products; 67 percent of interviewees delivered less than 30 percent of products to hospitals, and only eight percent delivered about 70 percent of the products to hospitals. The providers’ infrastructure (warehouses, transport, information technology, cold chain, gross domestic product) were adequately regulated and they adopted a wide list of indicators for monitoring performance. Private providers showed high interest in investing in the hospital sector. On the demand side (56 hospitals from 28 regions) the main weaknesses of SC are related to infrastructure, information technology, human resources, a lack of financial resources and inadequate process control.ConclusionsThe study highlighted extremely limited outsourcing in the hospital field to date, weaknesses in the public system and a high interest of private providers in investing in public hospital SC.
PP177 Health Preference Research In Europe: A Review Of Its Use
Authors: Marsh Kevin , Mühlbacher Axel , van Til Janine , Juhnke Christin , Choi Yookyung Christy , Duenas Alejandra , Greiner Wolfgang , Haas Kara , Hawken Natalia , Hiligsmann Mickael , Hockley Kimberley , Ivlev Ilya , Liu Frank , Molsen-David Elizabeth , Oehrlein Elisabeth , Ostermann Jan , Poder Thomas 
Published: December 2019

IntroductionHealth Technology Assessment (HTA) and regulatory decisions involve value judgements. As patient groups, industry, and regulatory agencies conduct more preference studies to quantify these judgements, a better understanding of the methods and practices is needed. Currently, there is no systematic mapping of the use of preference data in Europe. This study aimed to identify (i) the use of quantitative preference data by all relevant HTA bodies and regulatory authorities of the European Union (EU) member states, and (ii) key standards and guidelines.MethodsThis study used a mixed method approach based on a systematic literature review, survey and subsequent interviews with decision makers and experts.ResultsA total of 62 survey responses were received. Many respondents reported that their agencies were responsible for supporting more than one type of decision, with 69.0 percent supporting approval decisions, 64.3 percent supporting reimbursement decisions, 61.9 percent supporting pricing decisions, and 64.2 percent supporting guideline development. Respondents reported that their agencies supported these decisions in multiple ways: 78.6 percent by assessing health technologies; 54.8 percent by appraising health technologies; 45.2 percent by compiling an HTA report; 7.1 percent by conducting primary research; 9.5 percent by conducting secondary research. More than 40 percent (42.9 percent) of agencies had the final say on one of the decisions of interest – approval, reimbursement, or pricing. Of the 31 countries studied, 71 percent (n = 22) used quantitative preference data in their reimbursement and pricing decisions. Of those, 86 percent (n = 19) used general population preferences to inform the estimation of quality-adjusted life years (QALY) as part of cost utility analysis.ConclusionsMuch of this use of preference data can be understood within the standard framework of economic analysis adopted by many HTA agencies; either in in the form of: standard ways to estimate QALYs; ways to broaden the impacts of technologies captured in the QALY; or ways to weigh health gain with other decision-making criteria, such as disease severity or innovativeness.
VP47 Secondary Prevention For CV Disease: Population And Outcomes Using RWD
Authors: Sciattella Paolo , Mennini Francesco 
Published: December 2019

IntroductionThe study goal was to estimate prevalence of population in secondary prevention for Atherosclerotic Cardiovascular Disease (ASCVD) stratified by the pharmacological treatment and related outcomes using Health Information Systems (HIS).MethodsFrom HIS of Marche and Umbria Regions (1.8 millions of inhabitants) which collect information related to hospitalizations, drugs prescriptions, outpatient visits and results of laboratory tests, we identified all patients aged ≤ 80 years with one or more hospitalization with DRG related to Acute Coronary Syndrome, Peripheral Artery Disease, Ischemic Stroke and Transient Ischemic Attack and discharge date between 2011 and 2014 (study period). Pharmacological treatment for each subject was defined selecting all prescriptions of Statins, Ezetimibe and Simvastatin/Ezetimibe, retrieved between the date of the last prescription in the study period and the previous 90 days. We stratified patient in no-treated, treated with low/medium intensity statins (LMS), high-dose statins (HDS) and other Lipid-Lowering Therapies (LLTs). Furthermore, for Umbria region, we selected the last blood levels test of LDL-cholesterol occurred in period 2011-2016. Starting from test date, we defined the pharmacological treatment in the previous 90 days. Subject were stratified based on LDL-C levels in target (<70) and not at-target (≥70) patients.ResultsPopulation in secondary prevention for ASCVD in period 2011-2014 in Marche and Umbria was estimated in 23,043 (prevalence: 4.3 x 1,000 inhabitants), corresponding to more than 800,000 subjects in Italian population. Within treated patients: 51.3% received LMS, 38.1% HDS and 10.6% other LLTs. No-treated patients were 27.8%. LDL-C target was achieved by 34.9% of patients treated with LMS and by 46.1% of patients treated with other LLTs.ConclusionsThe study, based on Italian administrative databases, allowed to estimate the very high risk population in secondary prevention for ASCVD. It highlighted a relevant proportion of no-treated patients, and an high proportion of patients that did not achieve recommended LDL-C target.
Constraints from luminosity-displacement correlation of high-mass X-ray binaries
Authors: Zuo Zhao-yu 
Published: December 2019

AbstractWe have modeled the luminosity-displacement correlation of high-mass X-ray binaries (HMXBs) with an evolutionary population synthesis (EPS) code. Detailed properties including offsets of simulated HMXBs are presented under both common envelope prescriptions usually adopted (i.e., the αCE formalism and the γ algorithm), and several theoretical models describing the natal kicks. We suggest that the distinct observational properties may be used as potential evidence to discriminate between models.
Wind inhibition in HMXBs: the effect of clumping and implications for X-ray luminosity
Authors: Krtička Jiří , Kubát Jiří , Krtičková Iva 
Published: December 2019

AbstractWinds of hot stars are driven by the radiative force due to absorption of light in the lines of heavier elements. Consequently, the mass-loss rate and the wind velocity depend on the ionization state of the wind. As a result of this, there is a feedback between the ionizing X-ray source and the stellar wind in HMXBs powered by wind accretion. We study the influence of the small-scale wind structure (clumping) on this feedback using our NLTE hydrodynamical wind models. We find that clumping weakens the effect of X-ray irradiation. Moreover, we show that the observed X-ray luminosities of HMXBs can not be explained by wind accretion scenario without introducing the X-ray feedback. Taking into account the feedback, the observed and estimated X-ray luminosities nicely agree. We identify two cases of X-ray feedback with low and high X-ray luminosities that can explain the dichotomy between SFXTs and sgXBs.
Emission-line diagnostics of core-collapse supernova host HII regions including interacting binary population
Authors: Xiao Lin , Eldridge J. J. , Galbany L. , Stanway E. 
Published: December 2019

AbstractConsidering as many as 70% of massive stars interact with a binary companion (Sana et al.2012, 2014), we created a new model of the optical nebular emission of HII regions by combining the results of the Binary Population and Spectral Synthesis (BPASS, Eldridge, Stanway et al.2017) code with the photoionization code (CLOUDY). This is discussed more in detail in Xiao et al.2018a. Then we use this model to explore a variety of emission-line diagnostics of CCSN host HII regions from the PMAS/PPAK Integral-field Supernova hosts COmpilation (PISCO, Galbany et al.2018). We determine the age, metallicity and gas parameters for H II regions associated with CCSNe, contrasting the above variables to distribution type II and type Ibc SNe. We find their nebular emission and CCSN progenitor types are largely determined by past and ongoing binary interactions, for example mass loss, mass gain and stellar mergers. However we note these two types SNe have little preference in their host environment metallicity measured by oxygen abundance or in progenitor initial mass, except that at lower metallicities supernovae are more likely to be of type II. The BPASS and nebular emission models are available from bpass.auckland.ac.nz and warwick.ac.uk/bpass.
Multicolour photometry of SS 433
Authors: Koçak D. , İçli T. , Yakut K. 
Published: December 2019

AbstractWe presented long-term optical observations of the high mass X-ray binary system SS 433 (V1343 Aql) with a black hole component. New observations have been obtained by using the 0.6m telescope at the TÜBİTAK National Observatory (TUG) in B, V, R and I filters. We aim to investigate the long-term photometric behavior of the system.
Gamma-ray bursts: A brief survey of the diversity
Authors: Mészáros Attila , Řípa Jakub 
Published: December 2019

AbstractThe separation of the gamma-ray bursts (GRBs) into short/hard and long/soft subclasses, respectively, is well supported both theoretically and observationally. The long ones are coupled to supernovae type Ib/Ic - the short ones are connected to the merging of two neutron stars, where one or even both neutron stars can be substituted by black holes. These short GRBs - as merging binaries - can also serve as the sources of gravitation waves, and are observable as the recently detected macronovae. Since 1998 there are several statistical studies suggesting the existence of more than two subgroups. There can be a subgroup having an intermediate durations; there can be a subgroup with ultra-long durations; the long/soft subgroup itself can be divided into two subclasses with respect to the luminosity of GRBs. The authors with other collaborators provided several statistical studies in this topic. This field of the GRB-diversity is briefly surveyed in this contribution.
Clarifying the population of HMXBs in the Small Magellanic Cloud
Authors: Maravelias Grigoris , Zezas Andreas , Antoniou Vallia , Hatzidimitriou Despina , Haberl Frank 
Published: December 2019

AbstractAlmost all confirmed optical counterparts of HMXBs in the SMC are OB stars with equatorial decretion disks (OBe). These sources emit strongly in Balmer lines and standout when imaged through narrow-band Hα imaging. The lack of secure counterparts for a significant fraction of the HMXBs motivated us to search for more. Using the catalogs for OB/OBe stars (Maravelias et al.2017) and for HMXBs (Haberl & Sturm 2016) we detect 70 optical counterparts (out of 104 covered by our survey). We provide the first identification of the optical counterpart to the source XTEJ0050-731. We verify that 17 previously uncertain optical counterparts are indeed the proper matches. Regarding 52 confirmed HMXBs (known optical counterparts with Hα emission), we detect 39 as OBe and another 13 as OB stars. This allows a direct estimation of the fraction of active OBe stars in HMXBs that show Hα emission at a given epoch to be at least ∼75% of their total HMXB population.
A Global Probabilistic Prediction of Cold Seeps and Associated SEAfloor FLuid Expulsion Anomalies (SEAFLEAs)
Authors: Phrampus Benjamin J. , Lee Taylor R. , Wood Warren T. 
Published: December 2019

AbstractA newly compiled, open‐source database of focused fluid flow sites (e.g., cold seeps) and associated SEAfloor FLuid Expulsion Anomalies (SEAFLEAs) reveals a variable distribution of anomalies across global continental margins. The SEAFLEA distribution is heavily biased toward North American continental margins, with most observations between 100‐ and 200‐m water depth globally, and with an equal distribution between active and passive margins. Using a machine learning classification methodology based on outlier detection algorithms, we predict the probability of encountering a SEAFLEA globally. Results show the highest probability in regions with multiple SEAFLEA observations and parametrically similar regions concentrated on continental margins. In general, geologic, biologic, and chemical predictors are the best predictors of SEAFLEAs. We validate our results using a random and geospatial validation technique that reveals our methods are robust to random variations in observations, but that certain margins, such as the Svalbard Margin, represent parametrically distinct locals. These distinct regions have control over the global distribution of predicted anomalies due to their unique features. Our final prediction on a global 5 × 5 arc minute grid reveals that the average probability of encountering a SEAFLEA is 33.1 ± 17.7% on active margins and 31.2 ± 18.9% on passive margins, showing equal likelihood of encountering fluid expulsion between passive and active margins. Therefore, the lateral compaction on active margins does not increase the likelihood of fluid expulsion relative to the predominantly vertical compaction on passive margins. These results however say nothing of the fluid flux rates or density of expulsion features.
A New Framework to Incorporate High‐Latitude Input for Mesoscale Electrodynamics
Authors: Ozturk D. S. , Meng X. , Verkhoglyadova O. P. , Varney R. H. , Reimer A. S. , Semeter J. L. 
Published: December 2019

AbstractGlobal circulation models (GCMs) for the ionosphere‐thermosphere system traditionally use empirical models to specify upper boundary conditions to represent solar wind and magnetospheric drivers. However, the magnetosphere, ionosphere, and thermosphere systems are coupled on different spatial and temporal scales. During increased levels of geomagnetic activity, these empirical models can't resolve dynamic electric field variability (
500 km,
15 min) because of their statistical nature and/or low spatial and temporal resolutions. This results in an underestimation of energy input to the ionosphere, causing disagreements between model results and observations. This paper introduces a new framework to incorporate dynamic electric fields into GCMs: High‐latitude Input for Mesoscale Electrodynamics (HIME). As a demonstration HIME uses the Poker Flat Incoherent Scatter Radar (PFISR) electric field estimates during an experiment on 2 March 2017. The electric potentials were calculated using the PFISR estimates and merged with a global empirical model of electric potential. A set of high‐latitude electric potential drivers were used to drive the University of Michigan Global Ionosphere Thermosphere Model (GITM) to understand the effects of driving at different scales. Data versus model comparisons for ion temperature, electron temperature, and electron density are provided along the PFISR beams. The ion convection velocities and neutral winds at the PFISR location are compared with the PFISR and Scanning Doppler Imager data. The effects of different multiscale drivers are investigated. The results showed that energy deposited by HIME‐driven simulations was locally larger by approximately an order of magnitude compared to the empirical model‐driven results.