bluuebunny/crossref_metadata_2025_split huggingface dataset:
Historical Perspectives on Exceptional Climatic Years at the Labrador/Nunatsiavut Coast 1780 to 1950
Authors: Ouellet-Bernier Marie-Michèle , de Vernal Anne , Chartier Daniel , Boucher Étienne 
Published: December 2020

AbstractThis interdisciplinary study presents a human perspective on climatic variations by combining documentary, discursive, instrumental, and proxy data. Historical sources were used to characterize climate variations along the coast of Labrador/Nunatsiavut during the 19th century and the first half of the 20th century. Written and early instrumental archives provided original information on the state and perception of climate before the establishment of meteorological stations, which permitted an intra-annual perspective on climatic variations. Written sources depicted the sensitivity of humans to climatic variations. Exceptional seasonal climatic events were extracted from documentary and discursive sources, which were complemented by tree-ring and early instrumental data. From 1780 to 1900, data indicated a succession of relatively warm and cold episodes. Most warm periods were described as stormy and variable. The final part of the studied records showed cold conditions from 1900 to 1925 and warm conditions from 1925 to 1950. Historical sources helped to discriminate a seasonal signal. Mild autumn-winter conditions were recorded since 1910 in relation with positive anomalies of the North Atlantic Oscillation in winter. Relatively warm spring-summer conditions were recorded after 1920, which corresponds to a phase of positive anomaly of the Atlantic Multidecadal Oscillation.
Distribution and abundance of turritelline gastropods (Cerithioidea: Turritellidae) in Hong Kong and the English Channel: implications for a characteristic fossil assemblage
Authors: Shin Caren P. , Allmon Warren D. , Anderson Brendan M. , Kelly Bridget T. , Hiscock Keith , Shin Paul K.S. 
Published: December 2020

AbstractAbundant species are typically also viewed as ecologically dominant, and are frequently used to characterize the communities in which they live. Such characteristic assemblages may also be used as indicators of environmental conditions, such as relative stability. Fossil and modern turritelline gastropods are often the most abundant species in the marine assemblages and communities in which they occur, forming ‘turritelline-dominated assemblages’ (TDAs). We use data on modernTurritella bacillumfrom waters around Hong Kong as a case study to analyse fluctuations in abundance over 25 years. While turritellines were not always dominant in the area surveyed (~1650 km2), populations were notably persistent, and rebound after decline of abundances occurred within ~5 years at some sites. δ18O sclerochronology suggests that individuals were ~1–2 years old. It is also notable thatT. bacillumwas found to be abundant at salinities as low as 10–15 psu, despite the general characterization of turritellines as fully marine. Comparison with data on modernT. communisin the western English Channel corroborates this pattern, as localized sites of high abundance also appear transient. These results have implications for the interpretation of TDAs in the fossil record: they may signify the cumulative result of short-lived, spatially restricted populations, possibly resulting from essentially stochastic larval settlement. This suggests that the palaeoenvironmental setting of fossil TDAs does not always control their occurrence on short temporal scales.
OP270 Why The Haute Autorité de Santé Rejects the Widespread Use Of “Mini-Bypass”/One Anastomosis Gastric Bypass For Obesity In France
Authors: Lafarge Jean-Charles , David Denis-Jean , Carbonneil Cédric 
Published: December 2020

IntroductionOne anastomosis gastric bypass (OAGB) has become a widespread technique over the last few years in France, without any prior assessment and despite existing controversies among bariatric surgeons. An older bypass technique for treating obesity, the Roux-en-Y gastric bypass (RYGB), is available and reimbursed, having been assessed and approved for use in 2005. In 2019, the French Haute Autorité de Santé (HAS) assessed OAGB for the treatment of severe and massive obesity. This assessment, the first in the world, was undertaken for OAGBs carried out with a 200- or 150-centimeter biliopancreatic-limb (BP-limb) length.MethodsA systematic review (SR) of the literature and consultation of a working group consisting of both healthcare professionals (clinician and surgeons) and patients were carried out. The primary aim of our assessment was to determine whether the OAGB technique can replace RYGB. The efficacy and safety profile of OAGB was compared with RYGB in adult patients with massive, severe obesity. Complications and postoperative follow up specific to OAGB were identified.ResultsThe three selected randomized controlled trials (RCTs) could not confirm the superiority or the non-inferiority of OAGB, compared with RYGB, on the selected efficacy endpoints of weight loss, resolution of comorbidities, and quality of life. Adverse events reported for OAGB included severe nutritional complications and bile reflux that could potentially lead to lower esophageal cancer. In one RCT, the frequency of serious adverse events in the OAGB group was almost two times higher than in the RYGB group.ConclusionsHAS considered that OAGB carried out with a longer (200 centimeter) BP-limb is not a validated technique for the surgical treatment of massive, severe obesity. Thus, it cannot be considered an alternative to RYGB. There were insufficient data available on OAGB performed with a 150-centimeter BP-limb. Thus, HAS recommended undertaking a multicenter RCT to assess the efficacy and safety of OAGB. Patients who have already undergone OAGB should receive the same follow up as patients who have received RYGB, including close monitoring for nutritional complications and lower esophageal cancer and an endoscopic examination five years after surgery.
OP279 Monitoring The Effectiveness Of Implementing And Using New Health Technologies In Hospital Practice
Authors: Avdeyev Andrey , Benberin Valeriy , Shanazarov Nasrulla , Kudaibergenova Maigul , Kaptagayeva Aigul , Makalkina Larissa , Hailey David , Akhmedullin Ruslan , Ismailova Leilya , Nurmasheva Arailym 
Published: December 2020

IntroductionAccording to international experience in the field of hospital-based health technology assessment (HB-HTA), most of the implemented new health technologies must undergo a clinical and economic assessment (CEA) of their viability by creating a mini-health technology assessment report. However, HB-HTA should not be limited only to the initial CEA; further monitoring of the effectiveness of implemented new health technologies is necessary.MethodsWe developed a special reporting form for creating a CEA of implemented new health technologies and integrated it into the hospital information system. Indicators of clinical effectiveness are determined individually for each implemented technology. The main indicators of economic effectiveness are financial results (or net profit) and profitability—high-cost and high-tech health technologies have priority for monitoring.ResultsIn order to ensure a more detailed and complete CEA of implemented health technologies, the following measures were proposed: (i) before implementing the technology, determine the key clinical effectiveness criteria for further monitoring for each implemented health technology; (ii) if possible, determine comparative technologies (alternatives or analogs) for conducting comparative CEA of the implemented health technologies; and (iii) carry out a prospective CEA of the implemented health technologies with a view to publishing the results.ConclusionsThe organization of a continuous monitoring process that analyzes the effectiveness and usage of new health technologies in hospital practice will allow assessment of the following: the clinical effectiveness and safety of the implemented technologies in comparison with world data; the economic effectiveness of the technology, including an accurate calculation of the payback period for investments; and the “real” data on the effectiveness of implemented health technologies in comparison with the initial request for implementation.
OP315 An Artificial Intelligence Approach To Improve Medical Diagnosis Of Ischemic Cardiopathy In Patients With Non-Traumatic Chest Pain
Authors: Arri Eunate Arana , de Vicuña-Meléndez Aitor García , Santorcuato Ana , Revuelta-Antizar Ivan , González-Barcina Imanol , Rodríguez-Tejedor Santiago , López-Moreno Borja , Hernándo Carlos Saiz 
Published: December 2020

IntroductionCurrent clinical practice is based on guidelines and local protocols that are informed by clinical evidence. This means that clinical variability is reduced, but can lead to inefficient clinical decision-making and can increase medical errors, decreasing patient's safety. The aim of the EXCON project is to investigate the innovative concept of Intelligent Clinical History (ICH), and to develop functional prototypes of high added-value in healthcare services.MethodsThe innovative EXCON project will take advantage of recent advances in technologies for coding, structuring and semantizing medical information. Thanks to this new structuring, the EXCON platform will be developed. The final users will be health professionals and other decision-makers. Doctors, nurses, epidemiologists and information specialists will be involved in the development and subsequent validation of the platform.ResultsThe EXCON platform identifies profiles of patients with a high probability of ischemic heart disease. In the sample analyzed (n = 4,700), 17 percent of patients were admitted to a cardiology unit with suspected coronary heart disease. Of the patients admitted, 53.7 percent did not have ischemic heart disease at discharge. If we apply the algorithm developed by the EXCON project, 24.8 percent of patients would not have been admitted and did not have ischemic heart disease.ConclusionsIn coming decades, patient management will be impacted by the application of new advanced data analytics tools. This will allow for safer and more efficient clinical management, decrease variability in clinical practice, and improve equity. That is why the development and assessment of these technologies is necessary.
OP447 Feasibility And Validity Of Real-World Data As Evidence Of Effectiveness - Experience From Breast Cancer Care In Scotland
Authors: Gray Ewan , Marti Joachim , Brewster David H , Wyatt Jeremy C , Hall Peter S 
Published: December 2020

IntroductionData from randomized controlled trials (RCTs) are the primary source for health technology assessment (HTA) however these are limited by strict patient inclusion criteria, leading to concerns about whether treatment benefit estimates are accurate for all patients (generalizability). Real-World Data (RWD) have been proposed as a solution however as these are observational data there is additional potential for bias when estimating treatment effectiveness. To maximize the utility of RWD it is useful to consider the whole process of evidence generation and robustly address issues of feasibility and validity.MethodsA series of complementary studies investigated whether population-based routinely collected health data from Scotland are suitable for estimating the effectiveness of chemotherapy for early breast cancer. Firstly, a prognostic score was validated in this population. Secondly, a comparison of RWD and randomized trial effectiveness estimates was made to investigate feasibility and validity of several methods – Propensity Score Matching (PSM), Instrumental variables (IV) and Regression Discontinuity. Finally, effectiveness estimates in trial underrepresented groups were produced.ResultsPSM and IV were feasible and produced results in relatively close agreement with randomized data. Effectiveness estimates in trial underrepresented groups (women over 70 years and women with high comorbidity) were consistent with an approximate one-third reduction in the risk of death from breast cancer. This is equivalent to approximately a 3–4 percentage point difference in all cause mortality over 10 years in these groups.ConclusionsRWD are a feasible for generating estimates of effectiveness of adjuvant chemotherapy in early stage breast cancer. The process of using RWD for this purpose should include careful assessment of data quality and comparison of alternative strategies for causal identification in the context of available randomized data.
OP522 Years Of Potential Productive Life Lost Due To Cancer Premature Mortality In Brazil: 2000 to 2016
Authors: Martins Luís Felipe Leite , De Camargo Cancela Marianna , de Souza Leonardo Borges , Bezerra de Souza Dyego Leandro , Barchuk Anton , Schilithz Arthur Correa , Hanly Paul , Sharp Linda , Pearce Alison , Soerjomataram Isabelle 
Published: December 2020

IntroductionEarly death from cancer is potentially preventable. In developing countries, it is not only a human tragedy but also an economic tragedy. In Latin America and the Caribbean, the estimated number of deaths for people 15–64 years in 2018 was 262,141, with Brazil being the country with the largest number of cases in the region (38.2%). The mortality rate for cancer in Brazil was 68.7/100,000. The analysis of causes impacting premature mortality is an essential function of public health surveillance. This study aims to estimate Potential Productive Life Years of Lost (YPPLL) due to cancer from 2000 to 2016, according to the region, sex and cancer site.MethodsOfficial data from the Brazilian government were used for the period 2000–2016 for the 15–64 age group (economically active population). For each cancer death in working-age people, potential years of productive life lost (YPPLL) were calculated as the difference between pensionable age and age at death from cancer (based on the age group mid-point). The limit considered as pensionable age was 65 years for men and 60 years for women.ResultsThe total of cancer deaths among working-age people was 61,547 in 2000 and increased to 93,551 in 2016. The correspondent YPPLL was 717,883 and 944,565, respectively (increase of 31.6%), mostly coming from males (56.8%). Highest individual YPPLL were observed in the North and Northeast and Midwest, for both sexes. The most substantial changes observed from 2000 to 2016 in total YPPLL were for colorectal cancer, which moved from sixth to the second position nationally.ConclusionsThe YPPLL due to cancer is increasing in Brazil and present different patterns by sex and geographic regions. While in the South and Southeast lung cancer has the highest impact among males, in the North and Northeast most YPPLL come from stomach cancer. Among females, a clear pattern is observed with breast cancer being responsible for most YPPLL excepting in the North, where cervical cancer still having a major impact compared to other tumors.
OP611 Breast Cancer Classification In Histopathological Images Using Artificial Intelligence Assisted Diagnosis Technology: A Meta-Analysis
Authors: Huang Guo , Xue Di 
Published: December 2020

IntroductionArtificial Intelligence (AI) is an important product of the rapid development of computer technology today. It has a far-reaching impact on the development of medical diagnostic technology especially in combination with medical imaging. The aim of this study was to analyze the diagnostic accuracy of AI-assisted diagnosis technology for classification of breast cancer in histopathological images.MethodsA meta-analysis was conducted of published research articles on diagnostic accuracy of AI-assisted diagnosis technology for breast cancer classification between January 2010 and September 2019 in the databases of PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform and China Bio-medicine Database. Statistical analysis was performed with software Meta-Disc 1.4 and Stata 12.0, and the summary receiver operating characteristic (SROC) curve was drawn to evaluate accuracy of the method.ResultsA total of 18 studies with 13,573 breast histopathological images were considered for the analysis. The pooled sensitivity, specificity, diagnostic odds ratio and the area under the curve of the SROC for AI-assisted diagnosis technology for classification of breast cancer respectively, were 0.94 (95% confidence interval [CI]: 0.93–0.85), 0.84 (95% CI: 0.93–0.94), 255.47 (95% CI: 168.33–387.73) and 0.98 (95%CI: 0.96–0.99).ConclusionsSeveral limitations should be considered when interpreting the findings of this meta-analysis. First, despite the extensive literature search, the number of included studies was small; however, the number of images enrolled was satisfactory, thereby decreasing type II error. Second, data acquisition is not comprehensive enough because the language of literature search was limited to Chinese and English. Furthermore, the heterogeneity caused due to different sources of data affected the study results. Despite these limitations, our study suggests AI-assisted diagnosis technology for breast cancer classification in histopathological images is a highly accurate and reliable diagnostic method for clinical application.
PP143 TeCHO+ Program In Gujarat, India: A Protocol For Health Technology Assessment
Authors: Saha Somen , Kotwani Priya , Pandya Apurvakumar , Saxena Deepak , Puwar Tapasvi , Desai Shrey , Dahiya Gaurav , Vaghela Prakash , Patel DM , Patel Chintan , Rawal Devang , Ravi Jayanti 
Published: December 2020

IntroductionThe Health and Family Welfare Department of the Government of Gujarat is implementing a program called Technology for Community Health Operation (TeCHO+) to address the state's priority health issues. This paper details the protocol for using health technology assessment to assess the impact of the TeCHO+ program on data quality, service delivery coverage, rates of morbidity and mortality, and cost effectiveness.MethodsThis mixed-method study will be conducted in five districts. Data will be validated in a phased manner over a three-year period, along with an assessment of key outcome indicators. Additionally, key informant interviews will be conducted and cost data will be gathered.ResultsEarly implementation of TeCHO+ has highlighted mixed impact at an operational level, with gaps in implementation. Despite some gaps in the available evidence, TeCHO+ solutions can significantly improve health service delivery through increased accuracy of data management, high-risk identification, and quality and accessibility of care. However, implementation challenges require even greater efforts to establish comprehensive systems for troubleshooting and corrective measures for improving data quality. Positive experiences encourage grassroots teams for continuing the use of TeCHO+.ConclusionsTeCHO+ is expected to improve service coverage and reduce rates of morbidity and mortality by improving the population's nutritional status, the timeliness of care for high-risk cases, and the non-communicable disease profile of the community.
PP189 Operational Evaluations Of Laminar Flow Cabinets
Authors: Vallejos Benicio Grossling , Rivas Ronald , Galván Pedro 
Published: December 2020

IntroductionLaminar flow cabinets (LFC) are designed to maintain an area free of particles and contaminants that could damage the environment during the preparation of sensitive materials. Several regulations detail the types and frequency of tests that must be performed to ensure the proper functioning of LFCs. The objective of this work was to evaluate the operational and functional status of LFCs.MethodsA descriptive study was carried out in which three tests were selected for evaluating LFCs: the high-efficiency particulate air (HEPA) filter integrity test; the air speed and uniformity test; and the general physical verification test. In selecting these tests, we relied on recommendations established in international standards and the manufacturers’ technical manuals.ResultsDuring testing it was possible to verify the existence of leaks in the periphery of the HEPA filters due to a mismatch in their assembly, as well as a poor seal in the side panels of the cabinet through which particles were entering the work area. It was also discovered that the equipment lighting system (fluorescent tubes) was inadequate.ConclusionsThe use of these tests was very important for detecting certain faults in the equipment, which allowed us to introduce corrective actions to maintain sterile conditions in the cabinet. It is recommended to include these tests in the maintenance regimen of LFCs to pre-empt future failures.
PP277 Analysis Of The Current Situation Of Using Hospital-Based Health Technology Assessment In Kazakhstan
Authors: Avdeyev Andrey , Kaptagayeva Aigul , Benberin Valeriy , Shanazarov Nasrulla , Makalkina Larissa , Hailey David 
Published: December 2020

IntroductionHospital-based health technology assessment (HB-HTA) in Kazakhstan is currently at the initial stage of development. The Medical Center Hospital of the President's Affairs Administration, Nur-Sultan is one of the first examples of implementing and using an HB-HTA system in practice, having included in its structure an HB-HTA unit in 2015.MethodsIn order to evaluate the current situation of using the principles of HB-HTA in Kazakhstan hospitals, a special questionnaire was developed. The questionnaire was sent in the form of an official request on behalf of the Ministry of Health Care. An official response was received from twenty-nine hospitals, of which nine were at the federal level, thirteen at the regional level, and seven at the city level.ResultsOf the twenty-nine hospitals that participated in the survey, only half (52%) indicated that they were aware of the principles of using the HB-HTA system and of the structure and functions of mini-health technology assessment reports (55%). Nonetheless, most hospitals (90%) noted that the results of HB-HTA may affect the final decision on implementing new technologies in practice, and that using the systematic approach of technology assessment is necessary.ConclusionsIn assessing the clinical and economic effectiveness of new health technologies in hospitals, and the viability of implementing them, there is a lack of standardized processes in managerial decision making. The assessment of clinical effectiveness and safety when implementing technologies is carried out mainly by technology applicants or by the main specialists who are responsible for the profile of evaluating technology. This can be regarded as a conflict of interest, since the applicant's wish to introduce the new technology may bias the evaluation process.