bluuebunny/crossref_metadata_2025_split huggingface dataset:
Avaliação do modelo regional climático para a previsão de temperatura no centro de lançamento de Alcântara
Authors: De Souza Alexandre Santos , Correa Cleber Souza , Martin Inácio Malmonge 
Published: September 2021

Este estudo avaliou a previsão intrasazonal da temperatura à superfície (2 m de altura) na região do Centro de Lançamento de Alcântara (CLA) utilizando O Regional Climate Model RegCM4.7 em comparação aos dados de reanálises obtidos do modelo de reanalises globalERA5 do European Centre for Medium-Range Weather Forecasts (ECMWF) para os meses de abril de 2019 (estação chuvosa) e outubro de 2019 (estação seca). Foram realizadas 4 (quatro) membros de simulações de temperatura utilizando o RegCM4.7 em horários sinóticos, os quais foram comparadas com os dados observacionais e de reanálises do ERA5. Os resultados indicaram uma boa previsibilidade para a temperatura média nos dois períodos, diferenças inferiores a 1 °C, com um grau de diferença para abril e praticamente coincidindo em outubro. Para as temperaturas máximas médias o RegCM4.7 superestimou em 2 °C para abril e 4 °C para outubro. Para as temperaturas médias mínimas subestimou em 2 °C tanto para abril como para outubro. Essas avaliações indicaram um bom desempenho geral para a previsão de temperaturas médias, contudo, sabendo-se da tendência de superestimar temperaturas máximas médias e subestimar temperaturas mínimas médias, ainda assim, com as devidas correções, poderá ser utilizado com eficácia para a previsão intrasazonal de temperatura à superfície em apoio ao planejamento de operações de lançamento no CLA.

This study evaluated the intraseasonal surface temperature (2 m height) forecast in the Alcântara Launch Center (ALC) region using the Regional Climate Model RegCM4.7 against reanalysis data obtained from the European Center for Medium-Range Weather global Forecasts (ECMWF) reanalysis model ERA5 for the months of April 2019 (rainy season) and October 2019 (dry season). Four members of temperature simulations were performed using RegCM4.7 at synoptic times, which were compared with observational and reanalysis data from ERA5. The results indicated a good predictability for the average temperature in the two periods, differences below 1 °C, with one degree of difference for April and practically coinciding in October. For average maximum temperatures RegCM4.7 overestimated by 2 °C for April and 4 °C for October. For average minimum temperatures, it was underestimated by 2 °C for both April and October. These evaluations indicated a good overall performance for predicting average temperatures, however, knowing the tendency to overestimate average maximum temperatures and underestimate average minimum temperatures, even so, with the appropriate corrections, it can be used effectively for forecasting intraseasonal surface temperature analysis in support of ALC launch operations planning.
Pengaruh Pertumbuhan Ekonomi, Upah Minimum dan Pendidikan Terhadap Tingkat Pengangguran di Kabupaten dan Kota Provinsi Jawa Timur Tahun 2015-2019
Authors: Hikmah Lailatul , Imamah Nurul , Fattah Abdul 
Published: September 2021

Pengangguran merupakan salah satu masalah yang sering muncul dalam proses pembangunan. Meningkatnya pengangguran bisa menjadi penghambat bagi jalanya pembangunan dan berpotensi menimbulkan masalah-masalah dalam bidang sosial maupun ekonomi.kinerja perekonomian, pendidikan, serta peran pemerintah terutama dalam kebijakan upah minimum juga menjadi salah satu faktor yang berpengaruh terhadap pengangguran. Tujuan penelitian ini adalah mengetahui pengaruh pertumbuhan ekonomi, upah minimum, dan pendidikan terhadap tingkat pengangguran di kabupaten dan kota di Jawa Timur tahun 2015-2019. Hasil dari penelitian yang dilakukan diketahui bahwa pertumbuhan ekonomi, upah minimum dan pendidikan berpengaruh signifikan secara simultan.Sedangn secara parsial diketauhi bahwa pertumbuhan ekonomi dan pendidikan berpengaruh signifikan sedangkan upah tidal berpengaruh signifikan.
A controlabilidade (SCG) como propulsora do alinhamento entre o comportamento planejado e cenário ético-organizacionais
Authors: Dal Vesco Delci Grapegia , Pasquali Ketlyn da Silva 
Published: September 2021

A contabilidade sustenta-se em meio às influências de aspectos econômicos, políticos, culturais e históricos; dessa forma, essa ciência pode contribuir, por meio de controles gerenciais, a fim de conduzi-los a uma conduta ética e identificar aspectos associados a questões comportamentais, haja visto o sistema de controle gerencial relacionar-se às ações comportamentais dos indivíduos, direcionando-os ao cumprimento dos objetivos da instituição. Nessa perspectiva, esse estudo teve por objetivo discutir a validação do instrumento de pesquisa possível de captar a controlabilidade (SCG) como propulsora do alinhamento entre o comportamento planejado e cenário ético-organizacionais. Para o alcance do objetivo, discutiu-se a teoria e utilizou-se da metodologia de pesquisa descritivo-exploratória, quantitativa e transversal. Recorreu-se a um levantamento por meio da aplicabilidade de um instrumento submetido à validade de conteúdo, com o crivo de etapas que consistiram desde análise critica por especialistas até a realização e adequação de pré-testes até o instrumento e o desenho teórico mostrar-se conceitualmente adequado e compreensível aos sujeitos. Foi aplicado em duas etapas a 23 sujeitos em níveis de escolaridade distintos para a avaliação preliminar da consistência interna. Após a validade conceitual fez a validação do desenho teórico por meio da determinação da confiabilidade composta que avaliou a consistência interna, a confiabilidade do indicador individual e a variância média extraída (AVE) que verificou a validade convergente e o critério de Fornell-Larcker foi utilizado para avaliar a validade discriminante, isso permitiu determinar a qualidade da mensuração do modelo. Os resultados indicam que o modelo é capaz de representar e captar a qualidade do modelo de pesquisa. Essa pesquisa poderá contribuir para estudos na linha de pesquisa em ética organizacional e sistemas de controles gerenciais. Para futuras pesquisas recomenda-se a implementação do modelo conceitual para a validação das hipóteses. A pesquisa contribui teórica, empírica e socialmente. Em destaque a contribuição de forma empírica pela proposição de cenários projetistas (simuladores de uma situação hipotética) ético-organizacionais a fim de apresentar aos participantes cenários cuidadosamente construídos e realistas para avaliar as intenções, atitudes e comportamentos, aumentando assim o realismo instrumental, e por neutralizar a percepção pessoal do respondente ao avaliar SCG e ética restrito a sua base comportamental.
Transcatheter Aortic Valve Implantation for Patients with Severe Symptomatic Aortic Stenosis
Authors: Young Calvin , Horton Jennifer 
Published: September 2021

The cost-effectiveness of transcatheter aortic valve implantation (TAVI) compared to surgical aortic valve replacement was examined in patients with severe symptomatic aortic stenosis at high, intermediate, and low surgical risk, and the findings were mixed. When compared to surgical aortic valve replacement, some studies suggest that TAVI is cost-effective (less costly and/or more effective) and some studies suggest that TAVI is not cost-effective.
Factors such as the type of TAVI system used, the cost of treatment-associated expenses (such as post-operative follow-up costs and hospitalization costs), and the characteristics of patients selected for treatment likely impact the cost-effectiveness of TAVI for patients with severe symptomatic aortic stenosis.
Autologous Hematopoietic Stem Cell Transplantation for the Treatment of Multiple Sclerosis
Authors: Basharat Sinwan , Loshak Hannah 
Published: September 2021

Autologous hematopoietic stem cell transplantation is an emerging health technology for treating multiple sclerosis, in particular for relapse-remitting forms of the disease. In 2019, transplant societies in the US and Europe both indicated the procedure may be provided as a standard of care for a subset of people with multiple sclerosis based on age and clinical classification criteria. The Canadian Multiple Sclerosis Working Group indicated in their 2020 treatment optimization recommendations that autologous hematopoietic stem cell transplantation may be considered for younger people (aged 18 to 31) who are early in their treatment course. The procedure is offered in 2 provinces, Alberta and Ontario, as an experimental treatment.
Results from a phase III randomized controlled trial, a systematic review of single-arm trials, and retrospective analyses from European transplant registries provides evidence that the procedure may provide effective disease control for patients who show high disease activity despite receiving disease-modifying therapies. Evidence also shows that the safety profile of the procedure has been improving over the past 25 years.
Although cost-effectiveness studies are not yet available, the one-time procedure may have important economic implications and may have the potential to provide cost-savings to health systems, as it may reduce the need for ongoing disease-modifying therapies that may be required for patients throughout their lives.
At least 3 additional phase III randomized controlled trials are ongoing and aim to provide a stronger evidence base to inform optimal treatment regimens and appropriate eligibility criteria. As results from these studies develop, this horizon scan aims to provide health care stakeholders in Canada with an early overview of the technology and existing evidence, while highlighting considerations related to health equity, the need for multidisciplinary care, and transplant centre infrastructure that would be important if there is to be wider use across Canada should emerging evidence demonstrate value.
Vitamin D Supplementation for the Prevention and/or Treatment of Cardiovascular Disease, Cancer, and Other Conditions in Residents of Long-Term Care Facilities
Authors: Farrell Keeley , Horton Jennifer 
Published: September 2021

The results of 1 systematic review suggest that supplementation with vitamin D may provide some benefit for cancer-related mortality in older adults. It is unclear whether there is a benefit of vitamin D supplementation for all-cause mortality; however, no benefit was found for cardiovascular disease mortality, cardiovascular disease events, or cancer incidence.
There is limited and mixed evidence on the effectiveness of vitamin D supplementation for dementia and mild cognitive impairment in older adults.
The results of 1 systematic review suggest that vitamin D supplementation may provide protection against acute respiratory infections in the overall population; however, this result was not significant in the subgroup of patients older than 65 years.
No evidence-based guidelines were identified regarding vitamin D supplementation for the prevention and/or treatment of cardiovascular disease, cancer, and other conditions in elderly patients residing in long-term care facilities.
Point-of-Care Testing and N-Acetylcysteine for Acute Acetaminophen Overdose
Authors: Tran Khai , Horton Jennifer 
Published: September 2021

Evidence on the clinical utility and cost-effectiveness of point-of-care devices could not be identified.
Two evidence-based guidelines recommend a 2-bag regimen of N-acetylcysteine, consisting of both a loading dose and maintenance dose, administered by IV for patients with acute acetaminophen overdose.
Encorafenib (Braftovi) in Combination With Binimetinib (Mektovi)
Authors: Team Reimbursement 
Published: September 2021

CADTH recommends that Braftovi in combination with Mektovi should be reimbursed by public drug plans for the treatment of unresectable or metastatic melanoma with a BRAF V600 mutation if certain conditions are met.
Braftovi and Mektovi should only be reimbursed if used in combination and prescribed and monitored by clinicians with expertise in diagnosis and management of melanoma who are familiar with the toxicity profile associated with the Braftovi with Mektovi regimen and if it does not cost more than the least costly BRAF inhibitor and MEK inhibitor (BRAFi/MEKi) combination treatment.
Braftovi with Mektovi should only be covered to treat adult patients with advanced or metastatic melanoma who have a BRAF V600 gene mutation that has been identified through a validated test. Patients who have not received previous treatment and patients whose disease has progressed after first-line immunotherapy are eligible for coverage.
Encorafenib (Braftovi)
Authors: Team Reimbursement 
Published: September 2021

CADTH recommends that Braftovi should be reimbursed by public drug plans for the treatment of metastatic colorectal cancer (mCRC) if certain conditions are met.
Braftovi should only be reimbursed when given in combination with cetuximab, prescribed by clinicians with experience in treating colorectal cancer, and the cost of Braftovi is reduced.
Braftovi should only be covered for patients who have BRAF V600E–mutated mCRC, have received at least 1 previous systemic treatment for mCRC, have good performance status, and have adequate organ function. Braftovi should not be reimbursed for patients who have had previous treatment with epidermal growth factor receptor (EGFR) inhibitors or BRAF inhibitors.
Drugs for Rare Diseases: A Review of National and International Health Technology Assessment Agencies and Public Payers’ Decision-Making Processes
Authors: Team Reimbursement Review 
Published: September 2021

Drugs for rare diseases can address significant unmet therapeutic needs for patients living with seriously debilitating and life-threatening conditions; however, the high costs of these drugs can pose challenges for public drug programs and health care systems.
There are challenges with the application of standard health technology assessment methods for the assessment of drugs for rare diseases, including uncertainty with the clinical and economic evidence due to small sample sizes, poorly characterized natural history of disease, uncertain epidemiology, absence of comparative studies, heterogenous phenotypes, and lack of diagnostic accuracy. In addition, there are challenges applying commonly accepted economic benchmarks due to the very high cost of these drugs.
To address these challenges, agencies and public payers have established separate or modified processes and programs to review and make reimbursement recommendations for drugs for rare diseases. There is a lack of consistency across agencies with respect to how drugs for rare diseases are defined and what aspects of the process are modified to address the challenges with these drugs; however, common features include greater acceptance of uncertainty with the clinical and economic evidence and a higher willingness-to-pay threshold.
The majority of health technology assessment agencies have highlighted that drugs for ultra-rare diseases are particularly challenging and warrant special consideration. This includes the creation of completely separate review processes for drugs indicated for use in the treatment of ultra-rare conditions in the UK (both England and Scotland).
The majority of processes for funding drugs for rare diseases by public drug programs included in this report manage the drugs through standard formulary processes involving the use of special authorization to ensure that patients meet the eligibility criteria for the drugs. Those that have specialized formularies have largely focused on providing access to ultra-rare conditions.
Deliberative Appraisal Processes in Health Technology Assessment
Authors: Richardson Marina , Mittmann Nicole , Kaunelis David 
Published: September 2021

Deliberation — the bringing together of individuals with multiple perspectives, experiences, and values to critically examine evidence, share reasons and rationales, and reach a decision on a course of action — occurs at all stages of the health technology assessment (HTA) process.
The focus of this report is on deliberation at the committee appraisal stage of HTA.
The objectives are to review and conceptualize the evidence and key considerations for deliberative processes at the committee appraisal stage of HTA and the available guidance for assessing the quality of the deliberative process at this stage.
National and international practices for deliberative processes at the committee appraisal stage of HTA vary depending on contextual considerations (e.g., type of health technology and the medical condition being treated), the mandate of the HTA organization, health system and funding structures, and societal values.
Each aspect of the deliberative appraisal process should be rooted in the values of the health system and be principled, clear, transparent, purposeful, and reasoned.
Treat and Release for Patients Requiring Emergency Medical Services
Authors: Young Calvin , Horton Jennifer 
Published: September 2021

“Treat and release” and “treat and refer” protocols or practices refer to the onsite treatment of patients by responding emergency medical services personnel that does not involve transporting patients to health care facilities for additional assessment and treatment. The goal of these protocols is to allow patients to be released from care or to be referred directly to non-emergency services by emergency medical services personnel when appropriate, diverting patients from emergency departments.
One health technology assessment that included a relevant randomized controlled trial and economic evaluation and 2 non-randomized studies were identified for inclusion. These studies examined treat and release or treat and refer protocols for treating hypoglycemia and exertional heat stroke, and for attending to older people following a fall.
Overall, the clinical evidence summarized in this report suggests that treat and release protocols are as good as, or better than, usual care (i.e., onsite treatment of immediate medical care followed by transportation to health care facilities). Across most reported outcomes, there were no significant differences between patients who received care using treat and release or treat and refer protocols, and those who received usual care; however, there were some instances where the use of these protocols was associated with improvements in some clinical outcomes, such as patient satisfaction, risk for future falls or fractures, and some measures of repeat access to health care services.
Findings related to the cost-effectiveness of treat and refer protocols were inconclusive because of the limited generalizability of the findings from the included economic evaluation. The economic evaluation estimated that implementing a treat and refer protocol for older patients who experienced a fall did not result in significant changes to health care resource utilization and did not generate improved health-related quality of life compared to usual care.
No evidence-based guidelines regarding the use of treat and release protocols for patients requiring emergency medical services were identified.
Funding and Access to Assistive Technologies: Electronic Aids to Daily Living
Authors: Marchand Dave K. , Nakhuda Humaira , Dolcine Bert , Li Yan , MacDougall Danielle 
Published: September 2021

The overall objectives of this Environmental Scan were to identify and describe the essential components of an electronic aids to daily living (EADL) assistive technology (AT) program, circumscribe barriers and facilitators to equitable access, and identify and describe funding mechanisms. A literature search and stakeholder consultations informed this Environmental Scan.
There is a lack of consensus as to how to define EADLs, who should be eligible for EADLs and how they should be funded, as demonstrated by the heterogenous findings in both the literature and the consultations.
Funding mechanisms and eligibility criteria vary between jurisdictions with limited integration of funding available for EADLs and modified consumer product technologies.
The majority of included publications generally discussed AT devices and service provision, with a lack of availability of information specific to EADL devices.
User-centred approaches that are anticipatory of user needs in AT service delivery provision were noted in the literature as key to facilitating effective AT service delivery.
Barriers to providing equitable access to EADLs include lack of awareness by both health professionals and users of AT devices and services, shortage of trained professional staff to provide individual supports, affordability and access to ATs, and limited user participation in decision-making with professionals in selecting ATs.
Using Health Care Resources Wisely After the COVID-19 Pandemic: Recommendations to Reduce Low-Value Care
Authors: Basharat Sinwan , Born Karen 
Published: September 2021

Low-value tests, treatments, and procedures are an important health care quality problem in Canada and across the world because they provide little clinical benefit, may be harmful for patients, and waste limited resources.
Due to the COVID-19 pandemic, health care systems face increased challenges of limited resources, reduced capacity, and a growing backlog of surgeries and other procedures. The pandemic has compelled health care professionals to make challenging decisions to prioritize health care services while coping with increased demand.
As Canada emerges from the pandemic and health care systems rebuild and begin to address the backlog of delayed or cancelled services, there is an imperative to introduce lasting changes to reduce low-value care and ensure high-quality care is available to everyone.
To help inform efforts for using health care resources wisely and to support decision-making, CADTH and Choosing Wisely Canada convened a 10-member multi-disciplinary panel of clinicians, patient representatives, and health policy experts to review areas of low-value care that can be reduced or limited. This panel reviewed, deliberated, and prioritized 19 recommendations of the more than 400 Choosing Wisely Canada recommendations, the implementation of which can help ensure high-value care after the pandemic.

Examples of the 19 recommendations include:

Avoiding unnecessary transfers for patients in long-term care to hospitals unless there is an urgent medical need.
Limiting blood tests and imaging unless required to answer a specific clinical question or guide treatment.
Not transfusing red blood cells for hemodynamically stable patients in the intensive care unit.
Not delaying palliative care for patients with serious illness because they are pursuing disease-directed treatment.

Moreover, the panel’s discussion highlighted how the selected recommendations can advance key priorities, including improving health equity and access to care, appropriately using limited resources, emphasizing patient-focused care, and addressing challenges the pandemic has presented for long-term care.
Conventional Disease-Modifying Antirheumatic Drugs for the Treatment of Rheumatoid Arthritis
Authors: Hill Shannon , Frey Nina 
Published: September 2021

Nine evidence-based guidelines were identified that recommend the use of conventional synthetic disease-modifying antirheumatic drugs as a first-line therapy for patients with rheumatoid arthritis prior to using biologic disease-modifying antirheumatic drugs or Janus kinase inhibitors.
Methotrexate monotherapy was the most commonly recommended conventional synthetic disease-modifying antirheumatic drug recommended as first-line therapy by the included guidelines.
Eight of the included guidelines recommend combination therapy using multiple conventional synthetic disease-modifying antirheumatic drugs if monotherapy is ineffective and 4 included guidelines recommend the use of glucocorticoids in combination with conventional synthetic disease-modifying antirheumatic drugs.