bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nanocrystal–Polymer Particles: Extended Delivery Carriers for Osteoarthritis Treatment
Authors: Maudens Pierre , Seemayer Christian Alexander , Thauvin Cédric , Gabay Cem , Jordan Olivier , Allémann Eric 
Published: January 2018

AbstractAn efficient treatment for osteoarthritis (OA) can benefit from the local release of a high therapeutic dose over an extended period of time. Such a treatment will minimize systemic side effects and avoid the inconvenience of frequent injections. To this aim, nanocrystal–polymer particles (NPPs) are developed by combining the advantages of nanotechnology and microparticles. Nanocrystals are produced by wet milling kartogenin (KGN), which is known to promote chondrogenesis and to foster chondroprotection. A fluorescent biodegradable polymer is synthesized for intravital particle tracking. Polymer microparticles with 320 nm embedded KGN nanocrystals (KGN‐NPPs) show a high drug loading of 31.5% (w/w) and an extended drug release of 62% over 3 months. In vitro, these particles do not alter mitochondrial activity in cultured human OA synoviocytes. In vivo, KGN‐NPPs demonstrate higher bioactivity than a KGN solution in a murine mechanistic OA model based on histological assessment (Osteoarthritis Research Society International score), epiphyseal thickness (microcomputed tomography), OA biomarkers (e.g., vascular endothelial growth factor, Adamts5), and prolonged intra‐articular persistence (fluorescence analysis). This work provides proof‐of‐concept of a novel and innovative extended drug delivery system with the potential to treat human OA.
Experimental study of benzene, toluene, ethylbenzene, and xylene (BTEX) contributions in the air pollution of Tehran, Iran
Authors: Asadi M , Mirmohammadi M 
Published: January 2018

AbstractUrbanization and development are associated with air pollution, including emissions of volatile organic compounds (VOCs) such as benzene, toluene, ethylbenzene, and xylene (BTEX). For this study, we measured and investigated the outdoor concentrations of BTEX in Tehran, Iran. National Institute for Occupational Safety and Health (NIOSH, 1996) methods were applied to measure the concentrations of BTEX in winter and spring of 2015 at 46 air monitoring stations. BETX concentrations were also measured at 19 monitoring stations in June and July of 2003. In 2003, BTEX compound pollutants were observed at greater concentration in the eastern, central, and southern zones of Tehran than in other zones. The average concentrations of the BTEX compounds were 238 parts per billion (ppb), 130 ppb, 69 ppb, and 118 ppb, respectively, for benzene, toluene, ethylbenzene, and xylene. The benzene to toluene (B/T) ratios ranged from 0.8 to 3.2, which indicated that the gasoline used in the city was of poor quality at that time. In 2015, the BTEX concentrations in District 19 (south of Tehran) were higher than in the eastern and central regions, which included restricted “traffic zones” and the extensive development of public transportation systems. In the restricted traffic zones, only public vehicles, such as buses, taxis, ambulances, etc., and other authorized vehicles are allowed to operate. By ameliorating the quality of gasoline, encouraging the use of late model private cars, and development of subway and public transportation during the years between 2003 and 2015, the BTEX concentrations have fallen to levels that comply with Iran's air quality standards. The 2015 measurements revealed that the average concentrations of the BTEX compounds were 5.3, 9.2, 1.5, and 2.6 ppb, respectively. The B/T ratio fluctuated from 0.39 to 0.76, demonstrating the remarkable role that vehicle traffic plays in BTEX pollution.
Minimizing disruptions caused by damming and ensuring the health of downstream ecosystems
Authors: Mata‐Lima Herlander , Alvino‐Borba A. , Vasquez Ivan Y. Salazar , da Silva Jakelline Jard , Incau Bruno Hernandez , Almeida José A. 
Published: January 2018

AbstractIn view of the Brazilian Ten‐Year Energy Expansion Plan 2021, this article presents a discussion on environmental flow (e‐flow). The authors analyze the literature to show the evolution of publications concerning e‐flow releases from the perspective of ecosystems services preservation considering results from different case studies from throughout the world. Finally, two main recommendations are drawn regarding e‐flow are: (1) performing a holistic approach to e‐flow planning, including hydrological, hydraulic, water quality, habitat, and riparian zone considerations; and (2) installing in new structures adequate bottom outlets to allow a range of adjustable e‐flow from reservoir dams to reproduce natural flow variations.
An historical overview and update of wolf–moose interactions in northeastern Minnesota
Authors: Mech L. David , Fieberg John , Barber‐Meyer Shannon 
Published: January 2018

ABSTRACTWolf (Canis lupus) and moose (Alces americanus) populations in northeastern Minnesota, USA, have fluctuated for decades and, based on helicopter counts, moose numbers declined to a new low from 2006 to about 2012. Other steep declines were found in 1991 and 1998 during periods when moose counts were done with fixed‐wing aircraft; these declines also appeared to be real. Winter wolf numbers, monitored in part of the moose range, had been increasing since about 2002 to the highest population in decades in 2009. However, from 2009 to 2016, wolves decreased precipitously, and the moose‐population decline leveled off from 2012 to 2017. Calf:population ratios from 1985 to 1997 and from 2005 to 2016 were inversely related to wolf numbers in the wolf‐study area the previous winter both as wolves increased and decreased in abundance. Similarly, log annual growth rates of moose numbers were negatively correlated with counts of wolves in the prior year. Other factors such as nutrition and parasites, and possibly climate change, likely have been involved in the recent moose decline. However, wolves, as in other areas, appear to have contributed to the decline in the northeastern Minnesota moose population at least in part through predation on calves, supporting earlier reports. Published 2018. This article is a U.S. Government work and is in the public domain in the USA.
OP16 A Patient-centered Value Framework For Healthcare In Hemophilia
Authors: O'Mahony Brian , Dolan Gerard , Nugent Diane , Goodman Clifford 
Published: January 2018

INTRODUCTION:Hemophilia is a rare, inherited bleeding disorder affecting an estimated 400,000 people worldwide (1). Characterized by spontaneous bleeding and long-term, irreversible joint damage, persons with hemophilia are often limited in normal day-to-day activities, including work/school, and require comprehensive care at specialized treatment centers. With replacement therapies extending survival by decades and vastly improving quality of life (QoL), routine prophylaxis is considered the standard-of-care in developed countries. However, due to the cost of replacement factor, access to treatment remains a challenge, and increased scrutiny over funding has been augmented by growing demands on healthcare budgets (2). Thus, the hemophilia community shares a unified goal of objectively defining patient-centered value in hemophilia care.METHODS:Using a three-tiered outcomes hierarchy model initially described by Porter (3), an international, multidisciplinary panel of health economics outcomes researchers and hemophilia experts developed a value framework for decision makers to assess value of various healthcare interventions in hemophilia.RESULTS:The three tiers for assessing value are: (i) Health status achieved/retained; (ii) Process of recovery; and (iii) Sustainability of health. Tier one measures survival, quality of life (QoL), and hemophilia-specific outcomes of bleeding frequency, musculoskeletal complications, and severe bleeds, as well as function/activity (that is, lifestyle impairment). Tier two measures time to initial treatment or recovery and time missed at education/work, as well as disutility of care (that is, inhibitor development, pathogen transmission/infections, orthopedic intervention, and venous access). Tier three measures avoidance of bleeds, maintenance of productive lives, and long-term health, while capturing long-term consequences of insufficient therapy or age-related complications. Applicability of the framework can be demonstrated in areas of healthcare delivery, treatment regimen, and innovation for new therapies.CONCLUSIONS:This value framework represents an initial collaboration with stakeholders to define and organize an array of patient-centric outcomes of importance in hemophilia into a practical tool that can influence treatment and funding decisions in hemophilia care.
OP120 Recommendations From The Newly Developed French National Authority For Health (HAS) Guide On Budget Impact
Authors: Ghabri Salah , Pouillé Anne Isabelle , Autin Erwan , Rumeau-Pichon Catherine , Scemama Olivier , Josselin Jean Michel 
Published: January 2018

INTRODUCTION:Budget impact analysis (BIA) provides short and medium-term estimated effect of new health interventions on budgets and resources. Since January 2016, BIA is required as part of economic dossiers submitted to the French National Authority for Health (HAS) by manufacturers for innovative drugs with an expected 2-year sales revenue above EUR50 million. To this end and in order to promote good practices for conducting BIA, HAS developed a guide for BIA.Our objectives are:
–to present the guide development method and the resulting recommendations;–to compare the HAS BIA guide with existing BIA guides.METHODS:The HAS guide development process rests on findings derived from a systematic literature review on BIA methodology, an HAS retrospective investigation of BIA, public consultation, international expert advice, and approval from the HAS Board and Committee of Health Economic and Public Evaluation (CEESP). Relevant publications were identified through Pubmed and EMBASE and the grey literature (search dates: January 2000 to June 2016).RESULTS:The search strategy captured 144 publications of which 31 were retained (14 methodological papers, 12 national guides and 5 learned society recommendations). On the basis of this result, an extraction template was designed to synthesize the methodological aspects of BIA. Based on its research findings, HAS developed its first BIA guide which includes recommendations on the following main topics: BIA definition, perspective, populations, time horizon, compared scenarios, BIA models, costing, discounting, choice of clinical data, reporting of BIA and uncertainty exploration.Compared to existing BIA guides from other Health Technology Assessment (HTA) agencies, the HAS guide specifically described issues relating to off-label use of drugs, disease-related costs and scenario analysis.CONCLUSIONS:It is expected that the HAS BIA guide will improve the quality, transparency and standardization of BIA in France. It should also enhance the usefulness of BIA as an essential part of a comprehensive economic assessment of health care interventions.
PP064 Registration Of Healthcare Mobile Apps In Brazil
Authors: Bezerra Benefran , Alves Eduardo 
Published: January 2018

INTRODUCTION:The use of applications (app) on mobile phones to health care is a trend. Its applications range from the use as energy calculators, monitoring clinical parameters, as well association with medical devices, personal health records or used to request appointments (1). Thus, it is intended to evaluate the regulatory instruments available in Brazil as to their sufficiency to analyze this new technology.METHODS:Assessment of regulatory instruments for mobile app registration by the Brazillian Health Regulatory Agency (Anvisa) (2). The main variables in the form of Class I and II are: Submission type, Postal Code, Electronic Site, Product code, Classification Rule, Class, Indication of Use / Purpose, Principle of Operation, Platform, Target Audience, Type of Environment, Compatibility, Safety Characteristics, Technical Standards used, Product Origin.RESULTS:Since 2010, the registration of software in Anvisa has been observed. The evaluation of Class I and II software is performed through the registration analysis to be completed by the requesting company. Class III (high risk) software is registered as a medical device embedded software (2).Anvisa's analysis of the software still depends directly on the application for registration of the companies. In this way most of the analyzed software are for use by health professionals and health services.CONCLUSIONS:There are Brazilian regulations for health products with software registration forecast, however its use as a health service still lacks studies mainly with the trends of new information and communication technologies (3).The regulation of mobile applications becomes difficult because applications are freely downloaded in virtual stores, their domains are usually in foreign territory and their use is given directly by the user.
PP103 Characteristics Of Systems Applied To Language Rehabilitation
Authors: Núñez José , Rivas Ronald , Galvan Pedro , Grossling Benicio 
Published: January 2018

INTRODUCTION:In Paraguay the main cause of Traumatic Brain Injury are the accidents in ground transportation. According to data from the Basic Health Indicators 2013 of the Ministry of Public Health and Social Welfare, the regions with the highest rate of accidents in ground transportation are located in the rural zone of the country. Linguistic or communication disorder, attention and memory are the first functions that must be rehabilitated. Is essential to improve the patient's language skills to intervene the other cognitive functions. The objective of this study is to determine if free augmentative communication systems have the characteristics necessary for the cognitive rehabilitation of the language to provide a low cost solution for Traumatic Brain Injury patients in rural areas of the country.METHODS:A list of seven characteristics that contributed to verbal comprehension and expression, reading and writing, logical-verbal reasoning and numeration and calculation were compiled and compared to the Gazespeaker, which is a free augmentative communication system.RESULTS:The Gazespeaker meets the seven characteristics required for language rehabilitation.CONCLUSIONS:For patients with Traumatic Brain Injury are required low cost tools and ease-to-use like the Gazespeaker. It is a good augmentative communication system which satisfies all the characteristics required for a good language rehabilitation. In addition, this free software allows the use of an eye tracking device that can be applied to patients with Traumatic Brain Injury and severe motor deficit.
VP21 Telemedicine As A Tool For Public Health Planning
Authors: Galvan Pedro , Velazquez Miguel , Rivas Ronald , Benitez Gualberto , Barrios Antonio , Hilario Enrique 
Published: January 2018

INTRODUCTION:The telediagnostic systems can achieve relevant epidemiological information from local community needs to global countrywide opportunities. In this context the telemedicine applications should be directed to gain the prevalence of pathologies towards developing better equity in the provision of services (1), and greater concern for the effectiveness and usefulness of health technologies in remote locations without access to specialists (2). This study, has evaluated the results of a telemedicine system in remote public regional and district hospitals in Paraguay (3), in order to show the epidemiological trends in communities of a low income country.METHODS:This prospective study used the results of telemedicine for diagnosis in remote regional and district hospitals to evaluate a as tool to determine the prevalence of pathologies countrywide over three years (2014-16). For these purposes, type and frequency of pathology diagnosed was determined. Sampling was non-probabilistic of convenience.RESULTS:A total of 182,406 telediagnoses were performed in 54 hospitals. The electrocardiography (ECG) diagnosis performed in the 52 hospitals were normal (62.1 percent), unspecified arrhythmias (12.5 percent), sinus bradycardia (10.4 percent), left ventricular hypertrophy (4.1 percent), sinus tachycardia (4.4 percent), right bundle branch block (3.5 percent), ischemia (1.4 percent), atrial fibrillation (1.0 percent) and left bundle branch block (0.6 percent). Teletomography was performed in twelve hospitals, where 54.4 percent corresponded to skull as a consequence of accidents (motorcycles) and cerebrovascular diseases, 13.8 percent chest, 6.2 percent dorsal spine, 5.4 percent abdominal and the rest the other anatomical regions. Regarding electroencephalography (EEG), antecedents of seizure (54.3 percent), evolutionary control (14.0 percent), headache (11.5 percent), cognitive impairment (2.0 percent), attention deficit in children (learning) (2.0 percent), brain death (1.0 percent), abnormal movements (0.8 percent), and sleep disturbances (0.3 percent) were diagnosed. The nineteen ultrasound studies corresponded to prenatal controls.CONCLUSIONS:Despite the results of the telediagnosis implemented in the public health system to determine the prevalence of pathologies countrywide, a widespread use-assessment should be analyzed before deciding a large diffusion as a tool for public health planning.
VP47 Health Technology Assessment Of Intensive Care Ventilators For Pediatric Patients
Authors: Faggiano Francesco , Andellini Martina , Nocchi Federico , Capussotto Carlo , Sabusco Francesca , Derrico Pietro , Ritrovato Matteo 
Published: January 2018

INTRODUCTION:The purpose of the study was to evaluate different type and manufacturers of intensive care ventilators in order to support the healthcare decision-making process about the choice to adopt the best available technology for ventilation of pediatric patient in intensive care units at Bambino Gesù Children's Hospital.METHODS:The technology assessment process was developed by using a new methodology, the Decision-oriented Health Technology Assessment (HTA) (DoHTA), a new implementation of the European Network for Health Technology Assessment (EUnetHTA) CoreModel, integrating the Analytic Hierarchy Process (1). A literature review was carried out to gather evidence on safety and overall effectiveness of different kind of intensive care ventilators, with several ventilation modalities and strategies. The synthesis of scientific evidence, and results of the specific context analysis resulted in the definition of components of the decisional hierarchy structure, consisting in detailed characteristics of the technology's performances covering the aspects on feasibility, safety, efficacy, costs, and organizational and technical characteristics of the technology. A subgroup of these indicators has been included in a checklist form for the evaluation of different type and manufacturers of intensive care ventilators, each of which was tested in three independent runs performed in three different departments. In addition, an economic evaluation was also carried out.RESULTS:Preliminary DoHTA results showed that the domains with the highest impacts within the evaluation are safety and clinical effectiveness (34.8 percent and 25.7 percent, respectively) followed by organizational aspects, technical characteristics of technology and costs and economic evaluation. The final objective is to define the alternatives’ ranking through a comparison between alternative technologies’ performances.CONCLUSIONS:The technology assessment project allowed to identify strengths and limits of the most recent intensive care ventilator’ models in the specific contexts of use by involving all health professionals interested, and eventually identify the best option for the hospital.
VP57 Test-Retest Reliability Analysis Of The Patient Reported Outcomes Burdens And Experiences (PROBE) Study Questionnaire Test-Retest Reliability Analysis Of The PROBE Study Questionnaire
Authors: Skinner Mark , Chai-Adisaksopha Chatree , Curtis Randall , Frick Neil , Matino Davide , Nichol Michael , Noone Declan , O'Mahony Brian , Page David , Stonebraker Jeff , Iorio Alfonso 
Published: January 2018

INTRODUCTION:The Patient Reported Outcomes Burdens and Experiences (PROBE) questionnaire was developed with direct patient involvement in questionnaire design, conduct and analysis using patient-centered outcomes to assess health status in patients with hemophilia (PWH). Phase 1 confirmed robustness of the methodology and feasibility. Phase 2a investigated individual test-retest reliability. Phase 2b will explore population level reproducibility.METHODS:PWH and non-PWH individuals who attended a hemophilia-related workshop were asked to complete the PROBE questionnaire 3 times (paper-based survey on 2 consecutive days and then a web-based version). Test-retest reliability was analyzed using the percentage agreement and Kappa statistic. Kappa coefficient interpretation .81-1.00 almost perfect, .61- .80 substantial; .41- .60 moderate; .21 -.40 fair; .00 -.20, slight; and < .00 poor agreement.RESULTS:Sixty-three participants from twenty-one countries were enrolled with a median age of 50 (range 14–76) years. Of these, thirty (47.6 percent) were PWH or carriers, thirty-three (52.5 percent) were participants with no known bleeding disorders. On general health domain, Kappa coefficients ranged from .69 to .92, indicating substantial to almost perfect agreement, for all items. Reliability of the web-based questionnaire showed moderate to substantial agreement for all except one item. For the hemophilia-related domain, Kappa coefficients ranged from .5-1.0. Of these, five of eleven items were in perfect agreement (Kappa = 1.0). Reliability of web-based questionnaire items were in substantial to almost perfect agreement. For overall health related quality of life, the EuroQol five dimensions questionnaire (EQ-5D) had Kappa coefficients of .62 to .92. Intraclass correlation coefficient of visual analog scale (VAS) was .90 (95 percent Confidence Interval, CI; .83-.94). Test-retest reliability was comparable between hemophilia patients and participants with no known bleed.CONCLUSIONS:Phase 2a demonstrated individual test-retest reliability and suggests PROBE is a reliable tool to assess Patient Reported Outcomes in PWH. The Web-based questionnaire has an acceptable agreement with the standard paper-based version in all domains. PROBE Phase 2b, to demonstrate reproducibility at the population level, is on-going. To date, 1,039 participants have been recruited from 10 countries.