bluuebunny/crossref_metadata_2025_split huggingface dataset:
PP87 Glecaprevir/pibrentasvir (Maviret®) Remains A Cost-effective Treatment For Chronic Hepatitis C Virus Infection After Changes To The Treated Population
Authors: Castles Belinda , Warren Emma , Sharratt Gillian , Arteaga Aitor 
Published: December 2023

IntroductionThe first direct-acting antiviral (DAA) therapies for chronic Hepatitis C virus (HCV) infection were reimbursed via Australia’s Pharmaceutical Benefits Scheme (PBS) in March 2016. This was based on the recommendation from the Pharmaceutical Benefits Advisory Committee (PBAC) that the regimens would be acceptably cost-effective at an incremental cost-effectiveness ratio (ICER) of AUD15,000/quality-adjusted life-year (QALY). Broad access to DAA therapies has been a key strategy in driving a national health goal to eliminate viral hepatitis as a major health threat by 2030. Since the initial PBS listings for DAA therapies and subsequent listings of newer DAA treatments such as Maviret, the demographics and disease characteristics of currently treated patients have markedly changed. The aim of our analysis was to reassess the cost-effectiveness of Maviret, accounting for the changes of the treated population characteristics and retreatment in first-line failures and reinfected individuals.MethodsTo assess the cost-effectiveness six years after initial listing of Maviret, an update was made to the Markov model used to achieve PBS reimbursement for Viekira-Pak® in May 2016. Amendments to the Viekira-Pak model include: changes to baseline age and fibrosis distribution of treated patients, and incorporation of retreatment of first-line failures (those not achieving a sustained virologic response (SVR)) and reinfected individuals. Treatment-related inputs including SVR response rates, adverse events, treatment-related disutility and discontinuations were sourced from pivotal glecaprevir/pibrentasvir clinical trials.ResultsUsing the published price of Maviret, the ICER is above AUD15,000/QALY but well below the commonly used ICER threshold in other chronic diseases (AUD45,000/QALY). When the confidential effective price is used, the ICER is under the AUD15,000/QALY cost-effectiveness threshold set by the PBAC for DAA therapies.ConclusionsDespite substantial changes to the population seeking treatment in Australia since reimbursement in 2016, Maviret remains a cost-effective treatment for chronic HCV infection.
PP98 Phelan-McDermid syndrome: Methodology For Creating A Patient Adapted Version Of A Clinical Practice Guideline
Authors: Dominguez Josune , López-Argumedo Marta , Carmona-Hidalgo Beatriz , Gaasterland Charlotte , Klein Mirthe , Blasco Juan Antonio 
Published: December 2023

IntroductionPhelan-McDermid syndrome (PMS) is a chromosomal disorder caused by the loss of the end of chromosome 22, that is manifested as a neurodevelopmental disorder. Providing an adapted version of a guideline was seen as essential, as currently, there are no such booklets based on an international guideline for PMS patients, families and caregivers. The European Reference Networks (ERN) Guidelines programme results from a call for proposals funded (DG SANTE/2018/B3/030) for the development of Clinical Practice Guidelines (CPG) and Clinical Decision Tools in the area of rare diseases. Based on this European consortium, the purpose of this study is to describe how two Spanish HTA agencies, OSTEBA-BIOEF (Basque Office for Health Technology Assessment) and AETSA (Andalusian Health Quality Assessment Department) methodologically support the ERN-ITHACA (Rare malformation syndromes and rare intellectual and neurodevelopmental disorders) in the development of a comprehensive patient booklet based on a CPG to be used as an adjunct in the management of PMS syndrome that will be published in 2023.MethodsA preliminary booklet was created by HTA agencies using the new European guideline for PMS and a Dutch guideline. The booklet structure is an adaptation based on a European Commission template with the guidance of the methodological Handbook#11.ResultsThrough a comprehensive adaptation, following the PMS guideline and the Handbook #11, a booklet is developed for the PMS patients. Composed by 28 pages in DIN A5 format were introduction, diagnosis, treatment, pregnancy, do’s, supportive care, social networks (including a QR code) and a glossary are included. The selection of a symbol, colors at a chromatic level, a typography and graphical elements as illustrations were created as a corporate identity. Clinical experts and patient representatives that have participated in the creation of the guideline will assess and validate the booklet.ConclusionsCollaboration between agencies, clinicians and patients is critical to obtain evidence-based products adapted to the needs of patients and people involved in their care.
PP121 Assessment Of Heart Rate Characteristics Analysis
Authors: Kim Yoo Jin , Lee Worl Sook 
Published: December 2023

IntroductionThe heart rate characteristics (HRC) analysis is a technique for predicting and monitoring neonatal infectious diseases in infants with a risk for infectious disease, such as sepsis, using the HRC index based on the electrocardiogram (ECG) data transmitted from a HeRO® device connected to an ECG monitor.MethodsThe assessments were performed via a systematic review. Searching five databases (KoreaMed, Ovid-MEDLINE, Ovid-EMBASE, and Cochrane) yielded 284 related studies. Two reviewers independently assessed the quality of these studies, using the Scottish Intercollegiate Guidelines Network checklist and the assessment results were described based on the results of the quality appraisal and level of evidence.ResultsThe safety and effectiveness of the technique were assessed based on eight non-Korean studies (one randomized controlled trial (RCT), five cohort studies, one case-control study, one case series). The four studies that reported area under the curve (AUC) values, the timing of the analysis and AUC values (0.67– 0.75) were inconsistent among the studies. The elevation of the HRC index prior to the diagnosis of an infectious disease was not observed for meningitis or for multiple infectious diseases. In addition, although the group with additional monitoring using the technique had a significantly lower mortality rate, whether the HRC index had a direct impact on the infection prevention activities and the possibility of bias arising from the researchers’ precautionary treatment based on the clinical symptoms and other test results as well as the actual time of disease onset are unknown.ConclusionsTherefore, the committee presented the following recommendations based on the available evidence and expert opinion. HRC analysis is a safe technique for predicting and monitoring neonatal infectious diseases in infants with a risk for infectious disease, such as sepsis, using the HRC index based on the ECG data transmitted from a HeRO® device connected to an ECG monitor; however, further research is needed to determine its effectiveness (Level of evidence C, Technology category II-a).
PP129 Health Technology Assessment Adaptation: Pharyngolaryngeal Biopsies (OLB) For People with Suspected Head and Neck Cancer in the Outpatient Setting
Authors: Bowles Charlotte , Boyce Rebecca , Hopkin Gareth , Prettyjohns Matthew , Hughes Sophie , Hasler Elise , McDermott Katie , Myles Susan 
Published: December 2023

IntroductionIn the UK over 12,400 yearly cases of head and neck cancers are reported (2021). Pharyngolaryngeal biopsies (OLB) may improve the speed of diagnosis and treatment of head and neck cancers under local anesthetic. The Scottish Health Technologies Group (SHTG) published advice on this technology in 2018. Since this, additional evidence has been published to warrant a health technology assessment (HTA) for Wales. The aim of this review was to provide update on the clinical and cost-effectiveness of OLB when compared to undergoing biopsy in an operating theatre (OTB) under general anesthetic to inform decision making in Wales.MethodsA rapid review was undertaken of relevant databases since 2018 of the clinical evidence, health economics and patient perspectives relevant to Wales. Health Technology Wales (HTW) developed a de-novo cost-utility analysis comparing OLB to OTB over a lifetime horizon. Inputs were sourced from the SHTG budget impact analysis, updated with values more relevant to a Welsh setting.ResultsFrom consultation to biopsy procedure, the mean number of days was 1.3 for OLB compared to 17.4 days under OTB (p < 0.05). The mean time from consultation to start of treatment was 27 days for OLB compared to 41.5 days for OTB (p < 0.05). The economic analysis found a resulting ICER of GBP21,011 (EUR23,824.23) in a population with 2,183 at risk patients. As OLB was associated with lower costs (GBP816 per person) (EUR925.26) and fewer quality adjusted life years than OTB (-0.04), this ICER corresponds to OLB being considered a cost-effective diagnostic strategy.ConclusionsHTW guidance was able to recommend use of OLB within the diagnostic pathway for head and neck cancers within Wales. For people with a positive test, OLB is sufficient to confirm a diagnosis but should not be used to rule out a diagnosis due to the potential in reducing the time to diagnosis and treatment in a cost-saving way.
PP147 What Does Real World Evidence (RWE) Offer Health Technology Assessment (HTA) Procedures In Australia?
Authors: Challis Gabrielle , Hill Michelle , Strachan Liesl , King Kate , Shawon Shajedur Rahman , Sotade Oluwadamisola , Jorm Louisa 
Published: December 2023

IntroductionMedical device health technology assessment (HTA) in Australia is largely coordinated by the Medical Services Advisory Committee (MSAC). Its remit to improve the public’s health by deciding where to allocate public healthcare funding, can be enhanced by considering real world evidence (RWE). Existing data sources have limitations that can be addressed through RWE, including coverage of Australian patient populations who may not meet trial eligibility criteria, and long-term follow-up through data linkage and datasets. We partnered with a university to explore what information could be gained from an analysis of linked administrative patient data, with a view to addressing current evidence gaps and/or limitations. The findings can be used as a source of local data to define patient populations, estimate actual costs of care, and enable more comprehensive economic modeling to inform medical device HTA.MethodsThe University-developed New South Wales Cardiovascular Cohort dataset, comprising person-level longitudinal NSW administrative data for all patients admitted to hospital with a cardiovascular diagnosis from 2001 onwards, linked to national Medicare Benefits Schedule and Pharmaceutical Benefits Scheme claims data, was interrogated.ResultsWorking with RWE is resource intensive in terms of time and costs. The potential of these data was revealed as the research progressed. It was possible to continually refine the data analyzed and reported,as well as expand the data requested. Varied expertise is required to accurately analyze the administrative datasets, particularly clinical classification skills and expertise in methods for causal inference using observational data. Findings from this study will enable the refinement of information for MSAC submissions, including identifying the most relevant patient population and reporting comprehensive costs, beyond an admitted hospital setting. The data will enhance engagement with clinicians and refine messaging, for example regarding patient risk factors.ConclusionsRWE enhances Australian HTA applications. Local data, extended periods of time and insights not apparent from a focus on admitted hospital episodes can be revealed. Data can be refined during the process for specificity and applicability.
PP149 Reengineering Of Processes For The Elaboration Of Health Technology Assessment Reports In Catalonia
Authors: Estrada Maria-Dolors , Ruiz-Baena Jessica , Pastells-Peiró Roland , Gallastegui-Calvache Edurne , Godo Anna , Llinàs-Mallol Laura , Martinez-Diaz Pablo , Mestre-Lleixà Berta , Moltó-Puigmartí Carolina , Pérez-Troncoso Daniel , Ramos-Masdeu Laia , Segur-Ferrer Joan , Solís-Díez Gerard , Vivanco-Hidalgo Rosa Maria 
Published: December 2023

IntroductionIn order to increase the value of its services and activities, the Agency for Health Quality and Assessment of Catalonia (AQuAS) has incorporated in its strategic plan the commitment to improve the processes, quality and people, while ensuring transparency, independence, rigor and efficiency following the guidelines of the European Foundation for Quality Management. We aim to present the standardization processes to improve the efficiency in elaborating health technology assessment (HTA) reports at AQuAS.MethodsProcess standardization has been developed in seven stages: (i) definition of scope, objectives and creation of working groups; (ii) mapping and analysis of all ongoing processes to determine whether they needed improvement or were already optimal; (iii) creation of new processes by evaluating the inclusion of automatic tools and their possible digitization; (iv) creation of the process map; (v) communication to the team for its implementation after training; (vi) dissemination on corporate website; (vii) monitoring and evaluation of their impact.ResultsThe creation of AQuAS’ HTA report development process map has involved 14 people over the past two years. After an initial two-day workshop, the team was organized in working groups of two to three people, with regular monitoring and the creation of a specific knowledge management unit led by the AQuAS’ evaluation manager. The process map was configured based on three axes. The strategic axis contains legal frameworks, ethical principles, good practices and methodological frameworks (29 specific for HTA reports). The key axis presents in an integrated way the process and methodology followed from the request of the HTA report to the final product’s dissemination. The support axis includes, among other, the management of 31 requests, information specialist processes (37 searches), training (51 courses) and 6 internal procedures with their corresponding 26 templates and 27 tools.ConclusionsWith a process reengineering approach, HTA reporting has become more efficient. We believe this approach can help other agencies improve their internal processes and subsequently improve team and customer satisfaction.
Oscar DePriest and Black Agency in American Politics, 1928–1934
Authors: TEAGUE GREYSON 
Published: December 2023

AbstractCurrently, much of the literature surrounding Black politics in the 1920s and 1930s understates the role that Black citizens and politicians played in challenging Jim Crow and white supremacy at the national level. Instead, different factors like the “cage” that white Southerners placed on Civil Rights legislation or the influence that New Deal programs had on electoral decisions in the Black community. After realignment, Black Americans and their allies were then able to launch more effective challenges against white supremacy. Although these narratives contain much explanatory power, oftentimes they overlook critical aspects of Black politics during this period that complicate this narrative. Examining the career of Oscar DePriest, the first Black congressman elected in the twentieth Century, this article argues that Black citizens and their representatives were able to explicitly affect politics at the local, state, and federal levels through DePriest’s career prior to realignment.
Variational inequalities arising from credit rating migration with buffer zone
Authors: Chen Xinfu , Liang Jin 
Published: December 2023

AbstractIn Chen and Liang previous work, a model, together with its well-posedness, was established for credit rating migrations with different upgrade and downgrade thresholds (i.e. a buffer zone, also called dead band in engineering). When positive dividends are introduced, the model in Chen and Liang (SIAM Financ. Math.12, 941–966, 2021) may not be well-posed. Here, in this paper, a new model is proposed to include the realistic nonzero dividend scenarios. The key feature of the new model is that partial differential equations in Chen and Liang (SIAM Financ. Math.12, 941–966, 2021) are replaced by variational inequalities, thereby creating a new free boundary, besides the original upgrading and downgrading free boundaries. Well-posedness of the new model, together with a few financially meaningful properties, is established. In particular, it is shown that when time to debt paying deadline is long enough, the underlying dividend paying company is always in high grade rating, that is, only when time to debt paying deadline is within a certain range, there can be seen the phenomenon of credit rating migration.
Different interlocutors, different EFL interactional strategies: A case study of intercultural telecollaborative projects in secondary classrooms
Authors: Chimeva Yordanka , Trenchs-Parera Mireia 
Published: December 2023

AbstractThe purpose of this article is to investigate the interactional strategies that secondary school EFL learners use during telecollaboration with interlocutors from a different cultural and linguistic background. Its novelty lies in the educational level and cultural contexts explored as well as in the goal of examining whether frequency of strategy use may depend on the interlocutor and, if so, what the relevant factors are for such variation. The study focuses on two projects in which 10 participants from one Bulgarian school and 18 partners from two schools in Spain took part in dyadic synchronous videoconferences discussing culture-related topics. Data were collected via video recordings, field observations, semi-structured interviews, and questionnaires. The article presents both descriptive statistics and qualitative analysis of the communicative behavior of three case study students interacting with different telecollaborative partners. We found that the participants demonstrate differences in interactional behavior and utilize strategies with varying frequency depending on their interlocutor. The results also reveal crucial factors in the design of telecollaborative educational projects if learners are to successfully implement skills of discovery and interaction in real time.
Astroecology: bridging the gap between ecology and astrobiology
Authors: Meurer Juliana Campos , Haqq-Misra Jacob , Mendonça Milton de Souza 
Published: December 2023

Abstract
Although astrobiology studies how life functions and evolves, ecology is still largely overlooked in astrobiology research. Here we present an argument for astroecology, a merger of ecology and astrobiology, a self-aware scientific endeavour. Ecology is rarely mentioned in influential documents like the NASA Astrobiology Strategy (2015), and terms such as ‘niche’ can end up being used in a less precise fashion. As ecology deals with sequential levels of organization, we suggest astrobiologically-relevant problems for each of these levels. Organismal ecology provides ecological niche modelling, which can aid in evaluating the probability that Earth-like life would survive in extraterrestrial environments. Population ecology provides a gamut of models on the consequences of dispersal, and if lithopanspermia can be validated as a form of space dispersal for life, then metabiospheres and similar astrobiological models could be developed to understand such complex structure and dynamics. From community ecology, the discussion of habitability should include the concept of true vacant habitats (a misnomer, perhaps better called ‘will-dwells’) and contributions from the blossoming field of microbial ecology. Understanding ecosystems by focusing on abiotic properties is also key to extrapolating from analogue environments on Earth to extraterrestrial ones. Energy sources and their distribution are relevant for ecological gradients, such as the biodiversity latitudinal gradient – would tropics be species-rich in other inhabited planets? Finally, biosphere ecology deals with integration and feedback between living and non-living systems, which can generate stabilized near-optimal planetary conditions (Gaia); but would this work for other inhabited planets? Are there ‘strong’ (like Earth) and ‘weak’ (perhaps like Mars) biospheres? We hope to show ecology can contribute relevant ideas to the interdisciplinary field of astrobiology, helping conceptualize further levels of integration. We encourage new partnerships and for astrobiologists to take ecology into account when studying the origin, evolution and distribution of life in the universe.
Comparing Local Versus Hemispheric Perspectives of Extreme Heat Events
Authors: Van Loon Senne , Thompson David W. J. 
Published: December 2023

AbstractWe compare insights provided by local and large‐scale perspectives of extreme heat events in ERA5 near‐surface temperature data. Heat waves where temperatures exceed four standard deviations about the climatological‐mean are expected less than once a century locally but occur roughly once every 10 days somewhere in the Northern Hemisphere midlatitudes. The high frequency of occurrence indicated by the hemispheric perspective is not well represented by normal statistics because it strongly depends on the shapes of the local temperature distributions. The large effective sample size afforded by the hemispheric perspective provides robust evidence of trends in the frequency of occurrence of extreme heat events integrated over the Northern Hemisphere. It also confirms that trends in heat events summed over the hemisphere can be explained by changes in mean temperature alone.
On the Vertical Structure of Mesoscale Eddies in the Kuroshio‐Oyashio Extension
Authors: Yao H. , Ma C. , Jing Z. , Zhang Z. 
Published: December 2023

AbstractVertical structure of mesoscale eddies is key to the eddy‐induced heat/material transport that further affects the climate and marine ecosystem. This study explores the vertical structure of mesoscale eddies in the Kuroshio‐Oyashio Extension region (KOE) and its underlying dynamics. By applying the hierarchical ascending classification to the observational and reanalysis data sets, we classify mesoscale eddies with three distinct kinds of vertical structures. Each kind of eddies exhibits clear spatial aggregation along a distinct zonal band. Eddies have core depths of 100–300 m in the northern part of the KOE and core depths of 300–500 m and 0–100 m in the southern. The eddy splitting or merging does not introduce new kind of eddy vertical structure but causes large intra‐kind variability. The different kinds of eddy vertical structures can be partially accounted for by the baroclinic instabilities at the eddy generation sites and local adjustment process.