bluuebunny/crossref_metadata_2025_split huggingface dataset:
PD36 Outcomes Of Centenaries Hospitalized Due To COVID-19 In A Private Healthcare System
Authors: Camelo Ricardo Mesquita , Cruvinel Horta Maria da Glória , Coelho Ribeiro Geraldo Jose , Beltrão Campos Nelson Otávio , de Oliveira Douglas Ribeiro , Carvalho Lélia Maria de Almeida , de Castro Zocrato Karina , Pitchon dos Reis Daniel , Fernandes Mariana Ribeiro , Terenzi Cunha Patrícia Liz , Dusanek Annemarie , Biscione Fernando Martín , Kelles Silvana 
Published: December 2022

IntroductionLife expectancy is increasing worldwide. However, during the COVID-19 pandemic, people 100 years or more (centenaries) were challenged by a potentially fatal disease. We evaluated the outcome of centenaries hospitalized due to COVID-19 in a private healthcare system of Belo Horizonte/Brazil (Unimed-BH).MethodsAdministrative data were collected from the hospital database. Patients were included if they had a severe adult respiratory syndrome due to coronavirus type 2 (SARS-CoV-2) ribonucleic acid identified by quantitative real-time reverse transcriptase polymerase chain reaction (RT-qPCR) or by the International Code of Disease-10th review (ICD-10) hospitalization codes U07.1, B34.2, or B97.2.ResultsFrom March 1 2020 to October 31 2021, 316.4 ± 12.9 centenaries/month were registered. Eighteen hospitalizations due to COVID-19 were identified. Median age was 101.8 years (inter-quartile range [IQR]:100.7,103.0). Most patients were female (83%). There was a median of 6.0 morbidities per patient (IQR:5.3,7.8), range 2-12 morbidities, among 71 possible morbidities. The most described morbidities were systemic arterial hypertension (94%), dementia (61%), and congestive heart failure (61%). Median length of hospitalization was 6.5 days (IQR:3.3,8.0). No patient was dialyzed. Seven (39%) patients died during hospitalization, of whom 3 (17%) were admitted to the Intensive Care Unit and 2 (11%) were oxygenated by invasive mechanical ventilation. No other patients were admitted to the Intensive Care Unit or invasively mechanically ventilated.ConclusionsAlthough the hospitalization rate was low, the mortality rate during hospitalization was high among centenaries. Further research is required to evaluate the actual risks of centenaries to be infected by SARS-CoV-2 and the subsequent outcomes.
PD39 Strategies To Assist People With Disabilities During Health Emergencies, Concerning The COVID-19 – Systematic Review
Authors: Silva Ana Luiza , Ramos Sra Maira , Elias Flávia 
Published: December 2022

IntroductionThe COVID-19 pandemic has affected thousands of people worldwide. The collapse of health systems led to increased difficulties in accessing health care for people with disabilities. The objective was to define strategies to support the implementation of health care for people with disabilities.MethodsThe protocol for the systematic review was registered on PROSPERO (CRD42021266341). Searches were done in seven databases, using MeSH terms related to COVID-19 and disability, in 2021. We included interventions that addressed health, education and social assistance.ResultsTwenty-nine studies were included. A meta-synthesis identified strategies to assist individuals with disabilities: creation of emergency accommodation and protection programs; flexible work arrangements; cash transfer programs; community participation in planning; establishment of support networks; social assistance even in periods of health emergency; teleconsultation services, telerehabilitation and systems that facilitate the use of digital technologies for telemedicine; inclusive guidelines for computer literacy and learning. The main implementation action was comprehensive health care centered on the needs of people with disabilities, with a focus on training community informants, continuing education of health professionals and caregivers for emergency situations, decentralization of care, identification and elimination of barriers to access.ConclusionsEven though the focus was on telehealth and social assistance, achieving comprehensive healthcare requires a range of interventions that together will support the reduction of inequity faced by people with disabilities.
PD43 Estimating Societal Costs Associated With Vision Loss And Delayed Cataract Surgery: The Potential Impact Of The COVID-19 Pandemic
Authors: O’Boyle Derek , Naaman Nabeil , Paynton Emily , Dziekan Kristina 
Published: December 2022

IntroductionCataract surgery is the most commonly performed surgical procedure in the UK (approx. 472,000 annually). The suspension of interventions due to the COVID-19 pandemic, has had a devastating impact on patients’ access to care. In the UK a complete cessation of elective cataract surgery during the crisis has been an unfortunate reality and encompassed a 14 week hiatus to services in the National Health Service. Patients on prolonged waiting lists may experience negative outcomes during the wait period, including vision loss, increased risk of falls, and ultimately, poorer health-related quality of life (HRQoL). The objective of this research was to estimate the potential societal costs associated with vision-loss related to prolonged waiting times for cataract surgery, as a consequence of COVID-19 in the UK.MethodsIn this analysis, we present estimates relating to two cohorts: a hypothetical cohort of 1,000 cataract surgeries and quarterly estimates of cataract surgeries in the UK. Quarterly estimates (n=122,969) were chosen to reflect a suspension of cataract surgeries for 14 weeks during the COVID-19 crisis. UK cataract surgery numbers were attained from EUROSTAT. Estimates for decreasing visual acuity for those waiting for surgery were attained from the literature, as were the cost estimates associated with cataract-related sight-loss, which were made up of direct, indirect and intangible costs. Five scenarios (at 20% intervals) were simulated for the cost estimates, assuming from 20 percent to 100 percent clearing of waiting lists.ResultsFor cohort 1 (1,000 patients), the societal costs associated patients remaining on waiting list for one year, ranged between GBP 237,765 (EUR 279,533) (20% of patients remain untreated) to GBP 1.18m (EUR 1.39m) (100% remain untreated). For cohort 2 (n=122,969) cost estimates are in the region of GBP 29.23m to GBP 146.18m (EUR 34.36m to EUR 171.73m). Estimates consist of direct (15.6%), indirect (28.7%) and intangible costs (55.6%).ConclusionsCataract surgery is a sight saving procedure and its impact on HRQoL is overwhelmingly positive. Prolonged waiting times for cataract patients due to COVID-19 is likely to be associated with significant societal costs.
PD45 Paying For Digital Health: What Evidence Is Needed?
Authors: Burrell Anita , Zah Vlad , Zrubka Zsombor , Asche Carl 
Published: December 2022

IntroductionDigital transformation has been promoted by the World Health Organization (WHO), Food and Drug Administration (FDA) and the European Commission (EC) to help improve health outcomes. To ensure sustainability, digital health interventions (DHI) require funding by payers. Evidence-informed decision and policy making requires an assessment of the impact on relevant outcomes vs current healthcare practice. Various national and international organizations are involved in creating or guiding the development of standards for the evidence required for digital technologies.MethodsWe undertook an intensive individual investigation of the websites of leading payer and health technology assessment (HTA) bodies in France, UK, Germany, Belgium, Austria, Finland, Canada, Australia, and the USA to identify new frameworks and any updated information. As the objective focused on evaluation frameworks which were used across DHIs by a particular payer to support pricing and reimbursement decisions, we excluded individual case studies where DHIs had been assessed, regulatory frameworks for approval of DHIs and frameworks which assessed feasibility or applicability of a DHI since these were not directly influencing the decision for funding.ResultsWe found six frameworks which directly address digital health interventions for the purposes of pricing and reimbursement: NICE Evidence Standards, FinCCHTA, MSAC, Germany BfArM, Belgium RIZIV and France HAS. The context for the framework and the requirements were compared on parameters including those normally found in HTA and for criteria related to digital technologies. The parameters included varied considerably across the frameworks as did the level of evidence expected to be available for the assessment. In some cases, these related to the level of risk or impact of the intended DHI.ConclusionsWhile DHIs are increasingly used in health, HTA is struggling to adapt to assess these technologies. Due to the multidisciplinary nature of digital health (combination of health care and technology), and the speed and rate of change of innovations in this area, an approach based upon the risk assessment posed by the technology seems reasonable. In this way the level of effort can be tailored to those interventions which seek to influence care or predict outcomes rather than those which are tailored to increased awareness of the patient about their condition.
PD50 Value Of Healthcare Journey For Patients With Rare Diseases In The Brazilian Public Healthcare System: Methods And Preliminary Results
Authors: Gargano Ludmila , Salvador Bianca Caroline , Santana-da-Silva Luiz Carlos , Ogata Gabriel , Nita Marcelo Eidi , Félix Têmis Maria ,   JAV-Raras Study Group
Published: December 2022

IntroductionImplementing value-based healthcare (VBHC) services requires the ability to assess and integrate evolution of patient-centered outcomes (PCO), clinical/epidemiological data and resource consumption. Aligned with Porter’s framework of value, the “Value of Healthcare Journey for Patients With Rare Diseases Project” (JAV-RARAS) was implemented to evaluate the value of the healthcare journey of patients with rare diseases (RD) in the Brazilian Public Healthcare System (SUS). The goal of this project is to identify the value (clinical outcomes and costs) associated with the management of RD in the SUS.MethodsPatients diagnosed with eight pre-defined RD under active clinical follow-up in SUS medical centers were invited. Retrospective data on diagnosis and assistance carried out after diagnosis were collected from medical records. Prospective follow-up of one year will be collected through validated clinical questionnaires on three visits, with an average interval of 6 months. Clinical outcomes include exams and disease-specific features, quality of life, productivity loss, treatment adherence and satisfaction. Total cost of patient’s journey in each medical center will be assessed through Time-Driven Activity-Based Costing method. All data collection is being carried out through the Think Patient Value (TPValue®), a computerized management support system, based on Porter’s paradigm of value.ResultsThirty-five medical centers currently assisting patients with RD were enrolled, representing all macro-regions in Brazil: Midwest (n=4), North (n=5), Northeast (n=10), South (n=5) and Southeast (n=11). Recruitment started in March, and until November 2021, 28 centers had reported retrospective data of at least one RD. So far, JAV-RARAS recruited patients with osteogenesis imperfecta (number of patients=106), phenylketonuria (n=52), familial amyloidotic polyneuropathy (n=32), classical homocystinuria (n=25), Prader–Willi syndrome (n=30), acromegaly (n=33), hereditary angioedema associated with C1 esterase-inhibitor deficiency (n=42) and mucopolysaccharidosis type-II (n=17).ConclusionsFuture results of JAV-Raras real-world evidence study will bring PCO and costs according to Porter’s Value, bringing insights for decision-makers in SUS. This study was funded by National Council for Scientific and Technological Development –CNPq and Ministry of Health of Brazil –MoH.
PD51 Patient Perspective: A Preliminary Analysis Of The First Year Of The Patient Involvement in CONITEC Meetings
Authors: Portugal Clarice , de Souza Andrea Brigida , Prates Adriana , Almeida Andrija , de Pina Viana Bruna Cabral , Losco Luiza , Canuto Vania 
Published: December 2022

IntroductionThe Patient Perspective is an initiative to include the testimonials of patients or their representatives at the time of the initial recommendation of health technology assessment (HTA) processes developed by the National Committee for Health Technology Incorporation in the Brazilian Public Health System (CONITEC). It allows these actors to be involved prior to the public consultation. This action is articulated with a framework of strategies to encourage patient and public involvement (PPI) in HTA in Brazilian Public Health System (SUS). This paper aims to analyze the first year of its implementation.MethodsThis is a descriptive study, based on document analysis (minutes of meetings, technical and society reports, videos of CONITEC meetings, tables for internal control, etc.) and systematic observation of the activities related to the initiative. Field notes were taken and their contents were coded, following content analysis criteria.ResultsFrom December 2020 to November 2021, 1,052 subscribers were registered in 75 public calls, which resulted in the participation of 42 people. The testimonials presented information about the illness experience, its impact on quality of life, use of technologies, and difficulties of accessing and adherence to treatment. The patient perspective has been useful to give visibility to specific dimensions of experiences regarding not only the health conditions but SUS as well. Furthermore, some testimonials produced tensions and repercussions about HTA processes, such as the consideration of aspects or technologies not covered in the clinical studies and thus the HTA, as well as the need of reviewing some results of the technical report.ConclusionsThe patient perspective has had the support of the target audience. Additionally, it has been successful in including various types of participants and different aspects of the experience with the health condition and/or the technologies under evaluation. In general, it has been possible to observe the diversification of modes of PPI and institutional learning towards the improvement of HTA in SUS.
PD61 What Are The Drivers Of Transitioning From Fee-For-Service To Value-Based Payment Models In The Brazilian Private Healthcare System?
Authors: Bernz Iara Muller , Pedro Gabriel Ogata , Tanaka Marcos , Tanaka Sandra , Nita Marcelo Eidi 
Published: December 2022

IntroductionThe Brazilian National Agency for private healthcare system (ANS) makes the regulation for private healthcare system in Brazil. ANS, since 2019, is running the pilot value-based new payment models project. In total, 13 projects were selected by ANS. This research aims to identify the key drivers for moving from fee for service (FFS) to value-based payment models in the Brazilian healthcare private system.MethodsWe interviewed managers of private healthcare plans (13 in total) participating in the Value-Based Payment Models run by ANS. Data were collected through semi-structured interviews during 2021. Twelve managers were invited to the interview and eight accepted the invitation. The key questions were: “Why are healthcare providers transitioning from the fee for service model to value-based models?” and “What are your motivations to participate in the ANS project?” For data analysis, Bardin’s content analysis was chosen. Data validation was performed using the debriefing technique.ResultsThe main reasons for transitioning from FFS to value-based models were related to weaknesses of FFS (58%), strengths of the value-based payment model (14%) and sector needs (14%). Fee-for-service weaknesses are related to financial impacts – including waste and unsustainability (55%), and lack of transparency – including lack of trust and conflict of interest (28%). Strengths of the value-based payment model were related to financial benefits (100%), in other words, greater return on investment. The key unmet needs of the sector are related to improvement of the financial status - including lower costs and less waste (71%), and improvement of care delivery quality (29%). Continuity was reported as a benefit of FFS, according to 43 percent of respondents.ConclusionsOur results suggest that financial motivations are the main reason to transition from fee-for-service to value-based models.
PD63 Impact Of Parallel Submission On The Rollout Time and Health-Technology-Assessment Recommendation Of New-Active-Substances
Authors: Sola-Barrado Belen , Wang Tina , McAuslane Neil 
Published: December 2022

IntroductionAustralia and Canada have parallel submission processes that allow companies to submit their dossier to the respective Health-Technology-Assessment (HTA) body before the market authorization is issued, aiming to provide timelier access to drugs. The objective of this study is to investigate the associations of parallel submissions with the rollout times and HTA recommendations of new active substances (NASs).MethodsPublic data from 208 HTA appraisals were collected from the Pharmaceutical Benefits Advisory Committee (PBAC) from Australia and the Canadian Agency for Drugs and Technology in Health (CADTH) for NASs obtaining regulatory approval between 2012 and 2020. We implemented multivariable logistic and linear regression models allowing for type of submission (parallel or sequential) and jurisdiction (Australia and Canada) to examine associations with first HTA recommendation (positive and positive with restrictions vs negative) and rollout time (regulatory submission to HTA recommendation), respectively.ResultsA total of 121 appraisals followed a parallel submission. The therapeutic products that most used a parallel submission were antineoplastic agents (Anatomical Therapeutic Chemical Code=L;47.11%). A similar proportion of chemical and biotechnological products followed parallel submissions.Multivariable linear regression showed that parallel submission presented 14-months decrease in rollout time when compared to sequential (p<0.001). Regarding jurisdictions, longer rollout times were seen for Canada when compared to Australia (β:4.0, p-value=0.024).Parallel submission showed no association with HTA recommendation. Canada had higher odds of receiving a positive recommendation (Odds Ratio:4.84, 95% confidence interval:2.63-9.18) when compared with Australia (p<0.001).ConclusionsAntineoplastic agents were the main products using parallel submissions. Appraisals following a parallel submission showed a considerably faster rollout time than those following the traditional sequential submission, illustrating the advantage of this approach for dossier submission. The submission type did not have an impact on the HTA recommendation, indicating that although quicker, the HTA decision was not affected. Canada has a more restrictive criteria regarding the timing of dossier submission compared to Australia, which may lead to disparities in their rollout time.
Childhood sexual abuse and pervasive problems across multiple life domains: Findings from a five-decade study
Authors: Guiney Hayley , Caspi Avshalom , Ambler Antony , Belsky Jay , Kokaua Jesse , Broadbent Jonathan , Cheyne Kirsten , Dickson Nigel , Hancox Robert J. , Harrington HonaLee , Hogan Sean , Ramrakha Sandhya , Righarts Antoinette , Thomson W. Murray , Moffitt Terrie E. , Poulton Richie 
Published: December 2022

AbstractThe aim of this study was to use longitudinal population-based data to examine the associations between childhood sexual abuse (CSA) and risk for adverse outcomes in multiple life domains across adulthood. In 937 individuals followed from birth to age 45y, we assessed associations between CSA (retrospectively reported at age 26y) and the experience of 22 adverse outcomes in seven domains (physical, mental, sexual, interpersonal, economic, antisocial, multi-domain) from young adulthood to midlife (26 to 45y). Analyses controlled for sex, socioeconomic status, prospectively reported child harm and household dysfunction adverse childhood experiences, and adult sexual assault, and considered different definitions of CSA. After adjusting for confounders, CSA survivors were more likely than their peers to experience internalizing, externalizing, and thought disorders, suicide attempts, health risk behaviors, systemic inflammation, poor oral health, sexually transmitted diseases, high-conflict relationships, benefit use, financial difficulties, antisocial behavior, and cumulative problems across multiple domains in adulthood. In sum, CSA was associated with multiple persistent problems across adulthood, even after adjusting for confounding life stressors, and the risk for particular problems incremented with CSA severity. The higher risk for most specific problems was small to moderate, but the cumulative long-term effects across multiple domains reflect considerable individual and societal burden.
Left atrial appendage aneurysm enlarged in the neonatal period
Authors: Yamashita Naoto , Harada Masako , Moritake Hiroshi 
Published: December 2022

AbstractWe describe a newborn with a congenital left atrial appendage aneurysm. The aneurysm size did not change prenatally. However, it rapidly enlarged after birth. MRI was useful for assessing the aneurysm extent and exact size, and for diagnosis. Respiratory distress and feeding difficulties appeared, and surgery was performed. These symptoms disappeared post-operatively. The patient is alive without complications or recurrence.
Assessment and management of feeding difficulties for infants with complex CHD
Authors: Desai Hema , Jones Courtney E. , Fogel Jennifer L. , Negrin Karli A. , Slater Nancy L. , Morris Kimberly , Doody Lisa R. , Engstler Katherine , Torzone Andrea , Smith Jodi , Butler Samantha C. 
Published: December 2022

AbstractEarly surgical intervention in infants with complex CHD results in significant disruptions to their respiratory, gastrointestinal, and nervous systems, which are all instrumental to the development of safe and efficient oral feeding skills. Standardised assessments or treatment protocols are not currently available for this unique population, requiring the clinician to rely on knowledge based on neonatal literature. Clinicians need to be skilled at evaluating and analysing these systems to develop an appropriate treatment plan to improve oral feeding skill and safety, while considering post-operative recovery in the infant with complex CHD. Supporting the family to re-establish their parental role during the hospitalisation and upon discharge is critical to reducing parental stress and oral feeding success.
Japan: the harbinger state
Authors: Lipscy Phillip Y. 
Published: December 2022

AbstractWhy study Japan? Research on contemporary Japanese politics and foreign policy faces headwinds from the relative geopolitical decline of Japan and scholars skeptical about single-country studies. An overview of Japanese politics publications in English-language journals over the past four decades suggests the subfield remains active and robust. However, there is still room to grow. I argue that Japan is a harbinger state, which experiences many challenges before others in the international system. As such, studying Japan can inform both scholars and policymakers about the political challenges other countries are likely to confront in the future. In turn, scholarship on Japan offers a critical opportunity to develop theoretical insights, assess early empirical evidence, and offer policy lessons about emerging challenges and the political contestation surrounding them. I consider the reasons why Japan so often emerges as a harbinger across issue areas and suggest areas for ongoing scholarly attention.