bluuebunny/crossref_metadata_2025_split huggingface dataset:
PD58 Implementation And Assessment Of A Lung Cancer Screening Pilot Project In Québec Through Multi-Stakeholder Collaboration
Authors: Boily Gino , Bouchard Nicole , Boulanger Jim , Brie Marie-Hélène , Ezer Nicole , Guédon Aude-Christine , Hindié Valérie , Jehanno Cédric , Lehuédé Camille , Liberman Moishe , Lizotte Hélène , Massougbodji José , Nshimyumukiza Léon , Pelletier Andréa , Théberge Isabelle , Martel Simon , Truchon Catherine 
Published: December 2022

IntroductionIn 2019, the Québec provincial health technology assessment body (INESSS) recommended that lung cancer screening with low-dose computed tomography (LDCT) be accessible in Québec only within the context of an evaluation in the ‘real-world’ care setting. Based on this recommendation, the ministry of health (MSSS) decided, in 2020, to implement a screening pilot project and to conduct a formal evaluation, partnering with a clinical leader (principal investigator), participating hospitals, the provincial public health agency (INSPQ) and INESSS. The goal of this evaluation is to facilitate decision-making regarding the implementation of a province-wide screening program.MethodsTo support the implementation of the pilot project, algorithms and recommendations were developed to guide management of screening program participants. This material, based on Lung-RADS (Lung Computed Tomography Screening Reporting and Data System of the American College of Radiology), was developed by reviewing the literature and by consulting clinical experts. The evaluation plan proposes various indicators, focusing on six main topics: (i) costs, (ii) screening and investigation processes, (iii) clinical effectiveness and other effects on health, (iv) effects on smoking cessation, (v) organizational impact and (vi) implementation issues.ResultsINESSS has developed 12 algorithms and close to 50 recommendations for lung cancer screening and investigation, a tool for assessing lung cancer risk and a benefits/risks table. For the evaluation of the pilot project, MSSS, INSPQ and INESSS developed more than 100 indicators; short-term indicators are currently being measured and others will follow in the longer term. Since starting in June 2021, the pilot project is progressing well (as of November 28, 2021): 2,365 people have been referred, 1,272 were eligible for screening, 678 have had their first LDCT and 19 were Lung-RADS 4B or 4X. Results on indicators will help the ministry decide on the feasibility of scaling up screening to the provincial level and will highlight aspects to be improved.ConclusionsThis project shows how health technology assessment products can elicit changes in the health system, and how multi-stakeholder collaboration can actively support practice implementation and inform decision-making.
PD60 What Are The Opportunities And Challenges To Implementing Value Based Healthcare Pilots 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) regulates the private healthcare system in Brazil. ANS, since 2019, has been running the pilot value-based new payment models project. In total, 13 projects were selected by ANS. This investigation aims to identify opportunities and challenges to implement value based healthcare (VBHC) in Brazil.MethodsWe interviewed managers participating in the ANS’ Value-Based Payment Models. Data were collected through semi-structured interviews during 2021. Twelve managers were invited to participate in the interview and eight accepted the invitation. The key questions were: “what are the main factors that facilitate – or limit - the transition from the fee for service model to a value-based model in the private healthcare system? And “will the payment models be scalable?” For data analysis, Bardin’s content analysis was chosen. Data validation was performed using the debriefings technique.ResultsThe interviews identified two key facilitating factors: people (identified by 50% of respondents) and processes (identified by 50% of respondents). Reponses relating to people nominated the need for professionals with VBHC knowledge (33%), support of senior management (25%), support from the provider (25%) and care team (17%). Reponses relating to processes nominated the need for partnership (58%), health-driven management (25%) and results (17%). We also identified that limiting factors (49%) were: providers (39%), in details: non-support from the provider, (56%), fear of financial loss (22%) and provider only wanting profit (22%); information system (30%), with data management; culture (17%), current versus innovative models; and peoples (13%), knowledge. More than 90 percent found it to be scalable, particularly, in vertical health plans (38%), large operators (38%); and provide diagnostic services (13%). We found that non-scalable situations are those where fee for service is hegemonic in terms of payments.ConclusionsOur study found that knowledge and culture management positively impacts the projects. Service providers can be limiting when they are exclusively focused on economic perspectives. The new payment model is considered scalable.
PerformingOt(h)ello: Verdi, Salvini and the Stage Manual
Authors: De Francisci Enza 
Published: December 2022

AbstractThis article retraces Giuseppe Verdi'sOtello(1887) to the great Italianmattatori(star actors), particularly Tommaso Salvini (1829–1915), whose ground-breaking performances of the Moor of Venice, in a translation by Giulio Carcano, coincided with the time when Verdi and his librettist, Arrigo Boito, were collaborating on theirOtello. Thegrandi attorienjoyed a reputation for realistic immediacy and impulsiveness readily associated with cultural stereotypes about Italy's perceived ‘otherness’. In the ethnographic context of nineteenth-century Italy, it is argued here that the actors’ interpretation of Shakespeare's Moor not only synthesised the multilateral cultural threads of the Jacobean Othello, but also partnered this racial alterity with a new dramatic language, which went on to influence Verdi's opera and prompt book, and, ultimately, to perpetuate an exoticised ‘brand’ of Italian artistic culture on stage at a time when Italy was fashioning its own national identity.
Development of the Residual Lesion Score for congenital heart surgery: the RAND Delphi methodology
Authors: Nathan Meena , Newburger Jane W. , Bell Margaret , Tang Alexander , Gongwer Russell , Dunbar-Masterson Carolyn , Atz Andrew M. , Bacha Emile , Colan Steven , Gaynor J. William , Kanter Kirk , Levine Jami C. , Ohye Richard , Pizarro Christian , Schwartz Steven , Shirali Girish , Tani Lloyd , Tweddell James , Gurvitz Michelle ,   for the Pediatric Heart Network Investigators
Published: December 2022

AbstractBackground and Objective:The Residual Lesion Score is a novel tool for assessing the achievement of surgical objectives in congenital heart surgery based on widely available clinical and echocardiographic characteristics. This article describes the methodology used to develop the Residual Lesion Score from the previously developed Technical Performance Score for five common congenital cardiac procedures using the RAND Delphi methodology.Methods:A panel of 11 experts from the field of paediatric and congenital cardiology and cardiac surgery, 2 co-chairs, and a consultant were assembled to review and comment on validity and feasibility of measuring the sub-components of intraoperative and discharge Residual Lesion Score for five congenital cardiac procedures. In the first email round, the panel reviewed and commented on the Residual Lesion Score and provided validity and feasibility scores for sub-components of each of the five procedures. In the second in-person round, email comments and scores were reviewed and the Residual Lesion Score revised. The modified Residual Lesion Score was scored independently by each panellist for validity and feasibility and used to develop the “final” Residual Lesion Score.Results:The Residual Lesion Score sub-components with a median validity score of ≥7 and median feasibility score of ≥4 that were scored without disagreement and with low absolute deviation from the median were included in the “final” Residual Lesion Score.Conclusion:Using the RAND Delphi methodology, we were able to develop Residual Lesion Score modules for five important congenital cardiac procedures for the Pediatric Heart Network’s Residual Lesion Score study.
Life meaning constructed from dignity therapy in traditional Chinese culture: A qualitative analysis of dignity therapy generativity documents
Authors: Lin Junyi , Zhang Hong , Xi Lanxin , Liu Fang , Liu Wei , Guo Qiaohong 
Published: December 2022

AbstractObjectivesTo examine the thematic features of dignity therapy generativity documents of advanced cancer patients receiving chemotherapy in mainland China from the perspective of meaning-making during dignity therapy.MethodsThis is a qualitative descriptive study. Content analysis was used to analyze 24 dignity therapy generativity documents derived from a quasi-experimental trial of dignity therapy for advanced cancer patients receiving chemotherapy in a daycare center at a cancer hospital in northern China.ResultsAmong the 24 advanced cancer patients whose generativity documents were analyzed, 14 were male and ranged in age from 26 to 78 years (average = 50.3). Two dimensions emerged from the data: (1) the sources of meaning in life, which consisted of social relationships, things and circumstances providing meaning in life, and (2) the ultimate meaning in life, referring to finding one’s real self and realizing the purpose in life, including personal life goals, dignity and autonomy, and morality of patients.Significance of resultsThe multidimensional constructs of meaning in life with distinctive traditional Chinese cultural characteristics could provide insights into dignity-conserving care for advanced cancer patients with Chinese culture and provide evidence for refining the implementation protocol of DT through intentionally addressing the ultimate meaning of patients in the therapeutic session.
DISJUNCTION AND EXISTENCE PROPERTIES IN MODAL ARITHMETIC
Authors: KURAHASHI TAISHI , OKUDA MOTOKI 
Published: December 2022

AbstractWe systematically study several versions of the disjunction and the existence properties in modal arithmetic. First, we newly introduce three classes
$\mathrm {B}$
,
$\Delta (\mathrm {B})$
, and
$\Sigma (\mathrm {B})$
of formulas of modal arithmetic and study basic properties of them. Then, we prove several implications between the properties. In particular, among other things, we prove that for any consistent recursively enumerable extension T of
$\mathbf {PA}(\mathbf {K})$
with
$T \nvdash \Box \bot $
, the
$\Sigma (\mathrm {B})$
-disjunction property, the
$\Sigma (\mathrm {B})$
-existence property, and the
$\mathrm {B}$
-existence property are pairwise equivalent. Moreover, we introduce the notion of the
$\Sigma (\mathrm {B})$
-soundness of theories and prove that for any consistent recursively enumerable extension of
$\mathbf {PA}(\mathbf {K4})$
, the modal disjunction property is equivalent to the
$\Sigma (\mathrm {B})$
-soundness.
Sustainability of Regional Groundwater Quality in Response to Managed Aquifer Recharge
Authors: Guo Zhilin , Fogg Graham E. , Chen Kewei , Pauloo Rich , Zheng Chunmiao 
Published: December 2022

AbstractGrowing demands on water supply worldwide have resulted in aquifer overdraft in many regions, especially in alluvial basins under intensive irrigation. This further leads to serious deterioration of groundwater quality. Managed aquifer recharge (MAR) has been shown to mitigate groundwater overdraft, but whether MAR can actually stabilize or reverse the ongoing declines in regional groundwater quality caused by non‐point sources has not been demonstrated. This study was intended to address the question by investigating impacts of different MAR strategies on regional groundwater quality. A geostatistical model was first used to characterize a heterogeneous alluvial aquifer system in a portion of the Tulare Lake Basin. Three‐dimensional numerical models were then employed to simulate groundwater flow and mass transport. Next, MAR strategies were applied in locations with different geological conditions or joint with different irrigation activities, and their performances were evaluated. Results demonstrate the potential of significant, long‐term benefits for regional groundwater quality by applying strategic, high‐intensity recharge operations on geologically favorable subregions. Siting MAR above the incised valley fill (IVF) deposit, a near‐surface paleochannel containing unusually coarse, high‐conductivity hydrofacies, leads to more extensive improvement in the groundwater quality in terms of salinity due to significant vertical flow and lateral outward flow from the IVF. Overall, decades would be required to alleviate groundwater quality concerns in the studied 189 km2 region. The simulations indicate that the deep concentrations remain below the secondary maximum contaminant level as the solute mass migrates downward with the prominent contribution from the attenuation via dispersion and matrix diffusion.
Hydrologic and Landscape Controls on Dissolved Organic Matter Composition Across Western North American Arctic Lakes
Authors: Kurek Martin R. , Garcia‐Tigreros Fenix , Wickland Kimberly P. , Frey Karen E. , Dornblaser Mark M. , Striegl Robert G. , Niles Sydney F. , McKenna Amy M. , Aukes Pieter J. K. , Kyzivat Ethan D. , Wang Chao , Pavelsky Tamlin M. , Smith Laurence C. , Schiff Sherry L. , Butman David , Spencer Robert G. M. 
Published: December 2022

AbstractNorthern high‐latitude lakes are hotspots for cycling dissolved organic carbon (DOC) inputs from allochthonous sources to the atmosphere. However, the spatial distribution of lake dissolved organic matter (DOM) is largely unknown across Arctic‐boreal regions with respect to the surrounding landscape. We expand on regional studies of northern high‐latitude DOM composition by integrating DOC concentrations, optical properties, and molecular‐level characterization from lakes spanning the Canadian Taiga to the Alaskan Tundra. Lakes were sampled during the summer from July to early September to capture the growing season. DOM became more optically processed and molecular‐level aromaticity increased northward across the Canadian Shield to the southern Arctic and from interior Alaska to the Tundra, suggesting relatively greater DOM incorporation from allochthonous sources. Using water isotopes (δ18O‐H2O), we report a weak overall trend of increasing DOC and decreasing aromaticity in lakes that were hydrologically isolated from the landscape and enriched in δ18O‐H2O, while within‐region trends were stronger and varied depending on the landscape. Finally, DOC correlated weakly with chromophoric dissolved organic matter (CDOM) across the study sites, suggesting that autochthonous and photobleached DOM were a major component of the DOC in these regions; however, some of the northernmost and wetland‐dominated lakes followed pan‐Arctic riverine DOC‐CDOM relationships, indicating strong contributions from allochthonous inputs. As many lakes across the North American Arctic are experiencing changes in temperature and precipitation, we expect the proportions of allochthonous and autochthonous DOM to respond with aquatic optical browning with greater landscape connectivity and more internally produced DOM in hydrologically isolated lakes.
Enrichment of Organic Acids in Fine Particles Over a Megacity in South China
Authors: Fu Xuewei , Zhang Runqi , Li Sheng , Fang Hua , Yu Qingqing , Song Wei , Zhang Yanli , Wang Xinming 
Published: December 2022

AbstractOrganic acids are abundant aerosol components that impact the hygroscopicity and multiphase processes of particulate matter, yet their changing compositions and sources are poorly understood. In this study, filter‐based PM2.5 samples were collected concurrently at three sites (urban, rural, and coastal) during the summer and winter of 2018 in the megacity Guangzhou, south China, to determine organic acids including C9–C32 fatty acids, C4–C10 dicarboxylic acids, and aromatic acids. On average, the total concentrations of the speciated organic acids were higher in winter than in summer, and were the highest at the urban site. Compared to observations at the same sites in winter 2009, average concentrations of organic acids in winter 2018 increased by 35.0%, 66.0%, and −3.2% at the urban, rural and coastal sites, while their fractions in organic matter (OM) increased by approximately 261.5%, 266.7%, and 61.1%, and their fractions in PM2.5 increased by approximately 318.2%, 308.7%, and 221.1%, respectively. Source apportionment of organic acids revealed that cooking emission and vehicle exhaust were the major sources at the urban site, plant wax and vehicle exhaust were the two largest sources at the rural site with substantial contributions from biomass burning in winter, while vehicle exhaust and ship emission were the two major sources at the coastal site. Less contributions from secondary production were retrieved in winter 2018 than in winter 2009, and the enrichment of organic acids in PM2.5 or OM was attributed to their elevated primary emissions from vehicles and ships, cooking, and plant wax.
Season‐Dependent Modulation of Pacific Meridional Mode on Tropical Cyclone Genesis Over the Western North Pacific
Authors: Fu Meiling , Wang Chao , Wu Liguang , Zhao Haikun 
Published: December 2022

AbstractPacific Meridional Mode (PMM) has been found to be significantly correlated with tropical cyclone (TC) genesis in the western North Pacific (WNP), while the seasonality in their relationship remains unknown. Here we found that their relationship experiences remarkable seasonality, with a significant positive correlation in January–April and August–December but an insignificant relationship in May–July. This seasonality stems from the diverse responses of large‐scale conditions to the different magnitude of the PMM‐related sea surface temperature (SST) warming that is dependent on the strength of trade wind in the three seasons. In January–July, strong trade wind facilitates great PMM SST warming that stimulates large‐scale ascending motion in the eastern WNP but compensated descending motion in the western WNP, favoring TC genesis in January–April because its main genesis region is in the eastern WNP. However, the main genesis region extends to the whole WNP in May–July, the inconsistent large‐scale condition anomalies across the western and eastern WNP thus lead to the insignificant relationship in May–July. In August–December, the PMM‐related SST warming and the associated ascending motion fade away due to the much‐weakened trade wind, and the favorable large‐scale ascending motion over the whole WNP is linked to the PMM‐related SST cooling induced descending motion through a modification of the Walker circulation. The results highlight the season‐dependent mechanism of PMM influencing TC genesis and have some insights for improving seasonal forecasting.
Testing Hidden Assumptions of Representativeness in Reach‐Scale Studies of Hyporheic Exchange
Authors: Becker Paige S. , Ward Adam S. , Herzog Skuyler P. , Wondzell Steven M. 
Published: December 2022

AbstractField studies of hyporheic exchange in mountain systems are often conducted using short study reaches and a limited number of observations. It is common practice to assume these study reaches represent hyporheic exchange at larger scales or different sites and to infer general relationships among potential causal mechanisms from the limited number of observations. However, these assumptions of representativeness are rarely tested. In this study, we develop numerical models from four segments of mountain streams in different geomorphologic settings and extract shorter reaches to test how representative exchange metrics are in shorter reaches compared to their reference segments. We also map the locations of the representative reaches to determine if a pattern exists based on location. Finally, we compare variance of these shorter within‐site reaches to 29 additional reaches across the same basin to understand the impacts of inferring causal mechanisms, for example, the expectation that wide and narrow valley bottoms will yield different hyporheic exchange patterns. Our results show that the location and length strategy of the study reach must be considered before assuming an exchange metric to be representative of anything other than the exact segment studied. Further, it is necessary to quantify within and between site variations before making causal inferences based on observable characteristics, such as valley width or stream morphology. Our findings have implications for future field practices and how those practices are translated into models.
Multifaceted functions of STING in human health and disease: from molecular mechanism to targeted strategy
Authors: Zhang Zili , Zhou Haifeng , Ouyang Xiaohu , Dong Yalan , Sarapultsev Alexey , Luo Shanshan , Hu Desheng 
Published: December 2022

AbstractSince the discovery of Stimulator of Interferon Genes (STING) as an important pivot for cytosolic DNA sensation and interferon (IFN) induction, intensive efforts have been endeavored to clarify the molecular mechanism of its activation, its physiological function as a ubiquitously expressed protein, and to explore its potential as a therapeutic target in a wide range of immune-related diseases. With its orthodox ligand 2’3’-cyclic GMP–AMP (2’3’-cGAMP) and the upstream sensor 2’3’-cGAMP synthase (cGAS) to be found, STING acquires its central functionality in the best-studied signaling cascade, namely the cGAS–STING–IFN pathway. However, recently updated research through structural research, genetic screening, and biochemical assay greatly extends the current knowledge of STING biology. A second ligand pocket was recently discovered in the transmembrane domain for a synthetic agonist. On its downstream outputs, accumulating studies sketch primordial and multifaceted roles of STING beyond its cytokine-inducing function, such as autophagy, cell death, metabolic modulation, endoplasmic reticulum (ER) stress, and RNA virus restriction. Furthermore, with the expansion of the STING interactome, the details of STING trafficking also get clearer. After retrospecting the brief history of viral interference and the milestone events since the discovery of STING, we present a vivid panorama of STING biology taking into account the details of the biochemical assay and structural information, especially its versatile outputs and functions beyond IFN induction. We also summarize the roles of STING in the pathogenesis of various diseases and highlight the development of small-molecular compounds targeting STING for disease treatment in combination with the latest research. Finally, we discuss the open questions imperative to answer.
Tumour-infiltrating lymphocytes: from prognosis to treatment selection
Authors: Brummel Koen , Eerkens Anneke L. , de Bruyn Marco , Nijman Hans W. 
Published: December 2022

AbstractTumour-infiltrating lymphocytes (TILs) are considered crucial in anti-tumour immunity. Accordingly, the presence of TILs contains prognostic and predictive value. In 2011, we performed a systematic review and meta-analysis on the prognostic value of TILs across cancer types. Since then, the advent of immune checkpoint blockade (ICB) has renewed interest in the analysis of TILs. In this review, we first describe how our understanding of the prognostic value of TIL has changed over the last decade. New insights on novel TIL subsets are discussed and give a broader view on the prognostic effect of TILs in cancer. Apart from prognostic value, evidence on the predictive significance of TILs in the immune therapy era are discussed, as well as new techniques, such as machine learning that strive to incorporate these predictive capacities within clinical trials.