Institutional Research Funding Research Articles

SAT233 Clinical And Economic Burden Of Postsurgical Chronic Hypoparathyroidism: A US Medicare Retrospective Analysis

Abstract Disclosure: W. Noori: Employee; Self; Ascendis Pharma, Inc. S. Inguva: Employee; Self; OPEN Health. Other; Self; Research Funding (institution): Ascendis. C.T. Sibley: Employee; Self; Ascendis Pharma, Inc. V. Chirikov: Employee; Self; OPEN Health. Stock Owner; Self; OPEN Health. Other; Self; Research Funding (institution): Ascendis. A.R. Smith: Employee; Self; Ascendis Pharma, Inc. Background: Hypoparathyroidism is a rare endocrine disease characterized by insufficient parathyroid hormone (PTH) production and is associated with substantial burden of illness. Individuals with hypoparathyroidism often report physical, emotional, and cognitive symptoms indicating impaired health-related quality of life (HRQoL). Objective: To describe demographics, clinical characteristics, healthcare resource utilization (HCRU), and costs among individuals with postsurgical chronic hypoparathyroidism compared to individuals without hypoparathyroidism in Medicare Fee-For-Service (FFS). Methods: Adults with newly diagnosed postsurgical chronic hypoparathyroidism were identified from the Medicare 100% Limited Data Set between July 1, 2017, to March 31, 2020. All had a confirmed diagnosis within 6-12 months after index diagnosis. Individuals were required to be continuously enrolled for ≥6 months pre- and ≥12 months post-index for baseline and follow-up assessments. Those with a prior hypoparathyroidism diagnosis in the baseline period were excluded. A random sample of enrollees without hypoparathyroidism was synthetically assigned an index date of diagnosis to ensure similar baseline and follow-up periods as individuals with postsurgical chronic hypoparathyroidism. Baseline demographics and comorbidities were compared descriptively. All-cause HCRU and costs during baseline and follow-up were evaluated. All costs were inflated to 2021 US dollars. Results: Individuals with postsurgical chronic hypoparathyroidism (N=1,166) were older than those without hypoparathyroidism (N=11,258) (median age of 69 vs 64 years) and more were female (76% vs 57%); they also had higher Charlson Comorbidity Index scores at baseline (3.24 vs 0.73) and a higher prevalence of moderate or severe renal disease (28.8% vs 5.6%), nephrolithiasis (8.3% vs 1.0%), urinary tract infections (9.9% vs 2.2%), hospitalizations for infections (11.9% vs 2.5%), congestive heart failure (13.1% vs 3.0%), among others. Over a median follow-up of 30 months, mean [SD] all-cause medical costs per patient per year (PPPY) were significantly higher among individuals with postsurgical chronic hypoparathyroidism ($199,297 [$443,294] vs $61,897 [$210,825]). This difference was largely attributable to higher all-cause medical utilization among individuals with postsurgical chronic hypoparathyroidism (22.0 vs 11.6 inpatient days PPPY; 15.3 vs 5.8 outpatient visits PPPY). Individuals with postsurgical chronic hypoparathyroidism also had higher mortality compared to those without hypoparathyroidism (HR=2.75 (95% CI: 2.15-3.51). Conclusions: The clinical and economic burden of individuals with postsurgical chronic hypoparathyroidism in Medicare FFS is substantial, highlighting the need for innovative treatment options to replace the missing PTH hormone. Presentation: Saturday, June 17, 2023

Dementia Researchers’ Inside Views on Research Networks and Alignment With Public Research Funding: A Qualitative Study

This study presents the dementia researchers views of research networks, and how the networks fit into their pursuit of research objectives and dementia research funding. We conducted 10 semi-structured interviews with 10 leading dementia researchers in Norway, for a qualitative study inspired by grounded theory. The dementia researchers consider the six categories to determine the legitimacy of the proposed network and its proposing person. The six categories are: personal motivation, relationship and friendship, communication, research funding, research management, and network characteristics. The dementia researcher offers insights into best practice of research networks. The study suggests that leading dementia researchers collaborate effectively on research activities toward personal research interests and objectives, but these are not actively aligned coordinated with the interests of the public research funding institutions. Lack of coordination between the funded dementia researchers and the funding institutions limits the potential performance from the dementia research.

Priority setting to support a public health research agenda: a modified Delphi study with public health stakeholders in Germany

BackgroundResearch priority setting (RPS) studies are necessary to close the significant gap between the scientific evidence produced and the evidence stakeholders need. Their findings can make resource allocation in research more efficient. However, no general framework for conducting an RPS study among public health stakeholders exists. RPS studies in public health are rare and no such study has been previously conducted and published in Germany. Therefore, we aimed to investigate which research topics in public health are prioritised by relevant stakeholders in Germany.MethodsOur RPS study consisted of a scoping stage and a Delphi stage each split into two rounds. Firstly, we invited members of the German Public Health Association to gather expert insights during two initial workshops. Next, we defined the relevant stakeholder groups and recruited respondents. Thereafter, we collected research topics and assessment criteria with the respondents in the first Delphi round and aggregated the responses through content analysis. Finally, we asked the respondents to rate the research topics with the assessment criteria in the second Delphi round.ResultsIn total, 94 out of the 140 invited public health organisations nominated 230 respondents for the Delphi study of whom almost 90% participated in both Delphi rounds. We compiled a comprehensive list of 76 research topics that were rated and ranked by several assessment criteria. We split the research topics into two types, substantive research topics and methodological-theoretical research topics respectively, to ensure the comparability among the research topics. In both types of research topics—substantive research topics and methodological-theoretical research topics—the respective top five ranked research topics hardly differed between public health researchers and public health practitioners. However, clear differences exist in the priority ranking of many (non-top priority) research topics between the stakeholder groups.ConclusionsThis research demonstrates that it is possible, with limited resources, to prioritise research topics for public health at the national level involving a wide range of pertinent stakeholders. The results can be used by research funding institutions to initiate calls for research projects with an increased relevance for health and/or scientific progress.

Adjuncting for Life: The Gendered Experience of Adjunct Instructors in Ontario

The market-based imperatives driving economic growth in Western societies have, in ways, both been acknowledged and implicitly used to reorient public institutions - academia dramatically so. This article deals with upending of post-secondary academic hiring priorities, and the impact on the adjunct or sessional lecturers implicated in the change. Over half of the courses offered by academic departments and programs in Ontario, Canada, are now taught by part-time faculty members (Pasma & Shakes, 2018). Their use in post-secondary education is underpinned by a notion of just-in-time course delivery in a free market of untenured PhD holders. This study assessed 26 adjuncts in Ontario, Canada, equally divided between male and female. It found working conditions, development of research dossiers, and health and work-life balance to be characterized by gendered differences and hardships. Although the hardships of post-PhD adjunct work have been abundantly documented, this work brings to light components of the experience that have not been previously studied, most significantly, its health effects and gender nature. It concludes with policy recommendations to support adjuncts in Ontario and beyond, including mentorship, longer term contracts, institutional research funding, extended health benefits, and affordable childcare.

Structural Racism in Psychiatric Research Careers: Eradicating Barriers to a More Diverse Workforce.

Investigators from minoritized backgrounds are underrepresented in psychiatric research. That underrepresentation contributes to disparities in outcomes of access to mental health care. Drawing on lived experience, scholarly qualitative reports, and empirical data, the authors review how the underrepresentation of minoritized researchers arises from interlocking, self-reinforcing effects of structural biases in our research training and funding institutions. Minoritized researchers experience diminished early access to advanced training and opportunities, stereotype threats and microaggressions, isolation due to lack of peers and senior mentors, decreased access to early funding, and unique community and personal financial pressures. These represent structural racism-a system of institutional assumptions and practices that perpetuates race-based disparities, in spite of those institutions' efforts to increase diversity and in contradiction to the values that academic leaders outwardly espouse. The authors further review potential approaches to reversing these structural biases, including undergraduate-focused research experiences, financial support for faculty who lead training/mentoring programs, targeted mentoring through scholarly societies, better use of federal diversity supplement funding, support for scientific reentry, cohort building, diversity efforts targeting senior leadership, and rigorous examination of hiring, compensation, and promotion practices. Several of these approaches have empirically proven best practices and models for dissemination. If implemented alongside outcome measurement, they have the potential to reverse decades of structural bias in psychiatry and psychiatric research.

Co-creating community-led frugal innovation: An adapted Quadruple Helix?

Frugal innovation often requires cooperation among heterogeneous actors with diverse values, capabilities, interests, and norms. This qualitative, action-oriented case study presents the dynamics and interplay among the quadruple helix actors for community-led frugal innovation, thereby emphasizing the role of academia in its process. The findings of this study depict that informal actors can bring significant innovative inputs into the innovation system if the right kind of mechanisms are employed and trust-building exercises are undertaken. In addition, this study stimulates one to reflect on the challenges and complexities faced by academicians in publicly funded research institutions, especially for bringing informal actors into the innovation system and creating shared values. The quadruple helix model has been primarily discussed; most discussions involve advanced country settings. This study, conducted in a developing country setting, demonstrates that an intermediary actor linked to (but not identical to) the existing academia can significantly shape cooperation and its related activities in the desired direction. The findings indicate the necessity for adapting existing behavioural norms or institutional rigidities that exist among academic institutions if one wishes to galvanize the rich potential of community-led frugal innovations in India. Policy recommendations are discussed to create a conducive environment for such innovations.

Zanubrutinib, Alone and in Combination With Tislelizumab, for the Treatment of Richter Transformation of Chronic Lymphocytic Leukemia.

Zanubrutinib, Alone and in Combination With Tislelizumab, for the Treatment of Richter Transformation of Chronic Lymphocytic Leukemia.

Subcutaneous Nodules on the Head and Ankle: Challenge.

*Tulane University School of Medicine, New Orleans, LA; and Departments of †Pathology, and ‡Dermatology, Tulane University School of Medicine, New Orleans, LA. Correspondence: Kezia Surjanto, BS, Tulane University, 1430 Tulane Avenue, New Orleans, LA 70112 (e-mail: [email protected]). C. Bitar received institutional research funding from Amgen. The authors declare no conflicts of interest.

Subcutaneous Nodules on the Head and Ankle: Answer.

*Tulane University School of Medicine, New Orleans, LA; †Department of Pathology, Tulane University School of Medicine, New Orleans, LA; and ‡Department of Dermatology, Tulane University School of Medicine, New Orleans, LA. Correspondence: Kezia Surjanto, BS, Tulane University, 1430 Tulane Avenue, New Orleans, LA 70112 (e-mail: [email protected]). C. Bitar received institutional research funding from Amgen. The remaining authors have no relevant conflicts of interest.

Knowledge Retention Practices and Performance of Public Research Institutions in Kenya

In the dynamically changing environment, knowledge is becoming the most important resource for organisational performance, surpassing other resources such as land and capital. Therefore, retaining organizational knowledge is the key characteristic of sustainable improvement in organisational performance. On the contrary, publicly funded research institutions in Kenya lose experts’ knowledge from retiring employees. Knowledge management in publicly funded research institutions in Kenya seems to be a major challenge contributing to poor service delivery and gaps in work performance. Therefore, based on the Human Capital theory, this study sought to fill the gap by establishing the influence of knowledge retention practices on the performance of publicly funded research institutions in Kenya. The study used stratified random approaches to sample 135 respondents out of 6,799 employees in Kenya's 12 publicly funded research institutions. Both qualitative and quantitative primary and secondary data were collected to achieve the study objectives. While qualitative data was analysed through thematic methods, quantitative data were analysed using both descriptive statistics (mean scores, percentages and standard deviation) and inferential statistics (Multiple Regression Analysis) through the Statistical Package for Social Sciences (SPSS) version 24. It was established that adopting knowledge retention practices such as succession planning, use of retirees, mentoring and coaching are associated with a significant positive influence on the performance of publicly funded research institutions in Kenya. Based on the findings, the study recommends the management of public research firms provide regular training and mentoring programs to employees to help them retain knowledge and improve their skills. The organizations can also conduct exit interviews with departing employees as a useful way to capture their knowledge and insights before they leave the organization. This information can then be used to improve knowledge retention and prevent the loss of critical knowledge.  Keywords: Knowledge Retention Practices, Performance of Public Research Institutions, Kenya &nbsp

Effects of Sports, Exercise Training, and Physical Activity in Children with Congenital Heart Disease-A Review of the Published Evidence.

Children and adolescents with congenital heart disease (CHD) should be encouraged to adopt a physically active lifestyle, ideally by participating in sports activities at school and sports clubs. Children with complex CHD or other risk factors (for example, pacemakers, cardioverter-defibrillators, channelopathies) may, however, need specific individualized training programs. This review article summarizes the current knowledge regarding the clinical effects of sports and exercise training on CHD and its pathophysiologic mechanisms. An evidence-based approach based on a literature search, using PubMed, Medline, CINHAL, Embase, and the Cochrane Library was conducted, last completed on 30 December 2021. In studies with 3256 CHD patients in total, including 10 randomized controlled trials, 14 prospective interventional trials, 9 observational trials, and 2 surveys, exercise training has been shown to improve exercise capacity and physical activity, motoric skills, muscular function, and quality of life. Sports and exercise training appears to be effective and safe in CHD patients. Despite being cost-efficient, training programs are currently scarcely reimbursed; therefore, support from healthcare institutions, commissioners of healthcare, and research-funding institutions is desirable. There is a strong need to establish specialized rehabilitation programs for complex CHD patients to enhance these patients' access to this treatment intervention. Further studies may be desirable to confirm these data to investigate the impact on risk profiles and to identify the most advantageous training methodology and underlying pathophysiological mechanisms.

Where to Go to Get Unbiased Independent Advice on Pest Control in the UK in the 21st Century?

In the good old days (that is pre-Margaret Thatcher) agricultural research was conducted by various government funded research institutions. They provided a service to UK growers for which there was no charge. This advice was unbiased and supported by sound research. Then it was decided that this was a money making opportunity and charges were introduced. This led to much of this research being funded by the industry and out went the unbiased approach.

Unmet medical need in otorhinolaryngology: A challenge forotorhinolaryngologists and head and neck surgeons

Otorhinolaryngologists and head and neck surgeons are predestined to scientifically analyze and prioritize the medical needs in ENT medicine under the umbrella of the German Society of Otolaryngology, Head and Neck Surgery (DGHNO-KHC). This medical need assessment is important for targeting research and development of medical innovations to improve ENT patients' care with these needs and to trigger respective research and innovation funding programs at an early stage. This is to recommend that the DGHNO-KHC and its working groups and task forces in their specialty disciplines address the issue. The goal is a comprehensive medical need assessment for the fields of otolaryngology as well as head and neck surgery. The parameterization of medical needs is based on the unmet medical need (UMN) concept. Criteria for prioritization should follow the method of multi-criteria decision analysis (MCDA). The working groups of the DGHNO-KHC familiarize themselves with the concept of UMN. Subsequently, suggestions on ENT diseases with UMN in diagnostics and therapy will be collected considering the medical evidence. The suggestions are evaluated in a standardized way according to MCDA and a ranking is established. The results will be published and used to make research funding institutions aware of UMN in otorhinolaryngology, head and neck surgery. The work will contribute to the further development of the UMN concept and will also be able to provide a basis to investigate the evidence of the concept to define the UMN. Through this work, the DGHNO-KHC will be perceived as an important scientific player for the development of need-driven medical innovations in Germany.

Research Productivity for Augmenting the Innovation Potential of Higher Education Institutions: An Interpretive Structural Modeling Approach and MICMAC Analysis

Current literature merely identifies the driving factors of research productivity in higher education institutions without directly examining their interrelationships that would offer some fundamental insights into the nature of these factors. Thus, this work intends to identify those driving factors and establish their structural relationships to determine those factors with crucial roles in advancing research productivity. Due to the subjectivity of the identified driving factors and the notion that the evaluation of their relationships reflects an expert judgment, an interpretive structural modeling (ISM) approach and the Matrice d’impacts croisés multiplication appliquée á un classment (MICMAC) analysis were adopted. Results show that institutional support, reward system, research funding, mentoring, and electronic information resources are the most crucial factors influencing research productivity. When addressed, these driving factors would motivate other driving factors, contributing to higher research productivity. In particular, these findings encourage higher education institutions to (1) efficiently allocate research funds and design mentoring programs, (2) offer efficient research incentive schemes, (3) develop initiatives that would support promising research proposals beneficial to the institution, and (4) collaborate with external organizations to grant funding for research proposals. These results contribute significantly to the literature as it provides meaningful insights that aid decision-makers in higher education institutions in resource allocation decisions, policy-making, and the design of efficient initiatives for augmenting their innovation potential.

Therapy With Inhaled Treprostinil, Macitentan, and Tadalafil/Riociguat in High-Risk Pulmonary Arterial Hypertension.

Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Nebraska Medical Center, Omaha, NE K. El-Kersh provided consultative services to Acceleron, served on advisory boards for J&J Actelion, and United Therapeutics, received institutional research funding from J&J Actelion and United Therapeutics and participated in United Therapeutics speaker bureau (2018–2021).

Race- and sex-based variation in industry research and general payments to medical oncologists in the United States.

11050 Background: Industry partnerships offer financial incentives, prestige, and can facilitate career advancement in oncology. However, not all physicians may have equal access to these opportunities. We hypothesized that physicians who are underrepresented in the medical oncology workforce based on race, ethnicity, and gender receive less industry funding. Methods: All US medical oncologists (MOs) who received ≥1 industry research payment between 2016 and 2020 according to the Open Payments database were included in this retrospective study. Information extracted from Open Payments included MO’s name, institution, research payments (i.e. funding for a research project where the physician is a Principle Investigator), and general payments (i.e. fees not associated with research, such as consulting and travel fees). Additional web searches were conducted using institutional websites, NPPES NPI registry, LinkedIn, Doximity, Scopus, and NIH RePORTER to determine each MO’s race, ethnicity, sex, academic rank, degrees, h-index, institutional NIH research funding rank, and individual receipt of NIH funding. Log-linear regression was performed to identify associations of both industry and general payment data. Results: Of 7,542 physicians meeting inclusion criteria, 69% were male, 65% White, 29% Asian, 2% Black, and 4% Hispanic, which is comparable to the American Medical Association Physician Masterfile figures for MO. The median sum research payment and general payment was $134,857 and $11,537 per physician respectively. Significantly higher mean research payments were associated with an MS (+72%; P = 0.003) or PhD degree (+30%; P = 0.009), h-index (+3%; P < 0.001), top 50 institution rank by NIH funding (+44%; P < 0.001), and associate professor rank (+95%; P < 0.001). Significantly lower mean research payment were observed for Black physicians (-36%; P = 0.022) and those with non-academic affiliation (-47%; P < 0.001). No significant association was observed between sex and research payment. Significantly higher mean general payments were associated with male sex (+46%; P < 0.001), MS degree (+171%; P < 0.001), h-index (+2%; P < 0.001), and Asian race (+72%; P < 0.001). Significantly lower mean general payments were associated with an affiliation with a non-academic practice (-31%; P = 0.012). Conclusions: Black physicians received smaller sums of industry research payments compared to White physicians. Female sex was associated with decreased general payments compared to male sex. Further exploring the underlying mechanisms determining access to industry payments may help facilitate greater equity and inclusivity in oncology.

Long-term Outcomes With Ibrutinib Treatment for Patients With Relapsed/Refractory Mantle Cell Lymphoma: A Pooled Analysis of 3 Clinical Trials With Nearly 10 Years of Follow-up.

Long-term Outcomes With Ibrutinib Treatment for Patients With Relapsed/Refractory Mantle Cell Lymphoma: A Pooled Analysis of 3 Clinical Trials With Nearly 10 Years of Follow-up.

Health care costs and resource utilization among commercially insured adult patients with hemophilia A managed with FVIII prophylaxis in the United States.

BACKGROUND: Standard of care for patients with severe hemophilia A (HA) is life-long prophylaxis with factor VIII (FVIII) concentrate or other hemostatic agents. Published literature highlights a wide range of treatment costs for patients with HA. OBJECTIVE: To estimate average annual health care costs and resource utilization for a cross-section of adult patients managed with FVIII concentrate prophylaxis using recent data from a large US commercial claims database. METHODS: Adult males with 1 or more claim with HA diagnosis, continuous commercial plan enrollment, and 4 or more FVIII prescription dispenses during 12 months were identified from IBM MarketScan Research Database from January 2013 to September 2019, excluding those with FVIII inhibitors, an HIV/AIDS diagnosis, or diagnosis and treatment for hepatitis B or C. Patients were classified as using FVIII prophylaxis if they met any of the following definitions: (1) 6 or more FVIII dispenses, (2) a gap of 60 days or less between dispenses, and (3) at least 273 days supply in the 12-month period. Additionally, subgroups of patients meeting each individual definition were examined, with some patients included in all 3 subgroups. RESULTS: The overall cohort included 411 patients who met 1 or more of the 3 definitions, with a mean age of 28.9 years. Subgroups of 401, 325, and 237 patients met the first, second, and third FVIII prophylaxis definitions, respectively. Per-patient mean (SD) annual all-cause health care costs were $654,571 ($380,762) in the overall cohort and ranged from $650,065 ($382,196) to $759,661 ($387,040) among subgroups. Cost of FVIII concentrate accounted for more than 96% of total costs in the overall cohort and in each subgroup. Cost of FVIII in the overall cohort varied according to type of concentrate, with the highest among patients who were treated with both standard and extended half-life (SHL and EHL) FVIII ($784,945), followed by EHL FVIII only ($708,928), SHL FVIII only ($647,800), and plasma-derived FVIII ($535,614). The most common treatment type was SHL FVIII only (45.7% of all patients). In the overall cohort, the majority had 1 or more outpatient visits (94.9%), while emergency department visits, hospital admissions, and home health visits occurred less frequently (27.0%, 7.1%, and 7.1%, respectively). CONCLUSIONS: Commercially insured patients with HA incur substantial all-cause annual health care costs, with FVIII concentrate accounting for a majority of costs. DISCLOSURES: This study was funded by BioMarin Pharmaceutical Inc, which was involved in the protocol development, analysis plan development, data interpretation, manuscript preparation, and publication decisions. All authors contributed to protocol development, analysis plan development, data interpretation, and manuscript development and maintained control over the final content. Thornburg has received professional fees from BioMarin Pharmaceutical, CSL Behring, Genentech, Novo Nordisk, Sanofi Genzyme, HEMA Biologics, and Spark Therapeutics and institutional research funding from BioMarin Pharmaceutical, Novo Nordisk, and Sanofi Genzyme. Adamski, Cook, and Sendhil are employees of Analysis Group, a consulting company that was contracted by BioMarin Pharmaceutical to conduct this study and develop the manuscript. Vembusubramanian is a former employee of Analysis Group. Hinds, Chen, and Sammon are employees and shareholders of BioMarin Pharmaceutical. Solari is a former employee of BioMarin Pharmaceutical. Garrison has received consulting fees from BioMarin Pharmaceutical and Analysis Group. Croteau has received professional fees from BioMarin Pharmaceutical, Bayer, CSL Behring, HEMA Biologics, and Pfizer and institutional research funding from Novo Nordisk and Spark Therapeutics.

REASSEMBLING TECHNOLOGY TRANSFER IN INDONESIA

This article aims to provide a dynamic picture of the technology transfer process in public research institutions in Indonesia that has been updated by establishing the National Research and Innovation Agency in August 2021. This body is directly under the President of the Republic of Indonesia based on Presidential Regulation number 78 of 2021. During the research period, there was a change in the landscape of technology transfer actors. Some of these changes are in line with the results of the analysis, namely increasing the role of GFRI and research and development agencies under the ministry. This change is referred to as technology transfer reassembly. The arrangement of technology transfer leads to a new form. The research was initiated in October 2017 using the AHP to determine the best institutional arrangement for integrating research. The AHP results show the rank of institutional arrangements from highest to lowest as Government Funded Research Institutes (GFRI) (0.27833), a research division under the Ministerial Office (0.24890), universities (0.17966), private R&D (0.13589) and foreign agencies (0.07214). Government Funded Research Institutes are the top choice of experts for having a significant role in the technology transfer process. The core function of GFRI in the technology transfer system is to plan, conduct and develop technology and they have contributed significantly to the policy-making process by providing information and policy recommendations. This research enriched the application of the recommendations by establishing the National Research and Innovation Agency as the most influential actor in building a national technology transfer system.

PREDICT: A Multicenter, Prospective, Open-Label, Clinical Study Using a New Risk Score Approach to Assess the Most Appropriate Prophylaxis Regimen to Reach Favorable Outcomes in Hemophilia A, When Switching from Standard-Half-Life Products to Damoctocog Alfa Pegol

PREDICT: A Multicenter, Prospective, Open-Label, Clinical Study Using a New Risk Score Approach to Assess the Most Appropriate Prophylaxis Regimen to Reach Favorable Outcomes in Hemophilia A, When Switching from Standard-Half-Life Products to Damoctocog Alfa Pegol