Failing Forward Quickly as a Developmental Evaluator: Lessons from Year One of the LiveWell Kershaw Journey

Background: Learning to be a developmental evaluator is challenging because it is relatively new and sparsely documented in the scholarly literature. Developmental evaluation is intended to support the ever-changing and adaptive nature of complex environments. In a developmental, systems-oriented evaluation framework, the evaluator is embedded in the process to support and generate learnings from ongoing findings. Purpose: This article presents the lessons learned through one case study and how the concept of failing forward can guide the evaluator’s reflective process through a developmental evaluation.Setting: Free clinic and community setting in Kershaw County, South Carolina Intervention: NA Research Design: NA Data Collection and Analysis: The Evaluator documented mistakes and lessons learned during the beginning, planning and implementation stages of a complex community health initiative. Findings: The evaluation team shares five mistakes made along during the journey and lessons learned.  It’s important for teams to understand what differentiates developmental evaluation from other types of evaluation and the role of the evaluator.  The “critical friend” boundary can be easily crossed and the evaluator needs to have a strong understanding of the needs of the initiative

Addressing COVID-19 in the surgical ICU: Incidence of antibodies in healthcare personnel at a quaternary care center

Background: There is concern that frontline healthcare personnel (HCP) are at increased risk of exposure to COVID-19 compared to the general population. Multiple studies have demonstrated significant seroprevalence of COVID-19 antibodies in HCP. Increased seropositivity has been associated with reduced use of personal protective equipment (PPE) along with reported PPE shortages. This investigation aims to determine the seroprevalence of COVID-19 in frontline HCP working at a quaternary care center that was heavily impacted by the initial surge of COVID-19, while also identifying underlying factors associated with increased seropositivity. Methods & Materials: HCP who participated in the management of COVID-19 patients were recruited from April 27 to May 13 of 2020. Unidentifiable demographic data was collected, including a questionnaire to identify potential exposure, symptoms, medical comorbidities, and adherence to PPE usage on a scale of 1 to 5 (1 being always, 5 being never). Serological testing was performed using CMC-19D SARS-CoV-2 (COVID-19) Rapid Antibody Test manufactured by Audacia Bioscience. Seropositivity was captured by formation of a dark band at the G (IgG) and C (control) positions on the test device, while IgM alone was considered a false positive. Pearson chi-squared and Fisher exact tests were performed to analyze categorical variables. SPSS version 27.0 was used for statistical analysis (SPSS, Armonk, NY). Conclusion: Overall seropositivity of IgG antibodies was 10.6%. Non-ICU personnel showed higher seroprevalence compared to ICU personnel, this may be attributed to decreased reported adherence to strict PPE usage in non-ICU areas compared to ICU areas during patient contact. Compared to MICU, SICU personnel appeared to be less compliant with frequency of PPE use outside patient rooms. Adherence to PPE usage outside patient contact was a predictor of seropositivity, and non-ICU personnel had a tendency toward high seroprevalence.https://scholarlycommons.henryford.com/sarcd2021/1003/thumbnail.jp

Structural Control on Megathrust Rupture and Slip Behavior: Insights From the 2016 Mw 7.8 Pedernales Ecuador Earthquake

The heterogeneous seafloor topography of the Nazca Plate as it enters the Ecuador subduction zone provides an opportunity to document the influence of seafloor roughness on slip behavior and megathrust rupture. The 2016 M$_{w}$ 7.8 Pedernales Ecuador earthquake was followed by a rich and active postseismic sequence. An internationally coordinated rapid response effort installed a temporary seismic network to densify coastal stations of the permanent Ecuadorian national seismic network. A combination of 82 onshore short and intermediate period and broadband seismic stations and six ocean bottom seismometers recorded the postseismic Pedernales sequence for over a year after the mainshock. A robust earthquake catalog combined with calibrated relocations for a subset of magnitude ≥4 earthquakes shows pronounced spatial and temporal clustering. A range of slip behavior accommodates postseismic deformation including earthquakes, slow slip events, and earthquake swarms. Models of plate coupling and the consistency of earthquake clustering and slip behavior through multiple seismic cycles reveal a segmented subduction zone primarily controlled by subducted seafloor topography, accreted terranes, and inherited structure. The 2016 Pedernales mainshock triggered moderate to strong earthquakes (5 ≤ M ≤ 7) and earthquake swarms north of the mainshock rupture close to the epicenter of the 1906M$_{w}$ 8.8 earthquake and in the segment of the subduction zone that ruptured in 1958 in a M$_{w}$ 7.7 earthquake

Fluorescence in situ hybridization gene amplification analysis of EGFR and HER2 in patients with malignant salivary gland tumors treated with lapatinib

Gene amplification status of the epidermal growth factor receptor (EGFR) and the human epidermal growth factor receptor 2 (HER2) were analyzed and correlated with clinical outcome in patients with progressive malignant salivary glands tumors (MSGT) treated with the dual EGFR/Her2 tyrosine kinase inhibitor lapatini

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Phase II Study of Lapatinib in Recurrent or Metastatic Epidermal Growth Factor Receptor and/or erbB2 Expressing Adenoid Cystic Carcinoma and Non–Adenoid Cystic Carcinoma Malignant Tumors of the Salivary Glands

PURPOSE: Expression of erbB2 and/or epidermal growth factor receptor (EGFR) is associated with biologic aggressiveness and poor prognosis in malignant salivary gland tumors (MSGTs). This phase II study was conducted to determine the antitumor activity of lapatinib, a dual inhibitor of EGFR and erbB2 tyrosine kinase activity, in MSGTs. PATIENTS AND METHODS: Patients with progressive, recurrent, or metastatic adenoid cystic carcinoma (ACC) immunohistochemically expressing at least 1+ EGFR and/or 2+ erbB2 were treated with lapatinib 1,500 mg daily, in a two-stage cohort. Patients with non-ACC MSGTs were treated as a separate single-stage cohort. RESULTS: Of 62 patients screened, 29 of 33 (88%) ACC and 28 of 29 (97%) non-ACC patients expressed EGFR and/or erbB2. Forty patients with progressive disease were enrolled onto the study. Among 19 assessable ACC patients, there were no objective responses, 15 patients (79%) had stable disease (SD), nine patients (47%) had SD > or = 6 months, and four patients (21%) had progressive disease (PD). For 17 assessable non-ACC patients, there were no objective responses, eight patients (47%) had SD, four patients (24%) had SD > or = 6 months, and nine patients (53%) had PD. The most frequent adverse events were grade 1 to 2 diarrhea, fatigue, and rash. Eight paired tumor biopsies for correlative studies were procured; results did not correlate with clinical outcome. CONCLUSION: Although no responses were observed, lapatinib was well tolerated, with prolonged tumor stabilization of > or = 6 months in 36% (95% CI, 21% to 54%) of assessable patients. The antitumor effects of lapatinib in MGSTs appear mainly cytostatic, hence evaluation of other molecular targeted agents, or combinations with lapatinib, may be considered. Continued efforts should be made to gain better understanding into the biology of this heterogeneous group of malignancies

Disrupting the rhythm of depression using Mobile Cognitive Therapy for recurrent depression: randomized controlled trial design and protocol

Background: Major depressive disorder (MDD) is projected to rank second on a list of 15 major diseases in terms of burden in 2030. The major contribution of MDD to disability and health care costs is largely due to its highly recurrent nature. Accordingly, efforts to reduce the disabling effects of this chronic condition should shift to preventing recurrence, especially in patients at high risk of recurrence. Given its high prevalence and the fact that interventions are necessary during the remitted phase, new approaches are needed to prevent relapse in depression. Methods/design: The best established effective and available psychological intervention is cognitive therapy. However, it is costly and not available for most patients. Therefore, we will compare the effectiveness and cost-effectiveness of self-management supported by online CT accompanied by SMS based tele-monitoring of depressive symptomatology, i.e. Mobile Cognitive Therapy (M-CT) versus treatment as us usual (TAU). Remitted patients (n = 268) with at least two previous depressive episodes will be recruited and randomized over (1) M-CT in addition to TAU versus (2) TAU alone, with follow-ups at 3, 12, and 24 months. Randomization will be stratified for number of previous episodes and type of treatment as usual. Primary outcome is time until relapse/recurrence over 24 months using DSM-IV-TR criteria as assessed by the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID). For the economic evaluation the balance between costs and health outcomes will be compared across strategies using a societal perspective. Discussion: Internet-based interventions might be helpful in empowering patients to become their own disease managers in this lifelong recurrent disorder. This is, as far as we are aware of, the first study that examines the (cost) effectiveness of an E-mental health program using SMS monitoring of symptoms with therapist support to prevent relapse in remitted recurrently depressed patient

The Lyman Continuum Escape Fraction of Star-forming Galaxies at 2.4≲z≲3.72.4\lesssim z\lesssim3.7 from UVCANDELS

The UltraViolet Imaging of the Cosmic Assembly Near-infrared Deep Extragalactic Legacy Survey Fields (UVCANDELS) survey is a Hubble Space Telescope (HST) Cycle-26 Treasury Program, allocated in total 164 orbits of primary Wide-Field Camera 3 Ultraviolet and Visible light F275W imaging with coordinated parallel Advanced Camera for Surveys F435W imaging, on four of the five premier extragalactic survey fields: GOODS-N, GOODS-S, EGS, and COSMOS. We introduce this survey by presenting a thorough search for galaxies at $z\gtrsim2.4$ that leak significant Lyman continuum (LyC) radiation, as well as a stringent constraint on the LyC escape fraction ($f_{\rm esc}$) from stacking the UV images of a population of star-forming galaxies with secure redshifts. Our extensive search for LyC emission and stacking analysis benefit from the catalogs of high-quality spectroscopic redshifts compiled from archival ground-based data and HST slitless spectroscopy, carefully vetted by dedicated visual inspection efforts. We report a sample of five galaxies as individual LyC leaker candidates, showing $f_{\rm esc}^{\rm rel}\gtrsim60\%$ estimated using detailed Monte Carlo analysis of intergalactic medium attenuation. We develop a robust stacking method to apply to five samples of in total 85 non-detection galaxies in the redshift range of $z\in[2.4,3.7]$. Most stacks give tight 2-$\sigma$ upper limits below $f_{\rm esc}^{\rm rel}<6\%$. A stack for a subset of 32 emission-line galaxies shows tentative LyC leakage detected at 2.9-$\sigma$, indicating $f_{\rm esc}^{\rm rel}=5.7\%$ at $z\sim2.65$, supporting the key role of such galaxies in contributing to the cosmic reionization and maintaining the UV ionization background. These new F275W and F435W imaging mosaics from UVCANDELS have been made publicly available on the Barbara A. Mikulski Archive for Space Telescopes.Comment: 33 pages, 21 figures, and 5 tables. Resubmitted after addressing the referee repor