bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimizing the development and evaluation of complex interventions: lessons learned from the BetterBirth Program and associated trial
Authors: Barnhart Dale A. , Semrau Katherine E. A. , Zigler Corwin M. , Molina Rose L. , Delaney Megan Marx , Hirschhorn Lisa R. , Spiegelman Donna 
Published: February 2020

Abstract
Background
Despite extensive efforts to develop and refine intervention packages, complex interventions often fail to produce the desired health impacts in full-scale evaluations. A recent example of this phenomenon is BetterBirth, a complex intervention designed to implement the World Health Organization’s Safe Childbirth Checklist and improve maternal and neonatal health. Using data from the BetterBirth Program and its associated trial as a case study, we identified lessons to assist in the development and evaluation of future complex interventions.

Methods
BetterBirth was refined across three sequential development phases prior to being tested in a matched-pair, cluster randomized trial in Uttar Pradesh, India. We reviewed published and internal materials from all three development phases to identify barriers hindering the identification of an optimal intervention package and identified corresponding lessons learned. For each lesson, we describe its importance and provide an example motivated by the BetterBirth Program’s development to illustrate how it could be applied to future studies.

Results
We identified three lessons: (1) develop a robust theory of change (TOC); (2) define optimization outcomes, which are used to assess the effectiveness of the intervention across development phases, and corresponding criteria for success, which determine whether the intervention has been sufficiently optimized to warrant full-scale evaluation; and (3) create and capture variation in the implementation intensity of components. When applying these lessons to the BetterBirth intervention, we demonstrate how a TOC could have promoted more complete data collection. We propose an optimization outcome and related criteria for success and illustrate how they could have resulted in additional development phases prior to the full-scale trial. Finally, we show how variation in components’ implementation intensities could have been used to identify effective intervention components.

Conclusion
These lessons learned can be applied during both early and advanced stages of complex intervention development and evaluation. By using examples from a real-world study to demonstrate the relevance of these lessons and illustrating how they can be applied in practice, we hope to encourage future researchers to collect and analyze data in a way that promotes more effective complex intervention development and evaluation.

Trial registration
ClinicalTrials.gov, NCT02148952; registered on May 29, 2014
Factors influencing the implementation and uptake of a discharge care bundle for patients with acute exacerbation of chronic obstructive pulmonary disease: a qualitative focus group study
Authors: Michas Marta , Deuchar Lesly , Leigh Richard , Bhutani Mohit , Rowe Brian H. , Stickland Michael K. , Ospina Maria B. ,   for the COPD PRIHS-2 Group, Damant Ron , Mayers Irvin , Hall Jerry , Green Lee , Yan Charles , Pendharkar Sachin , Mody Chris , Field Stephen , Walker Brandie , Lohman Tara , Roman Michael , Graham Jim , Farris Peter , Ryan Allan , Mrklas Kelly , Dubois Roberta 
Published: February 2020

Abstract
Background
Chronic obstructive pulmonary disease (COPD) is one of the most common causes of mortality and morbidity in high-income countries. In addition to the high costs of initial hospitalization, COPD patients frequently return to the emergency department (ED) and are readmitted to hospital within 30 days of discharge. A COPD acute care discharge care bundle focused on optimizing care for patients with an acute exacerbation of COPD has been shown to reduce ED revisits and hospital readmissions. The aim of this study was to explore and understand factors influencing implementation and uptake of COPD discharge care bundle items in acute care facilities from the perspective of health care providers and patients.

Methods
Qualitative methodology was adopted. Nine focus groups were conducted using a semi-structured guide: seven with acute and primary/community health care providers and two with patients/family members. Focus groups were audiotaped, transcribed verbatim, and coded and analyzed using a thematic approach.

Results
Forty-six health care providers and 14 patients/family members participated in the focus groups. Health care providers and patients identified four factors that can challenge the implementation of COPD discharge care bundles: process of care complexities, human capacity in care settings, communication and engagement, and attitudes and perceptions towards change. Both health care providers and patients recognized process of care complexity as the most important determinant of the COPD discharge bundle uptake. Processes of care complexity include patient activities in seeking and receiving care, as well as practitioner activities in making a diagnosis and recommending or implementing treatment. Important issues linked to human capacity in care settings included time constraints, high patient volume, and limited staffing. Communication during transitions in care across settings and patient engagement were also broadly discussed. Other important issues were linked to patients’, providers’, and system attitudes towards change and level of involvement in COPD discharge bundle implementation.

Conclusions
Complexities in the process of care were perceived as the most important determinant of COPD discharge bundle implementation. Early engagement of health providers and patients in the uptake of COPD discharge bundle items as well as clear communication between acute and post-acute settings can contribute positively to bundle uptake and implementation success.
Prediagnosis cardiovascular risk and subsequent myocardial infarction (MI) among lymphoma survivors.
Authors: Salz Talya , Zabor Emily Craig , de Nully Brown Peter , Dalton Susanne Oksbjerg , Raghunathan Nirupa Jaya , Matasar Matthew J. , Steingart Richard , Hjalgrim Henrik , Specht Lena , Oeffinger Kevin C. , Johansen Christoffer 
Published: February 2020

7564 Background: Chest radiation is associated with increased risk of MI among lymphoma survivors. The extent to which pre-existing cardiovascular risk factors also contribute to risk is understudied. We investigated this association among a national population of lymphoma survivors with a full range of cardiovascular risk factors. Methods: Using Danish population-based registries, we identified all adults diagnosed with aggressive non-Hodgkin lymphoma or Hodgkin lymphoma from 2000-2010 and followed them from 1 year after diagnosis through 2016. MI was ascertained from the nationwide Hospital Discharge Register and Cause of Death Register. Cardiovascular risk factors (hypertension, dyslipidemia, and diabetes), vascular disease, and intrinsic heart disease prevalent at lymphoma diagnosis were ascertained algorithmically using the National Prescription Register and the Hospital Discharge Register. Controlling for age, sex, histology, receipt of chest radiation, and prevalent cardiovascular diseases, we used multivariable Cox regression to test the association between pre-existing cardiovascular risk factors and subsequent MI. Results: Among 4246 survivors of lymphoma, median age at diagnosis was 60 (interquartile range 45-70 years); median follow-up was 6.9 years (range 0-16 years). 115 survivors were diagnosed with MI. Before lymphoma diagnosis, 28% of survivors had ≥1 cardiovascular risk factor, and 16% of survivors received chest radiation. In multivariable analysis, survivors who received chest radiation had an increased risk of MI compared to survivors who did not (HR=1.92 [95% CI=1.16-3.17]). Survivors with ≥1 cardiovascular risk factor had an increased risk of MI compared to survivors with none (HR = 2.44 [95% CI=1.65-3.62]). Conclusions: In a large, well-characterized, nationally representative study of contemporarily treated lymphoma survivors, prevalent hypertension, dyslipidemia, and diabetes were associated with later MI. Findings suggest that pre-existing cardiovascular risk factors confer the same amount of MI risk as does chest radiation. To prevent MI among survivors, decisions about post-treatment monitoring should address prevalent cardiovascular risk.
Validation of broad panel clinical sequencing-based genomic risk stratification in patients with advanced lung adenocarcinomas.
Authors: Whipple Sam , Martin Axel , Martinec Michael , Arbour Kathryn Cecilia , Seshan Venkatraman E. , Riely Gregory J. , Crane Gracy , Shen Ronglai 
Published: February 2020

9113 Background: We recently established the ability of broad-panel clinical sequencing data to stratify overall survival of patients with advanced lung adenocarcinomas in a single institutional experience (Shen, Riely et al., JCO Precision Oncology 2019). Here we sought to assess its generalizability to a broader range of patients (including patients from multiple community and academic sites) using a different sequencing panel, with an integrated electronic health record and genomic database. Methods: We identified 2,779 next-generation sequencing-tested patients with advanced lung adenocarcinomas from the Flatiron-Foundation Medicine Clinico-Genomic database. A genomic risk model developed from the initial discovery cohort (n=1,054) was used to calculate a risk score for each patient in the validation cohort, scaled between 0 and 10, indicating the risk of cancer specific mortality. Results: Patients in the validation cohort were classified into four risk categories with median survival ranging from 37.6 months (95% CI: 32.9-43.8) in the low risk group (n=534) to 10.9 months (95% CI: 8.0-16.5) in the highest risk group (n=75), representing a hazard ratio of 3.0 (95% CI: 2.2-4.1) and closely matching the discovery cohort observations. A smaller proportion of patients were deemed high risk in the validation cohort (2.7% vs 10% in the discovery cohort). There were some differences in the frequencies of the most common genomic alterations between the validation and discovery cohorts, including TP53 (57.3% vs 55.1%) , KRAS (32.8% vs 30%), EGFR (18.6% vs 29.4%) as well as overlapping STK11 and KEAP1 co-mutations (2.4% vs 10%). Conclusions: We demonstrate that a clinical tumor sequencing-based genomic risk stratification strategy can be applied broadly across cohorts and different sequencing panels and platforms, to improve the understanding of heterogeneity in clinical outcome for patients with metastatic lung adenocarcinomas and the mutation and co-mutational patterns that underlie such heterogeneity.
Crenolanib versus midostaurin combined with induction and consolidation chemotherapy in newly diagnosed FLT3 mutated AML.
Authors: Stone Richard M. , Wang Eunice S. , Goldberg Aaron David , Sweet Kendra Lynn , Fathi Amir Tahmasb , Liu Hongtao , Messahel Boo 
Published: February 2020

TPS7068 Background: Despite the approval of multi-targeted protein kinase inhibitor midostaurin for use in combination with chemotherapy which improves 5-year survival in newly diagnosed (NDx) acute myeloid leukemia (AML) associated with FLT3 mutations; the cumulative incidence of relapse in FLT3 mutant AML remains high, with progression often characterized by secondary FLT3-TKD mutations. Crenolanib is a potent pan- FLT3 inhibitor that has shown promising efficacy and tolerability in combination with chemotherapy in Phase 1/2 trials for AML patients with FLT3-ITD or - TKD mutations. This is the first globally initiated, randomized Phase 3 trial comparing the efficacy of two FLT3-TKIs, crenolanib and midostaurin, combined with intensive chemotherapy in NDx FLT3-mutated AML patients. Methods: This Phase 3, randomized, multi-center trial will be conducted at multiple sites worldwide, with a target enrollment of 510 subjects. Patient inclusion was modified to match the midostaurin RATIFY criteria to enroll NDx FLT3-mutated AML (18 – 60 yo), who are eligible for intensive chemotherapy; with the addition of any FLT3-ITD and/or -TKD mutations being eligible. All subjects will receive TKI treatment and will be randomized in a 1:1 ratio to receive either crenolanib (arm A) or the active-control, midostaurin (arm B). All patients will be treated with 7+3 (100 mg/m2 IV cytarabine; 90 mg/m2 IV daunorubicin) and can initiate treatment while awaiting FLT3 results prior to randomization. Consolidation could include chemotherapy (3000 mg/m2 IV HiDAC) for up to 4 cycles and/or Allo-HSCT, depending on patient condition. During induction and consolidation patients on arm A will take crenolanib (100 mg TID) from d9 until 72h prior to the next cycle, and patients on arm B will take midostaurin (50 mg BID) on d8 to d21 of each cycle. Following consolidation or HSCT, patients may receive up to 12 months of FLT3-TKI maintenance. Maintenance efficacy will be evaluated over time using single-cell sequencing to assess MRD. Primary endpoint is event-free survival. Interim analyses will occur at approximately 178 and 267 events, and primary analysis at 356 events. Enrollment is underway as of January 31, 2019. Clinical trial information: NCT03258931.
Decreasing Cost and Decreasing Length of Stay After Implementation of Updated High-Dose Methotrexate Discharge Criteria
Authors: Binder Adam F. , Burdette Samantha , Galanis Patricia , Birchmeier Katlin , Handley Nathan , Piddoubny Maria 
Published: February 2020

PURPOSE: High-dose methotrexate (HD-MTX) is commonly used for the treatment of osteosarcoma or for CNS involvement in lymphoproliferative neoplasms. It is often given in the inpatient setting because of monitoring requirements after administration. We conducted a process improvement initiative to change our institutional discharge criteria for HD-MTX from 0.05 µmol/L to ≤ 0.1 µmol/L to reduce cost and length of stay (LOS) for this patient population. METHODS: After an assessment of drivers of LOS among patients receiving HD-MTX, we identified discharge criteria as an actionable factor. We developed a workflow to discharge patients with 3 days of oral leucovorin and sodium bicarbonate when the methotrexate level reached ≤ 0.1 µmol/L. Patient demographics, chemotherapy regimen, cycle, dose, and LOS data were collected for a 7-month period before and a 4-month period after the intervention. Cost savings were estimated on the basis of the daily cost of a hospital bed at the institution. RESULTS: Mean LOS for the pre-intervention and postintervention group was 4.84 days (n = 49) and 3.67 days (n = 42), respectively, resulting in a 24.4% reduction in LOS, with a mean ratio of 0.756 (95% CI, 0.615 to 0.927; P = .007). Reduced LOS resulted in a decrease in cost of $1,828.73 per admission, with a 4-month savings of $76, 806.56 and projected annualized savings of $230,419.67. No patient experienced complications because of the change in discharge criteria. CONCLUSION: Liberalizing discharge criteria for HD-MTX was feasible and safe and reduced cost. Additional efforts to reduce LOS for elective chemotherapy admissions or to safely transition some of these complex regimens to the home setting are currently underway at our institution.
Aliphatic Oxaboroles Enabling Remarkable Recognition of Diols
Authors: Arakawa Nozomi , Nagao Kazunori , Murakami Ryo , Sumida Yuto , Arakawa Hiroshi , Inagaki Fuyuhiko , Ohmiya Hirohisa 
Published: February 2020

Abstract
5-Membered ring aliphatic oxaboroles revealed unique characteristics in their reactivity with diols. The aliphatic oxaborole derivatives exhibited a higher complexation activity for Alizarin Red S than phenyl-, alkylboronic acid, benzoxaborole, and oxaborin. Furthermore, the sugar recognition ability depended on the chirality of the aliphatic boroles.
Adopting evidence-based guidelines for acute stroke care: barriers and enablers for health professionals
Authors: Harrison Joanna , Timoroksa Anne-Marie , Gregary Bindu , Hill James Edward 
Published: February 2020

An evidence summary based on the systematic review: Baatiema L, Otim ME, Mnatzaganian G, de-Graft Aikins A, Coombes J, Somerset S. Health professionals' views on the barriers and enablers to evidence-based practice for acute stroke care: a systematic review. Implement Sci. 2017;12:74. 10.1186/s13012-017-0599-3 Evidence-based practice is the keystone of clinical practice, policy and management. Despite this, a knowledge-to-practice gap still exists, and it is estimated to take 17 years for evidence to be translated into clinical practice. The reasons for slow translation in acute stroke care are not completely understood.
Application of RS/GIS in Conservation Studies for Surface and Groundwater Harvesting in Cold Arid Regions of Northwestern Himalayas
Authors: Khan Junaid N. , Ali Syed Rouhullah , Jillani Asima , Ashraf Ifra 
Published: February 2020

Abstract.The availability of erratic rainfall and high evapotranspiration causes temporal and spatial variability of water thereby causing crop yield reduction and crop failure. The potential of water harvesting (WH) both groundwater as well as surface water to mitigate the spatial and temporal variability of precipitation. One technique for water harvesting (WH) is to collect excess runoff water both rain and snowmelt, store it for agricultural purposes during dry spells. The present work accentuated the expediency of remote sensing (RS) and geographic information system (GIS) applications in water harvesting studies. The resultant water harvesting potential map prepared was thus classified into three WH potential zones namely, high, medium and low covering an area of 32.82, 10320.10, and 7596.18 ha (&lt;1%, 57.49%, and 42.32%) respectively. The groundwater map in the area was also classified as high potential areas covering 1421.69 ha (7.92%), medium potential areas covering 8762.69 ha (48.81%), and low potential areas covering 7764.72 ha (43.25%). The integrated remote sensing (RS), Geographical Information System (GIS), Soil and Water Assessment Tool (SWAT), and analytical hierarchy process (AHP) were found to be efficient methods to recover water and to select suitable water and groundwater harvesting sites in order to ensure better water accessibility to the people for domestic, irrigation and other activities in cold arid regions of northwestern Himalayas. Keywords: Analytical hierarchy process, Geographic Information System, Groundwater harvesting, Remote sensing, Spatial variability, Temporal variability, Water harvesting.
Mathematical Modelling, Moisture Transport, Shrinkage and Nutrient Content Properties in Drying Selected African Leafy Vegetables
Authors: Mutuli Gibson P , Mbuge Duncan O , Gitau Ayub N 
Published: February 2020

HighlightsPage model best described their drying pattern at moisture content above 0.5 w.b.Shrinkage linearly correlates to moisture loss.Activation energy correlates to air temperature.Vitamins A, C, and E are preserved by drying and storage. ABSTRACT. The study investigated physical, thermodynamic, and nutritional properties with drying and storage of selected African green leafy vegetables. The vegetables studied were: (Jute Mallow), (Slender Leaf), (Cowpea), (Nightshade), and (Amaranthus). Drying experiment was done at 30°C, 40°C, and 50°C in a convective laboratory dryer and drying was pattern fitted to existing models, moisture diffusivity, and activation energy trends were determined, shrinkage was determined from change in leaf thickness, and vitamins A, C, and E were analyzed using spectroscopy and high-pressure liquid chromatography as freshly harvested and after drying at 40°C and storage for 60 days. Results showed that drying occurred in the falling rate period and Page model could simulate the drying pattern of the vegetables with a ˜97% correlation between the empirical and predicted values with the model prediction being precise above 0.5 moisture content on wet basis (w.b.). Shrinkage was found to be a function of moisture loss at a range of 89% to 98% linear correlation. The rate of moisture loss and activation energy correlated with air temperature. The trend in the drying characteristics and moisture transport of the vegetables was unique with each vegetable. Drying at 40°C and storage for 60 days realized a retention in the scale range of 50% to 75% for vitamins A, C, and E. The study showed that drying is an effective way to preserve the vegetables. Keywords: Mathematical modeling, Mass transfer, Nutrient preservation, Shrinkage, Thermodynamic properties.
Inactivation of Aerosolized Newcastle Disease Virus with Non-thermal Plasma
Authors: Schiappacasse Charles , Peng Peng , Zhou Nan , Liu Xiaoying , Zhai Jie , Cheng Yanling , Shao J. , Verma V. , Singh N. , Chen P. , Janni, K.  A. , Liang Y. , Noll S. , Ruan R.  R. 
Published: February 2020

Abstract.HighlightsNon-thermal plasma treatment completely inactivated Newcastle disease virus (NDV).Higher airborne virus concentrations at lower humidity levels &amp; higher flow rates.Nebulization (20 min) did not inactivate NDV .Abstract.The airborne transmission of poultry viruses, such as Newcastle disease virus, is major health and economic concern. The poultry industry currently lacks a cost-effective solution to prevent airborne transmission. The present study explored non-thermal plasma’s ability to inactivate poultry viruses, by challenging a laboratory-scale non-thermal plasma reactor with aerosolized Newcastle disease virus at increasing flow rates (i.e., decreased direct treatment time). Viruses were inactivated below the green fluorescent protein (GFP) focus-forming units per mL (GFU/mL) limit of detection at the flow rates 18, 23, and 28 liters per minute (LPM). However, this study did not differentiate between inactivation effects caused by direct NTP treatment and indirect NTP treatment (viruses exposed to ozone after collection on gelatin membrane filters). A strong relationship (R2 =.99) was observed between decreasing relative humidity and increasing airborne virus concentrations. Twenty minutes of nebulization did not significantly change liquid virus concentration in the nebulizer. Keywords: Aerosol, Airborne, Newcastle disease, Non-thermal, Pathogen, Plasma, Virus.