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Item Amy Blevins, Medical Library Association President, 2023–2024(University Library System at the University of Pittsburgh, 2025) Kiscaden, Elizabeth; Craven, Hannah J.; Rios, Gabriel R.; Harris, Ryan; Nicholson, Joey; Ruth Lilly Medical Library, School of MedicineAmy Blevins served as the Medical Library Association president from 2023-2024. In this presidential biography, the authors outline a history of Blevins' recruitment to the career, career development, and impact on the association and the profession.Item Association of Extubation Failure Rates With High-Flow Nasal Cannula, Continuous Positive Airway Pressure, and Bilevel Positive Airway Pressure vs Conventional Oxygen Therapy in Infants and Young Children: A Systematic Review and Network Meta-Analysis(American Medical Association, 2023-06-05) Iyer, Narayan Prabhu; Rotta, Alexandre T.; Essouri, Sandrine; Fioretto, Jose Roberto; Craven, Hannah J.; Whipple, Elizabeth C.; Ramnarayan, Padmanabhan; Abu-Sultaneh, Samer; Khemani, Robinder G.IMPORTANCE: Extubation failure (EF) has been associated with worse outcomes in critically ill children. The relative efficacy of different modes of noninvasive respiratory support (NRS) to prevent EF is unknown. OBJECTIVE: To study the reported relative efficacy of different modes of NRS (high-flow nasal cannula [HFNC], continuous positive airway pressure [CPAP], and bilevel positive airway pressure [BiPAP]) compared to conventional oxygen therapy (COT). DATA SOURCES: MEDLINE, Embase, and CINAHL Complete through May 2022. STUDY SELECTION: Randomized clinical trials that enrolled critically ill children receiving invasive mechanical ventilation for more than 24 hours and compared the efficacy of different modes of postextubation NRS. DATA EXTRACTION AND SYNTHESIS: Random-effects models were fit using a bayesian network meta-analysis framework. Between-group comparisons were estimated using odds ratios (ORs) or mean differences with 95% credible intervals (CrIs). Treatment rankings were assessed by rank probabilities and the surface under the cumulative rank curve (SUCRA). MAIN OUTCOMES AND MEASURES: The primary outcome was EF (reintubation within 48 to 72 hours). Secondary outcomes were treatment failure (TF, reintubation plus NRS escalation or crossover to another NRS mode), pediatric intensive care unit (PICU) mortality, PICU and hospital length of stay, abdominal distension, and nasal injury. RESULTS: A total of 11 615 citations were screened, and 9 randomized clinical trials with a total of 1421 participants were included. Both CPAP and HFNC were found to be more effective than COT in reducing EF and TF (CPAP: OR for EF, 0.43; 95% CrI, 0.17-1.0 and OR for TF 0.27, 95% CrI 0.11-0.57 and HFNC: OR for EF, 0.64; 95% CrI, 0.24-1.0 and OR for TF, 0.34; 95% CrI, 0.16- 0.65). CPAP had the highest likelihood of being the best intervention for both EF (SUCRA, 0.83) and TF (SUCRA, 0.91). Although not statistically significant, BiPAP was likely to be better than COT for preventing both EF and TF. Compared to COT, CPAP and BiPAP were reported as showing a modest increase (approximately 3%) in nasal injury and abdominal distension. CONCLUSIONS AND RELEVANCE: The studies included in this systematic review and network meta-analysis found that compared with COT, EF and TF rates were lower with modest increases in abdominal distension and nasal injury. Of the modes evaluated, CPAP was associated with the lowest rates of EF and TF.Item Bibliometric analysis of publications on healthcare disparities among sexual and gender minorities: an exploratory study(2020-10-01) Ramirez, Mirian; Craven, Hannah J.Academic and scientific literature related to healthcare disparities among sexual and gender minorities has increased significantly over the past decade. For this study, a bibliometric analysis will be applied to examine the characteristics, as well as the growth and authorship patterns of worldwide research output, addressing issues related to barriers and disparities of the availability or access to medical services for the LGBTQ population. For this exploratory study, we used the Web of Science database, one of the most widely multidisciplinary databases, that provides the analytical tools for bibliometric calculations. For this analysis, we conducted a bibliographic search on the topic of healthcare disparities in order to collect the representative documents about the topic and to identify authors, document types, year of publications, sources, main thematic areas, most productive institutions, languages and most productive countries of research output. We used an open-source Bibliometrix/Biblioshiny R-package to conduct quantitative analysis. This approach aims to inform the development and trends of research outputs to understand what this research is focusing on, identify research productivity and topic trends.Item Claim your online scholarly presence: Google Scholar(2020-03-06) Ramirez, Mirian; Craven, Hannah J.; Whipple, Elizabeth C.Claiming, maintaining, and tracking research output is crucial to a researcher’s continued visibility and impact. This workshop will cover several (ORCiD ID, MyNCBI, Google Scholar, ResearcherID) of the commonly used scholarly profile tools. Tracking scholarly output and cultivating information about a researcher's work is made possible with online scholarly profile tools. Attendees participated in hands on activities to set up profiles, and discover more information about tracking their impact going forward, and utilize existing connections between different scholarly profile tools. Learning objectives: • List reasons why maintaining scholarly profiles is important to researchers • Describe the benefits of several scholarly profile tools • Set up and/or update your scholarly profile(s)Item Claim your online scholarly presence: ORCiD(2020-03-06) Craven, Hannah J.; Ramirez, Mirian; Whipple, Elizabeth C.Claiming, maintaining, and tracking research output is crucial to a researcher’s continued visibility and impact. Tracking scholarly output and cultivating information about a researcher's work is made possible with online scholarly profile tools. As the most widely accepted unique identifier for authors, ORCiD IDs are increasingly required for: paper submissions to journals, grant submissions, and various NIH research training and career development awards. Attendees participated in hands on activities to set up profiles, and discover more information about tracking their impact going forward, and utilize existing connections between different scholarly profile tools. Learning objectives: • List reasons why maintaining scholarly profiles is important to researchers • Describe the benefits of several scholarly profile tools • Set up and/or update your scholarly profile(s)Item Context and characteristics of the research metrics librarian(2019-10-25) Craven, Hannah J.; Grooten, Todd M.; Whipple, Elizabeth C.; Ralston, Rick K.; Odell, Jere D.Item Correspondence between actigraphy and PSG measures of sleep onset latency in young children(Associated Professional Sleep Societies, LLC, 2012-06-12) Craven, Hannah J.; Seifer, Ronald; LeBourgeois, Monique K.INTRODUCTION: Actigraphy is a non-invasive tool providing objective measurement of sleep onset, offset, and efficiency for extended periods of time based upon wrist-activity levels. Whether actigraphy may also provide an adequately-valid estimate of sleep-onset latency (SOL) in young children is not well-established. This study examined concordance between the gold standard of SOL, polysomnography (PSG), and actigraphy in a cohort of 2-5 year-olds studied at five different levels of prior wakefulness. METHODS: Participants were 8 healthy children (3 males) studied at three longitudinal time points (2.5-3.0y, 3.5-4.0y, 5.5-6.0y). Children followed a strict sleep schedule for at least 5 days before each of five home-based, PSG recordings in which they also wore an actigraph (AW64). Sleep assessments occurred after 4h, 7h, 10h, 13h, and 16h of prior wakefulness, reflecting different levels of sleep pressure. Visual stage scoring used 30-sec epochs from C3/A2. Lights-out time was simultaneously marked on PSG and actigraphy with event markers. Sleep-onset was the first epoch of stage 2 sleep (PSG) and the first of three consecutive epochs of scored sleep after lights-out (actigraphy). RESULTS: Analysis included 9-14 sleep assessments per child of SOL (concurrent PSG and ACT). Averaged SOL varied across sleep assessments and age (PSG range: 4.9+3.1 to 26.9+13.7; ACT range 4.2+3.1 to 19.3+15.9). We performed a nested correlation between PSG- and actigraphy-derived measures of SOL, covarying sleep pressure and age of assessment, nested within subject. The median partial correlation was r=.874 (p<.001), with a range of r=.243 to r=.969. Two children had very-low, non-significant correlations resulting from an outlier in which actigraphy underestimated SOL. CONCLUSION: Overall, these findings suggest actigraphy has adequate validity for estimating SOL in young children when using tightly-controlled data collection and analysis procedures. Future analyses should address methods for establishing the minimum number of nights for a reliable estimate of SOL.Item Doing better with library classes in 2019: Streamlining scheduling, marketing, and data gathering(2019-10-06) Stumpff, Julia C.; Craven, Hannah J.Objective: Librarians were hesitant to offer recurring classes because attendance was historically low. The scheduling system was cumbersome, and there was no consistent assessment of attendance, class content, or teaching quality. To improve this situation, the library adopted LibCal, marketed classes, and standardized assessment during the spring 2019 semester. The library is now has baseline data to make future evidence-based decisions about scheduled classes. Methods: After surveying current practices and discovering the campus had access to LibCal, two librarians and a staff member quickly trained themselves on and then employed LibCal. LibCal features adopted were: course templates, registration, email reminders, post-test emails with links to assessments, and attendance tracking. The librarians and staff successfully integrated into the marketing team in order to promote the classes across campuses. Results: With the new system in place, the number of classes offered doubled. This led to three times the number of attendees overall. The average class size increased by one. By providing a hard copy of our assessment survey complimented by an automated email with the online version, the survey response rate was 84%. Class attrition rate was 36%. Conclusions: Separating the registration and attendance data by month, day, and hour will inform future classes scheduling. Class content and teaching assessment will be analyzed and shared with the class instructors to improve course delivery. In the future, assessment will ask about participants’ locations to determine if distance learners are reached at other campuses across the state. Marketing efforts will continue to evolve.Item Drug-Induced Liver Injury Module for Medical Students(Association of American Medical Colleges, 2020-07-15) Dilly, Christen K.; Craven, Hannah J.; Molleston, Jean P.; Medicine, School of MedicineIntroduction No published curricula exist to introduce medical students to drug-induced liver injury (DILI). However, DILI is the most common cause of acute liver failure in the US, and drug-drug interactions are tested on the USMLE Step 1. Methods We developed an independent study module to introduce students to DILI. This module consisted of a narrated PowerPoint introduction, a journal article, and four example cases. Students completed the module independently. To evaluate the effectiveness of the activity, exam data and responses to the cases were reviewed, and end-of-course survey data were used. These responses were used to modify questions for clarity and to develop a feedback rubric. Results Mean scores on case-related questions in the module ranged from 44% to 73%. However, mean scores on test questions related to DILI ranged from 61% to 98%. It is possible that students learned from receiving feedback in the form of correct answers to the cases. On course evaluations, 52.4% of students agreed or strongly agreed that the online modules as a group (which included the DILI module) were an effective teaching method. Discussion This module introduces students to DILI and enables them to interact with valuable resources. We hope that modifications will improve the learning experience and effectiveness of the module. Going forward, we plan to collect validity evidence for the feedback rubric and develop an advanced version of the module for gastroenterology fellows.Item Executive Summary: International Clinical Practice Guidelines for Pediatric Ventilator Liberation, A PALISI Network Document(American Thoracic Society Journals, 2022-08-15) Abu-Sultaneh, Samer; Iyer, Narayan Prabhu; Fernández, Analía; Gaies, Michael; González-Dambrauskas, Sebastián; Hotz, Justin Christian; Kneyber, Martin C.J.; López-Fernández, Yolanda M.; Rotta, Alexandre T.; Werho, David K.; Baranwal, Arun Kumar; Blackwood, Bronagh; Craven, Hannah J.; Curley, Martha A.Q.; Essouri, Sandrine; Fioretto, Jose Roberto; Hartmann, Silvia M.M.; Jouvet, Philippe; Korang, Steven Kwasi; Rafferty, Gerrard F.; Ramnarayan, Padmanabhan; Rose, Louise; Tume, Lyvonne N.; Whipple, Elizabeth C.; Wong, Judith Ju Ming; Emeriaud, Guillaume; Mastropietro, Christopher W; Napolitano, Natalie; Newth, Christopher J.L.; Khemani, Robinder G.RATIONALE: Pediatric specific ventilator liberation guidelines are lacking despite the many studies exploring elements of extubation readiness testing. The lack of clinical practice guidelines has led to significant and unnecessary variation in methods used to assess pediatric patients' readiness for extubation. METHODS: Twenty-six international experts comprised a multi-professional panel to establish pediatric specific ventilator liberation clinical practice guidelines, focusing on acutely hospitalized children receiving invasive mechanical ventilation for more than 24 hours. Eleven key questions were identified and first prioritized using the Modified Convergence of Opinion on Recommendations and Evidence. Systematic review was conducted for questions which did not meet an a-priori threshold of ≥80% agreement, with Grading of Recommendations, Assessment, Development, and Evaluation methodologies applied to develop the guidelines. The panel evaluated the evidence, drafted, and voted on the recommendations. MEASUREMENTS AND MAIN RESULTS: Three questions related to systematic screening, using an extubation readiness testing bundle and use of a spontaneous breathing trial as part of the bundle met Modified Convergence of Opinion on Recommendations criteria of ≥80% agreement. For the remaining 8 questions, 5 systematic reviews yielded 12 recommendations related to the methods and duration of spontaneous breathing trials; measures of respiratory muscle strength; assessment of risk of post-extubation upper airway obstruction and its prevention; use of post-extubation non-invasive respiratory support; and sedation. Most recommendations were conditional and based on low to very low certainty of evidence. CONCLUSION: This clinical practice guideline provides a conceptual framework with evidence-based recommendations for best practices related to pediatric ventilator liberation.