From enhanced collaborations to space advancements: technologies to bring libraries (and librarians) full circle and into the future.

Since the Journal of the Medical Library Association (JMLA) Virtual Projects section was first announced in 2012, the virtual projects featured in the JMLA have expanded or improved library spaces, services, collaborations, connections, and future directions. Virtual projects selected by the JMLA Virtual Projects Section Advisory Committee have been both practical and responsive to library and patron needs and illustrate ways that librarians are leading their communities and services in new directions. Virtual projects highlighted in this year's section demonstrate innovative adaptations of technology into the modern medical library that strengthen collaborative commitments and clinical and research partnerships. They also illustrate how technologies support the idea of "library as place" by providing spaces for users to explore new technologies, as well as tools for space and service planning. This year's virtual projects fully embrace changes in learning, research patterns, technologies, and the role of the health sciences librarian and the library.

A competency framework for librarians involved in systematic reviews.

OBJECTIVE: The project identified a set of core competencies for librarians who are involved in systematic reviews. METHODS: A team of seven informationists with broad systematic review experience examined existing systematic review standards, conducted a literature search, and used their own expertise to identify core competencies and skills that are necessary to undertake various roles in systematic review projects. RESULTS: The team identified a total of six competencies for librarian involvement in systematic reviews: "Systematic review foundations," "Process management and communication," "Research methodology," "Comprehensive searching," "Data management," and "Reporting." Within each competency are the associated skills and knowledge pieces (indicators). Competence can be measured using an adaptation of Miller's Pyramid for Clinical Assessment, either through self-assessment or identification of formal assessment instruments. CONCLUSIONS: The Systematic Review Competencies Framework provides a standards-based, flexible way for librarians and organizations to identify areas of competence and areas in need of development to build capacity for systematic review integration. The framework can be used to identify or develop appropriate assessment tools and to target skill development opportunities.

Is there a relationship between oral health and diabetic neuropathy?

Diabetic neuropathy is the most common microvascular complication of diabetes mellitus with high morbidity and mortality, and low quality of life. It has a broad spectrum of clinical forms, although distal symmetrical polyneuropathy is the most prevalent. Several oral complications including burning mouth syndrome, dry mouth, and impairment of the senses taste and smell are less-known manifestations of diabetic neuropathy and often overlooked. Periodontitis, tooth loss, and temporomandibular joint dysfunction may be also present in these patients and are equally debilitating. Periodontitis was declared the sixth complication of diabetes in 1993 and may contribute to poor glucose control. Hence, periodontitis and diabetes mutually and adversely affect each other. This review summarizes the available body of scientific literature that discusses oral manifestations in patients with diabetic neuropathy and identifies important areas where more research is needed.

The Rise of the Expert Patient in Cancer: From Backseat Passenger to Co-navigator.

PURPOSE: Patients who have cancer have leveraged the Internet to gain a better understanding of their disease and connect across geographic boundaries with others facing the same challenges. Online cancer communities have developed into resources that highlight new research and evolving care pathways. Combined with increasing health literacy and social media, they have enabled some patients to become experts in their cancer. This combination of empowerment and expertise describes the new "e-patients." METHODS: We reviewed the literature to identify key areas where expert e-patients have directly participated in advancing cancer medicine, as well as opportunities available to those who wish to become more involved in research advocacy. RESULTS: E-patients are widely acknowledged as key stakeholders in oncology by clinicians, researchers, cancer centers, government agencies, and nonprofits. Their input is vital for informing cancer care delivery, developing and launching research initiatives, creating care guidelines and pathways, and formulating policy. CONCLUSION: Expert e-patients play an expanded role in their own care and in larger conversations regarding practice, research, and policy. Clinicians can engage e-patients as partners in cancer care as we work together towards improving health care access and outcomes for people with cancer.

Australia and New Zealand Islet and Pancreas Transplant Registry Annual Report 2018-Islet Donations, Islet Isolations, and Islet Transplants.

BACKGROUND: This is an excerpt from chapter 4 of the annual registry report from the Australia and New Zealand islet and pancreas transplant registry. The full report is available at http://anziptr.org/reports/. METHODS: We report data for all allogeneic islet isolation and transplant activity from 2002 to end 2017. Solid organ pancreas transplantation activity is reported separately. New Zealand does not have an islet transplant program. Data analysis was performed using Stata software version 14 (StataCorp, College Station, TX). RESULTS: From 2002 to 2017, a total of 104 allogeneic islet transplants were performed in 62 recipients. CONCLUSIONS: The number of islet transplants performed in Australia was slightly lower in 2017 but continues to increase over time.

Organizing Online Health Content: Developing Hashtag Collections for Healthier Internet-Based People and Communities.

Twitter use has increased among patients with cancer, advocates, and oncology professionals. Hashtags, a form of metadata, can be used to share content, organize health information, and create virtual communities of interest. Cancer-specific hashtags modeled on a breast cancer community, #bcsm, led to the development of a structured set of hashtags called the cancer tag ontology. In this article, we review how these hashtags have worked with the aim of describing our experience from 2011 to 2017. We discuss useful guidelines for the development and maintenance of health-oriented communities on Twitter, including possible challenges to community sustainability and opportunities for future improvement and research.

Systematic reviews and tech mining: A methodological comparison with case study.

When the Medical Library Association identified questions critical for the future of the profession, it assigned groups to use systematic reviews to find the answers to these questions. Group 6, whose question was on emerging technologies, recognized early on that the systematic review process would not work well for this question, which looks forward to predict future trends, whereas the systematic review process looks back in time. We searched for new methodologies that were more appropriate to our question, developing a process that combined systematic review, text mining, and visualization techniques. We then discovered tech mining, which is very similar to the process we had created. In this paper, we describe our research design and compare tech mining and systematic review methodologies. There are similarities and differences in each process: Both use a defined research question, deliberate database selection, careful and iterative search strategy development, broad data collection, and thoughtful data analysis. However, the focus of the research differs significantly, with systematic reviews looking to the past and tech mining mainly to the future. Our comparison demonstrates that each process can be enhanced from a purposeful consideration of the procedures of the other. Tech mining would benefit from the inclusion of a librarian on their research team and a greater attention to standards and collaboration in the research project. Systematic reviews would gain from the use of tech mining tools to enrich their data analysis and corporate management communication techniques to promote the adoption of their findings.

Risks and benefits of Twitter use by hematologists/oncologists in the era of digital medicine.

Twitter use by physicians, including those in the hematology-oncology field, is increasing. This microblogging platform provides a means to communicate and collaborate on a global scale. For the oncology professional, an active Twitter presence provides opportunities for continuing medical education, patient engagement and education, personal branding, and reputation management. However, because Twitter is an open, public forum, potential risks such as patient privacy violations, personal information disclosures, professionalism lapses, and time management need to be considered and managed. The authors have summarized the benefits and risks of Twitter use by the hematology-oncology physician. In addition, strategies to maximize benefit and minimize risk are discussed, and resources for additional learning are provided.

Sleep Tracking, Wearable Technology, and Opportunities for Research and Clinical Care.

Consumer-driven sleep-tracking technologies are becoming increasingly popular with patients with sleep disorders and the general population. As the list of sleep-tracking technologies continues to grow, clinicians and researchers are faced with new challenges and opportunities to incorporate these technologies into current practice. We review diagnostic tools used in sleep medicine clinical practice, discuss categories of consumer sleep-tracking technologies currently available, and explore the advantages and disadvantages of each. Potential uses of consumer sleep-tracking technologies to enhance sleep medicine patient care and research are also discussed.

Difficult Doctors, Difficult Patients: Building Empathy.

Effective doctor-patient communication facilitates the therapeutic relationship, promotes patient physical and mental health, and improves physician satisfaction. Methods of teaching effective communication use a range of techniques, typically combining didactic instruction with simulated communication encounters and reflective discussion. Rarely are patients and physicians exposed to these instructions as colearners. The evidence for the utility of graphic stories, comics, and cartoons to improve patient comprehension and self-regulation is small but encouraging. The authors describe the use of graphic medicine as a teaching tool for engendering empathy from both the physician and the patient for the other during a shared clinical encounter. This use of educational comics in a colearning experience represents a new use of the medium as a teaching tool.

The pulpal anesthetic efficacy of articaine versus lidocaine in dentistry: a meta-analysis.

BACKGROUND: The authors evaluated published evidence from controlled clinical trials regarding the efficacy of two local anesthetic solutions in providing successful pulpal anesthesia. METHODS: The authors searched MEDLINE and Embase databases to identify peer-reviewed randomized controlled trials in which researchers directly compared articaine and lidocaine local anesthetic solutions in adult participants. They extracted study characteristics and outcomes data as a basis for meta-analysis. They completed subgroup analyses for both infiltration and mandibular inferior alveolar block anesthetic techniques. RESULTS: Articaine solutions had a probability of achieving anesthetic success superior to that of lidocaine, with an odds ratio of 2.44 (95 percent confidence interval [CI], 1.59-3.76; P < .0001). The greater odds ratio for articaine increased to 3.81 (95 percent CI, 2.71-5.36; P < .00001) when the authors analyzed only infiltration data. There was weaker, but still significant, evidence of articaine's being superior to lidocaine for mandibular block anesthesia, with an odds ratio of 1.57 (95 percent CI, 1.12-2.21; P = .009), and no difference when the authors considered only symptomatic teeth. CLINICAL IMPLICATIONS: Research evidence supports using articaine versus lidocaine for achieving pulpal anesthesia when the infiltration mode of administration is used. It is premature to recommend articaine for mandibular block anesthesia in cases involving irreversible pulpitis.