Landscape of health sciences librarian-mediated search services.

BACKGROUND: Health librarians have traditionally provided mediated searches to support patient care, education and research. OBJECTIVES: This study aims to discover the types of search result formats used by health science libraries, determine current practice among health science libraries (types of requesters served, fees, deduplication, turnaround time and citation manager use) and uncover innovative methods for providing search results. METHODS: An online survey was distributed to the MEDLIB-L, ExpertSearching, MidContinental Chapter of the Medical Library Association and ICON listservs and through direct email to selected Association of Academic Health Sciences Libraries reference and education librarians. RESULTS: Librarians affiliated with 127 institutions from 11 countries (including the USS) and 36 USS states and territories responded. One hundred and forty-two of the total 150 analysed responses provided information on full-text access, and 81 of those 142 responses (57%) indicated that the institutions' link-resolver links were included in search results provided to the requester. The survey responses provide information on literature search services regarding turnaround time, use of a citation managers, fees and deduplication. CONCLUSION: With the developing landscape of citation managers and the tools offered, these data can be used as a benchmark for librarians who are considering evaluating or modifying their search service delivery.

Reduced Seroma Risk in Drainless Abdominoplasty Using Running Barbed Sutures: A 10-Year, Multicenter Retrospective Analysis.

BACKGROUND: Drains are still commonly inserted during abdominoplasties despite extensive evidence documenting the benefits of drainless procedures. Continued improvements in progressive tension suturing (PTS) techniques and suture technologies have consistently shown a reduced seroma risk profile that outperforms procedures involving surgical drains. OBJECTIVES: The aim of this report was to assess the authors' combined patient series, which represents the largest and longest-running, retrospective, multicenter set of abdominoplasty patients treated with a PTS technique involving running barbed sutures. METHODS: Two surgical groups, each at different surgical centers, have for the past decade performed drainless abdominoplasties in which running barbed sutures were used. The results for all 445 patients in this series are reported by surgical center and pooled across centers. RESULTS: The majority of the 445 patients underwent drainless abdominoplasty alone (n = 368; 82.7%); most of the remaining patients did so as part of a circumferential body lift (n = 55; 12.4%). Overall, 33 (7.4%) patients experienced a postoperative complication. The overall seroma rate was 4.7% (21 of 445 patients), but this dropped to 2.3% after surgical technique modifications were made to decrease upper abdominal dead space. The seroma incidence in this series is markedly lower than the 13% seroma rate with drains reported during the same time period and comparable to those seen in drainless abdominoplasties with interrupted suture techniques. CONCLUSIONS: Drainless abdominoplasty involving PTS with running barbed sutures shows long-term reproducibility in lowering seroma risk compared to techniques in which drains are inserted, supporting results from published series of drainless abdominoplasty procedures that use interrupted suture techniques.

Gaps in affiliation indexing in Scopus and PubMed.

OBJECTIVE: The authors sought to determine whether unexpected gaps existed in Scopus's author affiliation indexing of publications written by the University of Nebraska Medical Center or Nebraska Medicine (UNMC/NM) authors during 2014. METHODS: First, we compared Scopus affiliation identifier search results to PubMed affiliation keyword search results. Then, we searched Scopus using affiliation keywords (UNMC, etc.) and compared the results to PubMed affiliation keyword and Scopus affiliation identifier searches. RESULTS: We found that Scopus's records for approximately 7% of UNMC/NM authors' publications lacked appropriate UNMC/NM author affiliation identifiers, and many journals' publishers were supplying incomplete author affiliation information to PubMed. CONCLUSIONS: Institutions relying on Scopus to track their impact should determine whether Scopus's affiliation identifiers will, in fact, identify all articles published by their authors and investigators.

Smallpox Vaccination of Laboratory Workers at US Variola Testing Sites.

To evaluate the need to revaccinate laboratory workers against smallpox, we assessed regular revaccination at the US Laboratory Response Network's variola testing sites by examining barriers to revaccination and the potential for persistence of immunity. Our data do not provide evidence to suggest prolonging the recommended interval for revaccination.

Creating Interactive Online Instruction: The McGoogan Library Experience.

Online instruction is a hot topic at academic medical centers. Seizing the opportunity to join the online movement at the University of Nebraska Medical Center (UNMC), the McGoogan Library created an open access course made up of six learning modules. The modules addressed three issues: 1) supplementing one-shot library instruction, 2) offering opportunity for instruction when a librarian is not embedded in a course, and 3) showcasing the library as an online instruction supporter. This article discusses the planning process, technology used, how the modules were received, and how this initial project increased McGoogan Library's involvement in the UNMC online movement.

Using an Adaptive Listening Tour and Survey to Promote Faculty Reflection on Diversity, Equity, and Inclusion (DEI) in the Pre-clinical Undergraduate Medical Curriculum.

Descriptive studies regarding how to integrate diversity, equity, and inclusion (DEI) into medical education are lacking. We utilized the AAMC's Key Steps for Assessing Institutional Culture and Climate framework to evaluate our current curriculum via listening tours (n = 34 participants) and a survey of the 10 pre-clinical block directors, to better understand the opportunities and challenges of improving DEI in the pre-clinical curriculum. Opportunities included diversifying cases and standardized patients, enhancing information on systemic racism and social determinants of health, and increasing racial humility and population genetics/epigenetics training. Faculty had issues with "correct ways" to incorporate DEI and time constraints. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-023-01924-7.

Repair of the midline fascial defect in abdominoplasty with long-acting barbed and smooth absorbable sutures.

BACKGROUND: Traditionally, repair of the midline fascial defect has been performed with interrupted or running permanent sutures during abdominoplasty. Barbed suture devices, however, eliminate the need for knot tying and potentially are equally effective at maintaining the repair while allowing for faster deployment and elimination of a potential nidus for infection. OBJECTIVE: The authors report their experience with long-acting absorbable barbed and smooth sutures. METHODS: A retrospective chart review was conducted on 34 consecutive patients who underwent abdominoplasty, alone or in conjunction with other procedures, between August 2006 and December 2009. Seventeen patients had repair of the midline abdominal wall rectus diastasis performed with a smooth running absorbable polydioxanone suture, and 17 underwent repair with a barbed suture. RESULTS: All 34 patients were women; their mean age was 43.6 years, and their mean body mass index was 23.0 kg/m(2). Sixty-eight percent of the patients elected to undergo concurrent procedures. Patients were followed for a mean of 34 months (27 months barbed; 42 months smooth). No cases of recurrent diastasis were observed. Complications included minor seroma (two cases in the barbed suture group, one in the smooth group) and infected hematoma (one in the barbed suture group). CONCLUSIONS: Based on the data from this series of patients, long-acting absorbable barbed or smooth sutures appear to be equally effective in maintaining rectus diastasis repair. Barbed sutures therefore hold promise as a useful alternative to permanent sutures for the plication of the rectus fascia during abdominoplasty.

Epigenetic modifications of human placenta associated with preterm birth: a systematic review.

OBJECTIVE: Preterm birth (PTB) is one of the leading causes of neonatal mortality and morbidity around the world. Epigenetic alterations of the human placenta may be involved in the causal chain of adverse pregnancy outcomes specifically PTB. In this systematic review, we investigated whether epigenetic dysregulation of the human placenta is associated with PTB. METHODS: We searched MEDLINE and EMBASE and systematically reviewed all relevant studies on epigenetic placental modifications in PTB. Two independent reviewers selected controlled human studies published in any language, evaluated their quality, and graded them using the Newcastle-Ottawa Quality Assessment Scale. We resolved disagreements by consensus with a third reviewer. RESULTS: Eleven observational studies of low to moderate quality met the eligibility criteria out of 60 unique studies. Most studies reported an association between placental epigenetic changes (methylation, mRNA and miRNA) and PTB, although research methods were highly heterogeneous. CONCLUSIONS: Studies reported various associations between specific epigenetic findings and PTB, although methodological concerns limited results' validity. Additional high quality studies are needed to assess the repeatability of these findings. The STROBE guidelines can be used to improve the quality of reporting.

Preceptorship rurality does not affect medical students' shelf exam scores.

OBJECTIVE: This study's objective was to determine whether junior medical students' end-of-rotation shelf exam scores varied by the preceptorship county's rurality. METHODS: Student learning during rural preceptorship experiences, 1999 to 2005, was assessed using the students' scores on the National Board of Medical Examiners family medicine subject examination. Rurality was measured using both population density and the rural-urban continuum (RUC) codes. RESULTS: Exam scores were collected between January 1999 and May 2005 for 734 students. Mean scores did not vary significantly by rurality, although they did vary significantly by semester. Test scores of students in rural locations were not statistically significantly different from those of students in urban preceptorships. CONCLUSIONS: Students assigned to preceptorships in rural locations scored at the same levels as students in urban preceptorships. The finding that there were no differences in medical students' exam scores based on the rurality of their family medicine preceptorship site indicates a substantial degree of educational equivalency between urban and rural preceptorships.

Epigenetic dysregulation of Insulin-like growth factor (IGF)-related genes and adverse pregnancy outcomes: a systematic review.

OBJECTIVES: Preterm birth (PTB), low birth weight (LBW) and small for gestational age (SGA) are leading causes of neonatal mortality and morbidity around the world. Epigenetic alterations of the human genome may be involved in the causal chain of adverse pregnancy outcomes. In this systematic review we investigated whether PTB, LBW and SGA are associated with epigenetic dysregulation of insulin-like growth factor-related genes (IGF). METHODS: We searched MEDLINE and EMBASE for peer-reviewed articles about IGF and PTB, LBW and SGA published up to February 2015. Two independent reviewers selected original, controlled, human studies published in any language and graded them using the Newcastle-Ottawa Quality Assessment Scale. Disagreements were resolved by consensus with a third reviewer. RESULTS: Eighteen observational studies of low-to-moderate quality met the eligibility criteria out of 210 unique studies. There was substantial heterogeneity across studies. Most studies reported no, limited or borderline association between epigenetic changes (methylation or imprinting) of IGF-related genes and LBW or SGA. There were no IGF-related epigenetic studies of PTB. CONCLUSIONS: Overall, evidence of an association between epigenetic abnormalities of IGF-related genes and LBW or SGA was weak and inconsistent. Methodological concerns limited results validity.

The effect of preceptorship rurality on students' self-perceived clinical competency.

OBJECTIVE: This study's objective was to determine whether students' learning experiences, as measured by the improvement in students' perceived competence in several clinical areas, varied by the preceptorship county's rurality. METHODS: Rural preceptorship experiences from 1990 to 2003 were assessed using pre- and post-preceptorship questionnaires regarding students' perceived levels of competence. Questionnaires addressed basic clinical skills, common diagnoses, and advanced clinical skills. Rurality was measured both as population density and using the Rural-Urban Continuum (RUC) codes. RESULTS: Primary analysis was completed using 1,037 sets of questionnaires; 231 questionnaires were unsuitable for analysis due to missing information. Mean perceived competency improved for all items. Students in rural locations, regardless of operationalization, had no statistically significant differences from students in urban locations in perceptions of their clinical skill or comfort with basic diagnoses. Individual item analyses revealed a gendered pattern. Women improved more than men on the technical skills; men improved more on women's health and psychosocial items. CONCLUSIONS: There were no differences in medical students' perceived competence based on the rurality of their family medicine preceptorship site. The preceptorship experience provides both women and men with a variety of experiences that lead to increased confidence in areas where they were least confident prior to the preceptorship.

Influence of a rural family medicine rotation on residency selection: MS3 versus MS4.

BACKGROUND AND OBJECTIVES: Many family medicine educators feel that a required clinical rotation in family medicine has a positive influence on medical students' selection of family medicine residencies. We investigated the effect of a rural family medicine rotation on students' residency choices and examined the differences between a third-year and a fourth-year rotation. METHODS: We surveyed 1,260 students before and after they participated in a required rural family medicine rotation. RESULTS: The rotation had a small positive effect on student interest in family medicine. Over 20 years, there was a net gain of 4.7% (93 students) from before to after the rotation. Moving the rural rotation from the MS4 to the MS3 year resulted in a significant decline in the number of students who switched their preferences toward family medicine and ultimately matched to a family medicine residency. CONCLUSIONS: When the rotation occurs in the third year, there is more time following the rotation for other influences to exert an impact on a student's specialty choice, resulting in a small "bleed" away from family medicine. It might be useful to develop programs that continue to pique the interest in family medicine during their fourth year.