Background: Black, Indigenous, and People of Color (BIPOC) are underrepresented in librarianship. We developed a curriculum to introduce high school students from BIPOC communities to careers in health sciences librarianship and to concepts and skills in health information literacy. Case Presentation: Librarians at Weill Cornell Medicine partnered with Mentoring in Medicine, a Bronx-based nonprofit, to develop the Community Health Ambassador Program (CHAmP) curriculum. The project settings were at three New York City schools. The project took place over two years, with the pilot taking place in year 1, followed by an assessment which included data from pre- and posttests measuring student learning and focus groups with the students to gather feedback about their experience. Informed by data from the year one assessment, we worked with an experienced high school teacher to redesign the curriculum for year 2. Changes included reducing the amount of lecture and providing more time for activities to reinforce the content, including a team final project and presentations. In year two focus groups, students demonstrated increased understanding of health sciences librarianship and indicated increased engagement and enjoyment of the course compared to year 1. There was a statistically significant improvement in the mean student score from the pretest to the posttest. Conclusions: The revised curriculum resulted in increased student engagement and statistically significant improvement in learning compared to the year one pilot. We have published the full curriculum online under a Creative Commons license so that other organizations may implement it in their communities.

Locating health research on bisexual and pansexual (bisexual+) populations is challenging, as the data are usually collated with data for additional sexual minority and gender identities. To improve the findability of health research on bisexual+ populations, this study sought to develop a sensitivity-maximizing PubMed search filter for bisexuality. Using the relative recall method for the development and validation of search filters, we used PubMed, CitationChaser, and Covidence to search for and screen studies. To be included, studies had to report bisexual/pansexual-specific data and be MEDLINE-indexed with a PubMed Identifier (PMID). Of 291 eligible records, 252 had PMIDs; these records constituted the gold standard set used to develop the search filters. Combinations of search terms were tested against the gold standard set. Sensitivity and number needed to read (NNR) were calculated for each combination. Two search filters are presented. The sensitivity-maximizing search retrieved 100

OBJECTIVE:This study identifies factors influencing physician prescribing patterns for overactive bladder (OAB) pharmacotherapy. METHODS:This systematic review adheres to the 2020 PRISMA guidelines. MEDLINE, Embase, and Web of Science were searched from inception to manuscript creation using tailored strategies, including terms like "beta-3 agonist," "anticholinergic," and "overactive bladder." Interventional or observational studies on physician prescribing for OAB were included; non-human, non-English, or full-text-unavailable studies were excluded. Two reviewers screened all records, with a third resolving conflicts. Reference lists of relevant articles were also reviewed. Risk of bias was assessed using AXIS, ROBUST, or ROBINS-E. Data extraction identified six themes, which were reviewed collaboratively and presented. RESULTS:Of 1037 titles and abstracts reviewed, 48 were eligible for full-text review, and 18 were included in the final analysis. Conclusions were derived from an in-depth analysis of common underlying themes across included studies. The six themes identified as influencing physician initiation of overactive bladder medication were: (1) underlying medical comorbidities, (2) industry payments, (3) geographical differences, (4) patient clinical characteristics, (5) physician demographic characteristics, and (6) physician identified treatment goals. DISCUSSION:This systematic review characterizes factors influencing physicians' prescribing of pharmacotherapy for the management of OAB. We highlight the complexity of factors, aside from the common considerations of cost and medical comorbidities, that may impact treatment selection for patients with OAB. The study is limited by the heterogeneity of available studies, which precludes quantitative comparison. More directed studies are needed to understand how physicians balance these competing factors with treatment recommendations for OAB.

Introduction: A search filter for studies involving lesbian, gay, bisexual, transgender, queer, intersex, asexual, and additional sexual minority and gender identities (LGBTQIA+) populations has been developed and validated; however, the filter contained very small gold standard sets for some populations, and terminology, controlled vocabulary, and database functionality has subsequently evolved. We therefore sought to update and re-test the search filters for these selected subgroups using larger gold standard sets. We report on the development and validation of two versions of a sensitivity maximizing search filter for queer women, including but not limited to lesbians and women who have sex with women (WSW). Methods: We developed a PubMed search filter for queer women using the relative recall approach and incorporating input from queer women. We tested different search combinations against the gold standard set; combinations were tested until a search with 100 percent sensitivity was identified. Results: We developed and tested variations of the search, and present two versions of the strategy with 99% and 100% sensitivity. The strategies included additional terms to improve sensitivity and proximity searching to improve recall and precision. Conclusions: The queer women search filters balance sensitivity and precision to facilitate comprehensive retrieval of studies involving queer women. The filters will require ongoing updates to adapt to evolving language and search platform functionalities. Strengths of the study include the involvement of the population of interest at each stage of the project. Future research will include development and testing of search filters for other LGBTQIA+ subgroups such as bisexual and transgender people.

As the global population ages, the increasing number of individuals with chronic conditions places a growing burden on family caregivers. Behavioral interventions delivered via app-based interventions, including apps on mobile phones, tablet, or web, have emerged as a powerful tool for enhancing caregiver support. The current study aims to identify and describe app-based interventions for family caregivers of older adults with chronic conditions, focusing on their designs, features, and impact on caregiver outcomes. This review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). A search of publications from 2007 through December 20, 2022, was conducted across PsycINFO (EBSCO), MEDLINE ALL (Ovid), Embase (Ovid), Web of Science Core Collection (A&HCI, BKCI-SSH, BKCI-S, CCR-EXPANDED, ESCI, IC, CPCI-SSH, CPCI-S, SCI-EXPANDED, SSCI) (Clarivate), ACM Guide to Computing Literature (ACM Digital Library), and Engineering Village (Elsevier), using relevant keywords. The database search identified 9,482 studies, resulting in 290 full texts and a final 49 studies included. Forty-four unique apps were identified, demonstrating different designs and features. These studies primarily examined the impact of apps on caregiver well-being, burden, and mental health. While the majority of interventions were perceived as beneficial, several design and research limitations were noted. While many interventions demonstrate positive effects on caregiver outcomes, there are significant gaps in research design, evaluation, and reporting. Future studies should prioritize more integration of self-care practices, clarity in intervention components, rigorous adherence to behavioral intervention frameworks, and greater inclusivity in participant samples.

PURPOSE:Teamwork is an essential component of health care and health professions education (HPE). The assessment of teamwork remains a significant challenge, and little is known about teamwork assessment tools (i.e. structured instruments or methods) used to examine the performance of health care teams within HPE. In this scoping review, the authors aimed to map and synthesize recent empirical studies of teamwork assessment tools in HPE. METHOD:Arksey and O'Malley's framework was used to identify and select relevant studies, extract data, and examine the extent, range and nature of research activity across studies. The authors searched MEDLINE, Embase, CINAHL, ERIC and Web of Science for original research studies from January 2015 to March 2024. Studies were included if they (i) used quantitative, qualitative or mixed methods to develop and/or use an assessment tool for the performance of health care teams within HPE; (ii) focused on team-level assessments; and (iii) provided sufficient details on the teams and teamwork competencies being studied. RESULTS:Twelve studies were included. All studies used direct observations of health care teams to assess teamwork. The authors identified over 20 teamwork assessment tools developed and/or used-seven studies used previously published teamwork assessment tools; five studies developed new tools. Variability and ambiguity in definitions and conceptualizations of teamwork and its competencies was common; few were based on theoretical frameworks of teamwork. Gaps included a lack of attention to external factors that influence teamwork (e.g. workload and interruptions), limited exploration of team dynamics (e.g. hierarchy and power) and minimal consideration of patient roles. CONCLUSIONS:This scoping review found significant variability and highlighted gaps in current approaches to the assessment of health care teams within HPE. Future work should improve clarity in definitions and conceptualizations of teamwork, conduct theory-building and theory-guided studies of teamwork assessment tools and perform rigorous evaluations of teamwork assessment tools that account for external factors, team dynamics and the role of patients.

Objective: With the growing global incidence of thyroid carcinomas, there is an increasing need for distinct guidelines for isthmus-confined carcinomas. Here, we performed the first systematic review on the topic to date, aiming to provide understanding to isthmusectomy as surgical management for well-differentiated thyroid carcinoma of the isthmus. Methods: We conducted a systematic review following the PRISMA guidelines, analyzing English-language studies from the past decade that report on thyroid isthmusectomy. Exclusion criteria included isthmusectomy performed alongside full thyroidectomy or partial thyroid lobectomy, lack of data on tumor character-istics or survival outcomes, and non-English publications where a translation was unavailable. Our review identified a total of 227 patients from seven studies. Results: The average 5-year overall survival and disease-free survival rates for patients with isthmus-confined PTC who underwent isthmusectomy were 100 % and 93.1 %, respectively. Similar to that of total thyroidectomy. 3.1 % of patients required completion thyroidectomy. Furthermore, isthmusectomy resulted in fewer surgical complications than total thyroidectomy. Conclusions: The scarcity of studies providing detailed tumor characteristics and patient outcomes limits our ability to fully evaluate the safety and efficacy of isthmusectomy for isthmus-confined PTC. Additionally, the variable sample sizes and restricted geographic distribution of the included studies calls into questions the generalizability of their findings. Despite these limitations, the data suggest that isthmusectomy may be a viable surgical option for select patients with small, isthmus-confined PTC. In the absence of a randomized controlled trial on the noninferiority of isthmusectomy, significantly more publications are needed before strong conclusions can be drawn.

BACKGROUND:Head and neck paragangliomas (HNPs) have been associated with gene mutations in the succinate dehydrogenase (SDH) complex, but the clinical significance remains unclear. We sought to explore the demographics, clinical characteristics, treatment methods, and outcomes of SDH-mutated HNPs. METHODS:Databases were systematically searched. Pooled event ratio and relative 95% confidence intervals were calculated for dichotomous outcomes. Meta-regression was performed. Cochran's Q test and I2 test assessed heterogeneity. Funnel plot and Egger's regression test assessed publication bias. RESULTS:Forty-two studies with 8849 patients were included. Meta-regression revealed a significant correlation between multifocality and SDHD mutations (0.03 ± 0.006, p < 0.0001) and between distant metastases and SDHB mutations (0.06 ± 0.023, p = 0.008). There was no correlation between sex, age, tumor size, or familial occurrences and SDH-related mutations. CONCLUSION:Multifocality of HNPs correlates with the SDHD mutational subtype, and metastases correlate with the SDHB subtype. Knowledge of HNP phenotypes associated with SDH-related mutations has the potential to influence the management approach to such HNPs.

OBJECTIVES:To meet a growing demand for direct care workers (DCWs) in the United States, structural, organizational, and policy-related solutions are needed. Unionization of the workforce may be one such mechanism; however, its impact on outcomes remains poorly understood. To examine the impact of unionization on DCWs' financial well-being and employment attitudes, as well as patient outcomes. DESIGN:A systematic search of AgeLine, CINAHL, PubMed, Scopus, and Web of Science from database inception through June 20, 2024. We included peer-reviewed empirical studies that used observational, quasi-experimental, and experimental designs. SETTING AND PARTICIPANTS:Studies pertained to DCWs who provided care in the home and long-term care settings. We focused on studies that illustrated the financial outcomes of DCWs (wages, compensation, benefits), employment outcomes (job satisfaction, turnover), and health-related outcomes of DCWs and their patients. METHODS:Covidence was used to screen studies for inclusion criteria. Study characteristics were abstracted manually by prespecified domains. The Downs and Black tool was used for quality assessment. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed. RESULTS:A total of 19 studies met inclusion criteria; they were predominantly observational (94%), with local (47%) and national (53%) samples. Three studies focused on compensation and all found that unionization was associated with higher wages and benefits among DCWs. Seven studies focused on employment, finding that unionization was associated with greater job satisfaction, quality, and retention, particularly among nursing home staff and home health aides. Unionized workplaces reported better care quality and safety, including fewer injuries and better equipment provision. Unionization's impact on patient outcomes showed mixed results, particularly among nursing home residents. Overall, the quality of the research studies varied, with limitations in methodology and sampling affecting reliability. CONCLUSIONS AND IMPLICATIONS:Unionization among DCWs was generally associated with higher wages, benefits, and job satisfaction, as well as reduced turnover; however, its impact on worker and patient outcomes varied across studies. The overall quality of the studies was fair to poor, highlighting the need for more rigorous research in this area.

Conduct a scoping review of current evidence in headache disparities and treatment within the LGBTQ+ population.

Background:The Weill Cornell Medicine, Samuel J. Wood Library's Systematic Review (SR) service began in 2011, with 2021 marking a decade of service. This paper will describe how the service policies have grown and will break down our service quantitatively over the past 11 years to examine SR timelines and trends.Case Presentation:We evaluated 11 years (2011-2021) of SR request data from our in-house documentation. In the years assessed, there have been 319 SR requests from 20 clinical departments, leading to 101 publications with at least one librarian collaborator listed as co-author. The average review took 642 days to publication, with the longest at 1408 days, and the shortest at 94 days. On average, librarians spent 14.7 hours in total on each review. SR projects were most likely to be abandoned at the title/abstract screening phase. Several policies have been put into place over the years in order to accommodate workflows and demand for our service.Discussion:The SR service has seen several changes since its inception in 2011. Based on the findings and emerging trends discussed here, our service will inevitably evolve further to adapt to these changes, such as machine learning-assisted technology.

IntroductionHypertension (HTN) among adolescents is common in high-income countries, and leads to increased premature cardiovascular diseases (CVD). In sub-Saharan Africa (SSA), the prevalence of HTN among adolescents, associated risk factors and CVD complications are not well-described. Such data is needed for planning public health programs to prevent premature CVD in SSA.MethodsWe systematically searched 5 databases (MEDLINE, Embase, Google Scholar, Web of Science, and African Index Medicus) from their establishment to December 2021. Key search terms were: adolescent, arterial hypertension, and names of the 48 countries in SSA. We used Covidence® to manage the search results. The review was registered in the Open Science Framework (OSF) https://osf.io/p5sbt/.ResultsWe identified 4,008 articles out of which we screened 3,088 abstracts, and reviewed 583 full-text articles. We finally included 92 articles that were published between 1968 to December 2021. The majority were cross-sectional studies (80%) and conducted in school settings (78%). The risk of bias was low for 59 studies (64.1%), moderate for 29 studies (31.5%), and high for 4 studies (4.3%). Overall, the prevalence of HTN varied widely from 0.18% to 34.0% with a median (IQR) of 5.5% (3.1%, 11.1%). It was relatively higher in studies using automated blood pressure (BP) devices, and in studies defining HTN using thresholds based on percentile BP distribution for one's height, age, and sex. In addition, the prevalence of HTN was significantly higher in studies from Southern Africa region of SSA and positively correlated with the year of publication. Across studies, traditional risk factors such as age, sex, body mass index, and physical inactivity, were commonly found to be associated with HTN. In contrast, non-traditional risk factors related to poverty and tropical diseases were rarely assessed. Only three studies investigated the CVD complications related to HTN in the study population.ConclusionThe prevalence of HTN among adolescents in SSA is high indicating that this is a major health problem. Data on non-traditional risk factors and complications are scarce. Longitudinal studies are needed to clearly define the rates, causes, and complications of HTN.Systematic Review Registrationhttps://osf.io/p5sbt/, identifier (10.17605/OSF.IO/P5SBT).

Background: The availability and accuracy of data on a patient's race/ethnicity varies across databases. Discrepancies in data quality can negatively impact attempts to study health disparities. Methods: We conducted a systematic review to organize information on the accuracy of race/ethnicity data stratified by database type and by specific race/ethnicity categories. Results: The review included 43 studies. Disease registries showed consistently high levels of data completeness and accuracy. EHRs frequently showed incomplete and/or inaccurate data on the race/ ethnicity of patients. Databases had high levels of accurate data for White and Black patients but relatively high levels of misclassification and incomplete data for Hispanic/Latinx patients. Asians, Pacific Islanders, and AI/ANs are the most misclassified. Systems-based interventions to increase self-reported data showed improvement in data quality. Conclusion: Data on race/ethnicity that is collected with the purpose of research and quality improvement appears most reliable. Data accuracy can vary by race/ethnicity status and better collection standards are needed. (c) 2023 Elsevier Inc. All rights reserved.

PURPOSE:Most individuals with a hereditary cancer syndrome are unaware of their genetic status to underutilization of hereditary cancer risk assessment. Chatbots, or programs that use artificial intelligence to simulate conversation, have emerged as a promising tool in health care and, more recently, as a potential tool for genetic cancer risk assessment and counseling. Here, we evaluated the existing literature on the use of chatbots in genetic cancer risk assessment and counseling.METHODS:A systematic review was conducted using key electronic databases to identify studies which use chatbots for genetic cancer risk assessment and counseling. Eligible studies were further subjected to meta-analysis.RESULTS:Seven studies met inclusion criteria, evaluating five distinct chatbots. Three studies evaluated a chatbot that could perform genetic cancer risk assessment, one study evaluated a chatbot that offered patient counseling, and three studies included both functions. The pooled estimated completion rate for the genetic cancer risk assessment was 36.7% (95% CI, 14.8 to 65.9). Two studies included comprehensive patient characteristics, and none involved a comparison group. Chatbots varied as to the involvement of a health care provider in the process of risk assessment and counseling.CONCLUSION:Chatbots have been used to streamline genetic cancer risk assessment and counseling and hold promise for reducing barriers to genetic services. Data regarding user and nonuser characteristics are lacking, as are data regarding comparative effectiveness to usual care. Future research may consider the impact of chatbots on equitable access to genetic services.

e17597 Background: Approximately 20% of ovarian cancers are due to an underlying germline pathogenic variant. While several genes have been well-established in the development of hereditary ovarian cancer (e.g. BRCA1/2, RAD51C, RAD51D, BRIP1, mismatch repair genes), there are other genes for which the cancer risk is less certain and management recommendations remain controversial, including partner and localizer of BRCA 2 (PALB2). We sought to evaluate the association between PALB2 germline pathogenic mutations and ovarian cancer in the first meta-analysis on this topic. Methods: We conducted a systematic review and meta-analysis in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO no.: CRD42021281325). We searched key electronic databases to identify studies evaluating multigene panel testing in patients with ovarian cancer. Eligible trials were subjected to meta-analysis. Results: Thirty-seven studies met inclusion criteria. We found 55,137 cases of ovarian cancer with information available on germline PALB2 pathogenic variant status. Reported histological subtypes included serous adenocarcinoma (74.8%), endometroid (6.5%), clear cell (2.1%), mucinous (3.1%), and other (13.5%). Most ovarian cancers were stages III (73.5%) and IV (22.3%), followed by II (6.0%), and I (4.1%). Among ovarian cancer cases with PALB2 sequencing data available, 0.4% demonstrated a germline pathogenic variant in the PALB2 gene and the pooled odds ratio (OR) for having a PALB2 mutation was 2.31 (95% CI 0.89- 5.98). Among 94 patients with a germline PALB2 pathogenic variant, the pooled odds ratio (OR) for developing ovarian cancer was 2.85 (95% CI 1.58-5.15) relative to 33,855 patients without PALB2 mutations. Conclusions: Our meta-analysis demonstrates that the pooled OR for developing ovarian cancer with an underlying PALB2 germline pathogenic variant was 2.85 (95% CI 1.58-5.15). While this risk is lower than many of the well-established hereditary ovarian cancer genes, it does exceed the baseline population risk of 1-2%. Whether this meets the threshold to consider risk-reducing salpingo-oophorectomy is up for debate. Large population-based studies and evaluation of the combination of PALB2 mutations and cancer family history are needed to improve management recommendations for patients harboring pathogenic mutations in this gene.

Objective:Systematic reviews and other evidence synthesis projects require systematic search methods. Search systems require several essential attributes to support systematic searching; however, many systems used in evidence synthesis fail to meet one or more of these requirements. I undertook a qualitative study to examine the effects of these limitations on systematic searching and how searchers select information sources for evidence synthesis projects.Methods:Qualitative data were collected from interviews with twelve systematic searchers. Data were analyzed using reflexive thematic analysis.Results:I used thematic analysis to identify two key themes relating to search systems: systems shape search processes, and systematic searching occurs within the information market. Many systems required for systematic reviews, in particular sources of unpublished studies, are not designed for systematic searching. Participants described various workarounds for the limitations they encounter in these systems. Economic factors influence searchers' selection of sources to search, as well as the degree to which vendors prioritize these users.Conclusion:Interviews with systematic searchers suggest priorities for improving search systems, and barriers to improvement that must be overcome. Vendors must understand the unique requirements of systematic searching and recognize systematic searchers as a distinct group of users. Better interfaces and improved functionality will result in more efficient evidence synthesis.

Objectives Approximately 20% of ovarian cancers are due to an underlying germline pathogenic variant. While several genes have been well-established in the development of hereditary ovarian cancer (e.g. BRCA1/2, RAD51C, RAD51D, BRIP1, mismatch repair genes), the role of partner and localizer of BRCA2 (PALB2) remains uncertain. We sought to evaluate the association between PALB2 germline pathogenic mutations and ovarian cancer in the first meta-analysis on this topic. Methods We conducted a systematic review and meta-analysis in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO no.: CRD42021281325). We searched key electronic databases to identify studies evaluating multigene panel testing in patients with ovarian cancer. Eligible trials were subjected to meta-analysis. Results Thirty studies met inclusion criteria. We found 55,137 cases of ovarian cancer with information available on germline PALB2 pathogenic variant status. Among ovarian cancer cases with PALB2 sequencing data available, 0.4% demonstrated a germline pathogenic variant in the PALB2 gene and the pooled odds ratio (OR) for having a PALB2 mutation was 2.31 (95% CI 0.89- 5.98). Among 94 patients with a germline PALB2 pathogenic variant, the pooled odds ratio (OR) for developing ovarian cancer was 2.85 (95% CI 1.58–5.15) relative to 33,855 patients without PALB2 mutations. Conclusions Our meta-analysis demonstrates that the pooled OR for developing ovarian cancer with an underlying PALB2 germline pathogenic variant was 2.85 (95% CI 1.58–5.15), exceeding the baseline population risk of 1–2%. Further studies related to PALB2 mutations and cancer family history are needed to improve management recommendations for patients.

BACKGROUND:Prior to 2020, library orientation for first-year medical students at Weill Cornell Medicine took the form of an on-site treasure hunt competition. Due to the COVID-19 pandemic, the orientation for the MD class of 2024 was shifted to an all-virtual format. This shift mandated a full redesign of the library orientation.CASE PRESENTATION:The Samuel J. Wood Library sought to preserve the excitement and fun of the treasure hunt in the new virtual format. The competition was redesigned as a Zoom meeting using breakout rooms, with library faculty and staff serving as team facilitators. Tasks were rewritten, shifting the focus from the library's physical spaces to its virtual services and online resources. The redesigned orientation was evaluated using two data sources: a postsession survey of student participants and a debriefing of the library employees who participated. Student evaluations were positive, while the faculty and staff provided numerous suggestions for improving future virtual orientations.CONCLUSIONS:A successful virtual library orientation requires careful preparation, including testing the competition tasks, full rehearsal with library facilitators, and a thoughtful approach to technology and logistics. We have chosen to share the materials we developed for other academic health sciences libraries that may wish to take a similar approach to their own virtual orientations.