University Of Michigan Research Articles

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ON THE FRONT COVER: Myosin A staining in the earliest stages of muscle cytoskeletal organization in a comma‐stage C. elegans embryos shows an anterior‐posterior gradient in the organization of myosin A into a striated pattern.Credit: Kar Men Lee and Hao Peng (Western Michigan University Department of Biological Sciences). image

Artificial Intelligence and Strategic Decision-Making: Evidence from Entrepreneurs and Investors

This paper explores how artificial intelligence (AI) may impact the strategic decision-making (SDM) process in firms. We illustrate how AI could augment existing SDM tools and provide empirical evidence from a leading accelerator program and a start-up competition that current large language models can generate and evaluate strategies at a level comparable to entrepreneurs and investors. We then examine implications for the key cognitive processes underlying SDM—search, representation, and aggregation. Our analysis suggests that AI has the potential to enhance the speed, quality, and scale of strategic analysis, while also enabling new approaches, like virtual strategy simulations. However, the ultimate impact on firm performance will depend on competitive dynamics as AI capabilities progress. We propose a framework connecting AI use in SDM to firm outcomes and discuss how AI may reshape sources of competitive advantage. We conclude by considering how AI could both support and challenge core tenets of the theory-based view of strategy. Overall, our work maps out an emerging research frontier at the intersection of AI and strategy. History: This paper has been accepted for the Strategy Science Special Issue on Theory-Based View. Funding: The authors are grateful to their collaborating organizations and to the University of Michigan, Bocconi University Junior Researchers’ Grant, and the INSEAD eLab Research Fund for financial support.

Bridging Gaps With Experience: Priming Faculty for Successful Online Course Development

This article presents a novel approach to faculty onboarding in the development of online courses through an experiential learning framework, as implemented at the University of Michigan’s School of Public Health. By integrating faculty into a comprehensive, hands-on training process, the initiative aims to bridge common gaps in online course development and facilitate collaborative efforts among faculty and course development teams. The paper details the structured three-phase approach aimed at enhancing faculty's practical understanding of online education terminology, processes, and collaboration with cross-functional teams. The documented outcomes indicate a marked improvement in the efficiency, quality, and overall engagement of faculty in the course development process. They underscore the critical role of hands-on experience coupled with reflective practices in priming faculty for effective collaboration with diverse course development teams, proposing this model as a scalable and adaptable blueprint for faculty development practices.

NIMG-18. RAPID INTRAOPERATIVE DIFFERENTIATION OF PRIMARY CNS LYMPHOMA FROM COMMON CNS TUMORS USING STIMULATED RAMAN HISTOLOGY AND DEEP LEARNING

Abstract Accurate intraoperative diagnosis is crucial for decision-making during tumor surgery and stereotactic-guided biopsies. Differentiating between primary CNS lymphoma (PCNSL) and non-PCNSL entities such as gliomas and metastatic cancers presents significant challenges due to overlapping histomorphological features, time constraints, and the differing further therapy strategies required. Our study utilized deep learning and stimulated Raman histology (SRH) to address this challenge. We imaged unprocessed, label-free tissue samples intraoperatively using a portable Raman scattering microscope, generating virtual H&E-like images within less than five minutes. Our training set comprised over 54,000 SRH tumor patch images, including various brain tumors. We developed a deep learning pipeline utilizing a ResNet-50 feature extractor and the BYOL (Bootstrap Your Own Latent) self-supervised learning algorithm. We trained a binary linear classifier to distinguish between PCNSL and non-PCNSL entities. Data were collected from New York University (NYU), the University of Cologne (UKK), and the University of Michigan (UM), including 263 SRH whole slide images from 177 patients sourced from surgical resections and stereotactic-guided biopsies. In an international bicentric test cohort (N = 100, NYU and UKK), the model achieved an overall accuracy of 91.1%, an area under the receiver operating characteristic curve (AUROC) of 0.983, a sensitivity of 89.3%, and a specificity of 100% compared to the final formalin-fixed, paraffin-embedded-based diagnosis. Our algorithm can accurately extract typical histomorphological features to help differentiate between PCNSL and non-PCNSL tumors. These results underscore the potential of deep learning models to enhance the accuracy of intraoperative diagnoses for PCNSL and non-PCNSL entities, thereby improving intraoperative decision-making and further treatment strategies by supporting neuropathologists and surgeons.

NIMG-29. EARLY REDUCTION IN MRI DIFFUSION APPARENT DIFFUSION COEFFICIENT (ADC) STRONGLY PREDICTS LONG TERM RESPONSE TO ONC201 THERAPY IN PATIENTS WITH H3K27M-DMG

Abstract ONC201 is the first monotherapy to improve outcomes in H3K27M- diffuse midline glioma (DMG) beyond radiation. Despite impressive early efficacy in H3K27M-DMG, individual response to ONC201 is variable and no radiographic biomarkers predict long term response. Previous studies demonstrated baseline MRI diffusion apparent diffusion coefficient (ADC) is lower in DMG with H3K27M compared to wildtype but change after radiation therapy was not correlated with improved OS or PFS. We hypothesize ADC will enable stratification of patients more likely to respond to ONC201. Imaging and clinical data were abstracted from chart review of patients treated with ONC201 at University of Michigan. Two neuroradiologists performed centralized review for RAPNO measurements and mean ADC was assessed using ROI measured in consistent anatomic locations, with areas of cystic degeneration or necrosis excluded. Sixty-one patients were identified for review. Preliminary analysis was performed on twenty-three patients, with upfront ONC201 therapy, median age 14.8 years old (5-25yo), primary site includes pontine (n=15), thalamic (n=7). Baseline characteristics of age, ADC and size at diagnosis or follow-up RAPNO scored size were not statistically significant. Patients with longer than median survival (334 days) demonstrated increased ADC (+58.25x10-6mm2/s) from baseline to cycle 2 whereas patients with shorter than median survival demonstrated decreased ADC (-174.8x10-6mm2/s) (p = 0.0076). Further, patients with decreased ADC demonstrated mean OS of 302.8 days and patients with increased ADC had mean OS of 588.0 (p = 0.0054). In H3K27M-DMG patients treated with ONC201, increased ADC after two cycles of ONC201 was strongly predictive of longer overall survival. Our recent work demonstrated that ONC201 disrupts metabolic and epigenetic pathways to restore pathognomonic H3K27me3 reduction, which may underline greater change in ADC. Ongoing work will validate these findings in an independent external cohort and integrate histogram analysis, parametric assessments, MRI perfusion and liquid biopsy biomarkers (cf-tDNA and metabolomics).

Impressions of inclusivity within orthopedic surgery: Differences amongst women, minority, and LGBTQIA medical students

ObjectiveTo better understand reasons for the underrepresentation of certain groups in orthopedic surgery, we investigated whether there were differences in medical students’ perceptions of inclusivity in orthopedic surgery between (1) men and women, (2) White, Asian and URiM, and (3) LGBTQIA and non-LGBTQIA students. DesignA one-time survey consisting of validated and/or previously used instruments measuring students' sense of belonging in orthopedics, prospective belonging uncertainty (an individual's worry that they will not fit in), stereotype threat (the effect of negative stereotypes on stereotyped group-members), and pluralistic ignorance (erroneously believing your beliefs are different than “typical” group-members). SettingThe survey was distributed at Loyola University, St. Louis University, University of Michigan, and Washington University in St. Louis. ParticipantsAll medical students at these institutions were offered participation, and 441 medical students completed the survey (∼20% response-rate). ResultsThere was a lower sense of belonging for each of the following groups when compared to their majority-group peers: women (mean difference ​= ​0.5, 95% CI 0.3–0.7, p ​< ​0.001), Asian students (mean difference ​= ​0.4, 95% CI 0.1–0.7, p ​< ​0.001), URiM students (mean difference ​= ​0.4, 95% CI 0.07–0.7, p ​< ​0.001) and LGBTQIA students (mean difference ​= ​0.4, 95% CI 0.07–0.6, p ​= ​0.003). Medical students perceived that orthopedic faculty, residents, and the general public believe that men are better orthopedic surgeons than women, and that White surgeons are better surgeons than non-White surgeons. Women reported less confidence to succeed in orthopedics compared to “typical” peers (mean −0.5, SD 1.3), whereas men felt similar confidence compared to their peers (mean 0.1, SD 1.3; mean difference 0.6, 95% CI 0.4–0.9, p ​< ​0.001). ConclusionsThese differences in belonging, prospective belonging uncertainty, stereotype threat, and pluralistic ignorance provide insight into how medical students perceive the inclusivity of orthopedics, which may ultimately play a role in the underrepresentation of minority groups.

Current status and prospects of congenital adrenal hyperplasia: A bibliometric and visualization study.

Congenital adrenal hyperplasia (CAH) is increasingly prevalent, leading to a surge in related research. To pinpoint emerging trends and recommend future directions, a bibliometric analysis of relevant CAH literature was performed. From January 1, 2000, to October 1, 2023, we searched the Web of Science Core Collection for CAH literature. For the bibliometric analysis, tools such as VOSviewer, CiteSpace, and the R package "bibliometrix" were employed. The United States and England are at the forefront among 113 countries, contributing 5034 papers to CAH research. However, there is a need for more extensive global collaboration across institutions in this field. The number of publications on CAH is increasing annually. Leading research institutions include the University of Michigan, University of California, San Francisco, Karolinska Institutet, and Karolinska University Hospital. The Journal of Clinical Endocrinology & Metabolism is the most cited in this area. The most prolific author is Falhammar H, with 88 publications, 2568 co-citations, and a significant overall contribution. Key research areas include diagnostic methods and therapeutic strategies for CAH. Emerging research hotspots are identified by keywords such as "disorders of sex development," "21-hydroxylase deficiency," "ambiguous genitalia," "testosterone" and "adrenal insufficiency." Research on CAH is expected to expand globally. Future studies will primarily focus on exploring CAH's diagnostic aspects and developing new therapies. This paper will help scholars better understand the dynamic evolution of the CAH and point out the direction for future research.

Racial Disparities in Genetic Detection Rates for Inherited Retinal Diseases

The association of race and detection of pathogenic variants using wide-panel genetic testing for inherited retinal diseases (IRD), to our knowledge, has not been studied previously. To investigate the genetic detection rates of wide-panel testing in Black and non-Hispanic White patients with IRDs. This 2-group comparison used retrospective patient data that were collected at the University of Michigan (UM) and Blueprint Genetics (BG). At UM, inclusion criteria included having a clinical IRD diagnosis, wide-panel genetic testing, and both parents and the patient self-identifying as the same race (Black or non-Hispanic White). Logistic regression analysis was used; the dependent variable was genetic test result (positive or negative/inconclusive) and the independent variables were race, age, sex, phenotype, and number of genes tested. In the BG database, patients with wide-panel testing and self-reported race were included; detection rate comparison analysis based on race was performed using χ2 test of independence. These data were analyzed from October 30, 2013, through October 26, 2022. Genetic test result was considered positive if pathogenic/likely pathogenic variants were detected. A total of 572 patients were included in UM, 295 were males (51.6%). Mean age was 45 years. There were 54 Black patients (9.4%) and 518 White patients (90.6%). Black race (odds ratio [OR], 0.25; 95% CI, 0.14-0.46; P < .001) and age (OR per 10 years, 0.84; 95% CI, 0.76-0.92; P < .001) were independently associated with decreased odds of a positive test. In the BG database, 142 of 320 of Black patients (44.4%) had a positive/likely positive test result, a proportion lower than White patients (1691 of 2931 [57.7%]) (χ2 = 18.65; df = 1; P < .001). Results from this study highlight a lower genetic detection rate for Black patients than for White patients with IRDs. This supports a concern that the current development of IRD therapeutics is highly dependent on the ability to identify the genetic cause of disease. Patients with no known genetic diagnosis may be disadvantaged in terms of prognostication, inheritance counseling, reproductive decision-making, and eligibility for potential therapeutic options, including clinical trials. As future treatments become available, these findings suggest the need to examine the genetic detection rates across majority and minority subgroups alike.

A bibliometric analysis of research on black women: exploring social exclusion and racial discrimination (1977-2024)

Racism have been directed associated with social discrimination of black women caused by racial exclusion. We aimed to visualize the state-of-the-art black women and social and racial discrimination. A total of 214 English-language publications were analysis, comprising articles, books review, editorial, letter, meeting abstract, proceeding papers and reviews, sourced from the Web of Science Core Collection database spanning from January 1977 to May 2024. The results revealed: (1) Cultural Diversity &amp; Ethnic minority psychology journal has published the most studies. The University of Michigan and University of California play the most important role in research related to black woman and social and racial discrimination. The USA is the main publishing country with significant academic influence. (2) Seanna Leath, Jioni A Lewis, J Camille Hall are the leading scholars in black women and social and racial discrimination. Regarding local impact per author, using the H-index, Cochrane Database of Systematic Reviews and Frontiers in Psychiatry appeared to be the most relevant. (3) The research frontier of black women and social and racial discrimination has significantly shifted from focusing on community, racism, intersectionality, structural racism, and discrimination.

Change in Cardiometabolic Health Following Participation in Cardiac Rehabilitation for Coronary Heart Disease: Effect Modification by Metabolic Syndrome Status.

To investigate changes in cardiometabolic risk factors after completion of cardiac rehabilitation (CR) for coronary heart disease (CHD) and ascertain whether the magnitude of improvement in cardiometabolic health differs between those with and without metabolic syndrome (MetS). In this observational cohort study, data were analyzed from 1984 patients enrolled in CR at the University of Michigan between 2011-01-01 and 2020-02-29 for the indication of CHD. Patient characteristics were collected from standardized health questionnaires and during CR intake evaluations. Cardiometabolic biomarkers were recorded from baseline laboratory data and re-examined upon completion of CR. Differences in baseline patient characteristics by MetS status were compared using chi-square tests. Wilcoxon rank-sum tests were used to compare baseline differences, and signed-rank tests were used to evaluate the change in variables between baseline and completion of CR. The difference of change by MetS status was assessed using difference-in-differences regression models. Of the 1984 patients, 1070 (53.9%) met the criteria for MetS at baseline, of which 770 were male (72.0%). Those with MetS lost 1.43 pounds more (95% CI: 0.56, 2.31, P = 0.001), experienced a 0.21 larger drop in body mass index (95% CI: 0.03, 0.37, P = 0.02), and had a 0.31 greater reduction in waist circumference (95% CI: 0.08, 0.54, P = 0.008). Difference-in-differences regression models revealed those with MetS experienced a greater reduction in triglycerides and fasting glucose, with a difference of change of -8.70 for triglycerides (95% CI: -15.04, -2.37, P = 0.007) and -5.48 for glucose (95% CI: -10.44, -0.53, P = 0.03). There was no significant difference in the change in HDL-C or LDL-C for MetS status. Compared to those without MetS, patients with MetS experienced a comparable or greater benefit from CR, particularly with respect to improvements in MetS components.

7.H. Round table: Advancing societal goals through health systems: Insights from the Renewed HSPA Framework

Abstract The purpose of this workshop, entitled ‘Advancing societal goals through health systems: Insights from the renewed HSPA framework,’ is to take a deeper look at the intricate relationships between health systems and broader societal objectives. We will dissect the contributions of health systems to societal well-being, a concept that stretches beyond mere economic growth to include social cohesion, environmental sustainability, and economic development. The session will examine the renewed global Health System Performance Assessment Framework, which serves as a tool for policymakers to better understand how health systems fit together and explains how they perform. This framework allows for a clearer interpretation of health data and provides a pathway to pinpoint health system issues and design that are most likely to enhance performance and resilience. The workshop will delve into the three dimensions of societal well-being-social cohesion, economic development, and environmental sustainability-nested within the HSPA framework. We will explore the health system’s role in advancing these dimensions, such as fostering community bonds, supporting economic growth through a healthy workforce, and contributing to the sustainable management of environmental resources. Integrating health system performance into societal goals is a practical obligation to create a resilient, cohesive, and economically robust society. This workshop will engage stakeholders in a discourse to translate this integration into multisectoral and actionable policies, aligning health system goals with societal aspirations for a sustainable future. This workshop will focus on: How health system assessments can capture contributions to societal goals, underpinning sustainable economic and environmental practices. Real-world case studies showcasing health systems’ role in fostering societal well-being and advancing public health policies. Interactive discussions will shed light on how health systems can be pivotal in achieving the Sustainable Development Goals, particularly in the face of modern challenges such as climate change, demographic shifts, and economic pressures. Key messages • Health systems play a pivotal role in advancing societal well-being beyond traditional health outcomes. • The renewed HSPA framework is a robust tool for policymakers to align health system performance with broader societal goals. Speakers/Panelists Scott Greer University of Michigan, European Observatory on Health Systems and Policies, Ann Arbor, USA Andrea Schmidt Austrian Public Health Institute, Vienna, Austria

A bibliometric analysis and visualization of global food addiction over the last decade.

Food addiction is a chronic psychological disorder resulting from repeated consumption of highly palatable foods, leading to physical and mental harm. It involves individuals who struggle to control their intake of high-energy, high-fat, and high-sugar foods, often experiencing withdrawal reactions and intense cravings that trigger binge eating during stress. Recent research has focused on the impact of food addiction on physical health, nutrition, and mental well-being. This study aims to review and analyze current evidence on food addiction to advance research in China. A total of 941 articles on food addiction published between January 2013 and April 2023 were analyzed using the Web of Science Core Collection. CiteSpace software was utilized to identify research trends, collaborations among disciplines, authors, and institutions, as well as key topics and emerging keywords. The number of publications on food addiction has steadily increased over the past decade, with the United States leading in research output (393 articles). The University of Michigan and author Gearhardt AN were prominent contributors. Key research topics included obesity, eating disorders, addiction, and overeating. Emerging themes encompassed obesity psychology, food composition, brain function, and behavioral addiction. Global research on food addiction primarily focuses on understanding the psychological and neurological underpinnings, metabolic implications, addictive behaviors, and treatment modalities such as sleeve gastrectomy. Future research aims to develop personalized prevention and intervention strategies for food addiction.

Improving implementation and team communication by integrating a cystic fibrosis transition readiness (CF R.I.S.E.) program into electronic health records.

The cystic fibrosis (CF) Responsibility. Independence. Self-care. Education. (R.I.S.E.) program was developed to provide assessment and education, supporting transition readiness for people with cystic fibrosis (pwCF). Lack of integration within electronic health records (EHR) was a barrier to implementation of CF R.I.S.E. University of Michigan was able to integrate CF R.I.S.E. into EHR. To improve implementation and EHR documentation of CF R.I.S.E. module completion by pwCF across two (CF) programs from baseline (10.5%) to 75% per month in 6 months (January through June 2023). Two CF programs utilized quality improvement (QI) methods and tools and ad hoc support by a CF Learning Network (QI) specialist. Eligibility included pwCF ≥16 years old seen in CF clinics who accepted CF R.I.S.E. Beginning January 2, 2023, programs met in biweekly, virtual meetings to discuss implementation. Deidentified data were collected monthly tracking modules completed by pwCF and number of team members engaging with CF R.I.S.E. and documenting in EHR. Data timelines were baseline (November-December 2022), project period (January-June 2023), and post-project (July-December 2023). Completion rates increased from baseline (10.5%) to 48% (range 33% to 81%) through December 2023. During the project, an average 7.7 team members completed an average 19.2 modules per month. Post-project, an average 8 team members completed an average 16.5 modules per month. This collaboration demonstrated how utilization of EHR allowed for successful CF R.I.S.E. improvement at both programs. Shared software utilization and QI initiatives may be a way to facilitate timely dissemination of best practices through learning health systems.

Predictors of Desertion: Analysis of the First Michigan Colored Infantry in the American Civil War

AbstractOver 180,000 black soldiers served in the Union Army in the American Civil War. They endured horrific deprivation and disease, and also substantial institutional discrimination in such areas as wage and promotion. Nevertheless, most never deserted their duties as soldiers. However, it is not clear what distinguished those who did desert from their counterparts. The present case‐control study fills this gap. It applies social bonds theory to explain desertion among blacks. The general hypothesis is the greater the bonds or stakes to the military unit, the lower the risk of desertion. Data refer to the First Michigan Colored Infantry (First Michigan) and are from the Bentley Historical Library, University of Michigan. They refer to the population of all 189 deserters in the First Michigan and a comparison group of non‐deserters. Available measures of social bonds include substitute status (substitutes received a bounty upon completion of service), receiving a wound (having “skin in the game”), and noncommissioned officer status. In addition, loyalty to family is framed as a risk factor. The dependent variable is desertion, a dichotomy (0,1). Results are adjusted for other measurable variables. A multivariate logistic regression analysis determined that measures of military social bonds were protective factors against desertion. Substitutes were 73% less apt, wounded soldiers 93% less apt, and noncommissioned officers were 79% less apt to desert than their counterparts. However, family bonds were a risk factor. The model correctly classified 77.95% of the cases. The results largely support a social bonds theory of deviance, but also may support views of the conflicting bonds between family and state as increasing desertion. The investigation is the first quantitative study of desertion among blacks in the Civil War.

A New Hope - Patient Specific Bone-Anchored Subperiosteal Implants: Perspective of 3 US Institutions on this Resurrected Treatment Modality

BackgroundSince subperiosteal implants were first developed in the 1940s, they have fallen out of favour due to their high complication rate and low long-term survival rate. Many of these complications were due to micromotion. More recently, patient-specific bone-anchored subperiosteal implants (BASIs) have been developed, which utilize screw fixation to mitigate micromotion. This article discusses the early experience of three US institutions, Duke University, University of Michigan, and Mayo Clinic, describes the recommendations of the BASI’s European designer, and provides our treatment recommendations. ConclusionPatient-specific bone-anchored subperiosteal implants have demonstrated acceptable short-term success. At this point in time, we feel this is a viable treatment option but recommend utilizing traditional treatment modalities, such as standard endosseous implants, prior to utilization of a BASI until additional long-term research has been completed.

Intersecting Disciplines: Should LIS Competencies Include Social Work?

Social work in librarianship is a phenomenon that has gained momentum in public libraries since the first known social worker began working at the San Francisco Public Library in 2009. Few LIS programs offer courses to address this evolving phenomenon, yet librarians and library staff nationwide have expressed the need to have training in social work to help them meet the needs of their users. To date, there are only three universities (Dominican University, University of Michigan and Middle Tennessee State University) that offer dual degree programs and even fewer universities that offer social work librarianship courses. With the concern of librarians not feeling equipped to address the social needs of library users (eg. depression, anxiety, suicide, health issues, substance abuse, poverty) this paper emphasizes the critical need for LIS programs to adapt their curriculum to adequately prepare future librarians for public librarianship.

Rare Presentation of Extraskeletal Osteosarcoma Mimicking Phyllodes Tumor

Abstract Introduction/Objective A 57-year-old female presented with a palpable mass in the left breast, measuring up to 9 cm by ultrasound. core needle biopsy identified an atypical spindle cell lesion. The differential diagnosis included a metaplastic carcinoma, borderline phyllodes tumor, malignant phyllodes tumor with potential sarcomatous transformation. Methods/Case Report Histological examination of the tumor was performed, and immunohistochemical stains were conducted to characterize the lesion. Further consultation with a specialized pathologist at the University of Michigan was sought to confirm the diagnosis. Molecular analysis was performed to assess for specific genetic alterations and expression patterns. The histological examination revealed a proliferation of atypical spindle cells forming a fascicular and storiform pattern, with numerous large, pleomorphic, multinucleated tumor cells and a high mitotic rate. Immunohistochemical stains showed strong positivity for CD10 and vimentin, with focal weak expression for desmin, and negativity for a broad panel of cytokeratins and other markers. Consultation with Dr. Abbott at the University of Michigan supported the diagnosis of extraskeletal osteosarcoma. Molecular analysis revealed PD-L1 expression and absence of NTRK gene fusions. FISH analysis showed suggestive alterations including loss of BRAF gene, loss of MYC, and suggestive gains or polysomy of PTEN gene. Results (if a Case Study enter NA) NA Conclusion The case represents a rare presentation of extraskeletal osteosarcoma in the breast, with distinctive histological and immunohistochemical features. The comprehensive workup including histology, immunohistochemistry, and molecular analysis aids in accurate diagnosis and potential therapeutic implications. Further research may elucidate the underlying mechanisms and treatment options for this uncommon malignancy.

Cost Drivers of Pars Plana Vitrectomy for Retinal Detachment: Time-Driven Activity-Based Costing Analysis.

Introduction: To determine drivers of day-of-surgery costs for pars plana vitrectomy (PPV) in the management of retinal detachment (RD) repair, the mainstay treatment, based on surgical complexity and intraoperative factors. Methods: Economic analysis was performed using time-driven activity-based costing methodology for patients who had standard (Current Procedural Terminology [CPT] code 67108) or complex (CPT 67113) RD repair with PPV at the University of Michigan in 2021. Data were obtained via the electronic health record and previous literature. PPV expenses were determined with time-driven activity-based costing, a cost calculation that incorporates time and key resource costs, and were analyzed using univariate and multivariate regression. Results: The analysis included 412 PPVs (270 standard and 142 complex based on CPT code). The operating room time was significantly increased in complex cases (P < .01). Univariate analysis found that complex PPV, cryopexy, staining agent use, retinectomy, simultaneous scleral buckling, perfluoro-N-octane (PFO) use, silicone oil tamponade, and perfluoropropane tamponade were associated with a statistically significant difference in costs (P < .01); use of laser retinopexy was not significantly associated (P = .7190). Multivariate analysis found that standard PPV cost an average $5132.33 and significant incremental costs were found for complex PPV (+$1185.55; P < .001), cryopexy (+$465.02; P = .032), staining (+$525.16; P = .04), PFO use (+$1089.54; P < .0001), retinectomy (+$2031.17; P < .0001), and simultaneous scleral buckling (+$916.34; P = .006). Conclusions: The intraoperative factors that increase operating room time and ultimately the incurred cost of complex PPV cases vs standard PPV were identified and economically defined. These findings can improve practice patterns by optimizing costs for effective surgical planning in the management of RD repair.

Designing a framework for curriculum building in systematic review competencies for librarians: a case report.

Librarians play an important role on systematic review teams because of their expertise in information organization, database searching, and records management. Many systematic review training opportunities exist, but not all are tailored to the needs of librarians. The Medical Library Association, along with a workgroup of experts on systematic reviews and review services, developed a Systematic Review Services Specialization (SRSS) that was launched in 2022. One of the required courses in the specialization was developed by the authors, who set out to build a value-added curriculum that would provide essential searching skills for librarians working in evidence synthesis domains. The authors present a case report on creating a framework for developing a new course in the Medical Library Association's Systematic Review Services Specialization. The objectives of the course were intended to align with six systematic review competencies for librarians developed and published by a group of health science librarians from the University of Michigan in 2017, which include 1) conducting a reference interview, 2) performing preliminary searches, 3) selecting appropriate resources to search, 4) building an extensive, comprehensive, and documented search strategy, 5) peer reviewing search strategies, and 6) reporting search methods. With these objectives in mind, the instructors created four separate modules and an activity. Systematic review skills for librarians are essential to many health science library jobs since librarians are considered important collaborators within systematic review teams. Through eleven cohorts of the course held over 2022-2024, the authors constructed and delivered a comprehensive curriculum.

The Dissertation ECoach: Supporting graduate students as they transition to dissertation writing

Transitioning from coursework to dissertation writing presents unique challenges for graduate students. To support students in this phase of their careers, we created the Dissertation ECoach, a digital tool that provides automated and personalized support and guidance to address individual challenges and promote effective writing habits. By engaging with the Dissertation ECoach, students receive weekly surveys and tailored messages that encourage their writing process. This article discusses the development history, functionality, and methods of the Dissertation ECoach, as well as the results of its implementation at the University of Michigan for the period 2020–2023. Data show that a high percentage of students find the Dissertation ECoach experience helpful, to the point that a subset of students decide to enroll in the experience repeatedly. The article concludes by highlighting the potential of the Dissertation ECoach to be adopted by other universities, offering automated, customized support for graduate students across disciplines. The article also introduces updates that have been implemented in 2023/2024.