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Article ; Online: A Chief Health Security Officer for Every Academic Health Center: Improving Readiness, Response, Recovery, and Resilience.

Maggio, Lauren A / Byington, Carrie L / Toner, Eric S / Kanter, Steven L

Academic medicine : journal of the Association of American Medical Colleges

2023 Volume 98, Issue 11, Page(s) 1247–1250

Abstract: Academic health centers (AHCs) require expertise to ensure readiness for health security events, such as cyberattacks, natural disasters, and pandemics, as well as the ability to respond to and recover from these events. However, most AHCs lack an ... ...

Abstract	Academic health centers (AHCs) require expertise to ensure readiness for health security events, such as cyberattacks, natural disasters, and pandemics, as well as the ability to respond to and recover from these events. However, most AHCs lack an individual to coordinate efforts at an enterprise level across academic and operational units during an emergency; elevate the coordination of individual AHCs with local and state public health entities; and through professional organizations, coordinate the work of AHCs across national and international public health entities. Informed by AHCs' responses to the COVID-19 pandemic and a series of focused meetings in 2021 of the Association of Academic Health Centers President's Council on Health Security, the authors propose creating a new C-suite role to meet these critical needs: the chief health security officer (CHSO). The CHSO would be responsible for the AHC's overall health security and would report to the AHC's chief executive officer or president. The authors describe the role of CHSO in relation to the preparation, response, and recovery phases of public health events necessary for health security. They also propose key duties for this position and encourage institutions to offer training and credentials to facilitate the creation and define the portfolios of CHSO positions at AHCs and beyond.
MeSH term(s)	Humans ; Academic Medical Centers ; Pandemics ; Health Facilities ; Public Health ; Natural Disasters
Language	English
Publishing date	2023-08-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	96192-9
ISSN	1938-808X ; 1040-2446
ISSN (online)	1938-808X
ISSN	1040-2446
DOI	10.1097/ACM.0000000000005435
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Article ; Online: Vaccines: can transparency increase confidence and reduce hesitancy?

Byington, Carrie L

Pediatrics

2014 Volume 134, Issue 2, Page(s) 377–379

MeSH term(s)	Humans ; Vaccines/adverse effects
Chemical Substances	Vaccines
Language	English
Publishing date	2014-07-01
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Comment
ZDB-ID	207677-9
ISSN	1098-4275 ; 0031-4005
ISSN (online)	1098-4275
ISSN	0031-4005
DOI	10.1542/peds.2014-1494
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Article ; Online: Developing a clinical research infrastructure embedded in an academic medicine center that equitably supports future clinician scientists.

Holsti, Maija / Keenan, Heather T / Kadish, Howard A / Sapiro, Heather K / Giardino, Angelo P / Osborn, Katharine A / Cline, Kristen L / Byington, Carrie L

Clinical and translational science

2023 Volume 16, Issue 9, Page(s) 1547–1553

Abstract: Clinical research in academic medical centers can be difficult to conduct and meet enrollment goals. Students under-represented in medicine (URiM) are also under-represented in academic leadership positions and as physician-scientists but are critical to ...

Abstract	Clinical research in academic medical centers can be difficult to conduct and meet enrollment goals. Students under-represented in medicine (URiM) are also under-represented in academic leadership positions and as physician-scientists but are critical to help solve health disparities. Barriers in pursuing medicine as a career may be high for URiM students, therefore it is important to create pre-medicine opportunities accessible to all students interested in healthcare careers. We describe an undergraduate clinical research platform, the Academic Associate (AcA) program, embedded in the medical system that supports clinical research for academic physician scientists and provides students equitable access to experiences and mentoring opportunities. Students have the opportunity of completing a Pediatric Clinical Research Minor (PCRM) degree. This program satisfies many pre-medicine opportunities for undergraduate students, including those URiM, and allows access to physician mentors and unique educational experiences for graduate school or employment. Since 2009, 820 students participated in the AcA program (17.5% URiM) and 235 students (18% URiM) completed the PCRM. Of the 820 students, 126 (10% URiM) students matriculated to medical school, 128 (11%URiM) to graduate school, and 85 (16.5% URiM) gained employment in biomedical research fields. Students in our program supported 57 publications and were top-enrollers for several multicentered studies. The AcA program is cost-effective and achieves a high level of success enrolling patients into clinical research. Additionally, the AcA program provides equitable access for students URiM to physician mentorship, pre-medical experiences, and an avenue to early immersion in academic medicine.
MeSH term(s)	Humans ; Child ; Career Choice ; Mentors ; Biomedical Research ; Academic Medical Centers ; Physicians ; Students, Medical
Language	English
Publishing date	2023-06-18
Publishing country	United States
Document type	Journal Article
ZDB-ID	2433157-0
ISSN	1752-8062 ; 1752-8054
ISSN (online)	1752-8062
ISSN	1752-8054
DOI	10.1111/cts.13565
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Second-Line Pharmaceutical Treatments for Patients with Type 2 Diabetes.

Vashisht, Rohit / Patel, Ayan / Dahm, Lisa / Han, Cora / Medders, Kathryn E / Mowers, Robert / Byington, Carrie L / Koliwad, Suneil K / Butte, Atul J

JAMA network open

2023 Volume 6, Issue 10, Page(s) e2336613

Abstract: Importance: Assessing the relative effectiveness and safety of additional treatments when metformin monotherapy is insufficient remains a limiting factor in improving treatment choices in type 2 diabetes.: Objective: To determine whether data from ... ...

Abstract	Importance: Assessing the relative effectiveness and safety of additional treatments when metformin monotherapy is insufficient remains a limiting factor in improving treatment choices in type 2 diabetes. Objective: To determine whether data from electronic health records across the University of California Health system could be used to assess the comparative effectiveness and safety associated with 4 treatments in diabetes when added to metformin monotherapy. Design, setting, and participants: This multicenter, new user, multidimensional propensity score-matched retrospective cohort study with leave-one-medical-center-out (LOMCO) sensitivity analysis used principles of emulating target trial. Participants included patients with diabetes receiving metformin who were then additionally prescribed either a sulfonylurea, dipeptidyl peptidase-4 inhibitor (DPP4I), sodium-glucose cotransporter-2 inhibitor (SGLT2I), or glucagon-like peptide-1 receptor agonist (GLP1RA) for the first time and followed-up over a 5-year monitoring period. Data were analyzed between January 2022 and April 2023. Exposure: Treatment with sulfonylurea, DPP4I, SGLT2I, or GLP1RA added to metformin monotherapy. Main outcomes and measures: The main effectiveness outcome was the ability of patients to maintain glycemic control, represented as time to metabolic failure (hemoglobin A1c [HbA1c] ≥7.0%). A secondary effectiveness outcome was assessed by monitoring time to new incidence of any of 28 adverse outcomes, including diabetes-related complications while treated with the assigned drug. Sensitivity analysis included LOMCO. Results: This cohort study included 31 852 patients (16 635 [52.2%] male; mean [SD] age, 61.4 [12.6] years) who were new users of diabetes treatments added on to metformin monotherapy. Compared with sulfonylurea in random-effect meta-analysis, treatment with SGLT2I (summary hazard ratio [sHR], 0.75 [95% CI, 0.69-0.83]; I2 = 37.5%), DPP4I (sHR, 0.79 [95% CI, 0.75-0.84]; I2 = 0%), GLP1RA (sHR, 0.62 [95% CI, 0.57-0.68]; I2 = 23.6%) were effective in glycemic control; findings from LOMCO sensitivity analysis were similar. Treatment with SGLT2I showed no significant difference in effectiveness compared with GLP1RA (sHR, 1.26 [95% CI, 1.12-1.42]; I2 = 47.3%; no LOMCO) or DPP4I (sHR, 0.97 [95% CI, 0.90-1.04]; I2 = 0%). Patients treated with DPP4I and SGLT2I had fewer cardiovascular events compared with those treated with sulfonylurea (DPP4I: sHR, 0.84 [95% CI, 0.74-0.96]; I2 = 0%; SGLT2I: sHR, 0.78 [95% CI, 0.62-0.98]; I2 = 0%). Patients treated with a GLP1RA or SGLT2I were less likely to develop chronic kidney disease (GLP1RA: sHR, 0.75 [95% CI 0.6-0.94]; I2 = 0%; SGLT2I: sHR, 0.77 [95% CI, 0.61-0.97]; I2 = 0%), kidney failure (GLP1RA: sHR, 0.69 [95% CI, 0.56-0.86]; I2 = 9.1%; SGLT2I: sHR, 0.72 [95% CI, 0.59-0.88]; I2 = 0%), or hypertension (GLP1RA: sHR, 0.82 [95% CI, 0.68-0.97]; I2 = 0%; SGLT2I: sHR, 0.73 [95% CI, 0.58-0.92]; I2 = 38.5%) compared with those treated with a sulfonylurea. Patients treated with an SGLT2I, vs a DPP4I, GLP1RA, or sulfonylurea, were less likely to develop indicators of chronic hepatic dysfunction (sHR vs DPP4I, 0.68 [95% CI, 0.49-0.95]; I2 = 0%; sHR vs GLP1RA, 0.66 [95% CI, 0.48-0.91]; I2 = 0%; sHR vs sulfonylurea, 0.60 [95% CI, 0.44-0.81]; I2 = 0%), and those treated with a DPP4I were less likely to develop new incidence of hypoglycemia (sHR, 0.48 [95% CI, 0.36-0.65]; I2 = 22.7%) compared with those treated with a sulfonylurea. Conclusions and relevance: These findings highlight familiar medication patterns, including those mirroring randomized clinical trials, as well as providing new insights underscoring the value of robust clinical data analytics in swiftly generating evidence to help guide treatment choices in diabetes.
MeSH term(s)	Aged ; Female ; Humans ; Male ; Middle Aged ; Antiviral Agents ; Cohort Studies ; Diabetes Mellitus, Type 2/drug therapy ; Dipeptidyl-Peptidase IV Inhibitors/therapeutic use ; Hypoglycemic Agents/therapeutic use ; Metformin/therapeutic use ; Protease Inhibitors ; Retrospective Studies ; Sodium-Glucose Transporter 2 Inhibitors ; Sulfonylurea Compounds/therapeutic use ; Network Meta-Analysis
Chemical Substances	Antiviral Agents ; Dipeptidyl-Peptidase IV Inhibitors ; Hypoglycemic Agents ; Metformin (9100L32L2N) ; Protease Inhibitors ; Sodium-Glucose Transporter 2 Inhibitors ; Sulfonylurea Compounds
Language	English
Publishing date	2023-10-02
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2023.36613
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Rotavirus Vaccines-OK to Mix and Match.

Byington, Carrie L / Maldonado, Yvonne

Pediatrics

2016 Volume 137, Issue 2, Page(s) e20153618

MeSH term(s)	Child ; Humans ; Immunization Schedule ; National Institutes of Health (U.S.) ; Randomized Controlled Trials as Topic ; Rotavirus Vaccines/administration & dosage ; Translational Medical Research ; United States ; Vaccination/methods ; Vaccines, Attenuated/administration & dosage
Chemical Substances	Rotavirus Vaccines ; Vaccines, Attenuated
Language	English
Publishing date	2016-02
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	207677-9
ISSN	1098-4275 ; 0031-4005
ISSN (online)	1098-4275
ISSN	0031-4005
DOI	10.1542/peds.2015-3618
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Article ; Online: Parental Presence During Treatment of Ebola or Other Highly Consequential Infection.

Davies, H Dele / Byington, Carrie L

Pediatrics

2016 Volume 138, Issue 3

Abstract: This clinical report offers guidance to health care providers and hospitals on options to consider regarding parental presence at the bedside while caring for a child with suspected or proven Ebola virus disease (Ebola) or other highly consequential ... ...

Abstract	This clinical report offers guidance to health care providers and hospitals on options to consider regarding parental presence at the bedside while caring for a child with suspected or proven Ebola virus disease (Ebola) or other highly consequential infection. Options are presented to help meet the needs of the patient and the family while also posing the least risk to providers and health care organizations. The optimal way to minimize risk is to limit contact between the person under investigation or treatment and family members/caregivers whenever possible while working to meet the emotional support needs of both patient and family. At times, caregiver presence may be deemed to be in the best interest of the patient, and in such situations, a strong effort should be made to limit potential risks of exposure to the caregiver, health care providers, and the community. The decision to allow parental/caregiver presence should be made in consultation with a team including an infectious diseases expert and state and/or local public health authorities and should involve consideration of many factors, depending on the stage of investigation and management, including (1) a careful history, physical examination, and investigations to elucidate the likelihood of the diagnosis of Ebola or other highly consequential infection; (2) ability of the facility to offer appropriate isolation for the person under investigation and family members and to manage Ebola; (3) ability to recognize and exclude people at increased risk of worse outcomes (eg, pregnant women); and (4) ability of parent/caregiver to follow instructions, including appropriate donning and doffing of personal protective equipment.
MeSH term(s)	Child ; Hemorrhagic Fever, Ebola/diagnosis ; Hemorrhagic Fever, Ebola/transmission ; Humans ; Infection Control/methods ; Parents ; Personal Protective Equipment
Keywords	covid19
Language	English
Publishing date	2016-08-22
Publishing country	United States
Document type	Journal Article ; Practice Guideline ; Review
ZDB-ID	207677-9
ISSN	1098-4275 ; 0031-4005
ISSN (online)	1098-4275
ISSN	0031-4005
DOI	10.1542/peds.2016-1891
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Article ; Online: Palivizumab Prophylaxis for Healthy Preterm Infants: More Data Supporting American Academy of Pediatrics Guidelines.

Byington, Carrie L / Munoz, Flor M

Pediatrics

2016 Volume 138, Issue 2

MeSH term(s)	Antibodies, Monoclonal ; Antibodies, Monoclonal, Humanized ; Antiviral Agents ; Child ; Hospitalization ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Palivizumab ; Pediatrics ; Respiratory Syncytial Virus Infections ; United States
Chemical Substances	Antibodies, Monoclonal ; Antibodies, Monoclonal, Humanized ; Antiviral Agents ; Palivizumab (DQ448MW7KS)
Keywords	covid19
Language	English
Publishing date	2016
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Comment
ZDB-ID	207677-9
ISSN	1098-4275 ; 0031-4005
ISSN (online)	1098-4275
ISSN	0031-4005
DOI	10.1542/peds.2016-1494
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Article ; Online: "The Adjunct Faculty Are Our Lifeblood" An Institution's Response to Deliver Value to Volunteer Community Faculty.

Hobson, Wendy L / Olson, Lenora M / Hopf, Harriet W / Winter, Lisa C / Byington, Carrie L

Family medicine

2021 Volume 53, Issue 2, Page(s) 133–138

Abstract: Background and objectives: Because of the importance of and increasing competition for unpaid community faculty's time, we qualitatively evaluated the adjunct community faculty experience in order to identify mechanisms to improve the recruitment, ... ...

Abstract	Background and objectives: Because of the importance of and increasing competition for unpaid community faculty's time, we qualitatively evaluated the adjunct community faculty experience in order to identify mechanisms to improve the recruitment, training, and retention of these faculty members. Methods: The authors captured community faculty and key stakeholder opinion through interviews, focus groups, and a survey to elucidate their perspective of roles, responsibilities, facilitators, and barriers for providing quality teaching and learning experiences. After evaluating the data, we created an impact/effort matrix to guide suggested changes. Results: Key medical education stakeholders reported adjunct community faculty members were critical to delivery of the medical school curriculum and shared methods and barriers for retaining members. Adjunct community faculty focus groups revealed two major themes: (1) personal experience and motivation, and (2) individual advantages and institutional barriers that influence being a faculty member. The survey and impact/effort matrix led to interventions including an Office of Community Faculty to implement recruitment and retention programs and provide more comprehensive oversight, a clinical scheduling hub, improved access to specialists for community faculty, and awards to recognize the critical contributions of community faculty members. Conclusions: As competition for community placements increases, including community faculty voices to inform action is an effective investment that enables an institution to direct resources towards interventions that maximize their support and engagement. Including community faculty perspectives also increases faculty's ability to participate in training the next generation of physicians.
MeSH term(s)	Education, Medical ; Faculty ; Faculty, Medical ; Humans ; Learning ; Motivation ; Volunteers
Language	English
Publishing date	2021-02-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	639374-3
ISSN	1938-3800 ; 0742-3225
ISSN (online)	1938-3800
ISSN	0742-3225
DOI	10.22454/FamMed.2021.565994
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Article ; Online: National Academies of Sciences, Engineering, and Medicine Report on Sexual Harassment: Making the Case for Fundamental Institutional Change.

Fairchild, Amy L / Holyfield, Lavern J / Byington, Carrie L

JAMA

2018 Volume 320, Issue 9, Page(s) 873–874

MeSH term(s)	Engineering ; Female ; Humans ; Medicine ; National Academies of Science, Engineering, and Medicine (U.S.) Health and Medicine Division ; Natural Science Disciplines ; Organizational Culture ; Research Report ; Sexual Harassment/classification ; Sexual Harassment/prevention & control ; Sexual Harassment/statistics & numerical data ; United States ; Women, Working
Language	English
Publishing date	2018-08-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	2958-0
ISSN	1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
ISSN (online)	1538-3598
ISSN	0254-9077 ; 0002-9955 ; 0098-7484
DOI	10.1001/jama.2018.10840
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Article ; Online: PCV13 in the USA: early successes and potential challenges.

Stockmann, Chris / Byington, Carrie L

The Lancet. Infectious diseases

2015 Volume 15, Issue 3, Page(s) 254–256

MeSH term(s)	Bacteremia/epidemiology ; Bacteremia/prevention & control ; Female ; Humans ; Male ; Meningitis, Bacterial/epidemiology ; Meningitis, Bacterial/prevention & control ; Pneumococcal Infections/epidemiology ; Pneumococcal Infections/prevention & control ; Pneumococcal Vaccines/immunology
Chemical Substances	Pneumococcal Vaccines
Language	English
Publishing date	2015-03
Publishing country	United States
Document type	Comment ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2061641-7
ISSN	1474-4457 ; 1473-3099
ISSN (online)	1474-4457
ISSN	1473-3099
DOI	10.1016/S1473-3099(15)70018-6
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