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The ALISE Youth Services Special Interest Group (SIG) presents a panel that explores the ways in which youth services and programs in libraries empower community, inclusion, and active citizenship. The session will begin with presentations of six papers (10 minutes each) and conclude with a themed question and answer at the end of the session, transitioning to open conversation. Attendees will be invited to share their own works in progress and developing ideas on these topics and youth services more broadly during the open discussion portion of the panel. This panel and discussion will connect presenters and attendees in conversation about current trends, future goals, research and pedagogical priorities, and youth and community needs with regards to youth services. The panel brings together six presentations reporting on work at a variety of stages, including late-breaking research as well as long term projects in later stages. These presentations include research from Cahill, Sartin Long, and Adkins focusing on library services for young children with disabilities, reporting findings from focus group interviews seeking to identify ways that libraries can and should be serving young children with disabilities and their families. Farmer’s presentation discusses how diverse populations are targeted by fake news and how librarians can help them express their voice to speak to power. Excitingly this year’s panel also has strong representation of doctoral students. Koren will present work developed with Dywer, Acosta, Bonsignore, and Santacruz focusing on how they used the design thinking process to co-design programs alongside young people from communities impacted by issues of power. Petrella will share the preliminary findings of her doctoral research on ways pre-service school librarians are taught about race, racism, and whiteness in their school library professional programs. Salib will share work developed with Abbas and Agosto, detailing their Institute of Museum and Library Services funded Navigating Screens project which seeks to understand the ways parents desire to connect with other parents in their communities to talk about managing family use of digital media. Finally, Zalot will discuss the mislabeling of the Seuss books’ removal as an act of censorship and how the term is often incorrectly deployed to describe books that are evaluated in new contexts. The breadth of these presentations, techniques, and goals demonstrate how wide ranging the relevance of youth services is to libraries, librarianship, and library and information science (LIS) research and education. This panel will examine how youth services programs and services can support inclusion, nurture active citizenship, and develop community, and prompt an open conversation about how the LIS field can better support these priorities with an emphasis on next steps, research trajectories, teaching innovation, and community building.

Background: Treatment with natalizumab once every 4 weeks is approved for patients with relapsing-remitting multiple sclerosis, but is associated with a risk of progressive multifocal leukoencephalopathy. Switching to extended-interval dosing is associated with lower progressive multifocal leukoencephalopathy risk, but the efficacy of this approach is unclear. We aimed to assess the safety and efficacy of natalizumab once every 6 weeks compared with once every 4 weeks in patients with relapsing-remitting multiple sclerosis. Methods: We did a randomised, controlled, open-label, phase 3b trial (NOVA) at 89 multiple sclerosis centres across 11 countries in the Americas, Europe, and Western Pacific. Included participants were aged 18–60 years with relapsing-remitting multiple sclerosis and had been treated with intravenous natalizumab 300 mg once every 4 weeks with no relapses for at least 12 months before randomisation, with no missed doses in the previous 3 months. Participants were randomly assigned (1:1), using a randomisation sequence generated by the study funder and contract personnel with interactive response technology, to switch to natalizumab once every 6 weeks or continue with once every 4 weeks. The centralised MRI reader, independent neurology evaluation committee, site examining neurologists, site backup examining neurologists, and site examining technicians were masked to study group assignments. The primary endpoint was the number of new or newly enlarging T2 hyperintense lesions at week 72, assessed in all participants who received at least one dose of assigned treatment and had at least one postbaseline MRI, relapse, or neurological examination or efficacy assessment. Missing primary endpoint data were handled under prespecified primary and secondary estimands: the primary estimand included all data, regardless of whether participants remained on the assigned treatment; the secondary estimand classed all data obtained after treatment discontinuation or study withdrawal as missing. Safety was assessed in all participants who received at least one dose of study treatment. Study enrolment is closed and an open-label extension study is ongoing. This study is registered with EudraCT, 2018-002145-11, and ClinicalTrials.gov, NCT03689972. Findings: Between Dec 26, 2018, and Aug 30, 2019, 605 patients were assessed for eligibility and 499 were enrolled and assigned to receive natalizumab once every 6 weeks (n=251) or once every 4 weeks (n=248). After prespecified adjustments for missing data, mean numbers of new or newly enlarging T2 hyperintense lesions at week 72 were 0·20 (95% CI 0·07–0·63) in the once every 6 weeks group and 0·05 (0·01–0·22) in the once every 4 weeks group (mean lesion ratio 4·24 [95% CI 0·86–20·85]; p=0·076) under the primary estimand, and 0·31 (95% CI 0·12–0·82) and 0·06 (0·01–0·31; mean lesion ratio 4·93 [95% CI 1·05–23·20]; p=0·044) under the secondary estimand. Two participants in the once every 6 weeks group with extreme new or newly enlarging T2 hyperintense lesion numbers (≥25) contributed most of the excess lesions. Adverse events occurred in 194 (78%) of 250 participants in the once every 6 weeks group and 190 (77%) of 247 in the once every 4 weeks group, and serious adverse events occurred in 17 (7%) and 17 (7%), respectively. No deaths were reported. There was one case of asymptomatic progressive multifocal leukoencephalopathy (without clinical signs) in the once every 6 weeks group, and no cases in the once every 4 weeks group; 6 months after diagnosis, the participant was without increased disability and remained classified as asymptomatic. Interpretation: We found a numerical difference in the mean number of new or newly enlarging T2 hyperintense lesions at week 72 between the once every 6 weeks and once every 4 weeks groups, which reached significance under the secondary estimand, but interpretation of statistical differences (or absence thereof) is limited because disease activity in the once every 4 weeks group was lower than expected. The safety profiles of natalizumab once every 6 weeks and once every 4 weeks were similar. Although this trial was not powered to assess differences in risk of progressive multifocal leukoencephalopathy, the occurrence of the (asymptomatic) case underscores the importance of monitoring and risk factor consideration in all patients receiving natalizumab. Funding: Biogen.

The Critical Care Resource Nurse Team (CCRNT) evolved from our traditional Rapid Response Team (RRT). The CCRNT is a unique paradigm created using the conceptual framework of the American Association of Critical Care Nursing Synergy Model for Patient Care. The goal of the CCRNT is to help align nurse competencies with patient needs. This team was seen as a much-needed strong clinical support by nursing leadership as large numbers of inexperienced new graduate registered nurses were hired and senior experienced nurses were leaving the workforce. The CCRNT supports 24/7 RRT, Code Blue, Code Stroke, Emergency Airway Response Team, Early Warning System, Medical Emergency Team, simulation team training, and bedside nurse support and mentoring. Coverage expanded from inpatient medical/surgical areas to all areas of the medical center and included hospital-wide initiatives. The focus for the CCRNT changed to a system-wide nursing and patient safety model to improve practice and intervene in near-miss events. This model improved communication between disciplines, provided critical surveillance of at-risk patients, supported patient safety with a significant decrease in patient mortality, and offered a 24/7 expert critical care nurse resource team for staff.

To the Editor: We were not surprised to see that an intubation checklist, as described by Papali and colleagues,[1][1] can reduce time for intubation and improve communication between staff, particularly when intubating patients with acute respiratory failure from COVID-19. We applaud the efforts

Dwyer's book is unique and distinctive as it presents and discusses a modern conceptualization of critical thinking – one that is commensurate with the exponential increase in the annual output of knowledge. The abilities of navigating new knowledge outputs, engaging in enquiry and constructively solving problems are not only important in academic contexts, but are also essential life skills. Specifically, the book provides a modern, detailed, accessible and integrative model of critical thinking that accounts for critical thinking sub-skills and real-world applications; and is commensurate with the standards of twenty-first-century knowledge. The book provides both opportunities to learn and apply these skills through a series of exercises, as well as guidelines on how critical thinking can be developed and practised, in light of existing psychological research, which can be used to enhance the experience of critical thinking training and facilitate gains in critical thinking ability.

We give a construction for twisted equivariant K-theory in the case of a proper action of a discrete group using twisted bundles. Our construction uses results of Lueck and Oliver to extend a construction of Adem and Ruan. We also show the existence of a Chern character to twisted Bredon cohomology. This gives a partial answer to the question of when you can construct twisted equivariant K-theory out of finite rank twisted bundles., 13 pages