Thinking Outside the Box to Square the Circle: Realigning Library Services with Stakeholder Needs

Objectives: In an age of electronic databases and Google, librarians must find ways to expand library services to meet the needs of patrons who no longer seek some traditional services. How do we identify needs in our organizations that are not being met, and market our abilities to fill those needs while maintaining our identity as librarians? Methods: With the full support of the library director, whose priority was to update academic and clinical services, newly hired librarians took time to observe the initiatives and goals already established across their respective residency and nursing departments. Despite increased liaison activity, decreasing demand for literature searches led us to investigate other ways we could serve the departments. We discovered needs that librarians could help with such as: assisting with surveys and pretests, measuring research impact, growing institutional knowledge through tutorials and archives, finding grant opportunities, and dealing with technology questions. A search of the literature and recent job postings provided additional ideas for value-added services, as well as best practices for identifying needs and building patron relationships. Results: Librarians focused on outreach, listened to their stakeholders’ pain points, and offered to take on different kinds of projects. This required additional training in some cases, flexibility and willingness to fail, and undertaking responsibilities that might be seen as outside a librarian’s normal duties. However, these new assignments resulted in increased collaboration and visibility for librarians. Conclusions: While there is still a need for librarians in healthcare organizations, they must work harder than ever to market themselves and offer more value-added services. By defining those services through outreach and research, librarians can better align their goals with those of their respective stakeholders

Elevating Library Practice through Process Improvement Teams: The Electronic Resources Task Force

Objective Organizations in fields from manufacturing to health care use process improvement teams, an important aspect of LEAN practice, to improve their work. The library faced challenges with interfaces for electronic resources, including a dated electronic journals interface, out-of-control LibGuides, and lack of control over our web presence. The library formed the Electronic Resources Task Force to foster a collaborative approach to solving these problems. This poster will show techniques used and what we accomplished. Methods The library experienced many changes in the last year including changes in leadership and staff. With our new director’s emphasis on improving electronic access, new staff members, and a staff member’s recent training in Lean, we had a great opportunity to incorporate new techniques in team development. Our goal was to provide attractive, modern, and seamless access to evidence-based, high quality information resources. To share information and improve accountability, the team developed a shared flowchart document that allows any team member to update progress on any task at any time. The team meets regularly, further improving accountability and providing opportunities to address electronic resources and collections issues as a group. Results To date, the Electronic Resources Task Force has reduced the number of active LibGuides from 71 to 33 updated guides. Our transition to EBSCO’s Full Text Finder is complete. Additionally, we developed a new search box for LibGuides, introduced a LibGuides-based Databases A-Z page, updated LibAnswers, and rolled out a new literature search form and database. The team continues to follow up on a list of future improvements. Conclusions Incorporating Lean into our work is ongoing, as is our staff member’s training in these techniques. However, we can conclude that the techniques originally developed in manufacturing and being used in healthcare can also be used to improve library work

Transmissivity, Hydraulic Conductivity, and Storativity of the Carrizo-Wilcox Aquifer in Texas

Transmissivity, hydraulic conductivity, and storativity are crucial parameters for developing local and regional water plans and numerical groundwater flow models to predict the future availability of the water resource. To support this effort, we compiled and analyzed transmissivity, hydraulic conductivity, and storativity values from various sources for the entire Carrizo-Wilcox aquifer in Texas, resulting in a database of 7,402 estimates of hydraulic properties in 4,456 wells. Transmissivity and hydraulic conductivity results for all tests in the Carrizo-Wilcox aquifer follow a log-normal distribution. Transmissivity ranges from about 0.1 to 10,000 ft^2/day and has a geometric mean value of about 300 ft^2/day, while hydraulic conductivity ranges from about 0.01 to 4,000 ft/day and has a geometric mean value of about 6 ft/day. Transmissivity and hydraulic conductivity vary spatially, both vertically and laterally, within the Carrizo-Wilcox aquifer. The Simsboro Formation and Carrizo Sand portions of the aquifer exhibit transmissivity and hydraulic conductivity values that are 2.5 to 11 times higher and 2 to 6 times higher, respectively, than those of the Cypress aquifer, Calvert Bluff Formation, and undivided Wilcox Group. Semivariograms demonstrate that transmissivity and hydraulic conductivity values in the Carrizo Sand and undivided Wilcox Group are spatially correlated over distances of about 17 and 25 miles, respectively. Large nuggets in the semivariograms suggest local-scale heterogeneity and measurement errors. Kriged maps of transmissivity and hydraulic conductivity reveal the highest values for the Carrizo Sand in the Winter Garden area and the greatest values for the Wilcox Group in the south-central and northeast parts of the aquifer. Storativity and specific storage values exhibit approximately log-normal distributions. Storativity ranges from about 10^-6 to 10^-1 with a geometric mean of 3.0 x 10^-4, while specific storage ranges from about 10^-7 to 10^-3 with a geometric mean of 4.5 x 10^-6. Lower values of storativity and specific storage tend to occur at shallow depths where the aquifer is unconfined.Bureau of Economic Geolog

Numerical simulation of electromagnetic coupling in explicitly meshed wiring looms and bundles

In this paper, the Unstructured Transmission Line Modelling (UTLM) method based on a tetrahedral mesh is applied to model the electromagnetic coupling into wire looms and bundles with multiple cores that are typical of an aircraft system, when they are exposed to plane wave illuminations. The impact on the electromagnetic coupling into wires of both bundle configuration and the positioning of the bundle relative to simple structures are investigated using the UTLM method with explicit meshing of the wires. The work not only confirms that UTLM method as a powerful tool for dealing with wire looms and bundles but provides invaluable information on the margins to be expected in key experimental waveform parameters such as peak amplitude and frequency response

Maternal iron metabolism gene variants modify umbilical cord blood lead levels by gene-environment interaction: a birth cohort study

Background: Given the relationship between iron metabolism and lead toxicokinetics, we hypothesized that polymorphisms in iron metabolism genes might modify maternal-fetal lead transfer. The objective of this study was to determine whether maternal and/or infant transferrin (TF) and hemochromatosis (HFE) gene missense variants modify the association between maternal blood lead (MBL) and umbilical cord blood lead (UCBL). Methods: We studied 476 mother-infant pairs whose archived blood specimens were genotyped for TF P570S, HFE H63D and HFE C282Y. MBL and UCBL were collected within 12 hours of delivery. Linear regression models were used to examine the association between log-transformed MBL and UCBL, examine for confounding and collinearity, and explore gene-environment interactions. Results: The geometric mean MBL was 0.61 μg/dL (range 0.03, 3.2) and UCBL 0.42 (<0.02, 3.9). Gene variants were common with carrier frequencies ranging from 12-31%; all were in Hardy-Weinberg equilibrium. In an adjusted linear regression model, log MBL was associated with log UCBL (β = 0.92, 95% CI: 0.82, 1.03; p < 0.01) such that a 1% increase in MBL was associated with a 0.92% increase in UCBL among infants born to wild-type mothers. In infants born to C282Y variants, however, a 1% increase in MBL is predicted to increase UCBL 0.65% (βMain Effect = −0.002, 95% CI: −0.09, −0.09; p = 0.97; βInteraction = −0.27, 95% CI: −0.52, −0.01; p = 0.04), representing a 35% lower placental lead transfer among women with MBL 5 μg/dL. Conclusions: Maternal HFE C282Y gene variant status is associated with greater reductions in placental transfer of lead as MBL increases. The inclusion of gene-environment interaction in risk assessment models may improve efforts to safeguard vulnerable populations. Electronic supplementary material The online version of this article (doi:10.1186/1476-069X-13-77) contains supplementary material, which is available to authorized users

Maternal and Cord Blood Manganese Concentrations and Early Childhood Neurodevelopment among Residents near a Mining-Impacted Superfund Site

Background: Environmental manganese exposure has been associated with adverse neurodevelopmental outcomes among school-aged children; yet, few studies have evaluated prenatal exposure. Objectives: Our study examines associations between prenatal manganese concentrations and placental transfer of manganese with neurodevelopment in 224 2-y-old children residing near the Tar Creek Superfund Site. Methods: We collected maternal and cord blood at delivery, measured manganese using inductively coupled plasma mass spectrometry, and assessed neurodevelopment using the Bayley Scales of Infant Development-II. Associations between manganese and mental (MDI) and psychomotor (PDI) development indices were estimated in multivariable models. Placental transfer, approximated by cord/maternal manganese ratio, cord/total manganese ratio (total=maternal+cord), and by joint classification according to high or low (above or below median) maternal and cord manganese, was evaluated as a predictor of neurodevelopment. Results: Median levels [interquartile ranges (IQR)] of manganese in maternal and cord blood, respectively, were 24.0 (19.5–29.7) and 43.1 (33.5–52.1) μg/L. Adjusting for lead, arsenic, and other potential confounders, an IQR increase in maternal manganese was associated with −3.0 (95% CI: −5.3, −0.7) points on MDI and −2.3 (95% CI: −4.1, −0.4) points on PDI. Cord manganese concentrations were not associated with neurodevelopment scores. Cord/maternal and cord/total manganese ratios were positively associated with MDI [cord/maternal: β=2.6 (95% Cl: −0.04, 5.3); cord/total: β=22.0 (95% Cl: 3.2, 40.7)] and PDI (cord/maternal: β=1.7 (95% Cl: −0.5, 3.9); cord/total: β=15.6 (95% Cl: 0.3, 20.9)). Compared to mother–child pairs with low maternal and cord manganese, associations with neurodevelopment scores were negative for pairs with either high maternal, high cord, or high maternal and cord manganese. Conclusions: Maternal blood manganese concentrations were negatively associated with early childhood neurodevelopment scores in our study. Findings highlight the importance of understanding maternal exposures during pregnancy and factors influencing placental transfer. https://doi.org/10.1289/EHP92

Assessing the Quality of Care for Pneumonia in Integrated Community Case Management: A Cross-Sectional Mixed Methods Study

Background Pneumonia is the leading infectious cause of mortality in children under five worldwide. Community-level interventions, such as integrated community case management, have great potential to reduce the burden of pneumonia, as well as other diseases, especially in remote populations. However, there are still questions as to whether community health workers (CHW) are able to accurately assess symptoms of pneumonia and prescribe appropriate treatment. This research addresses limitations of previous studies using innovative methodology to assess the accuracy of respiratory rate measurement by CHWs and provides new evidence on the quality of care given for children with symptoms of pneumonia. It is one of few that assesses CHW performance in their usual setting, with independent re-examination by experts, following a considerable period of time post-training of CHWs. Methods In this cross-sectional mixed methods study, 1,497 CHW consultations, conducted by 90 CHWs in two districts of Luapula province, Zambia, were directly observed, with measurement of respiratory rate for children with suspected pneumonia recorded by video. Using the video footage, a retrospective reference standard assessment of respiratory rate was conducted by experts. Counts taken by CHWs were compared against the reference standard and appropriateness of the treatment prescribed by CHWs was assessed. To supplement observational findings, three focus group discussions and nine in depth interviews with CHWs were conducted. Results and Conclusion The findings support existing literature that CHWs are capable of measuring respiratory rates and providing appropriate treatment, with 81% and 78% agreement, respectively, between CHWs and experts. Accuracy in diagnosis could be strengthened through further training and the development of improved diagnostic tools appropriate for resource-poor settings

Two Glycosylation Sites in H5N1 Influenza Virus Hemagglutinin That Affect Binding Preference by Computer-Based Analysis

Increasing numbers of H5N1 influenza viruses (IVs) are responsible for human deaths, especially in North Africa and Southeast Asian. The binding of hemagglutinin (HA) on the viral surface to host sialic acid (SA) receptors is a requisite step in the infection process. Phylogenetic analysis reveals that H5N1 viruses can be divided into 10 clades based on their HA sequences, with most human IVs centered from clade 1 and clade 2.1 to clade 2.3. Protein sequence alignment in various clades indicates the high conservation in the receptor-binding domains (RBDs) is essential for binding with the SA receptor. Two glycosylation sites, 158N and 169N, also participate in receptor recognition. In the present work, we attempted to construct a serial H5N1 HA models including diverse glycosylated HAs to simulate the binding process with various SA receptors in silico. As the SA-α-2,3-Gal and SA-α-2,6-Gal receptor adopted two distinctive topologies, straight and fishhook-like, respectively, the presence of N-glycans at 158N would decrease the affinity of HA for all of the receptors, particularly SA-α-2,6-Gal analogs. The steric clashes of the huge glycans shown at another glycosylation site, 169N, located on an adjacent HA monomer, would be more effective in preventing the binding of SA-α-2,3-Gal analogs

The stoichiometry of trimeric SIV glycoprotein interaction with CD4 differs from that of anti-envelope antibody Fab fragments

Human and simian immunodeficiency viruses infect host lymphoid cells by binding CD4 molecules via their gp160 envelope glycoproteins. Biochemical studies on recombinant SIVmac32H (pJ5) envelope ectodomain gp140 precursor protein show that the envelope is a trimer. Using size exclusion chromatography, quantitative amino acid analysis, analytical ultracentrifugation, and CD4-based competition assay, we demonstrate that the stoichiometry of CD4 receptor-oligomeric envelope interaction is 1:1. By contrast, Fab fragments of both neutralizing and non-neutralizing monoclonal antibodies bind at a 3:1 ratio. Thus, despite displaying equivalent CD4 binding sites on each of the three gp140 protomers within an uncleaved trimer, only one site binds the soluble 4-domain human CD4 extracellular segment. The anti-cooperativity and the faster k(off) of gp140 trimer:CD4 versus gp120 monomer:CD4 interaction suggest that CD4-induced conformational change is impeded in the intact envelope. The implications of these findings for immunity against human immunodeficiency virus and simian immunodeficiency virus are discussed