4,800 research outputs found

    To Supersede or Supplement: Profiling Aggregator e-Book Collections vs. Our Print Collections

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    Presentation given at the XXVIII Annual Charleston Conference: Issues in Book and Serials Acquisitions, November 5 - 8, 2008. After the conference, Price and McDonald have verified their results using the xISBN work ID, which allows grouping of the various unique ISBNs that refer to the same intellectual work (e.g.cloth vs paperback). Wrangling these nearly 15 million lines of data took quite a while, and did not result in a substantive change to their results: only about 30% of the print books purchased during 2006-2007 by any of the 5 libraries they studied were available from the e-book aggregator marketplace

    Mifepristone reduces insulin resistance in patient volunteers with adrenal incidentalomas that secrete low levels of cortisol : a pilot study

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    Background: Incidental adrenal masses are commonly detected during imaging for other pathologies. 10% of the elderly population has an ‘adrenal incidentaloma’, up to 20% of these show low-grade autonomous cortisol secretion and 60% of patients with autonomous cortisol secretion have insulin resistance. Cortisol excess is known to cause insulin resistance, an independent cardiovascular risk marker, however in patients with adrenal incidentalomas it is unknown whether their insulin resistance is secondary to the excess cortisol and therefore potentially reversible. In a proof of concept study we examined the short-term effects of glucocorticoid receptor (GR) antagonism in patients with an adrenal incidentaloma to determine whether their insulin resistance was reversible. Methodology/Principal Findings: In a prospective open-label pilot study, six individuals with adrenal incidentalomas and autonomous cortisol secretion were treated with mifepristone (a GR antagonist) 200 mg twice daily and studied for 4 weeks on a Clinical Research Facility. Insulin resistance at four weeks was assessed by insulin resistance indices, lnHOMA-IR and lnMatsuda, and AUC insulin during a 2-hour glucose tolerance test. Biochemical evidence of GR blockade was shown in all individuals and across the group there was a significant reduction in insulin resistance: lnHOMA-IR (1.0vs0.6; p = 0.03), lnHOMA-%beta (4.8vs4.3; p = 0.03) and lnMatsuda (1.2vs1.6; p = 0.03). Five out of six individuals showed a reduction in insulin AUC .7237 pmol/l.min, and in two patients this showed a clinically significant cardiovascular benefit (as defined by the Helsinki heart study). Conclusions: Short-term GR antagonism is sufficient to reduce insulin resistance in some individuals with adrenal incidentalomas and mild cortisol excess. Further assessment is required to assess if the responses may be used to stratify therapy as adrenal incidentalomas may be a common remediable cause of increased cardiovascular risk

    Beguiled by Bananas: A Retrospective Study of the Usage and Breadth of Patron vs. Librarian Acquired eBook Collections

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    Library acquisitions lore contains a cautionary tale of a patron in a demand-driven environment who spent a huge chunk of the library budget on ebooks about bananas. This story and others like it have been used to perpetuate the argument that demand-driven acquisition will result in collections that don\u27t appeal to a broad audience or are otherwise unbalanced. We apply post-acquisition usage data from multiple libraries to test the hypothesis that patron-acquired versus librarian-acquired collections have different usage profiles. In addition, we analyze their subject profiles to evaluate collection breadth and balance. Our results will help libraries to anticipate the effect of adding a demand-driven component to their ebook acquisition strategy

    Naming and Framing Service Learning: A Taxonomy and Four Levels of Value

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    Service learning draws upon some of the noblest intentions of American higher education: its goal is to develop an educated and engaged citizenry willing and able to address society\u27s ills. This idea of service learning resonates deeply with the felt needs of our time, and perhaps nowhere more keenly than in the urban locations of metropolitan colleges and universities. Consequently, service learning is perhaps the fastest growing and the most promising movement within higher education today

    Topics in acute respiratory distress syndrome: the patient needs our tender loving and care

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    This editorial introduces a four-part series on acute respiratory distress syndrome (ARDS) that will cover a wide range of related topics in reviews written by internationally renowned experts. The first part of this series will be published in this issue of the European Respiratory Review by Guérin [1] on the role of prone positioning. This will be followed by articles on the topics of: 1) the role of imaging in the diagnosis and management of ARDS; 2) the novel ventilatory aspects involved in managing patients with ARDS; and 3) how to manage a patient failing conventional ventilation with extracorporeal support, in particular, extracorporeal membrane oxygenation (ECMO)

    The Effect of Discovery Systems on Online Journal Usage: A Longitudinal Study

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    Many academic libraries are implementing discovery services as a way of giving their users a single comprehensive search option for all library resources. These tools are designed to change the research experience, yet very few studies have investigated the impact of discovery service implementation. This study examines one aspect of that impact by asking whether usage of publisher-hosted journal content changes after implementation of a discovery tool. Libraries that have begun using the four major discovery services have seen an increase in usage of this content, suggesting that for this particular type of material, discovery services have a positive impact on use. Though all discovery services significantly increased usage relative to a no discovery service control group, some had a greater impact than others, and there was extensive variation in usage change among libraries using the same service. Future phases of this study will look at other types of content

    The Effect of Discovery Systems on Online Journal Usage: A Longitudinal Study

    Get PDF
    Many academic libraries are implementing discovery services as a way of giving their users a single comprehensive search option for all library resources. These tools are designed to change the research experience, yet very few studies have investigated the impact of discovery service implementation. This study examines one aspect of that impact by asking whether usage of publisher-hosted journal content changes after implementation of a discovery tool. Libraries that have begun using the four major discovery services have seen an increase in usage of this content, suggesting that for this particular type of material, discovery services have a positive impact on use. Though all discovery services significantly increased usage relative to a no discovery service control group, some had a greater impact than others, and there was extensive variation in usage change among libraries using the same service. Future phases of this study will look at other types of content

    Burden of podoconiosis in poor rural communities in Guliso woreda, western Ethiopia

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    Background. Podoconiosis is an environmental lymphoedema affecting people living and working barefoot on irritant red clay soil. Podoconiosis is relatively well described in southern Ethiopia, but remains neglected in other parts of the Ethiopian highlands. This study aimed to assess the burden of podoconiosis in rural communities in western Ethiopia. Methodology/Principal Findings. A cross-sectional study was conducted in Gulliso woreda (district), west Ethiopia. A household survey in the 26 rural kebeles (villages) of this district was conducted to identify podoconiosis patients and to measure disease prevalence. A more detailed study was done in six randomly selected kebeles to describe clinical features of the disease, patients’ experiences of foot hygiene, and shoe wearing practice. 1,935 cases of podoconiosis were registered, giving a prevalence of 2.8%. The prevalence was higher in those aged 15 – 64 years (5.2%) and in females than males (prevalence ratio 2.6:1). 90.3% of patients were in the 15 – 64 year age group. In the detailed study, 335 cases were interviewed and their feet assessed. The majority of patients were farmers, uneducated, and poor. Two-third of patients developed the disease before the age of thirty. Almost all patients (97.0%) had experienced adenolymphangitis (ALA - red, hot legs, swollen and painful groin) at least once during the previous year. Patients experienced an average of 5.5 ALA episodes annually, each of average 4.4 days, thus 24 working days were lost annually. The incidence of ALA in podoconiosis patients was higher than that reported for filariasis in other countries. Shoe wearing was limited mainly due to financial problems. Conclusions. We have documented high podoconiosis prevalence, frequent adenolymphangitis and high disease-related morbidity in west Ethiopia. Interventions must be developed to prevent, treat and control podoconiosis, one of the core neglected tropical diseases in Ethiopia
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