Consortial Collaboration in the Cloud: an Innovative Group Implementation of Web-scale Management

In 2013, a consortium of small to medium academic libraries prioritized moving to a shared web-scale management system in order to enhance collaboration between the members and realign services within them. The group implementation required a creative approach to data migration and workflow analysis, facilitated by technological solutions as well as internal change management. Panelists representing the consortium, member libraries and vendor will discuss innovative resource sharing in a consortial web-scale system, data migration from disparate local systems into the shared system and e-resource knowledgebase, plus the potential for new developments regarding shared print and online collections

A Pilot Study on the Effects of Exercise on Depression Symptoms Using Levels of Neurotransmitters and EEG as Markers

Context: The prescribing of exercise by physicians has become a popular practice, yet the effectiveness of exercise on symptoms of depression is difficult to determine due to a lack of randomized controlled trials with clinical populations. Reports also indicate that only a small percentage of physicians advise their patients regarding exercise and confusion still exists as to how much and what types are best. Aims: To understand the mechanisms that make exercise a viable treatment in depression. Settings and Design: This study employed a six‑week, two group, single‑level trial, pre‑ and posttest design using self‑report of symptoms, blood levels of serotonin, dopamine, epinephrine, and norepinephrine, and frontal slow wave EEG activity as markers. This study was registered with clinicaltrials.gov. ID# NCT02023281. Subjects and Methods: Eleven participants with a diagnosis of depression between the ages of 18 and 65 were enrolled from March 2013 through May 2013. Baseline and post‑intervention measures consisted of the Beck Depression Inventory‑II, blood serum levels of serotonin, catecholamines (epinephrine, norepinephrine, and dopamine), and mean alpha frequency. Statistical Analysis Used: A series of independent t‑tests for each dependent variable was conducted. Results: Independent t‑tests reveal significant between‑group differences in depression scores (P = 0.005, d = 2.23); F7 activity (P = 0.012, d = 1.92); and F8 activity (P = 0.04, d = 1.52). Conclusions: The results of this pilot study show that even mild to very moderate levels of exercise 2‑3 times per week consisting of alternating days of aerobic and strength resistance training can be effective in reducing symptoms of depression giving physicians concrete information for their patients on the prescription of exercise

The impact of using an intraoperative goal directed fluid therapy protocol on clinical outcomes in patients undergoing total pancreatectomy and islet cell autotransplantation.

BACKGROUND: Patients undergoing total pancreatectomy and islet cell autotransplant (TPIAT) for treatment of pancreatitis are at risk for complications of over and under resuscitation. We hypothesized that using a goal directed fluid therapy (GDFT) protocol might impact clinical outcomes. MATERIALS AND METHODS: A consecutive series of adult patients undergoing TPIAT were managed intraoperatively using either standard fluid therapy (SFT, n = 44) or GDFT (n = 23) as part of a pilot study between January 2013 and May 2015. Patient characteristics, intraoperative, and postoperative data were recorded prospectively, then retrospectively analyzed for differences between the groups. RESULTS: The GDFT group had lower total fluid resuscitation (3,240 cc vs 5,173 cc, p \u3c 0.0001) and transfusion requirements (1.0 cc/kg vs 3.3 cc/kg, p = 0.050) compared to the SFT group. The pre to postop nadir hemoglobin change was significantly less for GDFT (4.2 vs 5.1 gm/dl, p = 0.021) despite less transfusion. CONCLUSIONS: Compared to SFT, using an intraoperative GDFT protocol in TPIAT patients was associated with significantly decreased intraoperative fluid resuscitation, blood transfusion and less postoperative dilutional anemia, without any difference in complications of underresuscitation. This pilot study suggests that GDFT is likely safe and further investigation is warranted