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Purpose: Hospital pharmacists contribute to patient safety and quality initiatives by overseeing the prescribing of antidiabetic medications. A pharmacist-driven glycemic control protocol was developed to reduce the rate of severe hypoglycemia events (SHE) in high-risk hospitalized patients. Methods: We retrospectively analyzed the rates of SHE (defined as blood glucose ≤40 mg/dL), before and after instituting a pharmacist-driven glycemic control protocol over a 4-year period. A hospital glucose management team that included a lead Certified Diabetes Educator Pharmacist (CDEP), 5 pharmacists trained in diabetes, a lead hospitalist, critical care and hospital providers established a process to first identify patients at risk for severe hypoglycemia and then implement our protocol. Criteria from the American Diabetes Association and the American Association of Clinical Endocrinologists was utilized to identify and treat patients at risk for SHE. We analyzed and compared the rate of SHE and physician acceptance rates before and after protocol initiation. Results: From January 2015 to March 2019, 18 297 patients met criteria for this study; 139 patients experienced a SHE and approximately 80% were considered high risk diabetes patients. Physician acceptance rates for the new protocol ranged from 77% to 81% from the year of initiation (2016) through 2018. The absolute risk reduction of SHE was 9 events per 1000 hospitalized diabetic patients and the relative risk reduction was 74% SHE from the start to the end of the protocol implementation. Linear regression analysis demonstrated that SHE decreased by 1.5 events per 1000 hospitalized diabetic patients (95% confidence interval, −1.54 to −1.48, P <.001) during the 2 years following the introduction of the protocol. This represents a 15% relative reduction of SHE per year. Conclusion: The pharmacist-driven glycemic control protocol was well accepted by our hospitalists and led to a significant reduction in SHE in high-risk diabetes patient groups at our hospital. It was cost effective and strengthened our physician-pharmacist relationship while improving diabetes care. [ABSTRACT FROM AUTHOR]

The recurrent 16p11.2 microdeletion is characterized by developmental delays and a wide spectrum of congenital anomalies. It has been well reported that individuals with this ∼593-kb interstitial deletion have an increased susceptibility toward the autism spectrum disorder (ASD). Abnormalities of the eye and ocular adnexa are also commonly associated findings seen in individuals with the 16p11.2 microdeletion syndrome, although these ophthalmic manifestations have not been well characterized. We conducted an extensive literature review to highlight the eye features in patients with the 16p11.2 microdeletion syndrome and describe a 5-year-old boy with the syndrome. The boy initially presented with intellectual disability, speech delay, and defiant behavior; diagnoses of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) were established. He had a Chiari malformation type 1. His ophthalmic features included strabismus, hyperopia, and ptosis, and a posterior embryotoxon was present bilaterally. From a systematic review of prior reported cases, the most common eye and ocular adnexa findings observed were downslanting palpebral fissures, deep-set eyes, ptosis, and hypertelorism. [ABSTRACT FROM AUTHOR]

The present study investigated the validity of LibQUAL+™ scores, and specifically how total and subscale LibQUAL+™ scores are associated with self-reported, library-related satisfaction and outcomes scores. Participants included 88,664 students and faculty who completed the American English (n™ = 69,494) or the British English (nBE = 19,170) LibQUAL+™ language versions in the 2004 data collection cycle. Results suggest that LibQUAL+™ scores primarily measure satisfaction rather than outcomes. [ABSTRACT FROM AUTHOR]

LibQUAL+ is a Web-delivered ’total market survey,’ a term used in the marketing literature for evaluations across an industry of customer expectations and perceptions of service quality. Because the number of items on surveys affects response rates, one goal of instrument development is to create short forms that maintain the reliability and validity of scores on the longer, original protocol. Using data from 20,416 randomly selected users from forty-three academic libraries gathered during the spring 2001 LibQUAL+ run, we examined two methods for developing thirteen-item LibQUAL+ short forms. Both short forms appear to yield scores with sufficient reliability (α1 = .95, α2 = .90) and comparability (ϒLong Form with Short Form #1 = .923, ϒLong Form with Short Form #2 = .981) to long-form scores that either short form may be useful in expeditiously assessing user perceptions. These scores may then be consulted as part of service improvement endeavors. [ABSTRACT FROM AUTHOR]

Discusses the Association of Research Libraries' pilot project on client assessment of library service quality using a modified version of the ServQUAL instrument called LibQUAL+. Participating academic libraries; Preparation of a customized front-end Web page for the general survey; Addition of two dimensions to the original ServQUAL instrument.

Discusses LibQUAL+, a performance assessment tool for research and academic libraries in the United States. Origins in the SERVQUAL instrument; Affect of service; Reliability; Library as place; Provision of physical collections; Access to information; User perception of library quality at multiple levels.

Presents results of Texas A&M University's experience administering SERVQUAL as a performance assessment tool for research and academic libraries in the United States. Measurement of the difference between customers' minimum expectations and their perceptions of those services as delivered; Five customer-valued dimensions of service.

Presents information on a study which explored the reliability and validity of SERVQUAL scores used to evaluate perceptions of library service quality. History of SERVQUAL; Description of SERVQUAL in the library setting; Methodology; Results and discussion; Implications for library service evaluations; Conclusions.

Background: Identifying cytogenetic changes in tumors can aid in diagnosis/prognosis and disease management. Complete cytogenetic characterization has historically required a multimethod/time‐consuming approach. Optical genome mapping (OGM) offers a potential solution to this challenge by detecting both balanced and unbalanced abnormalities in a single assay. Methods: Genetic changes acquired with tumor‐forming potential in a prostate xenograft subline [M2205] (derived from a Black male) that were detected using cytogenetic versus OGM analyses were compared to assess the utility of OGM for analyzing solid tumors. Results: Cytogenetic/OGM concordance was noted for (a) copy number gains (16, 1p, 3q, 5q, 7p, 8q, 9q, 11p, 11q, 15q, 20q), (b) copy number losses (Y, 3p, 4p, 6p, 7p, 9p, 11q), and (c) structural changes, including multibreak rearrangements. Discordance was noted for two structural findings, both of which had breakpoints localized to repetitive sequences. The OGM studies identified new findings and confirmed/further characterized 8q24 structural abnormalities. It also detected genes gained/disrupted in the 8q24 region (e.g., MYC, DEPTOR, and EXT1); but recognizing a jumping translocation required cytogenetic analyses. Conclusion: These results support using OGM as a tool to analyze solid tumors in clinical/research settings. Moreover, this OGM analysis expanded the characterization of cytogenetic changes present in the M2205 subline, including alterations associated with tumors from Black males diagnosed with prostate cancer. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to describe a model of digital library (DL) work that surfaced through the ARL Profiles 2010 and resonates current work underway by the large-scale DL projects like DPLA, SHARE, Hathitrust, Academic Preservation Trust, and Digital Preservation Network. Design/methodology/approach – In total, 86 ARL members submitted institutional profiles that were analyzed using Atlas.ti and surfaced major themes that comprise the mission of research libraries including serving the public good, expanding their presence globally, setting standards for access and quality, needing to explore best practices, and being visible at the national and international levels. Findings – The analysis of the narratives identified three key areas for DL developments: first, digitized special collections, second, acquiring digital content, and third, developing digital services (Figure 1). Specific examples and context are provided in the paper. Research limitations/implications – The qualitative data collected from these profiles demonstrate that libraries are transforming their services to leverage digital technologies and meet the changing needs of their users. The approach was open ended and allowed libraries to celebrate their strengths and unique context. Some of the disadvantages of this approach include the amount of work both on behalf of the participating libraries as well as on behalf of the analysts and the difficulty of comparing libraries with one another. Originality/value – This was the first time ARL attempted to describe research libraries using narrative descriptions. The approach complements the traditional ARL Statistics and offers a viable alternative in a future environment that is dominated by radical change. This qualitative approach deployed here is critical for describing DL developments as current large-scale digitization projects have extended the directions that were surfacing in these profiles and have major implications for the future of digital content and research. Future research in this area is strongly encouraged. [ABSTRACT FROM AUTHOR]

Abstract: In rats bearing an intracranial T9 glioma, immunization with tumor antigens induces myeloid suppressor cells, which express neutrophil (His48) and monocyte (CD11bc) markers, to infiltrate the tumors. The His48+/CD11bc+ cells were not derived from CNS microglia but were hematogenous; suppressed multiple T cell effector functions; and are myeloid-derived suppressor cells (MDSC). The glioma-infiltrating MDSC expressed arginase I, iNOS, indoleamine 2,3-dioxygenase and TGF-β; however, inhibitor/blocking studies demonstrated that NO production was the primary mechanism of suppression which induced T cell apoptosis. These findings suggest that neuro-immunomodulation by MDSC in rat gliomas maybe mediated by a pathway requiring NO production. [Copyright &y& Elsevier]

This paper reviews the evolution of measurement and evaluation in libraries from the perspectives of three important figures who have shaped the history of library assessment activities: James Gerould, F. Wilfrid Lancaster, and Duane Webster. Although Lancaster is about a decade older than Webster and almost half a century removed from Gerould, the contributions of the three individuals knit a common fabric in the development of assessment in libraries in the past century. In investigating the interconnections of the three individuals, not only can we gain an understanding of how we got to today's world of evaluation in libraries, but also we can gain a glimpse into future developments in the field. James Gerould was a library administrator, Lancaster was a library educator, and Webster was a library association executive. Each brought unique perspectives into the evaluation and measurement of library services. In this article we attempt to offer a tribute to Lancaster's accomplishments within the context of the work done in the Association of Research Libraries as it was shaped over the years between Gerould and Webster, from the beginning toward the end of the twentieth century. [ABSTRACT FROM AUTHOR]

Objective: To develop normal ranges of endothelial function in normal human pregnancy to use as a screening test for preeclampsia. Methods: In this longitudinal study, women were studied five times during pregnancy and once postpartum using flow-mediated dilatation (FMD). FMD is a noninvasive ultrasound technique used to assess endothelial function. Healthy nonpregnant women were controls. Results: FMD increased non-significantly in pregnancy until 32 weeks, when it decreased significantly at 36+ weeks (n = 47). Conclusion: The fall in FMD in the third trimester has not been previously reported. This indicates the importance of gestational age when assessing FMD as a screening test for preeclampsia. [ABSTRACT FROM AUTHOR]

The article studies the LibQAUL+TM, a protocol created to help librarians asses the quality of service provided to users through a total market survey that measures the service performance and evaluates user's perception on the service provided. It examines the survey conducted on 20 institutions of Texas A&M Libraries that provide valuable ideas on the nature of user perceptions. Tables of the result of the survey are presented, representing the means, standard deviations, and optional augmentation items scores with LibQUAL+TM subscale and total scores in the American English and British English samples.

The formation of a micronucleus due to chromosome lagging is a well known mechanism of chromosomal loss. However, the post-mitotic fate of the micronucleus and the chromosomal DNA within it is poorly understood. We observed micronuclei (MN) that had multiple copies of the X chromosome (ranging from 4 to 10) when analyzing cultured human lymphocytes using fluorescence in situ hybridization (FISH). A possible mechanism for this observation is that the chromosome(s) or chromatid(s) contained within the micronuclei successfully completed one or more cycles of replication after their expulsion from the primary nucleus. [Copyright &y& Elsevier]

The 25-item LibQUAL+TM protocol has been developed over a series of large-scale studies originally grounded in careful qualitative work. This study for the first time invoked confirmatory factor analysis to evaluate LibQUAL+TM score integrity. Participants were 60,027 undergraduate students, graduate students, and faculty from 146 colleges and universities in the United States and Canada. The results suggest that the model implied by LibQUAL+TM scoring (a) is reasonable, (b) is invariant across independent samples, and (c) fits all 3 major subgroups of library users. [ABSTRACT FROM AUTHOR]

The paucity of cell lines from early-stage prostate cancer tumors has hindered the recognition of genetic and cellular changes that are associated with the acquisition of tumorigenesis. We describe the chromosomal complement of a novel tumorigenic prostate epithelial cell subline, called M2205, that acquired only three new, consistent chromosomal changes (from those present in the SV40T antigen immortalized parental cell line, P69SV40TAg) when it attained tumor-forming potential. The consistent changes, which were fully characterized using GTG-banding, CBG-banding, silver staining, fluorescence in situ hybridization (FISH), comparative genomic hybridization (CGH), and spectral karyotyping (SKY), involved segmental jumping translocations and resulted in gains in the copy number of genes located on the distal long arm of chromosome 8 (8q22 to 8q24.3), including c-myc. Furthermore, the jumping translocations also resulted in ribosomal genes being present in multiple, tandem copies next to the chromatin from 8q. Given the relatively small number of cytogenetic changes present, this subline provides a means for better understanding the cellular changes associated with the acquired chromosomal imbalances. Further studies of this subline could also provide insight as to the mechanism or mechanisms leading to the formation of jumping translocations, as well as potential position effects resulting from the relocation of ribosomal genes next to other cellular genes or oncogenes. [Copyright &y& Elsevier]

Presents a study on the perceptions on the quality levels of library services. Definition of 'zones of tolerance'; Expectations of library users and university students on quality of service; Applications of surveys in college community settings.

The present study reports a reliability generalization (RG) meta-analysis of subscale and total scale scores on the Web-administered LibQUAL+™protocol. Data were provided by 18,161 participants from 43 universities in the United States and Canada. Results indicate that score reliabilities were remarkably invariant across campuses and different user groups. [ABSTRACT FROM AUTHOR]

Examines the reliability and structure of the library service quality measurement tool LibQUAL+. Use of the Web-based LibQUAL+ to measure user perceptions of service quality in academic libraries; Reliability of LibQUAL scores; Identification of the most appropriate scales to report LibQUAL+ scores to librarians using LibQUAL+ to improve service quality.

Examines the psychometric validity of LibQUAL+ scores which measure academic library service quality. High correlation between LibQUAL+ subscale and total scores with satisfaction scores in two independent subsamples; Less correlation between LibQUAL+ mean scores with institutional Association of Research Libraries Index scores.

Discusses score norms developed to help university librarians interpret LibQUAL+ scores with respect to typical profiles at other universities. Development of norms for both perceived service scores and gap scores; Identification of specific areas for improvement; Peer institutions from which superior service practices can be modeled.

Unnumbered graphic rating scales theoretically can lead to greater score variance and thus greater score reliability. The use of Web-based graphic sliders overcomes the practical problems of administering graphic scales on paper measures: the excessive costs of scoring and excessive scoring errors arising from the tediousness of scoring done by hand. The study investigated whether graphic scales realize theoretically expected improved score reliability and how coarseness in slider scoring affects reliability. A large sample size (n = 4,407) and diverse respondent groups were employed so that more confidence could be invested in results. [ABSTRACT FROM AUTHOR]

Investigates the association of a single second-order factor with the delivery of high-quality library services in a research university in Texas. Hierarchical factor analysis; Association of Research Libraries' LibQUAL+ diagnostic tool; User perceptions of library services.

Focuses on a study which examined the psychometric integrity of scores of the LibQUAL+ evaluation of perceived library service quality. Method; Procedure of the study; Results; Dimensions of LibQUAL+.

Provides information on a study which examined the perception of users in North America on library service quality using the LibQUAL+ instrument. Problem statement; Methodology; Participants in the study; Role of the library Web page; Conclusion.

Response representativeness is more important than response rate in survey research. However, response rate is important if it bears on representativeness. The present meta-analysis explores factors associated with higher response rates in electronic surveys reported in both published and unpublished research. The number of contacts, personalized contacts, and precontacts are the factors most associated with higher response rates in the Web studies that are analyzed. [ABSTRACT FROM AUTHOR]

Maternal age is an established predictor of preterm birth independent of other recognized risk factors. The use of chronological age makes the assumption that individuals age at a similar rate. Therefore, it does not capture interindividual differences that may exist due to genetic background and environmental exposures. As a result, there is a need to identify biomarkers that more closely index the rate of cellular aging. One potential candidate is biological age (BA) estimated by the DNA methylome. This study investigated whether maternal BA, estimated in either early and/or late pregnancy, predicts gestational age at birth. BA was estimated from a genome-wide DNA methylation platform using the Horvath algorithm. Linear regression methods assessed the relationship between BA and pregnancy outcomes, including gestational age at birth and prenatal perceived stress, in a primary and replication cohort. Prenatal BA estimates from early pregnancy explained variance in gestational age at birth above and beyond the influence of other recognized preterm birth risk factors. Sensitivity analyses indicated that this signal was driven primarily by self-identified African American participants. This predictive relationship was sensitive to small variations in the BA estimation algorithm. Benefits and limitations of using BA in translational research and clinical applications for preterm birth are considered. [ABSTRACT FROM AUTHOR]

Objectives: Superficial pleomorphic liposarcoma (PL) has a favorable prognosis compared to deeply seated PL. Given developments in the classification of lipomatous neoplasms, we reappraised a series of cases.Methods: Retrospective clinicopathologic evaluation and genome-wide single-nucleotide polymorphism (SNP) microarray studies were performed for cases previously designated superficial PL.Results: Four cases were identified (age, 48-70 years). Two were dermally confined, whereas two were superficial subcutaneous; no recurrences or metastases were reported. Tumors demonstrated pleomorphic spindled morphology with variable cellularity. Multivacuolated atypical lipoblasts were focal in 3 and abundant in 1. Dermal tumors demonstrated atypical cells within sclerotic collagen. Genome-wide SNP microarray studies revealed consistent gains and losses, including losses at the 13q14.2 locus encompassing RB1 and DLEU2 and deletion/disruption of the TP53 locus. Although subcutaneous examples showed genomic changes similar to deep PL, the dermal examples showed fewer genetic alterations, including changes reported in the spectrum of atypical spindle cell/pleomorphic lipomatous tumors (ASPLT). All lacked MDM2 amplification.Conclusions: Careful integration of histologic and genetic features may improve classification of lipomatous neoplasms with atypia, allowing reclassification of some superficial PL as ASPLT. [ABSTRACT FROM AUTHOR]

The present study was conducted to explore library users' desired service quality levels on the twenty-two core LibQUAL+ items. Specifically, we explored similarities and differences in users' desired library service quality levels across user groups (i.e., undergraduate students, graduate students, and faculty), across geographic locations (i.e., institutions using the American English version of the protocol, as against institutions using the British English language version); and across time (i.e., the years 2004-6, during which time the protocol was not altered). The sample consisted of 297,158 LibQUAL+ participants from the years 2004, 2005, and 2006, who completed either the American English (nAE = 227,808) or the British English (nBE = 69,350) version of the protocol. Here, the language version was used as a marker for whether the 297,158 respondents were located in North America or Europe. The heterogeneity of user desires across disciplines was also evaluated. [ABSTRACT FROM AUTHOR]

Objective: Fatigue and cognitive dysfunction are major concerns for women with early-stage breast cancer during treatment and into survivorship. However, interrelationships of these phenomena and their temporal patterns over time are not well documented, thus limiting the strategies for symptom management interventions. In this study, changes in fatigue across treatment phases and the relationship among fatigue severity and its functional impact with objective cognitive performance were examined.Methods: Participants (N = 75) were assessed at five time points beginning prior to chemotherapy to 24 months after initial chemotherapy. Fatigue severity and impact were measured on the Brief Fatigue Inventory. Central nervous system (CNS) Vital Signs was used to measure performance based cognitive testing. Temporal changes in fatigue were examined, as well as the relationship between fatigue and cognitive performance, at each time point using linear mixed effect models.Results: Severity of fatigue varied as a function of phase of treatment. Fatigue severity and its functional impact were moderate at baseline, increased significantly during chemotherapy, and returned to near baseline levels by 2 years. At each time point, fatigue severity and impact were significantly associated with diminished processing speed and complex attention performance.Conclusions: A strong association between fatigue and objective cognitive performance suggests that they are likely functionally related. That cognitive deficits were evident at baseline, whereas fatigue was more chemotherapy dependent, implicates that two symptoms share some common bases but may differ in underlying mechanisms and severity over time. This knowledge provides a basis for introducing strategies for tailored symptom management that vary over time. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the present study was to explore clusters of psychoneurological symptoms and inflammation (levels of C-reactive protein) over time in a cohort of women with early-stage breast cancer. Specifically, we examined the relationships among affective symptoms (depression, anxiety, fatigue, sleep disturbances, pain, and perceived stress), domains of cognitive performance, and levels of peripheral C-reactive over a period of 2 years.Methods: This was a prospective, longitudinal study of 77 women diagnosed with early-stage breast cancer. Data collection, including symptom questionnaires, performance-based cognitive testing, and blood draws, took place at 5 time points: prior to initiating adjuvant chemotherapy, prior to the fourth chemotherapy treatment, and at 6, 12, and 24 months after the initiation of chemotherapy.Results: Exploratory factor analysis with varimax orthogonal rotation was used to examine the covariance among symptoms at each visit. Using the factor scores and weighted sums, three clusters were identified: global cognition, affective symptoms, and cognitive efficiency. Peripheral levels of C-reactive protein were inversely correlated with the cognitive efficiency factor across time.Conclusions: The findings suggest that objectively measured domains of cognitive function occur independently of other affective symptoms that are commonly reported by women with breast cancer in long-term survivorship. The cognitive efficiency symptom cluster may be amenable to interventions targeted to biological influences that reduce levels of C-reactive protein. [ABSTRACT FROM AUTHOR]

Objectives: To compare the performance of the rabbit monoclonal antihuman CD246 antibody (D5F3 clone) with the established ALK1 clone for immunohistochemical assessment of anaplastic large cell lymphoma (ALCL).Methods: Archival cases of ALCL (n = 27) were assessed immunohistochemically by use of ALK1 and D5F3 clones under standard Clinical Laboratory Improvement Amendments-compliant conditions. The intensity of cytoplasmic staining (0 = none; 1 = faint; 2 = moderate; 3+ = strong) and proportion of neoplastic cells (0%, <5%, 5%-50%, >50%) were evaluated and compared with clinical ALK break-apart fluorescence in situ hybridization (FISH) assays.Results: Nine ALCL specimens were positive for ALK expression by ALK1 staining (33%; 1 = 1+; 0 = 2+; 8 = 3+), while 14 were positive by D5F3 staining (48%; 3 = 1+; 1 = 2+; 10 = 3+). Across the cohort, D5F3 staining showed a significantly greater proportion of cells staining positive (P = .02) and greater intensity (P = .03). Of 3 cases positive for D5F3 only with FISH results, none showed rearrangements, although 1 showed copy number gains at the ALK locus in a subset of cells.Conclusions: Overall, D5F3 showed greater stain intensity and proportion staining than ALK1 in ALK-positive ALCL cases, which is especially helpful in limited samples. Caution and consideration of orthogonal ALK testing types is recommended, especially for cases with weak or focal staining. [ABSTRACT FROM AUTHOR]

Objectives. To assess flow-mediated dilatation (FMD) in women with preeclampsia (PE) versus gestational hypertension (GH) and to determine if results of this ultra-sound method vary with modifications to the technique. Methods. Pregnant women with hypertension (BP > 140/90 mmHg) were recruited. Women were allocated to the PE group if they had proteinuria >300 mg/24 h. FMD0 was calculated from the percentage difference in baseline and post-occlusion (PO) diameter at 45-60 s and FMDmax from baseline and maximum diameter between 45 and 90 s. FMDmax was adjusted for hematocrit and shear rate. Results. FMD° (m ± SD) was similar (p = 0.83) in the no medication GH (5.3 ± 3.2; n = 15) and the PE (6.5 ± 4.1; n = 13) groups. FMD0 was reduced (p < 0.001) in the medication GH (3.7 ± 2.8; n = 23) versus the PE (8.8 ± 4.3; n = 25) groups. For FMDmax the interaction between group and medication was not sig-nificant (both p = 0.08) in unadjusted analysis or analysis adjusted for covariates hematocrit (p = 0.023) and shear rate (p = 0.007). Means averaged over medication are presented. FMDmax was reduced (p < 0.0001) in the GH (5.7 ± 4.0; n = 38) versus the PE group (9.2 ± 4.0; n = 38). Of the PE women, 79% (30/38) reached maximum dilatation by 90 s compared with 63% (24/38) of the GH women (chi-square, p = 0.16). Conclusions. The FMDmax analysis revealed reduced FMD in GH women compared with PE women. We therefore hypothesize that PE may be a different disease to GH. Our work demon-strates differing results in FMD° and FMDmax because of modifications in the tech-nique. Previous work on PE and FMD may not be definitive due to this evolving technique. [ABSTRACT FROM AUTHOR]

Objectives: To explore how the library service expectations and perceptions of users might differ across health-related libraries as against major research libraries not operating in a medical context; to determine whether users of medical libraries demand better library service quality, because the inability of users to access needed literature promptly may lead to a patient who cannot be properly diagnosed, or a diagnosis that cannot be properly treated. Methodology: We compared LibQUAL+® total and subscale scores across three groups of US, Canadian and British libraries for this purpose. Results: Anticipated differences in expectations for health as other library settings did not emerge. Conclusions: The expectations and perceptions are similar across different types of health science library settings, hospital and academic, and across other general research libraries. [ABSTRACT FROM AUTHOR]

The article discusses the findings of the cross-cultural study concerning the use of on-premise library information resources and Internet information gateway among undergraduates, graduates and post graduate students. It reveals that dual usage is high among undergraduates, however, faculty usage is low in North America. Dual usage is frequent in Great Britain, however it is least known in Sweden and South Africa due to efficient access of right digital collections in their languages. Furthermore, suggestions on how academic libraries meet institutional missions and cope up technology effects are presented.

The enzyme telomerase correlates with cellular immortalization, and has been shown to be associated with more than 85% of all human cancers. Introduction of the catalytic subunit of telomerase (hTERT) into normal human cells has been shown to lengthen telomeres and extend life span, while ectopic expression of hTERT in immortal and tumor-derived cells lengthens telomeres even in the presence of endogenous telomerase. Because introduced telomerase has been shown to prevent genomic instability in normal cells, we sought to determine its effects on telomere dynamics and chromosome stability in our immortal cell line. We followed the telomere lengthening of an SV40 T antigen fibroblast cell line (SW39) with overexpressed hTERT for more than a year in culture and found that telomeres continued to elongate before the overall length stabilized. Overexpression of hTERT resets the weighted stable telomere length from an average of 4.5 kb to a final average length of 12.5 kb. The levels of telomerase activity and endogenous expression of hTERT mRNA does not change in these cells over time even after stabilization of telomere length, suggesting that the presence of exogenous hTERT has no effect on endogenous levels. Furthermore, our data suggests a lack of a feedback mechanism for endogenous telomerase expression as a result of hTERT introduction and telomere elongation. The G-rich telomeric overhangs were found to be threefold longer in both the elongating and stabilized populations, while chromosomal end fusion events were reduced by 50% in ectopic hTERT cells. Endogenous expression of the end-protective telomere binding protein, TRF2, increased substantially during telomere elongation and stabilization. Overall, we have established an excellent model to study the role of telomerase and telomere binding proteins in telomere biogenesis by showing that telomerase overexpression resets the homeostatic telomere length and cooperates with TRF2 to prevent genomic instability. [ABSTRACT FROM AUTHOR]

Although Web-based surveys are increasing in popularity, very little research has been conducted on the psychometric implications of using different user interfaces for eliciting responses to survey items. The purpose of this study was to compare the latent structures of responses to two different user interface response formats in a Web-based survey. Two different coherent cut kinetics taxometric procedures--MAMBAC and L-mode factor analysis--were used to examine the latent structure of responses to a survey of library service quality using an unnumbered slider-bar user interface versus a radio-button user interface. Strong evidence was found for a pure dimensional latent structure of responses from both user interfaces, which replicated across both taxometric procedures and across multiple survey items. It is concluded that the slider-bar and radio-button user interfaces both yield similar latent structures of survey item responses. The implications of these findings for the construction of Web-based surveys are discussed. [ABSTRACT FROM AUTHOR]

Down syndrome, which results from a trisomic imbalance for chromosome 21, has been associated with 80+ phenotypic traits. However, the cellular changes that arise in somatic cells due to this aneuploid condition are not fully understood. The primary aim of this study was to determine if germline trisomy 21 is associated with an increase in spontaneous somatic cell chromosomal instability frequencies (SCINF). To achieve this aim, we quantified SCINF in people with mosaic Down syndrome using a cytokinesis-blocked micronucleus assay. By comparing values in their isogenic trisomic/disomic cells, we obtained a measure of differences in SCINF that are directly attributable to a trisomy 21 imbalance, since differential effects attributable to "background" genetic factors and environmental exposures could be eliminated. A cross-sectional assessment of 69 people with mosaic Down syndrome (ages 1 to 44; mean age of 12.84 years) showed a significantly higher frequency of micronuclei in their trisomic (0.37 ± 0.35 [mean ± standard deviation]) compared to disomic cells (0.18 ± 0.11)(P <0.0001). The daughter binucleates also showed significantly higher levels of abnormal patterns in the trisomic (1.68 ± 1.21) compared to disomic (0.35 ± 0.45) cells (P <0.0001). Moreover, a significant Age x Cell Type interaction was noted (P = 0.0113), indicating the relationship between age and SCINF differed between the trisomic and disomic cells. Similarly, a longitudinal assessment (mean time interval of 3.9 years; range of 2 to 6 years) of 18 participants showed a mean 1.63-fold increase in SCINF within individuals over time for their trisomic cells (P = 0.0186), compared to a 1.13-fold change in their disomic cells (P = 0.0464). In summary, these results showed a trisomy 21-associated, age-related increase in SCINF. They also underscore the strength of the isogenic mosaic Down syndrome model system for "unmasking" cellular changes arising from a trisomy 21 imbalance. [ABSTRACT FROM AUTHOR]

Robust associations between adverse childhood experiences and shortened telomere length exist, but few studies have examined factors that may moderate this association, particularly with a resilience framework. The present study examined the association between exposure to childhood sexual abuse (and abuse severity) and mean telomere length, and whether social support and optimism moderated this association. The sample included 99 White monozygotic female twins, ranging in age from 35 to 70 (Mage = 52.74, SD = 8.55 years), who provided a blood sample for telomere assay, and data on their childhood sexual abuse history, trait optimism, and current social support. Linear mixed effects models were employed to test study hypotheses. There were no effects of exposure to abuse or abuse severity on mean telomere length, nor were there main or moderating effects of optimism, in analyses of the full sample. However, in analyses that only included women exposed to abuse, there was an abuse type × support interaction: among women who experienced abuse in forms other than intercourse, higher levels of social support were associated with longer mean telomere length. Findings from the current study clarify the role of childhood sexual abuse in telomere attrition, and identify one factor that may protect against the negative biological effects of childhood sexual abuse. [ABSTRACT FROM AUTHOR]