Information seekers are generally on their own to discover and use a research library’s growing array of digital col- lections, and coordination of these collections’ development and maintenance is often not optimal...Information seekers are generally on their own to discover and use a research library’s growing array of digital col- lections, and coordination of these collections’ development and maintenance is often not optimal. The frequent lack of a con- scious design for how collections fit together is of equal concern because it means that research libraries are not making the most of the substantial investments they are making in digital initiatives. This paper proposes a framework for a research library’s digital collections that offers integrated discovery and a set of best practices to underpin collection building, federated access, and sus- tainability. The framework’s purpose is to give information seekers a powerful and easy way to search across existing and future collections and to retrieve integrated sets of results. The paper and its recommendations are based upon research undertaken by the author and a team of librarians and technologists at Cornell University Library. The team conducted structured interviews of forty-five library staff members involved in digital collection building at Cornell, studied an inventory of the library’s more than fifty digital collections, and evaluated seven existing Open Archives Initiative (OAI) and federated search production or prototype systems. The author will discuss her team’s research and the rationale for their recommendations to: present a cohesive view of the library’s digital collections for both browsing and searching at the object level; take a programmatic (rather than project-based) approach to digital collection building; require that all new digital collections conform to library-developed and agreed-upon OAI best practices for data providers; and implement organizational structures to sustain the library’s digital collections over the long term.展开更多
BACKGROUND Pulmonary vein stenosis(PVS)is an uncommon but known cause of morbidity and mortality in adults and children and can be managed with percutaneous revascularization strategies of pulmonary vein balloon angio...BACKGROUND Pulmonary vein stenosis(PVS)is an uncommon but known cause of morbidity and mortality in adults and children and can be managed with percutaneous revascularization strategies of pulmonary vein balloon angioplasty(PBA)or pulmonary vein stent implantation(PSI).AIM To study the safety and efficacy outcomes of PBA vs PSI in all patient categories with PVS.METHODS We performed a literature search of all studies comparing outcomes of patients evaluated by PBA vs PSI for PVS.We selected all published studies comparing PBA vs PSI for PVS with reported outcomes of restenosis and procedure-related complications in all patient categories.In adults,PVS following atrial fibrillation ablation and in children PVS related to congenital etiology or post-procedural PVS following total or partial anomalous pulmonary venous return repair were included.The patient-centered outcomes were risk of restenosis requiring re-intervention and procedural-related complications.The metaanalysis was performed by computing odds ratios(ORs)using the random effects model based on underlying statistical heterogeneity.RESULTS Eight observational studies treating 768 severe PVS in 487 patients met our inclusion criteria.The age range of patients was 6 months to 70 years and 67%were males.The primary outcome of the re-stenosis requiring re-intervention occurred in 196 of 325 veins in the PBA group and 111 of 443 veins in the PSI group.Compared to PSI,PBA was associated with a significantly increased risk of re-stenosis(OR 2.91,95%CI:1.15-7.37,P=0.025,I2=79.2%).Secondary outcomes of the procedurerelated complications occurred in 7 of 122 patients in the PBA group and 6 of 69 in the PSI group.There were no statistically significant differences in the safety outcomes between the two groups(OR:0.94,95%CI:0.23-3.76,P=0.929,I^(2)=0.0%).CONCLUSION Across all patient categories with PVS,PSI is associated with reduced risk of re-intervention and is as safe as PBA and should be considered first-line therapy for PVS.展开更多
Purpose: To synthesize the present clinical evidence of efficacy and adverse events of commonly used anti-VEGF drugs for Diabetic Macular Edema. Methods: A systematic review was undertaken from the Medline, Biosis, CI...Purpose: To synthesize the present clinical evidence of efficacy and adverse events of commonly used anti-VEGF drugs for Diabetic Macular Edema. Methods: A systematic review was undertaken from the Medline, Biosis, CINAHL, Cochrane and Web of Science databases. Grey literature that consisted of lectures, seminars and conferences was also retrieved. The cut-off date was January 1 2014. A two-stage screening process was undertaken followed by a data extraction stage using the systematic review software EPPI. These were done by two reviewers. Heterogeneous meta-analysis was performed on the primary outcome which was change in macular thickness from baseline after injection. Side effects were tabulated. Results: From 846 articles that were initially screened, 18 papers were included in the data extraction stage. For all anti-VEGF treatments, the average decrease in macular thickness was 114.4 microns (95% CI: 66.8 - 162 μM). The average decrease in thickness from Lucentis (161.9 μM) was larger than that for Avastin (96.5 μM) but this was not statistically significant (p = 0.23). The most common complications were vitreous hemorrhage, endophthalmitis and retinal detachment. Vision threatening complications were rare but were reported regularly. Conclusions: The synthesized clinical evidence to date supports both of these treatments as efficacious and safe for diabetic macular edema (DME). There is a trend toward greater efficacy for Lucentis over Avastin but this is not statistically significant and will need a head-to-head RCT to assess accurately.展开更多
OBJECTIVE: To evaluate the effectiveness and safety of rhubarb-based Chinese herbal formulae(RCHF), which are widely used to treat hepatic encephalopathy(HE) in China.METHODS: Nine online databases were searched from ...OBJECTIVE: To evaluate the effectiveness and safety of rhubarb-based Chinese herbal formulae(RCHF), which are widely used to treat hepatic encephalopathy(HE) in China.METHODS: Nine online databases were searched from inception to November 22, 2016. Eligible studies were randomized controlled trials of Traditional Chinese Medicine(TCM) treatment for adult patients(≥ 18 years old) with HE. Outcomes such as mortality rate, clinical response rate, blood ammonia level, and alanine aminotransferase were evaluated between TCM group and control group.RESULTS: Thirty studies involving 2661 HE patients were analyzed. Most studies used RCHF treatment.Compared with conventional treatment as usual,lactulose, and vinegar, RCHF were associated with significant improvement in clinical response rate[risk ratio(RR) = 1.33, 95% confidence interval(CI) =1.25, 1.43, I2= 0%; RR = 1.26, 95% CI = 1.14, 1.38, I2=22%; and RR = 1.19, 95% CI = 1.06, 1.33, I2= 0%, respectively] and significant reductions in levels of blood ammonia and alanine aminotransferase. Only minor RCHF-associated adverse events, such as abdominal pain(0.3%), anal tenesmus(0.3%), and diarrhea(2.3%), were reported, and there were no significant differences in these events between the treatment group and the three types of control group.CONCLUSION: The findings suggest that RCHF may be an alternative treatment option for HE patients. More rigorous multicenter studies with larger samples and longer observational periods are needed to confirm these findings.展开更多
文摘Information seekers are generally on their own to discover and use a research library’s growing array of digital col- lections, and coordination of these collections’ development and maintenance is often not optimal. The frequent lack of a con- scious design for how collections fit together is of equal concern because it means that research libraries are not making the most of the substantial investments they are making in digital initiatives. This paper proposes a framework for a research library’s digital collections that offers integrated discovery and a set of best practices to underpin collection building, federated access, and sus- tainability. The framework’s purpose is to give information seekers a powerful and easy way to search across existing and future collections and to retrieve integrated sets of results. The paper and its recommendations are based upon research undertaken by the author and a team of librarians and technologists at Cornell University Library. The team conducted structured interviews of forty-five library staff members involved in digital collection building at Cornell, studied an inventory of the library’s more than fifty digital collections, and evaluated seven existing Open Archives Initiative (OAI) and federated search production or prototype systems. The author will discuss her team’s research and the rationale for their recommendations to: present a cohesive view of the library’s digital collections for both browsing and searching at the object level; take a programmatic (rather than project-based) approach to digital collection building; require that all new digital collections conform to library-developed and agreed-upon OAI best practices for data providers; and implement organizational structures to sustain the library’s digital collections over the long term.
文摘BACKGROUND Pulmonary vein stenosis(PVS)is an uncommon but known cause of morbidity and mortality in adults and children and can be managed with percutaneous revascularization strategies of pulmonary vein balloon angioplasty(PBA)or pulmonary vein stent implantation(PSI).AIM To study the safety and efficacy outcomes of PBA vs PSI in all patient categories with PVS.METHODS We performed a literature search of all studies comparing outcomes of patients evaluated by PBA vs PSI for PVS.We selected all published studies comparing PBA vs PSI for PVS with reported outcomes of restenosis and procedure-related complications in all patient categories.In adults,PVS following atrial fibrillation ablation and in children PVS related to congenital etiology or post-procedural PVS following total or partial anomalous pulmonary venous return repair were included.The patient-centered outcomes were risk of restenosis requiring re-intervention and procedural-related complications.The metaanalysis was performed by computing odds ratios(ORs)using the random effects model based on underlying statistical heterogeneity.RESULTS Eight observational studies treating 768 severe PVS in 487 patients met our inclusion criteria.The age range of patients was 6 months to 70 years and 67%were males.The primary outcome of the re-stenosis requiring re-intervention occurred in 196 of 325 veins in the PBA group and 111 of 443 veins in the PSI group.Compared to PSI,PBA was associated with a significantly increased risk of re-stenosis(OR 2.91,95%CI:1.15-7.37,P=0.025,I2=79.2%).Secondary outcomes of the procedurerelated complications occurred in 7 of 122 patients in the PBA group and 6 of 69 in the PSI group.There were no statistically significant differences in the safety outcomes between the two groups(OR:0.94,95%CI:0.23-3.76,P=0.929,I^(2)=0.0%).CONCLUSION Across all patient categories with PVS,PSI is associated with reduced risk of re-intervention and is as safe as PBA and should be considered first-line therapy for PVS.
文摘Purpose: To synthesize the present clinical evidence of efficacy and adverse events of commonly used anti-VEGF drugs for Diabetic Macular Edema. Methods: A systematic review was undertaken from the Medline, Biosis, CINAHL, Cochrane and Web of Science databases. Grey literature that consisted of lectures, seminars and conferences was also retrieved. The cut-off date was January 1 2014. A two-stage screening process was undertaken followed by a data extraction stage using the systematic review software EPPI. These were done by two reviewers. Heterogeneous meta-analysis was performed on the primary outcome which was change in macular thickness from baseline after injection. Side effects were tabulated. Results: From 846 articles that were initially screened, 18 papers were included in the data extraction stage. For all anti-VEGF treatments, the average decrease in macular thickness was 114.4 microns (95% CI: 66.8 - 162 μM). The average decrease in thickness from Lucentis (161.9 μM) was larger than that for Avastin (96.5 μM) but this was not statistically significant (p = 0.23). The most common complications were vitreous hemorrhage, endophthalmitis and retinal detachment. Vision threatening complications were rare but were reported regularly. Conclusions: The synthesized clinical evidence to date supports both of these treatments as efficacious and safe for diabetic macular edema (DME). There is a trend toward greater efficacy for Lucentis over Avastin but this is not statistically significant and will need a head-to-head RCT to assess accurately.
基金Supported by Major Projects of National Science and Technology:the Study of Optimal Regimen for Integrative Treatment of Acute-on-chronic Liver Failure(No.2017zx1020-5506-002)Special Scientific Projects from The State Administration of Traditional Chinese Medicine of The People'S Republic of China:the Study on the Mechanism of Chinese Herbs for Chronic Liver Failure Focused on the Signaling Pathway of Lps/tlr4(No.Jdzx2015187)
文摘OBJECTIVE: To evaluate the effectiveness and safety of rhubarb-based Chinese herbal formulae(RCHF), which are widely used to treat hepatic encephalopathy(HE) in China.METHODS: Nine online databases were searched from inception to November 22, 2016. Eligible studies were randomized controlled trials of Traditional Chinese Medicine(TCM) treatment for adult patients(≥ 18 years old) with HE. Outcomes such as mortality rate, clinical response rate, blood ammonia level, and alanine aminotransferase were evaluated between TCM group and control group.RESULTS: Thirty studies involving 2661 HE patients were analyzed. Most studies used RCHF treatment.Compared with conventional treatment as usual,lactulose, and vinegar, RCHF were associated with significant improvement in clinical response rate[risk ratio(RR) = 1.33, 95% confidence interval(CI) =1.25, 1.43, I2= 0%; RR = 1.26, 95% CI = 1.14, 1.38, I2=22%; and RR = 1.19, 95% CI = 1.06, 1.33, I2= 0%, respectively] and significant reductions in levels of blood ammonia and alanine aminotransferase. Only minor RCHF-associated adverse events, such as abdominal pain(0.3%), anal tenesmus(0.3%), and diarrhea(2.3%), were reported, and there were no significant differences in these events between the treatment group and the three types of control group.CONCLUSION: The findings suggest that RCHF may be an alternative treatment option for HE patients. More rigorous multicenter studies with larger samples and longer observational periods are needed to confirm these findings.
