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Objectives: Until the introduction of fidaxomicin, antimicrobial treatment for Clostridium difficile infection (CDI) was limited to metronidazole and vancomycin. The changing epidemiology of CDI and the emergence of epidemic C. difficile PCR ribotype 027 necessitate continued surveillance to identify shifts in antibiotic susceptibility. ClosER, currently the largest pan-European epidemiological study of C. difficile ribotype distribution and antibiotic susceptibility, aimed to undertake antimicrobial resistance surveillance pre- and post-introduction of fidaxomicin.\ud \ud \ud \ud Methods: Between July 2011 and July 2014, 39 sites across 22 European countries submitted 2830 C. difficile isolates for ribotyping, toxin testing and susceptibility testing to metronidazole, vancomycin, fidaxomicin, rifampicin, moxifloxacin, clindamycin, imipenem, chloramphenicol and tigecycline.\ud \ud \ud \ud Results: Ribotypes 027, 014, 001, 078, 020, 002, 126, 015 and 005 were most frequently isolated, and emergent ribotypes 198 and 356 were identified in Hungary and Italy, respectively. All isolates were susceptible to fidaxomicin, with scarce resistance to metronidazole (0.2%, 6/2694), vancomycin (0.1%, 2/2694) and tigecycline (0%). Rifampicin, moxifloxacin and clindamycin resistance was evident in multiple ribotypes. Lack of ribotype diversity correlated with greater antimicrobial resistance. Epidemic ribotypes (027/001) were associated with multiple antimicrobial resistance, and ribotypes 017, 018 and 356 with high-level resistance. Additional factors may also influence local ribotype prevalence.\ud \ud \ud \ud Conclusions: Fidaxomicin susceptibility was retained post-introduction, and resistance to metronidazole and vancomycin was rare. Continued surveillance is needed, with more accurate classification and clarification of ribotype subtypes to further understand their role in the spread of resistance. Other factors may also influence changes in prevalence of C. difficile ribotypes with reduced antibiotic susceptibility.

Over the past few years, data mining has moved from corporations to other organizations. This paper looks at the integration of data mining in digital library services. First, bibliomining, or the combination of bibliometrics and data mining techniques to understand library services, is defined and the concept explored. Second, the conceptual frameworks for bibliomining from the viewpoint of the library decision-maker and the library researcher are presented and compared. Finally, a research agenda to resolve many of the common bibliomining issues and to move the field forward in a mindful manner is developed. The result is not only a roadmap for understanding the integration of data mining in digital library services, but also a template for other cross-discipline data mining researchers to follow for systematic exploration in their own subject domains.

While a growing number of the digital reference services in libraries have become part of collaborative reference networks, other entities that serve similar information-seeking needs such as special collections and museums have not joined these networks, even though they are answering an increasing number of questions from off-site patrons via the Internet. This article examines the differences between questions asked electronically of traditional reference services and those asked of special collections services; it further explores how a better understanding of digital reference in special collections will facilitate the development of the tools and models needed to create a bridge between digital human intermediation at general academic libraries, special collections, and museums.

This research reports the findings from a survey that examined the differences in communication between students who used instant messenger (IM) services and those who did not in the same asynchronous distance education Web-based course. It was found that students who used IM services found it easier to communicate, felt a stronger sense of community, and had more venues for informal and social communication about not only class material, but also information about the school and their common degree program. In traditional classroom buildings, the common spaces such as hallways provide the venue for this informal communication; IM services can enhance the distance education environment by providing the “virtual hallways” for students and instructors to meet.

This paper exploits a natural experiment in which choice fatigue is isolated as an explanation for the usage of heuristics in decision-making. The em- pirical application provides evidence that voters who see a given contest relatively further down the ballot are more likely to vote "no" and to abstain. Within-election exogenous variation in ballot position is primarily due to differences in the set of overlaying local political jurisdictions. My central finding is that lowering a proposi- tion 10 positions on the ballot increases precinct-level "no" votes and undervotes by 1.3 and 0.7 percentage points, respectively. Interestingly, 8 of 124 statewide propo- sitions in the dataset have winning margins within the range of the "no" estimate. The empirical analysis employs a unique precinct-level panel dataset of votes cast for the entire menu of federal, state & local ballot choices in primary and general elections between 1992 and 2006 in San Diego County, California. Implications of the results range from the dissemination of information by firms and policy makers to the design of electoral institutions and the strategic use of ballot propositions.