Developing Reflective Learners: Serendipity and Synergy at Wheaton College

For the past decade, Wheaton College, a small liberal arts institution located in Norton, Massachusetts, has been creating, refining, and integrating a range of initiatives designed to develop students into active and reflective learners. Some of these initiatives grew out of explicit institutional commitments to teaching and learning innovation, while others were in fact happy accidents of circumstance, or situations where an individual interesting program idea took hold, spread into other units of the College, and was itself transformed in the process

ChatGPT and Simple Linguistic Inferences: Blind Spots and Blinds

This paper sheds light on the limitations of ChatGPT's understanding capabilities, focusing on simple inference tasks that are typically easy for humans but appear to be challenging for the model. Specifically, we target (i) grammatically-specified entailments, (ii) premises with evidential adverbs of uncertainty, and (iii) monotonicity entailments. We present expert-designed evaluation sets for these inference types and conduct experiments in a zero-shot setup. Our results show that the model struggles with these types of inferences, exhibiting moderate to low accuracy. Moreover, while ChatGPT demonstrates knowledge of the underlying linguistic concepts when prompted directly, it often fails to incorporate this knowledge to make correct inferences. Even more strikingly, further experiments show that embedding the premise under presupposition triggers or non-factive verbs causes the model to predict entailment more frequently {regardless} of the correct semantic label. Overall these results suggest that, despite GPT's celebrated language understanding capacity, ChatGPT has blindspots with respect to certain types of entailment, and that certain entailment-cancelling features act as ``blinds'' overshadowing the semantics of the embedded premise. Our analyses emphasize the need for further research into the linguistic comprehension and reasoning capabilities of LLMs, in order to improve their reliability, and establish their trustworthiness for real-world applications

Interprofessional Education In Healthcare: Establishing A Successful Dialogue For Students And Faculty

Effective healthcare today is built on interprofessional, population- and evidence-based approaches to provide care that is safe, timely, equitable, patient-centered, and efficient. As a result, there is increasing recognition by faculty, administrators, and community professionals of the importance of providing students with ongoing opportunities to problem-solve and learn together in interprofessional teams. In order to document baseline data on the interprofessional activities underway in a College of Health Professions, faculty and staff in each of the College’s departments completed a published survey, Interprofessional Education Assessment and Planning Instrument for Academic Institutions. Faculty comments showed they viewed interprofessional education and collaborative clinical practice as important. However, survey data showed interprofessional education generally was limited to discipline-specific activities. Data were important in encouraging faculty to begin a productive dialogue as to how interprofessional education opportunities could be implemented more effectively for students.

Root competition can cause a decline in diversity with increased productivity

1  Plant community theory often invokes competition to explain why species diversity declines as productivity increases. Competition for all resources might become more intense and lead to greater competitive exclusion or, alternatively, competition for light only could become more intense and exclude poor light competitors. 2  To test these hypotheses, we constructed communities of seven old-field species using combined monocultures. Constructs experienced no interspecific competition, only shoot competition or only root competition, with and without fertilizer. Diversity in these limited interaction communities was compared to diversity in unfertilized and fertilized mixtures of the seven species. 3  Diversity decreased with fertilization in mixtures and in communities with only root competition. Shoot competition had small effects on the community and did not contribute to changes in diversity with fertilization. 4  Root competition may strongly impact plant community structure in unproductive communities where light never becomes limiting, or under non-equilibrium conditions following human disturbances.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75541/1/j.1365-2745.2003.00768.x.pd

The Medical Necessity for Medicinal Cannabis: Prospective, Observational Study Evaluating the Treatment in Cancer Patients on Supportive or Palliative Care

Background. Cancer patients using cannabis report better influence from the plant extract than from synthetic products. However, almost all the research conducted to date has been performed with synthetic products. We followed patients with a medicinal cannabis license to evaluate the advantages and side effects of using cannabis by cancer patients. Methods. The study included two interviews based on questionnaires regarding symptoms and side effects, the first held on the day the license was issued and the second 6–8 weeks later. Cancer symptoms and cannabis side effects were documented on scales from 0 to 4 following the CTCAE. The distress thermometer was used also. Results. Of the 211 patients who had a first interview, only 131 had the second interview, 25 of whom stopped treatment after less than a week. All cancer or anticancer treatment-related symptoms showed significant improvement (P<0.001). No significant side effects except for memory lessening in patients with prolonged cannabis use (P=0.002) were noted. Conclusion. The positive effects of cannabis on various cancer-related symptoms are tempered by reliance on self-reporting for many of the variables. Although studies with a control group are missing, the improvement in symptoms should push the use of cannabis in palliative treatment of oncology patients

Anticoagulant Prescribing for Non-Valvular Atrial Fibrillation in the Veterans Health Administration

Background: Direct acting oral anticoagulants (DOACs) theoretically could contribute to addressing underuse of anticoagulation in non-valvular atrial fibrillation (NVAF). Few studies have examined this prospect, however. The potential of DOACs to address underuse of anticoagulation in NVAF could be magnified within a healthcare system that sharply limits patients\u27 exposure to out-of-pocket copayments, such as the Veterans Health Administration (VA). Methods and Results: We used a clinical data set of all patients with NVAF treated within VA from 2007 to 2016 (n=987 373). We examined how the proportion of patients receiving any anticoagulation, and which agent was prescribed, changed over time. When first approved for VA use in 2011, DOACs constituted a tiny proportion of all prescriptions for anticoagulants (2%); by 2016, this proportion had increased to 45% of all prescriptions and 67% of new prescriptions. Patient characteristics associated with receiving a DOAC, rather than warfarin, included white race, better kidney function, fewer comorbid conditions overall, and no history of stroke or bleeding. In 2007, before the introduction of DOACs, 56% of VA patients with NVAF were receiving anticoagulation; this dipped to 44% in 2012 just after the introduction of DOACs and had risen back to 51% by 2016. Conclusions: These results do not suggest that the availability of DOACs has led to an increased proportion of patients with NVAF receiving anticoagulation, even in the context of a healthcare system that sharply limits patients\u27 exposure to out-of-pocket copayments

Esterase mutation is a mechanism of resistance to antimalarial compounds

Pepstatin is a potent peptidyl inhibitor of various malarial aspartic proteases, and also has parasiticidal activity. Activity of pepstatin against cultured Plasmodium falciparum is highly variable depending on the commercial source. Here we identify a minor contaminant (pepstatin butyl ester) as the active anti-parasitic principle. We synthesize a series of derivatives and characterize an analogue (pepstatin hexyl ester) with low nanomolar activity. By selecting resistant parasite mutants, we find that a parasite esterase, PfPARE (P. falciparum Prodrug Activation and Resistance Esterase) is required for activation of esterified pepstatin. Parasites with esterase mutations are resistant to pepstatin esters and to an open source antimalarial compound, MMV011438. Recombinant PfPARE hydrolyses pepstatin esters and de-esterifies MMV011438. We conclude that (1) pepstatin is a potent but poorly bioavailable antimalarial; (2) PfPARE is a functional esterase that is capable of activating prodrugs; (3) Mutations in PfPARE constitute a mechanism of antimalarial resistance

Mechanical stretch regulates the expression of specific miRNA in extracellular vesicles released from lung epithelial cells

Acknowledgments This work was supported from the National Institute of Health (NIGMS grant Number P30GM114750 & P30GM103410, NCRR grant Numbers P30RR031153, P20RR018728 & S10RR02763); National Science Foundation (EPSCoR grant No 0554548); Oh–Zopfi for Perinatal Research Award, Women & Infants Hospital of Rhode Island. We thank Brenda Vecchio for her support in manuscript formatting and Quanfu Mao for his support to use the instruments.Peer reviewedPostprin

Reasons for and consequences of missed appointments in general practice in the UK: questionnaire survey and prospective review of medical records

Background Missed appointments are a common occurrence in primary care in the UK, yet little is known about the reasons for them, or the consequences of missing an appointment. This paper aims to determine the reasons for missed appointments and whether patients who miss an appointment subsequently consult their general practitioner (GP). Secondary aims are to compare psychological morbidity, and the previous appointments with GPs between subjects and a comparison group. Methods Postal questionnaire survey and prospective medical notes review of adult patients missing an appointment and the comparison group who attended appointments over a three week period in seven general practices in West Yorkshire. Results Of the 386 who missed appointments 122 (32%) responded. Of the 386 in the comparison group 223 (58%) responded, resulting in 23 case-control matched pairs with complete data collection. Over 40% of individuals who missed an appointment and participated said that they forgot the appointment and a quarter said that they tried very hard to cancel the appointment or that it was at an inconvenient time. A fifth reported family commitments or being too ill to attend. Over 90% of the patients who missed an appointment subsequently consulted within three months and of these nearly 60% consulted for the stated problem that was going to be presented in the missed consultation. The odds of missing an appointment decreased with increasing age and were greater among those who had missed at least one appointment in the previous 12 months. However, estimates for comparisons between those who missed appointments and the comparison group were imprecise due to the low response rate. Conclusion Patients who miss appointments tend to cite practice factors and their own forgetfulness as the main reasons for doing so, and most attend within three months of a missed appointment. This study highlights a number of implications for future research. More work needs to be done to engage people who miss appointments into research in a meaningful way