Improving Pneumococcal Vaccination Rates in Jefferson Hospital Ambulatory Practice Patients

AIM: To improve the pneumococcal vaccination initiation rates in patients 65 years and older in Jefferson Hospital Ambulatory Practice (JHAP) to the institutional quality measure goal of 80% over a 4 month period from January to May of 2017.https://jdc.jefferson.edu/patientsafetyposters/1031/thumbnail.jp

ANOMALOUS ORGANIZATION OF RANDOM EVENTS DURING AN INTERNATIONAL QIGONG MEETING: Evidence for Group Consciousness or Accumulated Qi Fields?

Research has documented anomalous organization of random events generated by an electronic random events generator (REG) during various group situations that promote group consciousness experiences. A group situation hypothesized to promote an intense group consciousness experience was an international Qigong conference. Over 2500 invited guests, scientists and practitioners from many countries attended the 1997 International Yan Xin Qigong Practice and Research Conference in New York City on August 30-September 1. Three basic REG predictions were evaluated: (1) the null hypothesis, (2) deviations from randomness would be observed during the days and would disappear during the nights, and (3) deviations from randomness would be observed during the days and continue during the nights (predicted by Chinese scientists YX, ZS, and LS to reflect "accumulating Qi over the entire meeting"). Three days and two nights of FieldREG data were collected prior to, during, and following the conference. During the conference, a total of 234,412 trials of 200 samples per second reflecting I's and 0's (100 I's would be expected to occur by chance per second on the average) were collected using a PEAR computerized FieldREG system and stored for later analysis. When the 3 days and 2 nights were analyzed in terms of trials above versus below 100, each of the five segments showed relative increases (p < .023). These patterns were not observed during the pre and post conference control days and nights. The data provide tentative support for the hypothesis that an intense group experience that continues over a three day period may create a consciousness or Qi field that can be discerned using the Fie1dREG paradigm

Amelioration of popolysaccharide-induced sepsis in rats by free and esterified carnitine

The purpose of this study was to determine if free or esterified carnitine could alter fatty acid metabolism and ameliorate sepsis in lipopolysaccharide (LPS)-treated rats. Throughout a 96 h observation post-LPS, i.p. administration of both markedly reduced illness and accelerated recovery. Carnitine prevented the acute LPS-induced rise in serum triglycerides (45 ± 6, 59 ± 5 vs. 83 ± 8 mg/ml, p < 0.001), respectively. This difference was accompanied by a significant increase in liver lipogenesis in LPS controls compared to both carnitines and normal rats (6.1 ± 0.3 vs. 3.9 ± 0.5, 4.3 ± 0.5, and 1.8 ± 0.4 μmol/h, respectively, p < 0.04). Compared to normal rats, total liver carnitine was significantly elevated in LPS controls and even higher in the carnitine groups (357 ± 40 vs. 736 ± 38, 796 ± 79, and 1081 ± 21 nmol/g). The data suggest that carnitines may be of therapeutic value in sepsis treatment and one action may be to partition fatty acids from esterification to oxidation

Load oriented order release (LOOR) revisited:bringing it back to the state of the art

In the workload control literature, the Load-Oriented Order Release (LOOR) approach has been neglected since its robustness was questioned at the end of the 1990s. This paper revisits LOOR and evaluates whether its performance can be improved in two ways. First, an intermediate pull release mechanism is added to avoid starvation between periodic release events. This mechanism was recently shown to be effective at improving the performance of a state-of-the-art release method known as LUMS COR. Second, an integer linear programming model is used to manage the trade-off between the timing and load balancing functions of order release. The two refinements are assessed using simulations of different shop configurations, which allow us to evaluate robustness. Results demonstrate that the refinements contribute to improving the performance of LOOR such that it can even outperform LUMS COR. Perhaps counter-intuitively, putting more emphasis on load balancing than on the urgency of individual orders is shown to lead to a lower percentage of tardy orders. Overall, the improvements mean that concerns about LOOR’s robustness are no longer valid – it now appears suitable for a wide range of shops found in practice

Determination of Endocannabinoid Receptor Antagonist SR141716 (Rimonabant) in Plasma by Liquid Chromatograph Tandem Mass Spectrometry

SR141716 (rimonabant) is an endocannabinoid receptor antagonist. Endocannabinoids are a class of chemicals that affect neurotransmission via G-protein coupled CB1 (brain) and CB2 (peripheral tissue) receptors. Numerous animal studies have shown that SR141716 binds with the CB1 receptor in the brain, resulting in several biological consequences including reduced alcohol intake and reward as well as reduced food consumption. In this work, an analytical method based on liquid chromatography and electrospray ionization tandem mass spectrometry (LC–ESI-MS/MS) has been developed and validated for the quantitative measurement of SR141716 in both human and rat plasma to support the investigation of this compound. A suitable internal standard (AM251) has been chosen and the experimental conditions have been optimized for the separation and detection of singly charged positive ions of SR141716 and the internal standard. A protein precipitation protocol has been developed for extraction of SR141716 and the internal standard from plasma samples. Quantitation was achieved using multiple-reaction-monitoring (MRM) mode for SR141716 (m/z 463 → m/z 363) and the internal standard (m/z 555 → m/z 455) and calibration curve over the concentration range of 5.00–1000 ng/ml was plotted using the peak-area ratio versus the concentration of SR141716 with a LOD and LLOQ of 1.09 and 3.62 ng/ml, respectively. The method developed has been used to analyze SR141716 in rat plasma samples from an animal study

Influence of Sex/Gender and Race on Responses to Raltegravir Combined With Tenofovir-Emtricitabine in Treatment-Naive Human Immunodeficiency Virus-1 Infected Patients: Pooled Analyses of the STARTMRK and QDMRK Studies.

BACKGROUND: Antiretroviral therapy in human immunodeficiency virus (HIV)-infected women and blacks merits particular scrutiny because these groups have been underrepresented in clinical trials. METHODS: To document the effects of raltegravir across sex and racial lines, we conducted a pooled subgroup analysis of the efficacy and safety of raltegravir 400 mg BID plus tenofovir-emtricitabine by sex (women vs men) and self-identified race (black vs non-black) using phase 3 studies in treatment-naive patients. RESULTS: Study participants included 42 black women, 102 non-black women, 48 black men, and 477 non-black men. Clade B infections were less common in women (43.8%) than men (84.6%) and in blacks (45.6%) than non-blacks (80.5%). Baseline CD4 counts were ≤200 cells/µL in 52.2% of blacks and 31.6% of non-blacks. Black men had the largest proportion of patients with baseline CD4 counts/µL and the highest nontreatment-related discontinuation rate among the 4 sex-by-race subgroups. Human immunodeficiency virus-ribonucleic acid levels/mL were achieved at week 48 in 92.7% (95% confidence interval [CI], 80.1-98.5) of black women, 93.6% (95% CI, 86.6-97.6) of non-black women, 82.9% (95% CI, 67.9-92.8) of black men, and 91.4% (95% CI, 88.4-93.8) of non-black men. Serious clinical adverse events were reported in 9.0% of women versus 8.8% of men and in 11.1% of blacks versus 8.5% of non-blacks. CONCLUSIONS: In this post hoc analysis of patients with previously untreated HIV-1 infection receiving raltegravir plus tenofovir-emtricitabine, generally comparable results were achieved across sex and racial subgroups. However, black men had a lower response rate than either black women or non-black men, partially attributable to lower baseline CD4 counts and higher discontinuation rates

GPT-4V(ision) as a Generalist Evaluator for Vision-Language Tasks

Automatically evaluating vision-language tasks is challenging, especially when it comes to reflecting human judgments due to limitations in accounting for fine-grained details. Although GPT-4V has shown promising results in various multi-modal tasks, leveraging GPT-4V as a generalist evaluator for these tasks has not yet been systematically explored. We comprehensively validate GPT-4V's capabilities for evaluation purposes, addressing tasks ranging from foundational image-to-text and text-to-image synthesis to high-level image-to-image translations and multi-images to text alignment. We employ two evaluation methods, single-answer grading and pairwise comparison, using GPT-4V. Notably, GPT-4V shows promising agreement with humans across various tasks and evaluation methods, demonstrating immense potential for multi-modal LLMs as evaluators. Despite limitations like restricted visual clarity grading and real-world complex reasoning, its ability to provide human-aligned scores enriched with detailed explanations is promising for universal automatic evaluator

Gating Walls and Bridging Gaps: Validity in Language Teaching, Learning, and Assessment

Theoreticians and practitioners often speak as though classrooms and clinics were located outside the real world, but this is not so. The demand for the teaching, learning, and assessment of English language proficiency for international pilots and air traffic controllers is just one practical example touching almost everyone in the world that shows that contexts of actual language use are invariably in the real world just as learners and teachers are. From actual instances of discourse processing, in some cases with life or death consequences, it follows that judgments of validity, like those of ordinary truth, involve the dynamic interactions of persons, sign systems, and variable content in real contexts. Studies of so-called task-based performance assessment (in various forms and by other names) afford many ways to connect teaching, learning, and assessment. The authenticity, representativeness, and consequent generalizability of teaching, learning, and assessment tasks depends on their incorporation of the sign systems, social actions, and realia found in actual contexts of discourse. While codes, contexts, and interactions must be distinguished in theory, in practice they interact holistically. Our theories need to accommodate and account for the synergistic interactions