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Abstract BackgroundRecent studies, including those by the National Board of Medical Examiners, have highlighted the remarkable capabilities of recent large language models (LLMs) such as ChatGPT in passing the United States Medical Licensing Examination (USMLE). However, there is a gap in detailed analysis of LLM performance in specific medical content areas, thus limiting an assessment of their potential utility in medical education. ObjectiveThis study aimed to assess and compare the accuracy of successive ChatGPT versions (GPT-3.5, GPT-4, and GPT-4 Omni) in USMLE disciplines, clinical clerkships, and the clinical skills of diagnostics and management. MethodsThis study used 750 clinical vignette-based multiple-choice questions to characterize the performance of successive ChatGPT versions (ChatGPT 3.5 [GPT-3.5], ChatGPT 4 [GPT-4], and ChatGPT 4 Omni [GPT-4o]) across USMLE disciplines, clinical clerkships, and in clinical skills (diagnostics and management). Accuracy was assessed using a standardized protocol, with statistical analyses conducted to compare the models’ performances. ResultsGPT-4o achieved the highest accuracy across 750 multiple-choice questions at 90.4%, outperforming GPT-4 and GPT-3.5, which scored 81.1% and 60.0%, respectively. GPT-4o’s highest performances were in social sciences (95.5%), behavioral and neuroscience (94.2%), and pharmacology (93.2%). In clinical skills, GPT-4o’s diagnostic accuracy was 92.7% and management accuracy was 88.8%, significantly higher than its predecessors. Notably, both GPT-4o and GPT-4 significantly outperformed the medical student average accuracy of 59.3% (95% CI 58.3‐60.3). ConclusionsGPT-4o’s performance in USMLE disciplines, clinical clerkships, and clinical skills indicates substantial improvements over its predecessors, suggesting significant potential for the use of this technology as an educational aid for medical students. These findings underscore the need for careful consideration when integrating LLMs into medical education, emphasizing the importance of structured curricula to guide their appropriate use and the need for ongoing critical analyses to ensure their reliability and effectiveness.

This observational study reports the process for the manufacture of RAPIDTM Biodynamic Haematogel and explores the properties of the platelet and leukocyte-rich plasma gels formed. Gels were manufactured from 60 mL of human blood using the protocol of Biotherapy Services. Platelet and leukocyte content, time-to-gel, gel weight and the temporal profile of liquid exudation from the gels were measured, along with the content of growth factors VEGF and PDGF in the releasate. The effect of the releasate on human keratinocyte (HaCat) cell proliferation was also determined. The platelet and leukocyte concentrations in donor blood were 1.60–8.10 × 108 and 1.00 × 106–2.00 × 107 cells/mL, which were concentrated 2.67- and 1.12-fold, respectively, during processing. Structurally weak gels were formed which exuded a clear liquid releasate (77.4% w/w of gel weight over 60 min) that contained 278 pg/mL VEGF and 1319 pg/mL PDGF. The releasate produced concentration-dependent proliferation of HaCat cells: 5–15% releasate produced a 2.7–8.9-fold increase in growth over 48 h. In conclusion, we have described the point-of-care manufacturing protocol and characterised the gel properties of RAPIDTM Biodynamic Haematogel. This is an essential first step towards identifying, understanding and controlling critical processing parameters that impact on this medicinal product’s quality.

This practical note presents striking findings from a research project in Malawi, comparing the cost effectiveness of a traditional project approach with a church and community mobilisation approach (CCM). The research found that CCM had the same level of positive impact on quality of life but at 4% of the cost. It also found that CCM communities were almost four times more confident in solving problems themselves, indicating a much greater likelihood of sustainability. To realise the potential advantages of faith in development means funders and faith-based organisations have to mobilise local faith communities. CCM is a challenging but cost-effective alternative to the NGO-project approach. [ABSTRACT FROM AUTHOR]

In 2017/18 wound healing cost the NHS 8.3 billion pounds. There is an urgent need for more effective, accessible, and safe treatments. Platelet-rich plasma (PRP) therapies have been emerging since the early 2000s, currently they are used across various medical fields treating conditions from cosmetic procedures through burn treatments to wound healing. RAPIDTM gel is a product for the treatment of diabetic foot ulcers that is currently in stage 2b of clinical trials. This project aims to better understand the properties of the gel and how these are affected by the manufacturing process. The PRP gels were characterized physiochemically by exploring the gel time, exudate release and growth factor content. These data provide a baseline for future studies exploring how variations in manufacturing conditions affect the gel properties.

Here, the authors perform repurposing screens of the ReFRAME drug library in two cell lines and identify inhibitors of SARS-CoV-2 infection. Antiviral activity of prodrug MK-4482 is confirmed in hamsters.

Pre-existing immune responses between antigenically related viruses can influence responses in viral infections or vaccinations. Here the authors assess and characterize the presence of antibody and memory B cell populations specific to SARS-CoV2 and endemic human coronaviruses.

We know what works in capacity development: a succession of studies from official agencies, academics and NGO practitioners have all highlighted similar principles of good practice. But the evidence also suggests that there is a distressing dissonance between what international development agencies know about capacity development and what they implement. This article explores the reasons for this failure. It highlights constraints that arise from the changing aid context and from a lack of resources and skills. Ultimately, however, it concludes that capacity development is driven more by self-interest than by knowledge of what works. Until agencies' pride, greed and self-interest can be restrained, much capacity development will continue to be disappointing and ineffective. But if agencies combine existing professional knowledge with virtues of humility, patience and a genuine commitment to others, then capacity development becomes something that can bring transformation. [ABSTRACT FROM AUTHOR]

Leadership development is a high priority for African nonprofit organizations, but we know very little about what causes leaders in Africa change their behavior and how. Most leadership development programs use imported Western models that at best pay only lip-service to the very different culture and context in Africa. This article outlines the research findings of a three-country study conducted in Malawi, Uganda, and Kenya. This study found that changes in leadership style, although individual and complex, followed an underlying pattern. External events catalyzed an inside-out change process. Effective leadership development requires in-depth understanding and application of local contextual and cultural issues. Ultimately, however, the process of leadership development is tied to deeper, universal principles of human behavior. [ABSTRACT FROM AUTHOR]

Looks into the dangers presented by HIV/AIDS among the workers of non-government organizations in sub-Saharan Africa. Trends in the financial support provided to the organizations for the management of the disease; Issues to be handled by the workers regarding their health and work brought about by the AIDS pandemic; Problems faced by development organizations in operating HIV/AIDS programs.

Organization development (OD) has become an increasingly popular approach among international donors who are eager to improve the impact of their aid to developing countries. Major questions, however, have been raised as to whether this is not another example of “technique peddling” by Western donors and consultants. Many argue that this participatory, imported, Western approach to organizational change relies on cultural assumptions of open discussion that are simply not present in many developing societies. Taking up Lewis's challenge in his article “Organization and Management in the Third Sector: Towards a Cross-Cultural Research Agenda” (NML 2002), this article explores the veracity of such concerns. Using practitioner experience of implementing OD with African NGOs, this article reveals that many principles of OD are pre-existing within African cultures and are not a new foreign import. It concludes that, as with any culture, there are aspects that undermine and reinforce particular approaches to management and change. An anthropological perspective can assist in understanding the local culture sufficiently to be able to identify, avoid, or overcome cultural resistance, while at the same time using cultural symbols as levers for change. [ABSTRACT FROM AUTHOR]

Learning and knowledge management are crucial capacities for many NGOs. This article attempts to answer such questions as: why is learning seen as so important for NGOs? How do successful NGOs actually learn? And what role do key individuals or leaders play in this process? The article draws heavily on the findings of a study of South Asian NGOs, which suggests that an NGO's ability to learn is dependent on its organisational culture and in particular the development of an internal culture of learning. The case studies from South Asia reveal that the creation of this 'learning culture' derives primarily from the attitude of the leadership towards learning: at the heart of a learning organisation is a 'learning leader'. [ABSTRACT FROM AUTHOR]

Displacement of peripherally inserted central catheter (PICC) lines during contrast-enhanced computed tomography examinations is an underappreciated phenomenon. We report a case of iatrogenic PICC line displacement following the power injection of contrast during a computed tomography pulmonary angiogram. During the study, the PICC line was shown to move on 2 occasions, resulting in 2 nondiagnostic studies. We review the available literature on the topic and suggest possible strategies to avoid this phenomenon. Radiologists should be aware of PICC line migration, and it should become common practice to review the catheter tip position after computed tomography examinations.

This paper explores the nature of organizational strengthening, the organizational implications for European NGOs wishing to strengthen Southern partner NGOs and the pressing organizational strengthening needs which European NGOs themselves have. The paper concludes that European NGOs through their donor role are not in the best position to actually implement the organizational support themselves and that their primary role is to be effective funders of the process, not directing the process itself. © 1997 by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Abstract Background Recently, the accuracies of many commercially available immunoassays for Vitamin D have been questioned. Liquid chromatography tandem mass spectrometry (LC- MS/MS) has been shown to facilitate accurate separation and quantification of the major circulating metabolite 25-hydroxyvitamin-D3 (25OHD3) and 25-hydroxyvitamin-D2 (25OHD2) collectively termed as 25OHD. However, among other interferents, this method may be compromised by overlapping peaks and identical masses of epimers and isobars, resulting in inaccuracies in circulating 25OHD measurements. The aim of this study was to develop a novel LC-MS/MS method that can accurately identify and quantitate 25OHD3 and 25OHD2 through chromatographic separation of 25OHD from its epimers and isobars. Methods A positive ion electrospray ionisation (ESI) LC-MS/MS method was used in the Multiple Reaction Monitoring (MRM) mode for quantification. It involved i) liquid-liquid extraction, ii) tandem columns (a high resolution ZORBAX C18 coupled to an ULTRON chiral, with guard column and inlet filter), iii) Stanozolol-D3 as internal standard, and iv) identification via ESI and monitoring of three fragmentation transitions. To demonstrate the practical usefulness of our method, blood samples were collected from 5 healthy male Caucasian volunteers; age range 22 to 37 years and 25OHD2, 25OHD3 along with co-eluting epimers and analogues were quantified. Results The new method allowed chromatographic separation and quantification of 25OHD2, 25OHD3, along with 25OHD3 epimer 3-epi-25OHD3 and isobars 1-α-hydroxyvitamin-D3 (1αOHD3), and 7-α-hydroxy-4-cholesten-3-one (7αC4). The new assay was capable of detecting 0.25 ng/mL of all analytes in serum. Conclusions To our knowledge, this is the first specific, reliable, reproducible and robust LC-MS/MS method developed for the accurate detection of 25OHD (Vitamin D). The method is capable of detecting low levels of 25OHD3 and 25OHD2 together with chromatographic separation from the co-eluting epimers and isobars and circumvents other instrumental/analytical interferences. This analytical method does not require time-consuming derivatisation and complex extraction techniques and could prove very useful in clinical studies.

Abstract Background Substances with performance enhancing properties appear on a continuum, ranging from prohibited performance enhancing drugs (PED) through dietary supplements to functional foods (FF). Anti-doping messages designed to dissuade athletes from using PEDs have been typically based on moralising sport competition and/or employing scare campaigns with focus on the negative consequences. Campaigns offering comparable and acceptable alternatives are nonexistent, nor are athletes helped in finding these for themselves. It is timely that social marketing strategies for anti-doping prevention and intervention incorporate media messages that complement the existing approaches by promoting comparable and acceptable alternatives to doping. To facilitate this process, the aim of this study was to ascertain whether a single exposure knowledge-based information intervention led to increased knowledge and subsequently result in changes in beliefs and automatic associations regarding performance enhancements. Methods In a repeated measure design, 115 male recreational gym users were recruited and provided with a brief information pamphlet on nitrite/nitrate and erythropoietin as a comparison. Measures of knowledge, beliefs and automatic associations were taken before and after the intervention with at least 24 hours between the two assessments. The psychological tests included explicit measures of beliefs and cognitive attitudes toward FF and PED using a self-reported questionnaire and computerised assessments of automatic associations using the modified and shortened version of the Implicit Association Test. Results The information based intervention significantly increased knowledge (p < 0.001), changed explicit beliefs in specific FF (p < 0.001) and shifted the automatic association of FF with health to performance (p < 0.001). Explicitly expressed beliefs and automatic associations appear to be independent. Conclusion Evidence was found that even a single exposure to a persuasive positive message can lead to belief change and can create new or alter existing associations - but only in the specific domain. Interventions to change outcome expectations in a positive way could be a rewarding avenue for anti-doping. Effective social marketing campaigns for drug free sport should follow appropriate market segmentation and use targeted messages via promoting the natural form as opposed to the purified form of the main active ingredient.