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I like a baseball analogy. Do you know what the record is for a season batting average That means how many times the batter successfully hit to get on base?It is a gentleman by the name of Ted Williams and his season batting average was . 411 one year. That means that out of 1000 times at bat he would get a hit 411 times. That is considered by baseball fans as one of the greatest records ever. There are players making millions of dollars who hit .

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Obviously, in that short a period of time, we have not really gotten to know the other person. Rather, we have used our cognitive biases and filters to form a snap judgment about someone, just as they have about us. Those judgments may or may not be accurate, but they endure. And if the judgment made is a negative one, the difficulty in shifting someones opinion is extremely high. In many ways, the snap judgment of first impressions is related to the halo effect where the perception of positive qualities in one thing or part gives rise to the perception of similar qualities in related things or in the whole. Accordingly, its important to know how to better manage first impressions and increase the odds of making a positive one. That means that sensory factors such as how we look, sound and smell drive much of the impressions conveyed when we meet someone new. People, whether consciously aware of it or not, generally prefer others who are similar to themselves in look, personality, attitude, belief and behavior. Deviations in our appearance, speech and behavior are likely to affect the initial impression someone has of us and we of them. Fortunately, people also tend to think that others share their opinions and beliefs more than they actually do, so theres a benefit of the doubt that one shouldnt violate too soon by demonstrating our differences with someone were meeting for the first time. One of the biggest cognitive biases people harbor is the fundamental attribution bias: We tend to ascribe behaviors of others to their inherent traits or incompetence, but tend to associate our own behaviors more to external circumstances and environment.

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Enriching HABP/VABP clinical studies with such patients should increase the ACM rate. The Barcelona study, conducted without commonplace registrational trial exclusions, reported the highest ACM, highlighting the potential limited generalizability of some industry trial results, as well as opportunities to increase enrollment and enrich for ACM. If the anticipated ACM rate is so low as to dictate a smaller NI margin to ensure the relative loss of efficacy at the extreme of the NI margin is not too large, then an ACM+ approach can be employed to increase the endpoint frequency. Defining SAEs and/or AEs post hoc is unacceptable. A better approach is employing the MedDRA toxic/septic shock SMQ to define the plus in an ACM+ endpoint. This endpoint could also add value as a sensitivity analysis, informing treatment effects on survivors. A weakness of the ACM endpoint is the exclusion of a majority of patients from analysis. Finally, use of an ACM+ endpoint could increase event rates at day 14 to a level compatible with a 10% NI margin. Is it methodologically appropriate to use ACM+ instead of ACM to increase the outcome event rate?The answer depends on whether the plus is important to how a patient feels or functions and would be impacted by antibiotic therapy. For example, an AE of gunshot wound after hospital discharge arguably should not be part of an ACM+ endpoint in a HABP/VABP study. However, plus events need not be rigidly pneumonia related eg, empyema but, rather, should include general infection related events such as those in the toxic/septic shock SMQ.

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Also, try running in the most outside lane. This lessens the sharpness of the turns which also puts less stress on your body. If you run outdoors dress in layers; you can always take off a layer after you have started. Let the effort dictate your pace and the conditions dictate your route. Also, be flexible to ice or snow, and expect to slow down. The last thing you want is a slip and fall injury that sidelines you for spring. Good training is about a collection of good days. Do not put your training at risk for a single workout. Greg Hipp is the Executive Director of the Chicago Area Runners Association. Greg is a USATF Level II certified coach and a former NCAA coach at Northwestern University, NIU, Missouri State and Appalachian State. He has coached athletes of all ages from beginners to elites, including runners who have represented Team USA in international competition.