Model-based Evaluation of the Clinical and Microbiological Efficacy of Vancomycin: A Prospective Study of Chinese Adult In-house Patients

Abstract

Web-scale search systems typically tackle the scalability challenge with a two-step paradigm: retrieval and ranking. The retrieval step, also known as candidate selection, often involves extracting standardized entities, creating an inverted index, and performing term matching for retrieval. Such traditional methods require manual and time-consuming development of query models. In this paper, we discuss applying learning-to-retrieve technology to enhance LinkedIn's job search and recommendation systems. In the realm of promoted jobs, the key objective is to improve the quality of applicants, thereby delivering value to recruiter customers. To achieve this, we leverage confirmed hire data to construct a graph that evaluates a seeker's qualification for a job, and utilize learned links for retrieval. Our learned model is easy to explain, debug and adjust. On the other hand, the focus for organic jobs is to optimize seeker engagement. We accomplished this by training embeddings for personalized retrieval, fortified by a set of rules derived from the categorization of member feedbacks. In addition to a solution based on a conventional inverted index, we developed an on-GPU solution capable of supporting both KNN and term matching efficiently.

An evaluation on the association of vancomycin trough concentration with mortality in critically ill patients: A multicenter retrospective study

“…12,[14][15][16] Another two prospective studies in Chinese patients with gram-positive bacterial infections suggested that no significant correlations were identified between VTC and clinical or microbiological efficiency. 13,21 Several clinical and simulation studies have even found that patients can achieve strong benefit when vancomycin therapy was guided by AUC/minimum inhibitory concentration rather than VTC. 22,23 Because the sample size of these aforementioned studies was relatively small and most of them focused on definitive MRSA infection, a large-scale multicenter cohort was performed to identify the association of initial VTC with prognosis in 7220 patients in the ICU, aiming to evaluate 17 but also indicates that a VTC of 10-15 mg/L should not be maintained to ensure vancomycin efficacy for critically ill patients.…”

Relationship Between Mean Vancomycin Trough Concentration and Mortality in Critically Ill Patients: A Multicenter Retrospective Study

“…Two other retrospective cohort studies have demonstrated that VTC > 15 mg/L fails to improve the outcomes of patients with MRSA infection [17,18]. Additionally, two prospective, multicenter, observational studies have demonstrated no signi cant association between VTC level and vancomycin treatment response in a Chinese population diagnosed with gram-positive bacterial infections [11,19]. Moreover, the latest consensus suggests that there are minimal to no data to support the safety and e cacy of a target VTC of 15-20 mg/L in patients with serious MRSA infections [9].…”

“…year, prospective study indicated that 68% of adults who were administered vancomycin with an AUC 0 − 24 ≥400 mg•h/L had a trough concentration of < 15 mg/L [29]. Additionally, a prospective study of Chinese patients suggested that C max , AUC 0 − 24 , and AUC 0 − 24 h /MIC are not signi cantly associated with clinical and microbiological outcomes based on multivariable logistic regression analysis [19]. Second, vancomycin has been associated with several adverse events.…”

Vancomycin area under the curve to minimum inhibitory concentration ratio predicting clinical outcome: a systematic review and meta-analysis with pooled sensitivity and specificity

“…One study could not report on the efficacy at any level of AUC:MIC because there were no failures recorded [43]. Seven studies could not establish a relationship between efficacy and either AUC [11,44] or AUC:MIC [41,45,46,48,49]. One study unexpectedly found an inverse relationship between AUC:MIC and positive infection outcome [47].…”