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Results at Midland Memorial Hospital in Texas, show that a low cost conversion to electronic medical records by using the VA system's open software and having computer software companies adapt it to Midland's needs. This cost Midland $7 million and has resulted in many benefits. Senator Rockefeller is introducing legislation to promote the use of this open software for conversion to electronic medical records. Medsphere chairman Kenneth Kizer, former undersecretary ohealth care at the VA oversaw the development of VIstA software. He says its enhanced version called Open Vist A, "can be installed in one third the timeand for about one thrid the cost of the big-name proprietary systems." There is alot to be said for open software as this would enable hospitals and clinics acoross the country talk to each other and pull up records and sen them electronically, wich is hard to do when different systems of differnt commerical vendors interact. If Midland Memorial is any guide there are huge savings in the conversion. By enabling access instantly of patient records, lab results and Xray images, there are a huge array of benefits. It helped Midland catch up with a$16.7 million coding and billing backlog for 4,500 patient records in 4 weeks instead of 5-6 months. In the 18 months since the system was made hospital wideinfection rates dropped 88%, because of guidelines in the record system that prompted nurses to follow infection control procedures, such as changing dressing or following procedures when inserting a new IV. That is huge. Bed sores were reduced from electronic prompting to nurses to turn patients.And Midland increased by 77%in staff compliancewith guidelinesfor care for patientson ventilators, which if not followed could lead to pheumonia....

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The most elegant shot in tennis aside from the lob and the drop shot is the one handed back hand. At one time this was the only way tne back hand was played. Lorenzo Musetti and a Swiss youngster Henry Bernet are some of the best single hand backhanders today. Italian Musetti meets another Italian Jannik Sinner in the quarterfinals of the US Open.

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Germany is now in the same situation as France, Spain and Britain during the second wave with over 500 deaths daily in the first week of December. The partial lockdown with closing of the leisure sector and keeping work open, and retail shops open has not helped keep the virus in check as hoped. Christmas is an important holiday period in Germany and crowds continue to form in many shopping areas spreading the virus. Chancellor Merkel lacks authority in a pandemic as the law says states have to decide how best to tackle a pandemic.

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Chinese president Xi tells Canada's prime minister Trudeau that details of their talks should not have been leaked to the press. Trudeau replies that Canada believes in free and open dialogue. The discussions involved Canada's concerns about Chinese espionage.  

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Lane Forsheim has this interview with tennis player Andre Agassi who won the Grand Slam in The Open era in 2003. Agassi suggests living in the present and avoiding future tripping thinking and solving problems for the future which may not exist. Agassi describes his daily routine. He says pickleball is a great way to exercise without thinking of exercise especially for over 50's. Agassi works for 3-4 hours a day and then plans his daily life around this. He loves the way Alcaraz, Sinner and Medvedev have brought new life into tennis as an exciting game to watch. Agassi talks about marraige- he is married to Steffani Graf, who also played tennis in the top ten. He says know yourself and you can't come into a relationship needing the other to be complete.  For breakfast he has oatmeal with protein or some granola and fruit. Less well known is that Andre Agassi is from Las Vegas, and has a thoughtful autobiography "Open" that is remarkably honest about his survival in the competitive world of tennis after many struggles with parental pressure to win. Yet he comes through having made his own choices. He started the preparatory Agassi Tennis academy for underprivileged children. When Sinner won the Australian Open yesterday he thanked his parents for not putting pressure on him for letting him try different sports. ...

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In a bold decision that shows courage and foresight president Biden lifts IP protection for Covid 19 vaccine patents of American companies such as Pfizer, Moderna, J&J and Novavax. This has huge implications for vaccination supplies for countries such as India, Indonesia, Brazil, Mexico, that are hard hit by the pandemic as well as the rest of the world. It will open up manufacturing additional vaccine supplies in countries as diverse as France and India, that can ramp up quickly because of already established pharmaceutical bases.

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The Mallorcan showed unbreakable spirit has he battled Medvedev, changing his game with drop shots, says Jason Gay in this report from the Australian Open final. In one of the most staggering wins Nadal won 2-6, 6-7 (5), 6-4, 6-4, 7-5.

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DeepSeek vs OpenAI -

1. chain of thought reasoning + mixture of experts = less computing power = 1/20 the cost

2. Open source makes it go viral

3. embeds DeepSeek in many places and gets developers to come up with new versions

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Sweden's Foreign Minister Maria Stengard says Swedish analysis Russia's economy is much weaker than official estimates show. She says one should not underestimate Russia, as well as not make the mistake of overestimating Russia. It shows Russian central bank interest rates set at 21% in 2024 when interest rates were 10%, suggesting that inflation was much higher than the 5% official figures. The minister also points out that instead of growing by 13% as official figures reported Russian economy had declined by 8% over 2020 to 2024. British government estimate is that the losses from the Ukraine war are $450 billion. Official growth estimate for 2026 is 0.4%, even with higher oil prices. About 1.2 million men were lost in the war in Ukraine, and this affects Russia's productive part of the economy.  A new package of $106 billion has been approved for Ukraine by the European Union. EU stands with Ukraine. Stengard says Russian elites are in favor of ending the war before it does serious irreversible damage to the economy. This is also shown in the article on Russian economic conditions in the NYT today by Russia's Mikhail Zygar with Putin about to make changes and end the war in January 2024 to reverse the downward course in the economy after over 3 years of war since Feb 24, 2022. Not much is changing on the battlefield as both sides are at an impasse. So that continuing the war makes little sense for the two countries and a pullback, geting to a peace agreement, open minded negotiations, makes real sense. ...

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US president DJT on the craziness of UK, China, Japan, India getting their oil and gas from Hormuz Straits after frequent disruptions over 40 years. And expecting US to keep lanes open, expecting the US to do this alone when US is self sufficient and exports oil and gas in 2026. UK, China, Japan and India does not want a wider war, US also does not want a wider war, and has asked these countries to stop shopping for the best price and find alternative sources of oil and gas for many years. China and Japan get 90% of their oil from the Hormuz Straits region- the US president is asking does that even make sense? Are they doing this because it is cheaper, ignoring the other costs, and the hidden costs of unreliable supplies to the poorest countries paying $125-150 a barrel? Germany has set a better example for these countries to follow getting only 6% of its oil and gas from the Hormuz Straits and being far ahead in renewable energy. China and Japan, South Korea are oblivious of all that has happened, the disruptions in supplies of the last 40 years, and have made no serious effort to find alternative sources and supplies. Whatever happens in coming weeks Mr President DJT has a point. Even more so as the MAGA base has insisted on a focus on domestic policy and problems, the Biden base also had the same desire to focus on domestic policy and problems. Nothing should divert from this focus, particularly the needs of countries that have not made changes in energy policy and logistics they should have a long time back. ...