IX
C.O.A.G. Lyrics
Jump to: Overall Meaning ↴ Line by Line Meaning ↴
Just plot the course for the place to be
Called Pleasure Station 9
Leave your troubles far behind,
You'll find amusement of any kind
At Pleasure Station 9
At PS9 you can have a good time at PS9
Spend your Quatloos on any game,
At Pleasure Station 9
Any something that you want to try,
Just go ahead and don't be shy
At Pleasure Station 9
At PS9 you can have a good time at PS9
The lyrics to C.O.A.G.'s song IX are about escaping the routines and stresses of life, particularly those related to living in the galaxy. The singer suggests that they can do this by plotting a course for Pleasure Station 9, a place where they can leave their troubles far behind and find amusement of any kind. Pleasure Station 9 is a utopian destination where all types of entertainment are available, and visitors can have a good time spending their Quatloos on games, hitting the bar and picking up a dame. The song encourages listeners to forget their inhibitions and try new things while enjoying themselves at Pleasure Station 9.
Overall, the lyrics to IX are a call to escape from reality and indulge in pleasures without any reservations. The song presents Pleasure Station 9 as an ideal destination to achieve this, where visitors can enjoy a fun-filled adventure, try new things, and create unforgettable memories.
Line by Line Meaning
When you're tired of the galaxy,
When you have become exhausted with the vastness of the universe,
Just plot the course for the place to be
Simply chart your way to the ideal destination
Called Pleasure Station 9
That goes by the name of Pleasure Station 9
Leave your troubles far behind,
Abandon all your worries
You'll find amusement of any kind
You will encounter varieties of entertainment
At Pleasure Station 9
Only at Pleasure Station 9
At PS9 you can have a good time at PS9
You can enjoy yourself exceedingly while you're at PS9
Spend your Quatloos on any game,
Invest your Quatloos on any gaming activity
Hit the bar and pick up a dame
Visit the bar and seduce a woman
At Pleasure Station 9
Only at Pleasure Station 9
Any something that you want to try,
Whatever it may be that you feel like doing,
Just go ahead and don't be shy
Do it unhesitatingly and without inhibition
At Pleasure Station 9
Only at Pleasure Station 9
At PS9 you can have a good time at PS9
You can enjoy yourself exceedingly while you're at PS9
Lyrics © O/B/O APRA/AMCOS
Lyrics Licensed & Provided by LyricFind
Hazel Gabon
Thank you so much for this video!
DrPardeep Kapoor
Again great lesson
K V
If the pt does not correct it can also be lupus anticoagulant
Jeanne Commer
The problem most people have with mixing studies is the interpretation of whether the original clotting time has actually "normalized" or not. For example, if the initial PT was 80 and the mixing PT clotting time (50/50 with pooled normal plasma) was 17 seconds --was this clotting time corrected ("normalized") or not? A 17 second PT is not "normal" in any laboratory reference range but the clotting time was significantly shortened by 63 seconds. Any presentation called "How to interpret a mixing study" that does not actually discuss how to decide (interpret) whether a clotting time has corrected or not is leaving out one of the most important parts of the discussion.
K V
@Jeanne Commer same here, more than 15 signifying a non corrected mixing studies.
The problem with standardising the mixing studies is that there are so many variables, that it is very difficult to have two laboratories with identical results.
With regards to the case of LA with fviii inhibitor, the easy way forward is to have a chromogenic fviii. We introduced this assay in 2019 and provides useful information in such cases.
Jeanne Commer
We do too. A two hour incubation.
Can you tell me what your validated cutoff for the Rosner index turned out to be? The one that worked best for us was 15.
K V
@Jeanne Commer in order to distinguish between a factor viii inhibitor from a factor deficiency, we make use of an incubated mixing studies.
Jeanne Commer
@K V Fortunately, we do have access to all or most of the clinical patient data but sometimes, it is unclear--even to the clinician. We have had cases where both bleeding and clotting have been reported and recently had a case where the patient had both a strong LA and a strong factor VIII inhibitor.
If a mixing study is ordered, we always also perform a lupus anticoagulant panel (we will call the doctor, if need be, to get this ordered). We use Hemosil DRVVT and SCT kits on the ACL TOP 750 and feel very confident about these results. With every lot number change we use 40 normal plasmas to determine normalized screening times and ratios. Our cutoffs are based on a 3 SD range-- following the recommendations of the manufacturer and ISTH. These procedure are clear and we have no problem identifying LA's.
The problem lies with mixing studies. We use mixing studies to try to distinguish a factor inhibitor from a factor deficiency. We have strict guidelines on what plasmas we will test. We will not test patients on anticoagulant. We run heparin levels to rule out heparin from a line draw or any other source. We check the patient's medication history carefully. There are plenty of examples, in the literature, of ways to run mixing studies and how to interpret them--but no rules or recommendations from regulatory agencies, or the ISTH on the BEST method to use. Do we mix 1:1? or 1:4? Does "normalization mean correction back to the reference range? Should the cutoff for the Rosner index be 15? or 11? or somewhere in between?
There are, however, plenty of admonitions that every lab should validate their own mixing study methods, cutoffs and interpretations. I spent almost a year doing just that. I collected a huge amount of data--from journal articles, web articles, web blogs (like this one) and designed my own validation study (ISTH does not have a detailed suggested mixing study validation procedure). I looked at plasmas from congenital factor deficient patients, patients with LA's, plasmas from patients that had factor VIII inhibitors and normal plasmas. We use FDA approved PNP from George King Biomedical for our mixing studies. This PNP contains citrated plasma from 30 or more carefully screened normal human donors and is platelet poor with no buffers or preservatives. They also supplied many of the frozen factor deficient plasmas and a plasma with a strong FVIII inhibitor. We also used frozen samples from patient samples.
I determined, very quickly, that defining correction as "back to the normal reference range" was not acceptable at all in our laboratory. By the way--we establish our own reference ranges for adults and use the "Toulon study" pediatric reference ranges for children (2016). After months of experiments, I had narrowed my options down to the Rosner Index. But, it was not 100% accurate. I had to choose the cutoff that was the most accurate and supplement that with a "most consistent" comment. I feel that ISTH or regulatory agency should publish both a recommended mixing study validation method and a recommended method to establish a Rosner index cutoff if that is the chosen method. They have recommendations on every other kind of coagulation testing!
I realize that I have gotten a little long-winded. Sorry! It just seems to me that there are too many articles on mixing studies that do not address the interpretation issue. They start with--If the mixing study normalizes--do this or if the mixing study does not normalize--do that. They tend to skip the part about how to determine if normalization has taken place. Thanks for sharing your thoughts and suggestions.
K V
@Jeanne Commer for the validation, we utilised residual plasma from previous cases. Reagent selection is very important and can be easily done. I once did an exercise in order to compare lupus sensitivity between two different PT reagents. So basically had excess stock of pos LA controls, did a dilution with NPP in order to obtain 100, 90, 80% etc up to 0% of normal controls, then analysed the PT. We plotted the data and the cutoff utilised was the upper limit of the PT reagent specific normal values. Despite both reagents are recombinant, they did have different sensitivities to LA, which might also pose a problem since LA strong patients are given warfarin.
Personally, without proper clinical details I would not perform a mixing studies. Also important is the choice of NPP which without sounding sexist, I would not include females due to high fviii and fibrinogen. Controls and calibrators may also not be suitable for mixing studies.
If you are interested, there is a very good e book from the wfh website by Dr. Steve Kitchen and is free to download.