Zobrazení zdroje stránky Delacruzoconnor2384

In persons with multiple sclerosis (MS), the Expanded Disability Status Scale (EDSS) is the criterion standard for assessing disability, but its in-person nature constrains patient participation in research and clinical assessments.<br /><br /> The aim of this study was to develop and validate a scalable, electronic, unsupervised patient-reported EDSS (ePR-EDSS) that would capture MS-related disability across the spectrum of severity.<br /><br /> We enrolled 136 adult MS patients, split into a preliminary testing Cohort 1 (<br /><br />  = 50), and a validation Cohort 2 (<br /><br />  = 86), which was evenly distributed across EDSS groups. Each patient completed an ePR-EDSS either immediately before or after a MS clinician's Neurostatus EDSS evaluation.<br /><br /> In Cohort 2, mean age was 50.6 years (range = 26-80) and median EDSS was 3.5 (interquartile range (IQR) = [1.5, 5.5]). The ePR-EDSS and EDSS agreed within 1-point for 86% of examinations; kappa for agreement within 1-point was 0.85 (<br /><br />  &lt; 0.001). The correlation coefficient between the two measures was 0.91 (&lt;0.001).<br /><br /> The ePR-EDSS was highly correlated with EDSS, with good agreement even at lower EDSS levels. For clinical care, the ePR-EDSS could enable the longitudinal monitoring of a patient's disability. For research, it provides a valid and rapid measure across the entire spectrum of disability and permits broader participation with fewer in-person assessments.<br /><br />The ePR-EDSS was highly correlated with EDSS, with good agreement even at lower EDSS levels. For clinical care, the ePR-EDSS could enable the longitudinal monitoring of a patient's disability. For research, it provides a valid and rapid measure across the entire spectrum of disability and permits broader participation with fewer in-person assessments.The current study examined hypotheses related to the development of suicidal ideation as directed by the interpersonal theory within a sample of acutely suicidal psychiatric inpatients. Consistent with ideation-to-action models, we distinguished suicidal desire from resolved plans and preparations. Although thwarted belongingness and perceived burdensomeness were correlated with suicidal desire, only perceived burdensomeness was associated with suicidal desire controlling for depression and thwarted belongingness. Depression alone was related to plans and preparations. Findings are interpreted as challenging the mechanisms hypothesis of the interpersonal theory and suggest that alternative conceptualizations of the development of suicidal desire may be warranted.Mass violence is often characterized by the disappearance of the victims' bodies, preventing families from mourning. In Latin America, the exhumation processes emerged partially as a response to this situation. The search for the dead has always been a political issue, as the mourning of the victim's relatives has been presented as a "humanitarian" objective and a peace-building tool, thus articulating individual and social healing. Based on extensive ethnographic fieldwork in Guatemala, this article questions the representations of the legacy of violence between generations, as well as local indigenous representations of mourning through appropriated notions such as trauma and susto.Background The COVID-19 pandemic has driven most clinicians, from those practicing in small independent practices to those in large system, to adopt virtual care. However, individuals and organizations may lack the experience and skills that would be considered fundamental prerequisites to adopting telehealth in less urgent times. What are those skills? Before the pandemic, the Association of American Medical Colleges (AAMC) convened national experts to identify and articulate a consensus set of critical telehealth skills for clinicians. Methods Through a structured review of the literature, followed by several rounds of review and refinement by committee and community members via a modified Delphi process, the committee came to consensus on a set of skills required by clinicians to provide quality care via telehealth. Conclusion The consensus set of telehealth skills presented in this paper, developed by the AAMC and national experts, can serve providers and health systems seeking to ensure that clinicians are prepared to meet the demand for care delivered via telehealth now and in the future.The burden of chronic liver disease (CLD) in India is high, particularly among middle-aged men, with nearly 220,000 deaths due to cirrhosis in 2017. CLD increases the risk of infection, severe disease (e.g. [https://www.selleckchem.com/products/cct251545.html CCT251545 molecular weight] hepatitis A virus or HAV superinfection, acute-on-chronic liver failure, fulminant hepatic failure), and mortality. Hence, various countries recommend HAV vaccination for CLD patients. While historic Indian studies showed high seroprevalences of protective HAV antibodies among Indian adults with CLD, the most recent ones found that nearly 7% of CLD patients were susceptible to HAV infection. Studies in healthy individuals have shown that HAV infection in childhood is decreasing in India, resulting in an increasing population of adults susceptible to HAV infection. As patients with CLD are at increased risk of severe HAV infection, now may be the time to recommend HAV vaccination among people with CLD in India.Cancer remains one of the leading causes of death in humans, and new drug substances are therefore being developed. Thus, the anti-cancer activity of xanthene derivatives has become an important topic in the development of new and potent anti-cancer drug substances. Previously published novel series of xanthen-3-one and xanthen-1,8-dione derivatives have been synthesized in one of our laboratories and showed anti-proliferative activity in HeLa cancer cell lines. This series serves as a good basis to develop quantitative structure-activity relationship (QSAR), to study the relations between anti-proliferative activity and chemical structures. A QSAR model has been derived that relies only on two-dimensional molecular descriptors, providing mechanistic insight into the anti-proliferative activity of xanthene derivatives. The model is validated internally and externally and additionally with the set of inactive compounds of the original data, confirming model applicability for the design and discovery of novel xanthene derivatives.