Pottsritter1955

The adequate management is an important challenge for both patients and caregivers with a multidisciplinary approach likely necessary.Introduction In recent years, computational polypharmacology has gained significant attention to study the promiscuous nature of drugs. Despite tremendous challenges, community-wide efforts have led to a variety of novel approaches for predicting drug polypharmacology. In particular, some rapid advances using machine learning and artificial intelligence have been reported with great success. Areas covered In this article, the authors provide a comprehensive update on the current state-of-the-art polypharmacology approaches and their applications, focusing on those reports published after our 2017 review article. The authors particularly discuss some novel, groundbreaking concepts, and methods that have been developed recently and applied to drug polypharmacology studies. Expert opinion Polypharmacology is evolving and novel concepts are being introduced to counter the current challenges in the field. However, major hurdles remain including incompleteness of high-quality experimental data, lack of in vitro and in vivo assays to characterize multi-targeting agents, shortage of robust computational methods, and challenges to identify the best target combinations and design effective multi-targeting agents. Vemurafenib Fortunately, numerous national/international efforts including multi-omics and artificial intelligence initiatives as well as most recent collaborations on addressing the COVID-19 pandemic have shown significant promise to propel the field of polypharmacology forward.During the COVID-19 pandemic, breast imaging must be performed using safe practices. Balancing the need to avoid delays in the diagnosis of breast cancer while avoiding infection requires careful attention to personal protective equipment and physical distancing and vigilance to maintain these practices. The Canadian Society of Breast Imaging/Canadian Association of Radiologists guideline for breast imaging during COVID-19 is provided based on priority according to risk of breast cancer and impact of delaying treatment. A review of the best practices is presented that allow breast imaging during COVID-19 to maximize protection of patients, technologists, residents, fellows, and radiologists and minimize spread of the infection. The collateral damage of delaying diagnosis of breast cancer due to COVID-19 should be avoided when possible.OBJECTIVE. The purpose of this article was to evaluate the diagnostic performance of the kinetic parameters of ultrafast and standard dynamic contrast-enhanced MRI (DCE-MRI) compared with morphologic evaluation in differentiating benign from malignant nonmass enhancement (NME) breast lesions. MATERIALS AND METHODS. A total of 77 consecutive patients with 77 NMEs (23 benign and 54 malignant) underwent 3-T MRI, including one unenhanced and eight contrast-enhanced ultrafast DCE-MRI scans (7-second scans) and standard DCE-MRI scans. The two readers evaluated the lesions' likelihood of malignancy on a continuous scale from 0 to 100% as the morphologic score using standard DCE-MRI. The kinetic curves of ultrafast DCE-MRI were fitted using an empirical mathematical model, ΔS(t) = A × (1 - e-αt), where A is the upper limit of signal intensity, e is the Euler number, and alpha (s-1) is the rate of signal increase. The initial slope of the kinetic curve (A × α) and the initial AUC (AUC30, which is the integration of thd malignant NMEs.OBJECTIVE. The objective of this article is to describe evidence-based guidelines for percutaneous minimally invasive imaging-guided thermal ablation of bone metastases. CONCLUSION. Safe and effective minimally invasive thermal ablation can be performed to achieve pain palliation, local tumor control, or cure in selected subgroups of patients with osseous metastases. Thermal protection strategies should be implemented to minimize the risk of undesired thermal injury.Performance on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey can affect up to 33% of a physician's reimbursement from the Centers for Medicare & Medicaid Services. At this pseudo-private orthopedic practice, the authors characterized how physicians often achieve drastically different scores between HCAHPS and an Internal Patient Satisfaction Questionnaire (IPSQ). Eighteen physicians were ranked separately according to percentage of top-box scores on HCAHPS and IPSQ. There was an inverse relationship between physician rank for the 2 surveys according to Spearman correlation coefficient (ρ = -0.36, P = .15). Qualitative subanalysis indicated that although "physician interaction" was the most common reason for negative comments on HCAHPS, "ancillary staff" and "workflow" concerns were common on IPSQ. The outpatient setting remains a critical component in achieving high-quality orthopedic care. Consequently, HCAHPS alone may not be a sufficient indicator of patient satisfaction for orthopedic and other subspecialty practices.Previous studies examining the factor structure of attention-deficit/hyperactivity disorder (ADHD) symptoms in adults using self-report measures have shown mixed results, supporting two-, three-, and bifactor solutions. The current study further investigated the structure of ADHD symptoms in adults using the Current Symptoms Scale and rigorous model evaluation in a sample of 892 college students. Confirmatory factor analysis was used to analyze and compare five-factor structures; a single-factor model, a two-factor model, a three-factor model, and two bifactor models. A single-factor model with correlated residuals best fit the data. Factor correlations with nearly all related constructs (i.e., symptoms of oppositional defiant disorder, depression, impairment, previous ADHD diagnosis, grades, and substance use) were significant in the expected directions and the model was invariant across gender. These findings contribute to a growing body of work suggesting a unidimensional factor may best represent ADHD symptoms in adults. Implications are discussed.OBJECTIVE. The purpose of this study was to analyze recent trends in abdominal imaging utilization in the Medicare population. MATERIALS AND METHODS. Medicare Part B databases for 2004-2016 were reviewed, and all Current Procedural Terminology codes pertaining to noninvasive imaging of the abdomen and pelvis were identified. Codes were grouped into six categories CT and CT angiography (CTA), MRI and MR angiography (MRA), ultrasound, radionuclide imaging, radiography, and gastrointestinal fluoroscopy. Annual utilization rates per 1000 Medicare beneficiaries were calculated. Medicare physician specialty codes were used to identify studies performed by radiologists versus nonradiologist physicians. Reimbursements were determined. RESULTS. Total abdominal imaging utilization decreased from 558.0 examinations per 1000 Medicare beneficiaries in 2004 to 441.9 in 2016 (-20.8%). CT and CTA examinations increased by 22.5% from 2004 to 2010, followed by a sharp drop in 2011 caused by code bundling. From 2011 to 2016, CTby radiologists.Research on the effects of restricted housing on inmate well-being indicates mild to moderate psychological effects and barriers opportunities for treatment and positive growth. Yet, there are few interventions tailored both to the needs of this high-risk population and to the institutional constraints of their environment. Given the financial and safety burdens associated with housing someone in segregation compared to the general population, correctional psychology should focus on developing programs that work. Using a prepost design, this study presents findings from a pilot investigation (N = 39) on the effects of a new, largely self-directed program (Stepping Up, Stepping Out [SUSO]) for inmates with mental and behavioral health concerns who are placed in restrictive settings. Results suggest that SUSO is associated with meaningful reductions in overall emotional distress and criminal attitudes; however, improvements in more stable criminal thinking patterns (i.e., distorted cognitions that are used to justify and support antisocial behavior; see Walters, 2012) were not observed. Overall, posttreatment working alliance was rated favorably by program participants. Demographic and preintervention comparisons between program completers and dropouts are also reported. Though preliminary findings suggest SUSO is a promising intervention for alleviating distress and aspects of criminal risk for inmates placed in restricted housing, future research should assess fidelity and engagement leading to a randomized controlled trial to determine the effectiveness of this program. (PsycInfo Database Record (c) 2020 APA, all rights reserved).Objectives Using symbolic interactionism theory, we explore the different identity labels that Latinx and Asian DACA recipients (Deferred Action for Childhood Arrivals) have reported are imposed on them (i.e., ascribed) and the different meanings behind such identity labels. We also examine the identity labels that DACA recipients adopt for themselves (i.e., avowed). Method Forty semistructured interviews were conducted with DACA recipients who attend a 2- or 4-year college in California. Results Our findings reveal that DACA recipients have different meanings for ascribed identity labels. Some of these meanings have positive connotations and denotations, which may help to construct a positive self-view. Nonetheless, most of the emergent themes in our study show that DACA recipients perceive that ascribed identity labels have negative connotations and denotations. To create more positive representations of undocumented immigrants, DACA recipients use certain labels to describe themselves. Conclusion Consideration of the ascribed and avowed identities of DACA recipients is important because such identities might reflect and influence others' views of undocumented immigrants and affect undocumented immigrants' self-view. (PsycInfo Database Record (c) 2020 APA, all rights reserved).A sequential three-component cascade process was developed for the synthesis of bridged tetrahydroquinolines and chromanes bearing 2,6-methanobenzo[d][1,3]diazocine and 2,6-methanobenzo[g][1,3]oxazocine scaffolds, respectively, in good yields from readily available materials. The InCl3-catalyzed reaction progressed via enamine formation, Michael addition, intramolecular cyclization, and intramolecular iminium ion cyclization steps. Notably, this high atom economic approach (-2H2O) allowed the generation of four new bonds (1 C-C and 3 C-N or 1 C-C, 1 C-O and 2 C-N) and two heterocyclic rings in a single operation.Novel bimetallic zinc acetate complexes supported by heteroscorpionate ligands have been developed for the ring-opening copolymerization of cyclohexene oxide and CO2 and the terpolymerization of cyclohexene oxide, phthalic anhydride, and CO2. Heteroscorpionate ligands precursors L1-L3 were reacted with two equivalents of zinc acetate to afford the dinuclear zinc complexes [Zn(κ3-bpzappe)(μ-O2CCH3)3-Zn(HO2CCH3)] (1), [Zn(κ3-bpzbdmape)(μ-O2CCH3)3-Zn(HO2CCH3)] (2), and [Zn(κ3-bpzbdeape)(μ-O2CCH3)3Zn(HO2CCH3)] (3) in excellent yields. The molecular structure of these compounds was determined spectroscopically and confirmed by X-ray diffraction analysis. Zinc acetate complexes 1-3 were screened as catalysts for the copolymerization of cyclohexene oxide and CO2 to produce poly(cyclohexene)carbonate, and complex 3 was found to be the most active catalyst for this process in the absence of a cocatalyst. Furthermore, the terpolymerization of cyclohexene oxide, phthalic anhydride, and CO2 was studied using the combination of complex 3 and 4-dimethylaminopyridine as catalyst system yielding the corresponding polyester-polycarbonate materials.