Implementing an AI algorithm in the clinical setting: a case study for the accuracy paradox.

Objectives: We report our experience implementing an algorithm for the detection of large vessel occlusion (LVO) for suspected stroke in the emergency setting, including its performance, and offer an explanation as to why it was poorly received by radiologists.

Materials And Methods: An algorithm was deployed in the emergency room at a single tertiary care hospital for the detection of LVO on CT angiography (CTA) between September 1st-27th, 2021. A retrospective analysis of the algorithm's accuracy was performed.

Konnektor: A Framework for Using Graph Theory to Plan Networks for Free Energy Calculations.

Alchemical free energy campaigns can be planned using graph theory by building networks that contain nodes representing molecules that are connected by possible transformations as edges. We introduce Konnektor, an open-source Python package, for systematically planning, modifying, and analyzing free energy calculation networks. Konnektor is designed to aid in the drug discovery process by enabling users to easily setup free energy campaigns using complex graph manipulation methods.

Kartograf: A Geometrically Accurate Atom Mapper for Hybrid-Topology Relative Free Energy Calculations.

Relative binding free energy (RBFE) calculations have emerged as a powerful tool that supports ligand optimization in drug discovery. Despite many successes, the use of RBFEs can often be limited by automation problems, in particular, the setup of such calculations. Atom mapping algorithms are an essential component in setting up automatic large-scale hybrid-topology RBFE calculation campaigns.

An NCLEX-RN Improvement Project: A Study of Student Attributes Associated With Test Success.

Background: A school of nursing developed a process to improve graduates' NCLEX-RN scores through a committee tasked with identifying approaches to assist students in passing the NCLEX-RN on the first attempt.

Method: The process involved: (1) engaging the faculty to use current published evidence; and (2) conducting an anonymous survey of previous graduates to identify the factors associated with NCLEX-RN success in the school's student population. Logistic regression analysis was conducted on a sample of 165 graduates of the program.

Path Sampling Simulations Reveal How the Q61L Mutation Alters the Dynamics of KRas.

Flexibility is essential for many proteins to function, but can be difficult to characterize. Experiments lack resolution in space and time, while the time scales involved are prohibitively long for straightforward molecular dynamics simulations. In this work, we present a multiple state transition path sampling simulation study of a protein that has been notoriously difficult to characterize in its active state.

Fluorination and hydrolytic stability of water-soluble platinum complexes with a borane-bridged diphosphoramidite ligand.

The high fluorophilicity of borane-containing ligands offers promise for accessing new metallodrug candidates capable of bifunctional [F]-positron emission tomography (PET) imaging, but this requires water soluble and hydrolytically stable ligands that can be fluorinated under mild conditions. Toward this goal, here we report the synthesis and characterization of water-soluble Pt(II) complexes containing a triaminoborane-bridged diphosphoramidite ligand called TBDPhos that can be fluorinated using simple fluoride salts. NMR and XRD studies show that (TBDPhos)PtCl (1) dissolves in water with cooperative H-OH addition across the bridgehead N-B bond to form 1-H2O.

ACR Appropriateness Criteria® Osteomyelitis or Septic Arthritis-Child (Excluding Axial Skeleton).

Imaging plays an integral role in the evaluation of suspected musculoskeletal infections in children, not only in the accurate identification of infection such as osteomyelitis or septic arthritis, but also in guiding management. Various diagnostic modalities serve different purposes in the assessment of suspected pediatric musculoskeletal infections. The purpose of this document is to provide imaging guidance in the most frequently encountered clinical scenarios in which osteomyelitis and/or septic arthritis are suspected, outside of the axial skeleton.

Programming Rapid Functional Group Diversification into a Solid-State Reaction: Aryl Nitriles for Self-Assembly, Click Reactivity, and Discovery of Coexisting Supramolecular Synthons.

A method to rapidly diversify the molecules formed in organic crystals is introduced, with aryl nitriles playing a novel dual role as both hydrogen-bond acceptors and modifiable organic groups. The discovery of coexisting supramolecular synthons in the same crystal is also described. The general concept is demonstrated by using a bis(aryl nitrile) alkene that undergoes a hydrogen-bond-directed intermolecular [2+2] photodimerization to form a tetra(aryl nitrile)cyclobutane.

Structures and Reactivities of Cocrystals Involving Diboronic Acids and Bipyridines: In Situ Linker Reaction and 1D-to-2D Dimensionality Change via Crystal-to-Crystal Photodimerization.

Cocrystallizations of diboronic acids [1,3-benzenediboronic acid (1,3-bdba), 1,4-benzenediboronic acid (1,4-bdba) and 4,4'-biphenyldiboronic acid (4,4'-bphdba)] and bipyridines [1,2-bis(4-pyridyl)ethylene (bpe) and 1,2-bis(4-pyridyl)ethane (bpeta)] generated the hydrogen-bonded 1 : 2 cocrystals [(1,4-bdba)(bpe) ] (1), [(1,4-bdba)(bpeta) ] (2), [(1,3-bdba)(bpe) (H O) ] (3) and [(1,3-bdba)(bpeta) (H O)] (4), wherein 1,3-bdba involved hydrated assemblies. The linear extended 4,4'-bphdba exhibited the formation of 1 : 1 cocrystals [(4,4'-bphdba)(bpe)] (5) and [(4,4'-bphdba-me)(bpeta)] (6). For 6, a hemiester was generated by an in-situ linker transformation.

Overlay Analysis of Cone-Beam Computed Tomography Volumes Acquired before and after Horizontal Alveolar Ridge Augmentation.

Objective: The objective of this study was to illustrate the efficacy of a novel imaging analysis technology to capture horizontal and vertical dimensional changes following horizontal alveolar ridge augmentation (HRA).

Methods: Cone-beam computed tomography (CBCT) volumes from 65 HRA sites in 57 patients were available for evaluation, employing a three-dimensional analysis software to overlay preoperative and post-augmentation CBCT volumes. Horizontal and vertical alveolar ridge dimensional (HRD/VRD) changes were recorded considering a panel of patient-, site-, and procedure-related explanatory variables.

Comparison of MRI appendix biometrics in children with and without acute appendicitis.

Objectives: The goal of this study is to improve MRI-specific diagnostic criteria for pediatric appendicitis through comparison of normal and abnormal appendix-related imaging features.

Methods: A retrospective multireader-multicase design was used, including non-contrast MRI performed for suspected pediatric appendicitis following non-diagnostic US from January 2014 to December 2017. Positive diagnosis was defined by surgical pathology or symptom resolution after antibiotics.

Broomeanamides: Cyclic Octapeptides from an Isolate of the Fungicolous Ascomycete from India.

The genus comprises fungi that colonize basidiomata of wood-inhabiting fungi, including important forest pathogens. Studies of fermentation cultures of an isolate (TFC201724) collected on the foothills of Himalayas, and closely related to isolates from Europe, led to the identification of a new cyclic octapeptide along with two closely related analogues (-) and four dioxopiperazines (-). The structure of the lead compound, broomeanamide A (), was assigned mainly by analysis of 2D NMR and HRESIMS data.

Cubane-forming cyclic dienes that exhibit orthogonal reactivities in the solid state.

Photoirradiation of a binary cocrystal composed of two different cyclic dienes generates a highly-symmetric cubane-like tetraacid cage regioselectively and in quantitative yield. The cage forms by a double [2+2] photodimerization of one of the diene cocrystal components. The second diene while photostable in the cocrystal reacts in a double [2+2] photodimerization as a pure form quantitatively to form a tetramethyl cubane-like cage.

Effects of multiphase versus single-phase CT angiography for the detection of distal cerebral vessel occlusion.

Purpose: The goal of this study was to determine whether the benefits of multiphase CTA (mCTA) over single-phase CTA (sCTA) for the detection of proximal cerebrovascular occlusions similarly extend to the distal cerebral vasculature.

Methods: Four attending radiologists, two neuroradiologists and two emergency radiologists, contributed as readers to this retrospective study. For each reader, two sessions were conducted, one using sCTA and one using mCTA.

How Electrode Position Affects Selective His Bundle Capture: A Modelling Study.

Unlabelled: In certain cardiac conduction system pathologies, like bundle branch block, block may be proximal, allowing for electrical stimulation of the more distal His bundle to most effectively restore activation. While selective stimulation of the His bundle is sought, surrounding myocardium may also be excited, resulting in nonselective pacing. The myocardium and His bundle have distinct capture thresholds, but the factors affecting whether His bundle pacing is selective or nonselective remain unelucidated.

Correction: Mechanical rigidity of a shape-memory metal-organic framework increases by crystal downsizing.

Correction for 'Mechanical rigidity of a shape-memory metal-organic framework increases by crystal downsizing' by Al A. Tiba et al., Chem.

Pediatric Panoramic Radiography: Techniques, Artifacts, and Interpretation.

Panoramic radiography, particularly in the pediatric population, is rarely addressed in the radiology literature. The authors provide an in-depth discussion of how these images are acquired, what artifacts can be visualized, and how to mitigate these artifacts. Dental anatomy, as well as relevant osseous and soft-tissue anatomy visible on a panoramic image, are reviewed.

Mechanical rigidity of a shape-memory metal-organic framework increases by crystal downsizing.

Soft porous nanocrystals with a pronounced shape-memory effect exhibit two- to three-fold increase in elastic modulus compared to the microcrystalline counterpart as determined by atomic force microscopy nanoindentation. The increase in rigidity is consistent with the known shape-memory effect displayed by the framework solid at the nanoscale. Crystal downsizing can offer new avenues for tailoring the mechanical properties of metal-organic frameworks.

Implementation and Impact of a Comprehensive Radiology Report Categorization System on Communication of Important Results.

Purpose: Effective communication of important imaging results is critical to patient care but difficult to accomplish efficiently. To improve communication at their institution, the authors introduced a radiology report categorization system (RADCAT) that organizes diagnostic imaging reports and uses automated communication systems. The study objectives were to (1) describe RADCAT's design, (2) evaluate its implementation for appropriate imaging, and (3) evaluate the communication of important, nonurgent results with recommended follow-up.

Survey of radiologists and emergency department providers after implementation of a global radiology report categorization system.

Purpose: Breakdown in communication of important imaging results threatens patient safety and risks malpractice claims. To facilitate closed-loop communication, our institution developed a unique radiology report categorization (RADCAT) system employing automated alert notification systems. This study aimed to understand users' initial experiences with the RADCAT system and obtain feedback.

Direct comparison of a novel antitachycardia pacing algorithm against present methods using virtual patient modeling.

Background: Antitachycardia pacing (ATP) success rates as low as 50% for fast ventricular tachycardias (VTs) have been reported providing an opportunity for improved ATP to decrease shocks.

Objective: The purpose of this study was to determine how a new automated antitachycardia pacing (AATP) therapy would perform compared with traditional burst ATP using computer modeling to conduct a virtual study.

Methods: Virtual patient scenarios were constructed from magnetic resonance imaging and electrophysiological (EP) data.

Supramolecular chemistry under mechanochemical conditions: a small molecule template generated and integrated into a molecular-to-supramolecular and back-to-molecular cascade reaction.

We describe the integration of a small-molecule hydrogen-bond-donor template into a cascade reaction that is comprised of a combination of molecular and supramolecular events. The cascade is performed mechanochemically and in the presence of μL amounts of water. The small-molecule template is generated (molecular) using water-assisted vortex grinding and is then used to assemble an alkene (supramolecular) to undergo an intermolecular [2 + 2] photodimerization reaction (molecular).