A difficult case in the practice of a dermatovenerologist: what is the patient hiding?

<div> <div> <p> </p><div> <div> <div> <p>This work presents the first simulations of the full optical rotation (OR) tensor at coupled cluster with single and double excitations (CCSD) level in the modified velocity gauge (MVG) formalism. The CCSD-MVG OR tensor is origin independent, and each tensor element can in principle be related directly to experimental measurements on oriented systems. We compare the CCSD results with those from two density functionals, B3LYP and CAM-B3LYP, on a test set of 22 chiral molecules. The results show that the functionals consistently overestimate the CCSD results for the individual tensor components and for the trace (which is related to the isotropic OR), by 10-20% with CAM-B3LYP and 20-30% with B3LYP. The data show that the contribution of the electric dipole-magnetic dipole polarizability tensor to the OR tensor is on average twice as large as that of the electric dipole-electric quadrupole polarizability tensor. The difficult case of (1S,4S)-(–)-norbornenone also reveals that the evaluation of the former polarizability tensor is more sensitive than the latter. We attribute the better agreement of CAM-B3LYP with CCSD to the ability of this functional to better reproduce electron delocalization compared with B3LYP, consistently with previous reports on isotropic OR. The CCSD-MVG approach allows the computation of reference data of the full OR tensor, which may be used to test more computationally efficient approximate methods that can be employed to study realistic models of optically active materials. </p> </div> </div> </div> </div> </div>

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The Motivational Power of Moral Beliefs

10.1093/oso/9780198811572.003.0007 ◽

2018 ◽

Author(s):

Joshua May

Keyword(s):

Moral Identity ◽

Motivated Reasoning ◽

Difficult Case ◽

Moral Integrity ◽

Normative Judgment ◽

Moral Beliefs ◽

Moral Hypocrisy ◽

Moral Licensing ◽

Self Interest

Even if we can rise above self-interest, we may just be slaves of our passions. But the motivational power of reason, via moral beliefs, has been understated, even in the difficult case of temptation. Experiments show that often when we succumb, it is due in part to a change in moral (or normative) judgment. We can see this by carefully examining a range of experiments on motivated reasoning, moral licensing, moral hypocrisy, and moral identity. Rationalization, perhaps paradoxically, reveals a deep regard for reason, to act in ways we can justify to ourselves and to others. The result is that we are very often morally motivated or exhibit moral integrity. Even when behaving badly, actions that often seem motivated by self-interest are actually ultimately driven by a concern to do what’s right.

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Ultrasound-guided Breast Abscess Aspiration in a Difficult Case

Academic Emergency Medicine ◽

10.1111/j.1553-2712.2001.tb02122.x ◽

2001 ◽

Vol 8 (4) ◽

pp. 398-401 ◽

Cited By ~ 24

Author(s):

Michael Blaivas

Keyword(s):

Difficult Case ◽

Breast Abscess ◽

Ultrasound Guided

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P1002Puncture of occluded coronary sinus ostium for left ventricle lead implant Troubleshooting for a difficult case - CASE REPORT

EP Europace ◽

10.1093/ehjci/eux151.183 ◽

2017 ◽

Vol 19 (suppl_3) ◽

pp. iii211-iii212

Author(s):

B. Papelbaum ◽

SS. Galvao Filho ◽

JT. Medeiros De Vasconcelos ◽

C. Eduardo Duarte ◽

R. Castro Galvao ◽

...

Keyword(s):

Case Report ◽

Left Ventricle ◽

Coronary Sinus ◽

Difficult Case ◽

Coronary Sinus Ostium ◽

Sinus Ostium

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Students' Perception of a Difficult Case in Psychotherapy

Psychological Reports ◽

10.2466/pr0.1997.81.1.67 ◽

1997 ◽

Vol 81 (1) ◽

pp. 67-75

Author(s):

Sylvia A. Linares ◽

Freddy A. Paniagua ◽

Michael O'Boyle

Keyword(s):

Mental Health ◽

Social Work ◽

Graduate Students ◽

Difficult Case ◽

Health Practice ◽

Mental Health Practice ◽

Present Sample ◽

Definition Of

Paniagua, et al. suggested that the definition of a “difficult” case in psychotherapy implies a relational definition involving the characteristics of the patient, the case, and the therapist. This study concerned this hypothesis with 44 graduate students in social work who received the Difficult Case Questionnaire representing examples of variables across each domain, e.g., motivation of the client, nature of the disorder, generic factors, and orientation of the therapist. The results were compared with the 1993 findings reported by Paniagua, et al., for a group of professionals in mental health practice. As in the earlier study, the present sample also agreed that, although all such domains are important in the formulation of that definition, their importance is not equal. Whereas professionals rated patient's, case's, and therapist's characteristics as the most important order of domains in that definition, students in this study agreed on the order of therapist's, patient's, and case's characteristics.

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Delayed presentation of complex complete dorsal thumb metacarpophalangeal joint dislocation: a difficult case to manage and review of literature

International Surgery Journal ◽

10.18203/2349-2902.isj20173429 ◽

2017 ◽

Vol 4 (8) ◽

pp. 2829

Author(s):

Praveen Kumar Pandey ◽

Inder Prakash Pawar

Keyword(s):

Case Report ◽

Metacarpophalangeal Joint ◽

Difficult Case ◽

Delayed Presentation ◽

Review Of Literature ◽

Present Case Report ◽

Joint Dislocation ◽

Joint Dislocations ◽

The Times ◽

Thumb Metacarpophalangeal Joint

Metacarpo-phalangeal (MCP) joint dislocation is a rare occurrence which commonly involves index and little finger. Thumb MCP joint dislocation is a pretty rare pathology. MCP joint dislocations are classified into dorsal or volar types. They are further categorized as incomplete, simple complete and complex complete. Complex complete MCP joint dislocation requires surgical reduction most of the times because of tissue entrapment in joint. In the present case report, a case of two and a half months old complex complete thumb MCP joint dislocation left in 18-year old male encountered which was irreducible by closed means and required surgical intervention. Dorsal hand surgical approach was utilized for reduction of dislocation. This unusual, difficult and rare case of two and a half months old complex complete dorsal dislocation of the thumb MCP joint is presented in this case report.

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