Digital Commons Network^™

Clinical Variant Of Serpentine Supravenous Hyperpigmentation Following Subcutaneous Bortezomib Injection, Madelyn Richards, Stephen E. Weis

HCA Healthcare Journal of Medicine

Introduction

Bortezomib is a reversible proteasome inhibitor that is a first-line chemotherapeutic agent for multiple myeloma. Bortezomib can be administered intravenously or subcutaneously with similar efficacy. Subcutaneous administration has fewer side effects. Many cutaneous reactions have been associated with bortezomib treatment. These include morbilliform exanthems, erythematous nodules and papules, leukocytoclastic vasculitis, Sweet syndrome, and rarely Stevens-Johnson Syndrome.

Case Presentation

This paper reports the occurrence of serpentine supravenous hyperpigmentation (SSH) after subcutaneous administration of bortezomib. SSH is a rare, characteristic cutaneous reaction that has been reported following intravenous administration of chemotherapeutic agents. Intravenous administration of bortezomib rarely results in documented cases …

An Unexpected Outcome Of An Ischemic Stroke On The Reward Pathways In The Human Brain, Karen Valadez-Cuen, Erica Kozorosky, Ferina Farahnik, Oscar Garcia

HCA Healthcare Journal of Medicine

Background

Addiction affects millions of people, often resulting from a complex interplay between genetic and environmental factors, and is frequently linked to mental health disorders. Many experts agree there is no cure for addiction, but there are effective treatments available. Many patients continue to succumb to addiction despite treatment. Therefore, more research is needed to develop new therapies in addiction medicine.

Case Presentation

This is the case of a 63-year-old woman with an extensive smoking history who suffered an acute stroke affecting her left-sided basal ganglia, including the caudate nucleus and nucleus accumbens. The patient presented with bilateral strokes to …

A Case Of Xylazine-Induced Necrotic Skin Ulcerations In An Iv-Drug User In Florida, Mark Zaki, Cynthia Dillon, Anjali Patel, Barbara Gracious

HCA Healthcare Journal of Medicine

Introduction

As illicit drug manufacturers find new ways to market their products and increase their profit margins, multiple contaminants have found their way into the illicit drug supply. The newest addition, xylazine, also known as “tranq,” has spread through the city of Philadelphia and has recently been gaining ground across the United States, including in the state of Florida.

Case Presentation

This case describes a 37-year-old male with a significant past psychiatric history of severe polysubstance intravenous (IV) use, including fentanyl and methamphetamine. He was comorbid with other mental and physical conditions and presented to the emergency department with acute …

Successful Treatment Of An Atypical Presentation Of Disseminated Retroperitoneal Seminoma: A Case Report, Mahmoud Abd-El-Hafez, Kylie Johnson, Joe Cates, Alosh Madala

HCA Healthcare Journal of Medicine

Background

Testicular seminoma is the most common malignant tumor of the testis. It occurs at a rate of 5 per 100 000 men, primarily between the ages of 15 to 34. While seminomas typically occur in the testis, other primary sites include the mediastinum, the retroperitoneum, or other extra-gonadal sites. Due to the curable nature of the malignancy (5-year survival rate > 95%), detection at early stages of the disease is key. This case presentation explores the delayed diagnosis and treatments of an atypical presentation of disseminated seminoma.

Case Presentation

We present the unusual case of a 56-year-old male who had …

Hemophagocytic Lymphohistiocytosis Due To Ehrlichiosis: A Case Series, Ajay Iyer, Mattias D'Anna, Shruti Verma, Thomas Pritchard, Vladimir Begilman, Himal Bajracharya, Kaveh Naemi

HCA Healthcare Journal of Medicine

Background

Hemophagocytic lymphohistiocytosis (HLH) is an immunologic syndrome characterized by excessive inflammation and tissue injury due to uncontrolled activation of the phagocytic system. The underlying mechanism is a lack of downregulation of activated macrophages and lymphocytes by natural killer and T cells. Unfortunately, the diagnosis is often delayed or missed due to the rarity of the disease, decreased awareness, and clinical picture variability. Ehrlichiosis is becoming a more prevalent tick-borne illness in endemic regions and a relatively uncommon but increasingly considered cause of HLH.

Case Presentation

We describe the cases of 2 patients diagnosed with secondary HLH as per the …

Endovascular Repair Of A Superior Mesenteric Arteriovenous Fistula And Pseudoaneurysm After A Single Gunshot Wound To The Abdomen, Robert Ringersen Iii, Michael Shockley, Sanjiv Gray, Tracy Bilski, Julio Calderin, Philip Kondylis

HCA Healthcare Journal of Medicine

Background

Traumatic arteriovenous fistulas (AVFs) are rare entities, especially when referring to visceral arterioportal AVFs. Currently, there are no large epidemiological studies looking specifically at traumatic visceral AVFs. When traumatic AVFs have been discussed in the literature, it is in the form of case reports or case series and focused on peripheral AVFs. The following case is a presentation of a traumatic arterioportal AVF and its management with an endovascular approach.

Case Presentation

A 16-year-old adolescent boy presented tachycardic and hypotensive with a single gunshot wound in his left abdomen. Multiple operations were required. His intensive care unit course was …

Investigating The Effects Of Nosocomial Clostridioides Difficile Infection Among Acute Leukemia Patients: Insights From The 2020 National Inpatient Sample, Zubair Hassan Bodla, Mariam Hashmi, Fatima Niaz, Umer Farooq, Muhammad Jahanzeb Khalil, Farhan Khalid, Kipson Charles, Christopher L. Bray

HCA Healthcare Journal of Medicine

Background

Rising nosocomial Clostridioides difficile infections pose high risks, especially for immunocompromised leukemia patients, necessitating targeted research to enhance patient care and outcomes.

The objective of this study was to investigate the impact of nosocomial Clostridioides difficile infections (CDI) on patients hospitalized with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML).

Methods

Our study was a retrospective analysis of adult patients hospitalized with a primary diagnosis of ALL or AML, using the Nationwide Inpatient Sample (NIS) database for 2020. Primary outcomes included the incidence of nosocomial CDI and all-cause inpatient mortality. Secondary outcomes included hospital length of stay, resource …

A Retrospective Data Analysis On Marine Animal Injuries At A Large, Multi-Site Medical System, Anthony Shadiack, J Burton Banks

HCA Healthcare Journal of Medicine

Background

With increasing numbers of human-animal interactions, there has been an increase in animal-related injuries. While canine bites are the most commonly reported animal injury, little data exists in regard to the other classes of animals, particularly marine life. The last comprehensive report on injuries related to noncanine bites and stings seen in emergency departments (EDs) across the US was between 2011 and 2015.

Methods

We performed a retrospective analysis from 2014-2019 on marine injuries from a large hospital network with over 180 hospitals, 100 freestanding EDs, and 170 urgent care centers to provide an update on the volume and …

Treatment Analysis Of Very Early And Early Onset Psychosis In The Youth Inpatient Setting, Acelyne Marie Summerson, Jordan Kalosieh, Sindhura Kompella, Clara Alvarez-Villaba, Yukthi Kodali

HCA Healthcare Journal of Medicine

Background

The United States Food and Drug Administration approved 6 atypical antipsychotics for pediatric treatment of schizophrenia. However, little has been published on the effectiveness of these medications in the acute treatment setting of adolescents with psychosis. Since the clinical uncertainty and poor prognosis proceeding the early onset of schizophrenia has a significant impact on a child’s development, there is a critical need for evidence-based data on this population. The aim of our study was to investigate the effect of various antipsychotics on young patients admitted to the inpatient ward presenting with acute psychosis.

Methods

A retrospective analysis was performed …

Assessment Of The European Hernia Society Classification Of Ventral Hernias And Clinical Outcomes, Oluwatunmininu A. Anwoju, Ashtyn Barrientes, Connor Hogan, Erik Askenasy, Jacob Greenberg, Keith Jerrod, Scott J. Roth, Zuhair Ali, Mike K. Liang

HCA Healthcare Journal of Medicine

Background

Ventral hernias are a common but heterogeneous disease. Communication among key stakeholders (eg, patients, clinicians, administrators, payers, and researchers) can be augmented by a widely utilized classification system. The European Hernia Society (EHS) developed an expert-opinion-based hernia classification system organized by hernia type (primary versus incisional) and size. We sought to assess what components of the EHS ventral hernia classification system were correlated to real-world clinical outcomes.

Methods

This was a multicenter cohort study. All hospitals contributing to the database were affiliated with 1 of 6 academic institutions. All adult patients who underwent ventral hernia repair over a 4-year …

Second Generation Antipsychotics And Cardiovascular Adverse Effects: Developing Evidence-Based Recommendations For Primary Care Medicine, Sana Borda, Ahn-Dao Lee, Paul F. Bell

HCA Healthcare Journal of Medicine

Background

Second-generation antipsychotic medications (SGAs) are often used by primary care physicians (PCPs) to treat multiple psychiatric diagnoses. SGAs have been connected to a number of adverse effects, including cardiovascular disease. Currently, there are no published evidence-based recommendations addressing SGAs and cardiotoxicity that are directed toward PCPs. This project aims to fill this gap.

Methods

Relevant search terms related to SGAs and cardiovascular disease were identified and then used to search databases (PubMed, PubMed Central, and AccessMedicine). Research studies obtained from the searches were narrowed to include systematic reviews and meta-analyses. The Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) tool was …

Sars-Cov-2 Vaccination Can Only Be Held Responsible For Thrombotic Thrombocytopenic Purpura After All Differentials Have Been Ruled Out, Josef Finsterer

HCA Healthcare Journal of Medicine

This letter to the editor addresses limitations to holding COVID vaccines responsible for the diagnosis of thrombotic thrombocytopenic purpura and discusses the potential differential diagnoses that must be considered.

Survey: A Study On Image Encryption Using Dna In Bioinformatics, Rana M. Zaki, Zaed S. Mahdi, Matheel E. Abdulmunim

Journal of Soft Computing and Computer Applications

One area of study between computer science and biology is bioinformatics, which deals with methods for collecting, processing, storing, and evaluating biological data. Sequences of RiboNucleic Acid (RNA), DeoxyriboNucleic Acid (DNA), and proteins make up biological data, which has a wide range of uses in domains such as feature extraction, data segmentation, data security, and more. In cryptography, DNA sequences are used as data carriers, enhancing the unique properties of biomolecules. This approach involves using DNA sequences to enhance the security of confidential data that must be transmitted over networks or stored securely. Several DNA-based security techniques have been developed, …

New Feature Selection Using Principal Component Analysis, Zaid Mundher Radeef, Soukaena Hassan Hashem, Ekhlas Khalaf Gbashi

Journal of Soft Computing and Computer Applications

Dimensionality reduction techniques streamline machine learning by reducing data complexity, improving model accuracy, and cutting computational costs. They remove noise and irrelevant features, making models faster and more efficient. These techniques also enhance data visualization and interpretation by condensing data into manageable, insightful dimensions. Ultimately, dimensionality reduction leads to simpler, more interpretable models without sacrificing critical information, making it a cornerstone of efficient data analysis and machine learning applications. Theoretically, feature extraction tends to create new features that encapsulate more information by combining multiple existing features, resulting in more concentrated and informative features. In contrast, feature selection involves choosing a …

Development Of A Hybrid Methodology Of Deep Learning And Machine Learning For Lung Nodule Detection In Medical Computed Tomography Images, Zaed S. Mahdi, Rana M. Zaki, Alaa Kadhim Farhan, Negar Majma

Journal of Soft Computing and Computer Applications

Deep learning and machine learning play an important role in the medical field, helping doctors make accurate, fast and effective diagnosis. Despite the progress achieved in the use of modern technologies in detecting cancerous nodes, current studies still suffer from some challenges and limitations that must be addressed to obtain high efficiency in identifying cancerous nodes. These challenges include using image pre-processing, combining deep learning and machine learning techniques, and constantly adapting to clinical changes, in order to address this. A hybrid methodology has been proposed for detecting cancerous nodules in the lung in medical Computed Tomography (CT) images. It …

Enhancing Image Classification Using A Convolutional Neural Network Model, Zena M. Saadi, Ahmed T. Sadiq, Omar Z. Akif, Marwa M. Eid

Journal of Soft Computing and Computer Applications

In recent years, with the rapid development of the current classification system in digital content identification, automatic classification of images has become the most challenging task in the field of computer vision. As can be seen, vision is quite challenging for a system to automatically understand and analyze images, as compared to the vision of humans. Some research papers have been done to address the issue in the low-level current classification system, but the output was restricted only to basic image features. However, similarly, the approaches fail to accurately classify images. For the results expected in this field, such as …

Improved Rapidly-Exploring Random Tree Using Firefly Algorithm For Robot Path Planning, Dena Kadhim Muhsen, Firas Abdulrazzaq Raheem, Yuhanis Yusof, Ahmed T. Sadiq, Faiz Al Alawy

Journal of Soft Computing and Computer Applications

In robotics, efficient path planning makes robots work independently and move through changing environments over time. This study combines the Rapidly-exploring Random Tree (RRT) architecture with the Firefly Algorithm (FA) to make robot’s path-planning better. The proposed ERRT-FA, which stands for "Enhanced RRT with Firefly Algorithm", generates better routes using Firefly social habits. Plan routes using Firefly social habits can effectively aid in exploring configuration space. The role of the FA is to enhance the RRT algorithm by providing an optimized exploration of the search space, ultimately leading to optimizing the path found by the RRT algorithm and better paths …

Ai-Powered Canary Rotation For Enhanced Source Code Leak Detection, Ray Van Hoose

Defensive Publications Series

This describes novel methods for rotating AI-generated code canaries to improve the resilience and effectiveness of source code leak detection. We introduce three distinct rotation strategies: simple rotation, dynamic rotation triggered by code changes, and algorithmic rotation using pseudorandom sequences. These methods enhance security by making it significantly more difficult for attackers to detect and neutralize canaries, thereby increasing the likelihood of early leak detection.

Foreword From Editor - 16th Edition: Toward An Inclusive Community Engagement, Yandi Andri Yatmo

ASEAN Journal of Community Engagement

This edition of AJCE defines and elaborates on the idea of inclusive community engagement as a means to involve the community in a meaningful process. ‘Inclusive’ refers to the principles of encompassing everyone, all individuals and groups alike, regardless of their identity, background, characteristics, needs, and perspectives, thereby ensuring that all voices are represented (Hodkinson, 2011). This practice extends beyond individuals with disabilities and embodies broader ideas of equality. Inclusive engagement plays a crucial part in fostering a constructive dialog that incorporates diverse perspectives within a community. Such engagements prioritize community participation in the decision-making process that affects their well-being …

Investigating Brand Awareness, Brand Image, And Perceived Quality On Customer Loyalty, Antaja Nadjwa, Diandra Srivania, Hasna Rizki Mardhiana

Jurnal Vokasi Indonesia

This study investigates the impact of brand awareness, brand image, and perceived quality on customer loyalty, with a focus on Telkomsel users within the Creative Business program at Universitas Indonesia. Employing a quantitative research methodology, data were collected from 50 respondents using a structured questionnaire and analyzed using SPSS 26. The findings reveal that all three factors—brand awareness, brand image, and perceived quality—positively influence customer satisfaction, which in turn significantly enhances customer loyalty. Specifically, perceived quality emerged as the most influential factor driving customer satisfaction, followed by brand image and brand awareness. The study underscores the critical role of perceived …

Satisfaction Of Excellent Service Training Participants With The Kirkpatrick Model At Alia Hospital Depok, Nur Fadilah Dewi

Jurnal Vokasi Indonesia

The study aims to improve the quality of human resources and services at Alia Hospital Depok through evaluation of training programs. The approach used is the Donald Kirkpatrick model evaluation which is a common method used in evaluating the effectiveness of training. The main problem faced by Alia Hospital Depok is the lack of evaluation conducted on the training programs that have been held. Therefore, training evaluation needs to be considered to improve the quality of human resources and services provided. The research method used is a survey by distributing questionnaires to service excellent training participants to evaluate their reactions …

Qualitative Characteristic Of Financial Statement Information And Implementation Psak 73 : Case Study In The Advertising Services Pt Abc, Hasnawati Hasnawati, Marsdenia Marsdenia, Trie Wiesty Cindy Salsabila

Jurnal Vokasi Indonesia

The quality of information presented in the financial statement is the most important thing for stakeholders in the business decision-making context. There has been a significant change in lease accounting practices due to changes in lease accounting standards for all business entities in countries that adopt IFRS. In 2017 the IASB published IFRS 16 Leases as new guidance on leases replacing IAS 17. DSAK IAI made adjustments related to IAS 17 to become PSAK 30, then based on the changes that emerged PSAK 30 was revoked and adjustments were made to IFRS 16 to become PSAK 73. These changes were …

The Importance And Role Of Public Relations In The Marketing Department At Mangkuluhur Artotel Suites, Habibillah Fitran, Mohammad Ridha

Jurnal Vokasi Indonesia

ABSTRACT The purpose of writing this research is to explain the role of Public Relations in the Marketing Communication Department regarding how to improve brand image, improve marketing and advertising to be more optimal, publish various information and promotions at Mangkuluhur ARTOTEL Suites through various information media and social media, and how to respond to customer complaints, as well as obstacles that occur in hotels related to various customer complaints and poor communication by several individuals within the hotel employees are also accompanied by appropriate solutions. To complete this research, the author collected data by conducting observations accompanied by interviews …

Environmental Tax Reform: Eco-Friendly Policies In Indonesia Amid The Climate Crisis, Ocktarani Ocktarani, Elsie Kasim

Jurnal Vokasi Indonesia

This research starts from the factual problem of the climate crisis phenomenon which causes a domino effect on the environment and the economic sector. Therefore, it is necessary to carry out environmental tax reform (green tax reform). Based on these problems, research was carried out to explain the green tax theory and look at green tax policy in Indonesia. The research method used in this research is qualitative with a constructivist approach. The result of the study indicate Indonesia's implementation of green tax rules signifies a proactive approach to addressing environmental challenges. However the effectiveness of these taxes is contingent …

Implementation Challenges And Opportunities Coretax Administration System On The Efficiency Of Tax Administration, Fitria Arianty

Jurnal Vokasi Indonesia

An efficient and transparent tax administration system is essential to ensure the optimization of state revenue and taxpayer compliance. The Indonesian government has initiated the implementation of the Coretax Administration System (CtAS) as part of tax reform efforts to improve efficiency in tax administration. This study aims to analyze the challenges and opportunities faced in the process of implementing CtAS in Indonesia. This study uses a qualitative method with data collection techniques in the form of literature studies, which are continued by conducting a SWOT analysis of this CtAS policy. The results of the discussion show that the main challenges …

Exploring Student Satisfaction In Learning With Podcast Applications: A Qualitative Study Based On Open-Ended Questions, Indah Permatasari, Peny Meliaty Hutabarat, Erni Adelina

Jurnal Vokasi Indonesia

This study aims to explore student satisfaction with the use of podcasts as a learning medium in the Non-News Radio Production course. A qualitative approach was used, with three open-ended questions posed to students: (1) What different experiences did you have when listening to the course material via podcast?(2) Did listening to the course material through podcasts help you focus on understanding the material? And why? And (3) provide your opinion on the Adapto podcast material shared during the Non-News Radio Production course in the 4th semester. The data obtained was thematically analyzed to identify the main emerging themes. The …

Silent Holy Spirit, October-December, 2024

Silent Holy Spirit

A newsletter published for Deaf Catholics in St. Louis, MO

Silent Holy Spirit Finding Aid

Learning Paradigms For Rhythm Detection And Generation Using Mathematical Models, Biophysical And Artificial Neural Networks, Prianka Bose

Dissertations

Humans possess an inherent ability to recognize evenly-spaced rhythms, known as isochronous rhythms, owing to the brain's predisposition to entrain to external auditory stimuli with regular temporal intervals. The central focus of this research is to understand how the brain learns and retains rhythmic time intervals in the context of music. This dissertation studies rhythm detection and generation through mathematical models, biophysical networks, and artificial neural networks, addressing both isochronous and non-isochronous patterns.

A primary focus of the thesis is on isochronous rhythms. In particular, given a perturbation to an isochronous rhythm such as a tempo change or phase shift …

Pushing The Boundaries Of Large Language Models: Innovations And Limitations In Nlp, Finance, And Mathematics, A M Muntasir Rahman

Dissertations

Large Language Models (LLMs) have emerged as transformative tools across a spectrum of domains, yet their practical deployment reveals a blend of remarkable potential and notable limitations. This research explores innovative methodologies to extend the capabilities of LLMs while addressing critical challenges in their evaluation and application. By leveraging rule-based approaches, the in-context learning capabilities of LLMs, and human-in-the-loop validation across three focused studies, this research introduces robust strategies for dataset synthesis, model enhancement, and model assessment in three distinct domains: natural language processing, financial sentiment analysis, and mathematical reasoning

The first study proposes an efficient data augmentation framework, EASE, …

Game-Based Learning With Augmented Reality, Kantida Nanon

Dissertations

Augmented Reality (AR) technology provides an effective and controllable learning environment, especially for complicated, potentially dangerous, or critical content. Effective implementation of interaction and platforms for educational tools can maximize learner engagement and optimize the learning experience. This dissertation explores the potential of AR technology to enhance learning experiences across multiple platforms and subject areas, particularly within chemistry and mathematics. The dissertation is grounded in the field of Human-Computer Interaction (HCI) and explores the potential of AR to increase learner engagement, improve learning outcomes, and transform traditional pedagogical practices.

The dissertation is divided into two parts. The first part examines …