Digital Commons Network^™

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.

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 …

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 …

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 …

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 …

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 …

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 …

Differential Item Functioning Of The Region-Based National Examinationequipment, Adi Setiawan, Gulzhaina Kuralbaevna Kassymova, Vianney Mbazumutima, Anggit Reviana Dewi Agustyani

REID (Research and Evaluation in Education)

This research aims to detect Differential Item Functioning (DIF) in the 2014/2015 National Examination Questions in mathematics of junior high schools and equivalent- level schools in the Yogyakarta region as a reference group and the South Kalimantan region as a focus group using the Likelihood Ratio Test (LRT) method, Area Measure Raju, and Lord. A sensitivity analysis was conducted to determine the most sensitive method. The data consisted of 5,465 National Examination papers of the students from the two regions who worked on type A questions. A sample of 1,000 exam papers for each region was established using the simple …

Exploring The Perceptions Of Literacy In Assessment For Learning Among High School English Teachers, Sukarno Sukarno, Nur Hidayanto Pancoro Setyo Putro, Ihtiara Fitrianingsih, Yasir Ayed Alsamiri, Fadhl Mohammed Awadh Gharamah, Ingrid A. Gavilan Tatin

REID (Research and Evaluation in Education)

In the field of English language education, the crucial role of assessment for learning (AfL) requires teachers to possess robust assessment literacy. This study explores AfL literacy among high school English teachers in Yogyakarta, Indonesia by utilizing Alonzo's validated AfL survey that establishes a comprehensive six-factor model, delineating teachers as assessors, pedagogists, student partners, motivators, learners, and stakeholder partners. Exploiting confirmatory factor analysis and examining demographic variations, this quantitative research invited 202 English teachers in the Special Region of Yogyakarta, Indonesia selected purposively based on the geographical service area. Data were collected through an online questionnaire adopting Alonzo's 42-questions AfL …

2024 Scholarly Productivity Report, Missouri University Of Science And Technology

Civil, Architectural and Environmental Engineering Scholarly Productivity Reports

No abstract provided.

Advanced Worker's Compensation, Indiana Continuing Legal Education Forum (Iclef)

Indiana Continuing Legal Education Forum 2024

Meeting proceedings of a seminar by the same name, held July 25-26, 2024.

Cme For Family Mediators, Indiana Continuing Legal Education Forum (Iclef)

Indiana Continuing Legal Education Forum 2024

Meeting proceedings of a seminar by the same name, held September 27, 2024.

Handling Cases Involving Eggshell Plaintiffs, Indiana Continuing Legal Education Forum (Iclef)

Indiana Continuing Legal Education Forum 2024

Meeting proceedings of a seminar by the same name, held April 18, 2024.

The Ethics Triangle, Indiana Continuing Legal Education Forum (Iclef)

Indiana Continuing Legal Education Forum 2024

Meeting proceedings of a seminar by the same name, held August 29 & October 10, 2024.

Law & The Good Life, Indiana Continuing Legal Education Forum (Iclef)

Indiana Continuing Legal Education Forum 2024

Meeting proceedings of a seminar by the same name, held November 19, 2024.

Construction Accident And Commercial Premises Liability Cases, Indiana Continuing Legal Education Forum (Iclef)

Indiana Continuing Legal Education Forum 2024

Meeting proceedings of a seminar by the same name, held September 24, 2024.

Elder Law Institute, Indiana Continuing Legal Education Forum (Iclef)

Indiana Continuing Legal Education Forum 2024

Meeting proceedings of a seminar by the same name, held October 3-4, 2024.

Understanding Barriers To Optimal Supervision And Delivery Of The Nationalcertificate (Vocational) Curriculum Through Tvet College Lecturers’Reflective Evaluations, Angelona Rewhydah Williams, Karel Prins, Bongani Innocent Nkambule, Sindile Amina Ngubane

REID (Research and Evaluation in Education)

Propounded by reflective theory, this qualitative case study drew on TVET lecturers' reflective evaluations of factors that they considered to have a bearing on optimal supervision and delivery of the National Certificate (Vocational) curriculum. Data were collected from participants across three campuses of a TVET college in the Eastern Cape Province, South Africa. Twelve lecturers of different seniority were purposively sampled and interviewed in two focus group sessions. The first focus session involved six participants: four post-level 2 and two post-level 3 personnel recognized by the South African Council for Educators (SACE) as "office-based lecturers" and classified within the middle …

22nd Annual Family Law Institute, Indiana Continuing Legal Education Forum (Iclef)

Indiana Continuing Legal Education Forum 2024

Meeting proceedings of a seminar by the same name, held November 14-15, 2024.