Digital Commons Network^™

Welcome Video Impact On Candidate Conversion To Matriculated Student: Dpt Program Case Study, Debra Beazley, Stephen Elam

Internet Journal of Allied Health Sciences and Practice

Purpose: This study examines the influence of a relationship marketing-inspired welcome video on the matriculation decisions of Generation Z candidates accepted into a Doctor of Physical Therapy (DPT) program in central Virginia. The Generation Z cohort, characterized as digital natives sensitive towards authentic, personalized communication, represents a significant segment of the higher education market. Utilizing the Generational Cohort Theory, this research explores how tailored marketing efforts can effectively engage this group. Methods: The study involved 163 applicants, 107 offers, and 52 students who accepted a position in the 2027 cohort, with 53% of these students receiving the welcome video in …

Doctor Of Physical Therapy Programs Report Teaching Telehealth With Large Discrepancies: A United States Survey, Jason Ashby, Jean-Michel Brismée, Derrick F. Campbell

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study was to describe the extent to which telehealth is taught in entry level Doctor of Physical Therapy (DPT) programs in the United States, and to describe where it is taught in the curriculum. Method: A survey was sent during spring 2023 to 254 United States DPT program directors using email addresses from the Commission on Accreditation in Physical Therapy Education (CAPTE) list of accredited DPT programs, with questions regarding telehealth education within the didactic and clinical portions of the programs. Results: Twenty-nine responses (11.4%) were received. Two participants did not complete the survey and …

The Current Status Of Multi-Modality Imaging Of Pulmonary Emboli, Rodney C. Fisher, Kimberly L. Onstott

Internet Journal of Allied Health Sciences and Practice

Background: Pulmonary emboli (PE) have a significant incident rate of 112.3 per 100,000 adults. When age-weighted, the population over 75 has an incident rate of 1 out of 100. 90% of deaths from acute cases occur within two hours of the onset of symptoms. In pregnancy-related deaths, 20% are attributed to PE, and pregnancy increases the risk of the development of PE by 400 – 600%. Significant risk factors for PE include COPD, obesity, recent trauma or surgery, a history of deep vein thrombosis (DVT), a history of hormonal therapy, smoking, and pregnancy. Purpose: This literature review discusses how PE …

Liveocean, Parker Maccready, Jilian Xiong, Roxanne Carini, Jan Newton

Benefits of Ocean Observing Catalog (BOOC)

LiveOcean is a realistic numerical model of ocean circulation and biogeochemistry for the coastal and estuarine waters of the Salish Sea and Pacific Northwest. Daily three-day forecasts are processed into different formats that provide useful information for a wide variety of stakeholders. Applications include predictions of hypoxia, ocean acidification, harmful algal bloom movement, and the effects of treated sewage discharge. The model also has an archive of over a decade of hindcasts which are used in several basic science research projects.

An Interprofessional Simulation To Address Health Misinformation And Vaccine Hesitancy, Sara W. Nelson, Leah Mallory, Shelly Cohen Konrad, Emily K. Dornblaser, Stephanie D. Nichols, Jennifer Hayman

Journal of Maine Medical Center

Introduction: The complexity of contemporary health care delivery underscores the need for future health care professionals to be adept at working in interprofessional teams and effectively managing the growing issue of medical misinformation. However, current health curricula often lack content on misinformation and have few, if any, opportunities for students to practice addressing misinformation with patients and colleagues.

Methods: To address this gap, our cross-institutional team developed a novel interprofessional simulation exercise and accompanying prework toolkit designed to develop communication skills for managing difficult conversations about COVID-19 misinformation. Ten third-year medical and 10 third-year pharmacy students piloted the toolkit and …

Estate Planning: Sec. 2039: Keeping Nonqualified Deferred Compensation Benefits Out Of The Estate, Joan Ellenbogen

Tax Adviser

No abstract provided.

Little Changes, Jessica Wolfe

HCA Healthcare Journal of Medicine

This collage is made of hundreds of small pieces of paper cut from old magazines and junk mail. As I worked on it, I thought about how each tiny piece of paper alters the canvas in a nearly imperceptible way, but the shapes and colors could shift completely in the course of an hour. This concept of making small changes is something I think a lot about in my work as a psychiatric nurse as well. Even though it doesn’t always feel like it, we become wiser each day. By looking for these small opportunities to evolve, we can build …

Breath Of Life, Cynthia Borum, Colleen Dowd, Meg Underwood, Shauna Graham, Terri Schmidt, Linda Myers

HCA Healthcare Journal of Medicine

We meet for friendship, laughter, and spending time together. Each person paints a 6 X 6 inch tile, some more competent than others. Each person comfortably shares their painting without judgment, and we are proud of what our bond produces. The output keeps us going with a refreshing breath of life. You see, we also work together every day in health care.

A Resident, Angelina Hong

HCA Healthcare Journal of Medicine

We are all passengers in this life, with unique trails and destinations but many common intersections along the way. I have always been fascinated by the multidimensional nature of the hospital—a place of hope, love, pain, mourning, reflection all at once, not only for patients, but also for friends, family, and employees. At times, journeys become so layered and intertwined that the lines between these different roles are blurred, seemingly dissolving the classical hierarchy we rely on to differentiate physicians, residents, nurses, patients etc. At the end of the day, we are all people persevering and growing the best we …

The Commonly Uncommon Presentation Of Cerebral Venous Thrombosis: A Case Report, Elizabeth Piwowarski, Kalyan Mantha, Martin Wegman

HCA Healthcare Journal of Medicine

Introduction

Cerebral venous thrombosis (CVT) is notoriously misdiagnosed as more benign etiologies during the initial examination owing to its relative rarity, its wide variety of presenting symptoms and onset and progression patterns, and its frequent requirement for less commonly utilized imaging techniques in its diagnosis. Accordingly, most cases are identified only after repeated evaluations for symptom persistence or progression, or in cases involving prothrombotic states linked to the disease, such as pregnancy, puerperium, genetic or acquired thrombophilia, and infection.

Case Presentation

We present the case of a 29-year-old woman with a history of obesity and oral contraceptive use who was …

Persistent Lichenoid Reaction And Eruptive Keratoacanthomas Following Pd-1 Inhibitor Therapy, Paul Vance, Michael Hohnadel

HCA Healthcare Journal of Medicine

Background

Immune checkpoint inhibitors, such as nivolumab, have become integral in treating metastatic malignancies by enhancing immune responses against tumors. However, they are associated with immune-related adverse events (irAEs), including cutaneous reactions. We report a case of persistent lichenoid dermatitis during therapy and eruptive keratoacanthomas (KAs) following the cessation of nivolumab.

Case Presentation

A 77-year-old Caucasian man presented with a subcutaneous melanoma on the left lateral chest, treated with excision followed by adjuvant nivolumab. Seven weeks into therapy, he developed pruritic erythematous macules, forming patches on his forearms, later spreading to his trunk. Biopsy confirmed lichenoid dermatitis. Treatment with triamcinolone …

Unraveling The Threads: A Case Report On Confusional Migraine And The Intricate Dance Between Psychiatry And Neurology, Mabit C. Gonzalez, Manjula Kottapalli

HCA Healthcare Journal of Medicine

Background

Migraine affects about 1 billion people worldwide and is associated with a significant negative impact on personal and occupational functioning. Migraine accompanied by aura is seen in about 15% of migraineurs. Visual aura is the most common type of aura. Much less common though are auras that involve higher mental function, such as confusional state. The confusional state may manifest with a wide variety of cortical dysfunction, such as speech impairment, increased alertness, agitation, and amnesia, often lasting longer than a typical migraine aura.

Case Presentation

The authors present the unique case of a 29-year-old patient with episodic and …

Unique Presentation Of Vertebral Artery Dissection: A Case Report, Rossen I. Kirkov, Daniel Fisher

HCA Healthcare Journal of Medicine

Background

Vertebral artery dissection (VAD) is a common cause of stroke within the younger patient population. It is usually associated with headache or neck pain, as well as signs and symptoms of a posterior circulation stroke, such as vertigo, dysarthria, and ataxia. However, there are very scarce reports of patients with this pathology presenting with focal neurologic deficits, which are more indicative of a cerebral stroke.

Case Presentation

This case involves a 46-year-old woman who presented to the emergency department (ED) with complaints of right-sided headache and neck pain, which had been ongoing for 1 week, with newly developed right …

Complications And Management Of Idiopathic Multicentric Castleman Disease, Kavanya Feustel, Jacob W. Keeling, Olivia Makos, Dmitriy Scherbak

HCA Healthcare Journal of Medicine

Background

The pathophysiology of idiopathic multicentric Castleman disease (iMCD) is poorly understood compared to the other subtypes of MCD, which has contributed to limited treatment options and poor prognosis for iMCD patients. The pathogenesis of iMCD is thought to be mediated in part by dysregulation of interleukin (IL)-6.

Case Presentation

We present a case report of a 39-year-old Caucasian man with siltuximab-refractory iMCD. He presented with severe lower extremity lymphedema and wounds. His disease progressed through standard-of-care siltuximab. Due to his severe disease-related morbidity, he contracted recurrent infections, often complicated by sepsis. Ultimately, he required a left lower extremity amputation. …

Long-Term Autoimmune Polyarthritis Due To Covid-19 Vaccine, Ramesh Pandit, Namratha Pallipamu, Trupiti Pandit

HCA Healthcare Journal of Medicine

Background

Vaccinations for COVID-19 have played a pivotal role in controlling the global pandemic, with most adverse events being mild and transient. However, rare post-vaccination autoimmune responses have been reported. The understanding of long-term rheumatologic sequelae, particularly autoimmune polyarthritis following COVID-19 vaccination, remains limited.

Case Presentation

We report the case of a 41-year-old previously healthy man who developed progressive polyarthritis and systemic symptoms following the Johnson & Johnson COVID-19 vaccine. The initial symptoms of joint swelling and arthralgia appeared within a week of the first vaccine dose, subsiding temporarily with medication. After receiving a booster dose, the patient experienced worsening …

Covid-19 Vaccine-Induced Rhabdomyolysis In A 53-Year-Old Woman, Akash Hazari, Jack Chien, Daniel Nunez

HCA Healthcare Journal of Medicine

Introduction

COVID-19-induced rhabdomyolysis is a common complication in COVID-19 infection. However, only a handful of cases have been reported showing links between COVID-19 vaccine and rhabdomyolysis.

Case Presentation

We present the case of a 53-year-old woman, who recently received COVID-19 vaccine and presented to the hospital with progressive extremity weakness. Common reasons for rhabdomyolysis were ruled out as possibility and the patient was found to have rhabdomyolysis induced from COVID-19 vaccine.

Conclusion

Even though COVID-19 vaccine-induced rhabdomyolysis is rare, it should be considered in the differential diagnosis with patients presenting with neuromuscular complaints and a recent COVID-19 vaccine.

Clinical Outcomes After Hospitalization For Acute Coronary Syndrome In Patients Treated With Semaglutide Versus Bariatric Surgery: A Retrospective Multicenter Analysis, Nameer Ascandar, Charles Boadu, Gauthier Stepman, George Skaf, Olugbenga Oyesanmi, Sabry Omar, Rias Ali, Michael Schandorf-Lartey

HCA Healthcare Journal of Medicine

Background

Obesity is a chronic medical condition with a rising prevalence in the United States. A wide range of morbidity and mortality is associated with obesity, with coronary artery disease being among the most common. Ischemic heart disease continues to be the primary cause of death in the United States. Taken together, interventions to minimize the detrimental effects of obesity on patients at risk of heart disease will not only benefit the patient, but the health care system as well.

Methods

In this retrospective study, we used the HCA Healthcare enterprise data warehouse to identify all adult patients who were …

The Prevalence Of Abdominal Compartment Syndrome In The State Of Florida, Jason M. Clark, Laura Mena-Albors, Huazhi Liu, Darwin Ang

HCA Healthcare Journal of Medicine

Introduction

Abdominal compartment syndrome (ACS) is associated with significant mortality. Multiple studies have evaluated the prevalence of ACS at individual institutions and/or for short durations. No study has looked at the change of prevalence over an extended time or included nonresearch institutions. This study aims to evaluate the trend in the prevalence of ACS over time within the state of Florida.

Methods

This is a population-based retrospective study using deidentified data from the Florida’s Agency of Healthcare Database between 2006 and 2021. A total of 16 217 617 patients were evaluated within the intensive care unit (ICU), with 4002 developing …

Care Alert Program In Chronic Emergency Department Using Patients: Expanded Study, Jonathan Leggett, Kaitlyn Phelps, David Nuñez, Brent Wright, Erica Gibbons, Jonathan Bryan, Brian Griggs

HCA Healthcare Journal of Medicine

Introduction

The Care Alert Program (CAP) is designed to help navigate encounters with patients who are high utilizers of Emergency Department (ED) resources. The CAP intends to address the needs of this challenging patient population by designing individualized care plans that are approved by a multidisciplinary committee. The patient populations that frequently use ED resources often have chronic medical conditions, a poor understanding of their conditions, unrealistic expectations regarding treatment, a lack of outpatient resources, and present with multiple complaints when using ED resources.

Methods

The CAP was adopted by our facility in the spring of 2020. The present study …

Automated Dispensing Cabinet Stocking Schedule And Inventory Management Optimization, Daniel Elkes, Victoria Timmons

HCA Healthcare Journal of Medicine

Background

Prior practice in a 523-bed community hospital required automated dispensing cabinets (ADCs) to be replenished daily by early afternoon to ensure accurate drug ordering. Because of the tight time window, technicians frequently refilled ADCs during peak medication administration times. After a positive report from a smaller facility in the health system, the study facility implemented a quality improvement project to optimize the ADCs. This involved new processes of every-other-day ADC replenishment staggered via shift-specific workflows, and a dedicated technician was assigned to optimize ADC inventories.

Methods

Monthly reports of ADC refilling and dispensing transactions were compiled from inpatient, nonprocedural …

Efficacy And Safety Of Lotilaner Ophthalmic Solution 0.25% In Demodex Blepharitis: A Systematic Review, Stephanie P. Fabara, Thalia Fabara, Akankcha Alok, Nausheen Khuddus

HCA Healthcare Journal of Medicine

Demodex blepharitis is a chronic eyelid inflammation caused by Demodex mites, which are ubiquitous skin parasites. Lotilaner, a newly United States Food and Drug Administration (FDA)-approved drug, is an antiparasitic agent that selectively inhibits parasite-specific γ-aminobutyric acid chloride channels, inducing spastic paralysis and death of Demodex mites. It is applied as an ophthalmic solution, 0.25%, twice a day for 6 weeks, and it has a long half-life and high lipophilicity, facilitating the penetration of the drug into the eyelash follicles and meibomian glands where the mites reside. This study systematically reviewed 6 clinical trials that compared lotilaner with placebo for …

Beneath The Label - Evaluating The Fda Approval Of Copenhagen Classic Snuff As A Modified Risk Tobacco Product, Yisroel Grabie, Tafani Chowdhury, Sudeep Acharya

HCA Healthcare Journal of Medicine

In this review, we critically evaluate the Food and Drug Administration's modified risk tobacco product (MRTP) status granted to a smokeless tobacco product (March 2023), Copenhagen Classic Snuff (CCS). This new status necessitates an assessment of the product CCS use and its public health impacts. We assess the impact of CCS as it relates to the reduction of lung cancer risk and the potential increased risk for nasopharyngeal cancer, chronic rhinitis, nicotine dependence, and other health hazards. Concerns persist regarding nicotine's harm and public misperception due to risk reclassification, and caution should be maintained to discourage novel snuff users. Advocating …

The Relationship Between Fast Food Consumption And Physical Activity With Primary Dysmenorrhea In Adolescents, Wahyuni Wahyuni

Jurnal Vokasi Indonesia

Background: Menstruation is a bleeding event that occurs when the inner lining of the uterus, known as the endometrium, sheds. Dysmenorrhea is one of the symptoms that teenage girls often feel during menstruation. Dysmenorrhea can affect women's comfort and quality of life. There are two types of dysmenorrhoea, namely primary dysmenorrhea and secondary dysmenorrhoea. Primary dysmenorrhoea refers to the condition of menstrual pain that adolescent girls often experience, with a prevalence rate of 60-90%. Risk factors for primary dysmenorrhoea are influenced by several factors, including fast food intake, physical activity level, stress level, age at first menstruation (menarche), and nutritional …

A Review Of Medications Listed In The 2023 Beers Criteria, Hanh Motilall, Kelley Maberry, Connor Quinter

Transformative Medicine

The American Geriatrics Society’s (AGS) 2023 Beers Criteria identifies potentially inappropriate medications (PIMs) to use in geriatric patients defined as greater than or equal to 65 years of age. This population experiences pharmacokinetic and pharmacodynamic changes, which raise the risk of potentially harmful side effects. The Beers Criteria were developed as a clinical tool to help healthcare providers improve medication safety in this vulnerable population. The main focus of this article is on commonly seen medications and the rationale for recommended avoidance in geriatric patients. Additionally, a table of potentially clinically important drug-drug interactions that should be avoided in older …

"What Is Causing This Sinus Tachycardia?", Muhammad Asad Hanif, Nayab Mirza, Jaswanth Jasti

Transformative Medicine

No abstract provided.

Neurosarcoidosis Presenting As Cauda Equina Syndrome: Case Report And Review Of The Literature, Benjamin Millar, Lauren Carmody, Fnu Naintara, Tara Dutta, Abhinav Hoskote

Transformative Medicine

Background

Sarcoidosis is a systemic immune disease with an unknown trigger, identified histologically by non-caseating granulomas. Neurosarcoidosis is a subset in which granulomatous inflammation infiltrates the central or peripheral nervous system. Sarcoid myelopathy affects a very small fraction of sarcoidosis patients. We present here the case of a 35 year old male who presented primarily for cauda equina symptoms.

Case Presentation

A 35-year-old Caucasian male with past history of hypertension, Hashimoto's thyroiditis, and type II diabetes mellitus presented to the emergency department complaining of a headache with left sided face numbness and periorbital swelling. He reported two months of gradual, …

Bilateral Patellar Tendon Rupture: Obesity As A Risk Factor, Alyssa Ison, Adam Sigal Md, Gary Canner Md

Transformative Medicine

Introduction
Bilateral patellar tendon rupture is an uncommon presentation in the Emergency Department but can occur in the setting of certain risk factors. Obesity is an independent predisposing condition in which early identification can expedite diagnosis and treatment.

Case Description
We report a case of bilateral patellar tendon rupture in a young male with obesity as the sole risk factor following a low-energy trauma. The patient ruptured his bilateral patellar tendons while jumping up during a basketball game. The diagnosis was made on exam and confirmed with plain radiographs and Magnetic Resonance Imaging. Because of the bilateral involvement and inability …

Retrospective Analysis Of Bleeding And Wound Complications After Preoperative Administration Of Ketorolac In Acute Appendicitis, Kate Yurick Md, Jahan Aslami Ms, John Lemoine Bs, Luke Rovenstine Bs, Tan Tran Bs, Traci Deaner Msn, Rn, Thomas Wasser Phd, Adam Sigal Md

Transformative Medicine

ABSTRACT:

Introduction:

Opioids are a mainstay of acute pain management and provide excellent analgesia for severe pain. However, their side effect profile and complication rates raise concerns regarding routine administration.

Methods:

This study is a retrospective cohort study of 1415 patients in a single tertiary care center comparing bleeding and operative complications in patients administered ketorolac prior to appendectomy.

Results:

There was no difference between the ketorolac and non-ketorolac groups regarding blood loss (0.7% vs 0.6%, p=0.572) and hemoperitoneum (0.4% vs 0.6%, p = 0.43) There was no difference between the groups regarding need for re-exploration (0.6% vs 0.6%, …

Effect Of Expanded Perlite And Exfoliated Vermiculite Aggregate Additives On Water Vapor Permeability Performance Of Cement-Based Lightweight Mortars, Lütfullah Gündüz, Şevket Onur Kalkan

Journal of Sustainable Construction Materials and Technologies

Vapor diffusion is the movement of water vapor molecules through porous materials such as wood, insulation products, and lightweight wall elements due to differences in vapor pressure. Vapor retarders are used to control vapor diffusion through wall sections and surfaces. All building materials provide some resistance to vapor diffusion, and the amount of resistance varies depending on the material's properties. These properties can vary with relative humidity and moisture content, age, temperature, and other factors. Vapor resistance is usually expressed using the inverse term of ``vapor permeability,'' which is the relative ease of vapor diffusion through a material. Water vapor …

Identification Of Barriers And Drivers In The Adoption Of Sustainable Construction Practices In The Turkish Construction Industry: Exploratory Factor Analysis, Tülay Çivici, Mustafa Serhan Ünlütürk

Journal of Sustainable Construction Materials and Technologies

Although the importance of sustainability in the construction industry has been emphasised by many researchers and endorsed by many authorities, it is clear that the practices in the industry still need to be improved. The primary issue for adopting sustainable practices in the construction industry is identifying the barriers and drivers. For this reason, the study analysed the literature to identify the critical barriers and incentives for adopting sustainable practices in the construction industry. In light of the information from the literature, the necessary barriers and motivators in adopting sustainable practices in the construction industry were determined, and a questionnaire …