Presentations Of Cutaneous Disease In Various Skin Pigmentations: Tinea Corporis, Braden Van Alfen, Navya Peddireddy, Marshall Hall, Henry Lim, Christian Scheufele, Garrett Furth, Dustin Wilkes, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Tinea corporis is a common superficial fungal infection caused by dermatophytes. It typically presents as well-defined, pruritic, annular papules and plaques with central hypopigmentation. The differential diagnosis includes pityriasis rosea, nummular dermatitis, plaque psoriasis, tinea versicolor, granuloma annulare, and discoid lupus. This article compares different presentations of tinea corporis in various skin types as classified by the Fitzpatrick scale. Recognizing varying presentations of tinea in patients of different skin tones will aid in early and appropriate diagnosis and treatment.

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Keratosis Pilaris, Henry Lim, Reem Ayoub, Madelyn Richards, Marshall Hall, Christian Scheufele, Dustin Wilkes, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Keratosis pilaris (KP) is a common benign disorder involving hyperkeratosis of the skin. It is associated with other common dry skin disorders such as atopic dermatitis and ichthyosis vulgaris. Lesions are clinically characterized as symmetrically distributed, monomorphic, folliculocentric, hyperkeratotic papules with a variable degree of perifollicular erythema. The appearance can be likened to spikey bumps that are commonly located on the arms, legs, and buttocks. Awareness of KP is important as every primary care clinician will see patients with this disorder. Identification can support the diagnosis of other associated skin diseases. Education about KP and its treatment may alleviate psychological …

Clinical Characteristics Of Patients With Lower Extremity Amputation During Inpatient Rehabilitation And Its Predictors For Home Discharge, Se Won Lee, Duke Shen, Ning Cao

HCA Healthcare Journal of Medicine

Background

Lower limb amputations significantly impair the mobility and activities of daily living (ADLs) and frequently require inpatient rehabilitation with opioid analgesics to control pain. Large-scale studies of clinical characteristics specific to rehabilitation outcomes after lower limb amputations are limited in the current literature. Identifying the associations between specific clinical characteristics and opioid analgesic use with home versus non-home discharge can help improve care for patients undergoing inpatient rehabilitation after lower-limb amputations.

Methods

In this retrospective study, we examined 1611 patients from 58 inpatient rehabilitation units who underwent transfemoral or transtibial amputations between January 2021 and December 2022, identified using …

Safety And Feasibility Of Same-Admission Transcarotid Arterial Revascularization Prior To Heart Surgery For Patients Presenting With Concurrent, Severe Carotid Artery Stenosis, And Surgical Cardiac Disease, Brittany Landavazo, Matthew D. Kenny, Chandler Vernon, Nicolas Zea, David Nation, Bradley Boone, Jeff Apple, Kofi Quaye, Shir Yelovitch, Ryan S. Turley

HCA Healthcare Journal of Medicine

Introduction

Carotid artery stenosis and coronary artery disease are often co-morbid, with a prevalence of concurrent carotid and coronary artery stenosis approaching 50%. The optimal treatment for these patients has long been debated, with open carotid revascularization generally reserved for those with severe symptomatic carotid disease that precludes cardiac surgery. In this scenario, the role of less-invasive carotid artery stenting, particularly transcarotid arterial revascularization (TCAR), remains controversial and is not yet well studied. This study aims to present our outcomes and methodology for treating severe carotid stenosis with TCAR prior to cardiac surgery.

Methods

A retrospective chart review of the …

Expanding Waste Segregation Initiatives To Reduce Regulated Medical Waste: A Multi-Departmental Quality Improvement Project, Emily M. Su, Anuja L. Sarode, Mohammed Sami, David R. Nehring, Erica L. Laipply, Mustafa Culcuoglu

HCA Healthcare Journal of Medicine

Background

Regulated medical waste (RMW) drives up health care costs, largely due to misclassification of general waste, especially in operating rooms (ORs), intensive care units (ICUs), and obstetrics and gynecology (OBGYN) departments. This study aimed to reduce RMW volume and costs at Akron City Hospital (ACH) through department-specific interventions aligning with Occupational Safety and Health Administration (OSHA) and Ohio Environmental Protection Agency guidelines.

Methods

Periodic analyses compared hospital-wide aggregate RMW volume, pick-up frequency, and disposal costs before and after interventions. The ORs initiated interventions in October 2022, expanding to ICUs and OBGYN by February 2024. Strategies included staff education, flyers …

Impact Of Palliative Care Consultation On Clinical Interventions And Outcomes In A Medical-Surgical Community-Based Intensive Care Unit, Manjot S. Malhi, Jude Tabba, Aunie M. Danyalian, Michele Iguina, Daniel Zapata, Raiko Diaz, Dionne Morgan, Daniel Heller, Sanaz Kashan, Mauricio Danckers

HCA Healthcare Journal of Medicine

Background

Integrating palliative care into intensive care unit (ICU) practice is an essential component of comprehensive patient management, ensuring that critical interventions are aligned with patient-centered care objectives. This study aims to evaluate the impact of palliative care consultation (PCC) on clinical interventions, patient outcomes, and decision-making processes in a community-based medical-surgical ICUs.

Methods

We conducted a prospective, observational, single-center cohort study of critically ill adult patients in a community-based medical-surgical ICU. Patients were grouped by the presence (PCCP) or absence (PCCA) of palliative care consultation. Primary outcomes included differences in clinical interventions (mechanical ventilation, vasoactive medications, renal replacement therapy, …

Replicability Of Highly Cited Comparative Studies In Orthopedic Journals, Cody Ashy, William E. Few, Gabriella A. Rivas, Emily Brennan, Langdon Hartsock, Kristoff R. Reid

HCA Healthcare Journal of Medicine

Introduction

Concerns are rising regarding the quality, validity, and reliability of clinical research findings in medical literature. This investigation sought to identify the most cited orthopedic clinical studies and assess the replicability of the findings reported.

Methods

Web of Science was used to identify the top ten orthopedic surgery journals by impact factor from which primary comparative studies cited at least 250 times were identified. A second literature search identified follow-up studies relevant to the respective primary studies. Studies investigating the same intervention via parallel methodology were summarized and their conclusions compared to their respective highly cited primary study.

Results …

Exploring The Effects Of Traumatic Brain Injuries On Cranial Nerve Injury, Caitlin J. Mcpartland, Michael J. Pienkos, Sarah E. Johnson, Saptarshi Biswas

HCA Healthcare Journal of Medicine

Background

Traumatic brain injuries (TBI) are a significant and growing health issue, leading to over 200 000 hospitalizations annually in the United States. Cranial nerve (CN) injuries accompanying TBI can severely impact patients’ quality of life. This review aims to address the gap in research regarding the severity, mechanisms of injury, and associated intracranial injuries, emphasizing the importance of early detection and intervention.

Methods

A comprehensive literature search was conducted across databases such as PubMed and Ovid using key terms, including “cranial nerve injury,” “cranial nerve palsy,” “traumatic brain injury,” and “Glasgow Coma Scale.” Inclusion criteria encompassed studies reporting CN …

The Efficacy Of The Fitzpatrick Scale In Clinical Practice, Dana Olsen, Cecilia Nguyen, Marshall Hall, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Many skin diseases can manifest differently depending on the pigment of one’s skin. The Fitzpatrick scale is a classification of phototypes (I-VI) that categorizes patients' skin based on its ability to tan and burn. Even though it is a simple questionnaire, the Fitzpatrick scale has numerous criticisms due to its dependence on patients’ self-perception, variability in how questions are asked, limited range, and the underestimation of the risk of skin cancers. Alternatives to the Fitzpatrick scale include the melanin index, pigment protection factor, a visual color scale, and using artificial intelligence along with existing or new scales. Having a more …

An Acknowledgement To The Hca Healthcare Journal Of Medicine's Reviewers And Editors For The Second Half Of 2025, Juan A. Sanchez, Graig Donini

HCA Healthcare Journal of Medicine

The HCA Healthcare Journal of Medicine would like to thank those behind the scenes who make this publication possible. Our journal would not be possible without the assistance of our peer reviewers, authors, and board members.

Electromagnetic Pins For Forest And Landscape Surveying, Djamila Hassan Djibril Professor

Defensive Publications Series

With As technology spreads, it is essential that forest management technologies follow the guiding principles of near-natural forest management, which include using tree species adapted to the site, growing forests that are structurally diverse, mixed and age-appropriate, avoid clear cutting, emphasis stability of the soil, and focus on individual tree growth. Many of the ideas and methods used in near-natural forest management are similar to those of complexity science. Examples include the importance given to diversity and structural differences.[1]. In this review paper we present a new scientific solution for Marker surveying and forest scaling and forest size structure , …

Evaluating Regularized Logistic Regression And K-Nn On Mnist Under Increasing Random Missingness, Daniel Markwei

Data Science and Data Mining

This paper investigates the effect of random missingness on the performance of regularized multinomial logistic regression and the k-nearest neighbors (k-NN) classifier for handwritten digit recognition on the MNIST dataset. In particular, we study L1-regularized (LASSO) logistic regression and L2-regularized (Ridge) logistic regression alongside k-NN. Varying percentages of random missingness were introduced into the original dataset, and each model was evaluated in terms of its classification performance. The results show that random missingness degrades the performance of all three classifiers. Overall, k-NN consistently achieves higher accuracy than both L1- and L2-regularized logistic regression across all missingness levels; however, its performance …

The Effectiveness Of A Proposed Brain-Targeted Instruction Program Based On Mariel Hardiman’S Model To Develop Sustainable Thinking Skills And Reduce Cognitive Failure Rate In The Ecology Course Among First-Year Secondary Students, Dr. Misfer Khafir Al-Qarni

University of Bisha Journal for Educational Sciences

The research aimed to reveal the effectiveness of a brain-targeted instructional program based on Mariale Hardiman’s model in developing sustainable thinking skills and reducing cognitive failure among first-year secondary stage students in the Ecology course. The research adopted the experimental method using a quasi-experimental design (experimental and control groups with pre- and post-testing). The research population consisted of first-year secondary stage students in Bisha city. A random sample of (59) students was selected, with (31) in the experimental group and (28) in the control group. The research materials and instruments included the proposed instructional program, a sustainable thinking skills test, …

Implementing Handwritten Notetaking : An Action Research Study Of Efl University Students’ Practices, Engagement, And Grammar Retention, Haifa Al-Amri

University of Bisha Journal for Educational Sciences

This paper reports on an action research study designed to enhance EFL university students’ grammar retention and increase their engagement through handwritten notetaking, while also examining their current notetaking practices. The study used a mixed-methods approach: The effect on grammar retention was assessed using a pre and post-test, while notetaking practices were assessed through analysis of students’ notes, and engagement was assessed through classroom observation and an open-ended questionnaire. The findings revealed that the intervention resulted in no statistically significant difference in the students’ grammar pre- and post-test scores. Furthermore, an examination of students’ notes revealed a deficiency in critical …

The Reality Of Practicing Proactive Leadership From The Perspective Of Faculty Members At The University Of Bisha: A Mixed-Methods Study, Wafaa Abdullah Farhan Al-Amari

University of Bisha Journal for Educational Sciences

The research aimed to examine the reality of proactive leadership at the University of Bisha from the perspective of faculty members, identify the requirements necessary to activate this type of leadership, and explore the challenges that hinder its implementation. In addition, it sought to determine whether there are statistically significant differences in proactive leadership practices based on academic rank and gender. The research adopted a mixed-methods approach, combining quantitative and qualitative data to achieve a comprehensive and in-depth understanding of the phenomenon. Data were collected through a questionnaire distributed to faculty members and administrators (quantitative method), as well as in-depth …

Students, Ai, And Scholarly Integrity: A Hermeneutic Phenomenology Of Postgraduate Research Practices In Saudi Higher Education, Maryam Jamal Alharthi

University of Bisha Journal for Educational Sciences

Background: This qualitative study explores how Master’s students in educational psychology at a Saudi university negotiate artificial intelligence AI use in research and coursework. Methods: The study adopted a hermeneutic phenomenological design, drawing on semi-structured interviews with seven eligible students in Medina, and analysed them thematically. The interpretive lens was informed by the Technology Acceptance Model/Unified Theory of Acceptance and Use of Technology (perceived usefulness, ease of use, social influence), Bourdieu’s cultural capital (1977), and a sociocultural perspective (e.g., Vygotsky, 1978) on institutional norms. Findings: Five interconnected themes captured student engagement with AI: (1) patterns of use and functional perceptions, …

Client Feedback Effects On Enjoyment, Motivation And Self-Efficacy In A Project-Based Learning Course, Krista Stacey, David M. Bourrie

University Faculty and Staff Publications

This paper reports a mixed-methods evaluation of how feedback/project source (faculty-led versus client-led) shapes student outcomes in a two-course undergraduate game and simulation development sequence (N = 29 across two academic years). Quantitative measures (enjoyment, intrinsic motivation, self-efficacy) were collected with a six-point Likert survey and analyzed, but due to small sample sizes were not used to empirically evaluate the constructs. Instead, qualitative data comprised of de-identified focus-group transcripts and open-ended survey responses were analyzed with a keyword-assisted codebook and manual validation. Year 1 (faculty feedback) exhibited more consistent post-course gains, especially in self-efficacy, while Year 2 (client feedback) produced …

Dampak Penerapan Integrated Care For Older People Dan Ina-Frail Dalam Menurunkan Sindroma Kerapuhan Pada Lansia, Mochamad Ramadhan Arista Pesat Eka Putra, Vetty Yulianty Permanasari

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Indonesia is facing a significant increase in its elderly population, requiring effective and sustainable integrated geriatric services, one of which is through the implementation of Integrated Care for Older People (ICOPE) to assess intrinsic capacity decline combined with the Ina-FRAIL questionnaire to measure frailty in the elderly. This study aims to assess the condition of frailty in older adults through the ICOPE approach in integrated geriatric services at Humana Prima Hospital in Bandung using a quantitative design with an experimental approach. The assessment was conducted using the ICOPE and Ina-FRAIL instruments to monitor intrinsic capacity and the level of frailty …

Creating Climate Healthy Work Environments In Healthcare, Janice E. Hawkins, Beth Tremblay

Creating Healthy Work Environments (CHWE)

Climate change is not only detrimental to our planet but poses a serious threat to human health. The World Health Organization (WHO, 2021) named climate change the greatest threat to human health and, by 2030, predicts an increase of 250,000 deaths each year from climate-related causes. Incongruent with our pledge to do no harm, healthcare industries are significant contributors of carbon emissions that cause climate change. Healthcare systems produce almost 5% of heat-trapping gases released into the atmosphere. Hospitals generate 20 pounds of waste per patient each day, equating to 5 million tons of waste annually (Practice Greenhealth, 2022). As …

Empowering Nursing Through Reflective Practice: A Path To Resilience, Well-Being, And Healthful Workplace Cultures, Joanne P. Bosanquet

Creating Healthy Work Environments (CHWE)

In the UK's health and care system, the cornerstone is safe, effective, and evidence-informed person-centered care. The pursuit of consistent high-quality care is an imperative, demanding the unwavering commitment of healthcare professionals. However, the increasingly complexity of healthcare, coupled with escalating costs, uncertainties in the work environment, recruitment and retention challenges, and the alarming rise in staff sickness and burnout, pose formidable obstacles (Aiken et al., 2023; Villarante et al., 2023).

Registered nurses, despite their comprehensive theoretical knowledge and philosophical grounding, confront emotionally taxing work.

Reflection emerges as a transformative tool, enabling nurses to connect with their inner selves, nurturing …

Institutionalizing A Culture Of Respect For Teaching And Professional Faculty, Laura E. Sponsler

Higher Education: Faculty Scholarship

The University of Denver has made great strides in improving faculty work and culture with the creation of full time non-tenure track lines – the Teaching and Professional Faculty. In 2015, DU’s faculty senate and Board of Trustees approved and created professional pathways with promotion, longer term contracts, and defined responsibilities for Teaching and Professional Faculty. Compared to other universities and colleges, our current strengths include multi-year contracts, participation and leadership in university governance, opportunities for advancement and promotion, and collegiality amongst faculty members.

This white paper serves to examine the institutionalization of these lines and the current status of …

Evolving From Stereotyping To Diversity, Linnea Warren

SOURCE Explore Program

Dolls of Our World is a geography game from around the 1950s in SCRC’s Plastics Artifacts Collection in which the player matches a doll to their flag based off outfit and short description. I wanted to know why Africa was not included, and overall, how geography games and teaching diversity have changed. I read several papers, including on plastic-color technology and the history of Black dolls. According to the categorization of “Gamification & Geography Education: A Survey & Typology of Games,” Dolls of Our World uses a storytelling narrative to teach, seen with the clothes and incorporation of people (however …

Cultural Science Night, Jiyoon Yoon

Mavs Open Press Open Educational Resources - Archive

This book is to learn water and weather by integrating with other cultures. This textbook is organized around two interconnected components. The first component provides cultural knowledge of China, India, Korea, and Mexico. The second component focuses on culturally responsive science instruction created for the Cultural Science Night event, an occasion in which teachers present hands-on, culturally responsive science activities in collaboration with students.

If you need an accessibility accommodation or have questions about the use of this text, please contact Mavs Open Press.

Intermittent Hypoxemia And Brain Injury Biomarker S100b In Preterm Infants, Elie G. Abu Jawdeh, Linda J. Van Eldik, Jennifer Stevenson, Abhijit Patwardhan, Philip M. Westgate, Lina Chalak, Richard J. Martin, Henrietta S. Bada

Epidemiology and Environmental Health Faculty Publications

Abstract – Introduction: Intermittent hypoxemia (IH) is common in preterm infants and linked to brain injury. S100B is a glial-derived protein that rises early after neural injury and can be measured noninvasively in urine. We evaluated the relationship between IH burden and urinary S100B in preterm infants of ≤32 weeks’ gestation. Methods: Preterm infants of ≤32 weeks’ gestation were prospectively enrolled. Oxygen saturation was continuously monitored, and IH profiles were quantified using validated algorithms. Urine S100B was measured by ultrasensitive immunoassay and normalized for urinary creatinine. Infants with severe intraventricular hemorrhage were excluded. Weighted Spearman correlations examined associations between IH …

Nanoscale Opportunities In Extracellular Matrix Mimicry, L. Andrew Lyon, Abbygail Caine, Elif Narbay, E. Daniel Cárdenas-Vásquez

Engineering Faculty Articles and Research

We present an overview of the composition, function, energetics, and dynamics of extracellular matrix and its relation to nanoscale structures and phenomena. These concepts are then related to the development of synthetic and biosynthetic materials that aim to mimic the extracellular matrix for regenerative medicine and tissue engineering technologies. Notable successes and advancements towards the goal of biomimicry are outlined, while remaining challenges and knowledge gaps towards that goal are highlighted. Finally, we frame the remaining challenges in the field in terms of nanoscience-related research opportunities that if solved, might prove to be transformative steps forward in the discipline.

Renewable Microgrid Frequency Regulation Using Active Disturbance Rejection Control And Elephant Herding Optimization, Ehab Bayoumi

Mechanical Engineering

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Renewable Microgrid Frequency Regulation Using Active Disturbance Rejection Control and Elephant Herding Optimization

Egain Tube Memristors Offering Reliable Switching On A Biological Time Scale, Yuriy V. Pershin, Liya Patel, Bapi Bera, Doug Aaron, Stephen A. Sarles

Faculty Publications

Memristive devices have been considered promising candidates for nature-inspired computing and in-memory information processing. However, experimental devices developed to date typically show significant variability and function at different time scales than biological neurons and synapses. This study presents a memristive device comprised of liquid-metal eutectic gallium indium (EGaIn) contained within a mm-scale tube that operates via a bulk, voltage-dependent switching mechanism and exhibits distinct unipolar resistive switching characteristics that occur on a biological time scale (tens of milliseconds). The switching mechanism involves voltage-controlled growth and dissolution of an oxide layer on the surface of the liquid metal in contact with …

Elixhauser Comorbidity Index To Predict Perioperative Bleeding And Adverse Spine Surgery Outcomes, Mitchell K. Ng, Michael A. Mont, Mosadoluwa Afolabi, Prathiksha N V, Amitha Kumar, Stephen S. Johnston

Rothman Institute Papers

Introduction: As spine surgery volume continues to grow, ensuring patient safety and minimizing complications are increasingly critical. Disruptive bleeding—defined as hemorrhagic events requiring clinical intervention—is a significant perioperative challenge. This study aimed to: (1) quantify disruptive bleeding incidence; (2) evaluate associations between patient demographics, Elixhauser Comorbidity Index (ECI), and bleeding risk; and (3) assess the impact of disruptive bleeding on mortality, ventilator use, length of inpatient stay, 90-day readmissions, and inpatient costs. Methods: A nationwide healthcare database was used to identify patients who underwent spine surgery in 2019. Patients were subdivided by the Elixhauser Comorbidity Index (ECI) from 0 to …

Sustainability Of Local Media In The Era Of Disruption: A Case Study Of Ayobandung.Com, Bibo Bani, Nindi Aristi, Ira Mirawati

JURNAL KOMUNIKASI INDONESIA

This study examines the sustainability strategy of local media in responding to the challenges of digital disruption in the media industry. The case selected for the research is AyoBandung.com, local digital news portal under PT Ayo Media Network. Local media are structurally vulnerable to platform dominance, forcing them to balance journalistic integrity with economic adaptation. This research employs a qualitative case study approach, with data collected through in-depth interviews with internal stakeholders, including editorial and business management teams. The findings reveal a clear structural and functional separation between the AyoBandung and creative agency, with distinct workflows, content types, and …

Choosing China: Unpacking The Motivations Of International Students Through A Case Study In Shanghai, Yu Zhang, Tian Qin, Xiaoqiao Zhang

Health Care Administration Faculty Research

The internationalization of higher education continues to accelerate with globalization, making China one of the top host nations for international students. This qualitative case study took place at a university in Shanghai, with 76 international students from 20 countries enrolled in the same English-taught engineering program. This research explored the motivations of international undergraduate students pursuing degree programs and their overall experience in China. The research reveals four main factors that shape students’ decision-making: academic reputation, social network influence, affordability, and safety. Additionally, many students identified academic difficulties even as they acknowledged the benefits of studying in China. This study …