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Author Index 12 Months Ended January 1982, American Institute Of Certified Public Accountants

Tax Adviser

No abstract provided.

Tax Trends, E. S. Linett

Tax Adviser

No abstract provided.

Thumbtax, Robert F. Manning

Tax Adviser

No abstract provided.

Tax Clinic, Stanton H. Vollman

Tax Adviser

No abstract provided.

Planning For Loans To Participants From Qualified Plans After Erisa (Part I), Vincent L. Holman, Ira S. Feldman

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. …

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 …

The Utilization Of Basic Oxygen Furnace Slag As Fine Aggregates In Concrete: Physical, Mechanical, And Durability Properties, Hakan Ozkan

Journal of Sustainable Construction Materials and Technologies

This study examines the feasibility of using basic oxygen furnace slag (BOFS) as an alternative to fine crushed limestone aggregate in concrete. BOFS is sourced from two steel production facilities in Türkiye, designated as I-BOFS and E-BOFS. The experimental results showed that as the E-BOFS aggregate replacement ratio increased, the water-to-cement (w/c) ratio increased to maintain the target workability. The concrete mixtures incorporating E-BOFS exhibited consistent reductions in the compressive strength with an increase in the BOFS ratio. At the same time, I-BOFS maintained higher compressive strength, with only minor losses up to 80% of the substitution ratio. Flexural strength …

Development Of A Self-Cured Alkali-Activated Mortar, Kübra Ekiz Barış

Journal of Sustainable Construction Materials and Technologies

Alkali-activated mortars (AAM) can be produced with self-curing (SC), which supplies internal moisture to accelerate alkaline-activation reactions. The aim of using SC is to make AAMs with an early-age strength without any additional curing energy consumption and higher CO2 emissions, and to obtain in-situ practical advantages that enable the large-scale application of AAMs. The previous study produced natural pozzolan-based AAMs by applying energy-intensive heat (HC), microwave (MWC), and hybrid (HC+MWC) curing. This study investigates alternative curing regimes that reduce production energy without compromising material properties. The impacts of air curing (AC), water curing (WC), and SC on the properties were …

Naoh Molarity Effect On Mechanical And Hydrochloric Acid Resistance Of Geopolymer Mortar Based On Slag, Mahmoud Ziada, Zahraa Mohammed Kamil Al-Mayali

Journal of Sustainable Construction Materials and Technologies

The present research investigates the influence of different sodium hydroxide (NaOH) molarities on the mechanical characteristics and hydrochloric acid (HCl) resistance of geopolymer grouts manufactured from ground granulated blast-furnace slag (GGBS). Geopolymer mortars have attracted interest as sustainable substitutes for traditional cementitious materials due to their advantageous environmental effects and enhanced durability features. This study involved the fabrication of geopolymer mortar specimens by altering the NaOH molarity (M) from 6 M to 14 M. The mechanical and physical qualities were assessed using compressive strength, capillary water absorption, flexural strength, slump flow, and ultrasonic pulse velocity (UPV) tests. Subsequently, the geopolymer …

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 …

Synergistic Effect Of Alccofine As Partial Replacement Of Cement And M-Sand As Sand Substitution In Concrete For The Assessment Of Mechanical And Microstructural Properties, Yellinedi Madhavi, R.S. Ravichandran, J. Saravanan, N. Venkatasairam Kumar

Journal of Sustainable Construction Materials and Technologies

Using supplementary cementitious materials (SCMs) and traditional binder mass has revolutionized concrete production technology in the building industry. This study examines how Alcofine-1203 affects the microstructure and mechanical characteristics of concrete. The mechanical qualities of the mixtures were evaluated using six different mixes prepared for each M25 and M40 Grade. In the proposed mixes, cement is substituted with alccofine at 0 to 25% and M-Sand as fine aggregate. The Compressive strength and ultrasonic pulse velocity were assessed after 3, 7, 14, 28, 56, and 90 days of curing, and split tensile strength and flexure strength were evaluated after 28 and …

Sustainable Modification Of Stone Column Technique With Polyethylene Terephthalate (Pet) Plastic For Strengthening The Expansive Clay, Ng Jun Shen, Muzamir Hasan

Journal of Sustainable Construction Materials and Technologies

This research investigated the modification of stone column application by the association of PET plastic as a coarse aggregate material for sustainable material replacement. Clay soil improvement with a granular material fabricated column substantially affected its soil-bearing capacity. Subsequently, it avoided severe problems such as soil settlement and structural instability. Previous studies have mentioned the function and alteration of stone columns using materials like bottom ash and fly ash. Still, no attention has been paid to the utilization of PET plastic for this area. This study examined the feasibility and reliability of materials, PET plastic, and kaolin clay S300 before …

Effect Of Reinforcement Thickness And Content On The Properties Of Compressed Earth Blocks, Salah Eddine Mokeddem, Abdelmadjid Hamouine, Rabia Abdeldjebar, Atef Hamaidi

Journal of Sustainable Construction Materials and Technologies

This study explores the mechanical, hygroscopic, and thermal behavior of stabilized and unstabilized compressed earth blocks (CEB) by incorporating date palm wood chips (DPWC) as a natural fiber additive. The investigation covers a range of DPWC thicknesses (1 mm, 2 mm, 3 mm) and content variations (0% to 1% by weight), focusing on the interaction between the bio-based reinforcement and the stabilized soil matrix, which is stabilized with 10% white Portland cement. The mixtures were compressed at a pressure of 5 MPa using a hydraulic press, providing a detailed examination of how these parameters impact the structural integrity and functional …

Psychological Development Serves As A Reliable Predictor Of Autism Spectrum Disorder Among Toddlers And Preschoolers, Hussein Allawi Hussein

Al-Ameed Journal for Medical Research and Health Sciences

Objectives: The goal of the current study was to use psychological development in toddlers and preschoolers to predict autism spectrum disorder (ASD). It was also looked at how sex differences affected ASD.

Methods: In this study (Case-Control), a purposive sample of 100 Children from the Karbala province-Iraq, ranging in age from 2 to 7, took part. There were two groups: 50 healthy Children (Control group) and 50 Children with ASD (Test group). To gauge the child's aptitude and response for communication and social interaction, the psychological development questionnaire-1 (PDQ-1) was used.

Results: The present study's sample was categorized into 2 …