Digital Commons Network^™

Ultrasound-Guided Epidural Caudal Block For Lumbar Spinal Stenosis In A Patient With Severe Scoliosis: A Case Report, Theresia Chandra Tania Novy, Daniel Hadimartana, Maria Jessica Yaputri

Advances in Clinical Medical Research and Healthcare Delivery

Background: Lumbar spinal stenosis (LSS) is a common degenerative condition in the elderly characterized by narrowing of the spinal canal that leads to neural compression and symptoms such as low back pain, neurogenic claudication, and sensory disturbances. LSS may coexist with degenerative lumbar scoliosis (DLS), which can further complicate clinical presentation and management. While surgical treatment is often considered for severe cases, nonsurgical interventions remain important treatment options, particularly for elderly patients with comorbidities. Case Presentation: We report the case of a 69-year-old male presenting with chronic low back pain for more than two years, accompanied by radiating pain, numbness, …

Appendiceal Neuroendocrine Tumor: A Case Report, Daniel Zipfel, Thomas Russo, Mathew Devine

Advances in Clinical Medical Research and Healthcare Delivery

Neuroendocrine tumors (NETs) are rare neoplasms that most commonly occur in the gastrointestinal tract, lungs, and pancreas but may arise anywhere where there are neuroendocrine cells within the body. When neuroendocrine tumors metastasize to the liver, patients present with carcinoid syndrome, a group of symptoms characterized by flushing, diarrhea, and right-sided heart disease. However, many NETs do not cause carcinoid syndrome, sometimes leading to a unique clinical presentation. Patients may present with symptoms of appendicitis, ovarian torsion, or be completely asymptomatic. We report a case of a 25-year-old male with a Grade 1 neuroendocrine tumor of the appendix, who underwent …

Checkpoint Inhibitor–Associated Autoimmune Diabetes Following Pd-1 Blockade: Severe Diabetic Ketoacidosis After Pembrolizumab, Divya Samat, Osadebamwen Osaghae, Shivam Singh, Mohammad Abu Tineh, Anthony Donato

Advances in Clinical Medical Research and Healthcare Delivery

Immune checkpoint inhibitors (ICIs) have transformed cancer therapy by enhancing antitumor T-cell activity through blockade of inhibitory pathways including programmed cell death protein 1 (PD-1) and its ligand (PD-L1). Loss of immune tolerance can lead to immune-related adverse events (irAEs), including endocrine toxicities. Checkpoint inhibitor–associated autoimmune diabetes (CIADM) is rare but clinically significant because it often presents abruptly with diabetic ketoacidosis (DKA) and profound insulin deficiency. We describe an 81-year-old male with stage III clear-cell renal cell carcinoma who developed abrupt-onset autoimmune diabetes 8 weeks after initiating adjuvant pembrolizumab. The patient presented with severe hyperglycemia and high anion-gap metabolic acidosis …

Intravenous Phenytoin-Induced Purple Glove Syndrome With Transient Hyperpigmentation: A Rare Adverse Drug Reaction In An Elderly Patient, Aarthi Ma, Revanth R

Advances in Clinical Medical Research and Healthcare Delivery

Background: Purple Glove Syndrome (PGS) is an uncommon but potentially serious adverse effect of intravenous (IV) phenytoin, characterized by limb pain, swelling, and purple-blue discoloration near the injection site. Although self-limiting in most cases, it can progress to ischemia or necrosis. Case Presentation: A 68-year-old male with a prior cerebrovascular accident (CVA) and coronary artery disease (CAD) was admitted for seizure management. He received IV phenytoin 100 mg thrice daily. By the evening of Day 1, he developed pain, edema, and purplish discoloration at the right wrist, followed by hyperpigmentation on the left palm and right-hand nails. IV …

Invasive Non-Typhoidal Salmonella Enterocolitis And Bacteraemia With Negative Initial Stool Culture Following Consumption Of ``Ceviche''- A Case Report, Maria Vasnaik, Nimrat Kaur Sandhu, Justin Nistico

Advances in Clinical Medical Research and Healthcare Delivery

Salmonellosis is a global public health concern, mainly presenting with non-specific signs and symptoms of gastrointestinal illness associated with the consumption of contaminated chicken, meat, eggs, unpasteurized milk, raw fruits and vegetables irrigated with fecally contaminated water. While non-typhoidal serotypes are known to cause mild, self-resolving symptoms, typhoidal serotypes such as Salmonella typhi and paratyphi may present with severe symptoms, including hyperpyrexia, bloody stools, osteomyelitis, and other symptoms. Such diseases are relatively uncommon in developed countries due to improved hygiene practices and are most often related to travel to endemic countries. Although vaccination against the disease has been recommended for …

A Case Of Reversible Acute Kidney Injury And Life-Threatening Gastrointestinal Bleed With Colitis In A Patient Receiving Tucatinib For Her2-Positive Breast Cancer, Geetha Keshav, Shanzae Naeem, Jalila Jafri

Advances in Clinical Medical Research and Healthcare Delivery

This case report describes the complex clinical course of a 73-year-old female with HER2-positive breast cancer enrolled in the CompassHER2 RD trial who developed acute kidney injury (AKI) requiring emergent hemodialysis shortly after initiation of tucatinib. In addition to severe renal dysfunction, the patient experienced a life-threatening lower gastrointestinal (GI) bleed in the setting of suspected drug-induced colitis and profound thrombocytopenia while receiving combination therapy with trastuzumab emtansine (T-DM1). Although tucatinib has demonstrated promising efficacy in improving outcomes for patients with high-risk HER2-positive disease, serious renal and gastrointestinal complications remain uncommon and underreported. This case underscores the importance of early …

Beyond The Algorithm: Empowering Clinicians And Researchers To Thrive In The Age Of Ai, Milan Sheth, Justin S. Brathwaite

Advances in Clinical Medical Research and Healthcare Delivery

Artificial intelligence (AI) is rapidly reshaping clinical research and healthcare delivery, yet meaningful adoption depends less on technical mastery and more on cultivating AI literacy among clinicians and research staff. Building a foundational understanding of concepts such as supervised learning, bias, and model validation enables professionals to interpret and apply AI-generated insights with confidence. Familiarity grows through exposure to AI-enabled electronic medical record systems, interdisciplinary collaboration with data scientists and informaticists, and small pilot projects that demonstrate workflow fit and real-world value. Prioritizing transparency, explainability, and ethical considerations ensures that AI augments clinical decision-making. Practical applications already span oncology research, …

Solutions To Dismantling Osteopathic Bias In American Medicine, Mathew Devine, Richard Terry

Advances in Clinical Medical Research and Healthcare Delivery

No abstract provided.

Addressing Doscrimination: Examining Bias Against Osteopathic Physicians, Sophia M. Valerino

Advances in Clinical Medical Research and Healthcare Delivery

Osteopathic medicine arose as a response to the limitations of conventional medical practices of the time. It emphasizes the body's innate ability to heal and the importance of holistic care and has since evolved into a rigorous and evidence-based system that parallels allopathic education in scope, standards, and licensure. Nevertheless, osteopathic physicians (DOs) continue to face systemic bias across multiple areas. This article examines the historical context and current manifestations of discrimination against DOs, highlighting disparities in residency selection, research participation, academic leadership, and media portrayal. Despite clear evidence showing comparable performance between DOs and MDs in clinical care and …

Vitamin D Deficiency And Risk Of Cognitive Decline And Dementia: Implications And Prevention Strategies, Auda Fares

Advances in Clinical Medical Research and Healthcare Delivery

Emerging evidence suggests a link between vitamin D deficiency and an increased risk of cognitive impairment and dementia, including Alzheimer's disease (AD). This paper reviews the epidemiological evidence, explores potential mechanisms underlying this association, and discusses implications for prevention strategies. Current supplementation strategies may not be fully effective due to individual variability. Personalized interventions based on genetic factors and routine vitamin D status testing in older adults are proposed as future directions for optimizing the impact of vitamin D supplementation in dementia prevention.

Nationwide Analysis Of Catheter-Directed Thrombolysis Versus Anticoagulation In Sub-Massive Pulmonary Embolism, Ayushma Acharya, Swarup Sharma Rijal, Anthony Donato

Advances in Clinical Medical Research and Healthcare Delivery

Background: Data on the real-world effectiveness and safety of catheter-directed thrombolysis (CDT) versus anticoagulation in sub-massive pulmonary embolism (PE) remain limited.

Objective: The aim of this study was to assess the differences in in-hospital mortality, length of stay (LOS), complications and healthcare resource utilization between catheter directed thrombolysis and anticoagulation in sub-massive pulmonary embolism using the National Inpatient Sample (NIS) dataset from 2016–2022.

Methods: The National Inpatient Sample (2016–2022) was queried to identify hospitalizations for sub-massive pulmonary embolism (PE) with cor pulmonale. Patients receiving CDT were compared to those treated with anticoagulation alone. We excluded patients with shock, ventilator …

Bilateral Beam-Assisted Rock Fracturing For Low-Gravity And Terrestrial Drilling Operations, Daniel Austin Harbison

Defensive Publications Series

A method is described for pre-fracturing rock using two or more counter-propagating millimeter-wave or microwave beams aimed at the same target volume from opposite sides. Standing-wave interference and overlapping absorption produce interior thermal-stress concentrations that initiate cracks at much lower bulk energy density than vaporization-based drilling, while the symmetric geometry largely cancels the net momentum imparted to the rock face. The architecture is intended primarily for low-gravity surface drilling on the Moon, Mars, and asteroids — where reaction-force budgets are extremely limited — and as a pre-conditioning step for terrestrial mechanical drills. The disclosure covers the baseline two-beam geometry at …

"Product Liability" Dalam Penyelenggaraan Penerbangan, Amad Sudiro

Jurnal Hukum & Pembangunan

Abstract

Tangan Tuhan Di Pengadilan: Dalih Bencana Alam Dan Pertanggungjawaban Perdata Dalam Kasus Lingkungan, Andri G. Wibisana

Jurnal Hukum & Pembangunan

Abstract

Survival And Factors Associated With Mortality Among Patients With Oral Cancer At A Tertiary Hospital In Northeastern Thailand: A Retrospective Cohort Study, Somkiattiyos Woradet, Bhunyabhadh Chaimay, Nuntiput Putthanachote

Journal of Health Research

Background: Oral cancer is a major cause of premature mortality in Thailand. This study examines survival and prognostic factors in a northeastern tertiary-care setting.

Methods: A hospital-based retrospective cohort study was conducted using the Cancer Registry and medical records in a tertiary care hospital in Northeastern, Thailand. Patients diagnosed with oral cancer between January 2005 and December 2015 and followed until death or February 2020. Overall survival was estimated using the Kaplan–Meier method. Cox proportional hazards models were used to assess factors associated with mortality

Results: The median survival time was 18.67 months (95% confidence interval [CI]: 15.70–22.83). It revealed …

Associations Between Perceptions Of Indoor Environmental Quality And Satisfaction With Life Among Residents In Saudi Arabia, Hatim M. Badri, Wahaj A. Khan, Mohammad N. Shah, Osama A. Banah, Mohamed Osman Elamin, Rakan Ekram, Rayan Khayat, Abdullah Muhammad Alzhrani, Baraa Sami Quronfulah, Muath Ahmed Aldomini

Journal of Health Research

Background: Indoor residential environments influence physical and mental health, but evidence linking perceived Indoor Environmental Quality (IEQ) to Satisfaction With Life (SWL) in Saudi Arabia is limited. This study explored residents’ perceptions of IEQ and its association with SWL.

Methods: A cross-sectional online survey (March–April 2025) was conducted among adults (≥18 years) in Saudi Arabia using convenience sampling. A total of 451 participants completed a structured questionnaire. Data were analysed using descriptive statistics, Pearson correlations, one-way ANOVA, and multivariable logistic regression to identify IEQ predictors of low SWL (≤20), adjusting for age, sex, and BMI.

Results: …

Caregiving Experiences And Challenges Among Caregivers Of Children With Epilepsy In Thailand: A Qualitative Study, Arthittaya Kaenkrai, Pramote Thangkratok, Pawanrat Panjatharakul, Apasri Lusawat, Moritz Tacke

Journal of Health Research

Background: Childhood epilepsy requires long-term management and places substantial responsibilities on caregivers. In Thailand, limited public awareness and persistent stigma surrounding epilepsy may intensify caregivers’ psychosocial and practical burdens. This study aimed to explore the lived experiences of caregivers of children with epilepsy in Thailand.

Methods: A qualitative study using two semi-structured focus group discussions (FGDs; 5 participants per group) and 15 in-depth interviews (IDIs) was conducted with primary caregivers of children with epilepsy receiving care at a neurological referral institute in Thailand. Participants were purposively selected to capture a diverse range of caregiving experiences. Data were audio-recorded, transcribed verbatim, …

Nicollo Machiavelli: Sang Belis Politik? Suatu Refleksi Dan Kritik Filosofis Terhadap Gagasan Politik Machiavelli Dalam Ll Principe, E. Fernando M. Manullang

Jurnal Hukum & Pembangunan

Abstract

Pertanggungjawaban Indonesia Terhadap Pencemaran Kabut Asap Di Kawasan Asean (Pendekatan Economic Analysis Of Law), Deni Bram

Jurnal Hukum & Pembangunan

Abstract

Plagiarisme Akademik: Perspektif Metode Keilmuan Dan Doktrin Hukum, Jufrina Rizal

Jurnal Hukum & Pembangunan

Abstract

Hukum Pengadaan Barang (Government Procurement) Dan Pembangunan Ekonomi, Ade Maman Suherman

Jurnal Hukum & Pembangunan

Abstract

Penyelesaian Sengketa Bisnis Di Luar Pengadllan Antar Warga Suku Sasak Dl Pulau Lombok, Idrus Abdullah

Jurnal Hukum & Pembangunan

Abstract

Analisa Law And Economics Atas Kompensasi Dan Asuransi Lingkungan Di Indonesia: Sebuah Kritik Atas Kompensasi Tanpa Sistem, Andri Gunawan Wibisana, Pramita K. Putri

Jurnal Hukum & Pembangunan

Abstract

Peresepan Dokter: Organized Crime?, Agus Budianto

Jurnal Hukum & Pembangunan

Abstract

Hak Asasi Manusia (Ham) Atas Lingkungan Hidup (Suatu Rekfleksi Sosio Yuridis Atas Implementasi Penyelesaian Sengketa Lingkungan), Junior B. Gregorius

Jurnal Hukum & Pembangunan

Abstract

Mental Accounting And The Green Premium, Omar P. Woodham, George W. Stone

Atlantic Marketing Association Proceedings

No abstract provided.

Consumers’ Willingness To Pay: The Price Of Brand Personality, Kenneth Hall, Thomas Tanner

Atlantic Marketing Association Proceedings

No abstract provided.

Franchisee Performance: A Signaling Perspective, Swati Panda, Audhesh Paswan

Atlantic Marketing Association Proceedings

No abstract provided.

To Purchase Or Not To Purchase: An Exploratory Investigation Of Electric/Battery Vehicle Attraction Versus Conventional Gasoline Powered Vehicles Among Potential African American Car Buyers As Moderated By The Individual’S Level Of Environmental Concern., George W. Stone

Atlantic Marketing Association Proceedings

No abstract provided.

Marketing College Football In The “New Normal”, Chris Croft, Tim Wilson

Atlantic Marketing Association Proceedings

No abstract provided.