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Evaluation Of A Patient With A Severe Systemic Inflammatory Response To Nitrofurantoin, Brigitte Vanle, Timothy Beatty

HCA Healthcare Journal of Medicine

Background

Nitrofurantoin is a prevalent antibiotic used to treat urinary tract infections. Despite nitrofurantoin’s general safety, it can cause serious side effects, including acute pulmonary toxicity, fulminant hepatitis, and severe systemic inflammatory responses, which may mimic conditions such as ischemia and infection. However, reports of acute systemic inflammatory response syndrome after nitrofurantoin ingestion are uncommon in medical literature.

Case Presentation

This case describes a severe systemic inflammatory response syndrome in an 85-year-old woman presenting with hypoxia, altered mental status, and profound leukocytosis after exposure to a single dose of nitrofurantoin.

Conclusion

Herein we report on a patient with suspected bacteremia …

Clinical Variant Of Serpentine Supravenous Hyperpigmentation Following Subcutaneous Bortezomib Injection, Madelyn Richards, Stephen E. Weis

HCA Healthcare Journal of Medicine

Introduction

Bortezomib is a reversible proteasome inhibitor that is a first-line chemotherapeutic agent for multiple myeloma. Bortezomib can be administered intravenously or subcutaneously with similar efficacy. Subcutaneous administration has fewer side effects. Many cutaneous reactions have been associated with bortezomib treatment. These include morbilliform exanthems, erythematous nodules and papules, leukocytoclastic vasculitis, Sweet syndrome, and rarely Stevens-Johnson Syndrome.

Case Presentation

This paper reports the occurrence of serpentine supravenous hyperpigmentation (SSH) after subcutaneous administration of bortezomib. SSH is a rare, characteristic cutaneous reaction that has been reported following intravenous administration of chemotherapeutic agents. Intravenous administration of bortezomib rarely results in documented cases …

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 …

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 …

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 …

Survey: A Study On Image Encryption Using Dna In Bioinformatics, Rana M. Zaki, Zaed S. Mahdi, Matheel E. Abdulmunim

Journal of Soft Computing and Computer Applications

One area of study between computer science and biology is bioinformatics, which deals with methods for collecting, processing, storing, and evaluating biological data. Sequences of RiboNucleic Acid (RNA), DeoxyriboNucleic Acid (DNA), and proteins make up biological data, which has a wide range of uses in domains such as feature extraction, data segmentation, data security, and more. In cryptography, DNA sequences are used as data carriers, enhancing the unique properties of biomolecules. This approach involves using DNA sequences to enhance the security of confidential data that must be transmitted over networks or stored securely. Several DNA-based security techniques have been developed, …

New Feature Selection Using Principal Component Analysis, Zaid Mundher Radeef, Soukaena Hassan Hashem, Ekhlas Khalaf Gbashi

Journal of Soft Computing and Computer Applications

Dimensionality reduction techniques streamline machine learning by reducing data complexity, improving model accuracy, and cutting computational costs. They remove noise and irrelevant features, making models faster and more efficient. These techniques also enhance data visualization and interpretation by condensing data into manageable, insightful dimensions. Ultimately, dimensionality reduction leads to simpler, more interpretable models without sacrificing critical information, making it a cornerstone of efficient data analysis and machine learning applications. Theoretically, feature extraction tends to create new features that encapsulate more information by combining multiple existing features, resulting in more concentrated and informative features. In contrast, feature selection involves choosing a …

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 …

Improved Rapidly-Exploring Random Tree Using Firefly Algorithm For Robot Path Planning, Dena Kadhim Muhsen, Firas Abdulrazzaq Raheem, Yuhanis Yusof, Ahmed T. Sadiq, Faiz Al Alawy

Journal of Soft Computing and Computer Applications

In robotics, efficient path planning makes robots work independently and move through changing environments over time. This study combines the Rapidly-exploring Random Tree (RRT) architecture with the Firefly Algorithm (FA) to make robot’s path-planning better. The proposed ERRT-FA, which stands for "Enhanced RRT with Firefly Algorithm", generates better routes using Firefly social habits. Plan routes using Firefly social habits can effectively aid in exploring configuration space. The role of the FA is to enhance the RRT algorithm by providing an optimized exploration of the search space, ultimately leading to optimizing the path found by the RRT algorithm and better paths …

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 …

Implementation Challenges And Opportunities Coretax Administration System On The Efficiency Of Tax Administration, Fitria Arianty

Jurnal Vokasi Indonesia

An efficient and transparent tax administration system is essential to ensure the optimization of state revenue and taxpayer compliance. The Indonesian government has initiated the implementation of the Coretax Administration System (CtAS) as part of tax reform efforts to improve efficiency in tax administration. This study aims to analyze the challenges and opportunities faced in the process of implementing CtAS in Indonesia. This study uses a qualitative method with data collection techniques in the form of literature studies, which are continued by conducting a SWOT analysis of this CtAS policy. The results of the discussion show that the main challenges …

Silent Holy Spirit, October-December, 2024

Silent Holy Spirit

A newsletter published for Deaf Catholics in St. Louis, MO

Silent Holy Spirit Finding Aid

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 …

Pushing The Boundaries Of Large Language Models: Innovations And Limitations In Nlp, Finance, And Mathematics, A M Muntasir Rahman

Dissertations

Large Language Models (LLMs) have emerged as transformative tools across a spectrum of domains, yet their practical deployment reveals a blend of remarkable potential and notable limitations. This research explores innovative methodologies to extend the capabilities of LLMs while addressing critical challenges in their evaluation and application. By leveraging rule-based approaches, the in-context learning capabilities of LLMs, and human-in-the-loop validation across three focused studies, this research introduces robust strategies for dataset synthesis, model enhancement, and model assessment in three distinct domains: natural language processing, financial sentiment analysis, and mathematical reasoning

The first study proposes an efficient data augmentation framework, EASE, …

Game-Based Learning With Augmented Reality, Kantida Nanon

Dissertations

Augmented Reality (AR) technology provides an effective and controllable learning environment, especially for complicated, potentially dangerous, or critical content. Effective implementation of interaction and platforms for educational tools can maximize learner engagement and optimize the learning experience. This dissertation explores the potential of AR technology to enhance learning experiences across multiple platforms and subject areas, particularly within chemistry and mathematics. The dissertation is grounded in the field of Human-Computer Interaction (HCI) and explores the potential of AR to increase learner engagement, improve learning outcomes, and transform traditional pedagogical practices.

The dissertation is divided into two parts. The first part examines …

First-Principles Study Of Ferroelectric Properties And Co2 Reduction Reaction Capabilities In Two-Dimensional Monolayers And Heterostructures, Mo Li

Dissertations

Two-dimensional (2D) materials hold significant potential for CO₂ reduction reactions (CO₂RR) due to their high surface-to-volume ratio. However, achieving high selectivity for desired products and overcoming limitations posed by scaling relationships remain challenging. Recent studies suggest that ferroelectric (FE) materials with switchable out-of-plane polarization (OOP) can effectively tune the adsorption behavior, thermodynamics, and kinetics of CO₂RR, offering promising solutions to these challenges. Using density functional theory (DFT) and the Berry phase approach, this work expands the family of 2D ferroelectrics by theoretically identifying Y₂CO₂, Y₂CS₂, and Sc …

Determination Of Electrochemical Parameters For Predicting Reaction Mechanism And Algorithmic Approaches To Pain Assessment, Huize Xue

Dissertations

This dissertation introduces novel advancements in electrochemical kinetics and pain assessment, structured into two main parts. The first part focuses on the comprehensive analysis of the kinetic and mechanistic aspects of electrochemical reactions, utilizing a combination of experimental techniques and simulation methods. A new software tool, Envismetrics, was developed using Python to facilitate the analysis of complex electrochemical data, including cyclic voltammetry (CV), chronoamperometry (CA), and hydrodynamic voltammetry (HDV). The software was rigorously tested and validated with well-characterized redox systems such as the ferricyanide/ferrocyanide couple, dimethylamine borane (DMAB), and Per- and Polyfluoroalkyl Substances (PFAS). It was successfully used to determine …

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 …

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.

How To Manage Documents & Email In The Law Practice - Getting Your Digital House In Order!, Indiana Continuing Legal Education Forum (Iclef)

Indiana Continuing Legal Education Forum 2024

Meeting proceedings of a seminar by the same name, held August 13, 2024.

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

Indiana Continuing Legal Education Forum 2024

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

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.

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 …