Digital Commons Network^™

Manufacturing Companies’ Strategies To Mitigate Supply Chain Disruptions, Trisha L. George

Walden Dissertations and Doctoral Studies

Supply chain disruption has the potential for adverse business outcomes. In manufacturing facility settings, leaders are concerned that supply chain disruption decreases the quality of productivity and profitability. Grounded in dynamic capability theory, the purpose of this qualitative pragmatic inquiry was to explore strategies leaders used to mitigate supply chain disruptions. The participants were six supply chain leaders from three manufacturing facilities located in Mexico who mitigated supply chain disruption. Data were collected using semistructured interviews and public records. Through thematic analysis, four themes were identified: (a) cultural differences, (b) communication, (c) organizational structures, and (d) disciplines. A key recommendation …

Sustainable Disinfecting Aerosol Spray, Anonymous Anonymous

Defensive Publications Series

New aerosol formula providing germ kill on hard and soft surfaces having cost savings and improved sustainability as compared to commercial formula.

Consistent Projection Electric Field Electrode Active Stylus, Hp Inc

Defensive Publications Series

What is active stylus

Nib Signal integrity is important to perform best user experience with an active stylus , As an active stylus, it will include “Nib”, “Body”, “Extremity”,

• Nib: Signal Out Put, Contact on screen
• Body: Heart of the stylus with devices e.g Battery, BT…etc
• Extremity: Additional function available e.g eraser key…etc

Vary Temperature/Fan Updating Frequency With Cpu Workload Type To Extend Turbo And Improve Performance, Hp Inc

Defensive Publications Series

This disclosure related to fan speed control in the notebook. Currently, fan speed depends on the readings from temperature sensors: CPU, dGPU and skin, which form a fan table. EC (Embedded Controller) constantly samples the temperature sensors at a fixed low frequency (for example, 1HZ), then put the readings through a smooth algorithm, then look up fan table and update fan speed. However, during CPU boost events, CPU power spike significantly for a brief period (few seconds), and it causes CPU/GPU temperature rising quickly. Thanks to the smooth algorithm, the fan does not depend entirely on the precise temperature at …

A Case Report Of Acute Idiopathic Hepatitis Requiring Liver Transplant, Nathan Rim, Nevin Varghese, Md, Zachary Pang, Md

The Medicine Forum

Acute liver injury may be very difficult to treat, especially when the etiology is unknown. We describe a case of a patient who presented with signs and symptoms of acute liver injury and went through an extensive work-up that did not reveal a definitive cause. The lack of diagnosis can be distressing for the patient, so it is important to regularly communicate the current plan and potential future necessary steps (such as a transplant surgery) to facilitate smooth, informed decision-making throughout the whole process.

A Rare Case Of Upper Gastrointestinal Bleeding And Esophageal Candidiasis In Severe Achalasia, Nevin Varghese, Md, Bertilia Tavárez, Md, Justin Robbins, Md

The Medicine Forum

Achalasia is an esophageal dysmotility disorder characterized by failure of relaxation of the lower esophageal sphincter (LES), accompanied by aperistalsis of the distal esophagus. Recent data show that the prevalence of achalasia in the United States is 10 per 100,000 individuals.¹ Complications of achalasia include esophagitis, esophageal ulcer, esophagealtracheal fistula, esophageal rupture, aspiration pneumonia, and squamous cell carcinoma. We report a rare case of upper gastrointestinal bleeding associated with esophageal ulcer and candidiasis in a patient with severe achalasia requiring multiple endoscopic interventions.

Bicuspid Aortic Valve With Right Coronary Cusp And Noncoronary Cusp Fusion On Transesophageal Echocardiogram, Kashka Mallari, Md

The Medicine Forum

A 39 year old male with a bicuspid aortic valve (BAV) developed progression of aortic valve regurgitation and enlargement of the ascending aorta, despite showing no symptoms. BAV, affecting approximately 2% of the population, poses risks such as aortic stenosis, aortic regurgitation, endocarditis, and aortic dilation, which can lead to aortic aneurysm and potential rupture. Due to the risk of further progression, he underwent a trans-esophageal echocardiogram (TEE) to facilitate aortic valve repair. While majority of patients with BAV exhibit fusion between the right coronary cusp (RCC) and left coronary cusp (LCC), this patient displayed fusion between the RCC and …

Hypertrophic Cardiomyopathy Illustrated On A Transthoracic Echocardiogram And Cardiac Mri, Youssef Elfatatry, Md, Marina Gonzalez, Md

The Medicine Forum

A 46-year-old woman presented to the hospital with subacute dyspnea on exertion and syncope. She had three syncopal episodes in the months prior, all of which occurred after standing from seated position and were associated with complete loss of consciousness. Echocardiogram showed severe concentric left ventricular hypertrophy (LVH) with preserved systolic function (Panels A and B). Cardiac magnetic resonance (CMR) imaging was performed which confirmed asymmetric septal hypertrophy measuring 28-mm in thickness (Panel C, arrow). Patchy, late gadolinium enhancement was also seen within the myocardium (Panel D, arrows). A diagnosis of hypertrophic cardiomyopathy (HCM) was made. The patient had no …

Wellens' Syndrome On Electrocardiogram, A Highly Specific Indicator Of Critical Stenosis Of The Left Anterior Descending Coronary Artery, Youssef Elfatatry, Md, Ryan Gardner, Md

The Medicine Forum

An 85-year-old male with a past medical history of hyperlipidemia presented to his primary care physician with chest pain. The patient had experienced an acute episode of substernal chest pain that resolved spontaneously three days prior to presentation. An electrocardiogram (ECG) was obtained in the office which showed inverted and biphasic T-waves throughout the precordial chest leads (Panel A, arrows). The patient was sent to the emergency department and underwent an emergent cardiac catheterization which revealed a 99% proximal left anterior descending (LAD) artery occlusion (Panel B, arrow). A drug-eluting stent was placed with successful revascularization (Panel C, arrow). Wellens …

Investigating The Etiology Of Non-Ischemic Cardiomyopathy; A Case Report Of Cardiac Amyloidosis, Zachary Pang, Md, Joshua M. Riley, Md, Yair Lev, Md

The Medicine Forum

Amyloidosis is the result of misfolded protein deposition in organs and tissues, including the heart also known as cardiac amyloidosis. We describe a case of a patient presenting with decompensated heart failure, which highlights the importance of identifying the etiology of the patient’s cardiomyopathy through a thorough history and physical. This led to a diagnosis of cardiac amyloidosis. The patient was subsequently initiated on tafamidis, a medication that is associated with reductions in all-cause mortality and cardiovascular-related hospitalizations, reduced decline in functional capacity, and improved quality of life of the patient.

Laao Device Mass: A Classic Condition Involving A Not - So - Classic Device, Ryan Gardner, Md, Rabia Naheed, Md, Youssef Elfatatry, Md, Irfan Ahsan, Md, Alyson N. Owen, Md

The Medicine Forum

Current evidence suggests Class 2a recommendation for a left atrial appendage occlusion with a closure device in patients with atrial fibrillation who have moderate to high risk of stroke (CHA2DS2-VASc score ≥2) and a contraindication to long-term oral anticoagulation due to a nonreversible cause.¹ Watchman device (WD) related infection is infrequent due to complete endothelialization of the device in a few weeks.² We report a highly challenging case of possible WD-related infection that involved complex decision-making.

Dissecting The Literature: A Systematic Review Of Conservative Therapy Versus Revascularization In Spontaneous Coronary Artery Dissection, Avinash Saraiya, Ms, Brian Schonewald, Md

The Medicine Forum

Spontaneous coronary artery dissection (SCAD) is a rare, but increasingly recognized cause of acute coronary syndrome (ACS). While previously only described in case series, the advent of advanced imaging techniques such as intravascular ultrasound (IVUS) and optical coherence tomography (OCT) has increased its prevalence dramatically. Anatomically, SCAD results from the formation of an intramural hematoma with or without intimal tear in a coronary artery, potentially leading to occlusion and ischemia. This phenomenon is especially common in women, accounting for 35% of ACS in women under the age of 50, and representing the leading cause of peripartum myocardial infarct.¹ There …

From The Chief Residents, Michael Dong, Md, Chantel Venkataraman, Md, Tamar Wolinsky Md, Benjamin Claxton, Md

The Medicine Forum

As we introduce the latest edition of The Medicine Forum, the journal of our Internal Medicine residency program, we're thrilled to showcase the diverse talents and perspectives of our resident physicians. Evolving alongside our program, this publication serves as both a platform for scientific inquiry and a canvas for creativity, reflecting the dynamic interests of each resident cohort.

We must extend our heartfelt gratitude to our current editors, Amman Bhasin, Suraj Nyalakonda, Mez Kamanu, and Alex Grivas, for their unwavering dedication and tireless efforts in shepherding this journal to new heights. Their commitment to excellence and their vision for …

From The Editors, Amman Bhasin, Md, Suraj Nyalakonda, Md, Chukwuemezie Kamanu, Md, Alexandros Grivas, Md

The Medicine Forum

We are honored to present the 25th Annual edition of The Medicine Forum, carrying forth a quarter-century tradition of scholarly work produced by faculty, residents, and students -- proudly shared with the Jefferson community and beyond. The Medicine Forum embodies the collective voice and spirit of our residency, serving as a vibrant platform for scholarly and artistic expression, and showcasing the remarkable talents and diverse perspectives of our program’s faculty, residents, and students.

Throughout the years, The Medicine Forum has evolved alongside our program, adapting to the changing interests and passions of each new cohort of residents. It serves …

Foreword From Faculty Advisor, Dagan Coppock, Md, Msce

The Medicine Forum

The latest edition of The Medicine Forum celebrates our community’s efforts toward scholarly inquiry and creativity. Our current editors have approached this project with a true passion. Throughout the academic year, it has been my pleasure to work with Amman, Suraj, Mez, and Alex, not only on this project, but also on the medical wards. They have applied the same thoughtfulness and joy to editing this journal that they do to the care of patients. I am in awe of their efforts.

As a department, we are a productive group of writers, thinkers, scientists, and artists. So much of our …

From The Desk Of The Residency Program Director, Christopher Henry, Md, Facp

The Medicine Forum

As we celebrate the silver jubilee of our beloved Jefferson Forum, it is with great pride and admiration that I extend a warm welcome to each of you. For a quarter-century, this annual publication has stood as a testament to the dedication, passion, and scholarly pursuits of our internal medicine residents.

Within the pages of the Jefferson Forum, you will find the embodiment of our residents' commitment to excellence in patient care, education, and research. As the Program Director, I have had the privilege of witnessing firsthand the remarkable growth and development of our residents. Their journey from eager learners …

Table Of Contents: The Medicine Forum, Volume 25, 2023-2024

The Medicine Forum

Table of Contents: The Medicine Forum, Volume 25, 2023-2024

The Medicine Forum: Volume 25

The Medicine Forum

The Journal of Thomas Jefferson University Hospital - Department of Internal Medicine, Volume 25, 2023-2024

TABLE OF CONTENTS

• Case Reports
• Clinical Images
• Humanities & Reflections

Memorandum 2.1 (End Matter), Memorandum Staff

Memorandum (student professional writing magazine)

No abstract provided.

Avoiding The Classroom: A Study In Unusual Jobs, Brandon Varner

Memorandum (student professional writing magazine)

No abstract provided.

5 Don’Ts Of Graphic Design, Memorandum Staff

Memorandum (student professional writing magazine)

No abstract provided.

An Interview With Scott Thigpen: Graphic Designer, Sarah Burch

Memorandum (student professional writing magazine)

No abstract provided.

The World Of Freelancing: Tips For Getting Started, Sadie King

Memorandum (student professional writing magazine)

No abstract provided.

Fonts: Expanding Your Horizons, Memorandum Staff

Memorandum (student professional writing magazine)

No abstract provided.

The Versatility Of Writing Skills, Memorandum Staff

Memorandum (student professional writing magazine)

No abstract provided.

Tips To Improve Your Professional Writing Skills, Payton Hamilton

Memorandum (student professional writing magazine)

No abstract provided.

Birmingham Creative Round Table, Memorandum Staff

Memorandum (student professional writing magazine)

No abstract provided.

Grad Programs: Things To Consider, Memorandum Staff

Memorandum (student professional writing magazine)

No abstract provided.

Jessica Thuston: The Modern Professional Writer, Peyton Chandler

Memorandum (student professional writing magazine)

No abstract provided.

David Hornbuckle: Creativity In Professional Writing, Sullivan Sanders

Memorandum (student professional writing magazine)

No abstract provided.