E2SVM: Electricity-Efficient SLA-aware Virtual Machine Consolidation approach in cloud data centers.

Cloud data centers present a challenge to environmental sustainability because of their significant energy consumption. Additionally, performance degradation resulting from energy management solutions, such as virtual machine (VM) consolidation, impacts service level agreements (SLAs) between cloud service providers and users. Thus, to achieve a balance between efficient energy consumption and avoiding SLA violations, we propose a novel VM consolidation algorithm.

Acute HIV presenting as rhabdomyolysis.

A man, in his early 30s, with no significant medical history presented with a 2-week history of fatigue, chest and abdominal pain, associated with anorexia and vomiting. Initial laboratory testing was suggestive of rhabdomyolysis with acute renal failure and transaminitis. The aetiology of his rhabdomyolysis initially remained unexplained as there were no clear risk factors or inciting events.

Bridged-U-Net-ASPP-EVO and Deep Learning Optimization for Brain Tumor Segmentation.

Brain tumor segmentation from Magnetic Resonance Images (MRI) is considered a big challenge due to the complexity of brain tumor tissues, and segmenting these tissues from the healthy tissues is an even more tedious challenge when manual segmentation is undertaken by radiologists. In this paper, we have presented an experimental approach to emphasize the impact and effectiveness of deep learning elements like optimizers and loss functions towards a deep learning optimal solution for brain tumor segmentation. We evaluated our performance results on the most popular brain tumor datasets (MICCAI BraTS 2020 and RSNA-ASNR-MICCAI BraTS 2021).

Manubriosternal Joint Involvement as a Presenting Feature of Axial Spondyloarthritis.

Anterior chest wall pain is a feature of axial spondyloarthritis that is understudied. It is rarely the presenting symptom, and when present, may suggest severe disease. We present the case of a 35-year-old female with recurring presentations of debilitating chest pain, subsequently diagnosed with axial spondyloarthritis.

Accelerated right heart failure due to lung resection in the setting of chronic respiratory failure.

A 68-year-old woman with a past medical history of chronic obstructive pulmonary disease and squamous cell carcinoma of the lung with recent right upper and middle lobectomy was admitted for dyspnea and volume overload. She was diagnosed with right-sided heart failure (RHF) through clinical, laboratory, and echocardiographic means. In the setting of chronic respiratory failure, the recent right lung lobectomy was deemed to be the inciting factor of the RHF.

Adrenal Infarction in Pregnancy Secondary to Elevated Plasma Factor VIII Activity.

Unilateral adrenal infarction is a rare cause of acute abdomen in pregnancy (AAP). Its presentation is non-specific and requires a high index of suspicion with a low threshold to obtain radiographic imaging for diagnosis. Evaluating AAP is challenging as diagnostic radiographic imaging is often limited in relation to radiation exposure to the developing fetus.

Myocardial Bridging Unmasks as an Acute Coronary Syndrome from Dehydration.

A 50-year-old male presented for loss of consciousness. He was initially treated with intravenous epinephrine and fluids, and an electrocardiogram (ECG) displayed an ST-segment elevation in lead aVR with global ST-segment depressions. A subsequent left heart catheterization revealed that the middle segment of the left anterior descending artery (LAD) demonstrated severe stenosis during systole but would become patent during diastole, which was suggestive of myocardial bridging.

Active bleeding from downhill varices: case report and management.

Video 1EGD revealing 1 column of nonbleeding grade 2 varices in the middle third of the esophagus at the anterior wall; absent red wale sign and 3 columns of nonbleeding grade 3 varices in the upper third of the esophagus in the anterior and posterior wall. Stigmata of recent bleeding evident, red wale signs present, and 1 white nipple sign identified in the anterior wall, in the same column coming from the middle esophagus. Successful variceal banding ligation was performed, and there was no recurrence of bleeding.

Cardiac papillary fibroelastoma.

Papillary fibroelastoma (PFE) is a primary, histologically benign endocardial neoplasm. Though PFE has long been reported as the second most common primary cardiac neoplasm, it has since pulled ahead of cardiac myxomas, largely due to evolving cardiac imaging modalities. While PFEs are benign histologically, they have the potential for devastating clinical consequences, transient ischemic attack, stroke, myocardial infarction, syncope, pulmonary, and peripheral embolism.

Cryptococcal meningitis presenting with acute hearing loss.

Reversible sensorineural hearing loss is a recognised complication of cryptococcal meningitis. Cryptococcal meningitis typically presents with usual symptoms of fever, headache and neck stiffness. This case highlights acute, profound, bilateral hearing loss as the initial symptom and presentation of cryptococcal meningitis in a young woman, who was later diagnosed with AIDS.

Unusual aetiology of respiratory compromise in a patient with AIDS.

A 36-year-old African American man with no medical history presented with a recent history of cough and dyspnoea. Initial chest imaging revealed diffuse bilateral lung infiltrates. A subsequent HIV test resulted positive, and he was presumptively diagnosed with AIDS, later confirmed by a CD4 of 88 cells/mm Empiric therapy with trimethoprim-sulfamethoxazole was initiated for presumed pneumonia.

Alarming Eosinophilia From Dobutamine Infusion.

A 49-year-old male with a history of nonischemic heart failure with reduced ejection fraction, hypertension, diabetes was admitted for cardiogenic shock. Treatment started with a high dose of dobutamine infusion. While the patient's volume status improved, his clinical status declined as he became febrile and hypotensive.

Mosquito borne illness in a Floridian hiker.

Chikungunya is an arboviral infection that manifests as an acute viral illness associated with an inflammatory arthritis. It was first described during an outbreak in Tanzania in 1952 and, until 2013, outbreaks had been limited in Africa, Asia, Europe and the Indian and Pacific Oceans. In late 2013, the first local transmission of Chikungunya was identified in Caribbean countries with subsequent spread throughout Central and South America.

Two cases of spontaneous pneumomediastinum with pneumothorax in patients with COVID-19 associated pneumonia.

Coronavirus 2019 (COVID-19) is an infectious viral illness caused by severe acute respiratory syndrome virus coronavirus 2 (SARS-CoV-2). This disease mainly affects the lungs manifesting as acute lung injury, pneumonia, and acute respiratory distress syndrome. We describe two patients who developed concomitant spontaneous pneumothorax and pneumomediastinum in the setting of SARS-CoV-2 leading to acute hypoxic respiratory failure.

Signs of early cardiac tamponade induced by Minoxidil.

Minoxidil is an antihypertensive that works by directly dilating peripheral vessels. This medication is typically reserved for patients with resistant hypertension, whose blood pressure remains above goal despite being on multiple agents. A rare but potentially dangerous side effect of Minoxidil is drug-induced pericardial effusion.