Professionalism and the Electronic Health Record.

Electronic health records (EHRs) have become integral to modern health care, facilitating documentation, billing, and care coordination. However, their increasing use introduces potential challenges to professionalism in the patient-physician relationship. This article explores both the positive and negative impacts of EHRs on professional behaviors, including empathy, communication, and efficiency.

Machine learning-aided hybrid technique for dynamics of rail transit stations classification: a case study.

Accurate classification of rail transit stations is crucial for successful Transit-Oriented Development (TOD) and sustainable urban growth. This paper introduces a novel classification model integrating traditional methodologies with advanced machine learning algorithms. By employing mathematical models, clustering methods, and neural network techniques, the model enhances the precision of station classification, allowing for a refined evaluation of station attributes.

The Impact of Glucagon-Like Peptide-1 Receptor Agonist on the Cardiovascular Outcomes in Patients With Type 2 Diabetes Mellitus: A Meta-Analysis and Systematic Review.

Background: Since 2005, the cardioprotective effects of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) have garnered attention. The cardioprotective effect could be an added benefit to the use of GLP-1 RA. This systematic review and meta-analysis aimed at summarizing observational studies that recruited type 2 diabetes individuals with fewer cardiovascular (CV) events before enrolling in the research.

Multilayer perceptron-based self-care early prediction of children with disabilities.

Early identification of children with self-care impairments is one of the key challenges professional therapists face due to the complex and time-consuming detection process using relevant self-care activities. Due to the complex nature of the problem, machine-learning methods have been widely applied in this area. In this study, a feed-forward artificial neural network (ANN)-based self-care prediction methodology, called multilayer perceptron (MLP)-progressive, has been proposed.

An Unexpected Outcome of Streptococcus sanguinis Endocarditis Associated With Orthodontic Bracing in a Young Healthy Patient.

We present a case of endocarditis in a 26-year-old female following orthodontic bracing. The rarity and debilitating consequences of endocarditis caused by are elaborated. The patient exhibited severe regurgitation with the eccentric posteriorly directed flow, leading to significant cardiac strain, further accentuated by systolic flow reversal in the right superior pulmonary vein.

Breast cancer awareness among women in the Syrian Coast: a cross-sectional study.

Unlabelled: Breast cancer is the most common malignancy in women and represents a leading cause of cancer-related mortalities. Females' awareness toward breast cancer is essential for the early diagnosis and detection especially in low and middle-income countries. This study aims to assess the awareness of breast cancer risk factors among females in the Syrian Coast.

Myopericarditis Associated With Marijuana Intake: A Case Report and Literature Review.

A 26-year-old male who endorses daily cigarette smoking and marijuana vaping presented to the emergency department with acute onset of left-sided chest pain radiating to the left shoulder. Physical examination was unremarkable, but laboratory investigations showed elevated white blood cells, cardiac biomarkers including troponin and creatine kinase, and mildly elevated C-reactive protein levels and erythrocyte sedimentation rate. Electrocardiogram displayed subtle ST-segment elevation in a diffuse pattern, leading to a diagnosis of acute myopericarditis.

A Case of Lactobacillus casei Endocarditis Associated With Probiotic Intake in an Immunocompromised Patient.

Probiotics are microorganisms, typically bacteria, similar to beneficial microbiota found in the human gut, usually consumed as dietary supplements or fermented foods. Although probiotics are generally safe, several cases of bacteremia, sepsis, and endocarditis associated with probiotics have been reported. Here we report a rare case of endocarditis in a 71-year-old female, immunocompromised due to chronic steroid intake, who presented with a productive cough and low-grade fever.

A Rare Case of Pembrolizumab-Associated Graves' Disease.

Immune checkpoint inhibitors (ICPis), such as pembrolizumab (Keytruda®), are associated with the development of several immune-related adverse events (irAEs). Thyroid dysfunction is a common endocrine irAE associated with pembrolizumab; however, Graves' disease induced by pembrolizumab is extremely rare. Few cases of this condition have been reported in the literature.

An Uncommon Case of Atrial Fibrillation due to a Lung Mass Invasion of the Left Atrial Cavity.

Atrial fibrillation remains one of the most common conditions that clinical physicians encounter on a daily basis in the inpatient setting. This arrhythmia brings with it numerous complications if not treated properly and leads to intensive analysis of its primary etiology which is unique to every patient. In this case, we present a previously asymptomatic individual who presented to the hospital with respiratory complaints and was found to have a large lung mass, consistent with neuroendocrine lung cancer with direct compression of the left atrium leading to new-onset atrial fibrillation.

Outcome Of The Distal Radius Fractures Managed With Across Wrist External Fixator Vs Buttress Plates.

Background: Distal radius fracture is one of the most common injuries presented to emergency department and can be presented in any age group. In young patients the most common cause is Road Traffic Accident (RTA), while old patient history of fall is the most common cause. Different surgical options are available to treat this injury.

A Rare Case of Lance-Adams Syndrome: Status Post-Successful Cardiopulmonary Resuscitation.

Lance-Adams syndrome (LAS), also known as chronic post-hypoxic myoclonus (PHM), is a rare condition that may present with intention myoclonus in a patient who has regained consciousness after cardiorespiratory arrest. This case report describes a patient who received successful cardiopulmonary resuscitation (CPR) after going into cardiac arrest. And regaining consciousness, the patient developed myoclonic jerks diagnosed as LAS.

Endobronchial metastasis secondary to occulting renal cell carcinoma: literature review and a rare case report.

Background: Endobronchial Metastasis from extrathoracic tumors is a rare neoplasm that accounts for approximately 1.1% of total endobronchial malignancies. The most common primary tumors associated with EBM are from the colorectal, breast, and kidney regions.

Assessment of Aging Impact on Wax Crystallization in Selected Asphalt Binders.

For a better understanding of the changing trend in crystalline components of asphalt binders, asphalt binders originating from the SHRP Materials Reference Library with different oxidation degrees (unaged, 20 h PAV, and 60 h PAV) were prepared. The native asphalt binders and their oxidized residues were characterized by liquid-state nuclear magnetic resonance (NMR) spectroscopy and high-temperature gas chromatography (HTGC). The results showed that, compared with other carbon types, the content of internal methylene carbons of long paraffinic chains between different SHRP binders was quite different.

Interlayer Shear Characteristics of Bridge Deck Pavement through Experimental and Numerical Analysis.

In order to study the interlayer shear behavior of bridge deck pavement, a numerical simulation was conducted to analyze the influence of varying interfacial conditions on shear stress at the bottom of pavement layers under the moving loading effect. Moreover, the shear strength of the different adhesive and waterproof adhesive materials was evaluated by conducting laboratory tests. The results showed that improving the bonding condition at the upper interlayer led to the reduction of the shear stress at the bottom of the pavement layers.

Magnetic Tile Surface Defect Detection Methodology Based on Self-Attention and Self-Supervised Learning.

As the core component of permanent magnet motor, the magnetic tile defects seriously affect the quality of industrial motor. Automatic recognition of the surface defects of the magnetic tile is a difficult job since the patterns of the defects are complex and diverse. The existing defect recognition methods result in difficulty in practical application due to the complicated system structure and the low accuracy of the image segmentation and the target detection for the diversity of the defect patterns.

A challenging case of ALK-negative anaplastic large cell lymphoma in a 12-year-old boy: A rare case report from Syria.

Introduction And Importance: Anaplastic Large-cell Lymphoma (ALCL) is a rare but aggressive type of NHL that develop from mature post-thymic T-cells. ALCL constitutes approximately 2% of all lymphoid neoplasm. It is typically found among children and young adults, accounting for 10-15% of pediatric NHL, compared to 2% of adult NHL.

Effects of Wax Molecular Weight Distribution and Branching on Moisture Sensitivity of Asphalt Binders.

Wax is an important factor that affects the durability of asphalt binder. In order to understand the molecular weight distribution and branching of wax on the moisture sensitivity of asphalt binder, pure wax-doped asphalt binders are prepared and the performance of model asphalt binders are evaluated by surface free-energy (SFE) and binder bond strength (BBS) tests. In addition, asphaltene is regarded as an additive in this study.

Inferior Vena Cava Thrombosis in a Young Patient With COVID-19 Infection.

Inferior vena cava thrombosis (IVCT) is a potentially fatal condition that may rarely occur in young patients with COVID-19 infection. This report describes a young adult female with a recent COVID 19 infection who presented with fever, bilateral flank pain, elevated inflammatory markers, and evidence of thrombosis in the inferior vena cava (IVC) on computed tomography (CT). The patient required treatment with anticoagulation therapy and catheter-directed thrombolysis, IVC filter placement, and mechanical suction-assist thrombectomy.

Routine Screening Mammogram Leading to the Incidental Diagnosis of a Metastatic Neuroendocrine Breast Cancer (NEBC) from an Unrecognized Asymptomatic Small Bowel Neuroendocrine Tumor.

Neuroendocrine neoplasms (NENs) are epithelial neoplasms with predominant neuroendocrine differentiation that arise in the gastrointestinal tract, unique to the site of origin, such as the pancreas and small intestine. Neuroendocrine breast carcinoma (NEBC) is a rare tumor. Diagnosing NEBC is challenging because there is no specific clinical presentation, as it is usually presented as a breast lump.

Effects of Geometry and Loading Mode on the Stress State in Asphalt Mixture Cracking Tests.

Currently, a variety of asphalt mixture cracking characterization tests are available as screening tools for the better selection of high-quality raw materials and also for the optimization of mixture design for different applications. However, for a same evaluation index, using different sample geometries and loading modes might lead to obtaining different values, which prevents the application of the evaluation index as a fundamental parameter in pavement design. In this paper, the effects of geometry and loading mode on the stress state in the experimental characterization of asphalt mixture cracking were discussed using numerical simulation.

Balancing Complex Signals for Robust Predictive Modeling.

Robust predictive modeling is the process of creating, validating, and testing models to obtain better prediction outcomes. Datasets usually contain outliers whose trend deviates from the most data points. Conventionally, outliers are removed from the training dataset during preprocessing before building predictive models.

Antigen-Multimers: Specific, Sensitive, Precise, and Multifunctional High-Avidity CAR-Staining Reagents.

Although chimeric antigen receptor (CAR) T-cell therapy has transformed cancer treatment, high-quality and universal CAR-staining reagents are urgently required to manufacture CAR T cells, predict therapy response, decipher CAR biology, and engineer new CARs. Here, we developed tetrameric and dodecameric forms of a multifunctional and extensible category of high-avidity CAR-staining reagents: antigen-multimers. Antigen-multimers detected CARs against CD19, HER2, and Tn-glycoside with significantly higher specificity, sensitivity, and precision than existing reagents.

Digitally Disconnected: Qualitative Study of Patient Perspectives on the Digital Divide and Potential Solutions.

Background: As telemedicine utilization increased during the COVID-19 pandemic, divergent usage patterns for video and audio-only telephone visits emerged. Older, low-income, minority, and non-English speaking Medicaid patients are at highest risk of experiencing technology access and digital literacy barriers. This raises concern for disparities in health care access and widening of the "digital divide," the separation of those with technological access and knowledge and those without.