Digital Commons Network^™

Oral Contraceptives Rate Of Reduction On Anterior Cruciate Ligament Injuries In Females: A Critically Appraised Topic, Paige Trent, Sara Stiltner

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

CLINICAL SCENARIO Anterior cruciate ligament (ACL) injuries occur more frequently in females than males, with estimates suggesting a 2-10 greater likelihood of females to sustain this trauma.3 FIFA issued a recent call to action encouraging further investigation into why females are still predisposed to this trauma.2 ACL incident rate is highest amongst females between 14–18-years-old with approximately 227.6 exposures per 100,000 persons per year.1 Multifactorial influences are suggested as predisposing risk factors including anatomical or hormonal components.1 Growing interest in hormonal contributions has led researchers to examine how fluctuations in estrogen, progesterone, and testosterone impact ligamentous integrity.8

Estrogen receptors are …

Case Report: Chronic Peroneal Subluxation, Natalie Weissman, Morgan Cooper Bagley, Colin Reidy

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE The case study presented explores the sign, symptoms, and unique treatment of a patient with a chronic peroneal subluxation of the right ankle. The clinical evaluation showed full range of motion with visible peroneal tendon movement over the right lateral malleolus. Surgery was not done or recommended; a four-phase rehabilitation with a return to play protocol was used. This case showed how rehabilitation through a non-surgical approach is still achievable.

The Effect Of Taper On Scapular Positioning In Division Iii Collegiate Swimmers, Maddie Hoyt, Elizabeth Starns, Andrew Busch

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE Scapular asymmetry and lateral translation are prevalent in competitive swimmers due to the repetitive overhead nature of the sport.^1,2 Additionally, ambiguity exists in the reliability of non-invasive scapular assessments. First, this study aimed to compare differences in scapular positioning during the competitive swimming season to the tapered season. The tapered season is marked by a significant decrease in intensity.^3,4,5 Second, this study aimed to determine the reliability of three commonly used scapular assessments.

Anterior Cruciate Ligament Autograft Reconstruction Outcomes In Adolescents And Young Adults: A Critically Appraised Topic, Klevione D. Brown, River A. Hamilton, Elizabeth A. Starns

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

CLINICAL SCENARIO Anterior cruciate ligament (ACL) tears are one of the most common serious knee injuries seen in high school and college-aged athletes.¹ Many athletes opt for surgical reconstruction because ACL injuries often result in knee instability and impair their ability to return to play in their sport.² There are three primary types of autografts used in reconstruction: bone-patellar tendon-bone (BTB), hamstring tendon (HT), and quadriceps tendon (QT) autografts.³ It is important to determine if a graft type has better return-to-play outcomes for adolescent and young adult athletes.

Sport-Related Concussion Incidents Across Sports, Surfaces, And Injury Mechanisms: A Retrospective Analysis Of A Digital Concussion Database, Justin Belle, Jay Alberts, Jason Cruickshank, Richard Figler, Kelsey Owen, Sami Rifat

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE/CONTEXT Sport-related concussion (SRC) represents a significant injury burden in youth athletics. Advances in digital injury surveillance platforms allow for large-scale clinical databases that may provide insight into injury mechanisms, sport distribution, and management patterns. The purpose of this study was to describe the distribution of concussion-related incidents across sports, playing surfaces, and mechanisms of injury using data from a prospectively maintained clinical concussion database.

Dysautonomia In Adolescent Athletes With Persistent Post‑Concussion Complaints, Jason A. Cruickshank

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE/BACKGROUND Dysautonomia is dysfunction in autonomic nervous system manifesting following concussion, contributing to Persistent Post‑Concussion Complaints (PPCC).^1,5 Patients with dysautonomia may present with dizziness, tachycardia, postural intolerance, headaches, cognitive fog, and activity/exercise intolerance.^1,5 Recognition of autonomic involvement is essential to recovery and preventing prolonged symptoms^.1,5

The Effectiveness Of A Mental Health Literacy Webpage For Parents, Coaches, And Athletic Trainers, Mackenzie Warner, Kimberly Peer, Hannah Harnar, David Dees

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

INTRODUCTION Mental health illnesses continue to emerge as a major public health concern, particularly among adolescents and young adults. Secondary school student-athletes face unique pressures related to academics, athletic performance, time management, injuries, and social expectations, all of which may contribute to anxiety, depression, stress, or other mental health conditions. However, there is limited research that explores secondary school student-athletes and how mental health affects their everyday lives. This could be due to the lack of mental health literacy in the individuals who surround secondary school student-athletes, including parents, coaches, and athletic trainers. Increasing their understanding of mental health literacy …

Understanding Athletic Trainer's Knowledge And Perceptions Of Mental Health Best Practices: A Mixed-Methods Study, Chelsea Pasukinis, Yvette Ingram, Malissa Martin, Robert B. Krueger

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE Mental health disorders are increasing in our society. Research on athletic trainers' (AT) knowledge and perception of mental health disorders, and whether policies are developed and used, is limited. The purpose of this study is to investigate AT’s knowledge of mental health illness, current policies and procedures, and the perceptions ATs have of mental health.

A Case Report Of Blunt Renal Trauma In A High School Football Athlete, Mariah Reeder

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE/BACKGROUND Blunt abdominal trauma in football athletes is uncommon but carries significant risk for internal organ injury and hemorrhage. Although sport-related renal injuries are rare, a significant portion of them are high-grade (IV-V) and may require advanced medical intervention if not recognized promptly.¹ Symptoms may initially appear benign, such as “having the wind knocked out,” increasing the risk of delayed diagnosis. Athletic trainers often serve as first responders and play a critical role in early recognition, on-field management, and prompt referral for advanced medical care. This case highlights athletic trainer led clinical decision making and interdisciplinary coordination following blunt …

Assessment Of A Middle School Return To Learn Concussion Protocol, Aaron Yaksich, Laura L. Harris

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE To evaluate the effectiveness of a newly implemented return to learn (RTL) concussion protocol in an adolescent athletic population.

Challenging The Standard: A Case Report Of Postpartum Rehabilitation Prior To Return To High-Intensity Functional Training, Aly Matejka

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE Postpartum athletes frequently attempt to return to high-intensity training without graded rehabilitation of the deep core and pelvic floor complex, contributing to urinary incontinence, impaired load transfer, unresolved diastasis recti, and decreased performance capacity. Despite increasing participation of postpartum individuals in high-load functional training, there is limited applied literature outlining structured, criterion-based return-to-exercise progressions that address breathing mechanics, pelvic floor function, and force development prior to reintroduction of impact and resistance training. This case report describes the implementation of a 15-week postpartum rehabilitation and return-to-training protocol designed to restore neuromuscular control, muscular endurance and strength, and impact tolerance prior …

A Post-Professional Athletic Training Education Module For Detecting Skin Conditions In Diverse Skin Tones, Lauren Oskam, Laura L. Harris

Journal of Sports Medicine and Allied Health Sciences: Official Journal of the Ohio Athletic Trainers Association

OBJECTIVE To develop and evaluate a learning module designed to improve athletic trainers’ proficiency in identifying skin conditions commonly acquired in the sport of wrestling across diverse skin tones.

A Tactile Trans-Flexor Carpi Radialis Surface Landmark Technique For Median Nerve Local Injection: A Cadaveric Study, Clark Chen, Keenan Sobol, Connor Hickey, Duncan Vannest, John Ibrahim, James Raphael

Einstein Health Papers

PURPOSE: Median nerve (MN) block under local anesthesia at the wrist is commonly performed but can be limited by anatomic variation, particularly absence of the palmaris longus tendon. This study investigates a novel trans-flexor carpi radialis (trans-FCR) technique for MN anesthesia that uses the flexor carpi radialis (FCR) tendon as a consistent surface landmark.

METHODS: Fourteen fresh frozen upper extremity cadaver specimens were used. A 25-gauge needle was inserted through the FCR sheath approximately 4 cm proximal to the wrist crease in a transverse fashion, angled approximately 0° to the vertical and parallel to the wrist crease. The trans-FCR technique …

A Lifecycle Governance And Learning Health System Framework For Trustworthy, Generalizable, And Sustainable Human-Ai Partnership In Clinical Practice: Lessons From The Asthma-Guidance And Prediction System (A-Gps), Chung-Il Wi, Shauna Overgaard, Momin Malik, Dave Watson, Deepak Sharma, Jennifer Le-Rademacher, Dan Kelleher, Lu Zheng, Joshua Ohde, Brian Lynch, Ashwani Khurana, Sunghwan Sohn, Mahmoud M Aljuhani, Chris Carpenter, Manuel Arteta, Jason Greenwood, Martha Hartz, Randy Foss, Elif Polat, Imad Absah, Carla Davis, Meera Gupta, Lynnea Myers, Björn Nordlund, Cui Tao, Mark L Wieland, Christi Patten, Amie Jones, Prathibha Varkey, Brenna T Loufek, David E Vidal, Nari Gopala, Eric Klee, Vijay H Shah, John D Halamka, Matthew R Callstrom, Nicholas L Rider, Hongfang Liu, Constantin Aliferis, Vesna D Garovic, Young J Juhn

Faculty, Staff and Students Publications

The integration of artificial intelligence (AI) into clinical decision support (CDS) holds promise for proactive, personalized, and precision care. However, current understanding of how to establish trustworthy human-AI partnerships is in its infancy, despite its critical importance for implementing AI in healthcare. We present the Asthma-Guidance and Prediction System (A-GPS) as a case study of a practice-integrated AI platform that demonstrates how trustworthy, generalizable and sustainable AI can be developed, evaluated, and implemented in real-world asthma care. We describe major challenges and solutions based on our real-world experience during the process and offer the practical framework, approaches, tools and workflow …

Robust Magnetoelectric Backscatter Communication System For Bioelectronic Implants, Fatima Alrashdan, Joshua E Woods, Ellie C Chen, Wendy Tan, Zhanghao Yu, Wei Wang, Mathews John, Lukas Jaworski, Drew Bernard, Allison Post, Angel Moctezuma-Ramirez, Abdelmotagaly Elgalad, Kaiyuan Yang, Mehdi Razavi, Jacob T Robinson

Faculty, Staff and Students Publications

Wireless communication technologies for bioelectronic implants enable remote monitoring for diagnosis and adaptive therapeutic intervention without the constraints of wired connections. However, wireless data uplink from millimeter-scale devices deep in the body struggles to achieve low power consumption while maintaining large misalignment tolerances. Here, we report a passive wireless backscatter communication system based on magnetoelectric transducers that consumes less than 0.3 pJ/bit and achieves less than 1E-6 bit error rate at a distance of 55 mm while tolerating a misalignment of 10 mm. Using this robust data uplink, we designed a wireless cardiac sensing node that can transmit electrocardiogram signals …

Frailty Is A Predictor Of Inpatient Mortality And Unplanned Icu Admission Following Early Fixation Of Intertrochanteric Fractures., Victor Koltenyuk, Jared Sasaki, Nithin Gupta, Zachary Chanmin, Ruby G Patel, Taylor Manes, Jack W Weick

Surgery Articles

Purpose: This study sought to examine the role of frailty in predicting inpatient mortality following early surgical fixation of intertrochanteric (IT) fractures.

Methods: The ACS-TQIP (2017-21) database was queried for patients with intertrochanteric fractures undergoing surgical fixation within 48 h. Frailty status was determined using the 5-item modified frailty index (mFI-5) (0 = nonfrail, 1 = prefrail, and, 2 = frail, and > 2 = severely frail). The primary end point was inpatient mortality. Secondary end points were unplanned ICU admission and thromboembolic events (DVT or PE). Significance was considered a p-value < 0.05.

Results: Frailty, as determined by the mFI-5, was …

Getting To The Heart Of The Problem: Blood Pressure Management Through Medication Adherence, Mallory G. Livengood

Evidence-Based Practice Project Reports

Clinical hypertension affects one in four adults globally, making it the most common chronic condition. Despite its widespread impact, hypertension can be prevented, as it represents the most modifiable risk factor in preventing cardiovascular disease. The primary purpose of this evidence-based project was to determine whether a one-month follow-up with a healthcare provider improved medication adherence through enhanced hypertension management. Twelve eligible participants were selected from a primary clinic located in Northwest Indiana, based on their newly initiated anti-hypertensive medications or who required a medication adjustment due to poor hypertension management. Each participant’s preferred method of communication was noted, and …

Breastfeeding Promotion For Infants With Neonatal Abstinence Syndrome (Nas), Olivia Czerwonka

Evidence-Based Practice Project Reports

Neonatal abstinence syndrome (NAS) is the exposure in utero to drugs with the incidence in the United States increasing from 4 to 6.3 per 1000 births (Wei et al., 2023). The purpose of this quality improvement project was to implement a breastfeeding support intervention to increase breastfeeding frequency and reduce hospital length of stay of newborns with NAS. A tailored multicomponent guideline based upon the current Ten Steps to Successful Breastfeeding as established by WHO and UNICEF (2017) was implemented. Mothers of infants diagnosed with NAS were recruited using convenience sampling from a Northwest Indiana Hospital. Key stakeholders within the …

Evaluating The Impact Of A Standardized Intimate Partner Violence Screening Tool In A Clinical Setting, Dylan Bogucki

Evidence-Based Practice Project Reports

Intimate partner violence (IPV) is defined as any act of violence, including physical, sexual, stalking, or psychological aggression by an intimate partner, former or current. Despite being preventable, IPV remains a leading nonobstetric cause of morbidity and mortality among women, which highlights the need for systematic screening in clinical settings. The purpose of this quality improvement project is to identify women who have previously experienced or are currently experiencing IPV and to connect them with appropriate resources. Twenty-one studies were identified, all demonstrating moderate to high methodological quality and supporting the need for routine IPV screening in women’s health settings. …

Restless Legs Syndrome And Neurological Comorbidities: A Narrative Review, Kyrillos Ghattas, Helen Hernandez, Yongwoon Huh, Zhanna Fast, Zhikui Wei

Department of Sleep Medicine Faculty Papers

Restless legs syndrome (RLS) is a common yet underrecognized neurological disorder characterized by uncomfortable sensations and an irresistible urge to move he legs, typically following a circadian pattern. RLS frequently co-occurs with various other neurological diseases, raising questions about shared mechanisms and clinical consequences. This review synthesizes evidence on the prevalence, outcomes, and pathophysiology of RLS in various neurological disorders, including Parkinson's disease, multiple sclerosis, migraine, dementia, stroke, epilepsy, and peripheral neuropathy. In Parkinson's disease, RLS is linked to disease progression and dopaminergic therapy. In stroke and multiple sclerosis, RLS is associated with structural lesions at specific locations, such as …

Postapproval Study For Brain-Responsive Neurostimulation For Drug-Resistant Focal Epilepsy: Three-Year Efficacy And Interim Safety Results, Dawn Eliashiv, Vikram R. Rao, Barbara C. Jobst, Jerzy P. Szaflarski, John D. Rolston, Lesley C. Kaye, Taneeta Mindy Ganguly, Katie Bullinger, Patricia C. Dugan, David E. Burdette, Angela Y. Peters, Atif Sheikh, Kevin F. Haas, Dileep R. Nair, Lilit Mnatsakanyan, Imran H. Quraishi, Meriem K. Bensalem-Owen, Michael J. Doherty, Babak Razavi, Tiffany L. Fisher, Christopher T. Skidmore, Pradeep N. Modur, Tawnya M. Constantino, Vicenta Salanova, Andrew J. Cole, Olga Taraschenko, Angelica Rivera-Cruz, James W. Wheless, Nitin Tandon, Antoaneta Balabanov, Sami Aboumatar, Itzhak Fried, Cornelia Drees, Hae Won Shin, Zeenat Jaisani, Stephanie E. Maciver, Sanjay E. Patra, Edward F. Chang, Jon T. Willie, Ryder Gwinn, Travis Stoub, John M. Stern, Tami Crabtree, Cairn G. Seale, Sharon C. Mcfadden, Jacob F. Norman, Lise Johnson, Martha J. Morrell

Department of Neurology Faculty Papers

BACKGROUND AND OBJECTIVES: Neuromodulation therapies are approved for the treatment of focal epilepsy based on data from randomized controlled trials (RCTs). After approval of a responsive direct brain stimulation device (The RNS System for focal epilepsy), the Food and Drug Administration required a prospective study to evaluate whether real-world safety and effectiveness differed from outcomes in the RCT.

METHODS: This open-labeled study enrolled adult participants who met the RNS System-approved indication for use. The primary effectiveness end point was median percent change in seizure frequency at 3 years of treatment. Interim safety is presented; the primary safety endpoint analysis will …

Comparing The Use Of Measured And Smoothed Data In Forecasting Visual Field Tests Using Deep Learning, Ashkan Abbasi, Sowjanya Gowrisankaran, Wei-Chun Lin, Xubo Song, Bhavna Josephine Antony, Gadi Wollstein, Joel Schuman, Hiroshi Ishikawa

Wills Eye Hospital Papers

OBJECTIVE: To evaluate the impact of training and testing deep learning (DL) models for visual field (VF) forecasting using input-target pairs in which the target is either the measured VF test result, or its smoothed counterpart constructed via linear regression.

DESIGN: A retrospective data analysis study evaluating DL models for VF forecasting under multiple training and testing configurations.

SUBJECTS AND CONTROLS: A total of 1400 subjects (healthy and glaucoma patients) with 19 437 reliable Humphrey VF (24-2 Swedish Interactive Threshold Algorithm) tests collected from longitudinal cohorts at the University of Pittsburgh and New York University.

METHODS: Three DL-based pointwise VF …

Neuroplasticity And Hippocampal Impacts Associated With Obstructive Sleep Apnea, Rumaysa Aliniazee

COD Library Student Research and Award Symposium

A review on the implications of Obstructive Sleep Apnea (OSA) and Hippocampal Brain Health. It explores the role of sleep medicine, its effect on the hippocampus, its influence on cognitive function, and emphasizes the need for continued research and intervention to preserve cognitive health.

Faculty Sponsor:  Professor Felipe Armas

Adrenal Crisis Induced-Seizures: A Case Report And Literature Review, Israel Umoh, Elizabeth Mikhail, Narjis Batool, Nosheen Hajra, Ibrahim Al-Sanouri

Journal of Community Hospital Internal Medicine Perspectives

This case report underscores the critical interplay between adrenal crisis and seizure activity, emphasizing the importance of rapid recognition and management of this life-threatening condition. Adrenal crisis, characterized by severe hypotension and electrolyte disturbances, often manifests with nonspecific symptoms such as fatigue, nausea, and altered consciousness, which can obscure diagnosis, especially in pediatric and young adult populations. The report details a 21-year-old female with a complex endocrinologic background who developed seizures precipitated by an adrenal crisis triggered by gastroenteritis and compounded by medication noncompliance. Clinical findings included profound dehydration, electrolyte abnormalities, refractory hypotension, and low cortisol levels, which responded favorably …

Pediatric Burns: Severity, First Aid, And When To Refer, Mike Smith, Pablo Aguayo

Pediatrics in Practice: A CME Podcast

This episode explains burn depth, TBSA estimation, and practical first aid that reduces complications—essential for pediatricians and ER providers who triage children with burns. Pablo Aguayo, MD (Children’s Mercy) walks through burn classification (superficial to fourth-degree), scald burns, and American Burn Association referral criteria. Keywords: pediatric burns, burn severity, burn first aid, scald injuries, TBSA, burn center referral. For more resources and show notes, visit the Pediatrics in Practice CME Podcast page and subscribe for updates.

Click here to stream the podcast episode.

Value Of The Non-Enhanced Cardiac Computed Tomography Scan Analysis In Determination Of The Appropriate Coronary Ct Angiography Scan Protocol Improving Image Quality While Minimizing Radiation, Osama A Smettei, Sawsan A Sayed, . Fatin M Ahmed, Tawfeeq H Alharbi, Mohammed Saied, Rami M Abazid

Journal of the Saudi Heart Association

Objective: Coronary computed tomography angiography (CCTA) is a cornerstone in the assessment of coronary artery disease. Despite technological advancements, balancing radiation does with diagnostic image quality remains a challenge. This study evaluates whether assessing preliminary non-enhanced CT scans allows for the optimization of CCTA gating protocols to enhance image quality and minimize radiation exposure.

Methods: We prospectively analyzed 150 patients undergoing CCTA on a 256-slice scanner. Non-enhanced scans were used to identify motion artifacts or anatomical challenges. Based on these findings, a specific gating protocol (prospective, prospective with padding, or retrospective) was selected. This cohort was compared to a …

Blue Light Exposure, Eye Strain, And Sleep Quality: Evaluating The Effectiveness Of Blue-Light Filtering Lenses, Sara Rozalowski

Honors Capstones

This study employs a literature review to critically evaluate the benefits of blue light–filtering lenses and to determine whether their use against eye strain and toward sleep quality is supported by empirical evidence. The aim of this research is to provide evidence-based information to better inform patients regarding the clinical utility and practical applications of blue light filtration in corrective lenses.

What Is Screen Apnea And How Does It Affect You?, Kristi M. Soileau

New Orleans Dental Association News

Screen apnea is a modern epidemic of significant proportions. Research suggests that nearly 80% of people unconsciously alter their breathing, often holding their breath or breathing shallowly, while working on digital devices. This subtle shift in respiration, sometimes called “email apnea,” can place the body into a low-grade stress response without being noticed by the individual at the screen. When breathing becomes restricted from poor posting or content anxiety, the nervous system enters into a sympathetic response, much as it interprets signs of threats to that person. The resultant physiological response may be exhibited by muscle tension, mental fog, increased …

Enhancing Pediatric Resident Trauma Education In The Pediatric Emergency Department, Dina Nassar, Elizabeth Kurian

St. Chris Research Day

No abstract provided.

Quantifying Patient Positioning Errors And Radiation Dose Variation In Cardiac Computed Tomography Angiography, Yasser H. Hadi, Hassan B. Hawsawi, Niamh Moore, Helle Precht, Andrew England, Mark Mcentee

Journal of the Saudi Heart Association

Objectives: Accurate patient centring at the computed tomography (CT) scanner isocentre is essential for optimising radiation dose. This study aimed to quantify positioning errors, assess their relationship with radiation dose, and estimate the potential dose reduction achievable with optimal centring. Methods: This retrospective observational study included adult patients (≥18 years) who underwent electrocardiography (ECG)-gated cardiac CT angiography between January 2023 and July 2025 at a tertiary hospital. Scans were performed using Siemens SOMATOM Force dual-source CT systems. Vertical and lateral deviations from the scanner isocentre were calculated from scout images using integrated analytics within the institutional dose monitoring platform (Qaelum …