Digital Commons Network^™

Induced Membrane Reconstruction Of A 6-Cm Ulnar Defect With Concurrent Revision Bone Grafting Of Radial Nonunion Following Gustilo-Anderson Type Iiib Open Forearm Fracture: A Case Report., John N Manfredi, Abdullah B Chandasir, Mitchell Lomis, Brent Prenger, Humzah Ali, Kyra Urquhart-Foster, Caleb J Bischoff, Abrar Adil Ansari

Surgery Articles

The induced membrane technique (IMT) is a two-stage reconstructive procedure for critical-sized bone defects. We report a 31-year-old male who sustained a Gustilo-Anderson grade IIIB open fracture of the radius and ulna following a high-energy dirt bike injury, complicated by Serratia marcescens fracture-related infection and septic nonunion. Intraoperative debridement at Stage 1 revealed a 6-cm defect of the ulna, which was managed with an antibiotic-impregnated polymethylmethacrylate (PMMA) spacer. A concomitant radial nonunion, identified on postdebridement CT, was addressed at Stage 2 with concurrent revision open reduction and internal fixation (ORIF) and autogenous femoral bone grafting. Culture-directed oral antibiotic therapy was …

Ceftaroline Pharmacokinetics On Ecmo, A Pediatric Case Report., Kathryn Pavia, Ashton Bellamy, Alaina Burns, Allison Scott, Ethan A. Poweleit

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: In-vitro studies suggest that patients on extracorporeal membrane oxygenation (ECMO) may struggle to achieve therapeutic ceftaroline exposure to treat infections due to antibiotic sequestration within the ECMO oxygenator; however, there are no published data regarding ceftaroline concentrations from patients supported by ECMO.

PATIENT PRESENTATION: Here we present an analysis of ceftaroline pharmacokinetics in a 5-y-old patient supported on ECMO due to influenza-associated necrotizing pneumonia.

RESULTS: A total of nine concentrations were analyzed, including three concentrations prior to cannulation and six on ECMO. ECMO cannulation was associated with a relatively small change in the volume of distribution (0.17 L/kg to …

Early Prediction Of The Breast Cancer Response To Neoadjuvant Chemotherapy Based On Intratumoral Interstitial Fluid Pressure Using 3-D Subharmonic-Aided Pressure Estimation, Sung In Choi, Basak Dogan, Corinne E. Wessner, Jessica H. Porembka, Priscilla Machado, B. Bersu Ozcan, Nisha Unni, Maysa Abu-Khalaf, Kenneth Hoyt, Flemming Forsberg, Kibo Nam

Department of Radiology Faculty Papers

Elevated intratumoral interstitial fluid pressure (IFP) may negatively impact the efficacy of neoadjuvant chemotherapy (NAC). This study aimed to predict the breast cancer response to NAC based on intratumoral IFP using 3D contrast-enhanced ultrasound (CEUS) with subharmonic-aided pressure estimation (SHAPE). This prospective study enrolled breast cancer patients undergoing NAC from two clinical sites. 3D CEUS was performed at 0%, 10%, and 30% of NAC completion using a GE Logiq E9 with Definity. The pressure gradients between the tumor and adjacent normal tissue were estimated by SHAPE, utilizing the inverse linear relationship between the ultrasound contrast agent’s subharmonic signal amplitude and …

Sex-Based Disparities In Artificial Intelligence For Cardiovascular Disease: A Scoping Review, Maurgan Lee, Tarek Atasi, Michael Mclellan, Yodit Beru, Jason Booza

Population, Patient, Physician and Professionalism Projects

No abstract provided.

Training Apart, Together: Team Dynamics In Individual Sports And Surgical Residency, W. Jack Palmer, Dylan Bertoni, Elizabeth E. Cottrill, Colin T. Huntley

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Surgeons in training share notable parallels with competitive athletes, including rigorous training, skill specialization, and functioning under pressure. Surgical educators have leveraged this comparison, incorporating techniques from sports psychology, such as mental imagery and mindfulness, to improve trainees' individual performance and well-being. Surgical trainees and athletes both rely on effective teamwork for optimal outcomes, suggesting that residency leaders can glean valuable team-level insights from sports psychology. This article examines how the structure of surgical residency influences team dynamics, using concepts from sports psychology to identify evidence-based strategies for improving program cohesion and resident well-being. The surgical literature typically conceptualizes surgery …

Clinical Presentations, Treatments, And Outcomes Of Pediatric Lupus Nephritis: A Prospective Cohort Study From The Pediatric Nephrology Research Consortium., Melonie Phillips, Mahmoud Kallash, Chloe Tang, Steve Rust, Kia Jubert-Bacon, Scott Wenderfer, Smriti Mohan, Neal Blatt, Don Batisky, Alejandro Quiroga, Tetyana L. Vasylyeva, Nilka Dejesus, Jerome C. Lane

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: There are few prospective studies of mycophenolate mofetil (MMF) versus cyclophosphamide (CYC) for pediatric lupus nephritis (pLN) and none evaluating rituximab (RTX).

METHODS: The Prospective Pediatric Lupus Nephritis Registry (ProPeL-R) enrolled patients <  21 years within 4 weeks of an initial kidney biopsy diagnostic of pLN. Demographic, clinical, and laboratory data were collected prospectively at enrollment, 3 months, 6 months, and then every 6 months thereafter for up to 5 years of follow-up. For this study, we compared patients receiving initial therapy with corticosteroids (CS) and either MMF (n = 33) vs. CYC (n = 18), and those treated with CS, either MMF or CYC, with RTX (n = 20) vs. without RTX (n = 51).

RESULTS: Histology consisted of 18% class III; 35% class IV; 25% mixed class; and 22% pure class V. Eighty-two percent were female. No significant differences in response or infection rates were identified between those receiving MMF or CYC. There was a significant increase in combined complete (CR) and partial response (PR) at 24 months with RTX use. Overall CR rates at 6 and 24 months were 35% …

Early Hands-On Surgical Exposure: Outcomes Of A Student-Led Surgical Externship Program For Preclinical Students, Meryem C. Guler, Elizabeth Spitz, Jennifer E. Geller, Talar Tatarian, Renee Tholey

Department of Surgery Faculty Papers

Objective: Early surgical exposure may potentially influence medical students' decision to pursue a surgical career. At our urban, academic medical school, senior medical students developed a Surgical Externship Program (SEP) to provide first-years with hands-on OR experience. This program is a structured 1- to 2-week immersive experience in which first-year students scrubbed into operations, participated in rounds, and engaged with surgical teams under resident and attending supervision. This study evaluates the SEP's impact on surgical interest, OR confidence, and clinical exposure.

Setting: Academic tertiary care hospital.

Participants: First-year medical students.

Design: First-year students participated in a 1- or 2-week SEP …

A Profile Of Assisted Living Direct Care Workforce Training Requirements Across The United States, Erh-Chi Hsu, Paula Carder, Lindsey Smith, Zhiqing E. Zhou, Olga Yakusheva, Anna S. Beeber, Eric Jutkowitz, Kali Thomas

Institute on Aging Publications

Objectives

To characterize assisted living (AL) direct care worker (DCW) training requirements across the United States and how these regulations have changed over time. Specifically, we examine state-level profiles of training regulations, including duration, frequency, content, source of materials, evaluation, and changes in regulatory coverage.

Design

Cross-sectional and longitudinal descriptive study using state policy data and AL directories from 2019, 2021, and 2023.

Setting and Participants

All US states' AL training–related regulations; all ALs and AL beds governed by those regulations.

Methods

We used a mixed-methods approach with an explanatory sequential design (QUAN → qual), first conducting health services regulatory …

Exploring The Contextual Relationships Between Match Day Load And Recovery Biomarkers In Professional Soccer Players, Carina Hanson-Evans, Ryland Morgans, Rafael Oliveira, Jule Scholten, Roi Gil, Ben Ryan, Jon Oliver, Piotr Żmijewski, Michael G. Hughes

Baltic Journal of Health and Physical Activity

Background: This study examined the relationship between match-day (MD) load and contextual factors on recovery biomarkers in professional soccer players across the 2024/2025 competitive season. Materials and Methods: Twenty-six male professional soccer players provided blood samples following 38 competitive matches. High-sensitivity C-Reactive Protein (hs-CRP), Free-Oxygen Radicals Test (FORT), Free-Oxygen Radicals Defence Test (FORD) and Oxidative Stress Index (OSI) were analyzed. Physical MD load was measured via a Global Positioning System (GPS). Results: Differences in High-Load vs Low-Load matches did not significantly influence post-match levels of hs-CRP, FORD, FORT or OSI. Increased high-intensity running and elevated inflammation, with non-significant moderate-to-large effects …

Korelasi Indeks Massa Tubuh Dengan Kekuatan Otot Dan Performa Fisik Pada Lansia Sarkopenia Di Posyandu Lansia Palembang, A. Deza Farista, Nur Riviati, Ridzqie Dibyantari, Erial Bahar, Taufik Indrajaya, Melani Melani, Michael Jonathan Tan, Crisnah Indah, Indah Aprilia

Jurnal Penyakit Dalam Indonesia

Introduction. The number of older adults in Indonesia continues to increase, and so does the number of older adults with sarcopenia. The decline in muscle mass, muscle strength, and physical performance can reduce quality of life. Body Mass Index (BMI) is easy to measure at community health posts, but it is unclear whether BMI reflects muscle strength and physical performance in older adults who already have sarcopenia. This study aimed to analyze the correlation between BMI and muscle strength and physical performance in older adults with sarcopenia.

Methods. This analytical observational cross-sectional study was conducted from September to …

Overview Of Glp-1ra Medications, Thomas A.F. Cordaro Pharmd, Sumaiya A. Difaa Pharmd, Amel J. Basil Pharmd

Transformative Medicine

GLP-1 is an incretin hormone that is naturally produced in the body that regulates blood glucose and appetite. The first GLP-1RA that was FDA approved, exenatide, in 2005, originated from the Gila monster and beaded lizard, via the discovery of the exendin-4 peptide. GLP-1RAs function by mimicking endogenous GLP-1 incretin hormone, leading to an increase in glucose-dependent insulin release from beta-cells of the pancreas, decrease in glucagon release, delayed gastric emptying, and satiety. Due to the benefits seen from initiating GLP-1RAs in the market, it sparked interest in numerous studies which proved that certain GLP-1RAs can provide cardiorenal protection. The …

Wolff-Parkinson-White Pattern: Recognition Of Ventricular Pre-Excitation And Risk Stratification, Devi Parvathy Jyothi Ramachandran Nair, Badri Aryal

Transformative Medicine

Background: Wolff-Parkinson-White (WPW) pattern is characterized by ventricular pre-excitation through an accessory atrioventricular pathway. Although often asymptomatic, some pathways carry a risk of tachyarrhythmia and sudden cardiac death.

Case Description: A 45-year-old man with hypertension, polysubstance use, and bipolar disorder presented with altered mental status following suspected substance intoxication. His course was complicated by hypoxic respiratory failure requiring intubation and a large right basal ganglia hemorrhage requiring surgical evacuation. During hospitalization, an abnormal ECG prompted Cardiology consultation. The ECG demonstrated sinus rhythm with a short PR interval, delta wave, and widened QRS complex, consistent with ventricular pre-excitation. He had …

Beyond Electromyography: A Systematic Review And Meta-Analysis Of Ai Enabled Wearables For Neuromuscular Assessment In Sports Medicine And Rehabilitation, Dariusz T. Skalski, Michał Spieszny, Łukasz Jaworski, Marcin Żak, Artur Terbalyan, Marlena Stawiarska, Wirginia Likus, Adam Maszczyk

Baltic Journal of Health and Physical Activity

Background: Conventional laboratory based EMG systems constrain neuromuscular assessment to controlled environments, limiting ecological validity in sport and rehabilitation. While AI enabled wearable sensor systems, including surface EMG (sEMG), high density EMG (HD-EMG), inertial measurement units (IMUs), and multimodal configurations, have expanded ambulatory monitoring capabilities, no prior meta-analysis has quantitatively synthesized their agreement with laboratory grade comparators or examined the moderating roles of sensor class and task domain. Objective: To determine the overall agreement between AI enabled wearable neuromuscular systems and laboratory benchmarks; to examine sensor class and task domain as moderators of measurement fidelity; to evaluate multimodal gain over …

Eeg-Emg Coupling And Functional Neuroplasticity In Elite Combat Athletes: Effects Of Neurofeedback Training On Corticomuscular Coherence And Performance, Alicja Markiel, Kinga Łosińska, Marcin Żak, Adam Maszczyk

Baltic Journal of Health and Physical Activity

Background: Neurofeedback training has gained attention as a neuroplasticity based intervention for athletic performance, yet pathways linking cortical oscillatory modulation to neuromuscular adaptation and strength remain poorly characterized in elite combat athletes. Objective: This study examines whether EEG neurofeedback targeting sensorimotor alpha upregulation and frontal theta/delta modulation enhances cortico-muscular coherence, neuromuscular function, and maximal strength in elite MMA athletes. Methods: Thirty elite male MMA athletes (n = 10/arm) were randomized to intensive neurofeedback (E20G, 20 sessions), abbreviated neurofeedback (E15G, 15 sessions), or sham control. EEG spectral indices, EMG parameters (RMS, MF, iEMG, onset latency), beta band CMC, and maximal strength …

Intimate Partner Violence And Child Wasting Across Countries: An Ecological Cross-Sectional Study, Wanri Lumbanraja, I Ketut Kasta Arya Wijaya, Ruben Cornelius Siagian

Journal of Indonesian Health Policy and Administration

Intimate partner violence (IPV) is a public health issue that can affect the well-being of women, their families, and the child-rearing environment. Meanwhile, wasting in under-five children reflects acute malnutrition linked to food insecurity, infectious diseases, poverty, and access to healthcare services. This study aimed to analyze the relationship between the prevalence of IPV among women in the past 12 months and the prevalence of wasting in children under the age of five at the national level. This study addresses the gap in cross-national research, which remains limited in linking IPV as an indicator of social vulnerability with wasting as …

The Importance Of Biopsy In New Lower Extremity Lesions: A Case Of Kaposi Sarcoma, Michael A. Higham, Stephanie N. Campbell, Naomie Jean, Amanda L. Killeen

School of Podiatric Medicine Publications

Introduction: Kaposi sarcoma is a vascular neoplasm associated with human herpesvirus-8 (HHV-8) that may present with atypical cutaneous findings in the lower extremity. Delayed diagnosis may occur when lesions resemble benign wounds or hypergranulation tissue, particularly in patients without a known oncologic history.

Aim: To present an atypical pedal presentation of Kaposi sarcoma initially encountered as a new lateral foot wound in an elderly patient with peripheral arterial disease and neuropathy.

Methods: An 80-year-old Hispanic male presented with a new “wound” of unknown duration on the lateral aspect of the left foot. Physical examination demonstrated xerotic skin with mild erythema …

Evaluating Platelet-Rich Plasma For Diabetic Foot Ulcer Healing: A Scope Review, Sairakshitha Yalla, Sarah Morales, Amanda Killeen

School of Podiatric Medicine - Student Research

Introduction: Chronic diabetic foot ulcers (DFUs) are becoming increasingly common with the rising prevalence of diabetes. These wounds are often difficult to heal due to the complex complications associated with the disease. Platelet-rich plasma (PRP), traditionally utilized as an adjunctive therapy for musculoskeletal injuries, has more recently been applied topically to promote the healing of DFUs.

Aims: To analyze if PRP heals DFUs faster than the standard of care.

Methods: A scoping review of PubMed and Google Scholar (2016-2026) was conducted. Inclusion criteria were published in the English language, randomized controlled trials involving adults, utilizing autologous PRP.  Exclusion criteria included …

A Hypothalamic Neuronal Population Coordinates Metabolic Adaptations To Cold, Hailan Liu, Qingzhuo Liu, Jonathan C Bean, Fuhui Wang, Jinjing Jian, Yongxiang Li, Kristine M Conde, Mengjie Wang, Yue Deng, Yuxue Yang, Tong Zhou, Jingjing Cheng, Yutian Liu, Meixin Sun, Xinming Liu, Jiamin Qiu, Xi Wu, Lamei Xue, Qingchun Tong, Benjamin R Arenkiel, Mingshan Xue, Huxing Cui, Tzu-Chiao Lu, Yanyan Qi, Hongjie Li, Chunmei Wang, Yang He, Yongjie Yang, Longlong Tu, Yong Xu

Faculty, Staff and Students Publications

Cold exposure increases feeding, thermogenesis, and energy expenditure to maintain body temperature and energy balance, but the underlying neural mechanisms remain unclear. Here, we identify cold-responsive neurons in the dorsal posterior periventricular hypothalamus that coordinate these adaptations. Activation of GABAergic or cold-activated neurons increased food intake, body temperature, and brown adipose tissue thermogenesis, whereas their inhibition attenuated cold-induced hyperphagia and thermogenesis. Single-nucleus RNA sequencing identified Lef1 as a marker of cold-activated neurons in this region. Activation of Lef1+ neurons recapitulated key cold responses, whereas silencing attenuated them. Lef1 positively regulated Kcnk2, which encodes the cold-sensitive potassium channel TREK-1. Cold …

What Causes Heavy Menstrual Bleeding In Teens?, Sarah Gubara, Ashli Lawson, Lauren Amos Md, Ms

Pediatrics in Practice: A CME Podcast

Curious why your teen’s periods are so heavy? Heavy menstrual bleeding and its causes are discussed. Lauren Amos, MD, MS, Pediatric Hematology/Oncology at Children's Mercy - Pediatrics in Practice - CME, and Ashli Lawson, MD, MS, Program Director, Pediatric & Adolescent Gynecology Fellowship at Children's Mercy - Pediatrics in Practice - CME, explain common contributors such as anovulatory cycles, underlying bleeding disorders (up to 30% in affected adolescents), and when to consider a transabdominal pelvic ultrasound or thyroid (TSH) check.

Click here to stream the podcast episode.

What Causes Enlarged Lymph Nodes In Kids?, Mike Smith, Lori E. Morgan

Pediatrics in Practice: A CME Podcast

Why are my child's lymph nodes enlarged? Lymphadenopathy — Lori Morgan, MD, MCR, Physician, Hematology and Oncology at Children's Mercy - Pediatrics in Practice - CME, explains that infection is the most common cause and why lymph nodes enlarge during immune responses. Hear about typical locations (cervical, submandibular, submental), how thin children may show prominent nodes, why parents commonly discover them, and when a history should prompt further evaluation.

Click here to stream the podcast episode.

Is My Child's Heart Murmur Dangerous?, Bob Underwood, Mahmoud Jaara, Pezad Doctor

Pediatrics in Practice: A CME Podcast

Is my child's heart murmur dangerous or just harmless? Heart murmurs and when they matter — Pezad Doctor, MD, Pediatric Cardiology at Children's Mercy - Pediatrics in Practice - CME, and Mahmoud Jaara, MD, pediatric cardiology fellow at Children's Mercy - Pediatrics in Practice - CME, explain how to tell innocent murmurs (soft, systolic, short, position‑dependent) from concerning ones, which symptoms and family history raise concern, and what to expect at a cardiology visit (exam, oxygen saturation, pulses).

Click here to stream the podcast episode.

Nemp1 Organizes The Meiotic Telomere-Linc Interface To Control Chromosome Movement And Telomere Integrity, Hui Zhang, Ling Zhang, Stephanie A Pangas, Andrea Jurisicova, Helen Mcneill

Faculty, Staff and Students Publications

Nuclear Envelope Membrane Protein 1 (NEMP1) is highly expressed in oocytes and required for fertility, yet its meiotic function remains poorly understood. Here, we identify NEMP1 as a critical organizer of meiotic telomere-nuclear envelope coupling and chromosome dynamics. Loss of NEMP1 causes telomere aggregation, loss of shelterin protection, telomere shortening, persistent DNA damage, aberrant non-homologous end joining, and chromosome end-to-end fusion, ultimately leading to aneuploidy in mouse oocyte. NEMP1 is required during early fetal meiotic prophase I for telomere-nuclear envelope attachment, bouquet formation, homolog pairing, and synapsis. Live-cell imaging revealed robust rapid prophase movements in wild-type meiocytes, which were nearly …

Risk Factors Associated With Moderate And Severe Traumatic Brain Injury Mortality In Admitted Older Adults: A Retrospective, Single-Center Study At A Level Ii Trauma Center., Michael Sawyers, Katherine Graham, John Elliott, Jeff Hubartt

Trauma and Acute Care Articles

Purpose: Approximately one in four adults aged ≥65 years experiences a fall each year, and over one-third of these events require medical care. Older adults are at higher risk of complications because of comorbidities. Most prior studies have focused on incidence rather than outcomes, and few have evaluated the association between age and traumatic brain injury (TBI) mortality. This study assessed risk factors and risk-adjusted mortality and morbidity among older adults with moderate or severe TBI.

Methods: We conducted a retrospective review of data from a single-center trauma registry. Inclusion criteria were age ≥65 years, admission ≥3 days (2019-2024), Abbreviated …

Feasibility And Acceptability Of Perioperative Application Of Biofeedback-Based Virtual Reality Vs Control For Pain And Anxiety In Children And Adolescents Undergoing Surgery: Pilot Randomized Controlled Trial, Anna Lin, Brenna Rachwal, Lindsey Asti, Zandantsetseg Orgil, Isabela Santiago, Lili Ding, Susmita Kashikar-Zuck, Christopher King, Sara Williams, William Black, Peter Minneci, Vanessa Olbrecht

Department of Anesthesiology Faculty Papers

BACKGROUND: The impact of biofeedback-based virtual reality (VR-BF) on pain and anxiety in pediatric surgical patients remains unexplored.

OBJECTIVE: The objective of this study was to evaluate the feasibility and acceptability of perioperative VR-BF use in children and adolescents.

METHODS: We performed a single-blind, 2-arm, randomized pilot trial. Children aged 12 to 18 years undergoing surgery with expected moderate-to-severe postoperative pain and more than 1 overnight admission were randomized (1:1) to the intervention or control group. Participants in the intervention group received VR-BF using ForeVR (functional outcome response to engaging virtual reality [VR]), a novel, gamified digital intervention that integrates …

Operative Vs Non-Operative Management Of Ventral Hernia: A Population Based Study Of Long-Term Benefits And Consequences, Sourav Podder, Julia A. Baran, Scott H. Koeneman, Francesco Palazzo, Nicole L. Dugan, Christopher Keating, Sami Tannouri

Department of Surgery Faculty Papers

Purpose: Ventral hernia (VH) management has progressed beyond simply physical repair of the defect. It now involves a strategy that purposefully restores abdominal core function and prevents future complications. This study investigates the association between ventral hernia repair (VHR) and functional disorders related to the abdominal core in addition to bowel obstruction, opioid misuse, and physical therapy utilization.

Methods: This retrospective cohort study used administrative codes from the TriNetX database. The outcomes of interest were spine and pelvic floor dysfunction, constipation, incontinence, genital prolapse, bowel obstruction, opioid misuse, and physical therapy utilization.

Results: A total of 587 384 patients were …

Interface Geometry Governs Probe Insertion Mechanics And Electrode Deviation In Layered Brain-Mimicking Phantoms For Deep Brain Stimulation, Siyu Chen, Chengyuan Wu, Ethan Anders, Rungun Nathan, Olivia M. Bailey, Qifu Wang, Curtis L. Johnson, Qianhong Wu

Department of Neurosurgery Faculty Papers

Parkinson's disease (PD) is a progressive neurological disorder often treated with Deep Brain Stimulation (DBS), a surgical procedure that involves implanting electrodes to improve motor function. Accurate electrode placement is critical for treatment efficacy but can be influenced by tissue deformation, insertion forces, and the mechanical properties of brain tissue. In this study, we investigated the role of layer interface angle as a controlled biomechanical factor affecting insertion forces and electrode deviation. A two-layer agar gel phantom was constructed to produce a prescribed stiffness transition between a lower-stiffness and a higher-stiffness gel layer, and its small-amplitude dynamic shear-stiffness contrast was …

A Mixed Methods Study Of Inpatients’ Experiences, Priorities, And Health-Related Quality Of Life During High- Flow Nasal Cannula Therapy, Cintamani H. Ellsworth, Rebecca S. Bartlett

Journal of Patient-Centered Research and Reviews

Purpose: High-flow nasal cannula (HFNC) is an oxygen delivery method with numerous benefits for severely ill patients. There is a paucity of research focused on the perspectives of patients receiving HFNC oxygen therapy. This study aimed to engage with patients to gain a clearer understanding of their experiences, priorities, and health-related quality of life.

Methods: A cross-sectional, mixed methods study was completed with 10 adult inpatients who had received HFNC oxygen therapy during their hospital admission. Semi-structured interviews and the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Scale were used to identify participant perceptions of their physical and …

Tarsal Tunnel Syndrome Due To Post-Traumatic Osseous Tunnel Formation: A Rare Case And Surgical Management, Dev Y. Patel, Eshan Doshi, Fiona Zimmerman, Jamal Revolus, Michael Kimball, Michael Franco

Cooper Rowan Medical Journal

Tarsal tunnel syndrome (TTS) is classically a compressive neuropathy of the posterior tibial nerve beneath the flexor retinaculum, presenting with plantar foot pain and paresthesias. Standard surgical management of TTS involves release of the flexor retinaculum to decompress the nerve. We report a rare and unusual case of TTS in which the posterior tibial nerve was encased within a post-traumatic osseous tunnel accompanied by dense fibrotic tissue, representing an atypical and previously undescribed etiology of nerve entrapment. In this case, surgical decompression required a modified approach involving meticulous dissection of the tibial nerve from its encasement by heterotopic ossification and …

Evaluating Medical Student Geriatric Competency Using A 5ms-Based Assessment Tool, Lauren R. Hersh Md, Amy Cunningham Phd, Mph, Xiya Wu Md

Cooper Rowan Medical Journal

INTRODUCTION

Driven by an aging Baby Boomer generation, the United States is navigating a demographic transformation with far-reaching implications that include increased demand for chronic disease management and long-term care as well as increased stress on both healthcare costs and infrastructure. Generating a workforce competent in the delivery of care to older patients with complex, multimorbid conditions is fundamental to addressing this shift. Recognizing that the development of primary and specialty care physicians skilled in geriatric care begins in medical school, the American Geriatric Society developed minimum competencies grounded in the Geriatric 5Ms (Mind, Mobility, Medication, Multicomplexity, and …

Estimating Radiation Dose And Proposing Institutional Diagnostic Reference Levels For Paediatric Fluoroscopy Of Micturating Cystourethrogram: Age- And Weight - Specific Comparisons, Khalid M. Aloufi

Saudi Medical Journal

Objective: To compare age- and weight-specific methods used to estimate radiation doses and to propose institutional diagnostic reference levels (DRLs) for paediatric fluoroscopy of micturating cystourethrogram (MCUG).
Methods: In this retrospective study, MCUG fluoroscopy parameters were gathered for 100 paediatric patients from July 2025 to January 2026. The data included the MCUG paediatric procedures for patients aged 0–15 years. The data were categorized into paediatric weight- and age-specific groups. Paediatric weight-specific groups were ≤ 5, 5 < – 10, 10 < – 20, and >20 kg, and paediatric age-specific groups were ≤ 1, 1 < – 5, 5 < – 10, and < 10 – 15 years old.
Results: Differences were observed in dose area product (DAP) and DRL results for age- …