A Comprehensive Review Of Bone Remodeling After Trauma And Operative Treatment In Orthopedic Surgery, Sarah E. Rabin, Ian P. Marshall, Benjamin A. Nelson, Justine N. Li, Madison M. Baldauf, Ashley B. Bozzay, Benjamin W. Hoyt

Department of Medicine Faculty Publications

Bone remodeling is a dynamic process involving bone resorption and formation that is regulated on a cellular level and impacted by mechanical stress. A variety of Orthopedic surgery treatment strategies can affect bone remodeling, which can in turn may have long-term impacts on skeletal stress tolerance and function. This review provides a comprehensive overview of bone remodeling involved in Orthopedic surgery. Materials related to bone remodeling principles across Orthopedic surgery domains were selected and compiled using databases including PubMed, MEDLINE, AccessMedicine, and CINAHL; case studies were not included. Relevant literature was summarized for a general review of bone remodeling and …

Cefazolin: A Rare Etiology Of Induced Coagulopathy, Ahmed Ismail, Anam Habib, Cayleigh Blumrick

Department of Medicine Faculty Publications

Cefazolin, a first-generation cephalosporin, is commonly used to treat methicillin-susceptible Staphylococcus aureus (MSSA) infections. Although generally well tolerated, coagulation abnormalities have rarely been reported during therapy. We describe the case of an 81-year-old man treated with prolonged cefazolin for MSSA endocarditis who developed severe coagulopathy characterized by marked elevation of both the international normalized ratio (INR) and activated partial thromboplastin time (aPTT). The abnormalities occurred after initiation of cefazolin and worsened despite cessation of other anticoagulants. Following discontinuation of cefazolin and administration of vitamin K, coagulation parameters rapidly improved and subsequently normalized. This case highlights a rare but clinically significant …

Seasonal And Geographic Patterns Of Gastroschisis In Canada: Protective Effect Of Periconceptional Sunlight Exposure, Shiliang Liu, Shin Jie Yong, Dunjin Chen, Gavin C. Hughes, Claude L. Hughes

Department of Medicine Faculty Publications

Background: Gastroschisis is a right-sided, full-thickness defect with extra-amnionic herniation of abdominal contents directly into the amniotic cavity. The causes of gastroschisis remain obscure. We hypothesized that limited periconceptional sunlight exposure might lead to insufficient vitamin D during fetal development and play a role in gastroschisis etiology.

Methods: We conducted a population-based cohort study of infants conceived in Canada between April 2006 and March 2020. We used winter months (i.e., November and December) and northern geographic latitudes as indicators of insufficient sunlight exposure, while summer months (July and August) and southern geographic latitudes were considered as reference. We examined the …

Platypnea-Orthodeoxia Syndrome Caused By A Patent Foramen Ovale And Interatrial Septal Aneurysm: A Case Report, Abes A. Bautista Neughebauer, Raymond L. Benza, Deepak Talreja

Department of Medicine Faculty Publications

Platypnea-orthodeoxia syndrome (POS) is a rare condition characterized by positional hypoxemia, often due to right-to-left shunting across a patent foramen ovale (PFO) despite normal right-sided pressures. Early recognition is essential as symptoms may be subtle and imaging is often unrevealing. A 78-year-old female patient with a known PFO presented with one week of lower abdominal pain and mild exertional dyspnea without chest pain. She was profoundly hypoxic to 76% on room air, with improvement when supine and worsening when upright. Initial labs were unremarkable, and arterial blood gas revealed primary respiratory alkalosis with severe hypoxemia. Despite unremarkable chest radiography, CT …

All-Inside Arthroscopic Technique For Repairing Radial Meniscus Tears At The Anterior Horn-Body Junction, Brandon Omari Boyd, Robert M. Walker, Harrison A. Volaski, Ferdinand J. Chan

Department of Medicine Faculty Publications

Radial meniscus tears are a common tear pattern that, if left untreated, can ultimately lead to accelerated degenerative changes and disability. There is well-established evidence that supports meniscal preservation in patients with radial meniscus tears. Various surgical techniques are used to repair radial tears, including inside-out, outside-in, and all-inside methods. Self-retrieving all-inside devices are a safe option when repairing radial tears. However, radial tears at the junction of the anterior horn and body present a unique surgical challenge, as surgeons may have difficulty maneuvering the jaws of the self-retrieving suture device around the anterior limb of the meniscal tear. We …

Missed Opportunities For Stroke Prevention In Patients With Hypertension: A Retrospective Case-Control Study, Huanhuan Yang, Yuntian Liu, Chungsoo Kim, Chenxi Huang, Mitsuaki Sawano, Patrick Young, Jacob Mcfadden, Mark Anderson, John S. Burrows, Harlan M. Krumholz, John E. Brush Jr., Yuan Lu

Department of Medicine Faculty Publications

Background

Hypertension is the leading modifiable risk factor for ischemic stroke, yet the adequacy of preventative hypertension care in routine clinical practice remains suboptimal, potentially representing missed opportunities for stroke prevention. We evaluated the association between hypertension care delivery and incident ischemic stroke.

Methods

 We conducted a retrospective, matched, nested case-control study among adults with hypertension using data from a large regional health system (2010-2024). Patients with a first-ever ischemic stroke were matched 1:2 to controls on age, sex, race and ethnicity, and calendar time. Three care metrics were assessed: (1) outpatient visits with blood pressure measurement per year; (2) …

Coffin–Lowry Syndrome: A Systematic Review Of Rps6ka3 Confirmed Cases And Implications For Diagnosis And Counseling, Sabyasachi Maity, Miranda Montion, Danielle Boothe, Mona Attarpour, Ivy Mageto, Simran Agarwal, Rujul Patel, Chloe Lark, Bharathi Gadad, Nikhilesh Anand

School of Medicine Publications

Background: Coffin–Lowry syndrome (CLS) is a rare X-linked disorder caused by pathogenic variants in RPS6KA3, presenting with intellectual disability, distinctive facial and skeletal features, and variable systemic involvement. Advances in genomic technologies have expanded the mutation spectrum, yet genotype phenotype correlations remain incompletely understood.

Methods: We conducted a systematic review of published cases (n = 72) following PRISMA guidelines. Demographic, phenotypic, and genotypic data were extracted, standardized, and summarized using descriptive statistics. Associations between mutation type and key clinical features were assessed with Chi-square or Fisher’s exact tests. Diagnostic approaches and global distribution were also analyzed.

Results: The cohort …

Breaking The Resistance: A Narrative Review Of The Evolution From Traditional Drugs To Precision Therapies In Epilepsy, Tirath Patel, Fathimathul Henna, Ashfaq Ahmed, Ayesha Ahmad, Noor Ul Huda, Syed Aaraiz Ul Hassan, Aiman Muhammad, Amna Javed, Maryem Filal, Nikhilesh Anand

School of Medicine Publications

Background: Epilepsy is a chronic neurological disorder characterized by recurrent seizures, affecting approximately 50 million individuals globally. While conventional antiseizure medications (ASMs) control seizures in 70-80% of patients, about 30% experience drug resistance or intolerable side effects, necessitating alternative approaches.

Objective: To critically compare the efficacy, safety, and accessibility of conventional and emerging therapies for epilepsy, particularly in the context of treatment-resistant cases and global disparities in care.

Methods: This narrative review synthesized evidence from 120 peer-reviewed articles published between 2015 and 2025. Literature was retrieved from PubMed, Embase, Cochrane Library, and Scopus using predefined search terms related to epilepsy …

Associations Of Blood Pressure Level And Variability With Cortical Thickness: A Cross-Sectional Analysis From The Maracaibo Aging Study, Romeo De Leon, Shana Garza, Silvia Mejia-Arango, Kristina Vatcheva, Sokratis Charisis, Claudia L. Satizabal, Luis J. Mena, Joseph H. Lee, Joseph D. Terwilliger, Eron Manusov

School of Medicine Publications

Background: Although high blood pressure (BP) level and variability are associated with Alzheimer's Disease (AD), their relationship with cortical thickness in brain regions that are associated with AD is unclear. Furthermore, the role of 24-hour BP has not been examined. We investigated the associations of office and ambulatory BP measures with cortical thickness in brain regions implicated in AD.

Methods: We performed a cross sectional analysis of 304 participants without dementia from a population-based study with office and 24-hour BP and magnetic resonance imaging (MRI) data. We considered cortical thickness values derived from 10 regions throughout the frontal, parietal, and …

Eeg And Imu Gait Signal Processing: A Comparative Assessment Of The "Reza" Exponential Filter And Classic Filters, Reza Pousti, Daniel M. Russell, Derek C. Monroe, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

Noise degrades both EEG and gait signals, and classical IIR filters (Butterworth, Chebyshev, elliptic) involve trade-offs between passband flatness, ripple, and roll-off. This study compared a novel exponential "Reza" filter with these designs for neural and locomotor data. We analyzed an open-source mobile brain-body imaging dataset with EEG and gait data from 49 healthy adults (EEG: 256-channel, 512 Hz; IMUs: six APDM Opals, 128 Hz). EEG channels were grand-averaged and band-pass filtered at 0.5-50 Hz, while IMU axes were averaged and band-pass filtered at 0.5-5 Hz. The outcomes were signal-to-noise ratio SNR (dB) and band-integrated Welch PSD (EEG:0.5-50 Hz; IMU:0.5-5 …

We-Making Through Technology: Social Cohesion And Virtual Adaptation In Community Arts Organizations For Artists With Idd During Covid-19 Pandemic, Yumi Shirai, Michelle Boulanger Thompson, Tamara Shetron

Rehabilitation Sciences Faculty Publications

COVID-19 public health restrictions disrupted in-person arts participation, increasing risks of social isolation and reduced community access. Prior research shows that many people engaged in home-based arts and cultural activities during lockdown, supporting emotional regulation, a sense of belonging, and social connection; however, little is known about how these shifts affected community arts organizations that serve artists with intellectual and/or developmental disabilities (IDD), a population disproportionately impacted by the pandemic and longstanding inequities. We examined how community-based arts organizations adapted programming for artists with IDD during the COVID-19 pandemic, including barriers and unanticipated outcomes relevant to equitable access and participation …

Walking It Off: Habituation Of Gait At Virtual High Elevation, Kelly Poretti, Toby J. Ellmers, Christopher K. Rhea, Tiphanie Raffegeau

Rehabilitation Sciences Faculty Publications

Introduction: Fear and anxiety about falling can disrupt gait control, leading to activity restriction and increased fall risk in older adults. VR can be used to induce postural threat (e.g., by simulating high elevation settings) within a controlled environment, inducing fall-related anxiety and cautious gait (i.e. slower, shorter steps) in young and older adults. However, it is unknown how emotional and motor responses to VR postural threat habituate across time because existing studies feature short exposures (10 seconds or less). Before VR-induced postural threat can be translated into an intervention, it is critical to understand threat-related gait habituation across time. …

Organized Sports-Based Interventions And Motor Outcomes In Children Diagnosed With Autism Spectrum Disorder: A Systematic Review, Kailash Ram, Maeren Hill, Caitlyn Stewart, Kaitlin P. Hardy Md, Sonia Khurana

Rehabilitation Sciences Faculty Publications

Aim

To evaluate the effectiveness of organized sports-based interventions on motor outcomes in children with autism spectrum disorder (ASD).

Method

Four databases were searched from inception to November 2025 for randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) reporting motor outcomes of organized sports-based interventions in children with ASD. Risk of bias was evaluated using ROB-2 (Cochrane Risk of Bias Tool, Version Two) for RCTs and ROBINS-I (Risk Of Bias In Non-randomized Studies - of Interventions) for NRCTs.

Results

Eleven studies (six RCTs, five NRCTs) were included and categorized as martial arts (n = 5), aquatic training (n = …

From Reactionary To Anticipatory Integrated Action: Novel Environmental Health Surveillance For Mass Gatherings, Benjamin J. Ryan, Michael Donahoo, Danielle Esler, Paul Barach, Benjamin Coghlan, Shelby Garner, Laura M. Langan, John Piispanen, Bryan W. Brooks

College of Population Health Faculty Papers

Advances in AI-driven analytics, human-in-the loop techniques, and wastewater monitoring provide the foundation needed to shift from reactive to anticipatory actions for mass gatherings. Traditional surveillance systems focus on clinical and laboratory-based notification pathways, which often result in tardy actions being implemented. Thus, traditional surveillance is becoming outdated. Mass gatherings pose heightened public health risks and hazards, including trauma; injury and substance misuse; deliberate poisoning; and infectious diseases such as food and waterborne illnesses, sexually transmitted infections, and respiratory diseases. There is also a heightened concern due to reduced vaccination coverage. As a result, future international events such as the …

The Long-Term Effects On Youth Growing Up In Foster Care, Brittney L. Olatunde

Murray State Theses and Dissertations

Abstract

This study examined the long-term effects of the foster care system on youth, with particular focus on how early life experiences shape developmental trajectories into adulthood. Findings indicated that involvement in the foster care system significantly influences socioemotional, psychological, and life outcomes that persist across the youth life span. Understanding these enduring effects is essential for recognizing how early disruptions and transitions impact later adult functioning. Guided by life course theory, this study explored how the timing of foster care experiences, critical life transitions, and environmental contexts collectively influence individual development over time. Emphasis was on how entry and …

Mending The Broken Heart: Applying Selective Spiritual Practices To Navigate The Grief Process At Reeder Memorial Baptist Church Charlotte, North Carolina, Kathryn A. Bonapart

Doctor of Ministry Projects

This Doctor of Ministry capstone examined how guiding congregants through intentional spiritual disciplines can foster grief healing at Reeder Memorial Baptist Church in Charlotte, NC. Many members face grief related to death, illness, relational loss, or communal trauma. The project integrated the biblical narrative of Jesus in Gethsemane (Matthew 26:36–46) with group practices such as prayer, silence, solitude, lament, and journaling. Quantitative pre- and post-surveys and qualitative data from journals, field notes, and interviews revealed growth in emotional awareness, spiritual endurance, consistent grief practices, deeper faith during mourning, greater awareness of God’s presence in suffering, and stronger community connections.  The …

Identifying The Best Cutoff Value Of The Fecal Occult Blood Immunochemical Test In The Detection Of Advanced And Neoplastic Colorectal Lesions [Identificación Del Mejor Punto De Corte De La Prueba Inmunoquímica De Sangre Oculta En Heces En La Detección De Lesiones Colorrectales Avanzadas Y Neoplásicas], Patricia Gaggero, Eduardo Fenocchi, Cecilia Silva, Juan C. Lopez-Alvarenga, Natalia Lambert, Fabian Batista, Sergio Sobrino-Cossio, Jonathan R. White, Adolfo Parra-Blanco

School of Medicine Publications

Objective: Screening is an effective tool for detecting colorectal lesions in asymptomatic subjects. There is a positive correlation between fecal immunochemical test (FIT) values and the size of tumors. Despite the efficacy of screening, the detection of colorectal cancer (CRC) remains low. The primary objective was to evaluate the best FIT cutoff value for detecting advanced adenomas and CRC among individuals at average risk in a country with a high incidence and morbidity from CRC.

Methods: This observational and prospective study analyzed consecutive cases in 1461 asymptomatic subjects with a positive FIT (≥ 100 ng hemoglobin [Hb]/ mL) referred for …

Developer Perspectives On Licensing And Copyright Issues Arising From Generative Ai For Software Development, Trevor Stalnaker, Nathan Wintersgill, Oscar Chaparro, Laura A. Heymann, Massimiliano Di Penta, Daniel M. German, Denys Poshyvanyk

Faculty Publications

Despite the utility that Generative AI (GenAI) tools provide for tasks such as writing code, the use of these tools raises important legal questions and potential risks, particularly those associated with copyright law. As lawmakers and regulators respond to these questions, the views of users can offer relevant perspectives. In this article, we provide: (1) a survey of 574 developers on the licensing and copyright aspects of GenAI for coding, as well as follow-up interviews; (2) a snapshot of developers’ views at a time when GenAI and perceptions of it were rapidly evolving; and (3) an analysis of developers’ perspectives, …

The Specter Of Jury Nullification, Anna Offit

Faculty Publications

Attention to the trial of Luigi Mangione has renewed debate about nullification—the jury’s inviolate power to acquit a defendant contrary to the evidence presented. Jury nullification proponents hold that it is a mechanism of last resort for refusing to apply laws that conflict with the public conscience. Opponents, by contrast, argue that nullification undermines the law by diminishing its legitimacy. To prosecutors and defense attorneys, however, these arguments are immaterial: Jury nullification is part of the institutional landscape of the contemporary jury trial and thus must be treated as a potentiality—a feature of the agnostic, strategic, and ethical terrain of …

Efficacy And Safety Of Pyrimidine Nucleos(T)Ide Therapy In Thymidine Kinase 2 Deficiency, Michio Hirano, Caterina Garone, Richard Haas, Carmen Paradas, Fernando Scaglia, Irene Rebollo Mesa, Carl Chiang, Anny-Odile Colson, Susan Vanmeter, Cristina Domínguez-González

Faculty, Staff and Students Publications

Thymidine kinase 2 deficiency (TK2d) (MIM 609560) is an ultra-rare, autosomal recessive mitochondrial myopathy caused by TK2 variants, leading to mitochondrial DNA depletion and/or multiple deletions. People with thymidine kinase 2 deficiency experience progressive myopathy, bulbar weakness and respiratory insufficiency, often losing the ability to walk, eat and breathe independently. Doxecitine and doxribtimine represents the first approved treatment for patients with thymidine kinase 2 deficiency with age of symptom onset ≤12 years by the US Food and Drug Administration and the European Medicines Agency; previously, disease management was limited to supportive care. We investigated the efficacy and safety of pyrimidine …

Mapping The Structural Connections Between The Anterior Cingulate Cortex And The Insula/Ventrolateral Prefrontal Cortex.Mapping The Structural Connections Between The Anterior Cingulate Cortex And The Insula/Ventrolateral Prefrontal Cortex, Wei Tang, Javier Guaje, Shreyas Fadnavis, Sarah R Heilbronner, Eleftherios Garyfallidis

Faculty, Staff and Students Publications

The anterior cingulate cortex (ACC) is functionally closely related with the insula and the ventral lateral prefrontal cortex (vlPFC). The ACC and insula are the main hubs of the salience network, a set of functionally related brain regions involved in detecting salient stimuli and coordinating inter-network communication, while communication between ACC and vlPFC is closely linked to inhibitory control. However, despite strong indirect evidence from nonhuman primate (NHP) tract tracing, the structural connections between the ACC and the insula/vlPFC remain poorly understood in the human brain, in part because standard approaches fail to capture this projection. In this study, we …

Guidelines For Standard Basic Notations In Applied Statistics, Abhaya Indrayan, Shivani Saini Ms

COBRA Preprint Series

Whereas some statistical notations are standard and uniformly used by different workers, many are not. Varying notations lead to confusion among the readers, particularly those engaged with applied statistics material, such as medical professionals. This communication proposes that all basic notations be standardized so that the same notations are consistently used by different authors, in different books, journals, and articles for the benefit of those who are not rigorously trained statisticians. Guidelines for such standard notations are also provided. The lead must be taken by statisticians.