Digital Commons Network^™

Full Issue: Volume 3, Issue 1 - June 2025

Bone Bulletin

i - Editors’ Note

ii - Foreword by Dr. Alan Hilibrand

7 - Challenges and Concerns of Artificial Intelligence in Shoulder and Elbow by Claude J. Regis

10 - Exploring Robotic-Assisted Total Knee Arthroplasty by Sahil Shah

13 - The Future of Robot-Assisted Surgery in Foot and Ankle Procedures by Sam Duggan

16 - Revolutionizing Spine Surgery: The Potential Role of AI in Enhancing Surgical Workflow and Patient Outcomes by Samuel Ezeonu

21 - Management of Periprosthetic Humeral Fractures Following Shoulder Arthroplasty by Akshay Khanna

24 - Patient Specific Implants in Total Shoulder Arthroplasty by Alexander Zavitsanos

26 - Posterior …

Innovative Pain Management Protocols In Orthopedics And Their Role In Reducing Postoperative Opioid Use, Jake Lamonaca

Bone Bulletin

Background

The opioid epidemic has emerged as one of the most pressing public health challenges of our time, marked by significant increases in opioid-related dependence, abuse, and death in recent years. Excess prescription of opioids represents a major contributing factor to this crisis.¹ The origins and impact of the opioid epidemic in the United States are documented in Sam Quinones research narrative, Dreamland. He highlights how pharmaceutical companies leveraged misinterpreted research—particularly a 1980 letter published in The New England Journal of Medicine suggesting a low risk of addiction associated with opioids—to normalize their widespread prescription. This flawed evidence served …

Posterior Shoulder Dislocations In The Setting Of Seizures, Alex Charlton

Bone Bulletin

The shoulder joint provides an exceptional range of motion that allows for flexion, extension, adduction, abduction, internal rotation, external rotation, and 360-degree circumduction; however, this mobility comes at the expense of decreased stability.¹ Shoulder dislocations account for 50% of all joint dislocations, with anterior dislocation being the most common and usually associated with trauma.² In comparison, about 2-5% of shoulder dislocations are posterior and are often associated with more unique etiologies.¹ One of the most interesting resulting from a tonic seizure in an individual with epilepsy.

Challenges And Concerns Of Artificial Intelligence In Shoulder And Elbow, Claude J. Regis

Bone Bulletin

Background

Artificial intelligence (AI) is rapidly transforming shoulder and elbow surgery, driving significant advancements across various domains. Currently, AI is enhancing diagnostic accuracy through imaging-based analysis, predictive modeling of clinical outcomes, implant identification, and automated image segmentation.^1,2 AI-driven personalized treatment plans are also anticipated to optimize patient care by tailoring interventions based on individual data analysis.³ Additionally, deep learning algorithms have been developed to automatically classify large sets of preoperative and postoperative radiographs in the setting of shoulder arthroplasty.⁴ These technologies, combined with AI, could revolutionize surgical training and intraoperative guidance, offering real-time data and enhanced visualization. …

Foreword, Alan S. Hilibrand

Bone Bulletin

As the Director of Undergraduate medical education for the Department of Orthopedic Surgery at the Sidney Kimmel Medical College, I am happy to once again oversee the third annual issue of the Bone Bulletin. Through the activities of the DePalma Orthopaedic Society, medical students at SKMC have an excellent venue to learn about orthopaedic surgery, and through articles in this publication our surgeons at Rothman Orthopaedics have enthusiastically mentored younger students interested in the field of orthopedic surgery. The DePalma leadership has worked hard on many initiatives in recent years: providing forums for orthopaedic faculty to speak about their …

President's Message

SFDDA Newsletter

Monthly update from Dr. Tim Franklin, DDS with details of recent events, upcoming activities and news from the association.

Sfdda Newsletter Fall 2023

SFDDA Newsletter

SFDDA Newsletter includes regular columns with regional news impacting the South Florida District membership including: columns from the President and editor, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

Sfdda Newsletter Spring 2022

SFDDA Newsletter

SFDDA Newsletter includes regular columns with regional news impacting the South Florida District membership including: columns from the President and editor, feature articles relating to the field of dentistry, association events and upcoming activities, component news, continuing education opportunities, and classifieds.

Deep Neck Space Infection As A Complication Of Transesophageal Echocardiogram For Atrial Flutter Ablation, Anish K Shrestha, Naffa Faisal, Kanchana Bali, Nadine Safi, Maria E. Mesalles, Nahar Saleh

Journal of Community Hospital Internal Medicine Perspectives

Transesophageal echocardiography is a relatively safe procedure; however, there are rare complications associated with it. Multiple attempts during TEE can lead to injury of hypopharyngeal or parapharyngeal wall leading to an infection. Here, we describe a case of hypopharyngeal-parapharyngeal abscess resulting from multiple TEE attempts during cardioversion leading to a prolonged hospital course.

Beyond Atrial Fibrillation And Heart Failure: Ibrutinib-Induced Pericardial Effusion, Anaiya Singh, Kathryn Ruckstuhl, Viraj Panchal, Poornima Ramadas

Journal of Community Hospital Internal Medicine Perspectives

Ibrutinib, a Bruton’s tyrosine kinase inhibitor, has transformed the management of various hematological malignancies. However, its association with cardiovascular toxicities, particularly atrial fibrillation (AF), hypertension, and heart failure (HF), has raised clinical concerns. Pericardial effusion, though rare, is an emerging complication warranting attention. We present the case of a 62-year-old male with lymphoplasmacytic lymphoma, initially treated with Bendamustine and Rituximab, which was discontinued due to significant neutropenia. Ibrutinib therapy was initiated, leading to a partial response at three months. Approximately ten months into ibrutinib treatment, the patient developed new-onset dyspnea, palpitations, and dizziness. ECG revealed AF with rapid ventricular response, …

Hydralazine-Induced Anca-Associated Vasculitis With Lupus Nephritis Features And A Unique Antibody Profile, Mahiar Rabie, Melissa Scalise

Journal of Community Hospital Internal Medicine Perspectives

Drug-induced antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a condition caused by a few culprit medications, notably hydralazine. Despite the significant morbidity and mortality associated with this condition, its rarity makes timely diagnosis challenging. A 68 year-old female presented to her nephrologist for a routine follow up of her chronic kidney disease stage III secondary to hypertension. Routine lab work noted worsened creatinine and protein to creatinine ratios. Additionally, her hypertension became more difficult to control, and she suffered from malaise, poor appetite, joint aches/pains and lower extremity edema. Given her sudden worsening of renal function, a serologic investigation was …

Intradialytic Atrial Fibrillation With Rapid Ventricular Response From Catheter-Related Right Atrial Thrombus, Anish K. Shrestha, Sakthi Gautham, Shiavax J. Rao, Khalid K. Al-Talib, Sriram Padmanabhan

Journal of Community Hospital Internal Medicine Perspectives

Right atrial thrombus is a rare complication of hemodialysis catheter with an incidence of

The Diagnostic Maze: Challenges In Autoimmune Hepatitis Lab Interpretation, Tina C. L. Phan, Esther Blondeau-Lecomte, Christopher D. Jackson

Journal of Community Hospital Internal Medicine Perspectives

Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease characterized by the presence of circulating autoantibodies. The spectrum of disease manifestations extends from asymptomatic cases to mild symptoms and, in rare instances, acute liver failure. AIH is a diagnosis of exclusion, supported by the detection of autoantibodies such as anti-smooth-muscle antibody (ASMA). This case describes a 43-year-old female with myasthenia gravis, receiving monthly intravenous immunoglobulin (IVIG) infusions, who presented with persistently elevated liver enzymes and mildly elevated ASMA titers across multiple clinical encounters. A liver biopsy revealed severe acute hepatitis. While drug-induced liver injury (DILI) secondary to IVIG was initially …

The Heart Of The Matter: A Case Of Massive Pedal Edema Erroneously Attributed To Liver Cirrhosis, Ankita Nekkanti, Harishankar Gopakumar, Kaneez Zainab, Teresa Lynch, Sonu Dhillon

Journal of Community Hospital Internal Medicine Perspectives

Liver cirrhosis is commonly diagnosed with etiologies such as viral hepatitis, alcoholrelated liver disease, and metabolic dysfunction-associated steatotic liver disease (MASLD). However, less common causes should be considered, especially in atypical presentations or suboptimal treatment responses. A 67-year-old man presented with massive bilateral pedal edema unresponsive to furosemide. He had well-controlled diabetes and hypertension but no history of alcohol use. Laboratory tests showed normal renal function, mild transaminitis, and mild thrombocytopenia. Imaging revealed liver morphology suggestive of cirrhosis, which prompted the presumptive diagnosis of metabolic-associated steatohepatitis (MASH). Despite diuretic therapy, the patient's edema worsened, necessitating repeated hospital admissions for intravenous …

Diagnostic Challenges In Concurrent Primary Biliary Cholangitis And Secondary Syphilis: A Case Report, Rakahn Haddadin, Danny Aboujamra, Emon Javadi, Humzah Iqbal, Pinak Shah, Homayon Iraninezhad

Journal of Community Hospital Internal Medicine Perspectives

Concurrent Secondary syphilis and Primary Biliary Cholangitis (PBC) presenting with liver dysfunction is exceedingly rare, warranting detailed examination and documentation. Syphilis, a sexually transmitted infection, and PBC, an autoimmune liver disease, rarely coexist, let alone concurrently manifesting liver complications. Our case report delves into the intricacies of such a unique presentation, highlighting the challenges in diagnosis, management, and the implications for patient care.

Acute Kidney Injury (Aki) In Adults With Leukemia: A Nationwide Inpatient Retrospective Analysis, Barath Prashanth Sivasubramanian, Sindhu Chandra Pokhriyal, Shashvat Joshi, Diviya Bharathi Ravikumar, Viraj Panchal, Ibthisam Ismail Sharieff, Tenzin Tamdin, Madhumithaa Jagannathan, Parvathy Anitha Rajeev, Idopise Umana

Journal of Community Hospital Internal Medicine Perspectives

Background: Leukemia ranks among the top three cancers in those who have Acute Kidney Injury (AKI), with an incidence of 7.5 % in hematological malignancies. Through this study, we aimed to assess the mortality of severe sepsis (SS), thrombocytopenia, and metabolic encephalopathy (MetE) in Leukemia with AKI.

Methods: We conducted a retrospective analysis using the National Inpatient Sample (2018e2021). Adults with Leukemia primarily admitted with AKI were included, and mortality was calculated. Patients were stratified by SS, thrombocytopenia, and MetE. Propensity matching for age over 60 and gender, and multivariate regression were performed with p ≤ 0.05.

Results: Among 388,449 …

Ownership And Perceived Usefulness Of Digital Health Tools (Dht) For Health Promotion Among Individuals With Rheumatologic Diseases In The United States, Ufuoma Nene Mamoh, Soziema Juliet Salia, Joseph Okiemute Atarere, Andrew Kamsoko Ndakotsu, Alejandro Jaller, David S. Weisman

Journal of Community Hospital Internal Medicine Perspectives

Introduction: Research on digital health tools (DHT) use in RD patients is lacking.

Method: Data from the 2017 and 2018 Health Information National Trends Survey (HINTS) were used to compare DHT ownership and perceived usefulness between individuals with and without RD and to evaluate how health applications usage influenced health behaviors in RD patients.

Results: No significant differences in smartphone or health applications ownership were found between the groups. Among RD patients, older males and those with lower incomes were less likely to use DHT. DHT users reported better communication with healthcare providers, but no significant impact on health behaviors. …

Incidence, Associated Abnormalities, And Outcomes Of Dextrocardia: A Registry-Based Study In Saudi Arabia, Naif Saad Alghasab, Bandar Alshehri, Sulaman Almesned, Hassan Harbi, Reem Alameer, Fahad Alshehri, Ahmad Alzeid, Meshari Alzhrani, Ghazi T. Almutiri, Sara Abou Al-Saud, Fahad Alobaid, Khalid S. Alnajashi, Federica Fogacci, Arrigo F.G. Cicero, Suleiman M. Kharabsheh

Journal of the Saudi Heart Association

Objective: The right-sided positioning of heart during embryonic development is termed dextrocardia, and it may be isolated or associated with visceral dextroposition or malformation. However, there are few studies on the condition. This study aimed to determine the incidence of cardiac and non-cardiac malformations, long-term follow-up, and survival analysis of patients with dextrocardia. Methods: This was a retrospective chart review of dextrocardia cases at King Faisal Specialist Hospital & Research Centre in Riyadh, Saudi Arabia from April 22, 1975, to December 31, 2016. A total of 259,246 transthoracic echocardiograms from that period were reviewed, and 357 patients were included in …

Artificial Intelligence Policies In Bioethics And Health Humanities: A Comparative Analysis Of Publishers And Journals, Christopher Bobier, Daniel Rodger, Daniel Hurst

Rowan-Virtua School of Osteopathic Medicine Departmental Research

INTRODUCTION: Rapid advancements in artificial intelligence (AI) pose novel ethical and practical challenges for scholarly publishing. Although AI-related policies are emerging in many disciplines, little is known about the extent and clarity of AI guidance in bioethics and health humanities journals.

METHODS: A search of publicly available journal lists from the American Society for Bioethics and Humanities, Health Humanities Consortium, and Association for Medical Humanities was supplemented with Google Scholar's top 20 bioethics journals ranked by h5-index. This yielded 54 unique journals, of which 50 remained after excluding those without a functional website or recent publications. AI policies were reviewed …

Presentación: Ciudad Y Modernidad En La Novela Venezolana De Entre Milenios., Miguel Gomes

INTI: Revista de literatura hispánica

No abstract provided.

Inti Transatlántico: Mapa Global De La Lectura. Últimas Estadísticas

INTI: Revista de literatura hispánica

No abstract provided.

Wrapped In The American Flag: Liberal Activism And Queer Political Organizing Post-1940s, Sam Markley

IdeaFest

By analyzing the United States Lavender Scare and immigration policy of the 1950s, this paper attempts to shed light on how the distinction between “American” and “Un-American” remains at the center of Queer rights advocacy. The heightened fear over the survival of the nation, along with the view of Queer immigrants as threats to the nation, was used to tighten immigration restrictions. This restriction, however, is complicated by existing prejudices against racial minorities and women. Queer rights groups began to rise to prominence during this time and mobilize against claims that they were anti-American or subversive deviants, working through the …

External Challenges For Individuals Who Need Or Use Aac Who Are Learning Language: Lived Experiences, Key Research Findings, And Future Directions, Christine Holyfield, Janice Light, Dana Nieder, Jamie Preece

Communication Disorders and Occupational Therapy Faculty Publications and Presentations

Language skills are essential to effective communication, but learning language is by no means a simple process for individuals with developmental disabilities who cannot rely on speech alone to be heard and understood. Research demonstrates that augmentative and alternative communication (AAC) interventions positively impact development across language domains (e.g., pragmatics, semantics, morphosyntax) and may also benefit speech production. However, these gains can only be realized if people have timely access to effective AAC and have meaningful opportunities to interact with others. This paper integrates the lived experiences of individuals who need or use AAC and their families with key research …

Beautifying Our Home On The Plains, July 03, 2025, Tisa Mason Ed.D.

Heart of a Tiger Columns

No abstract provided.

Unveiling Degradation Patterns In Dye-Sensitized Solar Cells: A Machine Learning Perspective, Ahmed Alali, Mahmoud Ashraf, Ahmad Muhammad, Sameh O. Abdellatif

Electrical Engineering

This study examines the time-dependent degradation of dye-sensitized solar cells (DSSCs) by systematically investigating several critical parameters, including TiO2 thickness, porosity, dye concentration, and iodine-based electrolyte concentration. We developed a novel figure of merit (FOM) to quantify the degradation rates, utilizing a finite element model (FEM) in COMSOL to simulate performance over time. 400 DSSC samples were fabricated, resulting in a comprehensive dataset comprising over 228,000 data points derived from experimental results and simulations. The findings reveal that PCE declines significantly over time, with an average initial efficiency of 4.0% for the DSSCs, dropping to approximately 0.5% after 360 h. …

The Role Of Cultural Humility In Enhancing Successful Intercultural Relationships, Felix Enyan

Research Papers

In the 21^st century, it is easy to locate a large group of population in U.S America. For society to thrive, a good intercultural relationship is a fundamental building block for societal advancement. However, individuals inherit cultural biases that discourages healthy intercultural relationships. Concepts like cultural humility aid in addressing the status quo. Cultural humility encourages lifelong learning and self-criticism of one’s view thereby acknowledging inherent bias. To remedy the status quo, cultural humility is introduced to intercultural communicators and individuals engaging in intercultural relationships.

Innovations In Percussion Literature: The Role Of Composers And Percussionists In Shaping The Evolution Of The Craft, Noah N. Newsom

Research Papers

No abstract provided.

Introduction To Sociology: Sociology - An Introduction, Dr. Marcia Morrison Ph.D.

Open Educational Resources

This comprehensive overview explores the foundational concepts, historical evolution, and seminal theorists of sociology, tracing its origins from the transformative revolutions of the 18th and 19th centuries to its modern-day significance. Central themes include the sociological imagination of C. Wright Mills, the complex interplay between individual experience and societal structure, and the pivotal roles of social structure, action, functional integration, power, and culture in shaping human relations. The discussion highlights the lasting contributions of early sociologists such as Auguste Comte, Adam Smith, Karl Marx, Émile Durkheim, Max Weber, and George Herbert Mead, examining how their theories continue to inform contemporary …

Introduction To Sociology: Interaction And Social Structure, Dr. Marcia Morrison Ph.D.

Open Educational Resources

Abstract

This paper explores the intricate interplay between micro- and macro-sociological perspectives on social interaction, identity, and structure. Through an examination of theoretical approaches such as symbolic interactionism, dramaturgy, and social exchange, it highlights how individuals construct and perform identities within complex webs of social expectations—particularly shaped by factors like race, status, and role dynamics. The discussion extends to the function of social networks in influencing opportunities, notably in the context of employment, underscoring the nuanced role of weak ties. The analysis further delves into the significance of social status, distinguishing between ascribed, achieved, master, and salient statuses, and examines …

Using Remote Behavioral Skills Training To Teach Staff To Implement Augmented Competing Stimulus Assessments, Tanvi Pendharkar

Doctoral Dissertations - College of Arts and Sciences

Despite a growing number of Board Certified Behavior Analysts^®(BCBA), there are many geographic regions without access to behavior analytic services. Remote training methods that can be implemented without face-to-face contact allow for behavior analytic services to reach areas without local BCBAs to provide services. One such method with promise for remote application is behavioral skills training (BST). BST consists of instructions, modeling, rehearsal, and feedback. BST has been used to train behavior-analytic service providers to implement a variety of procedures, but BST has yet to be used to teach clinicians how to conduct augmented competing stimulus assessments (A-CSA). …