Medicine and Health Sciences Commons^™

Enhancing Resident Preparedness For The American Board Of Surgery Certifying Exam Through Low-Stakes Mock Oral Sessions, Camila R. Guetter, Taylor Locklear, Omar Haque, P Nina Scalise, Saptarshi Biswas, R. Wesley Vosburg

HCA Healthcare Journal of Medicine

Background

The American Board of Surgery (ABS) requires trainees to pass both a written qualifying examination (ABSQE) and oral certifying examination (ABSCE) to achieve board certification. The high-stakes nature of the ABSCE, which assesses knowledge, clinical judgment, and decision-making, necessitates extensive preparation. To address the challenges of the ABSCE format and associated trainee stress, structured mock oral programs have been developed. Here we evaluate the impact of structured mock oral sessions on residents' comfort levels and familiarity with the ABSCE at a single institution.

Methods

A mixed-methods survey was given to 50 general surgery residents in different training years who …

Medical Education As Both Process And Environment For Innovation, Gerald Wickham

HCA Healthcare Journal of Medicine

The promise of better medicine, better health outcomes, and better lives depends on a culture of innovation and implementation in medical education. HCA Healthcare Graduate Medical Education continually strives to achieve this environment, to identify the health breakthroughs of tomorrow by fostering innovation in the daily work of the residents, scientists, and physicians of our enterprise. This special issue highlights some of this important work and shares actionable programs to elevate and inspire the next generation of physicians.

Lost In The Fine Print: A Phenomenological Inquiry Of Adhd, Student Loans, And Scarcity, Gaurav R. Sinha, Lakshya Kadiyan, Leon Banks, Kannappa V. Shetty

Journal of Student Financial Aid

The primary objective of this phenomenological study was to explore the cognitive and affective challenges faced by individuals experiencing ADHD and their student loans, particularly through the lens of “scarcity theory”. We analyzed 250 posts (~86 pages/67,000 words) from an online community on Reddit, where individuals experiencing ADHD shared experiences related to student debt. Thematic analysis was employed to identify key themes in these posts. Four key themes emerged: (1) ADHD and baseline mental bandwidth, highlighting preexisting executive functioning challenges that limit cognitive and affective capacity; (2) demands of student loan debt, which intensify stress through complex repayment systems and …

Interprofessional Palliative Care: Implementation Of What Matters Most, Nicole Moran, Madeleine A. Keppel, Madison E. Markey, Alicia Naccarato, Kristen Cumming, Lori Boright

Oncology Rehabilitation in Practice

Palliative care (PC) is defined as specialized care plans for people with serious, life-limiting illnesses, emphasizing comfort care and management of complex symptoms. Rehabilitation professionals such as physical and occupational therapists have unique skills and perspectives towards managing and contributing to this population though are often under-represented on interprofessional palliative care teams. The Guide to What Matters (The Guide) was created upon recognition of the need for an increased presence of rehabilitation services in PC.

Severe Chemotherapy-Induced Peripheral Neuropathy Presenting With Paraplegic Symptoms: A Rehabilitation Case Report, Cecilia Hammond, Elizabeth Campione

Oncology Rehabilitation in Practice

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is characterized by sensory and/or motor symptoms in distal extremities starting within 24 hours of receiving chemotherapy and can potentially last for years. Management of CIPN may include medication (i.e. Duloxetine) and physical therapy (PT). The purpose of this case report is to describe the rehabilitation process and adjustments to the plan of care for a patient with severe CIPN. This case underscores the importance of a proper diagnosis and the need for research to develop evidence-based guidelines for PT interventions for non-ambulatory patients with severe CIPN.

Case description: The patient was a 53-year-old female …

Clinical Management Of A Patient With Lipo-Lymphedema Using Adjustable Compression Wraps: A Case Report, Candace Alexander, Claire Davies, Martha Monroe

Oncology Rehabilitation in Practice

Background: Lipo-lymphedema indicates the presence of lipedema and lymphedema. Compression is used to achieve volume reduction and assist with long-term management. Adjustable compression wraps (ACWs) have been used in lymphedema care to replace traditional compression bandaging and facilitate patient self-care.

Case Description: This patient reported issues with bilateral leg edema for more than 35 years. She reported poor experiences with compression garments and had tried self-management with a compression pump only. She was referred for lymphedema care when her malfunctioning compression pump enabled her edema to worsen.

Assessment and Treatment: Lipedema may have been present for many years …

Recurring Axillary Web Syndrome (Aws) Following A Strenuous Increase In Upper Extremity Strengthening Exercise: A Case Report, David Locke, Linda Koehler

Oncology Rehabilitation in Practice

Background: Axillary web syndrome (AWS) refers to cords presenting in the axilla, upper extremity, and lateral chest wall after breast cancer surgery with axillary lymph node dissection. This unique case demonstrates the onset of AWS 2 weeks post-operatively with recurrence at 4 and 21 months, following rapid progression in upper extremity strengthening exercise.

Case Description: A 33-year-old athletic woman with invasive ductal carcinoma underwent a left mastectomy with sentinel node biopsy (6 nodes removed). Cord development occurred at 2 weeks after surgery. She sought physiotherapy consisting of AWS education, myofascial pin-and-stretch techniques applied to the cord in end-range abduction, a …

Physical Therapy Management Of An Adult Patient Diagnosed With Spindle Cell Rhabdomyosarcoma: A Case Report, Jennifer Carrano

Oncology Rehabilitation in Practice

Background: Rhabdomyosarcoma (RMS) is a rare soft tissue sarcoma that primarily affects children and adolescents. Adult RMS is uncommon and associated with poorer prognosis and limited evidence to guide rehabilitation.

Case Description: A 29-year-old male presented with right facial pain, hearing loss, tinnitus, and right facial and tongue paresthesia. Imaging and biopsy revealed spindle cell RMS of the right masticator space. He had no cancer-related family history, did not smoke, and used alcohol occasionally. Treatment included neoadjuvant chemotherapy, major oncologic resection with scapular free flap reconstruction, and adjuvant radiation. He was referred to outpatient physical therapy with trismus, restricted …

Navigating Care In Cancer: Aligning Rehabilitation And Exercise To Support Patients, Christopher M. Wilson

Oncology Rehabilitation in Practice

The growing evidence base supporting both exercise oncology and cancer rehabilitation highlights their complementary roles across the cancer continuum. Research consistently demonstrates that physical activity improves physical function, fatigue, quality of life, and survival, while rehabilitation addresses impairments and restores participation in meaningful activities. Despite these advances, current care models often lack coordination, resulting in fragmented services, inappropriate referrals, and missed opportunities for optimal patient outcomes. Some individuals are directed to exercise programs without adequate screening for underlying impairments, while others may receive rehabilitation services when supervised, independent or community-based activity would suffice.

To address these gaps, there is a …

Editorial Board Message: About This Issue, Bryan A. Spinelli

Oncology Rehabilitation in Practice

Bryan Spinelli provides a summary of the contents of the issue.

Cover And Front Matter, Volume 3, Issue 1

Oncology Rehabilitation in Practice

Cover and front matter, Volume 3, Issue 1

Predicting Epileptic Seizures From Eeg Signals Using Machine Learning, Hamzah Luqman, Galal M Binmakhashen, Hanan Alali, Marwa Alsleebi, Hamdi A. Al-Jamimi, Motaz Alfarraj, Shahid Bashir, Brent Hedgcock, Ali Mir, Raidah Albaradie

Neurosciences

Objective: To develop a machine learning-based model for predicting epileptic seizures by analyzing electroencephalogram (EEG) signals and classifying the interictal and preictal phases.

Methods: The EEG signals were analyzed in both the time and frequency domains using advanced feature extraction techniques. Three different machine learning approaches were employed, with special focus on long short-term memory (LSTM) networks. Features were extracted and classified to differentiate between seizure and non-seizure phases. The proposed models were evaluated using the publicly available CHB-MIT EEG dataset. The study was conducted between September 2022 and September 2024.

Results: Among the tested models, the LSTM-based approach using …

Epilepsy And Cluster C Personality Disorders: A Saudi Cross-Sectional Study, Mohammed A. Aljaffer, Ahmad H. Almadani, Ayedh H. Alghamdi, Mohammad N. Aljarba, Azzam A. Alotaibi, Mohammed A. Alorayyidh, Abdulaziz M. Alawwad, Rakan S. Alromayan, Faisal M. Alkhunein, Sohaila A. Alshimemeri, Bandar N. Aljafen

Neurosciences

Objective: Epilepsy is a neurological disorder with profound impacts on various aspects of life. It may lead to significant medical and psychiatric comorbidities, one of which is personality disorders (PDs). This study aims to assess the prevalence of Cluster C PDs among adult patients with epilepsy (PWE) at a tertiary care hospital in Riyadh, Saudi Arabia. Method: This cross-sectional study, conducted between January 2024 and April 2025, enroled 360 adult PWE using convenience sampling. The study tool included the Structured Clinical Interview for DSM Disorders criteria, along with additional demographic and epilepsy-related questions developed by the research team. Results: Cluster …

The Role Of The Ventral Tegmental Area In Reward And Addiction: A Comprehensive Review, Emad Ali Albadawi

Neurosciences

The ventral tegmental area (VTA) is a central hub in reward and motivation, integrating heterogeneous neuronal populations and projection-defined circuits to regulate learning, decision-making, and addiction. This review synthesizes anatomical organization and cellular diversity (dopaminergic, GABAergic, and glutamatergic neurons, including multitransmitter co-release), and maps major efferent pathways constituting the mesolimbic and mesocortical systems. We highlight computational roles of VTA activity, including reward prediction errors, incentive salience, and context memory integration, and summarize drug class-specific mechanisms that perturb VTA output. We then outline time-dependent neuroadaptations across mesocorticolimbic networks and discuss therapeutic implications spanning pharmacological, behavioral, and emerging circuit-targeted interventions. Together, these …

Associations Of Regional White Matter Hyperintensities Severity With Different Visual Rating Scales And Domain-Specific Cognitive Impairment, Xiaolu Zheng, Sipei Pan, Yi Man, Zhenghao Shi

Neurosciences

Objective: To explore the association between regional white matter hyperintensities (WMHs) severity and domain-specific cognitive impairment.
Methods: We analyzed 95 WMHs patients retrospectively and evaluated cognitive function. We quantified regional WMHs severity using the Scheltens Rating Scale (SRS) and Cholinergic Pathways Hyper intensities Scale (CHIPS). According to the regional WMHs scores, we divided the patients for intergroup comparisons of WMHs severity with domain-specific cognitive scores via the nonparametric Wilcoxon rank-sum test.
Results: Neither the SRS nor the CHIPS total scores showed statistically correlation with cognitive scores (p > 0.05). However, in the bands lateral ventricles of periventricular hyperintensities …

To Calculate The Nationwide Incidence/Prevalence Figures For Charcot-Marie-Tooth Disease, The Entire Population Must Be Screened, Sinda Zarrouk, Josef Finsterer

Neurosciences

No abstract provided.

Alterations In Gut Microbiota And Their Association With Intestinal Mucosal Injury In Children With Febrile Seizures, Lin Yang, Shuan Yin, Wenchao Zou

Neurosciences

Objective: To explore the correlation between diversity of the gut microbiota and key markers of inflammation and intestinal mucosal injury in pediatric febrile seizures (FS).

Methods: This study compared 15 FS children (FS group) and 15 healthy individuals (normal control group). The participants underwent 16S rDNA sequencing to analyze gut microbiota profiles. ELISA was employed to measure peripheral blood concentrations of the pro-inflammatory cytokines TNF-α and IL-6, as well as intestinal mucosal injury indicators such as endotoxin (BT), D-lactate (D-Lac), and diamine oxidase (DAO). Analysis assessed the correlation between gut microbiota composition, inflammatory factors, and indicators of intestinal mucosal damage …

Timing Matters: Optimizing Oncology Involvement In Pediatric Neuro-Oncology Pathways In Saudi Arabia, Ali H. Algiraigri, Mohammed Basamh, Ghadeer Alobaid, Lama M. Alsulami, Razan A. Almutairi, Zahraa S. Alsultan, Rawan M. Hammad

Neurosciences

Objective: To explore current practices and barriers in pediatric neuro-oncology care coordination, and to identify opportunities to optimize care pathways. Timely coordination between pediatric neurosurgery and oncology is critical for optimal outcomes in children with central nervous system (CNS) tumors. However, in many centers, pediatric oncologists are not involved until after surgery, which contributes to treatment delays and repeated procedures. Methods: A cross-sectional survey was conducted among neurosurgeons and pediatric oncologists in Saudi Arabia. The questionnaire addressed the timing of oncological involvement, neuroimaging practices, cerebrospinal fluid (CSF) cytology collection, and opinions on care coordination solutions. Results: A total of 62 …

Comparison Of Free-Hand Technique And Neuronavigation In Intraventricular Shunt Catheter Placement, Ümit Kocaman, Durmuş O Karakoyun, Emre Çavuşoğlu

Neurosciences

Objective: To compare the accuracy and clinical outcomes of proximal catheter placement using neuronavigation guidance versus the traditional free-hand technique in patients undergoing ventriculoperitoneal shunt (VPS) surgery. Methods: We performed a single-surgeon, before–after cohort study: free-hand cases (2013–2019) and neuronavigation cases (2020–2024). Ethics approval was obtained (İzmir Bakırçay University; Approval No. 2407; 20 Aug 2025). The primary endpoint was a composite of first-attempt ventricular entry and absence of postoperative day-1 (POD1) Grade-3 malposition. Secondary endpoints included grades, 12-month proximal tip dysfunction, and operative duration. Results: Fifty-two patients were included (neuronavigation N = 24; free-hand N = 28). Composite success was …

Science First, Formatting Second: Is It Feasible To Adopt A Free-Format Submission Policy?, Anas Alyazidi

Neurosciences

No abstract provided.

Neuroinflammation At The Crossroads Of Neurodegeneration: The Roles Of Microglia And Astrocytes In Parkinson's Disease, Alzheimer's Disease, And Multiple Sclerosis, Mohannad A. Almikhlafi

Neurosciences

Neuroinflammation plays a critical role in the pathogenesis of neurodegenerative disorders such as Parkinson's disease, Alzheimer's disease, and multiple sclerosis. This review explores the underlying mechanisms of neuroinflammation, with a focus on the roles of microglia, astrocytes, peripheral immune cell infiltration, and cytokine release. The complex interplay between oxidative stress and chronic inflammation accelerates neurodegeneration, contributing to disease progression. Microglial activation, initially protective, becomes harmful when sustained over time, driving chronic inflammation. Similarly, astrocytes once considered passive are now recognized for their active involvement in both inflammatory and neuroprotective responses, depending on their activation state. Prolonged activation of microglia and …

Protein Intake In Children With Cerebral Palsy: A Narrative Review Highlighting The Implications Of Protein Intake On Muscle Mass, Growth, And Overall Nutritional Status, Manar Waleed Simbawa, Sheikha Nasser Alqahtnai

Neurosciences

Children with cerebral palsy experience nutritional challenges that affect protein intake and may contribute to poor muscle mass and growth faltering. Since protein plays a major role in preserving muscle mass and supporting growth, ensuring adequate intake is critical. A comprehensive literature search was conducted for observational studies published between 2006 and 2025. The reviewed studies results were grouped into: [1] Protein intake, with values ranging from 0.66 to 4.1 g/kg/day, with higher intake observed among ambulatory or orally fed children, [2] Nutritional Status and Body Composition, as reduced muscle was reported in children with severe motor impairment, and [3] …

Role Of Bevacizumab In Multiple Glioblastomas: A Retrospective Single-Center Analysis, Yongrui Zhao, Yidong Chen, Leiming Wang, Ye Cheng, Feng Yan, Jiankun Xu

Neurosciences

Objective: To explore the prognostic factors of multiple glioblastomas (M-GBMs) and the role of bevacizumab (BEV) in M-GBMs. Methods: 162 patients treated for primary glioblastoma (GBM) from 2020 to 2024 were retrospectively reviewed. Kaplan–Meier analysis was performed to compare progression-free survival (PFS) and overall survival (OS) between the single glioblastoma (S-GBM) group and the M-GBMs group. Independent predictors of OS among M-GBMs patients were evaluated via multivariable Cox regression analysis. Results: 116 patients had S-GBM, and 46 had M-GBMs. Compared with S-GBM patients, M-GBMs patients had poorer PFS (6.5 vs. 11 months, p<0.001) and OS (15.5 vs. 21 months, p=0.005). In the M-GBMs group, based on the RANO resection criteria, both univariable analysis and multivariable Cox models confirmed that the extent of resection, use of radiotherapy and chemotherapy, p53 overexpression, and use of BEV were all factors that significantly influenced OS. Specifically, the use of BEV prolonged OS from 12 months to 19.5 months (p = 0.017). From the initiation of BEV therapy, the median PFS was 5.5 months (95% CI 4.45–6.56 months), and the median survival was significantly longer than in those who did not received BEV (10 vs. 3 months, p = 0.021). Conclusion: The extent of resection, radiotherapy/chemotherapy, p53 …

Time And Dose Dependent Effects Of Adipose-Derived Stromal Vascular Fraction Exosomes On Human Dental Pulp Stem Cell Proliferation, Sylva Dinie Alinda, Anggraini Margono, Indah Julianto, Dini Asrianti Bagio

Journal of Dentistry Indonesia

Background: Cell proliferation is essential for tissue repair and immunomodulation in regenerative dentistry. Adipose-derived stromal vascular fraction (AD-SVF) is a promising autologous source for tissue engineering. Its exosomes (AD-SVF Exo), as cell-free products stable under ischemic conditions, represent an ethical and attractive modality for dental tissue regeneration and broader regenerative applications. Prior study indicates that AD-SVF Exo can enhance human dental pulp stem cell (hDPSC) migration and proliferation, particularly at low concentrations, but their detailed time- and dose-dependent proliferative effects remain unclear. This study aimed to investigate the time- and dose-dependent effects of low-concentration AD-SVF Exo on hDPSC proliferation …

In Silico Model Of Musa Acuminata Stem As An Anticancer On Oral Squamous Cell Carcinoma Against Egfr, Nevrila Dewi Rachmayani, Amy Nindia Carabelly, I Wayan Arya Krishnawan Firdaus, Maharani Laillyza Apriasari, Juliyatin Putri Utami

Journal of Dentistry Indonesia

Background: Oral squamous cell carcinoma (OSCC) is characterized by overexpression of the epidermal growth factor receptor (EGFR). Citral, eucalyptol, and caffeic acid phenethyl ester (CAPE), which are derived from Musa acuminata, have shown anticancer activity. This study evaluated the potential of citral, eucalyptol, and CAPE from Musa acuminata as anticancer agents for OSCC by targeting EGFR using an in silico approach.

Methods: Potential biological activity was predicted using Prediction of Activity Spectra for Substances (PASS) Online. Molecular docking was conducted with AutoDock Vina, and BIOVIA Discovery Studio was used to analyze binding affinity, interaction types, and bond …

Micro-Ct Evaluation Of Root Canal Transportation And Centering Ability In Mesial Canals Of Mandibular First Molars, Selen Ince Yusufoglu, Esma Saricam, Mert Ocak, Ferhat Geneci, Burak Bilecenoğlu

Journal of Dentistry Indonesia

Background: This study aimed to evaluate canal transportation, centering ability, structure model index (SMI), surface area, and root canal volume changes in the mesial canals of mandibular first molars using micro-CT.

Methods: Twenty-four mandibular first molars with two separate mesial canals and moderate curvature were included. Teeth were scanned using micro-CT before instrumentation and randomly divided into three groups (N = 8). Root canals were prepared using OneShape, OneCurve, and Rotate file systems, followed by post-instrumentation micro-CT scanning (10µm/pixel resolution). Changes in canal volume, surface area, transportation, centering ability, and SMI were analyzed at the apical, middle, and …

Evaluation Of An Audiovisual Educational Tool With Reinforcement Messages For Orthodontic Patients: A 6-Month Randomized Controlled Trial, Laura Restrepo Quijano, Maria Paula Vasco Gomez, Natalia Hurtado Velasquez, Luis Fabian Benitez Moreno

Journal of Dentistry Indonesia

Background: Orthodontic treatment increases the risk of bacterial plaque accumulation; therefore, oral hygiene education is essential to prevent complications, but its impact is usually limited when it is not reinforced with effective tools. This study aims to evaluate an audiovisual educational tool with reinforcement messages, compared with a verbal explanation about the proper use of the orthodontic oral hygiene kit.

Methods: This was a randomized controlled trial that included 62 patients randomly assigned to an intervention group: 31 patients who received an educational video plus three reinforcement messages via WhatsApp, and a control group: 31 patients who received …

Sinus Formation As A Manifestation Of Chronic Periodontitis In Mandibular Anterior Region: A Report On 2 Cases, Anisha Kumari, Shikha Tewari

Journal of Dentistry Indonesia

Background: Periodontitis is defined as an inflammatory disease of the supporting tissues of the teeth caused by specific microorganisms, resulting in progressive destruction of the periodontal ligament and alveolar bone. Clinical manifestations of Persistent chronic periodontitis may mimic varied clinical manifestations, including those of apical abscess and systemic involvement.

Case report: This report presents the management of an intraoral sinus mimicking a chronic apical abscess in the mandibular anterior region associated with deep periodontal pockets in two male patients in their early thirties. With careful clinical and radiological examination and ruling out of endodontic and systemic involvement, the …

Antibacterial And Antibiofilm Effects Of Ziziphus Mauritiana Leaf Extract Against Staphylococcus Aureus, Wiwiek Poedjiastoeti, Irvan Septrian Syah Putra Rasad, Felicia Klarissa Tanzil, Indrayadi Gunardi, Armelia Sari Widyarman

Journal of Dentistry Indonesia

Background: Tooth extraction is a common dental procedure often complicated by postoperative infections, with Staphylococcus aureus as a key opportunistic pathogen. Rising antibiotic resistance and side effects of conventional antiseptics like chlorhexidine highlight the need for natural alternatives. This study evaluated the antibacterial and antibiofilm potential of 96% ethanol extract from Ziziphus mauritiana leaves against S. aureus.

Methods: The extract was prepared by maceration and tested in vitro using microdilution for minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) against S. aureus ATCC 25923. Antibiofilm activity was assessed via crystal violet staining on mature biofilms, with …

Correlation Between Maxillary Morphology And Sinus Dimensions In Skeletal Class I, Ii, And Iii Subjects: A Comparative Study, Nida Shaikh, Dipti Shastri, Pradeep Tandon, Gyan Prakash Singh

Journal of Dentistry Indonesia

Background: This study aimed to evaluate variations in maxillary and sinus morphology and their correlations with skeletal malocclusion patterns using CBCT.

Methods: This retrospective study analyzed CBCT records of 70 subjects aged 17–40 years, divided into three groups: Skeletal Class I (N = 25), Class II (N = 25), and Class III (N = 20). Five maxillary skeletal and four sinus parameters were assessed. Intergroup comparisons were performed using one-way analysis of variance (ANOVA) followed by Tukey’s post hoc test. Correlations were evaluated using Pearson’s correlation test. Intra-observer reliability was assessed by re-measuring 8 randomly selected CBCT scans …