Medicine and Health Sciences Commons^™

Development Of A Semi-Mechanistic Pharmacokinetic-Pharmacodynamic Model For Beta-Lactam Antibiotic Combination Against Enterococcus Faecalis Based On Time-Kill Assays To Predict Drug Disposition And Guide Dosing Strategy In A Severe Renal Impairment Population, Ruhma Zia Khan

Selected Full-Text Dissertations 2020-

Bacterial resistance to antibiotics continues to be a global health problem, limiting antibacterial therapy against infective endocarditis caused by Enterococcus faecalis. To overcome increasing resistance, dual beta-lactam therapy has been advocated as an alternative regimen for treatment – the synergistic activity against E. faecalis demonstrated to be effective. Currently, ampicillin plus ceftriaxone is the standard of care, but the practical application of this therapy is limited by ampicillin’s poor stability in solution at room temperature. A synergistic combination of penicillin plus ceftriaxone shows promise due to penicillin’s superior stability at ambient temperature, but ceftriaxone’s potential to cause hepatoxicity further limits …

Distal Adding-On As A Complication Of Posterior Spinal Fusion In Adolescent Idiopathic Scoliosis: A Scoping Review Of Contemporary Evidence, Hussein Hashem, Hassan Abou Adma, Joseph Hayek, Ali Rezazadeh Shirazi, Karim Gaber, Waleed Kishta

Western Journal of Orthopaedics

Distal adding-on (DAO) is a complication of spinal fusion characterized by postoperative deformity progression distal to the fusion construct. DAO after posterior spinal fusion for adolescent idiopathic scoliosis (AIS) is variably defined and inconsistently managed. This scoping review synthesizes evidence on DAO detection, management, and outcomes. A PRISMA-ScR–guided search identified relevant studies. Thirty-one studies (2,998 patients; median follow-up, 30 months) met inclusion criteria. Reported DAO incidence ranged from 3.5% to 62.5%, reflecting heterogeneity in definitions, patient factors, surgical constructs, and follow-up duration. Revision surgery was infrequent and typically delayed. When performed, it was most often prompted by progressive coronal decompensation …

Infection Rates In Gunshot-Related Hand Fractures Treated Nonoperatively, T. Kyle Summers, Ian Garrison, Matthew C. Watterson, Brandon Barnes, Charles Rodriguez-Feo

Western Journal of Orthopaedics

Background: Firearm-associated injuries in the U.S. represent a major public health crisis, contributing substantially to major levels of morbidity, mortality, and economic stress. Recommendations for the management of gunshot-related hand fractures remain limited, particularly in low-velocity injuries, and current guidance often leaves treatment decisions to the discretion of the operating surgeon. Methods: A retrospective analysis was performed to identify phalangeal and metacarpal fractures at a Level I trauma center from 2017 to 2023, resulting in 579 patients. Only fractures resulting from firearm injuries were included, resulting in 56 patients. Infection rates were observed in patients treated nonoperatively and those treated …

Increased Mortality And Reduced Survival In Nonagenarians With Hip Fractures: Implications For Geriatric Care, Roman Austin, Julio Avila, Audrey Wassef, Kate Parker, Katherine Gavin

Western Journal of Orthopaedics

Background: Hip fractures in nonagenarians (patients aged ≥ 90 years) are becoming increasingly common as the population ages, yet outcomes in this group remain poorly characterized. This study compared in-hospital mortality and survivorship at three months, six months, and one year after hip fracture surgery in nonagenarians with a younger elderly cohort aged 65 years to 89 years. Secondary outcomes included fracture characteristics, surgical management, and discharge disposition. Methods: A retrospective chart review was conducted on patients who underwent hip fracture surgery at a single Level I Trauma Center from August 2019 to December 2021. Patients were grouped into nonagenarians …

Massive Upper Extremity Neurofibroma Treated With Limb-Sparing Debulking: A Case Report, Danielle Cummings, Tomas Holy, Nathan Morrell

Western Journal of Orthopaedics

Surgical management of neurofibromas in Neurofibromatosis type 1 (Von Recklinghausen’s disease), can be challenging because tumor size, location, hypervascularity, and tissue friability pose the risk for significant intraoperative and postoperative blood loss. Despite these risks, surgery is often necessary because of functional losses or cosmetic concerns. The authors present a 31-year-old woman with a massive neurofibroma on her right distal forearm, wrist, and hand, who ultimately underwent surgical resection because of functional impairment of her hand. She required postoperative hospitalization and blood transfusion for management of acute blood loss anemia. Because of concerns regarding blood loss and surgical morbidity, the …

Median Nerve Intraneural Hematoma As An Intraoperative Finding During Carpal Tunnel Release: A Case Report, Ana Silva, Gil Gonrtre, Nikalus Skipp, Ana Love, Deana Mercer

Western Journal of Orthopaedics

Carpal tunnel syndrome (CTS) is the most common compressive neuropathy and typically progresses slowly. Intraoperatively, flexor tenosynovitis, nerve edema, or hourglass deformity may be observed. In rare cases, acute compression symptoms occur due to mass effect on the nerve. Intraneural hematoma of the median nerve is uncommon and has been reported primarily in acute CTS cases associated with trauma. This report describes an 87-year-old patient with a history of mild CTS who underwent carpal tunnel release due to worsening symptoms. After the initial incision, a thickened flexor retinaculum, an hourglass deformity of the median nerve, and an intraneural hematoma were …

Proximal Iliotibial Band Rupture In A 74-Year-Old High-Level, Female Athlete: A Case Report, Jeremiah M. Langsfeld, Joseph Esquibel, Dustin L. Richter

Western Journal of Orthopaedics

A 74-year-old female endurance athlete presented with progressive pain over the left proximal and lateral hip distal to the iliac crest. Symptoms developed over three weeks, impairing weightbearing. Magnetic resonance imaging demonstrated a high-grade tear of the proximal iliotibial band at its iliac crest insertion. The patient was treated nonoperatively and returned to high-level, asymptomatic competition three months after symptom onset. This case offers a nonoperative approach to the rare presentation of a proximal iliotibial band rupture.

Arthroscopic Treatment Of Extensive Synovial Chondromatosis Of The Knee: A Case Report, Gaurav Singh, Bhavna Singh, Rebecca Peebles, Justin Bartley

Western Journal of Orthopaedics

Synovial chondromatosis (SC) is a rare, benign monoarticular disorder characterized by intra-articular cartilaginous loose bodies resulting from synovial metaplasia, most commonly affecting the knee. The authors present the case of a 44-year-old man with progressive, debilitating left knee pain, mechanical symptoms, and functional limitations unresponsive to conservative treatment. Radiographs were unremarkable, but magnetic resonance imaging (MRI) demonstrated multifocal noncalcified intra-articular bodies consistent with SC. The patient underwent arthroscopic debridement of the knee with limited synovectomy. Intraoperative findings included innumerable intra-articular cartilaginous loose bodies throughout the knee, synovial proliferation, and grade II chondromalacia. At three months postoperatively, the patient had regained …

Fibula Strut Allograft With Proximal Tibia Autograft For Treatment Of Humerus Nonunion: A Case Report And Review Of Oligotrophic Nonunion Management, Paul Wilson, Naomi Kelley, Samer Kakish

Western Journal of Orthopaedics

Due to their high incidence and frequent need for reoperation, nonunions of the humerus present a significant challenge in orthopaedics. Using fibular struts to treat nonunions have demonstrated excellent results. While fibular autografts provide both biologic and structural benefit, high donor site morbidity must be considered. Although their application in midshaft humeral nonunions remains limited, fibular allografts avoid donor site morbidity. Enhancing fibular strut allografts with biological components offers a promising strategy for treating fractures that have failed prior revisions. This case study presents a 36-year-old woman with an aseptic oligotrophic midshaft humeral nonunion who had an unsuccessful revision surgery. …

When Speech Speaks Louder Than Truth: Language Variation And Credibility In The Courtroom, Melanie E. Spinnie

Graduate Theses/Dissertations

This study aims to investigate how linguistic variation affects perceptions of credibility in courtroom settings. It focuses on how jurors, judges, and other individuals in the legal system may exhibit bias (consciously or unconsciously) based on how a defendant or witness speaks-- this could include speech disorders as well as differences in dialect, accent, and speech style. Through review of relevant literature, review of a relevant historical case, conducting a survey, and conducting a semi-structured interview, this study explores whether certain speech patterns or characteristics are disproportionately associated with negative judgments during legal proceedings, such as reduced credibility and trustworthiness. …

A Qualitative Exploration Of Counselor Traits And Wellness Practices, Emily Velidow

Antioch University Dissertations & Theses

This study is a qualitative thematic analysis of counselor wellness practices as well as how selfidentified personal traits are part of how a counselor practices and prioritizes wellness. Theoretical underpinnings of the study integrate trait activation theory (Tett & Burnett, 2003), Martin Seligman’s wellbeing theory (Seligman, 2011), and Urie Bronfenbrenner’s ecological systems theory (Bronfenbrenner, 1977). Participants included nineteen licensed counselors (N=19). Analyzed responses lead to four main themes, each with two to four subthemes. Resulting themes included (1) intentional caseload and workday structure, (2) deliberately emphasizing physical wellness, (3) setting boundaries attending to mental and emotional energy, and (4) the …

Établissement De L'Équivalence De La Méthode Irsst 381 Pour La Mesure De L'Exposition Professionnelle Aux Fumées D'Asphalte En Conformité Avec La Nouvelle Valeur D'Exposition Admissible, Simon Aubin, Ousmane Bangoura, Corina Tue

États de la question, rapports d’expertise et revues de littérature

Depuis quelques décennies, la valeur d’exposition admissible consiste en une valeur d’exposition moyenne pondérée (VEMP) des fumées d’asphalte est de 5 mg/m³, prélevée en fraction « particules totales », pour laquelle une mesure gravimétrique non spécifique est préconisée. (Règlement sur la santé et la sécurité du travail) Une nouvelle VEMP entre en vigueur en mars 2026 avec la valeur et l’expression suivante : 1,5 mg/m³ [particules et vapeur exprimée en fraction soluble dans le benzène ou son équivalent] prélevé en fraction « particules totales » (Pt). La méthode préconisée pour soutenir cette VEMP est la …

Les Répercussions Des Changements Climatiques Sur La Sst : État Des Lieux Et Pistes D'Action, Sophie De Serres, Alain Marchand

États de la question, rapports d’expertise et revues de littérature

Cet état des lieux expose les répercussions multidimensionnelles des changements climatiques (CC) sur la santé et la sécurité du travail (SST), en se concentrant sur les contextes nord-américain et européen. L'augmentation de la température moyenne mondiale, qui atteint désormais +1,2 °C par rapport à l'ère préindustrielle, transforme les conditions de travail et exacerbe les dangers professionnels existants. Le stress thermique induit par la chaleur excessive provoque des pathologies allant de l'épuisement au coup de chaleur mortel, tout en dégradant la vigilance et en augmentant le risque de blessures traumatiques. Au-delà des atteintes physiques, les CC aggravent les risques psychosociaux, engendrant …

Real-Time Electronic Drug Monitoring: Experiences From A Multinational Phase 3 Clinical Trial To Prevent Multidrug-Resistant Tb, T. Jimah, J.E. Haberer, K.R. Amico, J. Tinkamanyire, M.A. Kendall, S. Moonsamy, R.T. Khan, K.B.F. Fetalvero, N. Suryavanshi, A. Gupta, A.C. Hesseling, Susan Swindells, G. Churchyard

Journal Articles: Infectious Diseases

OBJECTIVE: We describe the experience of implementing real-time electronic drug monitoring (EDM) within a clinical trial to prevent multidrug-resistant TB (MDR-TB) among high-risk household contacts.

METHODS: The Protecting Households On Exposure to Newly Diagnosed Index Multidrug-Resistant Tuberculosis Patients (PHOENIx) trial is a phase 3, open-label, cluster-randomised clinical trial conducted in 31 sites in Africa, Asia, and Latin America. Household contacts of adults with MDR-TB were enrolled from June 2019 to January 2025, each receiving an EDM device to monitor adherence to TB preventive therapy. Here, we review selection of the adherence monitoring approach and key procedures implemented to support EDM …

Physical Therapist Assistant Mobility Handbook, Sandra M. Ribeiro Dr., Emie Hyman

Open Educational Resources

This is a manual that will move through the various formats of mobility. As part of the Physical Therapist Assistant Program, students must gain knowledge and skill acquisition to support independence. One such way is to help individuals gain or regain mobility. There are many ways that individuals can access their environments. The choice of type of mobility depends on many factors and changes over time. Students must develop an understanding of such factors in making decisions and learn to safely foster forms of mobility. The ones developed in this manual will cover bed mobility, transfers, wheelchair mobility, and ambulation. …

January 2026, Swosu Rural Health Center

RURAL ROCKS

• Age-Friendly Requirements for Hospital Quality Reporting
• APhA secures key congressional win allowing pharmacists to prescribe buprenorphine with specialized training
• "When the hospital leaves town"
• Med Spa Illicit GLP-1s | Supply Chain Safety
• CMS unveils new model aimed at functional, lifestyle medicine

Enhancing The Sectra Educational Portal: Incorporating Resources Into An Integrated Medical Curriculum, Daniël Johannes Van Tonder, Dietrich Lorke

COM Scholarship

Introduction: In contemporary medical curricula, anatomy education frequently encounters fragmentation due to the reliance on disparate resources, including gross anatomy platforms, histology and pathology websites, radiological imaging repositories, and separate assessment tools. This cognitive switching can disrupt the learning flow and hinder the integration of micro- and macroscopic concepts. At Roseman University of Health Sciences (RUCOM), we aimed to centralize the student learning experience by utilizing the Sectra Educational Portal (SEP) not merely as a visualization tool but as a primary hub for asynchronous learning. This presentation outlines our workflow for embedding interactive H5P exercises and external histology repositories directly …

Resilience Shields And Grit Intensifies Subjective Cognitive Decline In Middle‐To‐Older Aged Black Americans, Sunkanmi Folorunsho, Maria Clark, Obinna Odo, Yolanda L. Jackson, Candidus C. Nwakasi, Darlingtina K. Esiaka

Behavioral Science Faculty Publications

Background: There is growing interest on the relationship between psychosocial factors and cognitive health trajectories in adulthood. While grit and resilience have been shown to influence health outcomes, their differential effects on subjective cognitive decline (SCD) in Black American adults remain understudied. The purpose of this study is to help fill this gap.

Methods: The study utilized a cross-sectional research design. Black American participants (N = 242; Mean age = 44.32) responded to a survey assessing SCD, grit, resilience, and sociodemographic factors. Linear regression analysis was performed to test the associations between grit and resilience and SCD, and to …

Evidence Of Heterogeneity In The Opioid Withdrawal Syndrome: Spontaneous And Precipitated Withdrawal, Suky Martinez, Jermaine D. Jones, Kelly E. Dunn, Andrew Huhn, Joshua A. Lile, Thomas P. Shellenberg, Laura Brandt

Behavioral Science Faculty Publications

Aims: This study characterized the heterogeneity of opioid withdrawal by comparing naturally occurring withdrawal during opioid abstinence (spontaneous withdrawal) with abrupt, pharmacologically induced naloxone-precipitated withdrawal in adults with Opioid Use Disorder (OUD).   Methods: A secondary analysis was conducted on de-identified data from 86 adults meeting DSM-5 criteria for moderate-to-severe OUD. Participants either presented in spontaneous withdrawal (n = 28) or underwent naloxone challenge to precipitate withdrawal (n = 58). Withdrawal symptoms were rated using the Wang procedure. Principal Component Analysis (PCA) of binary symptom data was performed to identify dominant patterns of symptom co-occurrence. Separate PCAs were then …

Popliteus Interposition In Metaphyseal Tibial Fractures: The Radiographic Clues That Cannot Be Missed, Lucca Gontijo Giarola, Paulo De Tarso Cardoso Gomes, Robinson Esteves Dos Santos Pires, Guilherme Moreira Abreu E Silva, Marco Antônio Percope De Andrade, Túlio Vinícius De Oliveira Campos

Western Journal of Orthopaedics

High-energy proximal tibia fractures present significant challenges for orthopaedic surgeons, with well-recognized risks including malreduction and nonunion. Although double plating through two mini-open parallel incisions is an established technique for selected patients, nonuion can still occur. One potential contributing factor is entrapment of the popliteus muscle within the distal spike of the posteromedial plateau fragment. This report uses illustrative cases to demonstrate how to identify, address, and prevent this complication. Strategies for managing delayed cases that progress to nonunion are also discussed

Socioeconomic Influences On Doula Access And Perceived Care Quality Among Black Women Experiencing Severe Maternal Morbidity, Deborah Esene

2026 Spring Honors Capstones Projects

Black women experience disproportionately high rates of maternal morbidity and mortality, making it essential to examine access to and the perceived impact of doula support. This study examines whether socioeconomic status influences access to and the perceived benefits of doula support among Black women who experienced severe maternal morbidity (SMM). Researchers surveyed Black women ages 18-49 who had a live birth within the past two years and experienced SMM. Participants were recruited and completed an online survey in late 2020. Key variables included income, education, doula use, and perceived quality of prenatal, intrapartum, and postpartum care. Among 188 participants, 12.2% …

Development And Evaluation Of A Modular 3-D Printed Adapter For Hands-Free Tissue Retraction, Fady E. Attia, Vijay A. Chhabra, Vaibhav Tadepalli,, Joseph Attia, Michael M. Hadeed

Stony Brook Orthopaedic and Musculoskeletal Journal

Fracture fixation procedures typically require precise retraction of soft tissues in order to provide adequate exposure of bone fragments for reduction and fixation. Such procedures require the use of multiple surgical assistants to maintain proper tissue retraction. This manual retraction using traditional instruments, such as Hohmann and Weitlaner retractors, can lead to inefficiencies and poor labor allocation within the operating room (OR). The purpose therefore is to develop and evaluate a three dimensional (3D)-printed Nylon PA12 adapter designed to dock Hohmann retractors onto Weitlaner retractors, enabling hands-free retraction during fracture fixation procedures and potentially improving labor allocation in the OR. …

Association Of Perioperative Steroid Use With Recovery Rate And Postoperative Infection Risk In Spinal Cord Injury, Nathan Zou, Athikur Rahman, Brian Lynch

Stony Brook Orthopaedic and Musculoskeletal Journal

Background: The purpose of this study is to compare recovery and infection outcomes between teenagers and adults who undergo surgery for traumatic spine injuries and the effect of steroid administration. Steroids are often used in traumatic spine injuries to help recovery, however there is a concern that steroid use could increase the risk of infection due to the suppression of the immune system. We examined the impact of postoperative steroid use on recovery rates and infection rates in both age groups.

Methods: A retrospective cohort study was conducted using the TriNetX Research Network, which includes data from over 100 healthcare …

Benign Painful Soft Tissue Tumors Of The Digits: A Contemporary Review, Nethmi Withanage, Athikur Rahman, Lawrence Hurst, Samantha Muhlrad

Stony Brook Orthopaedic and Musculoskeletal Journal

Purpose: Benign painful tumors of the digit are commonly encountered in hand surgery yet frequently pose diagnostic challenges due to overlapping clinical presentations. This review synthesizes current evidence on eight benign soft tissue tumors and cystic lesions that commonly cause digital pain: glomus tumor, giant cell tumor of the tendon sheath (GCTTS), digital mucous cyst, digital ganglion cyst, epidermoid inclusion cyst, pyogenic granuloma, nerve sheath tumors, and angioleiomyoma.

Methods: A comprehensive review of PubMed/MEDLINE was performed, supplemented by hand surgery textbooks and online educational resources. Case series, retrospective cohort studies, and review articles were included.

Results: Each tumor exhibits a …

Large Language Models Improve Readability Of Patient Education Materials On Vascular Conditions, Melissa Chen Xu, Nicola Habash, Justin Do, Jiaying Bi, Dawn Salvatore, Paul J Dimuzio, Michael Nooromid, Babak Abai

Department of Surgery Faculty Papers

Objective: Patient education materials frequently exceed the recommended sixth-grade reading level. Although large language models (LLMs) have shown inconsistent accuracy in medical query responses, they have demonstrated promise in simplifying complex text. This capability has not yet been studied in vascular patient education materials. This study evaluates whether ChatGPT-4o and Gemini 1.5 Pro can improve the readability of Society for Vascular Surgery (SVS) patient education flyers. Methods: SVS health flyers were selected based on five common vascular conditions: abdominal aortic aneurysm, carotid artery disease, deep vein thrombosis, peripheral artery disease, and varicose veins. Each flyer was submitted to ChatGPT-4o and …

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 …

Injury And Violence In Rhode Island, Ruth Mckinnon

Student Research Design & Innovation Symposium

The purpose of this project is to quantify Rhode Island's burden of injury and violence (2020‚Äì2023), describe key trends and demographic differences, and demographic differences, and inform targeted prevention. This statewide analysis used injury-related fatality, hospital discharge, and emergency department (ED) visit data from all Rhode Island hospitals (2020‚Äì2023). Events were classified by mechanism/intent via ICD-10/ICD-10-CM external-cause codes. Mortality, hospitalization, and ED visit rates per 100,000 were calculated using population estimates; counts were summarized. Rates were stratified by sex and age. Mechanisms included falls, traumatic brain injury (TBI), self-harm/suicide, motor-vehicle crashes (MVA), assault/homicide, and other causes (fire, firearm, drowning, non‚ …

Understanding The Link Between Infant Sensory Profiles And Breastfeeding/ Chest Feeding Co-Occupation, Lindsey Mcneill, Danielle Bomzer, Caitlyn Morin, Maya Shourie Ots

Student Research Design & Innovation Symposium

Breastfeeding/ chest feeding are complex co-occupations that support both infant development and parent infant bonding. There is limited research that has investigated how sensory processing factors may influence infants' experiences. Existing literature has focused on the challenges associated with breastfeeding such as latching complications, feeding aversions, allergies, and caregiver stress (Masztalerz-Kozubek et al., 2022). Other literature has focused on sensory profiles of infants; however, no real connections have been made to breastfeeding/ chest feeding (Freund-Azaria et al., 2023).

This gap indicates insufficient understanding of the influence of early sensory characteristics on feeding behaviors and the outcomes of breastfeeding or chest …

Effects Of Academic Workload On Work-Life Balance, Haylee Canadas, Kara Zumbahlen, Sadie Lindgren, Elizabeth Kwak

Student Research Design & Innovation Symposium

Origins and Importance: There is a significant gap in research regarding the toll of the workload assigned to students within specialized fields within the United States. These students have been found to have increased depression, anxiety, and burnout as well as decreased life satisfaction. This extends not only to physician assistants or medical students, but to students within many allied health fields. Positive occupational balance has been found to be associated with positive wellbeing. Dedicating research efforts to explore the work-life balance of health professional students will help students maintain their health and wellbeing as they become equipped to practice …

Facilitating Return To Work And School Post-Stroke, Amber Brown

Student Research Design & Innovation Symposium

Importance: Stroke is a leading cause of long-term disability, and many working-age survivors desire to return to work or school, where participation is closely tied to identity, routine, and well-being. However, structured supports for return to work (RTW) and return to school (RTS) are often limited. Objective: This scoping review aimed to identify strategies and programs that facilitated RTW and RTS among adult stroke survivors. Data Sources: A comprehensive literature search was conducted across four academic databases: Academic Search Complete (EBSCO), Taylor & Francis, PubMed, and SAGE Journals. Study Selection and Data Collection: Peer-reviewed articles published between 2015 and 2025 …