Medicine and Health Sciences Commons^™

Lost Fractures: Prevalence And Risk Factors For Missed Costosternal And Costal Cartilage Fractures Among Patients With Radiologic Chest Wall Injury., Joseph D Forrester, Mohamad Abou Chaar, Andrew T Barnes, Zachary M Bauman, Samy Bendjemil, Nizama N Betts, Benjamin Christie, Raaga Dasari, Devoe Wb, Michelle J Earley, Bradley Faliks, Tracy J Johns, Connie Johnson, Michelle S Junker, Brian D Kim, Jonathan M King, Ariel Whitney Knight, Alexis A Schweibinz, Daniel Stephens, Mary Stuever, Simeng Wang

Trauma and Acute Care Articles

BACKGROUND: Costosternal cartilages and the costal margin, collectively termed costal cartilage, are hyaline cartilage connecting ribs to the sternum and to adjacent ribs, respectively. Presence of intact costal cartilage is essential for elasticity of the chest wall. Anecdotally, costal cartilage injuries are underdiagnosed on trauma CT scan in patients with rib fractures. Our aim was to determine a baseline frequency of acute costal cartilage injury among patients presenting with rib fractures.

METHODS: We performed a retrospective cohort study of injured adult patients admitted to Level I/II trauma centers with rib fractures from January 2020 to July 2024. CT images obtained …

Reduced Threat-Related Neural Efficiency: A Possible Biomarker For Pediatric Anxiety Disorders, Julia O. Linke, Reut Naim, Simona P. Haller, Parmis Khosravi, Beck Scheinberg, Meghan E. Byrne, Anita Harrewijn, Ellen Leibenluft, Melissa A. Brotman, Anderson M. Winkler, Daniel Samuel Pine

School of Medicine Publications

Objective: Pediatric anxiety disorders are common and predict adult psychopathology, yet current treatments, such as cognitive-behavioral therapy (CBT), produce lasting remission in less than 50% of affected youths. To support the search for improved, mechanistically grounded interventions, this study evaluated neural efficiency, defined as similarity in functional connectivity between a threat task and rest, as a potential biomarker. The study evaluated neural efficiency in relation to anxiety diagnosis and treatment response.

Methods: The authors compared 103 youths with an anxiety disorder diagnosis (mean age, 12.5 years [SD=2.91], 62% female) to 103 youths with no psychiatric diagnosis (mean age, 13.4 years …

Beyond Hemostasis: A Narrative Review On The Multifaceted Therapeutic Potential Of Ankaferd Blood Stopper, Salima E. Tibi, Muhammad Hashir Nazir, Saleha Nazir, Bhumi Daishik Patel, Gayatri Misra, Tirath Patel, Fatima Nasir, Muhammad Farhan, Nana Sardarova, Nikhilesh Anand

School of Medicine Publications

Background: Effective hemorrhage control is essential in managing trauma and surgical patients, with uncontrolled bleeding being a leading cause of mortality. Ankaferd Blood Stopper (ABS), a hemostatic agent historically used in Anatolia, has gained recognition for its ability to modulate red blood cell-fibrinogen interactions to form a stable protein network for rapid bleeding cessation.

Objective: This review explores the multifaceted applications of ABS, evaluating its efficacy, safety, and potential therapeutic roles across various medical fields, including hemostasis, wound healing, antimicrobial activity, and antineoplastic effects.

Methods: A comprehensive synthesis of clinical trials, case reports, and experimental studies was conducted to assess …

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 …

A Position Statement On Endovascular Models And Effectiveness Metrics For Mechanical Thrombectomy Navigation, On Behalf Of The Stakeholder Taskforce For Artificial Intelligence-Assisted Robotic Thrombectomy (Start), Harry Robertshaw, Anna Barnes, Phil Blakelock, Raphael Blanc, Robert Crossley, Rebecca Fahrig, Ameer E. Hassan, Benjamin Jackson, Lennart Karstensen

School of Medicine Publications

Although we are making progress in overcoming infectious diseases and cancer, one of the major medical challenges of the mid-21st century will be the increasing prevalence of stroke. Occlusions in large vessels are especially debilitating, yet effective treatment—needed within hours to achieve best outcomes—remains limited because of geographic accessibility. One solution for improving timely access to mechanical thrombectomy in geographically diverse populations is the widespread deployment of robotic surgical systems. Artificial intelligence assistance may enable the safe and effective upskilling of operators in this emerging therapeutic delivery approach. Our aim was to establish consensus frameworks for developing and validating artificial …

Training Set Augmentation And Biology-Aware Harmonization Improve Radiomic Models For Lung Cancer Prediction In Indeterminate Nodules, Claire Huchthausen, Menglin Shi, Gabriel De Sousa, James Larner, Einsley Janowski, Jonathan Colen, Krishni Wijesooriya

Data Science Faculty Publications

CT radiomics-based machine learning has potential to predict lung cancer in pulmonary nodules (PNs) earlier than standard-of-care methods. Low malignancy rates in early-development PNs and variable image acquisition hinder development of radiomic models for diagnosing these PNs. To address these challenges, we augmented training using later-development PNs and harmonized for acquisition effects. We examine early-development benign and malignant PNs (n = 106) below the sensitivity of standard-of-care diagnosis. Classifiers predicting malignancy performed near chance when trained on ComBat-harmonized radiomic features from only early-development PNs. We then augmented training with later-development benign and malignant PNs (n = 225). We evaluated whether …

Drug-Induced Sleep Endoscopy Findings In Obese Adolescents With Sleep Apnea, Timothy Kearney, Turaj Vazifedan, Cristina M. Baldassari

Department of Otolaryngology (ENT) Faculty Publications

Objective

Data regarding drug-induced sleep endoscopy (DISE) findings in obese adolescents with obstructive sleep apnea (OSA) are lacking; such information could be used to direct and improve management as there is controversy whether adenotonsillectomy (AT) or positive airway pressure is standard therapy for this population. Our primary objective is to describe DISE findings in obese adolescents.

Study Design

Case-control.

Setting

Tertiary care children's hospital.

Methods

A 10-year retrospective review was conducted of obese adolescents 12 to 21 years old with OSA (apnea-hypopnea index [AHI] ≥ 1) that underwent DISE prior to AT. All DISE procedures were scored utilizing a modified …

Bias In Nursing Students: How Student Exposure Impacts Patient Interactions, Claire Roy

Honors Theses and Capstones

Bias is a pervasive issue in healthcare. It affects all aspects of the healthcare system and affects patients primarily through their interactions with healthcare providers. This study aimed to identify if exposure to various patient populations reduced bias among participants and increased their understanding of the way bias impacts patients. Two participants were recruited from a baccalaureate nursing program course titled “Living with Mental Illness” to participate in a series of two-semi structured interviews to identify bias, perceptions of community-based care, and the growth from the beginning to the end of their clinical experiences. Results showed skill development, increased understanding …

Mindfulness Matters: Reducing Anxiety In Prelicensure Undergraduate Nursing Students Using Virtual Reality Meditation Prior To High Fidelity Simulation., Lindsey K. Hildreth

Honors Theses and Capstones

Abstract:

The aim of this study was to evaluate the effectiveness of a 5-minute virtual reality (VR) meditation intervention in reducing self-reported anxiety among prelicensure nursing students immediately prior to their participation in a high-fidelity clinical simulation. Anxiety levels were measured using a Visual Analog Scale (VAS) and compared between students who participated in the VR meditation intervention and those in a control group receiving standard prebrief, and no VR meditation. It was hypothesized that students who engage in VR meditation would demonstrate a reduction in anxiety compared to students in the control group.

Improving Low Fresh Gas Flow Adherence To Lower Co2e Emissions, Luke Charles Ricci

Honors Theses and Capstones

Volatile anesthetic gases contribute significantly to healthcare-related greenhouse gas emissions. These greenhouse gas emissions can be increased due to higher fresh gas flows. At Dartmouth-Hitchcock Medical Center (DHMC), open and semi-open systems with fresh gas flow (FGF) rates above two liters per minute result in anesthetic gas waste. Literature suggests multifaceted quality improvement interventions are effective in improving low fresh gas flow adherence in anesthesia provider practices. The purpose of this study was to evaluate the potential reduction in anesthetic gas waste and carbon dioxide equivalent (CO₂e) emissions at Dartmouth-Hitchcock Medical Center through improved adherence to low fresh gas flow …

Preserved Artificial Grammar Learning In Individuals With Parkinson’S Disease: A Systematic Review, Sarah I. Cranna

Honors Theses and Capstones

Abstract

            Implicit statistical learning is a crucial cognitive function that is highly involved in the learning and processing of language. Since both language and implicit statistical learning are supported by the basal ganglia through cortico-striatal networks, disruptions to this network could result in their impairment. Parkinson’s Disease (PD) can therefore be used to model disruptions to this system as it is primarily characterized by dysfunction in the basal ganglia. Thus, this review aims to examine the current literature studying the performance of individuals with PD on artificial grammar tasks in order to investigate the impact of impaired basal ganglia function …