Medicine and Health Sciences Commons^™

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 …

Increased Risk Of Alzheimer Disease–Associated Mortality In Nonobese Vs Obese Metabolic Dysfunction–Associated Steatotic Liver Disease: A 30-Year National Cohort Study, Sarpong Boateng, Guy Loic Nguefang, Mexan Mapouka, Ridwan Lawal, Solomon Gyabaah, Bright Nwatamole, Amita Kasar, Selom Adatsi, Basile Njei

School of Medicine Publications

Background and aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly recognized for its extrahepatic consequences, including emerging links to neurodegenerative disorders such as Alzheimer disease (AD). Whether AD mortality risk differs across MASLD phenotypes, remains unclear.

Methods: We analyzed adults from the Third National Health and Nutrition Examination Survey (1988-1994) with mortality follow-up through 2019 via the National Death Index. Participants were followed for AD mortality. Cumulative incidence was estimated using Kaplan-Meier methods. Cox proportional hazards models evaluated MASLD phenotypes and AD mortality, adjusting for age, sex, race/ethnicity, poverty-income ratio, body mass index, and smoking status.

Results: Among 7125 …

Una Nueva Herramienta Para Estimar El Volumen Muscular Independientemente De La Edad, El Sexo Y El Nivel De Actividad Física, José J. Rivera-Sánchez, Laura P. Burgos-Morelos, Daniel Castillo-Castillo, Gerardo Méndez-Suárez, Juan C. Lopez-Alvarenga, Damián Carrillo-Ruíz

School of Medicine Publications

Antecedentes: Actualmente, la evaluación del volumen muscular requiere técnicas invasivas o de imagen, lo que aumenta los costos y retrasa la evaluación, y las mediciones antropométricas con frecuencia son inexactas.

Objetivo: Desarrollar una fórmula matemática para estimar el volumen del cuádriceps.

Material y métodos: Se evaluaron 127 sujetos: 40 adultos sedentarios de 20 a 35 años, 47 atletas adultos de 20 a 45 años y 40 adultos sedentarios de 70 a 94 años. Se dividieron en grupos de desarrollo y de validación. Se realizaron mediciones de variables antropométricas y fuerza de agarre, y se desarrolló la fórmula de predicción del …

Training Tomorrow’S Hand Surgeons: Clinical, Leadership, And Structural Trends In Fellowship Education, Ogonna N. Nnamani Silva, Aaron I. Dadzie, Chinenye Ogbonnah, Lydia A. Helliwell, Abhiram R. Bhashyam, Catherine M. Curtin, Tamara D. Rozental, Krystle R. Tuaño

School of Medicine Publications

Purpose: Hand surgery fellowships include trainees from orthopedic, plastic, and general surgery. These pathways present an opportunity to examine variations in graduate medical education structures, such as program size, sponsoring department, and leadership composition. Limited research exists on the characteristics of these programs. The purpose of this study is to assess the structural and leadership characteristics of the Accreditation Council of Graduate Medical Education-accredited hand surgery fellowships in the United States. We hypothesized that characteristics (ie, faculty-to-fellow ratios and case volume) vary by specialty sponsorship. Leadership, although shaped by merit-based criteria, faces challenges in achieving broader demographic diversity.

Methods: A …

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 …

Stability Of Salivary Microrna Measures Across An Ncaa Division I Football Season: Implications For Microrna As A Biomarker Of Concussion, Thomas R. Campbell, Martina Zamponi, Delaney Leathers, Julie Cavallario, Jessica C. Martinez, Peter A. Mollica

Rehabilitation Sciences Faculty Publications

Background

Clinicians often face challenges in concussion care due to a heavy reliance on subjective patient input. Recently, research has sought objective biomarkers, like salivary microRNAs, to improve concussion management. However, significant limitations hinder the use of microRNAs as a diagnostic tool, including the cumulative effects of a contact sport season. A better understanding of the response to a contact sport season would help researchers and clinicians interpret expression changes at the time of injury in the context of seasonal variation. in Therefore, this study investigated the reliability of previously identified salivary microRNA targets across one contact sport season.

Methods …

The Sequence (S) Index As A Marker Of Diminished Step-To-Step Transition Efficiency In Older Adults, Elham Alijanpour, Ashwini Kulkarni, Peter G. Adamczyk, Daniel M. Russell

Rehabilitation Sciences Faculty Publications

Introduction: Age-related declines in walking efficiency are often attributed to musculoskeletal and neuromuscular changes, yet the mechanisms underlying these inefficiencies remain poorly understood. One key contributor is the step-to-step transition (STST), during which the center of mass (CoM) is redirected between limbs. The Sequence (S) index quantifies the temporal overlap between push-off and collision forces during STST, with higher values indicating greater mechanical energy loss. This study investigated whether aging affects STST efficiency, as quantified by the S index, and examined the timing and impulse characteristics underlying observed differences.

Methods: Thirteen young and eleven older healthy adults walked at five …

Ultrasound-Based Assessment Of Talar Cartilage In Individuals With Chronic Ankle Instability: A Systematic Review, Amin Mohammadi, Saeed Eshghi, Iman Mohammadi, Patrick Wilson, Ryan Mccann

Rehabilitation Sciences Faculty Publications

Purpose

To systematically synthesize ultrasound (US) evidence on talar cartilage morphology and load-induced deformation in individuals with chronic ankle instability (CAI), and to map methodological approaches (acquisition, outcome definitions, loading paradigms, and normalization) to inform protocol standardization.

Methods

PubMed, Web of Science, and EBSCO were searched (March 31, 2025). Eligible studies reported quantitative US-derived talar cartilage morphology (e.g., thickness, cross-sectional area [CSA]) and/or deformation following standardized loading in CAI and comparison groups. Due to heterogeneity in imaging protocols, loading tasks, and outcome definitions, findings were synthesized narratively and organized by outcome domain.

Results

Across available cohorts, load-induced deformation was the …

Nonlinear Differences In Postural Sway Across Attentional Focus Conditions In Individuals With And Without Anterior Cruciate Ligament Reconstruction, Natalie L. Ferguson, Brian L. Cone, Christopher K. Rhea, Anne Beethe, Breanna Studenka

Rehabilitation Sciences Faculty Publications

BACKGROUND: The structure of variability in postural sway reflects the adaptability and health of the postural control system. Entropy quantifies this structure by measuring the regularity of repeated fluctuations over time. Although entropy has been used to examine sway in neurological populations, little is known about how sway complexity changes following anterior cruciate ligament reconstruction (ACLR). Attentional focus may also influence postural control, with external focus typically promoting more efficient and automatic regulation than internal focus.

AIM: To examine how attentional focus (internal vs. external) influences the structure of postural sway in individuals with and without ACLR.

METHODS: Forty-three participants …

A Narrative Review Of Bertolotti's Syndrome: Etiology, Classification, Diagnosis, And Treatment, Matyas Abel Tsegaye, Andrea Muffly

Rehabilitation Sciences Faculty Publications

Bertolotti's syndrome is a congenital condition characterized by chronic low back pain stemming from a lumbosacral transitional vertebra (LSTV). Because the condition is frequently overlooked, patients often face years of delayed diagnosis before the true source of their pain is identified. Furthermore, current information regarding the biological origins and clinical management of the condition remain scattered. To address this knowledge gap, this narrative review aims to provide a comprehensive overview of Bertolotti’s syndrome by consolidating these disparate sources and suggesting new connections. We synthesize the latest understanding of this condition, ranging from its genetic origins to modern clinical management. We …

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 …

Eeg Signatures Of Motor Development In Early Childhood: A Systematic Review, Sonia Khurana, Ashwini Kulkarni, Thomas C. Bulea, Hunter J. Bennett

Rehabilitation Sciences Faculty Publications

Background

Early identification of motor developmental disorders is limited due to lack of objective neural markers that characterize typical neurodevelopmental patterns. This systematic review interprets and synthesizes existing evidence to propose a framework of EEG signatures associated with motor development in children aged 0-5 years, which may help inform future benchmarks for early assessment and intervention.

Methods

Following PRISMA guidelines, we searched published and gray literature across five databases between 2000 and 2025 (registered protocol). Included studies examined EEG during task-based, resting-state, or sleep studies linked to motor milestones, task performance, or standardized motor assessments. Study quality was assessed using …

The Epidemiology Of Catastrophic Head And Neck Injuries In High School And College Non-Football Sports: A 4-Decade Review, Courtney M. Meyer, Kristen L. Kucera, Samantha E. Scarneo-Miller, Zachary K. Winkelmann, Susan W. Yeargin

Rehabilitation Sciences Faculty Publications

Background:

Catastrophic head and neck injuries (CHNIs) in sport are rare but can have disabling or fatal outcomes. Prior studies have focused on football, equipment-laden sports, or different injury severities, not CHNI in nonfootball sports.

Purpose:

To describe the epidemiology of CHNI across levels (high school vs collegiate) in nonfootball sports and evaluate differences in injury rates (IRs) by sport, sex, and decade.

Study Design

Descriptive epidemiological study.

Methods:

This study utilized 40 academic years (1982-1983 to 2021-2022) of surveillance data from the National Center for Catastrophic Sports Injury Research. Descriptive statistics summarized athlete, event, and injury characteristics. IRs were …

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. …

Hierarchical Clustering Reveals Multilevel Structure For Multifactorial Assessment In Community-Dwelling Older Adults, Brittany S. Samulski, Ashwini Kulkarni, Neda Moghim, Ross Gore, Soumya Banerjee, Christopher K. Rhea

Rehabilitation Sciences Faculty Publications

Multifactorial falls assessment is recommended for older adults at elevated risk but can generate numerous potentially overlapping measurements, increasing testing burden despite potentially diminishing informational returns as correlated measures are added. Characterizing how measures covary may inform subsequent efforts to evaluate more efficient assessment procedures. Community-dwelling older adults (n = 298) completed a single-visit assessment including the Physiological Profile Assessment (PPA), preferred- and maximal-speed walking, Montreal Cognitive Assessment (MoCA), and Modified Falls Efficacy Scale (MFES). Hierarchical agglomerative clustering was applied to 51 variables. Dendrogram fidelity, cluster separation, and resampling stability were evaluated using the cophenetic correlation coefficient (CCC), silhouette width, …

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 = …

Partnerships To Advance Patient Safety And Address Preventable Harm: Case Studies From International Health Care Leaders, Rachel Bonesteel, Robert Saunders, Tilithia Mcbride, Susan Sheridan, David W Bates, Mark Mcclellan, Charles H Kahn, Eyal Zimlichman

Faculty, Staff and Students Publications

There have been notable improvements in patient safety in recent years; however, significant challenges remain in reducing the incidence of preventable patient harm. Supporting patient safety efforts is increasingly important given increasing complexity of care and changing health needs, especially with aging populations. Emerging technologies and capabilities open new possibilities to address longstanding patient safety problems. For example, predictive analytics to support provider decision-making, increased patient interest in engagement in their care, and artificial intelligence provide opportunities to further reduce harm. Many of these examples support a more proactive approach to patient safety by focusing on anticipating, predicting, and preventing …

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.

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 Effects Of Speak Out! On Hypokinetic Dysarthria In Individuals With Idiopathic Parkinson’S Disease, Linden King

Murray State Theses and Dissertations

The purpose of this single subject research study was to prove the efficacy of SPEAK OUT! therapy in improving loudness, rate of speech, and quality of life for individuals who have hypokinetic dysarthria due to Parkinson’s Disease. In this A-B-A design, five weeks of SPEAK OUT! therapy was provided twice a week to four individuals with a diagnosis of Parkinson’s disease. Results showed an increase in loudness in conversation and improved quality of life measured by statistical and visual analysis. These findings contribute to the research behind the use of SPEAK OUT! therapy for individuals with HKD due to PD.

Tuberculosis Presenting As Multiple Pulmonary Nodules Mimicking Malignancy, Abdel Martinez Borrego, Fatimah Bello, Brandon Cantazaro, Luisa Montoya, Frank Mediola

School of Medicine Publications

Multiple pulmonary nodules often raise concern for metastatic malignancy; however, the differential diagnosis is broad and includes infectious, inflammatory, granulomatous, vascular, and benign etiologies. Tuberculosis (TB), although uncommon, can present with multiple nodules that closely mimic metastatic disease on advanced imaging, requiring careful clinicoradiologic and microbiologic correlation. We describe a woman in her 50s who presented with dyspnea and new-onset heart failure, in whom imaging revealed mediastinal lymphadenopathy and bilateral pulmonary nodules concerning for malignancy. Evaluation was limited by concurrent COVID-19 infection, and CT-guided biopsy demonstrated necrotizing granulomas without evidence of malignancy or infection. She later re-presented with fever and …

Pediatric Both Bone Fracture Leading To Median Nerve Entrapment: A Case Report, Joshua Lyndon Dale, Frank Gerold

School of Medicine Publications

Introduction: Both-bone forearm fractures are common in pediatric patients and most often result from a fall onto an outstretched hand. Although rare, nerve entrapments, particularly of the median nerve, can occur, especially following closed reduction.

Case report: We present the case of a 13-year-old male who sustained a both-bone forearm fracture while on vacation in Mexico. The injury was managed with closed reduction and casting. Despite appropriate treatment, the patient developed progressive numbness, tingling, and thenar atrophy in the median nerve distribution. Electromyography and nerve conduction studies confirmed significant median nerve dysfunction. Surgical exploration revealed the median nerve entrapped in …

Cytocompatibility, Osteogenic Potential, Antibacterial And Antibiofilm Efficacy Of A Calcium-Silicate-Based Intracanal Medication, Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

This study assessed the biological and antimicrobial properties of a calcium silicate-based material and calcium hydroxide (CH) when used as intracanal medications. MTT assay, osteogenic differentiation of human periodontal stem cells (hPDLSCs), cell mineralization-assay, and determination of ALP activity were assessed to investigate the biological properties. While the agar well diffusion, crystal violet (CRV) assay and LIVE/DEAD staining of dentin slices infected with a mature E. faecalis biofilm were used to assess the antimicrobial properties. Normally distributed data were analyzed using one and two-way ANOVA and post hoc Tukey test, while for non-normally distributed data Kruskal Wallis and Dunn's tests …

Enhancing Severely Compromised Premolar Strength: Role Of Cusp Reduction Design In Cad/Cam Composite Restorations, Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

The objective of this study was to assess the effect of different designs and depths of cusp reduction on fracture resistance of maxillary permanent premolars restored with CAD/CAM composite restorations. A total of 42 sound maxillary premolars were used. Standardized MOD cavities were prepared in all specimens. Teeth were randomly divided according to form of cusp reduction into three main groups (n = 14); G1:MOD cavities restored with inlays with no cusp reduction, G2:MOD cavities restored with overlays with buccal and palatal anatomical cusps reduction, G3; MOD cavities restored with overlays with buccal and palatal flat cusps reduction. Groups 2 …

Automatic Teeth Segmentation In Panoramic Radiographs Using Attention U-Net, Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

Aim: The aim of this study is to investigate the effectiveness of the Attention U-Net architecture for teeth segmentation in panoramic dental images. By exploring the potential of Attention U-Net, the study aims to contribute to the development of more precise and automated dental imaging analysis, which could enhance diagnosis, treatment planning, and computer-aided dental systems. Subjects and methods: The TUFTS University dataset consisting of 1000 de-identified panoramic radiographs was used for training and testing an Attention U-Net architecture with 10-fold cross-validation. These scores surpass those of all other networks implemented on the same dataset. using a newly available benchmark …

Dual Regulation Of Osteogenesis And Inflammation By Pomegranate (Punica Granatum L.) Extract In Periodontal Ligament-Derived Stem Cells: Implications For Regenerative Medicine, Mai Hafez

Dentistry

Objectives

This article aims to compare the osteogenic along with anti-inflammatory activity of different concentrations of pomegranate extract (PG) on human periodontal ligament-derived stem cells (hPDLSCs) in vitro.

Materials and Methods

hPDLSCs were acquired from the root surface of removed molars, cultured, and then distinguished by flow cytometry analysis and several lineage differentiation potentials. To identify the effect of PG on hPDLSCs' viability, an MTT assay was performed. hPDLSCs were maintained in osteogenic induction medium with varying concentrations of PG. At the end of the induction period, osteogenesis was assessed using Alizarin Red staining, ALP assay, and qRT-PCR to determine …

Effect Of Different Finishing And Polishing Systems On Surface Roughness And Color Stability Of Composite Cad/Cam Blocks (In-Vitro Study), Hend Sayed Ahmed, Mohamed Fouad Haridy, Noura Alzayyat, Reem Mohamed Gadao

Dentistry

No abstract provided.

Effect Of Caries Removal Techniques On Micro-Tensile Bond Strength Of Cad/Cam Composite Blocks To Dentine (In-Vitro Study), Hend Sayed Ahmed, Mohamed Fouad Haridy, Hoda Fouda, Basma Khalifa, Youssef M. Haridy

Dentistry

No abstract provided.

Laser Versus Fluoride Varnish In Management Of Dentine Hypersensitivity In Non-Carious Lesions: A Randomized Clinical Trial, Hend Sayed Ahmed, Mohamed Fouad Haridy, Hoda Fouda, Amr Adham Shalaby, Youssef M. Haridy

Dentistry

No abstract provided.

The Effects Of Cigarette Smoke And Heated-Tobacco Aerosol On Streptococcus Mutans Adhesion And Surface Topography Of Dental Hard Tissues In Vitro, Mohamed Shamel, Mahmoud Al Ankily, Nourhan Taha

Dentistry

No abstract provided.