Medicine and Health Sciences Commons^™

Thoracolumbar Fractures: Historical Systems And Advancements With The Ao Spine Classification, Barry Ting Sheen Kweh, Alex R. Vaccaro, Gregory D. Schroeder, Jose A. Canseco, Maximilian Reinhold, Mohamed M. Aly, Sebastian Bigdon, Mohammad El-Skarkawi, Richard J. Bransford, Andrei Fernandes Joaquim, Harvinder Singh Chhabra, Emiliano Vialle, Rishi M. Kanna, Charlotte Dandurand, Cumhur Öner, Jin Wee Tee

Rothman Institute Papers

Study Design: Systematic Review. Objective: To describe the historical classifications of thoracolumbar injuries and their evolution into the AO Spine Thoracolumbar Injury Classification System. Methods: A systematic review of MEDLINE, EMBASE and Cochrane Databases was performed in keeping with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Results: 445 articles were crystallized to 14 included studies. Simple categorization systems offered by Bohler or Watson-Jones merely identify fracture morphology. Holdsworth and Denis conveyed a sense of the stability of injuries by noting columns of stability, but still failed to take into consideration important factors such as neurological status or …

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.

Health Insurance As A Mediator Of Neighborhood Deprivation And Pediatric Cancer Survival: An Analysis Of State Cancer Registry Data, Emma Hymel, Cheng Zheng, Jenna Allison, Kendra L. Ratnapradipa, Edward S. Peters, Sarah H. Nash, Mei-Chin Hsieh, Shinobu Watanabe-Galloway

Journal Articles: Epidemiology

INTRODUCTION: To develop interventions to reduce neighborhood-level disparities in pediatric cancer outcomes, it is necessary to understand their underlying mechanisms. It has been suggested that individual-level health insurance is a mediator of neighborhood deprivation and pediatric cancer survival.

METHODS: This study was a population-based longitudinal study of children with cancer from 2000 to 2020 in the Iowa Cancer Registry and Louisiana Tumor Registry. Neighborhood deprivation was measured using the Area Deprivation Index. Log-binomial regression models were used to identify predictors of health insurance status at diagnosis. Cox regression models were used to assess the association between health insurance status at …

Pilot Study On The Use Of Multimorbidity Index In Patients Receiving Home Parenteral Nutrition, Michael M. Rothkopf, Mohan Pant, Zachary Rothkopf, Rebecca Brown Rdn, Jaime Haselhorst Rdn, Debbie L. Stevenson Rdn, Andrew Depalma Mba, Michael Saracco

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

Home parenteral nutrition (HPN) patients often have multiple comorbidities. A validated multimorbidity index (MMI) could help determine resource needs and risks with HPN. We evaluated MMI scoring to determine if it predicted HPN resource use and outcomes.

Methods

We performed a secondary analysis of 60 HPN patients from a previous study based on Cumulative Illness Rating Scale (CIRS) scoring. We examined three variables: PN formula changes, hospitalizations, and hospital length of stay (LOS). Density plots were produced to select a CIRS score cutoff value. Spearman correlations among the three variables of interest were computed. The data were then subjected …

Vitamin D Status During Pregnancy Modulates The Effect Of Pre-Pregnancy Obesity On Gestational Diabetes Mellitus Risk: A Birth Cohort Study, Ali H. Ziyab, Abdullah Al-Taiar, Reem Al-Sabah, Majeda S. Hammoud, Saeed Akhtar

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Objective:

To determine whether gestational vitamin D status modulates the effect of pre-pregnancy obesity on gestational diabetes mellitus (GDM) risk while stratifying by maternal age.

Design:

Birth cohort.

Setting:

A major maternity hospital in Kuwait.

Participants:

Pregnant women in their second/third trimester of gestation were enrolled. Pre-pregnancy body mass index (BMI, kg/m²) was categorized as under/normal weight (< 25.0), overweight (25.0 to < 30.0), and obesity (≥30.0). Gestational 25-hydroxyvitamin D concentrations were categorized as deficiency (< 50 nmol/L) or insufficiency/sufficiency (≥50 nmol/L). GDM status was ascertained according to international guidelines. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were estimated using logistic regression.

Results:

Data from 957 pregnant women were analyzed, with GDM affecting 166 (17.4%) pregnancies. Pre-pregnancy obesity and gestational vitamin D deficiency was ascertained in 275 (28.7%) and 533 (55.7%) pregnant women, respectively. The association between pre-pregnancy obesity and GDM risk differed according …

Integrating Pilates Into Outpatient Occupational Therapy:A Complementary Approach To Traditional Rehabilitation, Ellie Drechsler

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

INTRODUCTION: Reformer Pilates, originally developed by Joseph Pilates as a holistic method to enhance strength, alignment, and mind–body integration, has gained increasing recognition for its therapeutic potential in rehabilitation settings. Despite evidence supporting its benefits for balance, chronic pain, functional mobility, and mental wellbeing, its use in outpatient occupational therapy (OT) and physical therapy (PT) remains limited. The purpose of this quality‑improvement project aimed to bridge that gap by developing an accessible, reformer‑based educational resource for clinicians with minimal Pilates experience and by evaluating client and clinician perceptions of its therapeutic value.

METHODS: Using mixed-methods surveys, qualitative and quantitative feedback …

Promoting Caregiver And Staff Education For Motor Development And Feeding Skills On A Pediatric Heart Center, Karina Dharia

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Around the world, congenital heart disease (CHD) is one of the leading birth defects in infants and has been known to cause many long-term developmental effects (Scott & Neal, 2021). Given these developmental risks, recent literature suggests that there lack strong and effective resources for parents, caregivers and healthcare professionals about infant development and the application of occupational therapy in the setting of pediatric CHD (Marino et al., 2019). The purpose of this capstone was to promote parent, caregiver, and staff engagement with patients to promote motor development and feeding skills in the in-patient pediatric cardiac setting. Our aims were …

Optimizing The Utilization Of Interpreter Services In A Student Run Clinic, Mallory Vaclav

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

No abstract provided.

Collaboration In Acute Care: Enhancing Occupational Therapy Outcomes Through Canine Therapy Integration​, Deanna Hamke

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

The utilization of animal-assisted therapy has the potential to increase patient participation, motivation, and help simulate real-life experiences to promote a successful discharge from therapy services. The purpose of this doctoral capstone project was to: 1) expand collaboration between occupational therapists & canine therapy handlers through use of a communication platform and 2) to create a resource outlining in-session responsibilities to facilitate partnership between occupational therapists and canine therapy handlers. Occupational therapy treatment sessions were completed using canine therapy interventions targeting mobility, engagement, and emotional regulation. The final deliverables included multiple educational resources and a platform for communication. These deliverables …

Bridging Research And Practice In Occupational Therapy: Education On Regulation And Socioemotional Development For Caregivers And Novice Clinicians, Lily Andrews

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Background: New graduates in pediatric occupational therapy are frequently expected to be autonomous but experience poor self-confidence and challenges with clinical decision-making (Moir & Copley, 2025). Concurrently, parents of children receiving occupational therapy to improve regulation and socioemotional development often have limited understanding of these concepts, resulting in frustration and reduced carryover of therapeutic strategies at home. This dual gap highlights a clear need to enhance clinician confidence and caregiver understanding within pediatric occupational therapy practice.

Aim: This capstone project aimed to develop resources synthesizing key principles of pediatric practice and intervention to improve student clinician and new graduate confidence …

Creating An Effective Video Case-Based Teaching Tool To Enhance Undergraduate Clinical Skills, Tyler Kam

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

No abstract provided.

Enhancing Occupational Therapy Education In Cancer Rehabilitation​, Elizabeth A. Dorn

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

This doctoral capstone project aimed to enhance entry-level occupational therapy (OT) education by developing and evaluating evidence-based instructional materials addressing musculoskeletal and oncology rehabilitation within a doctorate curriculum. Designed as an oncology-focused experience, the project involved a two-phase approach: (1) testing educational techniques by implementation and evaluation of an elbow pathology lecture and lab, and (2) development of an asynchronous oncology rehabilitation unit informed by outcomes from the initial phase. The project was guided by the ASSURE instructional design model and emphasized active, visual, and case-based learning strategies to support clinical reasoning.

Student outcomes were assessed using pre- and post-lecture …

Anterior Cruciate Ligament Injury Resilience In Women’S Lacrosse: An Ecological Dynamics Approach, Annika Wozney

Undergraduate Symposium

Anterior cruciate ligament (ACL) injuries in women’s lacrosse arise from complex interactions involving biomechanical, anatomical, and neuromuscular factors. The aim of this project was to review current literature on ACL injury and traditional prevention strategies in women’s lacrosse. Recent perspectives highlight limitations of traditional approaches that often fail to simulate the unpredictability of game environments. An ecological dynamics approach is proposed that considers elements of the athlete, playing environment, and game tasks to guide future research and practice in reducing the incidence of ACL injury.

Investigating The Relationship Between Drug Overdose Deaths, Excessive Alcohol Drinking, And Adult Smoking In Urban And Rural Ohio Counties In 2025, Sumin Byoun, Anne Griffin

Scholarship in Medicine - All Papers

Deaths from drug overdoses have been increasing each year. Ohio ranks among states with the highest number of drug overdose deaths per year. There is a gap in the literature regarding discussions of how excessive alcohol drinking and cigarette smoking rates may predict drug overdose death rates in a community. First, this study investigates differences in excessive drinking, adult smoking, and drug overdose deaths between urban and rural counties in Ohio. Second, this study explores whether excessive drinking and smoking behaviors can predict drug overdose death rates in urban and rural Ohio counties. Data exclusive to Ohio counties was obtained …

Understanding The Impacts Of Food Insecurity On Education Outcomes In Ohio, Maria El Biri, Sreya Tummalapalli

Scholarship in Medicine - All Papers

Background: Food insecurity has been a growing concern in the United States, and prior research has shown how food insecurity in youth can correspond to negative psychosocial outcomes. Additionally, there are known disparities with access to food based on living in rural or urban counties. Objective: The goal of this study was to determine how differences in food security can impact youth educational outcomes in Ohio. Methods: Data from County Health Rankings & Roadmaps were obtained on variables such as access to healthy foods, food insecurity, high school graduation rates, average grade performance, and percentage of the population living in …

Infant Mortality In Ohio, Isabella Bacon, Alexis Jackson

Scholarship in Medicine - All Papers

Introduction: Infant mortality continues to occur at alarming rates that differ among various groups and states. Despite this, there has been a lack of intersectional examination of risk- and protective-factors. Methods: We examine how smoking status, education level, primary care to population ratio, teen birth rates, and urban vs rural status impact infant mortality rates in Ohio, Kentucky, Michigan, and Indiana using County Health Rankings data. Results: Ohio was shown to have no significant difference between urban and rural infant mortality rates; however,  risk-and-protective factors did differ. In urban counties, high school completion, teen birth rates, and primary care ratios …

Voice Your Choice, Sarah Olson, Mercy Bustamante-Vizarretea, Hannah Bauman, Sally Hall

SPARK Symposium Presentations

Our proposal seeks to develop and implement a standardized Charge Nurse Interest Survey which will create a structured process for identifying those most interested and best suited for the position of charge for all registered nurses on a local med-surg unit. Nurses on this unit are appointed and eligible to serve in the charge nurse role after six months of experience on the unit. Research shows that charge nurses who demonstrate emotional stability, composure under pressure, strong organizational skills, and proactive planning contribute to improved team functioning and decreased workplace strain (Gottlieb & Gøtzsche-Astrup, 2018).

To clarify the charge nurse …

Accuracy Of The Nestlé Mini Nutritional Assessment® (Mna®) Screen In Identifying Prealbumin–Defined Malnutrition Amongst Spine Surgery Patients, Stylianos Mysirlidis, Luke Fischbach, Matthew Giammanco, Alex Zhang, Phillip Alexeev, Ryan Snowden

SPARK Symposium Presentations

Abstract:

Background:

Malnutrition is a significant risk factor for patients undergoing surgery, including those receiving spine surgery. These patients are at greater risk of adverse postoperative outcomes, impaired wound healing, and spinal fusion failure. Therefore, it is essential to identify at-risk, malnourished patients prior to intervention to mitigate any complications such as surgical site infections, unplanned readmissions, and reoperations. The primary focus of this study was to assess the accuracy of the Nestlé Mini Nutritional Assessment® (MNA®) on identifying true malnutrition amongst those patients undergoing spine surgery.

Methods:

We conducted a retrospective cohort study of 674 consecutive …

The Relationship Between Phone Usage, Activity Participation, And Hand Strength, Debra Gibbs, Will Best, Raegan Adams, Amanda Finke, Rachel Pierce, Salem Swallows, Alisha Yoo

SPARK Symposium Presentations

Smartphone use among university students in the United States is steadily increasing. Longer duration of smartphone use has been associated with increased risk of smartphone addiction, reduced musculoskeletal strength, and engagement in meaningful activities. While prior research has examined these variables separately, limited evidence exists on the associations between smartphone use, hand grip and pinch strength, and extracurricular and leisure activities among U.S. university students. To address this gap, a correlational study was conducted using the Spearman rank correlation to analyze the relationship between phone use, activity participation, and hand strength. A Qualtrics survey including demographic information, phone usage, and …

Slow Your Pace; Do I-Trace!, Meghan Delaney, Mckenna Geary, Kacie Knary, Chloe Minnich

SPARK Symposium Presentations

SPARK Final Summary

Slow your pace; do I-TRACE! The purpose of this project is the addition of the I-TRACE method to strengthen the current strategies and practices with a long-term goal of reducing central line associated bloodstream infections (CLABSI) events. CLABSI remains an ICU concern, with an estimated 15,000 cases annually in the U.S. (NHSN, 2026). In 2025, a local ICU reported seven CLABSI events, an unusually high number for one hospital (LeapFrog, 2016). To combat CLABSIs, we will implement the I-TRACE method during every hand-off. The oncoming nurse will assess all central lines and dressings, and both nurses will …

The Impact Of An Aquatic Exercise Program On Self-Reported Balance And Confidence On Perceived Fall Risk: A Pilot Study, Antoney Labuschagne, Wesley Hopper, Bailey Watson, Alexis Ignatin, Ashtyn South, Whitney Dupree, Natalie Michaels

SPARK Symposium Presentations

Background: Each year, thousands of people experience one or more episodes of falling, that lead to a lasting impact in function and participation in daily life. Education regarding fall prevention is often focused mainly on the older adult population, but falls can happen at any age. Fear of falling and pain-related fear exists among adults at any age. The focus of this research study was to determine if participation in an aquatic exercise program that focused on balance, core body strength, and cardiopulmonary endurance could be utilized to alleviate the fear of falling and improve performance. Methods: Eight participants completed …

Investigating The Role Of Humic Acid In The Adsorption Mechanics Of Acetaminophen On Potassium Persulfate-Aged Polyethylene Terephthalate (Pet), Andrew Littleton, Maria Danielle Garrett, Phd

SPARK Symposium Presentations

Pharmaceutical contaminants such as acetaminophen (APAP) are showing a rising presence in aquatic environments, where their interactions with microplastics (MPs) can potentially modulate natural degradation mechanisms. Concurrent presence of the two substances has been shown to potentiate increase their individual harmful effects. This study investigates whether oxidative aging and humic-acid surface modification of PET microplastics influence APAP adsorption.

In this study, UV-aging was reproduced using an iron (II)-activated potassium persulfate (Fe(II)-KPS) oxidation system. Aqueous dissolved organic matter (DOM) is simulated using multi-hour exposure to humic acid. The MPs are then removed from the solution to examine adsorption mechanisms. While most …

Don't Let Them Fall, Let Ai Call, Ella Mills, Sara Barker, Andreea Ifrim, Yvette Uwase

SPARK Symposium Presentations

This project proposes a nurse-led pilot of AI-supported predictive mobility monitoring on a cardiac medical-surgical unit, to improve early identification of high-risk mobility behaviors and enhance patient safety. Current fall-prevention strategies, such as bed alarms and virtual sitters, often alert staff after unsafe movement has begun, creating a reactive cycle that contributes to alarm fatigue and delayed intervention (Abbe & O’Keeffe, 2020). This initiative uses monitors with contactless infrared sensors to identify movement before patients exit the bed, an alert system that goes straight to the nurse and PCT phones, and a central console for floor management and care coordination. …

Assessment Of Doxorubicin And Etoposide Effects On Cardiotoxicity Using Daphnia Magna As A Model Organism​, Jacob P. Bealle, Andrea Florian

SPARK Symposium Presentations

Chemotherapeutic agents such as doxorubicin and etoposide are widely used in cancer treatment but are known to produce cardiotoxic side effects that can limit their clinical use. Doxorubicin has been strongly associated with dose-dependent cardiac damage, and etoposide has also been reported to produce cardiotoxic effects although the cardiotoxic effects of etoposide are not as well studied. Daphnia magna is a useful model organism for cardiotoxicity studies because its transparent body allows direct observation of heart rate and provides a living system for detecting physiological responses to exposure. The purpose of this study was to investigate the cardiotoxic effects of …

Potential Environmental Triggers Of Goodpasture's Disease And The Role Of The Sulfimine Crosslink, Colton S. Miller, Andrea Florian, Elena Pokidysheva

SPARK Symposium Presentations

Goodpasture’s syndrome (GP) is an autoimmune disorder that primarily affects kidneys and lungs. The main issue for patients with Goodpasture's syndrome is the binding of autoantibodies to the glomerular basement membrane (GBM), which hinders the filtration of blood. A key characteristic of Goodpasture's syndrome is the presence of autoantibodies that target the NC1 domain of the α345 isoform of type IV collagen, a crucial component of the GBM that provides structural support and is critical for filtration function. Sulfilimine bonds crosslink the collagen IV NC1 hexamers, contributing to the stabilization of these structures. A recent clinical case of recurring Goodpasture's …

Retrospective Analysis Of High Flow Nasal Cannula Use In The Emergency Department: Association With Intensive Care Unit Admissions And Emergency Department Throughput, Raj Patel, Jesus Tamayo, James Duong, Nathaniel Banet, Hengameh Pajer, Anita Datta, Jake Valentine

Gulf Coast Division GME Research Day 2026

No abstract provided.

Drug-Induced Ild Requiring Ecmo, Arjun Kamath, Jose Garza, Matthew Wagner, Deekshita Valiveti, Percy Thomas, Christopher Ganson, Abhay Vakil, Zuhair Ali

Gulf Coast Division GME Research Day 2026

No abstract provided.

Acute Aortic Dissection Three Days After Starting Ciprofloxacin: A Case Of Fluoroquinolone-Associated Vascular Catastrophe, Victoria Jackson, Bryan Kharbanda, Derrick Huang

Gulf Coast Division GME Research Day 2026

No abstract provided.

Contemporary Nonfemoral Access For Tavr: Comparative Outcomes Of Transcarotid, Transsubclavian/Transaxillary, And Transcaval Approaches, Yves Najm Mrad, Snehalkumar Patel

Gulf Coast Division GME Research Day 2026

No abstract provided.

Medical Toxicology: A Safety Net For Snakebite Victims, Braden Capt, George Warpinski, Sharan Campleman, Anne-Michelle Ruha, Spencer Greene

Gulf Coast Division GME Research Day 2026

No abstract provided.