Anatomy Commons^™

Title: Professional Socialization And Development Of Athletic Training Professional Program Directors, N A. Wilkins, K D. Pagnotta, L Kunkel, S David, A B. Thrasher

Clinical Practice in Athletic Training

Introduction: The role of Program Directors (PD) has vastly expanded over the last decade to meet the evolving demands of athletic training education and higher education. While specific responsibilities such as programmatic planning and accreditation maintenance are directly outlined in accreditation standards, PDs often assume additional institutional and programmatic responsibilities that now include recruitment and retention efforts, mentorship of faculty and students, curriculum design and mapping, and other administrative tasks. Previous research demonstrates athletic training faculty have little formalized training in administrative roles, and Coordinators of Clinical Education (CCEs) desired more support and development for that role. Little research exists …

Preceptor Development: Identifying The Best Modality For Building Clinical Educators, G W. Cohen, R M. Lopez, A J. Tritsch

Clinical Practice in Athletic Training

Introduction: Preceptor training and development are not standardized within the athletic training profession. The Commission on Accreditation of Athletic Training Education (CAATE) requires that Athletic Training Programs provide an ongoing education plan for preceptors to promote a constructive learning environment for students. However, with the rapid expansion of clinical education opportunities outside of institutions' immediate area, programs must identify how to reach all their preceptors and uphold their programmatic expectations for clinical educators. Methods: The investigators conducted a cohort pre-test-post-test design study. A preceptor development program (PDP) was created and grounded in the theory of gamified learning and adult learning …

Adolescent Femoral Neck Fractures: A Case Study On Initial Surgical Intervention, Avascular Necrosis Development, And Subsequent Total Hip Arthroplasty, K A. Fisher

Clinical Practice in Athletic Training

Background: The patient sustained a femoral neck fracture at the age of 13 after slipping and falling in his home. He was seen in the Emergency Department the same day and underwent a closed reduction and percutaneous pinning procedure the following morning. Ten weeks after returning to full weightbearing, and 13.5 weeks after his initial fracture, he developed stress fractures of the medial distal femoral and proximal tibial metaphyses. He experienced gradual worsening of hip pain and difficulty with ambulation between 11 to 13 months post-closed reduction and percutaneous pinning (CRPP). Avascular necrosis and collapse of the femoral head was …

Clinat: In Service To Athletic Training Scholarship, Lindsey Eberman, Matthew J. Rivera

Clinical Practice in Athletic Training

To be of service to others means to help others without expecting anything in return. The ClinAT, or Clinical Practice in Athletic Training journal, is an online, open-access outlet for the dissemination of practice-based research in health care, and a donation of time, effort, and energy to the profession of athletic training. In 2018, when Indiana State University created its first issue of ClinAT, we were a faculty of 3 with 5 PhD students supporting the journal, one of whom was wholly dedicated to the effort. As the higher education landscape has changed, and the roles and responsibilities of our …

Prevalence, Perceptions, And Attitudes Of Accommodation For Students With Disabilities In Athletic Training Education Programs, T J. Babcock, L E. Eberman

Clinical Practice in Athletic Training

Introduction: Disability accommodation has been widely researched in healthcare education programs, including medical doctor (MD), doctor of osteopathy (DO), and physical therapy (PT). However, little research has been conducted on classroom and clinical education accommodation in athletic training education. The purpose of this study was to explore these settings and gain an understanding of student experiences with accommodation in athletic training education programs. This project was deemed exempt by Indiana State University’s Institutional Review Board. Methods: A cross-sectional 24-question survey was developed and adapted from prior qualitative research on accommodation in physical therapy education. Emails containing a link to the …

Enhancing Clinic Efficiency: A Quality Improvement Initiative For Postoperative Patient Care In An Outpatient Orthopedic Physician Practice Setting, D Stepan, T Jp Greffly, R M. Williams

Clinical Practice in Athletic Training

Introduction: Following orthopedic surgery, patient post-operative (post-op) visits are deemed global surgical observations where day 00 to day 90 are appointments that cannot be billed. Patients are typically seen 3 times during this global period. Thus, the outpatient clinic needs to have non-billable time slots each day for these patients. The current scheduling model double books patients every 15 minutes, with the physician being the primary provider seeing patients for post-op visits. Therefore, the clinic has demonstrated inefficiencies with scheduling these patients while having sufficient appointments available for billable patients. This quality improvement initiative aimed to decrease post-op patient visits …

Characteristics Of Athletic Trainers That Are Satisfied And Dissatisfied With Their Compensation, K Ef Mair, J P. Young, L E. Eberman

Clinical Practice in Athletic Training

Introduction: Job satisfaction among athletic trainers (ATs), particularly in relation to compensation, is a critical factor influencing retention and career fulfillment. Examining the factors linked to earnings satisfaction may offer insight into how workplace conditions can be improved to better support ATs. The purpose of our study was to investigate the attributes that distinguish ATs content with their compensation from those who are dissatisfied. Methods: We used a cross-sectional, web-based survey to gather AT compensation data, of which 1,887 participants responded to a question regarding their satisfaction with compensation. Respondents were divided into two groups based on their satisfaction with …

The Financial Stresses That Affect Athletic Training Students: A Qualitative Investigation, C Kuehner-Boyer, E León Zaragoza

Clinical Practice in Athletic Training

Introduction: A recent survey examining barriers that affect athletic training students found that financial-related barriers created significant stress for students in professional athletic training programs. The need to work while attending a professional athletic training program was the highest reported barrier with 54.82% of respondents indicating that this was a barrier for them during their program. Beyond the overall reporting rate, the need to work while completing a professional athletic training program was indicated by athletic training students to be the barrier that they encountered the most frequently with respondents reporting that this was a stress for them between monthly …

Musculoskeletal Tumors Disguised As Orthopedic Injuries: A Case Report, A Summers

Clinical Practice in Athletic Training

Background: Musculoskeletal tumors are relatively rare, accounting for only 0.2 to 0.5% of all malignancies across all age groups. More specifically, Pigmented Villonodular Synovitis, a type of musculoskeletal tumor, has an incidence rate of 1.8 cases per one million people in a population. This benign, proliferative disease is a type of tenosynovial giant cell tumor that can affect the soft tissue lining of joints, bursae, and tendon sheaths. These joint-related tumors often present with an insidious onset and non-specific physical exam findings. Therefore, they are often mistaken for other, more common orthopedic injuries, making them difficult to diagnose. Patient Information: …

Strength Assessment Protocol In Pre-Professional Ballet Dancers, Simona Di Nardo, Ivan Mascio

Clinical Practice in Athletic Training

Purpose: This research project aimed to investigate the effects, particularly regarding the ability to generate force, that could emerge following a ballet class. The purpose of the study was to support the thesis that low levels of fitness and performance in professional and amateur dancers, should be considered a significant gap that needs to be addressed. Larger will be the gap and bigger will be the demand of a dancer to be prepared athletically. While the shorter the gap and more efficient the artistic side of the dance performance will be. As a result, a stronger and healthier body will …

Aortoduodenal Syndrome: A Rare Case Of Duodenal Obstruction Due To Endovascular Aneurysm Endoleak., Raksha Adhikari, Parth Patel, Christopher Tait

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Aortoduodenal syndrome results from expansion of an abdominal aortic aneurysm, leading to symptoms of upper gastrointestinal obstruction. Endovascular aneurysm repair of large or symptomatic aortic aneurysms has become an important treatment modality for patients with abdominal aortic aneurysm. However, a large proportion of these grafts are complicated by endoleaks that can lead to a spectrum of significant symptoms. We present a case of rapidly worsening gastrointestinal obstructive symptoms in a patient with an already repaired aortic stent graft and a solitary kidney, found to be due to a type III endoleak that improved after emergent repeat endovascular aneurysm repair.

Atypical Presentation Of Non-Small Cell Lung Carcinoma With Metastasis To Breast Tissue, Tylar P. Seckman, Diane Krutzler-Berry, Mohamed Ashal, Waqas Mahmud, Krista L. Denning, Logan M. Lawrence

Marshall Journal of Medicine

Malignant neoplasms of the lung commonly metastasize to lymph nodes, bone, brain, and liver via hematogenous and lymphatic routes. Much less commonly, metastasis occurs in the breast. Secondary metastatic disease of the breast is very rare, with a reported incidence ranging from 0.4-1.3%­­—with primary lung cancer being one of the most anomalous sources. This case details non-small cell lung cancer metastasis to the breast with proven primary contralateral lung origination. This atypical finding prompts medical professionals to consider these malignant cells' immunologic, histologic, and pathologic makeup to understand further and treat the neoplasm.

Exploring Microrna Pathways And Metformin's Anti-Inflammatory Potential In Osteoarthritis, Quang D La, Benjamin Tangkamolsuk, David F Lo

Rowan-Virtua School of Osteopathic Medicine Departmental Research

No abstract provided.

Body Composition In Patients With Obesity-Related Heart Failure With Preserved Ejection Fraction: A Comparison Study, Hannah Salmons, Syed Imran Ahmed, Hayley E. Billingsley, Alex Reavey-Cantwell, Roshanak Markley, Michele Golino, Marco Giuseppe Del Buono, Juan Ignacio Damonte, Sebastian Pinel, R. Lee Franco, Antonio Abbate, Carrie P. Earthman, Salvatore Carbone

EVMS School of Health Professions Faculty Publications

Background

Appendicular lean mass index is a major determinant of cardiorespiratory fitness in patients with obesity-related heart failure with preserved ejection fraction (HFpEF). Moreover, appendicular lean mass index can be used to diagnose sarcopenia and sarcopenic obesity in this population. We aimed to validate the ability of segmental single-frequency bioelectrical impedance analysis (SF-BIA) to assess body composition compared with dual-energy x-ray absorptiometry (DXA) in patients with HFpEF and obesity, with a focus on appendicular lean mass index for its critical role in diagnosing sarcopenia and sarcopenic obesity.

Methods

We analyzed 62 euvolemic patients from a heart failure outpatient clinic with …

Percutaneous Levoatrial Cardinal Vein Closure For Stroke Prevention, Chee Spencer, Amir Hasani, Alexander Ellis, David Adler

Department of Medicine Faculty Publications

We report 2 cases of cerebral embolism related to congenital levoatrial cardinal vein anomalies. Both patients had positive echocardiographic agitated saline studies but intact interatrial septum on transesophageal echocardiography. Levoatrial cardinal vein was diagnosed using computed tomography angiography. A novel technique for percutaneous levoatrial cardinal vein closure using vascular plug devices was successful in both patients.

Wrongful Migration: A Hidden Culprit Behind Flank Pain, Ryan Miller, Anjeza Cipi, Emma Pierce

Department of Emergency Medicine Faculty Publications

[Introduction] A 32-year-old woman with no significant past medical history presented to the emergency department with 11 days of fever, fatigue, chills, and new-onset fullness in her left flank. She denied dysuria, abdominal pain, or vaginal bleeding. Vital signs showed fever and mild hypotension, and the physical examination revealed left-sided abdominal distension. Laboratory results demonstrated leukocytosis and a lactate of 3.2 mmol/L. She appeared nontoxic but was persistently febrile despite initial fluids and antibiotics. Computed tomography—shown in Figure 1, and ultrasound—shown in Figure 2, were obtained and revealed the diagnosis.

Diffuse Unilateral Leg Swelling, Bruce M. Lo, Kylie Butler, Navjot Kaur, Kirsten Pennell

Department of Emergency Medicine Faculty Publications

[Patient Presentation] A 46-year-old woman with a history of hypertension presented with 14 days of right leg pain. The pain began after straining her leg while lifting heavy boxes at work, with diffuse leg swelling noted 3 days later. She reported subjective fever but no other complaints. Patient denies any illicit drug use. Initial vital signs included a temperature of 100.1 °F, heart rate of 122 beats per minute, and blood pressure of 158/91 mm Hg. Physical examination revealed a diffusely swollen and tender right leg (Fig 1). Computed tomography (CT) of the right leg identified a 19 X 7 …

Ambulatory Arterial Stiffness Index: Regression Method Comparison And Its Association With Pulse Pressure And Circadian Patterns, José R. Ayala-Hernández, Cristina López-Sánchez, Orlando M. Ayala, Camilo E. Palencia-Tejedor

Engineering Technology Faculty Publications

The Arterial Stiffness Index (AASI) is a calculation obtained through Ambulatory Blood Pressure Monitoring (ABPM), and is an indirect measure of the elastic properties of the arterial wall; but there is heterogeneity in its scope as a predictor of vascular wall health. A comparison is made between linear regression and exponential regression of the AASI, as well as an analysis of variance, according to circadian patterns and pulse pressure (PP) values. This work is an analytical observational study in 106 individuals, most of them women (63%) with a mean age of 53 ± 17.32 years. The coefficient of determination (r2) …

Motion Artifacts Removal From Measured Arterial Pulse Signals At Rest: A Generalized Sdof-Model-Based Time-Frequency Method, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

Motion artifacts (MA) are a key factor affecting the accuracy of a measured arterial pulse signal at rest. This paper presents a generalized time–frequency method for MA removal that is built upon a single-degree-of-freedom (SDOF) model of MA, where MA is manifested as time-varying system parameters (TVSPs) of the SDOF system for the tissue–contact-sensor (TCS) stack between an artery and a sensor. This model distinguishes the effects of MA and respiration on the instant parameters of harmonics in a measured pulse signal. Accordingly, a generalized SDOF-model-based time–frequency (SDOF-TF) method is developed to obtain the instant parameters of each harmonic in …

An Analytical Model Of Motion Artifacts In A Measured Arterial Pulse Signal—Part I: Accelerometers And Ppg Sensors, Md Mahfuzur Rahman, Subodh Toraskar, Mamun Hasan, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

This paper, the first of two parts, presents an analytical model of motion artifacts (MAs) in measured pulse signals by accelerometers and photoplethysmography (PPG) sensors. As the transmission path from the true pulse signal in an artery to the sensor output (measured pulse signal), the tissue-contact-sensor (TCS) stack is modeled as a 1DOF (degree-of-freedom) system. MAs cause baseline drift of the mass and simultaneously time-varying system parameters (TVSPs) of the TCS stack. With arterial wall displacement and pulsatile pressure serving separately as the true pulse signal, an analytical model is developed to mathematically relate baseline drift and TVSP to a …

An Analytical Model Of Motion Artifacts In A Measured Arterial Pulse Signal—Part Ii: Tactile Sensors, Md Mahfuzur Rahman, Subodh Toraskar, Mamun Hasan, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

This paper, the second of two parts, presents an analytical model of motion artifacts (MA) in measured pulse signals by a tactile sensor, which contains a deformable microstructure sitting on a substrate. While the tissue-contact-sensor (TCS) stack and the sensor are both treated as a 1DOF (degree-of-freedom) system, tissue–sensor contact joins their mass together to form a 1DOF system with springs and dampers on both sides. MA on the sensor substrate causes baseline drift and time-varying system parameters (TVSP) of the TCS stack simultaneously. An analytical model is developed to mathematically relate baseline drift and TVSP to a measured pulse …

Motion Artifacts (Ma) At-Rest In Measured Arterial Pulse Signals: Time-Varying Amplitude In Each Harmonic And Non-Flat Harmonic-Ma Coupled Baseline, Md Mahfuzur Rahman, Mamun Hasan, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

Motion artifacts (MA) cause great variability in a measured arterial pulse signal, and treatment of MA solely as a baseline drift (BD) fails to eliminate its effect on the measured signal. This paper presents a study on the effect of MA at rest (< 0.7 Hz) on measured arterial pulse signals using a microfluidic-based tactile sensor. By taking full account of the dynamic behavior of the transmission path from the true pulse signal in an artery to a measured pulse signal at the sensor, the tissue-contact-sensor (TCS) stack, an analytical model of MA in a measured pulse signal is developed. In this model, the TCS stack is treated as a 1DOF system for its dynamic behavior; MA is quantified as the displacement (i.e., BD) and time-varying system parameters (TVSP) of the TCS stack. The mathematical expression of MA in a measured pulse signal reveals that while BD remains as low-frequency additive noise, TVSP causes time-varying harmonics in a measured pulse signal. Further time-frequency analysis (TFA) of measured pulse signals validates the existence of TVSP and, for the first time, reveals its effect on a measured pulse signal: time-varying amplitude in each harmonic and non-flat harmonic-MA-coupled baseline.

Surgical Management Of Gastroenteropancreatic Neuroendocrine Tumors, Lisa M. Kenney, Marybeth Hughes

Department Surgery Faculty Publications

Background/Objectives: Neuroendocrine tumors (NETs) are heterogeneous malignancies arising from enterochromaffin cells that can arise from the gastrointestinal (GI) tract and pancreas. Surgical management is the cornerstone of treatment, with the optimal approach tailored by tumor grade, size, location, and presence of metastasis. This review discusses the current strategies for the surgical management of NETs of the gastroenteropancreatic tract. Methods: A review of the available literature was conducted to evaluate surgical approaches to NETs. Consensus guidelines were incorporated to synthesize evidence-based recommendations. Results: For gastric NETs, surgical approach depends on Rindi Classification, WHO grade, and tumor size, with endoscopic approaches favored …

Advanced Nanocomposite-Based Electrochemical Sensor For Ultra-Sensitive Dopamine Detection In Physiological Fluids, Megha Shinde, Gymama Slaughter

Center for Bioelectronics Publications

This study presents a novel point-of-care electrochemical sensor for dopamine (DA) detection, featuring a flexible laser-induced graphene (LIG) modified with a unique nanocomposite comprising Nb₄C₃T_x MXene, polypyrrole (PPy), and iron nanoparticles (FeNPs). The LIG-Nb₄C₃T_x MXene-PPy-FeNPs is characterized by scanning electron microscopy to confirm the successful surface modification. The electrochemical performance of the fabricated sensor via cyclic voltammetry showed significant electrochemical activity upon Nb₄C₃T_x MXene-PPy-FeNPs nanocomposite modification of the LIG surface with an increased peak anodic current (Ipa) from 43 μA to 104 μA. The sensor …

Cochlear Electrode Insertion Training Model, Sarah Powell, Kaelyn E. Kraley, Nathan J. Smith

Williams Honors College, Honors Research Projects

Cochlear implant surgery is a delicate procedure performed by Otolaryngologists (ENTs) to implant an electronic device into the inner ear to provide a sense of sound for people who are profoundly deaf or hard of hearing. The current practices of training involve cadavers and 3D-printed models. Cadavers are commonly used but are expensive, single-use, and do not provide visual and haptic feedback, which are essential for medical students. 3D printed models are less commonly used and are hard to fabricate and not as realistic. If medical students are not properly trained for this delicate procedure, then risks are significantly increased …

Anaplastic Large Cell Lymphoma In Children And Adolescents, Eric J. Lowe, Wilhelm Woessmann

Department of Pediatrics Faculty Publications

Anaplastic lymphoma kinase (ALK)-positive anaplastic large-cell lymphoma (ALCL) accounts for >95% of ALCL cases in children and adolescents. The first description of ALCL as a CD30-positive lymphoma in 1985 was followed by the detection of chromosomal translocations involving the ALK gene at chromosome 2p23. The pathogenesis of ALK-positive ALCL is based on signalling from the constitutive active ALK kinase. The clinical characteristics, therapy regimens and outcome data were reported in the 1990s and 2000s. Different chemotherapy regimens led to astonishingly similar long-term event-free survival rates of 70%, independent of the drugs, doses and duration of therapy. Additionally, patients with relapsed …

Left Ventricular Assist Device Destination Therapy: A Journey To Home And Beyond, Mian Z. Munir, Marissa C. Galicia-Castillo, Mia Achitoov, Amin Yehya

Department of Medicine Faculty Publications

[Case] Mr H is a 74-year-old man with history of end-stage heart failure (ESHF) secondary to hereditary transthyretin cardiac amyloidosis. Our patient underwent placement of a HeartMate II (Abbott) left ventricular assist device (LVAD) as destination therapy (DT) at an outside hospital and later came to us (Sentara Heart Hospital) for continued management because he resided in the area. Over a 2-year period, the patient experienced multiple hospital admissions for acute heart failure (HF) exacerbations, delirium, and recurrent low-flow alarms. During his last hospitalization, the palliative medicine team was consulted to facilitate goals-of-care discussions with the patient and his family, …

The Pre-Polarization And Concentration Of Cells Near Micro-Electrodes Using Ac Electric Fields Enhances The Electrical Cell Lysis In A Sessile Drop, Kishor Kaphle, Dharmakeerthi Nawarathna

Electrical & Computer Engineering Faculty Publications

Cell lysis is the starting step of many biomedical assays. Electric field-based cell lysis is widely used in many applications, including point-of-care (POC) applications, because it provides an easy one-step solution. Many electric field-based lysis methods utilize micro-electrodes to apply short electric pulses across cells. Unfortunately, these cell lysis devices produce relatively low cell lysis efficiency as electric fields do not reach a significant portion of cells in the sample. Additionally, the utility of syringe pumps for flow cells in and out of the microfluidics channel causes cell loss and low throughput cell lysis. To address these critical issues, we …

Magnetization Transfer Ratio In The Typically Developing Pediatric Spinal Cord: Normative Data And Age Correlation, Sara Naghizadeh Kashani, Iswarya Vel, Zahra Sadeghi Adl, Shiva Shahrampour, Devon Middleton, Mahdi Alizadeh, Laura Krisa, Scott Faro, Slimane Tounekti, Julien Cohen-Adad, Feroze Mohamed

Department of Radiology Faculty Papers

BACKGROUND AND PURPOSE: This study presents automated atlas-based magnetization transfer (MT) measurements of the typically developing pediatric cervical spinal cord (SC). We report normative MT ratio (MTR) values from the whole cervical cord white matter (WM) and WM tracts, examining variations with age, sex, height, and weight.

METHODS: MT scans of 33 healthy females (mean age = 12.8) and 22 males (mean age = 13.09) were acquired from the cervical SC (C2-C7) using a 3.0 T MRI. Data were processed using the SC Toolbox, segmented, and registered to the PAM50 template. Affine and non-rigid transformations co-registered the PAM50 WM atlas …

Long-Term Safety And Effectiveness Of The Treo Stent Graft For The Endovascular Treatment Of Infrarenal Abdominal Aortic Aneurysms, Matthew J. Eagleton, Michael C. Stoner, John Henretta, Maciej Dryjski, Jean M. Panneton, Apostolos Tassiopoulos, Manish Mehta, Benjamin Pearce, Mel J. Sharafuddin, Treo Investigators

Department Surgery Faculty Publications

Objective

Report on the long-term safety and effectiveness of the TREO stent graft in endovascular repair of AAA from a US investigational device clinical study.

Methods

Data from a multicenter, nonrandomized, prospective, US investigational device exemption pivotal study (NCT02009644) were used. From November 2013 to February 2016, 150 patients were enrolled at 29 US centers. Safety endpoints were defined as major adverse events (i.e., all-cause mortality, myocardial infarction, stroke, renal failure requiring renal replacement therapy, respiratory failure, paraplegia, bowel ischemia, and procedural blood loss of 1,000cc or greater). Effectiveness endpoints were defined as no aneurysm rupture, absence of sac increase …