Anatomy Commons^™

Automated Segmentation Of The Ulnar Nerve In Mri Using Deep Learning Techniques, Akhil Nagulapalli

Theses

Cubital Tunnel Syndrome (CuTS), a condition caused by compression of the ulnar nerve, results in numbness, tingling, pain, and even muscle atrophy, affecting fine motor skills and diminishing patient quality of life. Accurate diagnosis of CuTS is challenging, as current diagnostic methods—including clinical exams, nerve conduction studies, and unaided MRI—often lack the precision to reliably identify the nerve and detect compression in its early stages. Deep learning-based segmentation offers a promising solution, enabling precise and automated identification of nerve structures in MRI images, which could significantly improve diagnostic accuracy and support timely intervention.

A novel deep learning model for segmenting …

Comparing Functional Outcomes Between 3d Printed Acetabular Cups And Traditional Prosthetic Implants In Hip Arthroplasty: A Systematic Review And Meta Analysis, Ryan St. John, Seth Spicer, Mo Hadaya, Hanna Brancaccio, Seungkyu Park, Sean Mcmillan

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVE: The primary research aim was to determine if the use of traditional or 3D printed prosthesis resulted in better functional outcome scores in hip arthroplasty.

METHODS: A systematic review and meta-analysis was conducted utilizing the PRISMA 2020 guidelines. Six databases (PubMed, Embase, Scopus, WebOfScience, and Cochrane Library, Google Scholar) were searched yielding 1117 article titles and abstracts. Rayyan.ai was used to detect duplicates (n = 246) and for manual screening for inclusion and exclusion criteria. Included were controlled studies of any publication time that assessed Harris Hip Score (HHS) at baseline and twelve months. Six papers were sought for …

The Percentage Of Sacroiliac Fusions Done In The U.S. By Non-Surgical Specialties Has Increased, Mathew Cyriac, Bela P. Delvadia, Julianna E. Winter, Jacob S. Budin, Olivia C. Lee, William F. Sherman

School of Medicine Faculty Publications

BACKGROUND: Surgical fusion of the sacroiliac (SI) joint is often performed to manage chronic lower back or buttock pain. When Current Procedural Terminology (CPT) codes were introduced, SI joint fusion procedures were done primarily by orthopaedic surgeons and neurosurgeons. The purpose of this study was to examine the utilization of SI joint fusion CPT codes by physician specialty over time. METHODS: A retrospective cohort study was conducted using the PearlDiver database. The database was queried using CPT codes to identify patients who underwent SI joint fusion via percutaneous, open, or trauma codes. Specialties queried included surgical specialties (orthopaedic surgery and …

Womb, Gravity, And Space: Shifting Towards The Cerebellum-Basal Ganglia Paradigm In Dystonia, Diego Iacono

Department of Neurology Faculty Papers

No abstract provided.

Pancreaticoduodenectomy In Trauma Patients With Grade Iv-V Duodenal Or Pancreatic Injuries: A Post Hoc Analysis Of An East Multicenter Trial, Rachel Leah Choron, Charoo Piplani, Julia Kuzinar, Amanda L. Teichman, Christopher Bargoud, Jason D. Sciarretta, Randi N. Smith, Dustin Hanos, Iman N. Afif, Jessica H. Beard, Navpreet Kaur Dhillon, Ashling Zhang, Mira Ghneim, Rebekah Devasahayam, Oliver Gunter, Alison A. Smith, Brandi Sun, Chloe S. Cao, Jessica K. Reynolds, Lauren A. Hilt, Daniel N. Holena, Grace Chang, Meghan Jonikas, Karla Echeverria-Rosario, Nathaniel S. Fung, Aaron Anderson, Caitlin A. Fitzgerald, Ryan Peter Dumas, Jeremy H. Levin, Et Al

School of Medicine Faculty Publications

INTRODUCTION: The utility of pancreaticoduodenectomy (PD) for high-grade traumatic injuries remains unclear and data surrounding its use are limited. We hypothesized that PD does not result in improved outcomes when compared with non-PD surgical management of grade IV-V pancreaticoduodenal injuries. METHODS: This is a retrospective, multicenter analysis from 35 level 1 trauma centers from January 2010 to December 2020. Included patients were ≥ 15 years of age with the American Association for the Surgery of Trauma grade IV-V duodenal and/or pancreatic injuries. The study compared operative repair strategy: PD versus non-PD. RESULTS: The sample (n=95) was young (26 years), male …

A Case Of Isolated Sma Dissection With Failed Initial Conservative Management, Salma Emara, Madison Kropp, Masoud Akbari, Kristin Cook

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Isolated superior mesenteric dissection (ISMAD) is an uncommon condition, often diagnosed incidentally for presentations of acute abdominal pain. Early identification and treatment are crucial as complications such as bowel ischemia or vessel rupture can occur. There remain no established treatment guidelines, making surgical and endovascular indications controversial. A 60-year-old male presented with acute abdominal pain, and was diagnosed with ISMAD via computed tomography imaging. He was initially managed conservatively which progressed to worsening abdominal pain, hypertensive crisis, and hemoperitoneum on follow-up computed tomography angiography (CTA). A mesenteric angiogram revealed a pseudoaneurysm in the superior mesenteric artery (SMA) which was subsequently …

Maresin-Like 1 Ameliorates Neuropathology Of Alzheimer's Disease In Brains Of A Transgenic Mouse Model, Pallavi Shrivastava, Yan Lu, Shanchun Su, Yuichi Kobayashi, Yuhai Zhao, Nathan Lien, Abdul-Razak Masoud, Walter J. Lukiw, Song Hong

School of Medicine Faculty Publications

(1) Background: Impeded resolution of inflammation contributes substantially to the pathogenesis of Alzheimer's disease (AD); consequently, resolving inflammation is pivotal to the amelioration of AD pathology. This can potentially be achieved by the treatment with specialized pro-resolving lipid mediators (SPMs), which should resolve neuroinflammation in brains. (2) Methods: Here, we report the histological effects of long-term treatment with an SPM, maresin-like 1 (MarL1), on AD pathogenesis in a transgenic 5xFAD mouse model. (3) Results: MarL1 treatment reduced Aβ overload, curbed the loss of neurons in brains especially cholinergic neurons associated with cleaved-caspase-3-associated apoptotic degeneration, reduced microgliosis and the pro-inflammatory M1 …

Corneal Transplants And Their Impact, Bianca Estrada

Honors Capstones

A corneal transplant, also called keratoplasty or corneal grafting, is a type of surgery where damaged or diseased corneal tissue is replaced by a healthy donor cornea. The first successful corneal transplant was performed in 1905 by Dr. Eduard Zirm, but since then, surgical advancements have developed greatly, leading to more beneficial outcomes. Corneal blindness is a major form of reversible blindness that is manageable with healthy donor cornea transplantation. Other recipients or possible candidates for corneal transplantation include those with keratoconus, Fuchs’ dystrophy, eye infections, or eye injuries. This remarkable surgery is now one of the most common transplant …

5-Fluorouracil Induced Oxidative Stress Is Variable Across Triple Negative Breast Cancer Cell Lines, Rachel L. Walker

Departmental Honors & Graduate Capstone Projects

Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer with treatment limited to chemotherapy. However, not all patient tumors respond to chemotherapy. The variable cytotoxic effects of chemotherapies may be due to how cancer cells regulate reactive oxygen species (ROS). In this study, we examined two mouse breast cancer cell lines: 4T1 and EO771, vary when treated with hydrogen peroxide (H2O2) and 5-Fluorouracil (5FU), known ROS-inducing substances. In 4T1 cells H2O2 increased oxidized DNA but caused minimal cell death. While in EO771 cells that same amount of H2O2 caused complete apoptosis. Cell number, ROS, and cell death showed …

Understanding Anatomy & Physiology Students’ Knowledge And Perceptions Of Learning Sex And Pleasure, Yaileen Velazquez

Honors Capstones

Undergraduate anatomy & physiology (A&P) is an opportune place for future healthcare providers to learn a diversity of topics related to human health and function, including sexual health. However, the current undergraduate curriculum and instruction in A&P classes do not support students in achieving a high level of understanding of sexual health, including sexual anatomy and physiology. Previous studies have shown that college students obtain a mean score of lower than 65% in sexual knowledge tests, with the lowest mean scores on sections concerning sexual anatomy and sexually transmitted diseases (STDs) (Weinstein et al., 2008). Sexual pleasure is an important …

Venous Thromboembolism Prophylaxis In Orthopedic Surgery: A Narrative Review, Jacob Lahti, Sarah Gallitto, Thomas C. Varkey

Annual Research Symposium

This poster highlights current and updated guidelines for chemical and mechanical prophylaxis for venous thromboembolism in patients undergoing major and minor orthopedic surgery. Existing and new potential therapies were reviewed, as well as an analysis into the lack of high-quality risk-prediction score calculators to improve personalization of prophylaxis regimens. Alongside a summary of existing and potential new prophylaxis protocols, a call to action to improve validity of said risk score calculators so as to improve patient outcomes and personalized medicine is made.

Port-Wine Stain Treatment With 577-Nm Laser: Treatment Outcomes Of Superficial Versus Deep Lesions, Yulia Siskawati

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Port-wine stains (PWS), or capillary malformations (CM), are congenital vascular anomalies characterized by gradual enlargement of the superficial cutaneous vascular plexus, leading to low-flow malformations in the skin. Laser therapy remains the preferred treatment for PWS. The 577-nm vascular laser system is particularly suited for treating cutaneous vascular disorders. This study evaluates the efficacy of the 577-nm vascular laser for both superficial and deep PWS lesions.

Case Illustration: Three adult patients, all aged over 17 years old, were treated with the 577-nm laser. In the first case with deeper PWS, four treatment sessions resulted in flattening of hypertrophic areas, …

Onycholysis In An Elderly Woman: Proposal For Treatment With Coix Seed Extract Administration, Yasuhiro Horiuchi

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: The exact etiology of onycholysis, which is characterized by the painless separation of the nail from the nail bed, remains unclear. Currently, there are no established effective treatments for this condition. Coix seed extract (C-S extract), a traditional Chinese medicine, is recognized for its various biological properties.

Case Illustration: This report describes a case of onycholysis affecting the left index finger of a 62-year-old female patient, with initial symptoms appearing three months prior. Despite ongoing internal administration of C-S extract, the patient experienced a recurrence of onycholysis on both the index finger and pinky finger of the left hand …

Systemic Antibiotic Selection In Skin And Soft Tissue Infections, Shafira Anindya Purnawan, Windy Keumala Budianti, Sandra Widaty

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Antibiotics are used in daily practice. To properly select antibiotics, it is important to pay attention to the definitive diagnosis, class of antibiotic, dose, interval, route of administration, and exact duration of use.

Discussion: The World Health Organization (WHO) categorizes antibiotics into three groups: Access, Watch, and Reserve—known as the AWaRe classification—to help guide appropriate usage and combat antibiotic resistance. The Gyssens flowchart serves as a valuable tool for clinicians to qualitatively evaluate antibiotic utilization. In skin and soft tissue infections (SSTIs), treatment strategies are tailored according to the characteristics of the infection, including purulence, necrosis, and overall severity. …

Verbal Working Memory And Syntactic Comprehension Segregate Into The Dorsal And Ventral Streams, Respectively, William Matchin, Zeinab K. Mollasaraei, Leonardo Bonilha, Christopher Rorden, Gregory Hickok, Dirk B. Den Ouden, Julius Fridriksson

Communication Sciences and Disorders Faculty Articles and Research

Syntactic processing and verbal working memory are both essential components to sentence comprehension. Nonetheless, the separability of these systems in the brain remains unclear. To address this issue, we performed causal-inference analyses based on lesion and connectome network mapping using MRI and behavioural testing in two groups of individuals with chronic post-stroke aphasia. We employed a rhyme judgement task with heavy working memory load without articulatory confounds, controlling for the overall ability to match auditory words to pictures and to perform a metalinguistic rhyme judgement, isolating the effect of working memory load (103 individuals). We assessed non-canonical sentence comprehension, isolating …

Non–Invasive Vulvovaginal Rejuvenation: A Review, Jesryn Dhillon, Nelva Karmila Jusuf

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Non–invasive vulvovaginal rejuvenation is a promising option for women who want to restore the appearance and function of the vagina. Vaginal atrophy and vulvovaginal laxity are caused by several circumstances, including ageing, menopause, delivery, and others. Until now, non–invasive vulvovaginal rejuvenation has not been medically indicated, but it is estimated to be the focus of cosmetic dermatology in the future.

Discussion: Non–invasive vulvovaginal rejuvenation can be divided into two methods: using energy-based devices and injectables. Carbon dioxide, Erbium:YAG laser and radiofrequency are the commonly used energy-based devices. Injectables most frequently used are hyaluronic acid and platelet–rich plasma. Some additional …

Immunization-Related Complex Regional Pain Syndrome: A Systematic Review Of Case Reports, William K Copenhaver, Brandon J Goodwin, Alexa Simonetti, Kunal P. Shah, Nicholas J Averell, David F Lo, Richard T Jermyn

Rowan-Virtua School of Osteopathic Medicine Departmental Research

AIM: Vaccines have been shown to have the highest efficacy in preventing infectious diseases through their ability to induce immunological memory against pathogens. An adverse reaction to a vaccine is an unexpected medical occurrence following immunization. Complex regional pain syndrome (CRPS) is a disease that has undergone much controversy regarding its onset post-vaccination. This systematic review aims to evaluate cases of CRPS post-vaccination to better understand the manifestation of the disease and its potential association with vaccines.

METHODS: A systematic review of case reports was conducted employing the PRISMA 2020 guidelines. Outcomes of interest include type of vaccination, patient age, …

Assessment Of Bite Force And Masseter And Temporal Muscles Thickness In Adult Women Undergoing Buccal Fat Pad Removal Surgery–Bichectomy, Thamyres Branco, Marcelo Palinkas, Alice Helena De Lima Santos Cardoso, Nicole Barbosa Bettiol, Paulo Batista De Vasconcelos, Gabriella Simi Gariba Silva, Jéssica Brandani Chiaratto, Patricia Santos De Lima, Samuel Porfírio Xavier, Isabela Hallak Regalo, Selma Siéssere, Simone Cecilio Hallak Regalo

Journal of Dentistry Indonesia

Objective: Bichectomy, a surgical procedure that removes the buccal fat pad, can affect masticatory function, including bite force and muscle thickness, in adult women. This study aimed to assess the bite force as well as masseter and temporal muscle thicknesses before and 30 and 60 days after bichectomy in adult women. Methods: This longitudinal study included a sample of 20 adult women (mean age 31.1 ± 9.84 years), with normal occlusion and no history of temporomandibular disorder. The molar bite force was assessed using a dynamometer, while the masseter and temporal muscle thicknesses at rest and during dental …

Drug-Induced Hypersensitivity Syndrome With Liver Injury Due To Phenytoin: A Case Report, Lorettha Wijaya, Stella Adevita, Steven Alvianto, Yoseveline Christiani, Alius Cahyadi, Raesa Yolanda

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Drug-induced hypersensitivity syndrome (DIHS) is a rare and severe systemic drug reaction characterized by skin involvement, internal organ complications, and hematologic disorders. Management of this condition is challenging due to its wide range of cutaneous manifestations and 10% mortality rate.

Case Illustration: A 52-year-old male presented with widespread redness throughout his body with a prior history of regular phenytoin consumption. The rash continued to spread despite the patient’s abrupt discontinuation of the suspected medication. He was diagnosed with atypical DIHS according to J-SCAR criteria and was given high-dose corticosteroid. Drastic clinical improvement was observed after nine days of therapy, …

The Spectrum Of Cutaneous Manifestations In Covid-19 Patients At Dr. Cipto Mangunkusumo Hospital, Sandra Widaty, Sri Linuwih Susetyo Wardhani Menaldi, Eliza Miranda, Melani Marissa, Hanny Nilasari, Thong Felicia Melinda, Emilina Faradila Cornain

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Cutaneous manifestations are identified in 0.2%–20% of COVID-19 cases, both in adult and pediatric patients. They can occur before, simultaneously with, or after the systemic symptoms of COVID-19. This study aims to analyze the association between cutaneous manifestations, severity, and outcomes of patients with COVID-19.

Methods: This observational study was conducted from April 2020 to April 2021 in Dr. Cipto Mangunkusumo Hospital, a referral center for COVID-19 in Jakarta, Indonesia. Medical records were used to collect demographic, clinical, and laboratory data.

Results: A total of 0.61% (31/5070) of COVID-19 cases showed cutaneous manifestations, consisting of maculopapular (80.6%), vesicular …

Telogen Effluvium Incidence In Women Wearing Hijab Compared To Non-Hijab: A Cross-Sectional Study, Sondang Pandjaitan Sirait, Sandra Widaty, Lili Legiawati, Lis Surachmiati Suseno, Roro Inge Ade Krisanti, Windy Keumala Budianti, Eliza Miranda, Rahadi Rihatmadja, Caroline Oktarina, Paulus Anung Anindita Pandelaki, Irhen Situmeang

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Hair loss is a normal experience, but if the amount of hair loss exceeds what is considered normal, it will usually cause anxiety for the patient. In Indonesia, almost every Muslim woman wears a hijab. The hijab is one of many factors believed to cause hair loss. Telogen effluvium (TE) itself is a hair cycle disorder in which the anagen phase terminates prematurely, resulting in diffuse club hair loss without scarring, and TE itself has many risk factors. The purpose of this study was to determine the relationship between the incidence of TE in women who wear hijabs …

A Prospective Study In The Treatment Of Androgenic Alopecia Using Combination Of Procapil, Capixyl, Redensyl, Garima Bansal, Rishi Bansal

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Androgenic alopecia is characterized by its diffuse loss and the miniaturization of the hair. The study aimed to assess the safety and efficacy of procapil, redensyl, capixyl, bicapil, and anagain in topical hair growth serum in androgenic alopecia.

Methods: A prospective study was conducted on 110 healthy subjects aged 18-60 with androgenic alopecia in the Department of Dermatology, Tundla, Etmadhpur. Each subject applied 1 ml of serum on a dry scalp and was followed up on the 4^th, 8^th, 12^th, and 16^th week. Mean, median, and standard deviation were calculated. A repeated measure …

Improving Hypertension Outcomes Through Biweekly Text Message Interventions, Patricia Thompson

Doctoral Projects

Improving medication adherence and blood pressure control is challenging in the management of hypertension. Hypertension is a risk factor for severe health complications such as kidney failure, premature death, stroke, and heart disease. Even though effective hypertensive medications are available, patients have a challenging time adhering to taking the medication as instructed.

There are several reasons patients do not adhere to taking their medication such as lack of understanding, forgetfulness, negative beliefs, inadequate communication, complex dosing regimen, cost, and access to healthcare. Ensuring patients take their blood pressure medication decreases the risk of uncontrolled hypertension complications. The plan to improve …

Insights Into Cerebrovascular Health: Comparative Study Of The Common Carotid And Middle Cerebral Artery, Emma Lou

2024 Fall Honors Capstone Projects - Archive

The carotid artery, responsible for blood flow to the brain, and the middle cerebral artery (MCA), which supplies the cerebrum, are both susceptible to atherosclerosis, a condition that impairs blood flow and can lead to cognitive decline and ischemic strokes. This study investigates whether blood flow and vasodilation responses in the MCA during a hypercapnic challenge are comparable to those in the common carotid artery, which supplies the entire brain. This project aims to address limitations in current assessment methods, such as transcranial and duplex Doppler ultrasonography, to ascertain whether these two arteries exhibit consistent vasodilation patterns under hypercapnic conditions. …

Microbiome Variation In Production Phenotypes And The Role Of Colonization History In Microbiome Establishment, Seidu Adams

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Ruminant-based agriculture is expected to continue to be a major contributor to food security to feed the growing population. At the heart of nutrient degradation of complex organic matter within the rumen are its microbes. These microbes can convert otherwise unusable organic matter into usable protein and energy and can provide up to 50% of the animal’s protein needs and up to 70% of the energy needs. The microbial functional capacity within the rumen determines the nutrients utilized and the end products of fermentation. However, our understanding of microbial functional capacity within the rumen and factors that influence the rumen …

Novel Mouse Models To Study The Role Of T Cells In Cardiac Autoimmunity, Meghna Sur

Dissertations and Doctoral Documents, University of Nebraska-Lincoln, 2023–

Myocarditis patients can chronically develop dilated cardiomyopathy and autoreactive T cells could contribute to the disease pathogenesis, but defining their antigen specificity remains a major challenge. To fill this gap, we generated T cell receptor (TCR) transgenic (Tg) mice specific to cardiac myosin heavy chain (Myhc)-α 334–352 and made a few observations. First, we unexpectedly noted both CD4 and CD8 T cells expressing TCRs specific to Myhc-α 334–352. Second, while Tg T cells from myocarditis-resistant C57BL/6J mice did not respond to Myhc-α 334–352, those from immunized mice responded, indicating that in vivo priming is necessary to break tolerance. Third, upon …

Impact Of An Interdisciplinary Team On Patients Seen At A Heart Failure Clinic, Nilda Pelegrino, Faaria Quadri, Elaina Rosario, Jacqualine Igwe, Sandra Chaparro, Lourdes Labrada, Sara Panella, Maria Pulido, Stephen Breazeale, Zhenwei Zhang

Nursing & Health Sciences Research Journal

Background: Heart failure is a complex clinical syndrome that requires the involvement of interdisciplinary teams to address patient needs and optimize therapy. Interdisciplinary teams, including physicians, advanced practice practitioners, and pharmacists, play a crucial role in implementing guideline-directed medical therapy and addressing barriers to self-care that ultimately improve patients’ overall survival. This study assessed the impact of an interdisciplinary team on patients’ heart failure outcomes compared to patients solely managed by clinical cardiologists. Methods: This was a single-center retrospective chart review study of Baptist Health patients seen at the heart failure clinic. The study compared patients seen by an interdisciplinary …

Cellular Signatures In Human Blood Track Bone Mineral Density In Postmenopausal Women, Kaichi Kaneko, Jefferson Tsai, Deniece Meñez, Brian Oh, Andrew Junwoo Suh, Seyeon Bae, Masataka Mizuno, Akio Umemoto, Eugenia G. Giannopoulou, Takayuki Fujii, Yaxia Zhang, Emily M. Stein, Richard S. Bockman, Kyung-Hyun Park-Min

Publications and Research

Osteoclasts are the sole bone-resorbing cells and are formed by the fusion of osteoclast precursor cells (OCPs) derived from myeloid lineage cells. Animal studies reveal that circulating OCPs (cOCPs) in blood travel to bone and fuse with bone-resident osteoclasts. However, the characteristics of human cOCPs and their association with bone diseases remain elusive. We have identified and characterized human cOCPs and found a positive association between cOCPs and osteoclast activity. Sorted cOCPs have a higher osteoclastogenic potential than other myeloid cells and effectively differentiate into osteoclasts. cOCPs exhibit distinct morphology and transcriptomic signatures. The frequency of cOCPs in the blood …

Dog Sniffing Biomechanic Responses In An Odor Detection Test Of Odorants With Differing Physical Properties, Lydia Burnett, Nicholas Hebdon, Pete A. Stevens, Monica Moljo, Lindsay D. Waldrop, Lauryn Degreeff

Biology, Chemistry, and Environmental Sciences Faculty Articles and Research

Dogs are utilized in forensic science for their extensive scent detection capabilities. They are often considered the “gold standard” in field detection for targets such as illicit drugs and explosives. Despite their prevalence in the field, relatively little is known about how dogs interact with and transport volatile organic compounds through their olfactory system. In this study, two groups of dogs were utilized – Sport detection dogs (n=19) that participate in the National Association of Canine Scent Work and have achieved advanced standing through training and successful search competitions and law enforcement explosive detection dogs (n=8) which were included for …

Legal Disputes Over Frozen Embryos After Dobbs: A Retrospective Study Of Claims, Contracts, And Liability In Cases Of Divorce Or Separation, Gerard Letterie, Dov Fox

Pace Law Review

This study reviewed legal claims and clinic liability over disputed frozen embryos in cases of divorce or separation. Our data shows that one-third of cases had no prior arrangement regarding disposition about what to do in the event of separation or divorce. When agreements were in place they were rarely clear enough to determine the court’s resolution in these cases. In a post-Dobbs era, absence of adequate guidance could have significant implications regarding liability for all parties.