Musculoskeletal, Neural, and Ocular Physiology Commons^™

Current Mechanobiological Pathways And Therapies Driving Spinal Health, Rahul Kumar, Kyle Sporn, Harlene Kaur, Akshay Khanna, Phani Paladugu, Nasif Zaman, Alireza Tavakkoli

SKMC Student Presentations and Publications

Spinal health depends on the dynamic interplay between mechanical forces, biochemical signaling, and cellular behavior. This review explores how key molecular pathways, including integrin, yeas-associated protein (YAP) and transcriptional coactivator with PDZ-binding motif (TAZ), Piezo, and Wingless/Integrated (Wnt) with β-catenin, actively shape the structural and functional integrity of spinal tissues. These signaling mechanisms respond to physical cues and interact with inflammatory mediators such as interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α), driving changes that lead to disc degeneration, vertebral fractures, spinal cord injury, and ligament failure. New research is emerging that shows scaffold designs that can …

Machine Learning Based Medical Ultrasound Image Classification And Grad-Cam Interpretation, Victoria C. Hemphill

All Theses

This work takes a step in creating a diagnostic tool for the classification decision process of Achilles tendinopathy using ultrasound images. An attention-based multiple instance learning model is developed to classify the images. Typically, doctors capture multiple ultrasound images of the Achilles tendon during a study to determine a complete diagnosis. Multiple instance models adopt this behavior by providing a single label for a set of instances (images). The images are grouped into ”bags” at the study level and passed into the model. The MIL model then uses its attention property to assign an importance score to each image to …

Advanced Interactions Of Directed Energy With Retinal Pigment Epithelial Cells And Their Photochemical And Photothermal Responses, Jin B. Ha

Theses & Dissertations

Excess optical radiation can injure the retina through either rapid heat deposition (photothermal damage) or cumulative photo‑oxidative stress (photochemical damage), yet current laser‑safety limits treat these mechanisms as independent. To test that assumption, this dissertation integrated systematic wavelength, duration and temperature‑controlled laser exposures with live/dead fluorescence imaging in a melanin‑loaded hTERT‑RPE1 monolayer model. First, concurrent 447 nm (blue) and 2 µm (infra‑red) beams delivered for 200 s demonstrated a strong thermal–photochemical synergy: each beam alone was sub‑threshold (≤25 % lethality) but together produced 100 % RPE death without exceeding 50 °C, proving that modest heating markedly lowers the photon dose …

Concurrent Use Of Skeletal Muscle Relaxants And Nsaids In Low Back Pain Management: A Critical Review Of Current Evidence And Future Directions, Rupesh A. Saindane, Nilima A. Thombre

The Thai Journal of Pharmaceutical Sciences

Low back pain (LBP) represents a leading cause of non-fatal disability globally. Its high prevalence and disabling nature highlight the urgent need for effective management strategies. The exact cause of LBP still remains unclear, and thus, its treatment remains symptomatic. LBP is commonly treated with non-steroidal anti-inflammatory drugs (NSAIDs) and skeletal muscle relaxants (SMRs). These agents are frequently used in combination to target both inflammation and muscle spasms. However, the clinical guidelines vary widely on the recommendation for the use of such combination therapy. The present review evaluates evidence from randomized clinical trials and systematic reviews on the concurrent use …

Imaging Hallmarks Of Idiopathic Intracranial Hypertension And Insights Into Pathogenesis, Albalooshy Basimah, Scott Faro, Hsiangkuo Yuan, Kiran Talekar, Prabath Mondel, Enchao Qiu, Joga Chaganti

Department of Radiology Faculty Papers

Idiopathic Intracranial hypertension (IIH), also referred to as pseudotumor cerebri, is a term used to describe increased intracranial pressure in the absence of a known identifiable secondary cause. Despite advancements of neuroimaging techniques, imaging of the pathological underpinnings in the diagnosis of IIH has been limited. Although the causation of IIH has been ascribed to increased Cerebrospinal Fluid production and disordered drainage through the dural sinuses, new evidence shows that the glymphatic system which is an alternate pathway of drainage is likely to play a pivotal role. In this review, we address the pathophysiological underpinnings in the causation of IIH …

Peripheral Neuroimmune Mechanisms Of Chronic Back Pain, Aleyah Esther Goins

Biomedical Sciences ETDs

Chronic back pain (CBP) affects 1 in 10 people worldwide, reducing mobility, productivity, and quality of life. Despite its prevalence, non-addictive treatments remain limited due to an incomplete understanding of chronic pain mechanisms. This dissertation examines peripheral neuroimmune interactions in CBP using a urokinase-type plasminogen activator (uPA)-induced mouse model (uPA-CBP). uPA, a pro-inflammatory serine protease, was injected into the L2/L3 lumbar spinous ligament, inducing prolonged mechanical and cold hypersensitivity. Flow cytometry of dorsal root ganglia (DRG) showed increased CD45+CD11b+ myeloid cells in males and CD45+CD3+CD4+ lymphocytes in females. DRG neurons from male uPA-CBP mice exhibited heightened action potential firing. Pharmacological …

Ovarian Cancer G Protein-Coupled Receptor-1 Signaling Bias Dictates Anti-Contractile Effect Of Benzodiazepines On Airway Smooth Muscle, Dominic R. Villalba, Arun K. Jannu, Elham Javed, Isha Dandekar, Ruping Wang, Deepak A. Deshpande, Steven S. An, Reynold A. Panettieri, Dale D. Tang, Raymond B. Penn, Ajay P. Nayak

Center for Translational Medicine Faculty Papers

BACKGROUND: We recently reported that the ovarian cancer G protein-coupled receptor-1 (OGR1) can be pharmacologically biased with specific benzodiazepines to couple with distinct heterotrimeric G proteins in human airway smooth muscle (ASM) cells. Lorazepam stimulated both G

METHODS: Models of histamine (His) -stimulated contraction included imaging of ex vivo human precision cut lung slices (hPCLS) and Magnetic Twisting Cytometry (MTC) analysis of human ASM cell stiffness. To explore mechanisms of regulation, we examined effects on myosin light chain (pMLC) phosphorylation and PKA activity in primary human ASM cultures, as well as actin cytoskeleton integrity as defined by changes in the …

Addressing The Lack Of Patient Adherence To Exercise Within The Physical Therapy Clinic And Creating Infographics To Improve Patient Adherence, Gretchen Panovich

Honors Program: Senior Projects (Public)

The primary objective of this applied knowledge project is to develop educational materials to enhance patient adherence. The World Health Organization defines adherence as “the extent to which a person’s behavior…corresponds with agreed recommendations from a healthcare provider.” Within the physical therapy field, non-adherence to exercise is a significant problem linked with increased duration of treatment, more patient complaints, reduced positive clinical outcomes, and even surgical intervention.

Multiple factors affect patient adherence, making it hard to pinpoint a singular cause. Clinical observations and research suggest that belief in the rehabilitation process may suffer due to a prolonged recovery period, lack …

Eye Dissection Video Guide: An Innovative Approach To Anatomy Education Of The Orbit, Eye, And Intraocular Lens, Jack Dryden, Malli Barremkala

Posters

No abstract provided.

Diabetic Retinopathy: A Pathophysiological Discussion, Nathanael C. Nicholls

Senior Honors Theses

Diabetic retinopathy is a severe complication of diabetes that is capable of causing vision loss or blindness. As a result of hyperglycemia, the disease increases oxidative stress and activates biochemical processes such as the Hippo pathway and the complement system to cause significant damage to the retina. Overexpression of BTG1 and microRNA-183 enables activation of biochemical pathways that lead to negative effects on the retinal vascular endothelium including angiogenesis and inflammation. Conventional methods of diagnosis for diabetic retinopathy include fundus examination, nucleoside detection, and optical coherence tomography angiography. Photocoagulation and hormonal intravitreal injection are the most popular current treatments, while …

A Hypoxia Research-Driven Path Led To Identifying Neuroprotection Mediators: An Interview With Dr. Nicolas G. Bazan, Nicolas G. Bazan

School of Medicine Faculty Publications

No abstract provided.

Ibuprofen, Flurbiprofen Or Naproxen Sodium Minimally Influences Musculoskeletal Adaptations To Treadmill Exercise In Rats, Brandon Roberts, Alyssa Geddis, Alexandra Ciuciu, Marinaliz Reynoso, Nikhil Mehta, Alyssa Varanoske, Alyssa Kelley, Maximus Leiss, Alexander Kolb, Julie Hughes, Marshall Naimo, Ryan Tomlinson, Jeffery Staab

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs) may influence musculoskeletal health. The purpose of this study was to compare the effects of three different NSAIDS: naproxen sodium, ibuprofen, flurbiprofen or a placebo on musculoskeletal adaptations in rodents with or without 6 weeks of aerobic exercise.

METHODS: Nine-week-old male Wistar rats (n = 80) were randomized to either exercise (EX) or no-exercise control (CON) conditions and treated with naproxen, ibuprofen (IBU), flurbiprofen (FLU) or placebo (PLA). For exercise, rats ran 5 days per week for 6 weeks at a 5% incline on a motorized treadmill for 30 min. Three-point bending (3 PB) and …

Intraocular Pressure Changes Associated With Psychological Stress Or Anxiety In Both Healthy And Glaucoma-Diagnosed Patients, Triston Crook, Porter Biggs, James Fini, Zane Kingsbury

Annual Research Symposium

No abstract provided.

Evaluation Of Seven Commercially Available Dna Extraction Kits For Ocular Tissues, Jakob Newton, Conrad K. Ashby, Michael Trapnell, Triston Crook, Mark Eisele, Porter Biggs, Prina Patel, Christina Nelson, John A. Kriak, Kyle B. Bills, David W. Sant

Annual Research Symposium

2025 Annual Roseman Research Symposium

Exploring The Vitality Of Athletic Training: Insights Into Professional Identity, Commitment, And Retention, L E. Eberman, M J. Rivera, K E. Games, M J. Drescher, J P. Young, J Clifton-Gaw, K Condrey, H Mccarn, N Mondelli, X Yuan

Clinical Practice in Athletic Training

Introduction: The confluence of fluctuating retention, fewer students entering professional programs, and the profession’s identity crisis (conflict between being a sports profession or a health profession) has created a serious question about the vitality of the athletic profession. However, research on the vitality of the profession has often focused on singular variables influencing professional identity, burnout, and commitment. The purpose of this project was to explore multiple factors influencing the vitality of the profession across professional identity and commitment in athletic training. Methods: We used a convergent parallel mixed-methods design, including surveys and interviews with athletic training students and athletic …

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: …

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 …

Escape From Diabetes, J E. Jochum, J Carmack, J Toon

Clinical Practice in Athletic Training

Introduction: In the past decade, interprofessional education (IPE) to promote interprofessional collaborative practice has become an integral component of pre-licensure education in the health professions. Research shows that IPE activities involving problem-solving in patient care that requires cooperation and communication among the professions is most effective. An effective activity to meet interprofessional competencies is the use of escape rooms. Escape rooms are team-based games where groups of individuals solve puzzles to accomplish a specific goal, typically in a limited amount of time. There are many benefits to using escape rooms in education, including promoting problem-solving, teamwork, and creativity, improving focus …

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 …

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 …

Barriers To The Implementation Of The Amsterdam 2022 Statement In The Secondary School Setting, L Torres, J L. Baldari, F A. Gardin, A M. Price

Clinical Practice in Athletic Training

Introduction: The Amsterdam 2022 International Consensus Statement on Concussion in Sport provides a summary of contemporary best practice recommendations for healthcare providers who are involved in the care of athletes at risk of sport-related concussion (SRC). Given that athletic trainers (ATs) have a professional responsibility to continually educate themselves on topics of great importance to the population that they care for, such as SRC management, it is reasonable to expect them to evolve their concussion management protocols to better align themselves with the recommendations found this statement. The purpose of this study was to identify the barriers associated with the …

Athletic Trainer Compensation Characteristics, J P. Young, K Ef Mair, L E. Eberman

Clinical Practice in Athletic Training

Introduction: Athletic trainers (ATs) are integral to healthcare yet face ongoing challenges that affect job satisfaction and retention. Factors such as long work hours, low pay, and work-family conflict contribute to dissatisfaction and a desire to leave the profession. Salary disparities and lack of administrative support are key factors impacting professional fulfillment and career longevity. Identifying how compensation influences job satisfaction is essential for improving retention and advancing the profession. Our study aimed to examine the compensation characteristics of ATs and determine the key factors that predict gross income. Methods: A cross-sectional, web-based survey was conducted. The survey was validated …

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 …

Modification Of Ergonomics For A World-Class Brass Instrumentalist With A Congenital Limb Difference: Level 3 Case, O G. Newhouse

Clinical Practice in Athletic Training

Background: A drum and bugle corps is a musical marching organization that consists of approximately 160 brass, percussion, and color guard performers. There are currently twenty-one drum corps organizations at the world-class level that compete. Organizations learn their 8–10-minute show in the late spring and begin traveling the country performing and competing in the early summer until August. Rehearsal days can be up to 10 hours of practice including visual and music. It has been reported that the incidence of upper limb pain is higher in those who have longer practice times, in which is a symptom of overuse. These …

The Effects Of A Joint Reduction Trainer On Confidence Levels In Professional Athletic Training Students, T Franklin, S Hacherl

Clinical Practice in Athletic Training

Introduction: Dislocations are common injuries managed by athletic trainers, yet athletic training students are unlikely to practice reduction techniques during clinical experiences. Current standards set by the Commission on Accreditation of Athletic Training Education require accredited programs to prepare students to manage patients with dislocations, including joint reductions. Research indicates the use of simulation techniques, such as joint reduction simulators, in education can fill clinical experience gaps and improve student confidence and skills. Shoulder dislocations make up nearly 50% of dislocations with several reduction techniques identified in the current literature. The use of a joint reduction simulator may provide athletic …

Using Ai-Generated Scenarios To Enhance Learning Of The Emergency Assessment Process, D Cobble, L Schroeder, J Vaughn, S Ford

Clinical Practice in Athletic Training

Introduction: Rigorous accreditation standards require students to demonstrate competency in various clinical proficiencies through clinical practice or simulation-based educational activities. Therefore, simulation has become an integral component of athletic training education, as scenarios can provide realistic and reproducible experiences for all students. To that end, our study had two primary objectives: investigate the ability of artificial intelligence (AI) to generate accurate and realistic athletic training simulation scenarios and evaluate AI's effectiveness in teaching and reinforcing the emergency assessment process through student-created scenarios. Methods: Phase one, AI developed three different scenarios for patients experiencing (1) an ovarian cyst, (2) a hypoglycemic …

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 …

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 …

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 …