Medical Specialties Commons^™

"How Can I Get Out Of This?": A Qualitative Study Of The Phenomenology And Functional Impact Of Misophonia In Youth And Families, Andrew Giles Guzick, Catherine Elizabeth Rast, Brenna Burns Maddox, Servando Rodriguez Barajas, Jane Clinger, Joseph Mcguire, Eric A Storch

Faculty, Staff and Students Publications

Introduction: Misophonia is an increasingly recognized disorder characterized by negative emotional and sensory reactions to specific noises. Although misophonia most often begins in childhood, there has been minimal research on its clinical presentation in youth. This qualitative study explored cognitive behavioral processes that are involved in misophonia and its associated functional impairment in young people and their families.

Methods: Focused interviews were conducted with 20 youth with misophonia (ages 10-17) and their parents. Thematic analyses of these interviews using a cognitive behavioral theoretical framework were conducted.

Results: A number of themes were identified, which included internalizing and externalizing cognitive behavioral …

The Use Of Primal Reflex Release Technique To Address Pain And Stress: An Exploratory Case Series, Nathan R. Reep, Sydney N. Leverett, Rebecca M. Heywood, Zachary Johnson, Alan Nasypany, James May, Scott W. Cheatham

Clinical Practice in Athletic Training

The majority of the world population is experiencing more stress after the COVID-19 pandemic. Working in an outpatient healthcare setting it can be expected that patients will present with stress in combination with other perceptions of pain related to injury. Stress alone may be the cause of pain perception especially in patients who present with no specific mechanism of injury. There is a need for a quick full-body approach to assessment and treatment while considering the stress response to injury. Therefore, the purpose of this study was to determine the immediate effects of Primal Reflex Release Technique (PRRT) Primals on …

Addressing Unprofessional Behaviors In The Clinical Learning Environment: Lessons From A Multi-Year Virtual, Intergenerational, Interdisciplinary Workshop, Stacey Rose, Anita Kusnoor, Phuong Huynh, Jocelyn Greely, Yesenia Rojas-Khalil, Doris Kung, Anne Gill, Nadia Ismail, Nital Appelbaum

Faculty, Staff and Students Publications

INTRODUCTION: Optimizing the clinical learning environment (CLE) is a medical education priority nationwide.

MATERIALS AND METHODS: We developed a virtual, one-hour workshop engaging students, housestaff and faculty in small-group discussions of five case scenarios adapted from reported unprofessional behaviors in the CLE, plus didactics regarding mistreatment, microaggressions and bystander interventions.

RESULTS: Over two sessions (2021-2022), we engaged 340 students and 73 faculty/housestaff facilitators. Post-session surveys showed significant improvement in participants' ability to recognize and respond to challenges in the CLE.

DISCUSSION: Our innovative workshop, including scenarios derived from institutional reports of unprofessional behaviors, advanced participants' knowledge and commitment to improve …

Approved Car-T Therapies Have Reproducible Efficacy And Safety In Clinical Practice, Daniel Goyco Vera, Hiral Waghela, Mohamed Nuh, Jonathan Pan, Premal Lulla

Faculty, Staff and Students Publications

CAR-T cell therapy has established itself as a highly effective treatment for hematological malignancies. There are currently six commercial CAR-T products that have been FDA approved for diseases such as B-ALL, LBCL, MCL, FL, MM, and CLL/SLL. "Real-world" studies allow us to evaluate outcomes from the general population to determine their efficacy and safety compared to those who were included in the original trials. Based on several well conducted "Real-world" studies that represent diverse populations, we report that outcomes from the original trials that led to the approval of these therapies are comparable to those in practice.

Concussions In Women’S Rugby: A Timely Review Of Available Data, Shannon M. Wright

Clinical Practice in Athletic Training

Rugby is a growing full-contact sport across the world for both men and women; as a full-contact sport with no protective equipment, it has a reputation for high injury rates, including concussions. Organized men’s rugby has been established for over a century, whereas organized women’s rugby has struggled to achieve the same success over the years. With a much shorter amount of time to track injuries, women’s rugby lacks data to assess when, where, and what kinds of injuries are most common. The guiding study attempts to examine epidemiological trends for concussion in women’s rugby union and league. After pooling …

Effective Anterior Cruciate Ligament Injury Prevention Programming In Young Female Athletes: An Evidence-To-Practice Review, Janay Ward, Kina M. Ingram, Jackson Biffle, Emily E. Hildebrand, Peter Lisman

Clinical Practice in Athletic Training

Anterior cruciate ligament (ACL) injuries are common in adolescents, in particular females participating in sports requiring frequent jumping, pivoting, and rapid acceleration. Consequently, the prevention of ACL injury is a principal concern of athletic trainers and other sports medicine professionals. Neuromuscular training (NMT) programs have been effective in reducing ACL injury risk in athletic populations, though additional clarity on programmatic factors, such as exercise selection, timing, and training dosage is warranted. Therefore, the primary purpose of this evidence-to-practice review was to present which components of NMT programs have been found to be most effective in reducing ACL injury incidence in …

Treating Type Ii Medial Tibial Stress Syndrome With Primal Reflex Release Technique: A Novel Approach, Shelli Green, Jenna Morogiello, Kurrel Fabian, James May, Alan Nasypany

Clinical Practice in Athletic Training

Five NCAA Division I cheerleaders (age 20 ± 1.4; 3 males, 2 females) presented with Medial Tibial Stress Syndrome (MTSS). Following an evaluation, all patients diagnosed with MTSS were treated using Primal Reflex Release Technique (PRRT). Immediate improvements in reported pain were demonstrated after one treatment. Improvements in perceived dysfunction were demonstrated after 4.2 (± 0.84) treatments over 15.4 (± 5.86) days with no time lost. All improvements were maintained at two-week follow-up. Type II MTSS patients treated with PRRT may experience an immediate, lasting reduction in pain, improvement in function, and shorter time to overall resolution.

A Descriptive Examination Of Perceived Stress And Coping Among Athletic Trainers Employed In The National Collegiate Athletic Association, Stephanie M. Singe, Elisabeth M. Mckenna, Alexandrya Cairns, Christianne Eason

Clinical Practice in Athletic Training

Time and work demands are high for the collegiatea athletic trainer, which can increase work stress and burnout may result. High perceived levels of stress and burnout can impact an athletic trainer’s mental health and wellness. Data were collected via an online descriptive, cross-sectional survey (Qualtrics) examining the perceived stress and coping strategies used among athletic trainers employed in the collegiate setting. Respondents completed the pereceived stress scale (ɑ=.90), and a series of close-ended questions related to their self-reported strategy of coping. Data was collected during September of 2022. We had 987 (men 371, women 607, did not disclose 9) …

Driving After A Concussion In Adolescents And Young Adults, What Is The Current Research And Consensus?, Melanie Kwok, Tamara Valovich Mccleod

Clinical Practice in Athletic Training

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Comparison Of Patellar Taping And Strapping For Treating Patellofemoral Pain, Kaison Ames, Eric G. Post

Clinical Practice in Athletic Training

Among collegiate athletes, patellofemoral pain (PFP) represents nearly one-third of all sport-related injuries. There have been multiple studies using a patellar tendon strap as an intervention to treat PFP that showed an improvement in knee pain, as well as studies showing improvement in knee pain when using patellar taping for PFP. However, there is very limited research written that compares the effectiveness of a patellar tendon strap versus a patellar tendon taping technique for patients with PFP. Therefore, the purpose of this study was to compare the effectiveness of patellar taping versus patellar strapping to reduce PFP in collegiate athletes. …

Thoracic Mobility And The Effects It Has On The Human Body: An Evidence To Practice Review, Megan Kurzec, Barton E. Anderson

Clinical Practice in Athletic Training

Decreased thoracic mobility, stability, and strength are prevalent issues in athletes, contributing to various musculoskeletal problems. This Evidence to Practice Review synthesizes findings from a guiding systematic review that identified exercises targeting the thoracic spine in athletes. The review included a comprehensive search across six databases, five journals, and five social media platforms, yielding 38 exercises designed to improve thoracic mobility, motor control, work capacity, and strength. Despite the low level of evidence (Level D), these exercises are widely used in clinical practice. This review provides a framework for exercise prescription, offering athletic trainers a range of exercise options to …

Psychological Effects Of Number Of Knee Surgeries In Female Collegiate Soccer Athletes, Jun Yamada, Eric G. Post

Clinical Practice in Athletic Training

Psychological readiness is an important factor for returning to sport successfully following anterior cruciate ligament (ACL) reconstruction. To date, no studies have determined the effect of the number of knee surgery to psychological readiness. The primary purpose of this investigation was to determine whether the number of knee surgeries impacts psychological readiness. The secondary purpose was to examine the relationship between the number of surgeries and knee function. Data was collected from participants on the women’s soccer teams at a local division Ⅰ, Ⅲ, and NAIA college. Inclusion criteria were 1) currently fully participating in activities without any limitations, and …

Treating Chronic Low Back Pain And Plantar Fasciitis With Myokinesthetic System: A Case Study, Sadie Buboltz-Dubs, Russell Baker

Clinical Practice in Athletic Training

The purpose of this case study was to report the effects of the MyoKinesthetic (MYK) System on the pain and function of a collegiate softball player previously diagnosed with chronic non-specific low back pain and foot pain. The patient had been experiencing bilateral foot pain since childhood and conservative treatment options had failed to resolve her pain long term. Additionally, the patient had been experiencing persistent back tightness and soreness. Upon arrival at the university, the patient was evaluated using the MYK postural analysis to identify if a primary nerve root dysfunction could be the cause of her pain. The …

Supporting Mental Wellness In Transgender Athletes, Abaigeal C. Fields, Zachary K. Winkelmann

Clinical Practice in Athletic Training

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A Review Of Automated External Defibrillator Considerations In Athletic Training, Bryana M. Mammana, Susan W. Yeargin, Zachary K. Winkelmann

Clinical Practice in Athletic Training

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Correlation Between Pre-Season Single-Leg Hop Testing Data And Lower Extremity Injuries In Collegiate Soccer Players, Ashley Kuchenbuch, Justin M. Stanek

Clinical Practice in Athletic Training

Lower extremity injuries are very common in collegiate soccer athletes and often lead to long-term rehabilitation programs and a decline in the athlete’s overall quality of life. Using single leg hop tests to identify “at-risk” athletes before the competitive season begins could allow medical staff to implement injury prevention programs that could help reduce the incidence of lower extremity injuries throughout the season. The purpose of this study was to determine if data taken from single leg hop (SLH) testing could help predict lower extremity injuries in female collegiate soccer players. A convenience sample of twenty-one participants were chosen to …

College Student-Athlete Perceptions Of Characterizations And Interpersonal Trust In Their Athletic Trainer: A Point-Of-Care Research Study, Ryan N. Moran, Deidre Leaver-Dunn, Jeff Allen, Jessica Wallace

Clinical Practice in Athletic Training

Patient-centered care is essential in athletic training with limited research examining the relationship between patient and clinician. Previous theory has identified constructs of quality athletic trainers (ATs); however, it remains unknown how current athletes perceive these theorized constructs in the ATs providing them medical care. The purpose of this study was to determine the perceptions of characterizations of a quality athletic trainer and interpersonal trust between the student-athlete and AT in the collegiate setting and establish reliability of these surveys. A second aim was to explore differences between sex, previous exposure to an AT, and having had access to an …

The Impact Of Video-Assisted Education On Knowledge And Retention Compared To Paper Education Material, Keiona M. Nance, Matthew J. Drescher, Lindsey E. Eberman, Matthew J. Rivera

Clinical Practice in Athletic Training

When educating patients, clinicians must be effective to assure patients understand their treatment plan and abide by such to achieve optimal outcomes. Teaching methods that stimulate numerous senses more positively impact learning outcomes. The purpose of this study is to compare paper and video-assisted education at the point-of-care with the aim of changing patient education and local practice in a system for individuals undergoing total hip arthroplasties (THAs). We used a randomized cohort design to explore patient knowledge and retention and educational method at the point-of-care. We compared the current education method (paper) to video-assisted materials using pre and post-education …

Exploratory Clinical Assessment And Treatment Of Autonomic Nervous System Dysregulation Post Concussion: A Case Study, Megan Coker, James May

Clinical Practice in Athletic Training

The physiological alterations in autonomic nervous system (ANS) function due to concussion are suggested to play a role in persistent post-concussion symptoms (PPCS). Currently, there are few objective and clinically feasible measurements to assess ANS vitality in patients experiencing PPCS. The following case study details an assessment and treatment protocol targeted towards regulating the ANS in an adolescent female suffering from PPCS one month after injury. Pre-intervention, patient-reported outcome measures (PROMs) used to assess perceived pain, anxiety, stress, and breathing function were administered as well as a physical assessment performed for breath function and vagus nerve integrity. The patient was …

Comparing Mental Health Between Ncaa Division Iii Student-Athletes Competing In Team- And Individual-Sports, Autumn Presley, Tiffany Franklin, Jeffrey Williams

Clinical Practice in Athletic Training

Mental health is a topic that has gained attention in recent years, but few studies have examined NCAA Division III student-athletes. Division III student-athletes are known to experience high levels of distress, and previous literature indicates there may be a significant psychological difference between student-athletes who compete in individual-sports compared to those who participate in team-sports. The purpose of this study was to explore mental health challenges (levels of depression, stress, and anxiety symptoms) among Division III student-athletes, particularly between those participating in team- and individual-sports. A cross-sectional survey design was used. The independent variable was group (team-sport athletes and …

Medical Disqualification As A Barrier To Healthcare In Military Service Members, Kaitlyn A. Jones, Joshua R. Jaime, Zachary K. Winkelmann

Clinical Practice in Athletic Training

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Transcriptomic Profile Analysis Of Brain Tissue In The Absence Of Functional Trpm8 Calcium Channel, Erick B Saldes, Alexandra Erdmier, Jai Velpula, Timothy E Koeltzow, Michael X Zhu, Swapna Asuthkar

Faculty, Staff and Student Publications

Background/Objectives: Transient Receptor Potential Melastatin 8 (TRPM8) is a non-selective, Ca2+-permeable cation channel involved in thermoregulation and other physiological processes, such as basal tear secretion, cell differentiation, and insulin homeostasis. The activation and deactivation of TRPM8 occur through genetic modifications, channel interactions, and signaling cascades. Recent evidence suggests a significant role of TRPM8 in the hypothalamus and amygdala related to pain sensation and sexual behavior. Notably, TRPM8 has been implicated in neuropathic pain, migraines, and neurodegenerative diseases such as Parkinson's disease. Our laboratory has identified testosterone as a high-affinity ligand of TRPM8. TRPM8 deficiency appears to influence behavioral traits in …

Disruption Of Distal Appendage Protein Cep164 Causes Skeletal Malformation In Mice, Hiroyuki Yamaguchi, Megumi Kitami, Margaret Li, Sowmya Swaminathan, Radbod Darabi, Ken-Ichi Takemaru, Yoshihiro Komatsu

Faculty, Staff and Student Publications

The primary cilium is a cellular antenna to orchestrate cell growth and differentiation. Deficient or dysfunctional cilia are frequently linked to skeletal abnormalities. Previous research demonstrated that ciliary proteins regulating axoneme elongation are essential for skeletogenesis. However, the role of the ciliary proteins responsible for initiating cilium assembly in skeletal development remains unknown. Here, we investigate the function of centrosomal protein of 164 kDa (CEP164), a key ciliogenesis regulator that localizes at the distal appendages of the mother centriole, during skeletal development in mice. Interestingly, the mesodermal cell-specific Cep164 deletion resulted in severe bone defects and osteoblast-specific deletion of Cep164 …

A Bayesian Pharmacokinetics Integrated Phase I-Ii Design To Optimize Dose-Schedule Regimes, Mengyi Lu, Ying Yuan, Suyu Liu

Faculty, Staff and Student Publications

The schedule of administering a drug has profound impact on the toxicity and efficacy profiles of the drug through changing its pharmacokinetics (PK). PK is an innate and indispensable component of the dose-schedule optimization. Motivated by this, we propose a Bayesian PK integrated dose-schedule finding (PKIDS) design to identify the optimal dose-schedule regime by integrating PK, toxicity, and efficacy data. Based on the causal pathway that dose and schedule affect PK, which in turn affects efficacy and toxicity, we jointly model the three endpoints by first specifying a Bayesian hierarchical model for the marginal distribution of the longitudinal dose-concentration process. …

Neurofilament Light Chain In Serum Of Cancer Patients With Acute Neurological Complications, Amulya Gottiparthy, Keng Lam, Suprateek Kundu, Zixi Yang, Ivo Tremont-Lukats, Sudhakar Tummala

Faculty, Staff and Student Publications

Aim: Neurofilament light chain (NfL) is a nonspecific sensitive biomarker of axonal damage.

Methods: This case series identified cancer patients with neurological complications who had serum NfL measurements and paired these results to outcomes.

Results: NfL serum levels were available in 15 patients with hematological malignancies or solid tumors. The neurological complications studied were immune effector cell-associated neurotoxicity syndrome, immune checkpoint inhibitor-related encephalopathy, anoxic brain injury, Guillain-Barre syndrome, hemophagocytic lymphohistiocytosis, transverse myelitis, paraneoplastic syndrome, central nervous system demyelinating disorder and chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids. All patients but one with serum NfL >900 pg/ml died …

Predicting Kidney Graft Function And Failure Among Kidney Transplant Recipients, Yi Yao, Brad C Astor, Wei Yang, Tom Greene, Liang Li

Faculty, Staff and Student Publications

Background: Graft loss is a major health concern for kidney transplant (KTx) recipients. It is of clinical interest to develop a prognostic model for both graft function, quantified by estimated glomerular filtration rate (eGFR), and the risk of graft failure. Additionally, the model should be dynamic in the sense that it adapts to accumulating longitudinal information, including time-varying at-risk population, predictor-outcome association, and clinical history. Finally, the model should also properly account for the competing risk by death with a functioning graft. A model with the features above is not yet available in the literature and is the focus of …

Implications Of Myocardial Strain In Primary Mitral Regurgitation-A Cardiovascular Magnetic Resonance Study, Simone Romano, Danai Kitkungvan, Duc T Nguyen, Carlos El-Tallawi, Edward A Graviss, Afshin Farzaneh-Far, Dipan J Shah

Faculty, Staff and Student Publications

Aims: Chronic primary mitral regurgitation (MR) results in progressive left ventricular (LV) remodelling. Abnormal myocardial deformation (strain) can be present despite preserved ejection fraction (EF). Cardiovascular magnetic resonance (CMR) feature-tracking techniques allow assessment of global longitudinal strain (GLS) from routine cine images. The aim of this study is to evaluate the prognostic value of CMR feature tracking-derived GLS in patients with primary MR.

Methods and results: Consecutive patients undergoing CMR for chronic MR from January 2012 to June 2018 were enrolled. Patients with LVEF < 50% were excluded. The composite primary outcome aiming to detect decompensation related to MR comprised (i) referral for mitral surgery owing to symptoms or LV systolic dysfunction or (ii) cardiovascular death. The secondary outcome was all-cause death. A total of 422 patients were followed for a median of 2.7 years, and the primary endpoint was met in 93 patients (34 patients reported symptoms at baseline). At multivariable analysis, GLS≥ -16.6% was associated with primary outcome [hazard ratio (HR) 1.90, P = 0.01]. In moderate MR cohort, patients with GLS≥ -16.6% had worse event-free survival, whereas there was no significant difference in mild or severe MR groups. GLS≥ -16.0% remained associated with all-cause death after adjusting for other covariates including the MR severity (HR 2.24, P = 0.02).

Conclusion: In patients with primary MR with preserved systolic function, GLS was associated with our composite …

Implementation Of Patient Care Documentation Standard For Athletic Training Staff In Intercolle, Lucas Bianco, Maria Popek, Bri Durics, Christian Miles

Clinical Practice in Athletic Training

Documentation is a professional standard for all health care professions. As part of a relatively young profession, athletic trainers have had to adjust to the expectations around documentation to stay at the same level as other health care providers. Documentation is often a highly discussed topic with more and more education sessions and resources being provided by NATA, BOC and NATA Research Education Foundation. The need for Continuous Quality Improvement projects and subsequent studies has continued to grow. Projects with a focus on documentation can be completed then disseminated to determine the most effective ways to improve documentation across our …

Transition To Enteral Triazole Antifungal Therapy For Pediatric Invasive Candidiasis: Secondary Analysis Of A Multicenter Cohort Study Conducted By The Pediatric Fungal Network, Robert F T Bucayu, Craig L K Boge, Inci Yildirim, Martha Avilés-Robles, Surabhi B Vora, David M Berman, Tanvi S Sharma, Lillian Sung, Elio Castagnola, Debra L Palazzi, Lara Danziger-Isakov, Dwight E Yin, Emmanuel Roilides, Gabriela Maron, Alison C Tribble, Pere Soler-Palacin, Eduardo López-Medina, José Romero, Kiran Belani, Antonio C Arrieta, Fabianne Carlesse, Dawn Nolt, Natasha Halasa, Daniel Dulek, Sujatha Rajan, William J Muller, Monica I Ardura, Alice Pong, Blanca E Gonzalez, Christine M Salvatore, Anna R Huppler, Catherine Aftandilian, Mark J Abzug, Arunaloke Chakrabarti, Michael Green, Irja Lutsar, Elizabeth D Knackstedt, Sarah K Johnson, William J Steinbach, Brian T Fisher, Rachel L Wattier

Faculty, Staff and Students Publications

Of 319 children with invasive candidiasis, 67 (21%) transitioned from intravenous to enteral antifungal therapy. Eight (12%) transitioned back to intravenous antifungal therapy, one due to perceived treatment failure defined by clinical progression or worsening. Global treatment response at study completion was successful in 66 participants who transitioned to enteral therapy.

Age-Dependent Regulation Of Axoglial Interactions And Behavior By Oligodendrocyte Ankyring, Xiaoyun Ding, Yu Wu, Anna Vainshtein, Victoria Rodriguez, Emily Ricco, James T Okoh, Yanhong Liu, Daniel C Kraushaar, Elior Peles, Matthew N Rasband

Faculty, Staff and Students Publications

The bipolar disorder (BD) risk gene ANK3 encodes the scaffolding protein AnkyrinG (AnkG). In neurons, AnkG regulates polarity and ion channel clustering at axon initial segments and nodes of Ranvier. Disruption of neuronal AnkG causes BD-like phenotypes in mice. During development, AnkG is also expressed at comparable levels in oligodendrocytes and facilitates the efficient assembly of paranodal junctions. However, the physiological roles of glial AnkG in the mature nervous system, and its contributions to BD-like phenotypes, remain unexplored. Here, we show that oligodendroglia-specific AnkG conditional knockout results in destabilization of axoglial interactions in aged but not young adult mice. In …