Medical Specialties Commons^™

Effects Of Pubertal Growth Variation On Knee Mechanics During Walking In Female And Male Adolescents, Andrew W. Froehle, Brian A. Edwards, Matthew Peterson, Brian Meyerson, Dana Duren

School of Health and Exercise Sciences Faculty Publications

Introduction: Puberty substantially alters the body's mechanical properties, neuromuscular control, and sex differences therein, likely contributing to increased, sex-biased knee injury risk during adolescence. Female adolescents have higher risk for knee injuries than male adolescents of similar age engaging in similar physical activities, and much research has investigated sex differences in mechanical risk factors. However, few studies address the considerable variation in pubertal growth (timing, pace), knee mechanics, and injury susceptibility within sexes, or the impact of such growth variation on mechanical injury risk.

Objectives: The present study tested for effects of variation in pubertal growth on established mechanical …

Analysis Of Vein Grafting Versus Arteriovenous Loop In Microvascular Head And Neck Reconstruction: Multicenter Series Of 36 Patients, Kaitlynne Y. Pak, Spencer R. Anderson, Tyler L. Langenfeld, Kenneth Tan, Allison Slijepcevic, Sunishka Wimalawansa, Yadranko Ducic, Mark K. Wax, Sameep P. Kadakia

Orthopaedic Surgery Faculty Publications

Background: The utilization of an arteriovenous loop is an underreported technique that affords the creation of reliable vascular options. Understanding the efficacy and impacting variables of microvascular reconstruction with an arteriovenous loop can be critical to its use.

Methods: Multi-institutional study of 36 patients who underwent vein grafting or AV loop with free tissue transfer.

Results: 58.3% of patients received prior radiation and 38.9% prior flap reconstruction. Flap success for vein grafting was 76% and AV loop was 100% (p = 0.16). Success for the radiated cohort was 90.5% and non-radiated 80% (p = 0.63). Flap success for the radiated, …

Second Annual Research Symposium Program With Abstracts, Office Of Research Affairs, Boonshoft School Of Medicine

Boonshoft School of Medicine Research Symposium

The program booklet is a compilation of abstracts from oral and poster presentations at Wright State University's First Annual Boonshoft School of Medicine Medical Research Symposium held on April 13, 2023.

Vital Signs, Spring 2023, Boonshoft School Of Medicine

Vital Signs

A nine page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, alumni profiles, class notes, and more.

Using Multiple Imputation Of Real-World Data To Estimate Clinical Remission In Pediatric Inflammatory Bowel Disease, Nanhua Zhang, Chunyan Liu, Steven J. Steiner, Richard B. Colletti, Robert Baldassano, Shiran Chen, Stanley Cohen, Michael D. Kappelman, Shehzad Saeed, Laurie S. Conklin, Richard Strauss, Sheri Volger, Eileen King, Kim Hung Lo

Pediatrics Faculty Publications

Aim: To evaluate the performance of the multiple imputation (MI) method for estimating clinical effectiveness in pediatric Crohn's disease in the ImproveCareNow registry; to address the analytical challenge of missing data. Materials & methods: Simulation studies were performed by creating missing datasets based on fully observed data from patients with moderate-to-severe Crohn's disease treated with non-ustekinumab biologics. MI was used to impute sPCDAI remission statuses in each simulated dataset. Results: The true remission rate (75.1% [95% CI: 72.6%, 77.5%]) was underestimated without imputation (72.6% [71.8%, 73.3%]). With MI, the estimate was 74.8% (74.4%, 75.2%). Conclusion: MI reduced nonresponse bias and …

A Close-Up Examination Of Racial Disparities In Infant And Maternal Outcomes In Montgomery County, Ohio, Kelsey M. Harman, Keith M. Reisinger-Kindle, Rose Maxwell

Obstetrics and Gynecology Faculty Publications

Background: Infant and maternal outcomes in Montgomery County, Ohio, are among the worst in the state and rival that of many low-income nations. This study compares maternal and infant outcomes across 3 zip codes in Montgomery County to discern factors that are influencing health outcomes for their residents. The zip codes represent 3 distinct communities with unique racial and socioeconomic makeups.  Methods: A cohort of maternal-infant dyads (n=5098) who delivered at Miami Valley Hospital and Good Samaritan Hospital from January 1, 2009, to January 1, 2019, were analyzed via retrospective chart review. Maternal (MCS) and infant (ICS) outcome composite scores …

Comparing The Impact Of Food Insecurity, Access To Exercise Opportunities, And County Classification On Obesity Rates In Ohio, Ankur Parekh, Deborah Lee

Scholarship in Medicine - All Papers

Objective: We completed a study to determine how food insecurity, access to exercise opportunities, and county classification (rural or urban) impacted obesity rates in Ohio. We hypothesized that the county classification impacted obesity the most followed by food insecurity and access to exercise opportunities.

Methods: We obtained data on food insecurity, access to exercise opportunities, and obesity from County Health Rankings and county classification data from the United States Department of Agriculture Census. We analyzed correlations between obesity and food insecurity and obesity and access to exercise opportunities in both county types. We also analyzed changes in obesity rates in …

A Case Of Spontaneous Adrenal Hemorrhage In Pregnancy, Benjamin Mallicoat, Kelly Nagy, Christopher Croom

Obstetrics and Gynecology Faculty Publications

A case study looking at a 25 year old patient at 31 weeks gestation with spontaneous adrenal hemorrhage.

The Balance Between Sleep And Lifestyle: How Lifestyle Impacts Insufficient Sleep, Evan Hartman, John Monnig

Scholarship in Medicine - All Papers

Sleep insufficiency is a common but overlooked problem for many people. This is harmful because adequate sleep is important to cognitive, emotional, and physical health. This study analyzed how food environment index, smoking, physical activity, and median household income impact sleep insufficiency on an Ohio population. All data was utilized from the County Health Rankings (CHR) database. This analysis presented that the food environment index (r = -0.676, p < .001) and median household income (r = -0.743, p <.001) negatively correlated to insufficient sleep percentage. Furthermore, both adult smoking percentage (r = 0.735, p < .001) and physical inactivity (r = 0.761, p < .001) positively correlated to insufficient sleep percentage. It is also important to note that there was a significant difference between Ohio and Indiana counties (t = -12.347, p < .001), two neighboring states that both contain a mixture of urban and rural populations. Lastly, there was no significant difference between rural and urban Ohio counties (t=-1.521, p=.132). This data presents that more physical activity and less smoking may have positive benefits on sleep along with eating healthier, more nutrient dense food. Moreover, increased median household income may also positively impact sleep. Lifestyle factors such as smoking, physical activity, and increased nutritious food consumption are all avenues for patients to try to implement into their own lives to improve their sleep. Hopefully, such lifestyle modifications will improve sleep quality and thus result in an improvement in other aspects of their overall health.

Factors Contributing To Adult Obesity: A Midwestern Analysis, Makul Sharma, Hop Lewis

Scholarship in Medicine - All Papers

Objective: To investigate the association between adult obesity and several health-related factors: access to healthy food, exercise opportunities, and physical inactivity in Ohio compared to other Midwestern regional states (Illinois and Iowa) in 2022

Methods: Data was obtained from a County Health Rankings Model using the Behavioral Risk Factor Surveillance System (BRFSS). Data were then weighted to reflect population distribution and then used to measure various health behaviors and health-related quality of life (RQoL) indicators.

Results: We found significantly higher rates of adult obesity in Ohio compared to Illinois and Iowa. It was also determined that adult obesity in Ohio …

The Effect Of Neighborhood Safety On Childhood Mental And Behavioral Health Problems, Courtney Kiggins, Alayna Pavol

Scholarship in Medicine - All Papers

The correlation between socioeconomic status (SES) and adverse childhood experiences (ACEs) with mental and behavioral health problems is well documented, however the connection between neighborhood safety and mental and behavioral health problems is not well understood. This study analyzes the impact of neighborhood safety on childhood mental and behavioral health outcomes. Data collected by the National Survey of Children’s Health (NSCH) was used for this study and statistically analyzed using IBM SPSS software. A strong connection was found between poverty level and childhood mental and behavioral health outcomes, where those who were more impoverished had higher percentages of children experiencing …

Family Medicine Editors Collaborate Towards Antiracist Publishing, Sarina Schrager, Sumi Sexton, Marjorie A. Bowman, Caroline Richardson

Population and Public Health Sciences Faculty Publications

Editors of 10 North American Family Medicine journals simultaneously published a Joint Call for Action to address systemic racism and encourage diversity, equity, inclusion and accessibility/antiracism (DEIA) initiatives in medicine and medical publishing in January 2021. The efforts of the journals since publication of the joint editorial are summarized and include working to diversify editorial teams, editorial boards and authors; enhanced content about DEIA topics; mentoring of authors who are underrepresented in medicine (URM); and presenting content related to DEIA in Family Medicine publishing at national meetings. Editors had a follow up meeting in November 2022 to continue working toward …

Intensivist -Driven Ventilator Management Shortens Duration Of Mechanical Ventilation In Coronary Artery Bypass Graft Surgery Patients, Yonatan Dollin, Brian Elliott, Ronald J. Markert, Angela Morman, Matthew Koroscil

Internal Medicine Faculty Publications

Background Prolonged mechanical ventilation in post Coronary Artery Bypass Graft Surgery (CABG) is associated with deleterious effects including, increased ICU and hospital length of stay (LOS), infectious complications, and mortality. Standardized ventilator weaning protocols and the utilization of critical care physicians in post CABG patient care vary substantially among institutions. The purpose of this study was to evaluate if intensivist consultation in conjunction with a multidisciplinary, standardized ventilator weaning protocol improves outcomes in CABG patients. Materials and Methods We performed a single-center, retrospective, before-after cohort analysis at Miami Valley Hospital in Dayton, OH, a 970-bed community hospital. Patients were divided …

Bamlanivimab Use In A Military Treatment Facility, Eric Karr, Theodore Chung, Kathryn Burtson, Ronald J. Markert, Devin Kelly

Internal Medicine Faculty Publications

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), was first identified in 2019 in Wuhan, China, and has rapidly spread across the world. As of April 2021, SARS-CoV-2 has infected more than 140,000,000 and caused more than 3,000,000 deaths globally. In November 2020, the monoclonal antibody bamlanivimab was approved by the FDA for non-hospitalized patients with SARS-CoV-2 (COVID-19) who possessed risk factors for progression to severe COVID-19. This provided a treatment option that may help prevent hospitalization. Methods Patients who regularly received ambulatory care at a military treatment facility and who were …

Impact Of An Education Intervention On Covid-19 Vaccine Hesitancy In A Military Base Population, Peter C. Li, Samuel R. Theis, Devin Kelly, Col Thad Ocampo, Andrew Berglund, Damien Morgan, Ronald J. Markert, Evan Fisher, Kathryn Burtson

Internal Medicine Faculty Publications

Background: Coronavirus disease 2019 (COVID-19) vaccine hesitancy is a major impediment to achieving herd immunity and overcoming the current pandemic. Our aim was to decrease the prevalence of vaccine hesitancy through an education intervention. Method: An education intervention, consisting of a PowerPoint presentation addressing the two mRNA COVID-19 vaccine concerns/myths and a question and answer panel comprising health care providers from various specialties, was implemented to address vaccine hesitancy among personnel associated with Wright-Patterson Air Force Base through a series of virtual and in-person seminars. Participants completed a post-seminar survey as a retrospective self-assessment to identify attitudes and views surrounding …

Perceptions And Concerns Regarding Covid-19 Vaccination In A Military Base Population, Samuel R. Theis, Peter C. Li, Devin Kelly, Thad Ocampo, Andrew Berglund, Damien Morgan, Ronald J. Markert, Evan Fisher, Kathryn Burtson

Internal Medicine Faculty Publications

Introduction: Safe and effective vaccines against severe acute respiratory syndrome-associated coronavirus 2 are essential tools in the fight against the coronavirus disease 2019 (COVID-19) pandemic. However, hesitancy to vaccination is a major barrier to achieving herd immunity, particularly among a population working on a military base. To better understand the perceptions and concerns of these individuals, a voluntary survey was conducted. Materials and methods: An interactive, online survey was constructed and disseminated to individuals associated with Wright-Patterson Air Force Base (WPAFB) in Dayton, OH. Survey participation was voluntary with responses collected over the initial weeks in which WPAFB began to …

Pyemotes Herfsi Dermatitis: A Case Of 17 Year Itch, Christina E. Borchers, Taylor Schaetzle, Samia Borchers

Dermatology Faculty Publications

No abstract provided.

Effects Of Ohio Opioid Prescribing Policy On Postsurgical Prescriptions Following Sports Procedures, Joseph D. Henningsen, Scott Huff, Andrew D. Schneider, Fady Y. Hijji, Andrew W. Froehle, Anil Krishnamurthy

Orthopaedic Surgery Faculty Publications

Background: Prescribed opioid medication after orthopedic sports surgery has been shown to exceed patient requirements. In 2017, as a response to the opioid epidemic, Ohio passed Opioid Prescribing Guidelines (OPG) limiting narcotic prescriptions for acute pain. This study sought to evaluate the effects of the OPG on prescribing behavior of orthopedists following knee arthroscopy (KA), shoulder arthroscopy (SA), and anterior cruciate ligament reconstruction (ACLR).

Methods: An institutional database was queried to calculate morphine equivalent dose (MED) prescribed at discharge, acute follow-up (<90 days), and chronic follow-up (>90 days) and compare MED pre- and post-OPG. Cases were identified over a 2-year period starting 1 year …

Surgical Stabilization Versus Nonoperative Treatment For Flail And Non-Flail Rib Fracture Patterns In Patients With Traumatic Brain Injury, Jonne T.H. Prins, Esther M. M. Van Lieshout, Francis Ali-Osman, Zachary M. Bauman, Eva-Corina Caragounis, Jeff Choi, D. Benjamin Christie Iii, Peter A. Cole, William B. Devoe, Andrew R. Doben, Evert A. Eriksson, Joseph D. Forrester, Douglas R. Fraser, Brendan Gontarz, Claire Hardman, Daniel G. Hyatt, Adam J. Kaye, Huan-Jang Ko, Kiara N. Leasia, Stuart Leon, Silvana F. Marasco, Allison G. Mcnickle, Timothy Nowack, Temi D. Ogunleye, Prakash Priya, Aaron P. Richman, Victoria Schlanser, Gregory Semon, Ying-Hao Su, Michael H. J. Verhofstad, Julie Whitis, Fredric M. Pieracci, Mathieu M. E. Wijffels

Department of Surgery Faculty Publications

Purpose: Literature on outcomes after SSRF, stratified for rib fracture pattern is scarce in patients with moderate to severe traumatic brain injury (TBI; Glasgow Coma Scale ≤ 12). We hypothesized that SSRF is associated with improved outcomes as compared to nonoperative management without hampering neurological recovery in these patients.

Methods: A post hoc subgroup analysis of the multicenter, retrospective CWIS-TBI study was performed in patients with TBI and stratified by having sustained a non-flail fracture pattern or flail chest between January 1, 2012 and July 31, 2019. The primary outcome was mechanical ventilation-free days and secondary outcomes …

Optimal Dosing Of Enoxaparin In Overweight And Obese Children, Abdallah Derbalah, Stephen Duffull, Catherine M. Sherwin, Kathleen Job, Hesham Al‐Sallami

Pediatrics Faculty Publications

Aim:Current enoxaparin dosing guidelines in children are based on total bodyweight. This is potentially inappropriate in obese children as it may overestimate thedrug clearance. Current evidence suggests that obese children may require lower ini-tial doses of enoxaparin, therefore the aim of this work was to characterise the phar-macokinetics of enoxaparin in obese children and to propose a more appropriatedosing regimen.Methods:Data from 196 unique encounters of 160 children who received enoxa-parin treatment doses were analysed. Enoxaparin concentration was quantified usingthe chromogenic anti factor Xa (anti-Xa) assay. Patients provided a total of 552 anti-Xa samples. Existing published pharmacokinetic (PK) models were fitted …

Hypothesis: Hypermobile Ehlers Danlos Syndrome Is A Determinant Of Fetal And Young Infant Bone Strength, Marvin E. Miller

Pediatrics Faculty Publications

Several studies have demonstrated that young infants who present with unexplained fractures have a higher frequency of joint hypermobility, either in themselves or their parents, compared to the general population. The joint hypermobility is often associated with the autosomal dominant hypermobile form of Ehlers Danlos Syndrome (h-EDS) in which the mother is far more likely the affected parent. Most of these infants have metabolic bone disease as their radiographs often show poor bone mineralization. Some have alleged these infants were abused, while others have stated infants who have h-EDS or a parent with h-EDS are at increased risk to fracture …

Comparison Of Unmet Health Care Needs In Children With Intellectual Disability, Autism Spectrum Disorder And Both Disorders Combined, K. Haller, Adrienne Stolfi, John Duby

Medical Education Faculty Publications

Background: The purpose of this study was to assess the unmet health care needs of children with intellectual disability (ID) compared with children with autism spectrum disorder (ASD) and whether access to health insurance coverage is a contributing factor. Children with ID may be masked in the health care system due to increased diagnosis and awareness of ASD. The needs, unmet needs and insurance coverage of children with ID alone, ASD alone, and co-occurring ID and ASD were assessed in this study.

Methods: The 2016 to 2019 United States' Census Bureau National Survey of Children's Health was used to determine …

Vital Signs, Summer 2022, Boonshoft School Of Medicine

Vital Signs

A seventeen page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, alumni profiles, class notes, and more.

Use Of Physiologically-Based Pharmacokinetic Modeling To Inform Dosing Of The Opioid Analgesics Fentanyl And Methadone In Children With Obesity, Jacqueline G. Gerhart, Fernando O. Carreño, Jennifer L. Ford, Andrea N. Edginton, Eliana M. Perrin, Kevin M. Watt, William J. Muller, Andrew M. Atz, Amira Al-Uzri, Paula Delmore, Daniel Gonzalez, Catherine Sherwin

Pediatrics Faculty Publications

Obesity is an increasingly alarming public health threat, with nearly 20% of children classified as obese in the United States today. Children with obesity are commonly prescribed the opioids fentanyl and methadone, and accurate dosing is critical to reducing the risk of serious adverse events associated with overexposure. However, pharmacokinetic studies in children with obesity are challenging to conduct, so there is limited information to guide fentanyl and methadone dosing in these children. To address this clinical knowledge gap, physiologically-based pharmacokinetic models of fentanyl and methadone were developed in adults and scaled to children with and without obesity to explore …

The Impact Of Surgical Delay On Resectability Of Colorectal Cancer: An International Prospective Cohort Study, Covidsurg Collaborative

Department of Surgery Faculty Publications

Aim: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. Methods: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in …

Oral Drug Dosing Following Bariatric Surgery: General Concepts And Specific Dosing Advice, Jurjen S. Kingma, Desirée M. T. Burgers, Valerie M. Monpellier, Marinus J. Wiezer, Heleen J. Blussé Van Oud‐Alblas, Janelle D. Vaughns, Catherine M. T. Sherwin, Catherijne A. J. Knibbe

Pediatrics Faculty Publications

Bariatric or weight-loss surgery is a popular option for weight reduction. Depending on the surgical procedure, gastric changes like decreased transit time and volume and increased pH, decreased absorption surface in the small intestine, decreased exposure to bile acids and enterohepatic circulation, and decreased gastrointestinal transit time may be expected. In the years after bariatric surgery, patients will also substantially lose weight. As a result of these changes, the absorption, distribution, metabolism and/or elimination of drugs may be altered. The purpose of this article is to report the general influence of bariatric surgery on oral drug absorption, and to provide …

A Case Of Blue Toes: Dic As The Initial Presentation Of Metastatic Pancreatic Adenocarcinoma, Bipul Gnyawali, Christina E. Borchers, Sarah Doell, Katherine House

Dermatology Faculty Publications

Disseminated intravascular coagulopathy (DIC) is the widespread deposition of thrombin and fibrin in microvascular circulation. It is a condition in which clots form throughout the body leading to blockage of small blood vessels. The pathologic clotting in DIC is due to the consumption of coagulation factors and platelets. Patients can present with complications of bleeding or vascular thrombi. Most common causes of DIC include sepsis, malignancy, pregnancy complications, major trauma, and surgery.

First Annual Research Symposium Program With Abstracts, Office Of Research Affairs, Boonshoft School Of Medicine

Boonshoft School of Medicine Research Symposium

The program booklet is a compilation of abstracts from oral and poster presentations at Wright State University's First Annual Boonshoft School of Medicine Medical Research Symposium held on April 6, 2022.

Metabolic Bone Disease Of Infancy In The Offspring Of Mothers With Bariatric Surgery: A Series Of 5 Infants In Contested Cases Of Child Abuse, Marvin E. Miller, David Ayoub

Pediatrics Faculty Publications

Background and aims: Metabolic Bone Disease of Infancy is a multifactorial disorder of bone fragility in infants who typically present under 6 months of age with multiple unexplained fractures. Major risk factors for this disorder relate to the fetal time period and include decreased provision of the essential nutrients for bone formation during pregnancy (calcium, phosphate, vitamin D, and protein), prema- turity, and decreased fetal bone loading. Methods: This study presents 5 infants with multiple unexplained fractures born to women who had prior bariatric surgery in which child abuse was alleged, and the alleged perpetrator denied wrong doing. Results: The …

Toward An Ontology Of Collaborative Learning Healthcaresystems, Alexandra H. Vinson, Michael Seid, Breck Gamel, Shehzad Ahmed Saeed, Brandy Fureman, Susan C. Cronin, Katherine Bates, David Hartley

Pediatrics Faculty Publications

Objective:To establish a basis for a domain ontology - a formal, explicit specificationof a shared conceptualization - of collaborative learning healthcare systems (CLHSs)in order to facilitate measurement, explanation, and improvement.Methods:We adapted the“Methontology”approach to begin building an ontologyof CLHSs. We specified the purpose of an ontology, acquired domain knowledge vialiterature review, conceptualized a common framework of CLHSs using a groundedapproach, refined these concepts based on expert panel input, and illustrated con-cept application via four cases.Results:The set of concepts identified as important to include in an ontologyincludes goals, values, structure, actors, environment, and products. To establish thisset of concepts, we gathered input …