Diagnosis Commons^™

Prescribed Aerobic Exercise And Sport-Related Concussion Recovery: A Validation Case Series, Lacy L. Chapel, Tamara C. Valovich Mcleod

Clinical Practice in Athletic Training

Active rehabilitation, including prescribed sub-symptom threshold aerobic exercise implemented during the acute phase of recovery after sport-related concussion, has been shown to facilitate recovery and reduce the risk of persisting postconcussion symptoms. The purpose of this validation case series was to evaluate currently available external evidence regarding the effects of prescribed aerobic exercise interventions on recovery after sport-related concussion. For this study, the patient population included college athletes diagnosed with a sport-related concussion who participated in at least 5 days per week of supervised, prescribed aerobic exercise, based on graded aerobic exercise testing and heart rate threshold. Our study findings …

Quality Of Athletic Training Services For Lower Extremity Injuries, Katie Sniffen, Michael Rozier, Katherine Stamatakis, Paula Buchanan, Janet E. Simon, Leslie Hinyard

Clinical Practice in Athletic Training

The use of patient-reported outcomes in athletic training is inconsistent, limiting the ability to communicate service quality and value to key stakeholders. The objective of this study is to calculate meaningful quality outcome measures for athletic training services for lower extremity injuries in high school student-athletes. Data were collected from a subset of the National Athletic Treatment, Injury and Outcomes Network Surveillance Program and a convenience sample of high school student-athletes with patient-reported outcome measures for lower extremity time-loss injuries. Failure-toprogress proportions (FTPPs) were calculated using the Knee Injury and Osteoarthritis Outcome Score (KOOS) for knee/thigh injuries and the Foot …

Comfort Level Of Collegiate Student-Athletes In Opposite And Same-Gender Patient/Provider Relationships In Athletic Training, Samantha Dickie, Yashu Tang, Sydney Nelson, Emily Madrak

Clinical Practice in Athletic Training

Gender-based comfort in patient-provider relationships is a vital aspect of athletic training care. As the profession continues to evolve—particularly with a growing number of women athletic trainers (ATs) and progression of athletic training curriculum—it is essential to understand how gender dynamics influence the comfort of collegiate athletes when receiving care. This cross-sectional survey study examined how athlete comfort varies when treated by same- versus opposite-gender ATs in general patient care and in pathology-based scenarios. Ninety-six collegiate student-athletes (62.5% female) with the mean age of 20.26 (SD 1.7) years from NCAA and NAIA institutions completed the Gender Comfort with Athletic Trainer …

Acute Management Of A Hamate Fracture In A Collegiate Baseball Player: A Disablement Model Case Study, Kayleigh A. De Koker, Cory E. Barton, Lindsey E. Eberman

Clinical Practice in Athletic Training

The purpose of this disablement model case study was to outline a collegiate baseball player with an isolated hamate fracture including the injury evaluation, diagnosis, and acute management. During a tournament game, the collegiate career of the patient ended abruptly following an injury sustained while at bat. The patient attempted to bat again but encountered significant difficulty due to the increasing pain in his hand. Consequently, the athletic trainer was called out for an on-field examination. The patient presented with no edema or ecchymosis but severe pain in the hypothenar eminence. This patient also presented with decreased grip strength with …

Suture Augmentation With Ucl Repairs In Baseball Pitchers As An Alternate To Reconstructions: An Evidence-To-Practice Review, Kayleigh A. De Koker, Kenneth E. Games

Clinical Practice in Athletic Training

An injury to the ulnar collateral ligament (UCL) is sustained through repetitive valgus motions, increasing in prevalence across all levels of baseball due to the increasing workload demands placed on the medial elbow in pitching. Traditionally, UCL tears have been managed through reconstructions followed by a lengthy rehabilitation process. In recent years, the UCL repair with suture augmentation has gained favor given the enhanced patient and clinician outcomes in return-to-play timelines, decreased medial gapping, improved Kerlan Jobe Orthopedic Clinic (KJOC) scores, and long-term functionality. Utilizing 4 databases (MEDLINE, Embase Cochrane library, Science Direct, and Scopus), literature was obtained addressing the …

Artificial Intelligence-Enhanced Cardiac Point-Of-Care Ultrasound: A Prospective Single-Arm Study, Lior Fisher, Michael Fiman, Yuval Yarkoni, Ella Segal, Boris Fishman, Kobi Faierstein, Noa Rubin, Adiel Am-Shalom, Howard Amital, Qiong Zhao, Smadar Kort, Praveen Mehrotra, Ehud Schwammenthal, Robert Klempfner, Eyal Zimlichman, Ehud Raanani, Elad Maor

Division of Cardiology Faculty Papers

OBJECTIVE: To evaluate the clinical utility of combining artificial intelligence (AI) with handheld focused cardiac ultrasound (FoCUS) performed by noncardiologist physicians in clinical care settings.

PATIENTS AND METHODS: In this prospective, single-arm study conducted from July 1, 2022, through December 31, 2023 (ClinicalTrials.gov NCT05455541), 660 adult patients presenting to the emergency department or internal medicine wards were assessed with handheld ultrasound devices enhanced by AI algorithms. These algorithms provided automated analysis of ventricular function, valvular disease, pericardial effusion, and inferior vena cava size. Participating physicians received focused training and performed examinations either in response to clinical suspicion or as part …

Automated Abdominal Aortic Calcification And Trabecular Bone Score Independently Predict Incident Fracture During Routine Osteoporosis Screening, Abadi K. Gebre, Marc Sim, Syed Zulqarnain Gilani, Afsah Saleem, Cassandra Smith, Didier Hans, Siobhan Reid, Barret A. Monchka, Douglas Kimelman, Mohammad Jafari Jozani, John T. Schousboe, Joshua R. Lewis, William D. Leslie, Joshua R. Lewis

Research outputs 2022 to 2026

Abdominal aortic calcification (AAC), a marker of subclinical cardiovascular disease, has previously shown to be associated with low BMD and fracture. However, it remains unclear whether AAC is associated with trabecular bone score (TBS), a gray-level textural measure, or whether it predicts fracture risk independent of this measure. Here, we examined the cross-sectional association of AAC scored using a validated machine learning algorithm (ML-AAC24) with TBS, and their simultaneous associations with incident fractures in 7691 individuals (93.4% women) through the Manitoba BMD Registry (mean age 75.3 yr). The association between ML-AAC24 and TBS was tested using generalized linear regression. Cox …

Assessment Of Early Breast Cancer Response To Chemotherapy With Ultrasound Radiomics, Swapnil Dolui, Basak Dogan, Corinne Wessner, Jessica Porembka, Priscilla Machado, Bersu Ozcan, Nisha Unni, Maysa Abu-Khalaf, Flemming Forsberg, Kibo Nam, Kenneth Hoyt

Department of Medical Oncology Faculty Papers

Objective: This prospective study investigated the use of H-scan ultrasound (US) imaging as a novel component of a multiparametric radiomic analysis framework for characterizing human breast cancer response to neoadjuvant chemotherapy (NAC) before and early after treatment initiation. Methods: Thirty breast cancer patients scheduled for NAC were scanned using a clinical US system (Logiq E9, GE HealthCare) equipped with a 9L-D linear array transducer. Radiofrequency (RF) data was obtained at baseline (pre-NAC) and after 10% and 30% of the complete dose of chemotherapy. The RF data was analyzed by a bank of 256 frequency-shifted bandpass filters to form H-scan US …

Defining A Multi-Omic, Ai-Enabled Stool Screening Paradigm For Colorectal Cancer: A Consensus Framework For Clinical Translation, Arturo Loaiza-Bonilla, Yan Leyfman, Viviana Cortiana, Rhys Crawford, Shivani Modi

Einstein Health Papers

Colorectal cancer (CRC) develops through both conventional adenoma-carcinoma and serrated neoplasia pathways, yet noninvasive screening still under-detects the advanced precursor lesions that enable true cancer prevention. Stool-based screening reduces CRC mortality, but its preventive impact remains constrained by limited detection of advanced precancerous lesions (APLs), including advanced adenomas and sessile serrated lesions. Next-generation multitarget stool DNA assays (mt-sDNA; e.g., Cologuard Plus) have established high sensitivity for CRC and specificity approaching 94%, leaving improved APL detection as the principal opportunity for innovation. This review presents a consensus framework for a multi-omic stool screening paradigm that integrates host epigenetic markers (DNA methylation) …

Endometriosis Knowledge Among Emergency Medicine Providers: Diagnostic Skills And Symptom Recognition, Caidon Iwuagwu, Laurel X. Chen, Ellen Slattery, Pranjal Srivastava, Hamsitha Karra, Sheyenne Tung, Adrienne Burton, Camila Bomtempo, Jamie Aranda

Department of Surgery Faculty Papers

Objective: Endometriosis is associated with significant diagnostic delays, averaging 6.7 years, largely due to nonspecific symptoms and inadequate diagnostic approaches. Over 15,000 emergency department (ED) visits in the United States annually involve patients with endometriosis, highlighting the need for knowledge of endometriosis. This study surveys emergency medicine (EM) attendings, residents, nurse practitioners, physician assistants, and fellows to assess knowledge and practice in managing endometriosis-related ED complaints. Methods: A questionnaire from a prior endometriosis survey was modified for EM providers and administered anonymously via email (Qualtrics, Provo, UT) in monthly newsletters to providers at an academic and six associated community EDs. …

Differences Between Sexual Orientations Regarding Perceived Knowledge Of And Attitudes Toward Lgbtia+ Persons Among Athletic Trainers, Julianne Goza, S. Andrew Cage, Meredith Decker, Brandon J. Warner

Clinical Practice in Athletic Training

Context: LGBTQIA+ athletic trainers and patients encounter difficulties in their workplaces and sport communities. Several medical professional associations have produced statements claiming their commitment to fostering an patient-centered environment for healthcare for LGBTQIA+ patients. To date, there has been little research on the factors that impact perceived knowledge of and attitudes toward the LGBTQIA+ community among healthcare providers. With more information on what factors impact perceived knowledge of and attitudes toward the LGBTQIA+ community, better interventions for improving perceived knowledge and attitudes toward the LGBTQIA+ community could be created. The purpose of this study was to determine differences between sexual …

Differences Between Genders Related To Perceived Knowledge Of And Attitudes Toward Lgbtia+ Persons Among Athletic Trainers, Brandon J. Warner, Julianne Goza, Meredith Decker, S. Andrew Cage

Clinical Practice in Athletic Training

Context: Previous literature reports that healthcare providers and student-athletes identifying as LGBTQIA+ encounter difficulties in their respective communities. A number medical professional associations have published statements affirming their commitment to providing access to patient-centered healthcare for LGBTQIA+ patients. Unfortunately, there is a lack of research related to the factors that influence perceived knowledge of and attitudes toward the LGBTQIA+ community among healthcare providers. More information on what factors impact perceived knowledge of and attitudes toward the LGBTQIA+ community would assist with creating interventions that improve perceived knowledge and attitudes toward the LGBTQIA+ community. The purpose of this study was to …

Awareness Of Native American Living Conditions Among Athletic Trainers, Laurel Trail, Brandon Warner, Rebecca Peebles, Robert French, Lynzi Warner, S. Andrew Cage

Clinical Practice in Athletic Training

Context: Native Americans and First Nations People have dealt with healthcare disparities that have been documented in previous studies. One factor that appears to have played a role in these disparities was the Indian Removal Act of 1851 which established the first Native American reservations. The foundation of these reservations led to many Native Americans being displaced from areas where the United States was establishing new population centers. This has led many individuals not understanding the conditions that Native Americans live in. Lack of knowledge of the conditions patients live in may negatively affect clinicians’ ability to provide optimal healthcare. …

Sleep And Stress Experienced By Collegiate Baseball Players During A Fall Season, Andrew R. Gallucci, Katie M. Lee, Eric Rash, Jeremy A. Bigalke, Jason R. Carter

Clinical Practice in Athletic Training

Introduction: College students are notoriously poor sleepers due to academic and social demands. Collegiate athletes have additional athletic responsibilities that can also affect sleep. During a season, baseball players experience prolonged bouts of high intensity activity that increase the need for recovery and sleep. Athletes can also experience higher perceived stress levels, a factor also known to impact sleep. Reduced sleep quality and quantity during a competitive season can impede recovery and decrease performance. The present study sought to determine the relationships between sleep [Total Sleep Time (TST), Sleep Efficiency (SE), Sleep Onset Latency (SOL), Awakenings] and stress over a …

Impressions And Gastrointestinal Tolerance Of An Electrolyte Hydration Beverage Among Individuals Participating In Collegiate Baseball, S. Andrew Cage, Alexander Jacobsen, Brandon Warner, Jessie Gibson, Derek Lege, Robert French

Clinical Practice in Athletic Training

Context: Performing physical activity in numerous environmental conditions often results in mild to moderate dehydration. Dehydration can be problematic for the physically active population, as it can lead to decreases in physical and cognitive performance. This places emphasis on making sure individuals are properly hydrated during exercise. One of the barriers to appropriate hydration behaviors that has been identified in physically active individuals is a dislike of available hydration options. This highlights the need for sports medicine professionals to provide physically active individuals with appealing hydration options. Currently there is a lack of research exploring the flavor appeal of hydration …

Extensor Hallucis Longus Focal Dystonia In A Patient With Parkinson’S Disease: A Case Study, Jessika Truax, Linda Bobo, Keilea Sumrall

Clinical Practice in Athletic Training

Introduction: Parkinson’s Disease (PD) is a common neurodegenerative disorder that affects a person’s ability to produce dopamine and control motion of the body. PD affects 1% of people over the age of 65, but the disease can occur earlier and later in life. The uncontrollable movement of any body part involved with PD is referred to as a tremor. Pathophysiology of PD causes the thalamus to have a decreased activation of the frontal cortex, thus decreased motor activity. Patients commonly have dystonia mostly in the foot resulting in striatal toe. Optional pain relief is a tenotomy of the extensor hallicus …

Sacroiliac Dysfunction In A Middle-Aged Female Runner: A Case Study, Blair Bradshaw

Clinical Practice in Athletic Training

Introduction: Research has indicated an increased prevalence of low back pain (LBP) due to SIJ dysfunction, with some reports suggesting it is the main source of pain in 15- 30% of cases. Women are more prone to incidence of SIJ pain due to a wider, more uneven, less curved, and posteriorly rotated sacrum. Additionally, women have increased mobility at the SIJ which increases stress and shear loading. Repetitive loading such as running can further contribute to SIJ dysfunction. Research suggests that female runners with SIJ pain had common biomechanical patterns putting them at more risk for injury including decreased knee …

Breaking Barriers: Disparities Among Minority Collegiate Athletes In Concussion Reporting, Josette Villanueva, Melissa Long

Clinical Practice in Athletic Training

Introduction: Concussions are a serious concern in sports medicine because of their potential long-term effects on cognitive and neurological health. However, many athletes, especially those from minority groups, hesitate to report symptoms due to fears of being sidelined, pressure to keep playing, and challenges like limited access to education, language barriers, and distrust in healthcare systems. The objective of this study was to investigate the barriers to concussion reporting among Division I collegiate athletes, with a particular focus on demographic differences, particularly racial and ethnic disparities. The goal was to identify key factors that hinder self-reporting and to propose strategies …

Hyoid Bone Fracture In A Division 1 Football Player: A Conservative Management Case Study, Kynnedy Louis, Andrew Crane, Mark Knoblauch, Layci Harrison

Clinical Practice in Athletic Training

Introduction: The hyoid bone plays an important role in speaking, swallowing, and supporting the tongue. Hyoid bone fractures account for 0.002% of all fractures and are typically seen in cases dealing with strangulations or a blunt force trauma such as occurs from vehicle accidents or martial arts injuries. Signs and symptoms of hyoid fractures can include dyspnea, pharyngeal tear, or subcutaneous emphysema, and if not recognized early can significantly damage the airway. Patient Information: A 23-year-old male collegiate football player sustained blunt trauma to the anterior part of his neck due to a tackle forcing the helmet chin strap against …

Ulnar Collateral Ligament Reconstruction Compared To Common Flexor Tendon Repair With Ulnar Collateral Ligament Reconstruction: A Case Series, Amanda Dubois, Melissa Long

Clinical Practice in Athletic Training

Introduction: The ulnar collateral ligament (UCL) is found in the medial aspect of the elbow joint capsule and is commonly injured in baseball pitchers. The common flexor tendon (CFT) is also found in the medial elbow and is less commonly injured. Both structures are key in overhead throwing, repaired via surgery, and injured due to valgus stress placed on the elbow. There is research on UCL injuries but very little on CFT injuries. There is not substantial research on the return to play protocol or rehabilitation process for either of these two structures after surgery. Patient Information: The patients for …