Investigative Techniques Commons^™

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 …

Overcoming Thoracic Outlet Syndrome In A Young Athlete: A Case Study, Cormia Lewis, Christina Fry, Mark Knoblauch, Layci Harrison

Clinical Practice in Athletic Training

Introduction: Thoracic Outlet Syndrome (TOS) is a rare and complex condition caused by the compression of neurovascular structures in the thoracic outlet. TOS is estimated to affect 3 to 80 individuals per 1,000,000 annually, with neurogenic TOS accounting for approximately 95% of cases. Athletes who perform repetitive overhead motions are at higher risk due to increased stress on the brachial plexus. Diagnosis can be challenging as symptoms such as pain, numbness, and weakness, often mimic other conditions such as nerve entrapment or tendon pathologies. Treatment for TOS typically begins with a conservative approach, including postural correction and strengthening, activity modification, …

Athletic Trainers’ Motivations For And Satisfaction With Transition To The Physician Practice Setting, Abigail G. Overstreet, Nicolette A. Harris, Cailee E. Welch Bacon

Clinical Practice in Athletic Training

An increasing number of athletic trainers are transitioning from traditional settings, such as secondary schools, colleges, universities, and professional sports, to physician practice. Although research suggests athletic trainers may be changing settings in search of better working conditions, little is known about their motivations for and satisfaction with the setting transition. The objective of this research was to explore athletic trainers’ motivations for and satisfaction with transition to the physician practice setting. A qualitative design was used to collect and interpret data. Eleven certified athletic trainers (6 women, 5 men; age 1⁄4 38.5 6 10.0 years) who transitioned from a …

Improving Entry-Level Athletic Training Student Confidence In Emergency Care: A Pilot Study, Michele Pye, Cade Watts, John Hunt, Kimberly Pritchard

Clinical Practice in Athletic Training

Introduction: Immediate and emergency care is essential to athletic training education and clinical practice. Athletic training students (ATS) may have limited exposure to emergencies during their clinical experiences, which can undermine their confidence. AT educators can improve ATS confidence and clinical reasoning using a simulation-based, learner-centered SNAPPS approach. SNAPPS consists of Summarizing the history and findings, Narrowing and Analyzing the differential diagnoses, Probing peers about uncertainties or confusion, Planning management, and Selecting case-related knowledge gaps for self-directed learning. This empowers students to control the learning environment while adding realism to encounters. The purpose of this pilot study was to determine …

Trust, Culture, And Conversation: How Athletic Training Leaders Navigate High-Stakes Interactions, Nicole A. Wilkins, Ashley B. Thrasher, Ericka P. Zimmerman

Clinical Practice in Athletic Training

Introduction: Engaging in difficult conversations is central to leadership growth and requires sustained effort to refine and strengthen these skills. Leaders not only need to navigate the complexities of their role within an organization, but also the intersectionality of interpersonal dynamics, emotional intelligence, structural hierarchies, and the nuanced environments that influence how communication occurs. Furthermore, leaders must adapt to role expectations that shift across clinical, academic, and administrative contexts, adjusting their approach to engaging in conversations based on these complexities. As part of a larger research project examining difficult conversations, this portion of the study explored how leaders in athletic …

Integrating Wearable Technologies Into Athletic Training: Bridging Innovation And Clinical Practice, Michael Douglas

Clinical Practice in Athletic Training

Athletic training is entering a transformative period driven by the convergence of wearable technologies, artificial intelligence (AI), and advanced biomechanical modeling. Historically, wearable technology in sport was primarily used for performance tracking, including workload monitoring, heart rate assessment, and movement quantification. However, advances in sensor accuracy and data analytics have expanded the clinical relevance of wearable systems, allowing athletic trainers to monitor fatigue markers, movement asymmetry, and neuromuscular control patterns that inform injury risk and rehabilitation progression. Wearable sensor technologies provide objective data that can support clinical decision-making when integrated with traditional evaluation methods.¹Despite these advancements, wearable technologies present persistent …

Performance On The Timed Single-Leg Step-Down Test Is Correlated With Hip And Knee Biomechanics As Measured By 3d Markerless Motion Capture, Ghislain Aminake, Anthony Drazick, Christ Focht, Chloe Roy, Emily Clark, Savannah Knighton, Edward Austin, Jeremy Burnham

Clinical Practice in Athletic Training

Introduction: The timed single-leg step-down (SLSD) test is widely used in clinical and sports settings to assess lower extremity function and injury risk, yet the specific biomechanical determinants of performance on this test remain poorly understood. The purpose of this study is to investigate the relationship between performance on the timed SLSD test and hip and knee biomechanics captured by a markerless 3-D motion-analysis system. Methods: Twenty (20) healthy high school athletes with no recent history of lower extremity injury completed a 60-second timed single leg step down test. The number of quality SLSD repetitions (REPS) constituted their SLSD score. …

Recurrent Lateral Patellar Dislocation After Mpfl Repair With Subsequent Tibial Tubercle Anteromedialization And Concomiant Mpfl Reconstruction, Jacob Hardy, Anthony Thomas Drazick, Joshua Pratt, Jeremy M. Burnham

Clinical Practice in Athletic Training

Introduction: Patellar instability is a common knee pathology, particularly among adolescents and young adults, with reported incidence rates ranging from 7 to 77 per 100,000 person-years. Following an initial patellar dislocation, recurrence rates have been reported as high as 86%, particularly in patients with underlying anatomic risk factors. Identification of the multifactorial contributors to patellar instability is critical to guide appropriate management and prevent recurrent episodes. Common pathoanatomic factors associated with recurrent instability include trochlear dysplasia, patella alta, lateralized tibial tubercle, coronal or torsional malalignment, and abnormal patellar shift. This case report describes a patient who presented with a chronic …

In Vitro Studies Of The Effects Of Antithrombotic Zn-Dipicolylamine-Harboring Liposomes (Dpals) On Serum Albumin And Human Umbilical Vein Endothelial Cells, Michelle Tanujaya, Gianna Cai, Jia Patel, Zana Moldavsky, Yumna Ejaz, Malia Mahazabin Ahmed, Sangsang Duong, Lawrence E. Goldfinger, Koon Y. Pak, Brian D. Gray, Parkson Lee-Gau Chong

Cardeza Foundation for Hematologic Research

Thrombosis remains a leading cause of cardiovascular morbidity and mortality. During thrombosis, activated platelets and endothelial cells expose phosphatidylserine (PS) on their outer membranes, creating a surface that accelerates clot formation. Current antithrombotic therapies, such as heparin and warfarin, carry significant bleeding risks, highlighting the need for safer alternatives. In response, we developed a PS-targeting liposomal formulation composed of Zn-dipicolylamine (DPA)-cyanine-3[22,22] and 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine (molar ratio 3:97). This DPA-harboring liposome (DPAL) binds selectively to PS-rich surfaces such as activated platelets and has demonstrated efficacy in reducing thrombosis in mouse models, with minimal bleeding. In the present study, we examined the interaction …

Exploring The Optimal Age For Total Knee Arthroplasty To Minimize Risk Of Adverse Outcomes: Machine Learning Analysis Of A Statewide Cohort, Chloe Heiting, Yiyuan Wu, Susan M. Goodman, Peter Sculco, Fei Wang, Said A. Ibrahim, Peter Cram, Rich Caruana, Bella Mehta

Department of Medicine Faculty Papers

BACKGROUND: Rates of total knee arthroplasty (TKA) in the United States have risen in patients of a wide age range. Although rates of postoperative TKA complications have decreased, they remain a significant concern. In this study, we aim to determine how the risk of adverse TKA outcomes changes dynamically with age and explore the optimal ages with the lowest risk for adverse outcomes.

METHODS: This retrospective cohort study included patients who underwent elective primary TKA from 2012 to 2018 in the Pennsylvania Health Care Cost Containment Council Database. We trained (70% train:30% test) an explainable boosting machine (EBM), a modern …

Safety And Feasibility Of Same-Admission Transcarotid Arterial Revascularization Prior To Heart Surgery For Patients Presenting With Concurrent, Severe Carotid Artery Stenosis, And Surgical Cardiac Disease, Brittany Landavazo, Matthew D. Kenny, Chandler Vernon, Nicolas Zea, David Nation, Bradley Boone, Jeff Apple, Kofi Quaye, Shir Yelovitch, Ryan S. Turley

HCA Healthcare Journal of Medicine

Introduction

Carotid artery stenosis and coronary artery disease are often co-morbid, with a prevalence of concurrent carotid and coronary artery stenosis approaching 50%. The optimal treatment for these patients has long been debated, with open carotid revascularization generally reserved for those with severe symptomatic carotid disease that precludes cardiac surgery. In this scenario, the role of less-invasive carotid artery stenting, particularly transcarotid arterial revascularization (TCAR), remains controversial and is not yet well studied. This study aims to present our outcomes and methodology for treating severe carotid stenosis with TCAR prior to cardiac surgery.

Methods

A retrospective chart review of the …

Elixhauser Comorbidity Index To Predict Perioperative Bleeding And Adverse Spine Surgery Outcomes, Mitchell K. Ng, Michael A. Mont, Mosadoluwa Afolabi, Prathiksha N V, Amitha Kumar, Stephen S. Johnston

Rothman Institute Papers

Introduction: As spine surgery volume continues to grow, ensuring patient safety and minimizing complications are increasingly critical. Disruptive bleeding—defined as hemorrhagic events requiring clinical intervention—is a significant perioperative challenge. This study aimed to: (1) quantify disruptive bleeding incidence; (2) evaluate associations between patient demographics, Elixhauser Comorbidity Index (ECI), and bleeding risk; and (3) assess the impact of disruptive bleeding on mortality, ventilator use, length of inpatient stay, 90-day readmissions, and inpatient costs. Methods: A nationwide healthcare database was used to identify patients who underwent spine surgery in 2019. Patients were subdivided by the Elixhauser Comorbidity Index (ECI) from 0 to …

The A1 Segment Of The Anterior Cerebral Artery: A Systematic Review Of Cadaveric Morphometry Studies, Marlena Muszynska, Emily Awdish, Afua Osei-Wusu, Parker Ballard

Annual Research Symposium

No abstract provided.

The P1 Segment Of The Posterior Cerebral Artery: A Systematic Review Of Cadaveric Morphometry Studies, Marlena Muszynska, Afua Osei-Wusu, Emily Awdish, Parker Ballard

Annual Research Symposium

No abstract provided.

Review Of Methodological Practices In Cadaveric Cerebral Arterial Morphometry: Variability In Contemporary Protocols (2015-2025), Marlena Muszynska, Emily Awdish, Afua Osei-Wusu, Parker Ballard

Annual Research Symposium

No abstract provided.

Safety Of Carotid Endarterectomy In The Elderly And Octogenarian Population: A Nationwide Study Including 80,000 Patients, Victor Gabriel El-Hajj, Joanna Roy, Basel Musmar, Wi Jin Kim, Michael Rizzuto, Nathaniel Ellens, Rabab Alshahrani, Victor Staartjes, Adrian Elmi-Terander, Ramachandra Tummala, Stavropoula Tjoumakaris, Michael Gooch, Robert Rosenwasswer, Ziad Khabbaz, Pascal Jabbour

Department of Neurosurgery Faculty Papers

INTRODUCTION: Carotid endarterectomy (CEA) is an established procedure for stroke prevention in patients with carotid artery stenosis. While CEA is considered safe in younger patients, perioperative risks in octogenarians remain debated, with current guidelines classifying the procedure as "high-risk" in this patient population. This study aimed to evaluate short-term outcomes of CEA across age groups and to assess whether comorbidity burden better predicts outcomes than chronological age.

METHODS: The ACS-NSQIP database (2013-2020), was used to identify patients eligible for inclusion. The cohort was stratified based on age <  60, 60-80, and > 80 years. Propensity score matching and multivariable logistic regression were used to compare …

Reliability Of Existing Measures And Classification Systems For Trochlear Dysplasia, Sean R. Waldron, Nihar S. Shah, Matthew W. Veerkamp, Brendan A. Williams, John A. Schlechter, Lauren H. Redler, Matthew D. Ellington, Shital N. Parikh

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Patellofemoral instability (PFI) is common in adolescent patients and can lead to a reduction in quality of life and function, as well as long-term arthritis. Treatment of PFI involves assessing and, at times, surgically correcting underlying anatomic abnormalities. Trochlear dysplasia is the most common anatomic risk factor present in PFI.

PURPOSE: To determine the interrater reliability of existing measures and classification systems for the assessment of trochlear dysplasia.

STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 3.

METHODS: As part of the PRISM (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) patellar instability Research Interest Group (RIG) project, a …

Epidemiology Of Healthcare-Associated Ventriculitis And Meningitis (Hcavm) And Community-Acquired Meningitis/Encephalitis And Evaluation Of An Off-Label Pcr Panel For Hcavm Diagnosis, Jaime Nassur, Katarina Schnell, Christine Dolon, Laura Walters, Devin Weber, Matthew Pettengill

Department of Medicine Faculty Papers

Healthcare-associated ventriculitis and meningitis (HCAVM) is associated with high morbidity and mortality, but rapid diagnostic tests intended to cover microorganisms that typically cause HCAVM are not commercially available. We sought to evaluate the etiology of HCAVM compared to community-acquired meningitis/encephalitis (CAME) at our healthcare system, and to study the utility of repurposing a multiplex molecular panel intended for positive blood cultures for HCAVM cases. Our epidemiologic review demonstrated that HCAVM cases were primarily caused by bacteria and fungi also associated with bloodstream infections, in contrast with CAME cases, which were primarily caused by herpesviruses and Cryptococcus. Eighty-two cerebrospinal fluid …

Controlled Antibiotic Release From Emulsion-Loaded Alginate And Fibrin Hydrogels Using Ultrasound, Ziba Ghareh Nazi Fam, Asia Winslow, Mario Fabiilli, Sam Varghese, Brian Oeffinger, Flemming Forsberg, Noreen Hickok, Lauren Delaney

Department of Radiology Faculty Papers

Postoperative infections remain a major complication after spinal fusion surgery, often caused by biofilm-forming bacteria that resist short-term antibiotic prophylaxis. Vancomycin (VAN) is sometimes delivered locally during surgery; however, levels diminish rapidly, leaving patients vulnerable to late-onset infections. We developed a composite hydrogel integrating perfluorohexane-based emulsions within alginate or fibrin matrices to enable both sustained and ultrasound-triggered VAN release. Water-in-oil-in-water emulsions were prepared using fluorosurfactant-stabilized perfluorohexane as the volatile oil phase, then embedded in hydrogels and exposed to ultrasound (2.5 MHz, 5.5 MPa peak negative pressure) to initiate acoustic droplet vaporization for triggered release. Drug release was quantified spectrophotometrically and …