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Anatomical study of the anterolateral ligament of the knee: prevalence in embalmed cadavers
No full textAbstract
The anterolateral ligament (ALL) of the knee was first referenced by a French surgeon in 1879 but was not referenced in anatomical literature until 2013. Studies on it have increased significantly the last 2 years. The ALL is a deep ligament on the lateral aspect of the knee. There is some discrepancy about its origin. Most agree that it is anteromedial to or under the origin of the lateral collateral ligament (LCL) sharing fibers on the lateral femoral epicondyle. The ligament courses obliquely in an anteromedial direction fanning anterolaterally distally. It has been described as attaching on the tibia between Gerdy’s tubercle and the LCL insertion on the fibula. Along its course, the ALL has an attachment to the lateral meniscus which makes it a possibly significant structure in orthopedics. Also relevant for orthopedic surgery is the growing evidence that the ALL has a significant role as a secondary stabilizer to the anterior cruciate ligament. Since its discovery, there have been various studies that have explored the prevalence of the ALL in the general population. Cadaveric studies done in Japan, India and Belgium have found the percent prevalence of the ALL in their cadaveric studies to be over 90%. Shetty et. Al. from India described four different shape variations including cord, band, mixed and Y-shaped types. This study looked specifically for the cord type in 70 preserved knees. A distinct ALL in 37 knees for a prevalence of 52.86%, compared to 69.04% in the study from Shetty et al
Second screw optimal compression of the posterior facet with subtalar joint arthrodesis: A comparison of two different screw placements
No full textAbstract
Introduction: Subtalar joint ( arthrodesis has historically been a common method of treating a variety of foot and ankle pathologies. Previous research describes varying surgical methods, as well conflicting evidence on success rates for STJ arthrodesis. One of the potential limitations of STJ arthrodesis is the small joint size for the arthrodesis and the unique joint anatomy. The purpose of this study is to provide a consensus on the optimal screw placement for the second screw that is extra articular that will allow optimal compression across the posterior facet.
Methods: 5 frozen cadavers were utilized for this study. Ultra low contact film was carefully placed and secured within only the posterior facet of the joint. Two screw positions were utilized: ( Posterior inferior aspect of the calcaneus to the talar neck and ( plantar aspect of the calcaneus to the dorsal talus just anterior to the posterior facet. 6.5mm compression screws were used separately for each location. The film was then analyzed using a Fujifilm Pressure Mapping System © while varying the location of the second screw.
Results: In all 5 cadavers, the plantar inferior to the talar neck screw provided more compression across the posterior facet of the subtalar joint compared to the plantar to dorsal screw.
Conclusion: This cadaveric study shows that the compression pressure and area of the posterior facet greater when the second screw runs from posterior inferior calcaneus to the dorsal distal talar neck compared to the plantar to dorsal screw configuration
Group 3 - Biomedical Posters, 21-26 - Movement Science Posters, 27-30
No full textThe third group of the presentation breakout consists of Biomedical posters 21-26 and Movement Science Posters 27-30
Non-Hispanic Black women face staggering hypertension rates and ineffective treatment Outcomes
No full textAbstract
Nearly half of the adult population has hypertension, with the incidence increasing as people age. Hypertension is a major risk factor for cardiovascular disease and uncontrolled high blood pressure can lead to stroke, myocardial infarction, heart failure, end-organ damage, and early death. Hypertension costs the United States billions of dollars every year in hospital fees. On average, men develop high blood pressure at earlier ages, however, hypertension poses a greater burden for women than men. Non-Hispanic Black (NHB) women are particularly susceptible to developing hypertension and have a higher prevalence than black men at any age over 20. Various factors contribute to the current trend that is seen for NHB people in the United States including the pathophysiology of hypertension in those of African ancestry, lack of education, increased weight, discrimination, and management of hypertension. These factors, however, do not fully explain why NHB women have higher rates of hypertension than NHB men, especially when the opposite trend is often seen with women of other races. Some studies suggest stress and stigma as important factors in the development of high blood pressure for NHB women. Still, many gaps in knowledge persist. This review aims to address some of those gaps, such as if there is a gene that makes NHB women particularly susceptible to salt intake and if this pattern of hypertension is seen with NHB women in other parts of the world, and if not, what factors may be contributing to these differences in blood pressure
“Even I can do AI!” Some examples of machine learning in aiding medical education and clinical practice.
No full textAbstract
Artificial intelligence (AI) is rapidly becoming an integral part of our modern lives. From a clinical and biomedical perspective, AI promises much for accelerating our diagnostic and prediction abilities as well as better serving the healthcare needs of our communities. However, the speed at which these modalities continue to develop and the ongoing challenge of bridging the divide between the highly technical language of neural networks and its application by non-expert users, has proved a formidable obstacle. In the following study, we present examples of exploratory uses of AI technology by DMU faculty, staff and students and highlight resources as well the application of these technologies to members of the healthcare and medical education community
Addressing the gap: didactics on health care disparities by medical students in their Internal Medicine core rotation
No full textAbstract
The American Association of Colleges of Osteopathic Medicine (AACOM) Foundational Core Competencies for Undergraduate Medical Students, published in 2012, emphasizes the need to identify sources of disparities in population’s health and access to care as part of the Practice-Based Learning and Improvement competency. Third-year medical school course structure does not have formal academic activities dedicated to the instruction of population health disparities. The 3rd year medical school Internal Medicine core rotation is a 4-week duration course, with multiple clinical sites located in a diverse geographic area throughout the country. Didactic meetings for all students are conducted once a week using a virtual platform. Students are required to
do a brief 5-minute slide presentation on a preselected Internal Medicine topic. To provide a baseline background on population health disparities to the whole group, the topic review assignment included a search of the literature on related health care disparities and presentation of the findings to their peers. Threading spaces to discuss population health disparities into the core clerkship rotations didactics could be a strategy to increase the much-needed awareness, contribute to the fulfillment of the AACOM competency requirements and motivate the future generations to actively engage in narrowing the gaps in health care outcomes
The gut microbiome and its role in influencing running behavior in male rats
No full textAbstract
Exercise has well-established physiological benefits, and a lack thereof often gives rise to health conditions. Exercise encompasses a spectrum of activities and varies on an individual level. Prior studies have established connections between our gut microbiome (GMB) and disease pathogenesis and behaviors. We explored the relationship between voluntary wheel running in male rats and GMB composition.
Each rat was randomly assigned into a running (n=8) and sedentary group (n=3). Initially, all rats had no access to a running wheel for one week, after which the running group had full access to the wheel for four weeks. Differences in running distance stratified the running group into high (n=3) and low (n=5) runners. We ran alpha/beta diversities with QIIME2 and analyzed the relationship between bacterial abundance and rungroup/time using generalized least square models.
Ruminococcaceae abundance increased (R2: 0.65, p \u3c 0.001), while Peptostreptococcae decreased with running distance (R2: -0.47, p: 0.006) in high runners only. Peptostreptococcaceae decreased with time (R2: -0.42, p: 0.012) with high runners, while a significant, yet weaker, relationship was observed in low runners (R2: -0.03, p: 0.0421). Ruminococcaceae ferments starch into short-chain fatty acids, which helps maintain gut barrier integrity. These findings demonstrate a relationship between GMB composition and behaviors such as running. Further investigation will help us understand what influences exercise variability among individuals
THC supplementation results in weight loss and sex-dependent gut microbiota changes
No full textAbstract
Introduction: Obesity and high-fat diets induce consistent alterations in gut microbiota composition, corroborating the relationship between microbiome with host physiology.1 Observations from epidemiological reviews and experiments also illustrate weight regulation effects of delta(9)-tetrahydrocannabinol (THC) with microbiome shifts.2,3 We aimed to examine associations connecting gut microbiome changes with THC-induced weight loss.
Methods: High-fat diet induced obese mice were treated with oral THC supplementation while maintaining diet. In addition to measuring weight, fecal samples were obtained at various timepoints, sequenced for bacterial 16s rRNA content and analyzed using QIIME2. Alpha and beta diversity were analyzed along with linear mixed effects (LME) models of bacterial relative abundance relationship to THC treatment and weight change.
Results: In both male and female mice, the THC group had significantly greater average weight loss than controls (-17.8% vs. -0.22%, p=0.00002 and -13.8% vs. +2.9%, p=0.00006 respectively). Male rats had 8 bacterial taxonomic features that were both significantly different in change of relative abundance between THC and controls and correlated with weight change. An LME model of three features explained 76% of the variance in weight change and accurately predicted weight change in a completely different male rat cohort (R=0.64, R^2=0.41, p=0.000001). Female mice had fewer significant predictive features and were difficult to model, but the 3-feature model still accurately predicted weight change (R=0.66, R^2=0.44, p=7e-9).
Conclusions: Our results indicate that gut microbiome composition changes play some role in THC-induced weight loss. Additionally, we proved the concept of a microbiome-based approach to predict weight loss utilizing statistical modeling
A rare presentation of Charcot neuroarthropathy: ipsilateral recurrence in the presence of end-stage renal disease
No full textAbstract
Charcot neuroarthropathy (CN) is a rare, catastrophic joint complication that is most often seen in patients with peripheral neuropathy secondary to diabetes mellitus (DM). It is generally accepted that CN rarely recurs in the ipsilateral limb, and very few cases of multiple CN events occurring on the same limb have been reported in literature. This case study aims to illustrate a rare presentation and progression of a patient with CN currently undergoing offloading treatment. Due to the patient’s presentation of extreme pain, an HbA1c within goal limits, and history of uricemia secondary to renal dysfunction, we believe our patient’s CN is secondary to impaired uric acid clearance in the setting of end-stage renal disease (ESRD). To our knowledge, this case is the only description of an ipsilateral CN incident secondary to uremic neuropathy. In addition, it appears that this is the only reported incidence of tertiary ipsilateral CN. A literature search indicates that about 30% of patients with CN also present with ESRD. Therefore, early consultation with podiatric care is essential in renally-impaired patient populations to prevent amputations and morbidity associated with foot complications, such as CN
Challenges in Project Development for Adolescent Sports-Related Concussion Baseline Testing
No full textAbstract
Background: There are a variety of tests available to determine the severity of sports-related concussions (SRC). The primary project aim was to determine a battery of baseline concussion assessments for youth athletes, which could be used by clinicians in diagnosing SRC. Through project development, certain challenges were encountered, delaying the process. The secondary aim was to evaluate an engaging neuro-cognitive tool (BlazePodsTM) to enhance athlete motivation during testing.
Methods: A literature review was completed to evaluate the psychometrics of available concussion and neuro-cognitive tests. Medline and CINAHL were searched using the terms: “concussion”, “neurocognitive”, “diagnosis”, “sports”, and “athletes”. Delimiters included 2000-2022 and the English language. Protocol development included pilot testing concussion assessments with college-aged individuals and high school athletes in clinical settings.
Outcomes: Literature identified a battery of tests assessing oculomotor, cognitive ability, response time, and symptoms in participants to determine if further assessment would be necessary. The delays in project progression were due to the timeline in the IRB approval process, scheduling conflict with education delivery for parental consent and participant assent, and the perception of combining research and athletic training services.
Future Work: Additional work will include investigating the feasibility of determining the reliability and validity of available tests for baseline concussion testing using a retrospective methodology. Ongoing efforts continue to mitigate challenges associated with testing adolescents