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Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/29936

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Movement Patterns in Dancers: Analysis of Pelvis and Hip Movement in Elite Ballerinas
(2020) Patterson, Rita; Surve, Sajid; Hershberger, Nathan; Balyakina, Elizabeth; Thomas, Andrew; Mirochnitchenko, Alissa
Purpose: Ballet dancers place extreme demands on their bodies throughout their careers. To reduce injury risk and prolong a ballet dancer's career, attention must be paid to correct positioning and joint biomechanics. The specific aim of the Movement Patters in Dancers study was to observe changes in posture and movement throughout the ballet performance season. Methods: The study sample consisted of five male and five female professional ballet dancers. Using motion capture technology, each dancer was filmed completing barre exercises at three different times during the performance season. Movement of the pelvis was analyzed in three planes of motion: medial/lateral, flexion/extension, and torsion about a longitudinal axis. Additionally, the hip angle, defined as the angle between the femurs, was calculated. Results: Dancers demonstrated consistency in pelvis movement in all planes throughout the performance season. The degrees of motion observed in each plane varied with the direction in which the movement was performed (side, front, and back). No significant changes were observed between visits. Hip angle varied between the left and right side in both male and female dancers, with female dancers demonstrating larger differences between legs. Conclusions: The pelvic stability demonstrated in this study was reflective of dancers' level of proficiency and training. The difference in hip angle between the left and right legs could be explained by dancers having a dominant leg. Further analyses of the collected data can contribute towards creating a model to assess dancers at different levels of training and assist dancers recovering from injury.
Human Trafficking Awareness Among First Year Medical Students
(2020) Smith, Michael; Taskov, Viktoria
Purpose: Human Trafficking is an exceedingly prevalent problem in today's society. Unfortunately, this issue is also not well publicized or commonly known among the general population. Studies have estimated that anywhere between 50-80% of human trafficking victims will seek medical attention while being trafficked. This provides an important opportunity for the medical community to play a critical role in identifying potential victims and interrupting the cycle of trafficking. An initial step to empower the medical community is to increase awareness and education of future health practitioners. Thus, this study aims to assess the pre-existing knowledge that future medical professionals have on the topic. Methods: A survey was administered to XX first-year medical students that focused on individual's knowledge of the scope of the trafficking problem. Results: The data indicate three areas of significant knowledge deficits about trafficking including a lack of 1) confidence in identifying a victim of human trafficking, 2) knowledge of the correct avenues to help these people when identified, and 3) awareness of the likelihood that they will encounter one of these patients in their future practice. Conclusion: Continuation of this and/or similar surveys will enhance the awareness of the problem among future physicians, and help to identify areas of need for education of future physicians.
Is it Working?: A literature review of School Violence Interventions in Texas
(2020) Johnson, Ahrein
Youth violence has been a Public Health concern for decades, but in recent years, youth violence in schools has taken the forefront and captured the attention of the media, parents, and policy makers. Most violent crimes committed by youth ages 12-18 occur at school. Moreover, in 2015, 90% of high schools experienced some form of violence, compared to 57% of primary schools and 88% of middle schools (National Center for Education Statistics, 2019). School violence is a local concern. According to the 2017 Youth Risk Behavior Surveillance, Texas high schoolers experience higher averages of school violence compared to the national average. Due to these higher rates of violent crimes in Texas high schools, nearly 1 in 12, or 8%, of Texas high schoolers did not attend school at least one day within the last 30 days of taking the survey because they felt as if it was unsafe (Centers for Disease Control and Prevention [CDC] Youth Risk Behavior Surveillance, 2017). A literature review was conducted to determine current policies and interventions that are in place to reduce school violence in Texas high schools. The review revealed that Texas primarily utilizes ineffective and controversial responsive interventions rather than utilizing more effective proactive policies to reduce violence. Most identified gaps in services are contributed to schools being overwhelmed and underfunded. This review will provide recommendations to program developers and policy makers to ensure safety in Texas high schools.
Prevalence of Pectus Excavatum in an Adult Population-Based Cohort Estimated from Radiographic Indices of Chest Wall Shape
(2020) Garcia, Christine; Kozlitina, Julia; Alder, Adam; Foglia, Robert; McColl, Roderick; Peshock, Ronald; Kelly, Robert Jr.; Biavati, Mikaela
Purpose: Pectus excavatum is the most common chest wall skeletal deformity. Although commonly evaluated in adolescence, its prevalence in adults is unknown. Methods: Radiographic indices of chest wall shape were analyzed for adult participants of the first (n=2687) and second (n=1780) Dallas Heart Study and compared to pectus cases (n=297). Thoracic computed tomography imaging studies were examined to calculate the Haller index, a measure of thoracic axial shape, and the Correction index, which quantitates the posterior displacement of the sternum relative to the ribs. Results: At the level of the superior xiphoid, 0.5%, 5% and 0.4% of adult Dallas Heart Study subjects have evidence of pectus excavatum using thresholds of Haller Index >3.25, Correction Index >10%, or both, respectively. There is a greater prevalence of pectus in women than men. In the general population, the Haller and Correction Indices are associated with height and weight, independent of age, gender, and ethnicity. Repeat imaging of a subset of subjects (n=992) demonstrated decreases in the mean Haller and Correction Indices over seven years, suggesting development of a more circular axial thorax and with less sternal depression. Conclusions: In this study, we estimate the prevalence of pectus excavatum at 0.4% or 1 in 25 individuals in a large, population-based, multi-ethnic adult population with a mean age of 44 years old. To our knowledge, this is the first population-based study estimating the prevalence of pectus in adults.
Trafficking in Medical Education: The TIME is Now
(2020) Lindsley, Joshua; Beeson, Jeffrey; Ingram, Aubrey; Reynolds, Conner; Steffel, Eric; Beck, Brooke; Grant, Kelley; Turnbow, Austin; Biavati, Mikaela; Guillette, Jill; Freudenberger, Jacob
According to the International Labor Organization (ILO) and Walk Free Foundation, there are an estimated 24.9 million individuals enslaved by human trafficking practices around the world. The United States government predicts that 600,000-800,000 new individuals are trafficked across international borders each year, earning criminal organizations approximately $150 billion annually. The physical and mental health impacts of human trafficking have been well documented by previous research. It is common for human trafficking victims to come into contact with healthcare providers during all phases of their victimization. This puts healthcare workers in a unique position to identify human trafficking victims and practice informed care when dealing with victims of human trafficking. Trafficking in Medical Education (TIME) is a non-profit organization that seeks to help eliminate human trafficking by the 2050 through educating the healthcare workforce. To do this, with the help of UnBound, we have held training sessions with up-to-date research on intervention strategies to 500 medical students across Texas since 2018. We seek to continue such training until we are able to reach all Texas medical schools yearly. We have also reached out to local, regional, and state government representatives in an effort to expand our educational efforts across undergraduate medical education. We plan to design two research initiatives to assess current human trafficking education in osteopathic medical students through surveying Council of Osteopathic Student Government Presidents' (COSGP) representatives from each school and emergency medical technicians through Agency & Regional Medical Directors.
An application of Markov chain Monte Carlo (MCMC) methods in alcohol research: item parameter recovery for the Protective Behavioral Strategies Survey
(2020) De La Torre, Jimmy; Mun, Eun-Young; Tan, Zhengqi
Purpose: This study was motivated by the measurement challenges of Project INTEGRATE, a large-scale synthesis study of aggregate data and individual participant data (IPD) from brief alcohol intervention trials for young adults. Methods: The present study utilized Markov chain Monte Carlo (MCMC) methods to help address the measurement challenges using the Protective Behavioral Strategies Survey. We aimed to recover item parameters for a two-parameter logistic item response theory (2PL-IRT) model. We tested the viability and feasibility of the custom-developed MCMC algorithm in R under study conditions that varied the number of items (J=5, 10, 20 and 40) and sample size (N=300, 500 and 1000). For each condition, 25 replications were conducted. We evaluated the accuracy of parameter recovery based on the mean bias and root mean square error (RMSE). Results: The MCMC algorithm for the 2-PL IRT model adequately recovered item parameters: for J=5 items and N=300, the bias and RMSE of the item discrimination parameter were -.039 and .073, respectively; and of the item severity parameter were .033 and .065, respectively. As the number of items and sample size increased, both item parameters were more accurately estimated. Conclusions: We presented the outcomes of MCMC methods for a 2PL-IRT model in the recovery of item parameters as the first step toward obtaining commensurate latent trait scores for participants from multiple studies and ensuring the same data interpretation across multiple studies for IPD meta-analysis or integrative data analysis.
Are alternatives to Bisphenol A associated with general and abdominal obesity in general US population?
(2020) Sumihiro, Suzuki; Igara Uche, Uloma
Purpose Bisphenol F (BPF) & bisphenol S (BPS) currently serve as alternatives to bisphenol A, an endocrine disrupting chemical in both consumer and commercial products. However, the safety of these chemicals is not confirmed as there are very limited studies on their effects on metabolic and physiological functions in humans. The purpose of the study is to examine whether these alternatives are associated with general and abdominal obesity in both U.S children/adolescents and adults using data from the National Health and Nutrition Examination Survey (NHANES) 2013-2016. Methods A multinomial logistic regression was conducted to determine the association between BPF, BPS and obesity while controlling for behavioral, demographic and socioeconomic factors as well as urinary creatinine levels. A logistic regression was also conducted to evaluate the association between BPF, BPS and abdominal obesity while controlling for the same covariates. Results BPF concentrations were significantly associated with overweight {OR=1.272(95% CI: 1.063, 1.522)} and obesity {OR=1.208(95% CI: 1.003, 1.455)} in children/adolescents as well as obesity {OR=1.108(95% CI: 1.004, 1.223)} and abdominal obesity {OR=1.117(95% CI: 1.001, 1.247)} among adults after adjusting for covariates. Conclusion This study showed that urinary concentrations of Bisphenol F were positively associated with overweight and obesity in U.S children/adolescents as well as obesity and abdominal obesity among U.S. adults. Thus, further investigation is needed on this chemical as it is possible that it may have an endocrine disrupting capability as Bisphenol A.
Left Hemi-Diaphragmatic Paralysis After Left Cervical Transforaminal Epidural Steroid Injection of the C5-C6 Level
(2020) Mathew, Ezek; Dickerman, Rob; Farrell, Molly
Background: Cervical radiculopathy is a common cause of neck pain with radiation into the upper extremity in a dermatomal pattern. The age-adjusted incidence is 83.2 per 100,000 persons per year. The most common causes are vertebral spondylosis and intervertebral disc herniation. Corticosteroid injection is a conservative management option with a low risk of major adverse events. Adverse events could include epidural hematoma, infection, allergic reactions, seizures, nerve damage, or intravascular injections. No reviewed literature or case reports have indicated phrenic nerve injury secondary to cervical transforaminal epidural steroid injection (TFESI). Case Presentation: A 45-year-old male physician with severe left C6 radiculopathy secondary to a large left-sided C5-C6 herniated intervertebral disc presented to the neurosurgical clinic. The patient underwent a left side C6 TFESI. Immediately upon awakening from anesthesia, the patient experienced shortness of breath. A Sniff test demonstrated the patient had left diaphragmatic paralysis. Six weeks later, the patient underwent a C5-C6 anterior cervical discectomy and fusion with complete relief of his radicular symptoms. The left hemi-diaphragmatic paralysis remained at the one-year postoperative visit. Conclusion: A thorough literature review shows no indication of phrenic nerve injury with cervical TFESI. In the current study, we explore the suspected mechanisms of possible injury to the phrenic nerve. Epidural corticosteroid injection is a viable and safe option for conservative management of cervical radiculopathy. This report unveils a unique and important adverse event that should be held in consideration before undergoing a cervical TFESI.
Laparoscopic Robotic Repair of Bilateral Incarcerated Morgagni Hernia with Mesh: a case study
(2020) Pineda, Jonathan
INTRODUCTION: Congenital diaphragmatic hernias are generally discovered and corrected in infancy. Morgagni hernias compose 2% to 4% of all diaphragmatic hernias and is typically found in the anteromedial portion of the diaphragm and on the right. These types of hernia are usually repaired via laparotomy, laparoscopically, thoracoscopy and less so using a robot-assisted laparoscopic repair. We present the case of a 29 year old female with bilateral Morgagni hernias that was successfully repaired using robot assisted laparoscopy. CASE PRESENTATION: A 29 year old female presented with a lifetime difficulty of breathing and constipation with no clear indication why. She had gone to the emergency room for a ruptured ovarian cyst, where an incidental note was made of a large right Morgagni hernia that contained a majority of her transverse colon, as well as incarcerated fat on the left. She underwent robot-assisted laparoscopic repair using the abdominal approach. While intraoperative it was found that her hernia was in fact, bilateral. The hernial contents were reduced and the defect was closed using a Parietene mesh. The patient was discharged the same day. CONCLUSIONS: Morgagni hernias are relatively rare and bilateral are even less common. The most common approach to repairing these are via laparotomy, however with the ergonomics of sitting, the added dexterity with increased range of motion of the tools, and the 3d view, and decreased length of stay after surgery, the robot should be more heavily considered for these types of surgeries.
Effects of Urinary Tract Infection on Hip and Knee Arthroplasty Outcomes
(2020) Wagner, Russell; Teigen, Kari; Barnes, Kalan; Garcia, Laura; Dalton, Stewart
Introduction: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common procedures performed in the United States. However, the effects of periprosthetic joint infections (PJI) can be devastating leading to invasive interventions and potentially impaired functionality, decreased patient satisfaction, and increased mortality. Many risk factors for the development of PJIs have been well-documented, however, the association between urinary tract infections (UTIs) and PJIs remains controversial. Our aim was to establish the risk of developing a PJI in patients with an identified UTI in the preoperative, perioperative, and postoperative periods. Methods: Through retrospective chart review, data was abstracted from electronic medical records from JPS Health Network of all patients with a scheduled THA and TKA since 2014. We identified patients with UTIs 15 days prior to surgery and followed up with 12 months post-surgery for development of PJI. Results: A total of 2,220 surgeries were scheduled, and 1,697 surgeries were completed. Forty-six patients with a UTI completed surgery within 15 days of the UTI diagnosis, and 2 patients developed a PJI (4.3%, 95% Confidence limits: 0.5%, 14.8%) within 12 months post-surgery. Out of 1,274 patients with surgery without UTI, 47 (3.7%, 95% confidence limit: 2.7%, 4.9%) developed a PJI. Conclusions: Our data does not suggest UTI in the preoperative period increases the risk of PJIs after THA and TKA. However, the study needs more power to establish significant results and future analysis will look at the association between UTIs in postoperative settings and development of PJI.
Dental size reduction in the domesticated fox: Implications for the 'domestication syndrome'
(2020) Maddux, Scott D.; Franciscus, Robert; Kharlamova, Anastasiya; Southard, Thomas; Trut, Lyudmila; Wood, Emma
Purpose: The "Domestication Syndrome" is an explanatory model for the suite of morphological and physiological traits common across domesticated species. One oft-cited morphological change common to domesticates is a reduction in dental size relative to wild progenitors, yet there are a dearth of studies exploring this dynamic. Moreover, domestication theory has long emphasized that dental size reduction is a byproduct of artificial selection for non-aggressive behavior. The Russian fox domestication experiment provides an untapped source for studying this evolutionary dynamic because it provides a controlled, long term study of selection for non-aggressive behavior and attendant morphological consequences. Yet, the dentition of these experimental foxes has not been heretofore studied. Methods: We employed univariate and multivariate comparisons of maxillary P4, M1, and canine mesiodistal length, buccolingual breadth, and crown height of the canine, as well as mandibular M1 mesiodistal length and buccolingual breadth. These data were collected in sex-balanced samples of the unselected (n=50), tame (n=49), and aggressive (n=50) experimental strains. All measurements were taken directly on macerated, fully cleaned elements using Vernier calipers affording measurement accuracy to 0.05 mm. Results: Consistent with expectations from the 'domestication syndrome' model, tame fox skulls exhibited statistically significantly reduced tooth dimensions in virtually all comparisons relative to both unselected and aggressive strain individuals. Tame-selected foxes also demonstrated more variability in the dentition. Conclusion: These results appear to support domestication hypotheses and highlight the utility of dental evidence as a morphological indicator of reduced aggression.
MT-CYB Gene Mutation Associated With the Hypermobility Variant of Ehlers-Danlos Syndrome: A Case Study
(2020) Sudanagunta, Sneha; Lee, Yein; Shrestha, Ribesh
Background: Ehlers-Danlos Syndrome (EDS) is a group of disorders that are associated with defects in collagen. They present with symptoms ranging from loose skin to hypermobile joints to fragile tissues leading to organ and vessel ruptures. Most genetic screenings for EDS reveal a mutation in either the COL5A1 or the COL3A1 genes. In this case, we present a mitochondrial gene mutation that could be suggested as a variation of hEDS. Additionally, due to the variable, yet treatable, combination of symptoms this patient presented with, treatment plans were tailored specifically to her requirements to minimize her symptoms. Case Information: A 31-year-old female doctorate student in flute performance presented to the outpatient clinic radicular pain from a C6 disc herniation. The patient began experiencing syncopal episodes, one of which resulted in a car accident. Past medical history includes polycystic ovarian syndrome, migraines, and scoliosis. Genetic testing revealed a mutation in the mitochondrial MT-CYB gene that could be associated with the Articulo-Autonomic Dysplasia variant of EDS. Conclusion: EDS can present with a wide constellation of symptoms that can be managed to maximize the quality of life; therefore, it is pivotal to identify and diagnose patients with EDS early in their presentation. This case report identifies a mitochondrial mutation in the MT-CYB gene that may significantly affect the quality of life of patients if screened for during genetic testing. Additionally, with a correct diagnosis, this patient received appropriate medical care that allowed her to continue her performances.
Surface Plasmon Assisted Microscope
(2020) Borejdo, Julian
Total Internal Reflection Fluorescence (TIRF) microscopy is able to image 100-200 nm thick layer of a cell adjacent to a coverslip. However, it suffers from the fact that and excitation and emission light paths are shared. Here we suggest an alternative method of visualizing layer adjacent to a coverslip: a sample is put on a coverslip layered with a thin layer of gold and illuminated from the top, through water-based solution (Kretschmann illumination). The fluorophores near metal surface induce surface plasmons in the metal film. Fluorescence from these fluorophores couple with surface plasmons, permitting them to penetrate the metal. They emerge at Surface Plasmon Coupled Emission (SPCE) angle. The thickness of the observational layer is further reduced by metal quenching proximal (below 10 nm) to a surface. Fluorophores that are not proximal to a surface are unable to couple with the plasmons and are reflected back into the free space. High NA objective is used to collect image by EMCCD. Alternatively, the fluorescent signal is collcted by avalanche photodiode inserted in the conjugate image plane of the objective. The signal can be used to produce autocorrelation function of the motion of a sample and provide detailed information about its size and shape. Since the excitation and emission light paths are not shared, the system avoids problems associated through-the-objective TIRF detection. In addition, it the thickness of the observational volume is smaller than TIRF and has outstanding background rejection.
Development of a Stress Scale for Faculty: Preliminary Findings & Next Steps
(2020) Nandy, Karabi; Atanda, Adenike; Wettergreen, Sara; White, Annesha
Purpose: Faculty face multiple stressors balancing numerous responsibilities. Although validated instruments (e.g. Perceived Stress Scale) exist, there is none specifically for pharmacy faculty. The objective was to develop and validate a stress scale for pharmacy faculty. Methods: As prompted from discussions during faculty meetings and independent focus groups, a stress scale was developed to support faculty wellness initiatives. A literature search was conducted using PubMed, 2007-2017, key search terms: 'faculty stress and burnout', 'faculty job satisfaction', 'pharmacy faculty stress', and 'stress survey'. Over 40 articles including 20 stress scales were reviewed. Themes and 150 scale items were categorized. The survey was then administered via Qualtrics to select faculty across various institutions to evaluate the instrument's psychometric properties. Results: Respondents representing a wide range of backgrounds (e.g. age, rank, position) provided feedback on question wording, format, and preference (one year or month reference). Content and face validity were confirmed. Four constructs characterized faculty stress: Support systems (spirituality, social support, coping strategies), Mental health (emotional reactivity/health, personality traits), Physical health (energy, wellness activities), and Satisfaction (compensation, work-life balance). The final survey was refined to consist of 10 items. Conclusions: Results of this study demonstrate the reliability and validity of a new scale for evaluating faculty stress. Next steps include survey administration to faculty at multiple pharmacy schools allowing for comparisons of rankings based on demographics. Future research will include developing a modified version for other health disciplines to create strategies to reduce stress as indicators of targeted wellness initiatives.
A Unique Presentation of Intersection Syndrome
(2020) Harris, Payton
Intersection syndrome is an underdiagnosed condition that many primary care and sports medicine physicians often miss. The reason for this may be due to its relative obscurity outside of the field of orthopedics, difficult to interpret presenting symptoms, or lack of access to proper diagnostic imaging. The goal of this case report is to educate physicians of the etiology, symptoms, and presentation of intersection syndrome in hopes that the effects this potentially debilitating condition can be minimized.
Single stage bilateral flexible intramedullary fixation of periprosthetic distal femur fractures
(2020) Wagner, Russell; Sambhariya, Varun; Rahman, Shawn; Neal, David; Tran, Apollo
We present a patient with bilateral Rorabeck II/Su III periprosthetic distal femur fractures treated successfully with bilateral single stage flexible intramedullary fixation. Flexible intramedullary fixation of Rorabeck II/Su III periprosthetic distal femur fractures provides the benefits of shorter operative time, lower blood loss, and preservation of bone stock compared to plate fixation and distal femur replacement. We suggest that for patients with similar injuries flexible intramedullary fixation can be a viable treatment option.
Sleep Quality, Perceived Stress, and Doctor of Physical Therapy Students
(2020) Trimble, Ruth; Papa, Evan; Santurri, Laura; Miller, Haylie; Halford, Nathan; Williams, Erin; Richardson, Mike
Purpose: To examine the relationship between sleep quality and perceived stress among Doctor of Physical Therapy (DPT) students. Poor sleep quality in other health professional and undergraduate students has been linked to impaired academic performance as well as poorer mental and physical health. Since research on this topic is limited, new data should further understanding of the potential impact of sleep quality on DPT students and provide valuable information to DPT programs. Methods: Researchers conducted a non-experimental study using a single-site, cross-sectional design. A convenience sample of DPT students completed an online survey that measured perceived stress (Perceived Stress Scale; PSS-10) and sleep quality (Pittsburgh Sleep Quality Index; PSQI). Results: One-hundred sixty-three DPT students (42 entering year one, 37 ending year one, 43 ending year two, 41 ending year three) participated. The mean PSS-10 score for each cohort was as follows: entering year one 13.45 (SD 4.98), ending year one 11.22 (SD 4.81), ending year two 16.02 (SD 6.62), ending year three 16.69 (SD 4.27), with an overall mean PSS-10 score of 14.47 (SD 5.65). Using the PSQI, researchers identified that 38.04% of students across all of the cohorts had poor sleep quality. There was a low, direct association between perceived stress and sleep quality. Conclusion: A better understanding of perceived stress and sleep quality while in physical therapy school may help identify students at risk for burnout and increase the window of opportunity for teaching DPT students effective stress management strategies.
The Impact of Comorbidities on Chronic Low Back Pain
(2020) Licciardone, John C.; Bibb, Patrick
Background: With an estimated treatment cost of $635 billion, low back pain is one of the costliest national public health challenges. The NIH Pain Consortium defines chronic low back pain (CLBP) as any back problem lasting longer than 3 months, with pain symptoms in more than half of the days during the past 6 months. Since 2016, the PRECISION Pain Research Registry has been collecting data from patients with CLBP in Texas. Purpose: This purpose of this study is to determine the impact of multiple comorbidities on psychological and physical components of pain in patients with CLBP. Methods: There were 519 patients in the study, including 264 (50.9%) with < 2 comorbidities (CLBP-S) and 255 (49.1%) patients with >3 comorbidities (CLBP-CM). The psychological characteristics of these two comorbidity groups were compared using the Pain Self-Efficacy Questionnaire (PSEQ) and the Pain Catastrophizing Scale (PCS). The physical characteristics of the groups were compared using a numerical rating scale for pain intensity (NRS) and the Roland-Morris Disability Questionnaire (RMDQ). Results: There was a statistically significant (p< 0.05) negative correlation between comorbidity scores and PSEQ scores, and there were significant positive correlations between comorbidity scores and PCS, NRS, and RMDQ scores. Discussion: These results provide evidence that patients with CLBP and a greater number of comorbidities experience more difficulty in psychologically coping with physical pain and disabilities than such patients with fewer comorbidities. These results suggest that psychological interventions, such as cognitive behavioral therapy, may benefit patients with CLBP and numerous comorbidities.
Recurrent Heterotopic Ossification and Varus Deformity of the Knee Following Retrograde Intramedullary Nailing of Fractured Femur
(2020) Wagner, Russell; Read, Jordan
Background: Retrograde femoral nailing is an indicated procedure for femoral shaft fractures. Heterotopic ossification, tibial deformity, and fibular collateral ligament laxity are rare and not well understood complications of retrograde femoral nailing. Case Information: This case documents a 16-year-old female who suffered polytraumatic injuries following a high-speed motor vehicle accident. Following repair of left ipsilateral femoral neck and shaft fracture with sliding hip screw and retrograde femoral intramedullary nailing patient developed left knee stiffness, loss of motion, and pain. Following arthroscopy patient was found to have heterotopic ossification and arthrofibrosis. Nine months later patient was taken for third orthopedic procedure after development of left knee varus due to tibial deformity, fibular collateral ligament laxity, and recurrent heterotopic ossification. Conclusion: This case illustrates patient with recurrent development of heterotopic ossification, development of knee varus treated with high tibial open angle osteotomy, and advancement of the proximal attachment of the fibular collateral ligament with the use of intramedullary nailing locking screw hole remnants.
Assessing the Utility and Effectiveness of Monitoring Technology for Reducing Caregiver Burden for Alzheimer's Disease
(2020) Ahn, Soongjin
Although some caregivers (CGs) for a person with dementia (PWD) report positive aspects of caregiving, psychosocial health of CGs is often negatively affected. CGs comment about the worry they experience regarding the safety of PWD, including getting lost. Use of a smartwatch featuring GPS tracking has been proposed as a means to reduce CG burden, but remains largely untested. This pilot study will yield evidence about the efficacy of a technology that represents a new generation in dementia care. Purpose: to assess the usability and user satisfaction of a wearable technology-based approach to interact with a PWD. The goal is to enroll 35 PWD and CG dyads selected from UNTHSC Gerontology Assessment and Planning Program Clinic. The CG completes a pre-survey about their level of caregiver burden. After trial period of three months, a post-survey will be administered to the CG. Demographics of CGs based on their gender and relationship to the PWD were analyzed to explore the types of individuals willing to participate in this study. Striking proportion of CGs were female, approximately 50% were spouses; 30% were adult children; 4.5% were siblings and 9% were categorized as "others." Twenty-five dyads are enrolled to date, but no post-survey data are currently available. Barriers so far were no-show appointments and PWD's lack of participation in wearing the technology. These limitations will be investigated further in addition to analyzing the post-surveys to determine the efficacy of this type of wearable technology for dementia care.

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