Advance Articles

Shortages in medical subspecialty care, particularly endocrinology, present a growing challenge in the United States. In Ohio, structural inequities in the rural and Appalachian regions, including fewer healthcare providers, limited facilities, and barriers to transportation and broadband connectivity, contribute to delayed diabetes diagnoses, increased complications, and a higher mortality rate. This study aimed to examine the distribution of endocrinology subspecialists in Ohio and the corresponding prevalence of diabetes.

The purpose of this paper is to present a self-assessment rubric for colleges of osteopathic medicine (COMs) that encompasses all aspects of the academic medical enterprise. This work endeavors to capture the extent to which a COM creates an institutional culture of professional behavior, from the first touchpoints of interaction with the COM, through all aspects of the educational experience as well as provision of care, education, and service toward the COM’s mission.

Child maltreatment impacts an estimated 7.4 per 1,000 children in the United States. Given the severity of some abusive injuries, children may present to emergency departments (EDs). As such, EDs are primary screening locations for early identification of maltreatment. The objective of this study was to assess rates of maltreatment among pediatric patients presenting to the ED.

Heart failure affects 6.7 million American adults. The gold standard for heart failure assessment is echocardiography to determine the ejection fraction (EF). Evaluating the cardiac apex angle may be a possible way to estimate EF; however, there is a lack of investigation into this relationship. This study aimed to evaluate whether a correlation exists between the cardiac apex angle and EF.

The United States is facing a persistent physician shortage, particularly in rural and tribal regions. Oklahoma ranks 43rd nationally for primary care provider availability, with rural and tribal communities experiencing some of the most severe health workforce shortages. This study aimed to evaluate the geographic distribution and practice outcomes of graduates from three family medicine residency programs located in tribal healthcare systems in Oklahoma and to assess their contributions to addressing physician shortages in rural and underserved areas.

Burnout is a critical issue, with prevalence as high as 76 % among medical students. Associated with decreased empathy, cheating, withdrawal from medical school, and suboptimal patient care, burnout correlates with work hours (WH) and self-harm thoughts (SHT). This study analyzes the correlations of burnout, WH, SHT, and various socioeconomic, demographic, experiential, and behavioral factors among medical students.

Acute neck and low back pain are common emergency department presentations, generally treated with nonsteroidal anti-inflammatory drugs. Osteopathic manipulative treatment (OMT) is a hands-on treatment modality utilized to treat a variety of musculoskeletal conditions. The authors sought to evaluate the relative efficacies and side effects of hands-on OMT vs. one dose of oral ibuprofen, in the treatment of adult patients presenting with acute neck or back pain.

Concerns about differences in medical training between DO and MD students may lead to biases against DOs as applicants for entry into residency or fellowship programs. This study aimed to compare Milestone assessments across ACGME competencies of residents who attended US allopathic vs. osteopathic medical schools, hypothesizing that there would be no differences throughout residency.

Kinesiology tape (KT) is a common adjunct in the management of patellofemoral pain syndrome (PFPS), with the intention to alleviate pain and facilitate microcirculation by providing positional stimuli to the surrounding musculature. The purpose of this systematic review and meta-analysis is to analyze the effectiveness of KT in pain reduction for individuals with PFPS.

The pediatric surgical workforce in the United States faces increasing strain due to a limited supply of specialists, geographic maldistribution, and rising complexity in pediatric cases. This review analyzes current gaps in the pediatric surgical workforce and propose actionable solutions through an osteopathic lens, including the integration of osteopathic principles such as whole-person care, preventive health, and OMT.

Whiplash is common after road traffic accidents and affects millions of people worldwide. The incidence of whiplash-associated disorders has risen to at least 300 per 100,000 in Western countries, with global emergency room visits estimated at 235–300 per 100,000 annually. The aim of this study was to evaluate an osteopathic intervention for whiplash and determine whether pain, mobility, and quality of life improve with respect to conventional treatment.

Interprofessional education in health professions training strives to create a future collaborative healthcare workforce for the betterment of patient care. This study aimed to critically analyze the discourse of an interprofessional team of healthcare students following a simulated patient encounter to assess the power dynamic among the professions present.

Overhead throwing in elite baseball pitchers is a rapid, highly coordinated motion that culminates in extreme action from the upper extremity. Injuries to throwing athletes stereotypically occur to the shoulder and elbow; however, throwing is not solely an upper-extremity task. Previous studies have sought to improve pitch performance and shoulder function utilizing the Muscle Energy Technique or Spencer’s technique. This study is the first to measure the effects of OMT among key points of the kinetic chain, measuring range of motion of the shoulder and the hip, as well as pitch metrics beyond release velocity.

Acute lateral ankle sprain (ALAS) is responsible for short-term disability, increased risk for future acute ankle sprain, and chronic ankle instability. The objectives of this study were to evaluate the effectiveness of osteopathic care in ALAS, to assess pain, edema, and functional stability of the injured ankle, and to assess and comparing mobility between the injured and noninjured ankle.

Osteopathic manipulative treatment (OMT) encompasses a wide range of diagnostic and treatment techniques for many conditions, but few studies have evaluated OMT use on injured patients. The authors aimed to describe the use of OMT on injured patients from a nationwide sample of emergency department encounters.

The clinical relationship between cardiovascular disease and deleterious surgical outcomes has been extensively examined; however, the relationship between cardiovascular risk and the association with major surgical interventions has yet to be examined at the population level. This study attempts to quantify the relationships between cardiovascular risk factors and the history of open-chest or abdominal surgery.

Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a life-sustaining therapy for severe refractory cardiogenic shock. Although VA-ECMO provides various degrees of cardiopulmonary support, mortality rates remain high. Serum biomarkers have potential to identify the rising risk of mortality in patients receiving ECMO, but evidence supporting their prognostic value is inconsistent. This study aims to systematically investigate existing evidence on the relationship between biomarkers and mortality in adult patients with refractory cardiogenic shock undergoing VA-ECMO support.

The purpose of this study was to evaluate formerly American Osteopathic Association (AOA) - accredited orthopaedic surgery programs to identify the prevalence of DO degrees among program directors and residents, and stratify the association of program geography, program director degree, and osteopathic recognition status on resident composition.

The Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) is a three-level national standardized licensure examination designed for the practice of osteopathic medicine. The purpose of this study is to investigate the differences in student Level 1 self-reported stress levels, test preparation, and performance following the transition to pass/fail score reporting.

The primary objective of this study was to assess the current rates of UTIs among perinatal women and to identify associations with sociodemographic and comorbid factors. Findings from this study should allow for more comprehensive screening and preventive measures to be addressed, and potentially identify current barriers to accessing treatment during this critical time frame.

Since healthcare workers and medical students are at higher exposure risk to the hepatitis B virus (HBV), immunity status is important to assess and maintain. The objective of this study is to evaluate whether various factors, including the interval between vaccination and antibody titer measurement and the timing of first vaccination, contribute to a reduction in HBV immunity among medical students with a history of HBV vaccination.

Randomized controlled trials (RCTs) are essential for developing effective treatments, but when trials are discontinued or unpublished, valuable data are lost. This study aims to evaluate the rates and characteristics of discontinuation and nonpublication among US-registered phase 3 and 4 RCTs investigating osteoporosis therapies from 2000 to 2022.

>The benefits of breastfeeding are well established, from reduced incidence of common childhood infections to decreased incidence of sudden infant death syndrome and infant mortality. The purpose of this study was to evaluate whether utilization of a standardized OMT protocol as an adjunct to lactation support improves feeding dysfunction in breastfed newborns.

This study was undertaken to build upon the work of J. Gordon Zink, DO, FAAO, by developing a novel screening examination (Expanded Zink screen) that can correlate with proper identification of somatic dysfunction, the area of greatest restriction, and effective treatment in soccer players,

This study aims to assess the reliability of a novel, systematic musculoskeletal examination model — called the Functional Pathology of the Musculoskeletal System (FPMSS) model, which assesses the musculoskeletal system as an integrated organ system — to identify somatic dysfunction after stroke or transient ischemic attack in healthy participants.

Osteopathic manipulative medicine (OMM) has gained attention as a complementary therapy for cerebral palsy-related symptoms. Techniques such as muscle stretching, gentle pressure, and joint manipulation have been shown to reduce muscle stiffness, alleviate stress, and enhance mobility in neuromuscular disorders. This narrative review synthesizes current evidence on OMM’s role in cerebral palsy management, with a focus on its application within the five models of osteopathic approach: behavioral, biomechanical, neurologic, metabolic, and respiratory-circulatory

Most adult mental health conditions begin in early childhood and adolescence, the most common being anxiety and behavioral disorders. Early intervention can improve outcomes and may reduce the risk of developing a clinical disorder in the future. However, children may not have the communication or understanding to share their symptoms with those around them, leaving pediatric primary care providers responsible for identifying concerning signs. This paper reviews both general symptoms that suggest possible mental health conditions as well as specific correlations between symptoms and psychiatric diagnoses.

While previous review articles investigated the effectiveness of manual therapies for treating headaches, they did not focus specifically on OMT or perform a pooled meta-analysis to evaluate the effectiveness of outcomes. The aim of this study was to systematically evaluate the effectiveness of OMT for managing headaches associated with musculoskeletal dysfunction and to assess the associated harm outcomes.

Many studies have suggested that participation in pre-clerkship volunteering opportunities is associated with higher confidence in clinical skills, improved perspectives on social barriers, and greater soft skills and empathy. he aim of this study was to explore the relationship between volunteer hours and third-year evaluations, with the hypothesis being that these previously studied, perceived benefits of volunteerism would translate to better evaluations.

The etiology of cranial base strains (CBS) in newborns is poorly elucidated in historical and current literature. There have been few studies examining the prevalence of CBS in newborns or vaginal birth presentation prevalence individually, let alone their relationship. The objective of this review was to consolidate all historical and current research on the potential link between vaginal birth presentation and CBS in infants.

Traumatic musculoskeletal injuries may result in chronic pain and mobility limitations, decreasing quality of life, and increasing predisposition to comorbid disorders. The objective of this study was to detail the potential benefits of utilizing OMT in a trauma outpatient program for the care of injured patients suffering from chronic pain and mobility limitations.

People experiencing homelessness are at a disproportionately greater risk for developing traumatic brain injury (TBI) than the general population. There has been minimal research to evaluate the prevalence of TBI or the long-term cognitive impacts of TBI among the population experiencing homelessness within the US. This study aimed to assess primarily whether those experiencing unsheltered homelessness had a higher prevalence of TBI than those in shelter.

Experimental evidence supporting the existence of the viscerosomatic reflex highlights an involvement of multiple vertebral levels when renal pathology is present. Further exploration of this reflex, particularly in the context of nephrolithiasis, could offer valuable insights for osteopathic treatments related to this pathology. This study aimed to compare the rotation of vertebrae at levels associated with the viscerosomatic reflex in renal pathology in patients with nephrolithiasis vs. those without kidney stones.

The purpose of this study is to: (1) evaluate the predictive value of major performance measures from preadmission to the clerkship years on COMLEX-USA Level 2-CE, including the new COMLEX-USA Level 1 pass/fail only scoring and the less-studied COMSAE Phase 2 to establish a predictive model; and (2) identify optimal cutoff scores of strong predictors to advise students on their preparation of Level 2-CE.

Osteopathic manipulative treatment (OMT) has been shown to improve athletic performance by enhancing shoulder range of motion, flexibility, and balance in various sports. The present study aims to investigate the effects of OMT, with a focus on muscle energy technique, and its subsequent impact on sprinting performance in young adults.

Necrobiosis lipoidica (NL) is a rare chronic granulomatous disease that is historically associated with diabetes mellitus. The exact etiology and pathogenesis are not fully understood; however, microangiopathy is believed to be a contributing factor. NL classically manifests as erythematous papules that coalesce into plaques commonly localized to the lower extremities. The authors present a case of NL arising within a port-wine stain, in which the NL was successfully treated with topical ruxolitinib monotherapy.

Long COVID, a debilitating condition characterized by persistent symptoms following acute SARS-CoV-2 infection, continues to pose a significant public health burden. Currently, research is ongoing regarding risk factors for developing Long COVID. The objectives of this study are to evaluate a cohort of patients who followed up in the Long COVID clinic who were experiencing cardiopulmonary symptoms 8–12 weeks from initial inoculation, and to retrospectively identify any statistically significant risk factors or clinical features present.

Dermatology remains one of the most competitive medical specialties, with successful candidates often demonstrating outstanding academic performance, extensive research experience, and strong letters of recommendation. This study examines the differences in DO and MD match rates following the single graduate medical education accreditation system, focusing on the match performance of DO dermatology applicants.

Evidence supports osteopathic manipulative medicine (OMM) as an effective manual therapy, although it remains underutilized by Doctors of Osteopathic Medicine (DOs). Understanding barriers preventing the broader adoption of OMM is essential to expanding access to it as a noninvasive treatment option, so the authors of this paper surveyed both DOs and non-DO clinicians to identify perceived barriers to OMM.

Temporomandibular disorders (TMDs) have a high prevalence ranging between 15 and 25 % among young adults and adults globally. The primary objective of this study was to investigate the additional effect of forward head posture correction by a cervical extension traction orthotic on myogenic TMD symptoms of pain and function.

Clinical research plays a crucial role in advancing medical knowledge and contributing to the resume of medical students attempting to match into a residency, so the creation of sustainable and effective research opportunities within medical education is paramount. The authors describe a template that they've created to assist osteopathic medical students conduct streamlined, scalable, and cost-effective clinical research at their institution, which they believe can be implemented at other COMs.

This commentary examines the sentiments of a Phoenix-area hospitalist who feels underpaid despite earning an objectively high salary. The article concludes that true professional value transcends monetary figures, calling for systemic changes to better acknowledge and support physicians while ensuring their profound contributions are recognized beyond financial metrics.

The purpose of this study was to compare the effects of social determinants of health on the prevalence and treatment of asthma in Appalachian vs. non-Appalachian regions of Ohio, and how those factors affect the rate at which sinus surgery is performed in different populations.