Nicholas A. Kerna

Background: The Emerald City Volleyball Classic is an annual tournament involving over 1,000 amateur female youth athletes. Since 2010, a medical team composed of licensed naturopathic physicians and student clinicians from Integrative Medicine Group and Bastyr University has provided onsite sports medicine support. Purpose: To retrospectively analyze the injury types and treatment modalities delivered during the 2024 tournament and to evaluate how this data can inform future medical planning and healthcare provider readiness for similar athletic events. Methods: Over three days (May 25–27, 2024), medical care was administered to athletes at a central treatment station. Interventions included athletic and elastic taping guided by the Manual Tissue Direction Test, soft tissue release, joint manipulation, concussion assessments (Sport Concussion Assessment Tool-6), and first aid. Treatment data were collected and categorized by body region, treatment type, and day. Results: A total of 664 injury-related treatments were provided to more than 300 athletes. The most common interventions were elastic taping of the lower extremities and athletic taping of the ankles and knees. The left ankle, right shoulder, and lumbar spine were the most frequently treated areas. Ten concussions were assessed using Sport Concussion Assessment Tool-6, and two athletes were referred for suspected fractures. A trend of cumulative fatigue was observed, with increased spinal and shoulder complaints by Day 3. Discussion: This report highlights key injury trends and treatment demands observed in amateur female youth volleyball athletes. The findings support the importance of lower extremity support, early fatigue recognition, and concussion management readiness. Integrating naturopathic providers into event coverage may enhance preventative and functional care. Limitations include lack of diagnostic coding and stratification by age or player position. Recommendations include expanding future data collection and strengthening provider preparation for recurrent treatment patterns. Conclusion: This retrospective observational report provides clinically relevant insights for improving athlete care, training protocols, and medical preparedness at youth tournaments. It supports the role of structured, evidence-informed naturopathic care in multidisciplinary sports medicine delivery.

Purpose: Concussions are a form of traumatic brain injury frequently observed in youth sports, with variable recovery patterns. Integrative medicine, including naturopathic care, has gained interest as a supportive approach, though limited research exists on compliance with such protocols. To evaluate compliance with a naturopathic concussion protocol and assess its relationship to return-to-play timelines among youth female volleyball athletes.Methods: This observational pilot study was conducted at the 2023 Emerald City Classic volleyball tournament. Athletes aged 14–18 diagnosed with concussion by licensed naturopathic physicians were enrolled. Participants received a naturopathic concussion protocol including supplements (e.g., vitamin D, N-acetylcysteine), lifestyle and dietary modifications, and structured return-to-play guidelines. Follow-up spanned up to six weeks. Assessment tools included Sport Concussion Assessment Tool-5, symptom severity scoring, and physical/cognitive exams.Results: Six concussions were evaluated; three athletes met inclusion criteria and were enrolled. All three were diagnosed with mild concussion and demonstrated improvement in acute symptoms after initial naturopathic care. Symptom severity scores ranged from 37 to 51 out of 132. However, none of the participants completed follow-up after the event.Conclusion: The naturopathic concussion protocol was feasible in an acute sports setting and demonstrated short-term benefit. However, loss to follow-up hindered evaluation of long-term compliance and outcomes. Future studies should incorporate improved follow-up strategies to assess sustained adherence and clinical efficacy.

This paper examines fundamental and innovative solutions for improving and sustaining efforts to address rural healthcare disparities in the United States. As a foundation for these solutions, it also examines the persistent healthcare disparities affecting rural populations. It analyzes the contributing geographic, economic, and systemic factors that hinder access to care, including workforce shortages, limited healthcare infrastructure, and socioeconomic challenges. The paper identifies key service gaps—such as preventive care, mental health, dental, and emergency services—and evaluates the effectiveness of prior policy efforts, including Medicaid expansion and telehealth implementation. Drawing on evidence-based research, it presents a multifaceted set of recommendations—enhancing workforce development, strengthening telehealth infrastructure, promoting community-based interventions, and advancing supportive policies—to improve healthcare access and outcomes for rural communities. These findings emphasize the need for fundamental, innovative, and sustained approaches to ensure long-term improvements in rural healthcare access and outcomes.

Artificial intelligence (AI) has increasingly permeated clinical domains, including reproductive medicine, where its applications span from gamete assessment to population-level epidemiology. The convergence of machine learning, deep learning, natural language processing, and computer vision has enabled novel diagnostic, predictive, and decision-support tools that enhance clinical efficiency and patient outcomes. This paper provides a review of current AI technologies in reproductive medicine, encompassing assisted reproductive technologies, prenatal care, maternal health, sexual and contraceptive health, epidemiology, and low-resource settings. Ethical, legal, and social implications, as well as challenges related to data quality, clinical validation, and integration, are explored. Future opportunities in explainable AI, precision medicine integration, real-world evidence generation, and global collaboration are discussed. The analysis underscores AI’s transformative potential and highlights pathways for responsible deployment to advance reproductive medicine.

The integration of artificial intelligence (AI) into psychiatric practice has accelerated rapidly, driven by advances in computational methods and the availability of diverse data sources. The present paper examines contemporary AI applications across diagnostic support, predictive analytics, therapeutic interventions, digital phenotyping, telepsychiatry integration, and ethical, legal, and social considerations. Foundations in machine learning, deep learning, and natural language processing are delineated alongside relevant data modalities, including structured clinical records, unstructured clinical notes, and multimodal signals. The roles of AI in symptom detection, neuroimaging pattern recognition, biomarker discovery, and differential diagnosis are evaluated. Predictive models for suicide risk, relapse, and treatment response are reviewed, with attention to personalization algorithms. Therapeutic tools, such as conversational agents, virtual reality, and gamified mobile applications, are discussed. Passive monitoring techniques, telepsychiatry workflows, and clinician dashboards are described. Ethical challenges, including data privacy, algorithmic bias, and regulatory frameworks, are considered. Implementation barriers and adoption factors are analyzed. Emerging trends, such as federated learning, multimodal fusion, explainable AI, and applications in low-resource settings, are explored. Implications for patient outcomes, health systems, and policy are synthesized, concluding with recommendations for future research and practice.

This paper presents a comprehensive overview of the current applications of artificial intelligence (AI) in internal medicine, highlighting its transformative potential in improving diagnostics, treatment and management, prognostication, and operational efficiency. The discussion encompasses AI-driven imaging analysis, including advanced techniques such as convolutional neural networks that enhance the accuracy and speed of radiological and pathological diagnoses. AI applications in electronic health record analytics and laboratory data interpretation are examined, demonstrating how predictive models and natural language processing facilitate early disease detection and more informed clinical decisions. The integration of AI in personalized medicine and clinical decision support systems is explored, with emphasis on tailoring treatment plans and optimizing therapeutic monitoring through real-time data analysis. Furthermore, the paper reviews the development of predictive analytics and risk assessment models that enable targeted interventions and proactive patient care. Operational efficiency is addressed through the investigation of workflow optimization, virtual assistants, and administrative automation, which collectively contribute to reducing clinician workload and enhancing patient satisfaction. The paper also identifies key challenges and ethical considerations, including data privacy, algorithmic bias, and regulatory uncertainties, while providing recommendations for future research and policy development. The findings indicate that, although AI holds significant promise in revolutionizing internal medicine, multidisciplinary collaboration and ongoing evaluation are essential for ensuring safe, equitable, and effective integration into clinical practice.

Obesity is a known risk factor for various cancers, influencing carcinogenesis through metabolic, hormonal, and inflammatory pathways. Excess adiposity leads to insulin resistance, chronic inflammation, and hormonal imbalances, all of which contribute to tumor development. Obesity increases the risk of cancers in the endocrine system (e.g., thyroid, pancreatic, adrenal) due to insulin resistance and altered hormone levels. In the reproductive system, it raises the risk of breast, ovarian, endometrial, and prostate cancers through hormone dysregulation and inflammation. Obesity is also linked to digestive system cancers, including esophageal, liver, and colorectal cancers, due to metabolic dysfunction and chronic inflammation. The role of obesity in lung cancer remains debated, but metabolic changes may influence tumor progression. Obesity contributes to hematologic cancers, such as leukemia, by altering immune function and promoting inflammation. Other systems show varying associations with obesity and cancer risk. Key mechanisms include metabolic dysregulation, chronic inflammation, epigenetic changes, and elevated insulin/IGF-1, which promote tumor growth. Early detection through imaging and biomarkers, along with lifestyle changes (e.g., diet, exercise) and pharmacologic treatments (e.g., metformin, GLP-1 agonists), can reduce cancer risk and improve outcomes. Personalized treatment for obese cancer patients requires adjustments in surgery, chemotherapy, radiotherapy, and immunotherapy. This review explores obesity’s association with cancers across body systems, overviews the mechanisms of obesity contributing to carcinogenesis, and summarizes clinical and public health implications, including screening, prevention, treatment, and policy interventions.

PFAS (per- and polyfluoroalkyl substances) exposure has been linked to kidney damage through mechanisms involving gut microbiota dysbiosis and alterations in blood metabolites. These disruptions trigger renal inflammation, oxidative stress, and metabolic dysregulation, impairing kidney function. PFAS exposure significantly alters gut microbial communities, impacting metabolites like short-chain fatty acids (SCFAs), bile acids, and trimethylamine N-oxide (TMAO). These imbalances contribute to chronic inflammation and kidney fibrosis through the gut-kidney axis. Additionally, PFAS disrupts blood metabolites related to energy metabolism, mitochondrial function, lipid oxidation, and amino acid metabolism. Biomarkers such as uric acid, creatinine, and homocysteine indicate nephrotoxic stress. This paper explores the potential mechanisms by which PFAS impact kidney health through interactions with gut microbiota and blood metabolites. It also highlights its effects and role in affecting multiple body systems that may involve various medical specialists, such as internists, gastroenterologists, cardiologists, obstetricians, gynecologists, and psychiatrists.

Ultra-processed foods (UPFs) are defined by their high levels of refined carbohydrates, unhealthy fats, artificial additives, and preservatives. These foods contribute to biological aging through mechanisms such as chronic inflammation, oxidative stress, and metabolic dysfunction. Inflammation, oxidative stress, and disruptions in insulin signaling are key factors in the development of aging-related diseases, including cardiovascular disease, diabetes, and neurodegenerative disorders. Specifically, advanced glycation end-products (AGEs) and epigenetic modifications significantly contribute to the acceleration of aging by disrupting cellular function, promoting tissue damage, and driving disease development. UPF consumption is linked to cardiovascular diseases, cancer, gastrointestinal disorders, obstetric and gynecological conditions, neurodegenerative diseases, and a range of adverse effects on various body systems. Reducing UPF intake and encouraging healthier dietary patterns are crucial for mitigating the impact of UPFs on aging and related health conditions. For individuals unable to transition to whole food-based diets, pharmaceutical and medical interventions offer alternatives to reduce UPF-related biological aging. A combined approach of pharmacologic therapies and dietary adjustments may optimize outcomes, with ongoing research into novel treatments further enhancing strategies to counteract aging effects. This review examines the impact of UPFs on accelerating biological aging, the mechanisms by which they contribute to aging and associated health conditions, and potential interventions to mitigate their effects.

Physical activity has been gaining recognition as a key component in managing depression, with its physiological, biochemical, and neurological effects playing a crucial role in improving mental health. Exercise enhances neuroplasticity, promotes the release of mood-regulating neurochemicals, and reduces stress, all contributing to alleviating depressive symptoms. Also, lifestyle modifications, including physical activity, are increasingly integrated into clinical practice as essential non-pharmacological interventions for depression. Alongside these interventions, the growing recognition of St. John’s wort (SJW) as an effective treatment for mild to moderate depression underscores its potential as an alternative or adjunct to conventional antidepressants. Both physical activity and SJW represent promising approaches in the comprehensive treatment of depression, offering safe, effective, and well-supported options for individuals struggling with depressive disorders. This review will explore the integration of lifestyle interventions, including exercise and SJW, in depression management.