Medicine and Health Sciences Commons^™

Identification And Characterization Of De Novo Germline Tp53 Mutation Carriers In Families With Li-Fraumeni Syndrome, Carlos C. Vera Recio

Dissertations and Theses (Open Access)

Li-Fraumeni syndrome (LFS) is an inherited cancer syndrome caused by a deleterious mutation in TP53. An estimated 48% of LFS patients present due to a de novo mutation (DNM) in TP53. The knowledge of DNM status, DNM or familial mutation (FM), of an LFS patient requires genetic testing of both parents which is often inaccessible, making de novo LFS patients difficult to study. Famdenovo.TP53 is a Mendelian Risk prediction model used to predict DNM status of TP53 mutation carriers based on the cancer-family history and several input genetic parameters, including disease-gene penetrance. The good predictive performance of Famdenovo.TP53 was demonstrated …

Automation Of Radiation Treatment Planning For Cervical Cancer, Dong Joo Rhee

Dissertations and Theses (Open Access)

Cervical cancer is one of the most common cancer in low- and middle-income countries (LMICs). The mortality rate can be reduced if radiation treatment becomes widely available. However, due to the lack of radiation treatment facilities and human resources, many cervical cancer patients in Africa are not able to receive timely treatments or advanced therapies. To increase the availability of radiation treatment in low-and middle-income countries (LMICs) including African countries, many attempts have been made to reduce the cost of medical linear accelerators. However, increasing the number of treatment machines would not instantly resolve the issues, as there would be …

Quantitative Magnetic Resonance Imaging For The Early Prediction Of Treatment Response In Triple Negative Breast Cancer, Benjamin C. Musall

Dissertations and Theses (Open Access)

Triple Negative Breast Cancer (TNBC) is an aggressive subtype of breast cancer which lacks upregulated hormone receptors. Because of this, it is not vulnerable to clinically available targeted therapies. When treated with standard of care neoadjuvant systemic therapy (NAST), TNBC only shows approximately a 40% rate of pathologic complete response (pCR). A biomarker which could predict TNBC response to NAST early during treatment would be useful, as it would allow for non-responders to be triaged to alternative therapies and potentially allow for the treatment of responders to be de-escalated.

Quantitative Magnetic Resonance Imaging (MRI) may be used to probe and …

The Importance Of Dna Repair Capacity To (And A Model To Predict) Cell Radiosensitivity To Ions, David B. Flint, David B. Flint

Dissertations and Theses (Open Access)

Radiation therapy with ions has a number of advantages over conventional radiation therapy with photons, including favorable depth-dose distributions, greater relative biological effectiveness (RBE) and a lesser dependence on a number of biological factors known to affect radiosensitivity to photons, including DNA repair capacity. Thus, it is expected that an additional benefit of using ions is that they mitigate the great heterogeneities in treatment responses commonly observed in photon therapies.

However, by analyzing the cell survival of human cancer cell lines exposed to clinically relevant photon, proton, and carbon ion beams, we show there is not significantly less relative variability …

Advancement Of A 3d Computational Phantom And Its Age Scaling Methodologies For Retrospective Dose Reconstruction Studies, Aashish Gupta

Dissertations and Theses (Open Access)

We have used a 3D age-scalable computational phantom for over two decades for retrospective dose reconstruction studies of childhood cancer survivors (CCS) treated with 2D historic radiotherapy (RT). However, our phantom and its age scaling functions (ASF) must be updated so that it can be used in studies that include survivors treated with contemporary RT. We aimed to implement our phantom and its age scaling functions in DICOM format and determine the feasibility of applying our ASFs to accurately scale the whole-body CT-based anatomies.

In the implementation study, we developed Python scripts that model the phantom and ASFs in a …

Graphical Models In Reconstructability Analysis And Bayesian Networks, Marcus Harris, Martin Zwick

Complex Systems Faculty Publications and Presentations

Reconstructability Analysis (RA) and Bayesian Networks (BN) are both probabilistic graphical modeling methodologies used in machine learning and artificial intelligence. There are RA models that are statistically equivalent to BN models and there are also models unique to RA and models unique to BN. The primary goal of this paper is to unify these two methodologies via a lattice of structures that offers an expanded set of models to represent complex systems more accurately or more simply. The conceptualization of this lattice also offers a framework for additional innovations beyond what is presented here. Specifically, this paper integrates RA and …

A Multidimensional Welfare Status Of Leprosy Patients Living In A Suburban Area, Yunia Irawati, Sri Linuwih Sw Menaldi, Melinda Harini, Luh Karunia Wahyuni, Wanarani Alwin, Astari Dwiranti, Adhityawarman Menaldi, Sonny Tirta Luzanil, Qaishum Matsurah, Dadun ., Rico Kurniawan, Ida Ruwaida, Gunawan Wicaksono, Muhammad Hidayat Sahid, Febrina Rahmayanti, Florentina Priscilia, Anis Fitriana, Tri Rahayu, Made Susiyanti, Gitalisa Andayani, Anna Puspitasari Bani, Hisar Daniel, Yeni Dwi Lestari

ASEAN Journal of Community Engagement

Leprosy has a high incidence of physical complications that will impact directly the physiological, economic, and social status of patients. Indonesia has a high burden of the disease, and several leprosy settlements are still spread in the country. Neglasari Village, Sitanala, Tangerang serves as one of the places of residence of people who have had leprosy. A health service initiative known as Identifikasi Tanda-Tanda Mata, Ekstremitas, dan Kulit pada Kusta (KATAMATAKU) was launched as a collaboration of health services among multi-departments (ophthalmology, dermatovenereology, and medical rehabilitation). Sitanala has a relatively high incidence of people who have had leprosy with disabilities …

Predictors Of Chronic Opioid Therapy In Medicaid Beneficiaries With Hiv Who Initiated Antiretroviral Therapy, Gyeon Oh, Emily S. Brouwer, Erin L. Abner, David W. Fardo, Patricia R. Freeman, Chris Delcher, Daniela C. Moga

Epidemiology and Environmental Health Faculty Publications

The factors associated with chronic opioid therapy (COT) in patients with HIV is understudied. Using Medicaid data (2002-2009), this retrospective cohort study examines COT in beneficiaries with HIV who initiated standard combination anti-retroviral therapy (cART). We used generalized estimating equations on logistic regression models with backward selection to identify significant predictors of COT initiation. COT was initiated among 1014 out of 9615 beneficiaries with HIV (male: 10.4%; female: 10.7%). Those with older age, any malignancy, Hepatitis C infection, back pain, arthritis, neuropathy pain, substance use disorder, polypharmacy, (use of) benzodiazepines, gabapentinoids, antidepressants, and prior opioid therapies were positively associated with …

Treatment Patterns And Outcomes In Elderly Patients With Newly Diagnosed Multiple Myeloma: Results From The Connect® Mm Registry, Hans C. Lee, Sikander Ailawadhi, Cristina J. Gasparetto, Sundar Jagannath, Robert M. Rifkin, Brian G.M. Durie, Mohit Narang, Howard R. Terebelo, Kathleen Toomey, James W. Hardin Ph.D., Lynne Wagner, James L. Omel, Mazaher Dhalla, Liang Liu, Prashant Joshi, Rafat Abonour

Faculty Publications

No abstract provided.

Physical Activity Barriers And Assets In Rural Appalachian Kentucky: A Mixed-Methods Study, Natalie Jones, Deirdre Dlugonski, Rachel Gillespie, Emily M. Dewitt, Joann Lianekhammy, Stacey A. Slone, Kathryn M. Cardarelli

Sports Medicine Research Institute Faculty Publications

Obesity is an increasing public health concern in the U.S. and a contributor to chronic illness, with trends revealing a rise in adult obesity and chronic disease rates among the most vulnerable and disadvantaged populations, including those in rural communities. A mixed-methods approach was used to examine perspectives on perceived physical activity barriers, resources, and level of community support. Researchers utilized the socioecological model to examine the multiple domains that support physical activity in rural Appalachia. The present study focuses on baseline data, including a cohort survey to assess physical activity, health status, and barriers to physical activity, and five …

From Reaction Kinetics To Dementia: A Simple Dimer Model Of Alzheimer’S Disease Etiology, Michael R. Lindstrom, Manuel B. Chavez, Elijah A. Gross-Sable, Eric Y. Hayden, David B. Teplow

School of Mathematical & Statistical Sciences Faculty Publications

Oligomers of the amyloid β-protein (Aβ) have been implicated in the pathogenesis of Alzheimer’s disease (AD) through their toxicity towards neurons. Understanding the process of oligomerization may contribute to the development of therapeutic agents, but this has been difficult due to the complexity of oligomerization and the metastability of the oligomers thus formed. To understand the kinetics of oligomer formation, and how that relates to the progression of AD, we developed models of the oligomerization process. Here, we use experimental data from cell viability assays and proxies for rate constants involved in monomerdimer-trimer kinetics to develop a simple mathematical model …

Multiple Baseline Interrupted Time Series: Describing Changes In New Mexico Medicaid Behavioral Health Home Patients’ Care, Jessica Reno

Mathematics & Statistics ETDs

In 2016, the CareLink New Mexico behavioral health homes program began enrolling Medicaid recipients with the goal of increasing care coordination, improving access to services, and decreasing long-term costs of care for adults with serious mental illness (SMI) and children with severe emotional disturbance (SED). To evaluate these aims, a retrospective interrupted time series study using Medicaid claims data was designed. First, a comparable subset of non-enrolled individuals was selected from the pool of Medicaid recipients with SMI or SED using propensity score matching. Then, segmented regression was applied to three outcomes: total Medicaid charges, number of outpatient behavioral health …

Understanding Covid-19 Dynamics And The Effects Of Interventions In The Philippines: A Mathematical Modelling Study, Jamie M. Caldwell, Elvira P. De Lara-Tuprio, Timothy Robin Y. Teng, Ma. Regina Justina E. Estuar, Raymond Francis R. Sarmiento, Milinda Abayawardana B. Eng, Robert Neil F. Leong, Richard T. Gray, James G. Wood, Linh-Vi Le, Emma S. Mcbryde, Romain Ragonnet, James M. Trauer

Mathematics Faculty Publications

Background

COVID-19 initially caused less severe outbreaks in many low- and middle-income countries (LMIC) compared with many high-income countries; possibly because of differing demographics; socioeconomics; surveillance; and policy responses. Here; we investigate the role of multiple factors on COVID-19 dynamics in the Philippines; a LMIC that has had a relatively severe COVID-19 outbreak.

Methods

We applied an age-structured compartmental model that incorporated time-varying mobility; testing; and personal protective behaviors (through a “Minimum Health Standards” policy; MHS) to represent the first wave of the Philippines COVID-19 epidemic nationally and for three highly affected regions (Calabarzon; Central Visayas; and the National Capital …

Thanatechnology And The Living Dead: New Concepts In Digital Transformation And Human-Computer Interaction, Vural Özdemir, Simon Springer, Arif Ylldlrlm, Sehmus Biçer, Asllgül Kendirci, Semra Sardaş, Hakan Klllç, Nezih Hekim, Tanja Kunej, Kazlm Yalçln Arga, Kevin Dzobo, Wei Wang, Marius Geanta, Angela Brand, Mustafa Bayram

Research outputs 2014 to 2021

In a digital society, shall we be the authors of our own experience, not only during our lifetime but also after we die? We ask this question because dying and bereavement have become even harder, and much less private, in the digital age. New big data-driven digital industries and technologies are on the rise, with promises of interactive 3D avatars and storage of digital memories of the deceased, so they can continue to exist online as the "living dead"in a digital afterlife. Famous rock and roll icons like Roy Orbison, Frank Zappa, Ronnie James Dio, and Amy Winehouse have famously …

Modeling Of Island Block Scatter For Intensity Modulated Bolus Electron Conformal Therapy, Joseph G. Scotto

LSU Master's Theses

Purpose: Bolus electron conformal therapy (BECT) benefits treatment of the post-mastectomy chest wall, head and neck, paraspinal muscles, and extremities. Patient dose heterogeneities caused by bolus can be reduced through intensity modulation (IM) across the incident electron beam. This requires passive radiotherapy intensity modulation for electrons (PRIME) devices, which utilize tungsten pins (island blocks) imbedded in machinable foam. IM-BECT treatment planning requires accurate dose calculation using the pencil beam redefinition dose algorithm (PBRA). Currently, the PBRA models island blocks as perfect collimators. This work explores models to account for electrons scattering into and out of the sides of island blocks. …

Decoding Clinical Biomarker Space Of Covid-19: Exploring Matrix Factorization-Based Feature Selection Methods, Farshad Saberi-Movahed, Mahyar Mohammadifard, Adel Mehrpooya, Mohammad Rezaei-Ravari, Kamal Berahmand, Mehrdad Rostami, Saeed Karami, Mohammad Najafzadeh, Davood Hajinezhad, Mina Jamshidi, Farshid Abedi, Mahtab Mohammadifard, Elnaz Farbod, Farinaz Safavi, Mohammadreza Dorvash, Shahrzad Vahedi, Mahdi Eftekhari, Farid Saberi-Movahed, Iman Tavassoly

Publications and Research

One of the most critical challenges in managing complex diseases like COVID-19 is to establish an intelligent triage system that can optimize the clinical decision-making at the time of a global pandemic. The clinical presentation and patients’ characteristics are usually utilized to identify those patients who need more critical care. However, the clinical evidence shows an unmet need to determine more accurate and optimal clinical biomarkers to triage patients under a condition like the COVID-19 crisis. Here we have presented a machine learning approach to find a group of clinical indicators from the blood tests of a set of COVID-19 …

Medical Schools Ignore The Nature Of Consciousness At Great Cost, Anoop Kumar

Journal of Wellness

The essential question of the relationship between consciousness and matter is ignored in medical school curricula, leading to a machine-like view of the human being that contributes to physician burnout and intellectual dissatisfaction. The evidence suggesting that the brain may not be the seat of consciousness is generally ignored to preserve the worldview of the primacy of matter. By investigating new frameworks detailing the nature of consciousness at different levels of hierarchy, we can bring intellectual rigor to a once opaque subject that supports a fundamental reality about our experience: We are human beings, not only human bodies.

Clinical Outcomes Of Molecular Tumor Boards: A Systematic Review, Kara L. Larson, Bin Huang, Heidi L. Weiss, Pamela C. Hull, Philip M. Westgate, Rachel W. Miller, Susanne M. Arnold, Jill M. Kolesar

Markey Cancer Center Faculty Publications

PURPOSE: We conducted this systematic review to evaluate the clinical outcomes associated with molecular tumor board (MTB) review in patients with cancer.

METHODS: A systematic search of PubMed was performed to identify studies reporting clinical outcomes in patients with cancer who were reviewed by an MTB. To be included, studies had to report clinical outcomes, including clinical benefit, response, progression-free survival, or overall survival. Two reviewers independently selected studies and assessed quality with the Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group or the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies depending on the type …

Distilling Professional Opinion To Gauge Vulnerability Of Guam Avifauna To Brown Treesnake Predation, Robert M. Mcelderry, Eben H. Paxton, Andre V. Nguyen, Shane R. Siers

United States Department of Agriculture Wildlife Services: Staff Publications

The avifauna of Guam was devastated by the introduction of the Brown Treesnake, and the restoration of native birds would need to address the problem with eradication or suppression of BTS. With eradication of the snake unlikely in the near term, and suppression capabilities limited to specific finite areas, key information for reintroductions is how low BTS abundance will likely need to be for each bird species to be re-established based on their vulnerability to BTS predation. Here, we estimate vulnerability, which can no longer be measured directly, so biologists who are familiar with one or more of seven Guam …

Diagnostic Accuracy Of Machine Learning Models To Identify Congenital Heart Disease: A Meta-Analysis, Zahra Hoodbhoy, Uswa Jiwani, Saima Sattar, Rehana A. Salam, Babar Hasan, Jai K. Das

Department of Paediatrics and Child Health

Background: With the dearth of trained care providers to diagnose congenital heart disease (CHD) and a surge in machine learning (ML) models, this review aims to estimate the diagnostic accuracy of such models for detecting CHD.
Methods: A comprehensive literature search in the PubMed, CINAHL, Wiley Cochrane Library, and Web of Science databases was performed. Studies that reported the diagnostic ability of ML for the detection of CHD compared to the reference standard were included. Risk of bias assessment was performed using Quality Assessment for Diagnostic Accuracy Studies-2 tool. The sensitivity and specificity results from the studies were used to …

Pattern Of Use Of Electronic Health Record (Ehr) Among The Chronically Ill: A Health Information National Trend Survey (Hints) Analysis, Rose Calixte, Sumaiya Islam, Zainab Toteh Osakwe, Argelis Rivera, Marlene Camacho-Rivera

Publications and Research

Effective patient–provider communication is a cornerstone of patient-centered care. Patient portals provide an effective method for secure communication between patients or their proxies and their health care providers. With greater acceptability of patient portals in private practices, patients have a unique opportunity to manage their health care needs. However, studies have shown that less than 50% of patients reported accessing the electronic health record (EHR) in a 12-month period. We used HINTS 5 cycle 1 and cycle 2 to assess disparities among US residents 18 and older with any chronic condition regarding the use of EHR for secure direct messaging …

Cognitive Complaints In Age-Related Chronic Conditions: A Systematic Review, Nikki L. Hill, Sakshi Bhargava, Monique J. Brown, Hyejin Kim, Iris Bhang, Kaitlyn Mullin, Kathleen Phillips, Jacqueline Mogle

Faculty Publications

Introduction

Cognitive complaints in older adults may be indicative of progressive cognitive decline including Alzheimer’s disease (AD), but also occur in other age-related chronic conditions, complicating identification of early AD symptoms. To better understand cognitive complaints in aging, we systematically reviewed the evidence to determine their prevalence and characterization among older adults with the most common age-related chronic conditions.

Methods

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and the review protocol was prospectively registered with PROSPERO (ID: CRD42020153147). Searches were conducted in PubMed, CINAHL, PsycINFO, Web of Science, and …

Association Of Chronic Pain With Participation In Motor Skill Activities In Children With Cerebral Palsy, Haresh Rochani, Christopher M. Modlesky, Barbara Weissman, Joshua Vova, Gavin T. Colquitt

Biostatistics, Epidemiology & Environmental Health Sciences: Faculty Publications

Many children with cerebral palsy (CP) experience the secondary condition of pain, which is problematic because children with CP face barriers to participation in motor skill activities.^1,2 Motor performance in activities of daily living among children with CP is markedly lower than that among their age-matched peers.³ Because of the potential effect of pain on children with CP, we sought to examine the association between pain and activities requiring motor skill performance (ie, difficulty dressing or bathing and participation in sport) among a nationally representative sample of US children with CP.

Mathematical Modeling, Analysis, And Simulation Of The Covid-19 Pandemic With Behavioral Patterns And Group Mixing, Comfort Ohajunwa, Padmanabhan Seshaiyer

Spora: A Journal of Biomathematics

Due to the rise of COVID-19 cases, many mathematical models have been developed to study the disease dynamics of the virus. However, despite its role in the spread of COVID-19, many SEIR models neglect to account for human behavior. In this project, we develop a novel mathematical modeling framework for studying the impact of mixing patterns and social behavior on the spread of COVID-19. Specifically, we consider two groups, one exhibiting normal behavior who do not reduce their contacts and another exhibiting altered behavior who reduce their contacts by practicing non-pharmaceutical interventions such as social distancing and self-isolation. The dynamics …

Structural Shielding Considerations For Vmat, Ana Lucia Dieguez

LSU Master's Theses

Introduction: As noted in National Council on Radiation Protection and Measurements (NCRP) Report 151, the medical physicist or other qualified expert has the responsibility to keep abreast of any new technology or treatment method that could potentially impact structural shielding design. Volumetric arc therapy (VMAT) became prevalent after the publication of Report 151 and thus was not explicitly addressed in Report 151. If the shielding-related characteristics of VMAT differ enough from the expectations of Report 151, especially in the circumstance of a vault utilized exclusively for VMAT, a shielding design based on Report 151 could potentially be inadequate. The …

A Kinetic Model For Blood Biomarker Levels After Mild Traumatic Brain Injury, Sima Azizi, Daniel B. Hier, Blaine Allen, Tayo Obafemi-Ajayi, Gayla R. Olbricht, Matthew S. Thimgan, Donald C. Wunsch

Mathematics and Statistics Faculty Research & Creative Works

Traumatic brain injury (TBI) imposes a significant economic and social burden. The diagnosis and prognosis of mild TBI, also called concussion, is challenging. Concussions are common among contact sport athletes. After a blow to the head, it is often difficult to determine who has had a concussion, who should be withheld from play, if a concussed athlete is ready to return to the field, and which concussed athlete will develop a post-concussion syndrome. Biomarkers can be detected in the cerebrospinal fluid and blood after traumatic brain injury and their levels may have prognostic value. Despite significant investigation, questions remain as …

Ganglioside Alters Phospholipase Trafficking, Inhibits Nf-Κb Assembly, And Protects Tight Junction Integrity, John J. Miklavcic, Qun Li, Jordan Skolnick, Alan B. R. Thomson, Vera C. Mazurak, Michael Tom Clandinin

Food Science Faculty Articles and Research

Background and Aims: Dietary gangliosides are present in human milk and consumed in low amounts from organ meats. Clinical and animal studies indicate that dietary gangliosides attenuate signaling processes that are a hallmark of inflammatory bowel disease (IBD). Gangliosides decrease pro-inflammatory markers, improve intestinal permeability, and reduce symptoms characteristic in patients with IBD. The objective of this study was to examine mechanisms by which dietary gangliosides exert beneficial effects on intestinal health.

Methods: Studies were conducted in vitro using CaCo-2 intestinal epithelial cells. Gangliosides were extracted from milk powder and incubated with differentiated CaCo-2 cells after exposure to pro-inflammatory stimuli. …

Caries And Restoration Detection Using Bitewing Film Based On Transfer Learning With Cnns, Yi-Cheng Mao, Tsung-Yi Chen, He-Sheng Jhou, Szu-Yin Lin, Sheng-Yu Liu, Yu-An Chen, Yu-Lin Liu, Chiung-An Chen, Yen-Cheng Huang, Shih-Lun Chen, Chun-Wei Li, Patricia Angela R. Abu, Wei-Yuan Chiang

Department of Information Systems & Computer Science Faculty Publications

Caries is a dental disease caused by bacterial infection. If the cause of the caries is detected early; the treatment will be relatively easy; which in turn prevents caries from spreading. The current common procedure of dentists is to first perform radiographic examination on the patient and mark the lesions manually. However; the work of judging lesions and markings requires professional experience and is very time-consuming and repetitive. Taking advantage of the rapid development of artificial intelligence imaging research and technical methods will help dentists make accurate markings and improve medical treatments. It can also shorten the judgment time of …

Covid-19 And The Impact On Rural And Black Church Congregants: Results Of The C-M-C Project, Lovoria B. Williams, Anita F. Fernander, Tofial Azam, Maria L. Gomez, Junghee Kang, Cassidy L. Moody, Hannah Bowman, Nancy E. Schoenberg

Nursing Faculty Publications

The COVID-19 pandemic has had devastating effects on Black and rural populations with a mortality rate among Blacks three times that of Whites and both rural and Black populations experiencing limited access to COVID-19 resources. The primary purpose of this study was to explore the health, financial, and psychological impact of COVID-19 among rural White Appalachian and Black nonrural central Kentucky church congregants. Secondarily we sought to examine the association between sociodemographics and behaviors, attitudes, and beliefs regarding COVID-19 and intent to vaccinate. We used a cross sectional survey design developed with the constructs of the Health Belief and Theory …

Identification Of Novel And Rare Variants Associated With Handgrip Strength Using Whole Genome Sequence Data From The Nhlbi Trans-Omics In Precision Medicine (Topmed) Program, Chloé Sarnowski, Han Chen, Mary L. Biggs, Sylvia Wassertheil-Smoller, Jan Bressler, Marguerite R. Irvin, Kathleen A. Ryan, David Karasik, Donna K. Arnett, L. Adrienne Cupples, David W. Fardo, Stephanie M. Gogarten, Benjamin D. Heavner, Deepti Jain, Hyun Min Kang, Charles Kooperberg, Arch G. Mainous, Braxton D. Mitchell, Alanna C. Morrison, Jeffrey R. O'Connell

Epidemiology and Environmental Health Faculty Publications

Handgrip strength is a widely used measure of muscle strength and a predictor of a range of morbidities including cardiovascular diseases and all-cause mortality. Previous genome-wide association studies of handgrip strength have focused on common variants primarily in persons of European descent. We aimed to identify rare and ancestry-specific genetic variants associated with handgrip strength by conducting whole-genome sequence association analyses using 13,552 participants from six studies representing diverse population groups from the Trans-Omics in Precision Medicine (TOPMed) Program. By leveraging multiple handgrip strength measures performed in study participants over time, we increased our effective sample size by 7-12%. Single-variant …