Medicine and Health Sciences Commons^™

Preterm Birth Increases Susceptibility To Hyperglycemia-Induced Kidney Injury With Sex-Specific Differences In Structural And Molecular Responses, Rachel K Dailey, Aleksandra Cwiek, Logan C Hamil, Sage Timberline, Ayyappa Kumar Sista Kameshwar, Masako Suzuki, Jaya Isaac, Kimberly Deronde, Mark Conaway, Kevin M Bennett, Edwin J Baldelomar, Matthew R Hoch, Kimberly J Reidy, Jennifer R Charlton

2020-Current year OA Pubs

BACKGROUND: Preterm birth increases the long-term risk of diabetes and chronic kidney disease (CKD), yet its impact on diabetic kidney disease (DKD) is unclear. We previously showed that male preterm mice with diabetes develop early features of DKD, including reduced podocyte density, decreased renin expression, activation of angiogenesis pathways, and impaired endothelial-podocyte signaling. Here, we examine whether preterm birth similarly accelerates DKD progression in female mice and compare structural and transcriptomic outcomes in the females to the prior male cohort to assess sex-specific differences.

METHODS: Preterm mice were delivered by Caesarean section at 19 days post conception (dpc) and term …

A Prospective, Multi-Center, Observational Study Of The Safety, Tolerability And Effectiveness Of Nusinersen In Adult Patients With Spinal Muscular Atrophy, Craig M Zaidman, Crystal Proud, Bing Liao, Nassim Rad, Doreen Ho, Mary-Lynn Chu, Shafeeq Ladha, Thomas O Crawford, Shakti Nayar, Angela Genge, Margaret Frey, Chad Heatwole, Daphne Lew

2020-Current year OA Pubs

Nusinersen, an antisense oligonucleotide, modulates pre-mRNA splicing to produce full length survival motor neuron protein in spinal muscular atrophy (SMA). It was approved in the US for SMA in all ages based on evidence in children. In adults, studies of nusinersen rely on real-world observational data and show stability or small improvements over time. We performed a prospective, 30 month longitudinal, observational multi-center study of adults initiating nusinersen with SMA types II/III to examine its safety, tolerability, and effectiveness. 43 participants (20 female; 14 ambulatory; 3, 17, and 23 with 2, 3, and ≥4 SMN2 copies, respectively), mean (SD) age …

From Low Field To High Value: Robust Cortical Mapping From Low-Field Mri, Karthik Gopinath, Timothy Coalson, Matthew F Glasser, David Van Essen, Et Al.

2020-Current year OA Pubs

Three-dimensional reconstruction of cortical surfaces from MRI for subsequent morphometric analysis is fundamental for understanding brain structure. While high-field Magnetic Resonance Imaging (HF-MRI) is the standard in research and clinical settings, its relatively limited availability hinders widespread use. Low-field MRI (LF-MRI), particularly portable systems, offers a cost-effective and accessible alternative. However, existing cortical surface analysis tools, such as FreeSurfer, are optimized for high-resolution HF-MRI and struggle with the lower signal-to-noise ratio (SNR) and resolution of LF-MRI. In this work, we present a machine learning method for 3D reconstruction and analysis of portable LF-MRI scans over a range of contrasts and …

Spleen Volume Reduction And Transfusion Independence With Momelotinib Versus Ruxolitinib And Associated Overall Survival With Momelotinib In Jak Inhibitor-Naive Patients With Myelofibrosis And Anemia: Subgroup Analyses Of Simplify-1, Francesca Palandri, Stephen T Oh, Et Al.

2020-Current year OA Pubs

INTRODUCTION: Improvements in splenomegaly, anemia, and overall survival (OS) are key considerations in the management of patients with myelofibrosis. In the phase III SIMPLIFY-1 trial (NCT01969838), momelotinib was noninferior to ruxolitinib for spleen volume reduction ≥ 35% (SVR35) and nominally superior for transfusion independence (TI) at week 24 in Janus kinase (JAK) inhibitor-naive patients. However, the relative impact of these endpoints on OS in anemic patients has not been described.

MATERIALS AND METHODS: The present post hoc analysis evaluated week 24 SVR35, TI, and dual responses (SVR35 + TI) in patients with baseline hemoglobin < 10 g/dL.

RESULTS: SVR35 rates were similar overall …

Utility Of Routine Histopathologic And Culture Analysis In Wrist Tenosynovectomy, Andrew Straszewski, Stockton Troyer, Martin I Boyer, Charles A Goldfarb

2020-Current year OA Pubs

PURPOSE: Routine practices without a clear impact on patient care merit continuous reassessment. This retrospective study evaluated the value of routine histopathologic and culture analysis in patients who underwent flexor or extensor tendon tenosynovectomy.

METHODS: Current Procedural Terminology codes for isolated tenosynovectomy procedures were queried from an institutional database from 2018 to 2023, including all patients aged ≥18 treated by one of seven fellowship-trained hand surgeons. Demographics, past medical and surgical history, clinic notes, operative notes, imaging, pathology, and culture data were reviewed. We assessed for changes to the treatment course of each patient based on the pathology and culture …

Vustruct: A Compute Pipeline For High Throughput And Personalized Structural Biology, Christopher W. Moth, Jonathan H. Sheehan, Abdullah Al Mamun, R. Michael Sivley, Alican Gulsevin, David C. Rinker, Zenab F. Mchaourab, Undiagnosed Disease Network, John A. Capra, Jens Meiler

2020-Current year OA Pubs

Effective diagnosis and treatment of rare genetic disorders requires the interpretation of a patient's genetic variants of unknown significance (VUSs). Today, clinical decision-making is primarily guided by gene-phenotype association databases and DNA-based scoring methods. Our web-accessible variant analysis pipeline, VUStruct, supplements these established approaches by deeply analyzing the downstream molecular impact of variation in context of 3D protein structure. VUStruct's growing impact is fueled by the co-proliferation of protein 3D structural models, gene sequencing, compute power, and artificial intelligence. Contextualizing VUSs in protein 3D structural models also illuminates longitudinal genomics studies and biochemical bench research focused on VUS, and we …

The Camus Initiative: A Multiphase, Multicentre International Collaboration To Redefine Risk Stratification, Reporting, And Grading Of Surgical Complications In Urology., Christopher Soliman, Niranjan J. Sathianathen, Niall M. Corcoran, Nathan Lawrentschuk, Patrick Y. Wuethrich, Marc A. Furrer, Paul Chung, Camus Study Group Collaborators

Department of Neurology Faculty Papers

Surgical complications remain a major source of preventable morbidity, mortality, and health care expenditure, but existing frameworks such as the Clavien-Dindo classification and Comprehensive Complication Index are clinician-centred and intervention-focused and fail to capture cumulative patient-centred outcomes. This protocol outlines the Complications After Major and Minor Urological Surgery (CAMUS) initiative, a global, multiphase effort to redefine complication reporting, risk stratification, and outcome measurement in urological surgery. CAMUS aims to address these limitations via an integrated, seven-arm programme combining retrospective and prospective data analysis, consensus development, and digital infrastructure design. Arm 1 has assembled a retrospective data set of 130 034 …

Show And Tell: Integrating The Arts Into Transdisciplinary Public Health And Community Organizing Education, Bree L. Hemingway, Margaret Hawkins

The Transdisciplinary STEAM+ Journal

This field note examines the integration of arts-based pedagogy into a transdisciplinary graduate course that brings together students from public health, medicine, the social sciences, humanities, education, technology, and the arts. Central to the course is the Show and Tell assignment, in which students select and present a work of art connected to a social movement. Over three years and 42 student submissions, this assignment has served as an accessible entry point for exploring how artistic expression shapes activism, fosters community, and deepens understanding of justice-oriented work. Through an inductive content analysis of student-selected artworks and presentations, five major thematic …

Measuring Time, Measuring Impact: Reimagining Protected Time In Graduate Medical Education, Rehan Qayyum

Eastern Virginia Medical Journal

This article does not have an Abstract.

Optimal Timing Of Coronary Artery Bypass Grafting In Patients With Nstemi – A National Study From The United States, Viet Nghi Tran, Hoang Nhat Pham, Ramzi Ibrahim, Hong Hieu Truong, Mahmoud Abdelnabi, Amreen Dhindsa, Pham Thao Vy Le, Doan Ngoc Chau Nguyen, Aisha Jamal, Phillip Tran, Thach Nguyen, Anwar Chahal, Kwan S. Lee, Reza Arsanjani, Amitoj Singh

Marshall Journal of Medicine

Background: The timing of coronary artery bypass grafting (CABG) in patients with non-ST-elevation myocardial infarction (NSTEMI) may critically impact clinical outcomes, yet the ideal surgical window remains unclear. We aimed to evaluate the association between time-to-CABG and in-hospital outcomes among NSTEMI admissions undergoing CABG.

Methods: This retrospective cohort study utilized the US National Inpatient Sample database from 2017 to 2021 to evaluate the association between time-to-CABG and key in-hospital outcomes, including mortality, cardiac arrest, cardiogenic shock, ischemic stroke, acute kidney injury, and blood transfusion rates, while assessing length of stay (LOS) and hospital charges exclusively among survivors. Adult admissions with …

Operative Management Of An Ulnar Stress Fracture In A Collegiate Cheerleader, Catherine Allen, Jacob Hackett, Alan Koester, Madison Cunningham, Dana Lycans

Marshall Journal of Medicine

Ulnar stress fractures are relatively rare, particularly in the context of collegiate cheerleading. This case report explores the presentation, diagnosis, and surgical management of an unexpected stress fracture in the ulna of a collegiate cheerleader. An 18-year-old female presented with persistent, localized pain in her non-dominant arm. Imaging revealed an isolated ulnar stress fracture, an unusual finding despite participating in this physically demanding sport. Surgical intervention was deemed necessary, and a nail fixation technique was employed to stabilize the fracture. Ulnar stress fractures, though rare in cheerleading, can present unique challenges. This case report documents the effectiveness of an operative …

Extraparotid Warthin Tumor Presenting As A Cervical Lymph Node Mass: A Case Report., Kristen E. Bowman, Colin Bashline, Konstantinos C. Mantzios, Jack Kelly, David Maki, David Webb

Marshall Journal of Medicine

A Warthin tumor is a salivary gland neoplasm that arises in the parotid gland which is frequently benign. This case study presents a rare instance of a Warthin tumor occurring in an extraparotid location; specifically, within the left-sided cervical lymph nodes of a 64-year-old male patient. The patient initially presented with fluctuating cervical adenopathy. Although an initial ultrasound-guided biopsy was inconclusive,  a computed tomography (CT) scan revealed a well-demarcated, heterogeneous lesion in an atypical location between the parotid gland and the sternocleidomastoid muscle. Surgical excision of the mass was performed and the specimen was sent to pathology for further analysis. …

Leading Academic Health Centers In Times Of Uncertainty, Wendy L. Ward

Marshall Journal of Medicine

Times of uncertainty and rapid change can negatively impact academic health centers (AHC) in complex ways, creating challenges for leaders. These include policy uncertainty, financial instability, workforce stress, reputational risk, operational disruptions, and advocacy pressure. There are also potential opportunities for AHCs during this time of immense change and disruption. This perspective piece reviews the diverse negative and positive impacts of political turmoil on academic health centers. Five considerations are offered for leaders navigating times of uncertainty.

Under Chiron's Care, Deethya Trivedi

HCA Healthcare Journal of Medicine

This painting depicts young Asclepius under the guidance of Chiron, the wise centaur renowned for his knowledge of healing and medicine. In Greek mythology, Asclepius was entrusted to Chiron after Apollo recognized his potential. Within the nurturing environment of Chiron’s home, Asclepius absorbed lessons on the use of medicinal herbs, wound treatment, and the foundational principles of care, skills that would eventually elevate him to become the Greek God of Medicine. The herbs symbolize hands-on learning and the practical foundation of healing, while the book signifies the accumulation and sharing of knowledge, showing how medical innovation progresses through study, collaboration, …

Ethical Use Of Artificial Intelligence For Clinical Vignettes, Henna Iqbal, Jennifer J. Park, Yelena Burklin

HCA Healthcare Journal of Medicine

The purpose of this report is to introduce a systematic process model for publishing clinical vignettes through vignette-based learning (VBL), with an emphasis on the ethical use of artificial intelligence (AI). We have provided a comprehensive walk-through outlining the process from initial case identification to the final dissemination of clinical vignettes, and we have highlighted how AI tools can support each step. This guide is intended to be especially beneficial for clinicians and early-career medical professionals aiming to develop and submit their cases for presentations, publications, and other avenues of knowledge sharing.

Artificial Intelligence In Medicine: Barriers, Solutions, And Strategies, Anil Harrison, Melissa Stradley Moreno, Caroline E. Williams, Munevver Mine Subasi, Ersoy Subasi

HCA Healthcare Journal of Medicine

The integration of artificial intelligence (AI) and machine learning (ML) into health care holds the potential to revolutionize patient care by enhancing clinical decision-making, improving diagnostic accuracy, and reducing costs. Despite this promise, adoption remains limited due to a range of technical, regulatory, educational, and cultural barriers. This paper examines these challenges and proposes strategies to support safe and effective implementation of AI in clinical practice.

Key barriers include the lack of model interpretability, often referred to as the "black box" problem, which undermines clinician trust and accountability in clinical settings, evolving regulatory frameworks and unresolved questions surrounding liability, and …

The Role Of Simulation In General Surgery Residency: Advancing Technical Proficiency And Clinical Confidence, Matthew A. Daniel, Alyssa Mcmandon, Rachel Daley, Andrew Gustetic, Alexis Howarth, Meghana Jacob, Holden Lewis, Kushali Patel, Taylor Locklear, Saptarshi Biswas

HCA Healthcare Journal of Medicine

Surgical training has changed significantly over the past several decades, largely due to advances in technology. After the introduction of laparoscopic and robotic surgery into residency programs, simulation-based training (SBT) has become an important addition to surgical education. Simulation-based training offers a safe and structured environment to practice skills, receive feedback, and develop technical and non-technical abilities. While its benefits are well recognized, wider use of SBT continues to face challenges, including high costs, limited faculty availability, and time constraints within residency schedules. New technologies such as artificial intelligence, virtual and augmented reality, and standardized simulation frameworks may help address …

An Innovative Model For Graduate Medical Education Faculty Development Through Physician-In-Training Delivery, Daniel A. Nguyen, Dustin Wilkes, Marshall Hall, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Background

Faculty development is a core requirement for Accreditation Council for Graduate Medical Education (ACGME)-accredited residency programs. Successfully delivering content to faculty can be challenging. This pilot study aimed to assess expert-developed sessions delivered by resident physicians to faculty at the completion of their clinical rotations.

Methods

A prospective cohort project was conducted, involving precepting faculty and resident physicians in a dermatology residency program. Each resident, at the end of their rotation, delivered a faculty development program to their attending physician. Each resident participated in the program for 1-3 years. The faculty development programs were based on faculty development programs …

A Scalable Model For Resident And Faculty Well-Being: Applying Self-Determination Theory And The Job Demands-Resources Framework In Graduate Medical Education, Gregory Guldner, Adam Neufeld

HCA Healthcare Journal of Medicine

Despite growing attention to burnout in graduate medical education (GME), many institutional efforts remain fragmented and lack theoretical coherence. In response, HCA Healthcare developed a system-wide initiative grounded in Self-Determination Theory (SDT) and the Job Demands-Resources (JD-R) framework to guide leadership development, learning climate improvement, and resident and faculty well-being. What began as a single-program effort evolved into a multi-year, system-wide initiative involving more than 5800 residents across 366 programs at 85 hospitals. In collaboration with workplace psychologists from Claremont Graduate University and Immersyve Health, the initiative integrated theory-informed leadership workshops, validated assessment platforms, and continuous quality-improvement processes to help …

Fostering Leadership Competency And Professional Identity Formation Through Near Peer Educator Programs, Justin Choi, Gabriela Martin Gonzalez, Tahina Ahmed, Shirley Eisner

HCA Healthcare Journal of Medicine

Introduction

Leadership competency development is a pivotal component of physician professional identity formation (PIF), and its instruction across undergraduate medical education (UME) institutions is diverse. Near-Peer Educator Programs (NPEPs) foster experiential leadership development through teaching junior learners. We evaluated the impact of participation in a structured longitudinal NPEP on medical students’ self-reflections of their leadership growth.

Methods

Medical students serving as Near-Peer Educators (NPEs) were invited to complete a baseline survey prior to facilitating any sessions and a follow-up survey after facilitating more than 1 session. The surveys, measured using a 7-point Likert scale, were modeled on a validated clinical …

Resident Scholarly Activity Plan And Scorecard Implementation In Graduate Medical Education, Michele L. Mccarroll, Afsha Rais Kaisani, Joseph Kessler, Tasaduq H. Mir

HCA Healthcare Journal of Medicine

Background

Scholarly activity (SA) is a requirement of the Accreditation Council on Graduate Medical Education (ACGME); however, many programs struggle with interpreting ACGME trainee requirements and lack standardized tools to effectively communicate, document, and track individualized, resident-centered approaches to SA. This educational project aimed to develop a universal educational graduate medical education (GME) SA plan and scorecard tool to establish shared program expectations, provide formative and summative feedback on SA progression, track SA, and support individualized SA pathways aligned with residents’ professional goals.

Methods

In May 2022, faculty, associate program directors, and program directors within the North Texas Division of …

Icare Compassionately: An Innovative Approach To Improving Nursing Education, Lori M. Brodie

HCA Healthcare Journal of Medicine

Historically, compassionate care has been briefly introduced in nursing education, without a sustained focus throughout nursing programs. Compassionate care models define the essential qualities needed to deliver meaningful care. Many of the traditional compassionate care models rely on high-level concepts that can be difficult to operationalize in academia. Further, current compassionate care models are typically limited to specific settings and are taught separately from other parts of the nursing curriculum. To address these concerns, a single purpose nursing college created and implemented the iCare Compassionately Model, which emphasizes both measurable behaviors and concepts related to compassion. As a result of …

Owning Difficult Outcomes: Navigating Medical Error Disclosure For Trainees In Accordance With Acgme Standards, Sara Andrabi, Anita Rohra, Kelly Keene, Alison Haddock, Daniela Ortiz

HCA Healthcare Journal of Medicine

Background

The American College of Graduate Medical Education (ACGME) mandates that physicians promote patient safety and high-quality care, including training trainees in disclosing adverse events to patients and families. Despite its importance, many trainees lack formal preparation in error disclosure, leading to inconsistent practices. Structured training programs are essential to meet societal expectations and professional responsibilities.

Methods

A simulation-based curriculum was integrated into our annual "Difficult Communications" simulation day in response to feedback from residents. The curriculum employs standardized patients to create realistic error disclosure scenarios. Sessions include pre-briefing with faculty facilitators and standardized patients, simulated encounters, and structured debriefings. …

Building A Better Clinical Competency Committee: A Multi-Institutional Approach To Improving The Quality Of Resident Feedback Through Appreciative Inquiry, Nikita Khetan, Emma Omoruyi, Elizabeth Hanson

HCA Healthcare Journal of Medicine

Background

The Accreditation Council for Graduate Medical Education (ACGME) requires pediatric faculty to convene twice yearly as a Clinical Competency Committee (CCC) to review resident performance and provide feedback. Variability in review processes and limited feedback quality remain common challenges. Incorporating Appreciative Inquiry within a Deliberate Practice framework may enhance the quality of summative feedback provided to residents.

Methods

This project was conducted with pediatric residents and faculty during the 2019–20 academic year at The University of Texas Health Science Center at Health San Antonio (UTHSA) and during the 2021-22 academic year at The University of Texas Health Science Center …

The Distinguished Humanitarian Society, Ashley Charales, Grace Desrochers, Lakshmi Tatineni, Shane Jenks, Rajeev Raghavan

HCA Healthcare Journal of Medicine

Background

The Gold Humanism Honor Society (GHHS) is a nationally recognized organization present at over 80% of medical schools in the United States to promote humanism, integrity, and volunteerism among students. There is no equivalent national honor society present at the majority of Graduate Medical Education (GME) training programs.

Methods

Our institution created the Distinguished Humanitarian Society (DHS) as a local honor society in 2022 to recognize trainees who exemplified the ideals espoused by GHHS. In January and February 2025, we conducted semi-structured interviews to extract themes regarding inductees’ experiences with the DHS. Both interviewers used the same list of …

Gamification To Improve Emergency Medical Service Personnel Knowledge Of Medical Capacity Determination, Ross Sinicrope, Nasim Motaghedi, Zackary Yates, Elliott Richardson, Stephanie Schiffert, Jacob Wright, Abigail Alorda, Jeffrey Katz, Linh Nguyen, Shayne Gue, Christine Van Dillen, Ayanna Walker

HCA Healthcare Journal of Medicine

Background

As medical education evolves, innovative techniques are being explored to enhance learning and engagement. While existing literature on gamification in medical education primarily focuses on graduate medical education, its application in other fields, such as nursing or emergency medical services (EMS), remains underexplored. This study evaluates the feasibility of using gamification to teach EMS personnel about patient capacity assessment and examines its impact on the frequency of pre-hospital transport.

Methods

A relay race with 3 stations was developed by emergency medicine residents, EMS fellows, and emergency medicine and emergency medical services teaching faculty to teach capacity assessment. Each station …

Optimizing Antibiotic Strategies With A Clinical Pathway Approach: Enhanced Initiation And De-Escalation In Community-Acquired Pneumonia, Ahmad Behzadpour

HCA Healthcare Journal of Medicine

Background

Community-acquired pneumonia (CAP) remains a leading cause of hospitalization, mortality, and health care expenditure worldwide. Inappropriate use of broad-spectrum antibiotics contributes to antimicrobial resistance, adverse drug events, and increased costs. Antibiotic stewardship and standardized clinical pathways are key strategies to improve prescribing practices.

Methods

This quality improvement (QI) initiative was conducted at a 240-bed tertiary care teaching hospital from January 2023 through January 2025. A CAP-specific digital clinical pathway was developed using Curbside Health® and integrated into the electronic health record (EHR), accessible through a structured order set to support real-time clinical decision-making. The intervention included provider education and …

Impact Of Innovative Interprofessional Practice And Education Intervention Led By Graduate Medical Education Resident Physicians With School-Based Nursing In 32 School Districts, Christoffer A. Amdahl, Hans Drawbert, Sadra Forati, Tyler Fields, James Mantil, Afsha Rais Kaisani, Marci Ayers, Michele L. Mccarroll Phd

HCA Healthcare Journal of Medicine

Background

School nurses play a critical role in student well-being, underscoring their growing importance in both education and health care systems. Research consistently demonstrates their contributions to individual student care and broader population health.

Methods

This resident-led project explored community-based partnerships to facilitate mutual learning between school nurses and graduate medical education (GME) physicians. Conducted during the 2023–2024 academic year, this quality initiative (QI) involved the Medical City Healthcare (HCA Healthcare) GME programs and North Texas school districts. Educational resources were delivered through in-person teaching sessions led by resident physicians and hands-on medical simulations. School nurses who attended the Continuing …

Establishing Nurse Innovator Competencies: A Collaborative Initiative, Lori M. Brodie, Susan B. Patton, Dara Lanman, Ismail Dilek, Noah R. Zanville, Tracy A. Ortelli

HCA Healthcare Journal of Medicine

Background

Rapid advancements in augmented and artificial intelligence (AI) are reshaping health care, necessitating a strategic approach to integrating innovation into nursing education and practice. This article details a collaborative initiative between academic and practice partners aimed at the initial steps towards establishing the required knowledge, skills, and abilities for nurses to lead change through the creation of Nurse Innovator Competencies.

Methods

After an extensive review of literature, the team identified the absence of established Nurse Innovator Competencies. Through a collaborative and iterative process involving subject matter experts (SMEs) in both innovation and academia, key domains for the competencies, including …

Improving Scholarly Activity Through A Bundled Intervention Of Resident-Faculty Connection And Research Ideas, Katie Suleta, Norman W. Gill

HCA Healthcare Journal of Medicine

Background

Residents report barriers to engaging in scholarly activity despite this being a common requirement across residency programs. Two commonly reported barriers are a lack of mentorship by faculty and a lack of ideas for projects that meet the criteria for scholarly activity. The study objective is to describe the effect of an intervention to address a lack of mentorship and a lack of ideas for scholarly activities.

Methods

A retrospective cohort design was utilized to investigate changes in scholarly activity between 2 academic years. An internal medicine residency program with 30 residents and 17 faculty members participated in an …