Medicine and Health Sciences Commons^™

Multi-Ancestry Genome-Wide Association Study And Meta-Analysis Of Lung Function Decline, Bonnie K Patchen, Jingwen Zhang, Nathan Gaddis, Traci M Bartz, Jing Chen, Catherine Debban, Hampton Leonard, Ngoc Quynh H Nguyen, Jungkyun Seo, Courtney Tern, Richard Allen, Dawn L Demeo, Myriam Fornage, Carl Melbourne, Melyssa Minto, Matthew Moll, George T O'Connor, Tess Pottinger, Bruce M Psaty, Stephen S Rich, Jerome I Rotter, Edwin K Silverman, Jeran Stratford, Chengyue Zhang, R Graham Barr, Michael H Cho, Sina A Gharib, Ani Manichaikul, Kari North, Elizabeth C Oelsner, Eleanor M Simonsick, Martin D Tobin, Bing Yu, Seung Hoan Choi, Josée Dupuis, Patricia A Cassano, Dana B Hancock

The Brown Foundation: Institute of Molecular Medicine

Background

Despite evidence for a genetic component, few genetic associations with lung function decline have been identified. We aimed to evaluate genome-wide associations and putative downstream functionality of genetic variants for lung function decline.

Methods

We conducted genome-wide association study (GWAS) analyses of decline in FEV1, FVC, and FEV1/FVC in 52,056 White (N = 44,988), Black (N = 5,788), Hispanic (N = 550), and Chinese American (N = 730) participants across seven general population cohorts. GWAS analyses were stratified by cohort, ancestry, and sex. Results were combined in cross-ancestry and ancestry-specific meta-analyses. Significant variants available in …

Exploring The Optimal Age For Total Knee Arthroplasty To Minimize Risk Of Adverse Outcomes: Machine Learning Analysis Of A Statewide Cohort, Chloe Heiting, Yiyuan Wu, Susan M. Goodman, Peter Sculco, Fei Wang, Said A. Ibrahim, Peter Cram, Rich Caruana, Bella Mehta

Department of Medicine Faculty Papers

BACKGROUND: Rates of total knee arthroplasty (TKA) in the United States have risen in patients of a wide age range. Although rates of postoperative TKA complications have decreased, they remain a significant concern. In this study, we aim to determine how the risk of adverse TKA outcomes changes dynamically with age and explore the optimal ages with the lowest risk for adverse outcomes.

METHODS: This retrospective cohort study included patients who underwent elective primary TKA from 2012 to 2018 in the Pennsylvania Health Care Cost Containment Council Database. We trained (70% train:30% test) an explainable boosting machine (EBM), a modern …

Rate And Characteristics Of Frequent Attenders At Primary Healthcare Centres In Muscat Governorate, Oman: A Cross-Sectional Study, Manar Al Sanaa Ali Alzeedi, Najlaa Jaafar Mohammed, Fatma Al Hadhrami, Hadya Al Lawati, Muna Aal Talib, Rahma Al Riyami, Rahma Al Shuhaimi, Wiam Al Tuqi

Sultan Qaboos University Medical Journal

Objectives: Frequent attenders (FAs) are patients who use primary healthcare centre (PHC) services at disproportionately high rates which puts a strain on health systems and affects the quality of care. This study aimed to determine the prevalence of FAs in PHCs in Muscat Governorate, Oman, and to identify their demographic, socioeconomic and clinical characteristics. Methods: This cross-sectional study was conducted across 10 randomly selected PHCs in Muscat from January to December 2024. Data were collected retrospectively from electronic medical records for 2023. FAs were defined as individuals with 10 or more visits per year. Descriptive statistics and multivariate Poisson regression …

Prenatal Stress Induces Changes In Behavior, Hpa Axis, Inflammation, And Oxidative Stress In Adult Rats Offspring, Jorge M Aguiar-Geraldo, Jefté Peper-Nascimento, José Henrique Cararo, Taise Possamai-Della, Alexandra I Zugno, João Quevedo

Faculty, Staff and Student Publications

Prenatal stress is related to the development of psychiatric disorders involving inflammation, oxidative stress, and hypothalamic-pituitary-adrenal (HPA) axis. Therefore, the aim of the present study was to evaluate the effects of prenatal stress on behavior, inflammation, oxidative stress, and the HPA-axis in the dams and their offspring treated with lithium. Thirteen pregnant Wistar rats were exposed to a prenatal chronic unpredictable stress protocol from the 14th day of gestation until birth. At the 60th postnatal day (PND), a treatment protocol was carried out in the offspring with lithium (intraperitoneally - 47.5 mg/kg) or saline for seven days (twice a day). …

Profiling The Genomic Landscape And Evolutionary History Of Polyploid Giant Cancer Cells In Undifferentiated Pleomorphic Sarcomas, Amy L Bowes, Sara Waise, Tom Lesluyes, Thomas Butters, Christie English, Annelien Verfaillie, Jianan Chen, Emma Nye, Richard Stone, Jiten Manji, Adrienne M Flanagan, Jonas Demeulemeester, Maxime Tarabichi, Nischalan Pillay, Peter Van Loo

Faculty, Staff and Student Publications

Polyploid giant cancer cells (PGCCs), characterised by multinucleation and atypical nuclear morphology, are a common feature of undifferentiated pleomorphic sarcomas. While PGCCs may be a critical substrate for cancer evolution, their formation pathways and genomic consequences remain underexplored. In this study, we characterise PGCCs in ten pleomorphic sarcomas and use topographic single-cell DNA sequencing (scDNA-seq) to investigate their genomic landscape. We selected PGCCs based on their nuclear morphology, including mononucleated or multinucleated bizarre, misshapen nuclei, and analysed them at single-cell resolution. Histopathological analysis showed that PGCCs were often randomly distributed throughout the tumour and did not appear in clusters, suggesting …

Profiling The Genomic Landscape And Evolutionary History Of Polyploid Giant Cancer Cells In Undifferentiated Pleomorphic Sarcomas, Amy L Bowes, Sara Waise, Tom Lesluyes, Thomas Butters, Christie English, Annelien Verfaillie, Jianan Chen, Emma Nye, Richard Stone, Jiten Manji, Adrienne M Flanagan, Jonas Demeulemeester, Maxime Tarabichi, Nischalan Pillay, Peter Van Loo

Faculty, Staff and Student Publications

Polyploid giant cancer cells (PGCCs), characterised by multinucleation and atypical nuclear morphology, are a common feature of undifferentiated pleomorphic sarcomas. While PGCCs may be a critical substrate for cancer evolution, their formation pathways and genomic consequences remain underexplored. In this study, we characterise PGCCs in ten pleomorphic sarcomas and use topographic single-cell DNA sequencing (scDNA-seq) to investigate their genomic landscape. We selected PGCCs based on their nuclear morphology, including mononucleated or multinucleated bizarre, misshapen nuclei, and analysed them at single-cell resolution. Histopathological analysis showed that PGCCs were often randomly distributed throughout the tumour and did not appear in clusters, suggesting …

Aggregation Of Gene Regulatory Information And Knowledge On Fair Principles Enables Discovery Of Pathogenic Gene Regulatory Variants, Tierra R Farris, Jessie E Arce, David Chen, Andrew R Jackson, Yiran Guo, Qi Li, Bosko Jevtic, Dubravka Jevtic, Vuk Milinovic, Yuankun Zhu, Jeremy Costanza, Eric D Wenger, Christopher Nemarich, Lisa Anderson, Aleksandar Mihajlović, Kristin Ardlie, Shaine A Morris, Matthew E Roth, Deanne M Taylor, Adam C Resnick, Lilei Zhang, Aleksandar Milosavljevic

Faculty, Staff and Students Publications

Motivation: Methods for sharing gene regulatory information and knowledge on FAIR principles, particularly in the context of tissue-specific gene regulation, remain poorly defined and implemented, hampering discovery and clinical genetic diagnosis.

Results: We specified FAIR principles for tissue-specific gene regulatory information and knowledge; implemented them by developing a registry of regulatory elements and aggregating FAIR gene regulatory information from several major sources; developed computational tools that utilize these FAIR resources; and demonstrated their utility by associating gene regulatory variants with major subtypes of congenital heart disease.

Zotero: Your Research Lifeline, Jennifer Stockton

Library Class: Lunch & Learn

No abstract provided.

Exploring The Attributes Of Varied Interventions To Reduce Firearm Violence Among Youth And Emerging Adults: A Systematic Review, Vickie Blakely Reed, Lashanda D. Brumfield, Maaz Ali, Traci Hayes

Journal of Public Health in the Deep South

The death rate among children and adolescents, 14-26 years old, from firearms has increased 46% from 2019 to 2021. Among this demographic population, Black and Latino youth account for most firearm deaths. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used in conducting this study. Studies from January 2020 to October 2025 were identified through a search of PubMed, Web of Science, and ProQuest databases. Searches for the review included but were not limited to terms and phrases such as “gun violence prevention interventions for youth” and “firearm violence prevention interventions.” The purpose of this systematic …

School Climate As Primary Prevention: Mental Health And Violence Outcomes Among Lgbtq+ Youth In The U.S. South (2015–2024), Latarsha H. Michael, Brieah D. Hudson, Kenya T. Horne

Journal of Public Health in the Deep South

Lesbian, gay, bisexual, transgender, queer, and other sexual and gender minority (LGBTQ+) adolescents in the U.S. South experience disproportionately high rates of bullying, discrimination, depression, and suicidality. Supportive and inclusive school climates are identified as key protective factors that can mitigate these risks and function as primary prevention against violence. This systematic narrative review synthesizes peer-reviewed research and high-quality survey reports published between 2015 and 2024 that assess school climate, mental health, and violence-related outcomes among LGBTQ+ youth with representation from Southern states, including Mississippi, Alabama, and Louisiana. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 1,167 records …

Violence And Abuse Against Adult Stroke Survivors In The Deep South: Epidemiology, Risk, And Public Health Responses, Dawn S. Mclendon, Shaneka S. Patterson, Shreyas Gangadhara

Journal of Public Health in the Deep South

Adults living with neurologic disability, particularly stroke survivors, face disproportionately high rates of violence and abuse. This vulnerability is amplified in the Deep South due to elevated stroke burden, structural disadvantage, and persistent community-level disparities in both violence and health care access. We conducted a narrative review of peer-reviewed literature indexed in PubMed, along with relevant surveillance and policy reports, to synthesize current evidence on the burden, patterns, risk factors, and prevention opportunities related to violence among adult stroke survivors. The review focused on elder mistreatment, intimate partner violence, sexual violence, caregiver abuse and neglect, and financial exploitation. Findings indicate …

Socioeconomic Factors Affecting Length Of Hospital Stay And Discharge Disposition Among Male And Female Gunshot Injury Patients In Jackson, Mississippi., Okechukwu Erinne, Deanna Howington, Sarah Mcgraw, Jonathan B. Lowrie, Matthew Kutcher, Alyscia Severance, Masoumeh Karimi, Leila Seidfaraji, Lei Zhang

Journal of Public Health in the Deep South

Background: Gun violence remains a public health concern in the United States, with Jackson, Mississippi, ranking among the highest in gun violence rates. Understanding how sociodemographic factors influence clinical outcomes is essential for improving care delivery and resource allocation. 

Purpose: This study examined the association between age, education, employment, and insurance status with hospital length of stay (HLOS) and discharge disposition among adult male and female firearm injury patients residing in Jackson, Mississippi.

Methods: Data were obtained from the electronic health records of adults (≥ 18 years) presenting to the University of Mississippi Medical Center emergency department …

A Secondary Analysis Of Mississippi Domestic Violence Trends From 2019 To September 2025 Based On The Trace Atlas Of Gun Violence Archives, Lashanda D. Brumfield, Bernice Akinwande, Vickie Blakely Reed, Traci Hayes, Tanya Funchess

Journal of Public Health in the Deep South

Abstract

Background: Domestic violence remains one of the most heartbreaking yet overlooked public health challenges across the Deep South. Prevention programs and effective policies addressing domestic violence issues must be driven by translatable, applicable, and reliable data in order to see outcome-driven results. Purpose: The objective was to identify temporal, regional, and city-level patterns in the frequency and severity of domestic violence gun incidents. Methods: This study presents a secondary analysis of domestic violence gun incidents in Mississippi from January 2019 to September 2025. To examine geographic distribution, incidents were aggregated at the regional level: Central, Northeast, Northwest, Southwest, …

Demographic, Circumstantial, And Geographic Patterns Of Firearm-Related Homicides And Suicides In Mississippi, 2021-2023, Zhou Fang, Utsav Nandi, Cerissa Eubanks Neely, Lei Zhang

Journal of Public Health in the Deep South

Background: Firearm violence ranks among the leading causes of death in Mississippi. Understanding its demographic, circumstantial, and geographic patterns is essential to inform prevention efforts.

Purpose: To describe demographic, circumstantial, and geographic patterns of firearm-related homicides and suicides in Mississippi during 2021–2023 using Mississippi Violent Death Reporting System (MSVDRS) data.

Methods: Percentages and crude rates of firearm-related homicides and suicides were analyzed by demographic characteristics for 2021–2023. z tests assessed rate differences between years. Chi-square (χ²) tests compared proportions of decedents with specified precipitating circumstances for 2022 versus 2021 and 2023 versus 2021. County-level crude rates were mapped to visualize …

Community-Guided Adaptation Of Violence Prevention Strategies: Insights From The Mississippi Violence Injury Prevention (Ms-Vip) Program, Erin Dehon, Masoumeh Karimi, Leila Seidfaraji, Michelle Brassfield, Melinda Todd, Rukia Lumumba, Matthew Kutcher, Matthew Morris, Fredrick Womack, Roy Hart, Lei Zhang

Journal of Public Health in the Deep South

No abstract provided.

Training Mississippi Providers To Address Intimate Partner Violence In Maternal Care: Pilot Outcomes From The Simm Initiative, Xiaoshan Z. Gordy, Catherine Poehling, Saijun Zhang, Chinedu Chukwu, Jerome R. Kolbo, Masoumeh Karimi, Matthew Morris, Andrew Voluse, Erin Dehon, Michelle Brassfield, Danielle Lahn, Lisa Slade, Deanna Howington, Kathleen Rhodes, Tearsenee Davis, Sonja Fuqua, Lei Zhang

Journal of Public Health in the Deep South

No abstract provided.

Gun Violence And Maternal Mortality In The Mississippi Delta: A Dual Public Health Crisis, Nelson Atehortua, Mary Shaw-Ridley

Journal of Public Health in the Deep South

No abstract provided.

The Mississippi Violence Injury Prevention Program (Ms-Vip): Building A Community-Driven Model For Healing And Safety, Rukia Lumumba

Journal of Public Health in the Deep South

No abstract provided.

Facing Dissection, Aya E. Cannon

HCA Healthcare Journal of Medicine

The summer prior to beginning medical school, our anatomy professor prompted us to reflect on the experience of dissection and create an image based on our thoughts and feelings. I was thrilled by the assignment and immediately began listing my emotions. Excitement: For so long, I had worked toward this point, and now the quintessential medical school experience was within reach. I expressed my appreciation for the beauty and complexity of the human body through color and collage, using the vibrant layers to reflect the awe and range of emotions I felt. Nervousness: Despite my enthusiasm, I was faced with …

Benign Transient Hyperphosphatasemia In Adults: Case Report And Literature Review, Jose L. Rodriguez Castro, Grettel Gonzalez Garcia, Daniel Heller, Bernardo J. Reyes

HCA Healthcare Journal of Medicine

Background

Benign transient hyperphosphatasemia (BTH) in children is characterized by temporary highly elevated serum alkaline phosphatase (ALP) activity in the absence of liver or bone disease and a return to normal within 3 to 4 months. Since its first description in the 1950s, several cases of BTH in infants and children have been reported. Although there is no known etiology for this illness, it has been associated with viral infections. This condition has rarely been seen in the adult population, and there is scarce available information. The sialylation of the ALP isoenzymes decreases their renal clearance from the circulation; however, …

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Tinea Corporis, Braden Van Alfen, Navya Peddireddy, Marshall Hall, Henry Lim, Christian Scheufele, Garrett Furth, Dustin Wilkes, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Tinea corporis is a common superficial fungal infection caused by dermatophytes. It typically presents as well-defined, pruritic, annular papules and plaques with central hypopigmentation. The differential diagnosis includes pityriasis rosea, nummular dermatitis, plaque psoriasis, tinea versicolor, granuloma annulare, and discoid lupus. This article compares different presentations of tinea corporis in various skin types as classified by the Fitzpatrick scale. Recognizing varying presentations of tinea in patients of different skin tones will aid in early and appropriate diagnosis and treatment.

Presentations Of Cutaneous Disease In Various Skin Pigmentations: Keratosis Pilaris, Henry Lim, Reem Ayoub, Madelyn Richards, Marshall Hall, Christian Scheufele, Dustin Wilkes, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Keratosis pilaris (KP) is a common benign disorder involving hyperkeratosis of the skin. It is associated with other common dry skin disorders such as atopic dermatitis and ichthyosis vulgaris. Lesions are clinically characterized as symmetrically distributed, monomorphic, folliculocentric, hyperkeratotic papules with a variable degree of perifollicular erythema. The appearance can be likened to spikey bumps that are commonly located on the arms, legs, and buttocks. Awareness of KP is important as every primary care clinician will see patients with this disorder. Identification can support the diagnosis of other associated skin diseases. Education about KP and its treatment may alleviate psychological …

Clinical Characteristics Of Patients With Lower Extremity Amputation During Inpatient Rehabilitation And Its Predictors For Home Discharge, Se Won Lee, Duke Shen, Ning Cao

HCA Healthcare Journal of Medicine

Background

Lower limb amputations significantly impair the mobility and activities of daily living (ADLs) and frequently require inpatient rehabilitation with opioid analgesics to control pain. Large-scale studies of clinical characteristics specific to rehabilitation outcomes after lower limb amputations are limited in the current literature. Identifying the associations between specific clinical characteristics and opioid analgesic use with home versus non-home discharge can help improve care for patients undergoing inpatient rehabilitation after lower-limb amputations.

Methods

In this retrospective study, we examined 1611 patients from 58 inpatient rehabilitation units who underwent transfemoral or transtibial amputations between January 2021 and December 2022, identified using …

Safety And Feasibility Of Same-Admission Transcarotid Arterial Revascularization Prior To Heart Surgery For Patients Presenting With Concurrent, Severe Carotid Artery Stenosis, And Surgical Cardiac Disease, Brittany Landavazo, Matthew D. Kenny, Chandler Vernon, Nicolas Zea, David Nation, Bradley Boone, Jeff Apple, Kofi Quaye, Shir Yelovitch, Ryan S. Turley

HCA Healthcare Journal of Medicine

Introduction

Carotid artery stenosis and coronary artery disease are often co-morbid, with a prevalence of concurrent carotid and coronary artery stenosis approaching 50%. The optimal treatment for these patients has long been debated, with open carotid revascularization generally reserved for those with severe symptomatic carotid disease that precludes cardiac surgery. In this scenario, the role of less-invasive carotid artery stenting, particularly transcarotid arterial revascularization (TCAR), remains controversial and is not yet well studied. This study aims to present our outcomes and methodology for treating severe carotid stenosis with TCAR prior to cardiac surgery.

Methods

A retrospective chart review of the …

Expanding Waste Segregation Initiatives To Reduce Regulated Medical Waste: A Multi-Departmental Quality Improvement Project, Emily M. Su, Anuja L. Sarode, Mohammed Sami, David R. Nehring, Erica L. Laipply, Mustafa Culcuoglu

HCA Healthcare Journal of Medicine

Background

Regulated medical waste (RMW) drives up health care costs, largely due to misclassification of general waste, especially in operating rooms (ORs), intensive care units (ICUs), and obstetrics and gynecology (OBGYN) departments. This study aimed to reduce RMW volume and costs at Akron City Hospital (ACH) through department-specific interventions aligning with Occupational Safety and Health Administration (OSHA) and Ohio Environmental Protection Agency guidelines.

Methods

Periodic analyses compared hospital-wide aggregate RMW volume, pick-up frequency, and disposal costs before and after interventions. The ORs initiated interventions in October 2022, expanding to ICUs and OBGYN by February 2024. Strategies included staff education, flyers …

Impact Of Palliative Care Consultation On Clinical Interventions And Outcomes In A Medical-Surgical Community-Based Intensive Care Unit, Manjot S. Malhi, Jude Tabba, Aunie M. Danyalian, Michele Iguina, Daniel Zapata, Raiko Diaz, Dionne Morgan, Daniel Heller, Sanaz Kashan, Mauricio Danckers

HCA Healthcare Journal of Medicine

Background

Integrating palliative care into intensive care unit (ICU) practice is an essential component of comprehensive patient management, ensuring that critical interventions are aligned with patient-centered care objectives. This study aims to evaluate the impact of palliative care consultation (PCC) on clinical interventions, patient outcomes, and decision-making processes in a community-based medical-surgical ICUs.

Methods

We conducted a prospective, observational, single-center cohort study of critically ill adult patients in a community-based medical-surgical ICU. Patients were grouped by the presence (PCCP) or absence (PCCA) of palliative care consultation. Primary outcomes included differences in clinical interventions (mechanical ventilation, vasoactive medications, renal replacement therapy, …

Replicability Of Highly Cited Comparative Studies In Orthopedic Journals, Cody Ashy, William E. Few, Gabriella A. Rivas, Emily Brennan, Langdon Hartsock, Kristoff R. Reid

HCA Healthcare Journal of Medicine

Introduction

Concerns are rising regarding the quality, validity, and reliability of clinical research findings in medical literature. This investigation sought to identify the most cited orthopedic clinical studies and assess the replicability of the findings reported.

Methods

Web of Science was used to identify the top ten orthopedic surgery journals by impact factor from which primary comparative studies cited at least 250 times were identified. A second literature search identified follow-up studies relevant to the respective primary studies. Studies investigating the same intervention via parallel methodology were summarized and their conclusions compared to their respective highly cited primary study.

Results …

Exploring The Effects Of Traumatic Brain Injuries On Cranial Nerve Injury, Caitlin J. Mcpartland, Michael J. Pienkos, Sarah E. Johnson, Saptarshi Biswas

HCA Healthcare Journal of Medicine

Background

Traumatic brain injuries (TBI) are a significant and growing health issue, leading to over 200 000 hospitalizations annually in the United States. Cranial nerve (CN) injuries accompanying TBI can severely impact patients’ quality of life. This review aims to address the gap in research regarding the severity, mechanisms of injury, and associated intracranial injuries, emphasizing the importance of early detection and intervention.

Methods

A comprehensive literature search was conducted across databases such as PubMed and Ovid using key terms, including “cranial nerve injury,” “cranial nerve palsy,” “traumatic brain injury,” and “Glasgow Coma Scale.” Inclusion criteria encompassed studies reporting CN …

The Efficacy Of The Fitzpatrick Scale In Clinical Practice, Dana Olsen, Cecilia Nguyen, Marshall Hall, Michael Carletti, Stephen E. Weis

HCA Healthcare Journal of Medicine

Many skin diseases can manifest differently depending on the pigment of one’s skin. The Fitzpatrick scale is a classification of phototypes (I-VI) that categorizes patients' skin based on its ability to tan and burn. Even though it is a simple questionnaire, the Fitzpatrick scale has numerous criticisms due to its dependence on patients’ self-perception, variability in how questions are asked, limited range, and the underestimation of the risk of skin cancers. Alternatives to the Fitzpatrick scale include the melanin index, pigment protection factor, a visual color scale, and using artificial intelligence along with existing or new scales. Having a more …

An Acknowledgement To The Hca Healthcare Journal Of Medicine's Reviewers And Editors For The Second Half Of 2025, Juan A. Sanchez, Graig Donini

HCA Healthcare Journal of Medicine

The HCA Healthcare Journal of Medicine would like to thank those behind the scenes who make this publication possible. Our journal would not be possible without the assistance of our peer reviewers, authors, and board members.