Southern Medical Journal最新文献

{"title":"Publication Bias in Coronary Artery Disease Clinical Trials: A Bibliometric Review.","authors":"Anchal Shukla, Tejasvi Paturu, Shreya Shivan, Trenton Lippert, Vic Velanovich","doi":"10.14423/SMJ.0000000000001955","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001955","url":null,"abstract":"<p><strong>Objective: </strong>The objective of our study was to determine the extent of publication bias of clinical trials pertaining to the treatment of coronary artery disease. Specifically, studies are more likely to be published if the results are positive and have a higher citation rate.</p><p><strong>Methods: </strong>The US National Library of Medicine Clinical Trials database was used to identify a total of 242 terminated and completed clinical trials with reported results since 2017. Studies were excluded if they had fewer than two treatment arms, fewer than five participants in any of the treatment arms, or no data analysis to determine significance. A trial was deemed \"positive\" if there was a statistically significant difference between the treatment arms that agreed with the hypothesis. A \"negative\" was not statistically significant and/or did not agree with the hypothesis of the trial. Data were collected on intervention, treatment arms, funding type, publication rates, citation rate, impact factor and H index of the journal.</p><p><strong>Results: </strong>Of the 144 trials analyzed, 86 had positive results and 58 had negative results. There was a statistically significant difference in the length of study and publication rate. The publication rate for positive studies was 92%, whereas for negative studies it was 50% (<i>P</i><0.001).</p><p><strong>Conclusions: </strong>Positive outcomes had a higher publication rate compared with the negative results. Identification of this bias is critical in addressing the impact it could have on the practice of evidence-based medicine. If negative results are not being published, then this pushes physicians to rely on positive results more heavily, thereby skewing evidence-based decision making. This in turn impacts decisions that affect the quality of care.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 4","pages":"169-172"},"PeriodicalIF":0.8,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Study of Perceptions of Equity, Diversity, and Inclusion Work at University of Utah Health.","authors":"Edén Cortés López, Julie E Lucero, Donna Baluchi, Valerie J Flattes, Clare Lemke, Heather Nyman, Paloma Cariello, José E Rodríguez","doi":"10.14423/SMJ.0000000000001954","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001954","url":null,"abstract":"<p><strong>Objectives: </strong>The Diversity Engagement Survey (DES) was administered at University of Utah Health (UUHealth) in 2015 and 2023. In 2023, leaders provided an opportunity for participants to express their opinions on equity, diversity, and inclusion work at UUHealth as part of the DES.</p><p><strong>Methods: </strong>E-mails were sent with a survey link to all employees and learners at UUHealth (N = 23,945). This article focuses on the responses to the question, \"If you wish, please provide additional comments on the diversity and inclusion efforts at University of Utah Health.\" The responses were entered into NVivo. Data were then coded inductively into parent codes. Parent codes were grouped and merged to create themes that captured recurring experiences.</p><p><strong>Results: </strong>Twenty percent of those surveyed (n = 4879) completed the survey. Of these, 882 (18%) answered the open-ended question, and 779 distinct responses were coded after the elimination of duplicates and blanks. The following eight themes were revealed by the analysis: experiences of discrimination and equity; lack of accountability for perceived discrimination; perceived change resulting from equity, diversity, and inclusion efforts (EDI); EDI initiatives perceived as discriminatory and exclusionary; implementing and improving EDI outcomes; political views and tensions with EDI; diversity within executive levels; and overall recommendations.</p><p><strong>Conclusions: </strong>In response to the above themes, UUHealth EDI has expanded to include veterans and older adults, changed its communication strategy to ensure that employees and students know about both reporting and accountability structures, implemented a religious diversity program, and incorporated the equity diversity and inclusion surveys in the unified Better U survey.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 4","pages":"197-202"},"PeriodicalIF":0.8,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of Large Language Models on Diagnostic Radiology Board-Style Questions: A Comparative Evaluation of GPT-4o, Perplexity AI, and OpenEvidence.","authors":"Randall Aziz, Sydney Stewart, Rebecca Liscomb, Beecher Baldwin, Katie Bailey, Karim Hanna","doi":"10.14423/SMJ.0000000000001950","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001950","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to compare the diagnostic accuracy and internal consistency of GPT-4o (Generative Pre-Trained Transformer-4 omni), Perplexity AI (artificial intelligence), and OpenEvidence when applied to text-based, specialty-level radiology board questions.</p><p><strong>Methods: </strong>A total of 161 text-based multiple-choice questions from the American College of Radiology (ACR) Diagnostic Radiology In-Training Examination were administered across three independent runs for each large language model (LLM). Questions containing images were excluded. All three models were accessed through their respective public Web interfaces. A final answer was assigned to each model based on majority vote across the three runs (two out of three). If all three responses differed, the third (last) response was selected. Our selected answer was then compared with the ACR reference key. Internal consistency as well as agreement between each model's final answer and the ACR reference key was assessed using Cohen's kappa. In addition, descriptive statistics were used to analyze performance by radiology subspecialty. SPSS version 30 was used for all statistical analyses, and <i>P</i><0.05 were considered statistically significant.</p><p><strong>Results: </strong>Perplexity AI demonstrated the highest agreement with the ACR reference key (κ=0.883, <i>P</i><0.001), followed by OpenEvidence (κ=0.858, <i>P</i><0.001), and GPT-4o (κ=0.709, <i>P</i><0.001). All models showed high internal consistency; however OpenEvidence was the only LLM to demonstrate absolute internal consistency (κ=1.00 for all three runs). Perplexity AI showed the least variability across the 14 radiology subspecialties.</p><p><strong>Conclusion: </strong>Emerging LLMs such as Perplexity AI and OpenEvidence may offer greater diagnostic reliability than general-purpose models in radiology-specific contexts.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 4","pages":"191-194"},"PeriodicalIF":0.8,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot Cross-Sectional Study Assessing the Correlation between Marijuana Use and Rheumatoid Arthritis and Systemic Lupus Erythematosus Exacerbations.","authors":"Ujjwal Madan, Emily Puthawala, Roshni Thomas, Onyi Oligbo, Aatif Syed, Evelyn Peng, Sarah Ifteqar","doi":"10.14423/SMJ.0000000000001956","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001956","url":null,"abstract":"<p><strong>Objective: </strong>Cannabis use is increasing among patients with autoimmune rheumatic diseases, often for symptom relief; however, its impact on disease activity remains unclear. This pilot study assessed whether cannabis use was associated with differences in flare frequency or duration among patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), or both.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at a university-based rheumatology clinic in a US state where medical and recreational cannabis is legal. Adults (≥18 years) with confirmed RA, SLE, or both, receiving disease-modifying antirheumatic drug therapy for ≥3 months were included. Participants (N = 85) completed structured interviews assessing cannabis use, flare characteristics, and patient-reported outcomes. Demographics, comorbidities, substance use, and inflammatory markers also were collected.</p><p><strong>Results: </strong>Among 85 participants (mean age 54 years; 89.4% female), 74.1% had RA, 17.6% SLE, and 8.2% had both. Cannabis use was reported by 30% of RA participants, 47% of SLE participants, and 71.4% of participants with both diagnoses. In the RA subgroup (n = 60), cannabis users had a greater odds of experiencing flares lasting longer than 3 days (odds ratio 4.4, 95% confidence interval 1.4-14.3). No association was found with RA flare frequency. Due to small sample sizes, no statistical analysis was conducted in the SLE or RA/SLE subgroups.</p><p><strong>Conclusions: </strong>Cannabis use was associated with prolonged RA flares but not increased flare frequency. As cannabis becomes more accessible, further research is needed to clarify its immunologic effects. Clinicians should counsel patients regarding the potential risks of cannabis use in autoimmune disease management.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 4","pages":"161-168"},"PeriodicalIF":0.8,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibody-Drug Conjugates in the Management of Breast Cancer.","authors":"Sangeetha Isaac, Sameer Batoo","doi":"10.14423/SMJ.0000000000001885","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001885","url":null,"abstract":"<p><p>Breast cancer remains a predominant contributor to global cancer-related morbidity and mortality among women, with its incidence steadily rising and presenting complex therapeutic challenges. Conventional treatment modalities, including chemotherapy, endocrine therapy, and molecularly targeted interventions, have demonstrated substantial clinical efficacy. The emergence of therapeutic resistance, systemic cytotoxicity, and metastatic progression continues to impede optimal treatment outcomes, however. Antibody-drug conjugates (ADCs) represent an advanced class of targeted therapeutics engineered to deliver cytotoxic agents selectively to malignant cells, thereby augmenting antitumor efficacy while mitigating off-target toxicities. This review provides a comprehensive analysis of the molecular mechanisms underpinning ADC activity, evaluates the current clinical landscape, and examines the inherent challenges in ADC-based breast cancer therapy. In addition, it discusses the clinical utility of Food and Drug Administration approved ADCs, ongoing clinical trials, and prospective advancements in ADC development.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 3","pages":"123-127"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancement of a Vertically Integrated Training Program (VITP): Introspective Assessment and Expansion.","authors":"Logan Hitchcock, Timothy Pitts, Rebecca Stoltz, Allyson Halbach, Jeffrey Behling, Greyson Fox Tran, Donald J DiPette","doi":"10.14423/SMJ.0000000000001941","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001941","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 3","pages":"137-139"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decreased Maternal Weight Gain in Pregnancy Is Seen with Buprenorphine Medication-Assisted Treatment.","authors":"Kara Weishaar, Nicole Lewis, Olivia Knoll, Lori Moore, Martin Olsen","doi":"10.14423/SMJ.0000000000001943","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001943","url":null,"abstract":"<p><strong>Objectives: </strong>Medication-assisted treatment (MAT) is associated with low maternal weight gain, and low maternal weight gain is associated with infant mortality. Many MAT patients also are smokers. This study investigates buprenorphine administration during pregnancy as a possible independent risk factor for low maternal weight gain. To our knowledge, this is the first study that compares pregnant buprenorphine patients with both smoking and nonsmoking pregnant control groups.</p><p><strong>Methods: </strong>Our institution offers a combined MAT and prenatal care program for pregnant patients with opioid use disorder. With institutional review board approval, we retrospectively studied four groups of pregnant patients: very-low-dose (University) MAT, 83 patients; standard dose (community) MAT, 77 patients; smokers not taking MAT, 75 patients; and nonsmokers also not taking MAT, 167 patients. Informed consent was waived by the institutional review board, and standard methods were employed to maintain confidentiality. Exclusion criteria were body mass index greater than 30 at onset of care or inability to document body mass index, preterm delivery, incomplete data, intrauterine fetal demise or fetal anomaly, late prenatal care, polysubstance use, and maternal medical comorbidities.</p><p><strong>Results: </strong>An analysis of variance of 402 patients showed that women using buprenorphine gained less weight than women not using buprenorphine (<i>P</i> = 0.021). Although the very-low-dose group gained more weight (average 24.92 lb) compared with the standard-dose group (average 21.34 lb), the difference was not significant. The difference between the very-low-dose buprenorphine group and the nonsmoking, nonbuprenorphine group, as well as between the standard-dose buprenorphine group and the nonsmoking, non-buprenorphine group also were statistically significant.</p><p><strong>Conclusions: </strong>Buprenorphine MAT may be an independent risk factor for decreased maternal weight gain. Given this association of maternal MAT with low birth weight, further research could explore potential advantages of nutritional supplementation for pregnant patients undergoing MAT at risk for the delivery of low-birth-weight infants.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 3","pages":"109-112"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Florida Pediatric Gun Safety: Policy Recommendations and Ways Forward.","authors":"Myron L Rolle, S Hassan A Akbari","doi":"10.14423/SMJ.0000000000001939","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001939","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 3","pages":"128-129"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowering the Community Health Worker Role in the Stroke Continuum of Care: Development of the Florida Stroke Registry CHW Stroke Training Program.","authors":"Esmeralda Segura, Farya Fakoori, Christina Ampie, Valarie Butler, Carolina M Gutierrez, Lisa Hamilton Schueler, Hannah Gardener, Victor Del Brutto, Gerard Job, Olveen Carrasquillo, Lauri Bishop, Erika Marulanda, Negar Asdaghi, Tatjana Rundek, Jose G Romano, Gillian Gordon Perue","doi":"10.14423/SMJ.0000000000001947","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001947","url":null,"abstract":"<p><strong>Objectives: </strong>Community health workers (CHWs) help patients navigate community resources and support healthier lifestyles. Although stroke transitions of care require navigating complex clinical services and behavioral changes, there is no established formal training for CHWs in stroke care across Florida. We describe the impact of a comprehensive stroke training course designed and tailored for community health workers.</p><p><strong>Methods: </strong>We developed a CHW stroke care curriculum with input from the Florida CHW Coalition, vascular neurologists, epidemiologists, and Florida Stroke Registry stakeholders. The course, featuring a 12-credit continuing medical education curriculum, was a hybrid of live and recorded lectures, modules, and community engagement exercises. Free registrations were promoted via the Florida CHW Coalition advertisements, Florida Stroke Registry Web site and listserv, and stakeholder meetings.</p><p><strong>Results: </strong>Three separate cohorts accomplished the course. Across 3 years (2022-2024), a total of 75 participants (54 of whom completed the course) were included in this analysis. The median age was 44 years (interquartile range 35-54), with 74% of participants aged 54 years or younger. The racial/ethnic distribution was 33% Hispanic, 30% White, and 26% Black. The majority were female (n = 50, 93%). The mean pretraining score was 72% (standard deviation 15.2%), which increased to 91% (standard deviation 6.2%) posttraining. Due to the nonnormal distribution of score differences, we used the Wilcoxon signed-rank test (S) which confirmed a statistically significant improvement in scores post training (S = 735.5, p < 0.001) indicating higher post-training scores and reduced variability, indicating both effectiveness and consistency of learning gains.</p><p><strong>Conclusions: </strong>The formal training of CHWs to recognize stroke risk factors, promote self-management, and support stroke care equipped CHWs with the essential skills and knowledge to confidently foster meaningful partnerships with the community aimed at improving stroke outcomes.</p>","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 3","pages":"140-145"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When a Pandemic Challenges the Art of Medicine.","authors":"Zachary M Harris","doi":"10.14423/SMJ.0000000000001940","DOIUrl":"https://doi.org/10.14423/SMJ.0000000000001940","url":null,"abstract":"","PeriodicalId":22043,"journal":{"name":"Southern Medical Journal","volume":"119 3","pages":"155-156"},"PeriodicalIF":0.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}