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Trends and Determinants of Blood Pressure Control in US Hypertensive Patients: Insights from NHANES 1999-2021. 美国高血压患者血压控制的趋势和决定因素：来自NHANES 1999-2021的见解
Missouri medicine Pub Date : 2026-01-01
Yiming Shi, Ke Xie, Zhichen Xu, Jingyi Zhang, Lei Liu
{"title":"Trends and Determinants of Blood Pressure Control in US Hypertensive Patients: Insights from NHANES 1999-2021.","authors":"Yiming Shi, Ke Xie, Zhichen Xu, Jingyi Zhang, Lei Liu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This study analyzes trends and determinants of blood pressure control among hypertensive patients in the United States (US) using National Health and Nutrition Examination Survey NHANES data from 1999 to 2021. Blood pressure control rates improved through 2013 but declined thereafter. Applying machine learning methods such as XGBoost, we identify hypertension awareness and antihypertensive medication use as the strongest predictors of successful control. In contrast, resistant hypertension, chronic kidney disease, and elevated low-density lipoprotein (LDL) levels are associated with poorer control. The shift from JNC7 to JNC8 hypertension guidelines reclassified some individuals from uncontrolled to controlled, influencing observed trends. Additionally, a reduction in antihypertensive medication use among female patients may have contributed to the recent decline. These findings highlight the critical role of medication adherence and patient awareness in maintaining blood pressure control.</p>","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"123 1","pages":"50-54"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Advancing Decision Support Systems with Data, Informatics, and Learning Health Systems in a Post-Meaningful Use Era. 推进决策支持系统与数据，信息学和学习卫生系统在后有意义的使用时代。
Missouri medicine Pub Date : 2026-01-01
Adam Wilcox
{"title":"Advancing Decision Support Systems with Data, Informatics, and Learning Health Systems in a Post-Meaningful Use Era.","authors":"Adam Wilcox","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The HITECH Act and Meaningful Use (MU) successfully drove widespread EHR adoption but largely missed the strategic goal of healthcare transformation. While EHRs are now ubiquitous, few institutions have transitioned to a true Learning Health System (LHS). To support achieving transformative impact, this article proposes an extension of a previously-described quality improvement life cycle model, aligning it with modern informatics and artificial intelligence (AI) capabilities. We detail how the stages of DMAIC (Define, Measure, Analyze, Improve, Control) provide the necessary structured framework for advancing decision support within a post-MU environment. We argue that by integrating AI-driven tools into each step of the DMAIC cycle, healthcare organizations can effectively leverage their vast stores of electronic clinical data. This structured approach offers a pathway to establishing agile, data-driven learning health systems necessary to fulfill the latent promise of health information technology.</p>","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"123 1","pages":"40-44"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Artificial Intelligence as a Catalyst for Quality, Safety, and Value in Healthcare Delivery. 人工智能作为医疗保健服务质量、安全和价值的催化剂。
Missouri medicine Pub Date : 2026-01-01
Philip R O Payne
{"title":"Artificial Intelligence as a Catalyst for Quality, Safety, and Value in Healthcare Delivery.","authors":"Philip R O Payne","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Artificial intelligence (AI) has the potential to transform healthcare by enhancing quality, improving safety, and increasing value. However, achieving these benefits requires navigating a complex interplay between data quality, interoperability, computability, workflow integration, and governance, as well as the need to create and sustain what have been described as learning health systems. The full promise of AI will only be realized through rigorous data stewardship, the design and demonstration of novel computational methods, cross-disciplinary collaboration, and a commitment to responsible and equitable technology implementation. Substantial work remains to address these challenges and capitalize on these opportunities, which can and should lead to significant improvements in human health and well-being.</p>","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"123 1","pages":"45-49"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cochlear Implants: An Overview. 人工耳蜗：综述。
Missouri medicine Pub Date : 2026-01-01
Gabriella L Boone, Joshua M Sappington
{"title":"Cochlear Implants: An Overview.","authors":"Gabriella L Boone, Joshua M Sappington","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Importance: </strong>Hearing loss poses a significant health burden to the Missouri population and broader United States (US). Cochlear implantation is the most effective intervention for patients with sensorineural hearing loss who do not find adequate benefit from hearing aids.</p><p><strong>Objective: </strong>This review provides an overview on cochlear implantation including its history, mechanisms, candidacy criteria, outcomes, and continued challenges in access and utilization.</p><p><strong>Methods: </strong>A literature review was conducted using PubMed to identify peer-reviewed articles using relevant keywords pertaining to cochlear implantation.</p><p><strong>Findings: </strong>Cochlear implantation has evolved significantly over the past six decades, and advancements continue to be made. Extensive research has supported cochlear implantation as a highly effective intervention in both adults and children, and its indications and candidacy criteria continue to expand. However, cochlear implantation is underutilized, driven by a combination of socioeconomic, individual, and health systems related factors.</p>","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"123 1","pages":"67-72"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
AI for Scientific Discovery in Omics Data-Driven Precision Medicine. 人工智能在组学数据驱动的精准医学中的科学发现。
Missouri medicine Pub Date : 2026-01-01
Fuhai Li, Heming Zhang, Di Huang, Hao Li, Wenyu Li, Tianqi Xu, Yixin Chen, Michael Province, Philip R O Payne
{"title":"AI for Scientific Discovery in Omics Data-Driven Precision Medicine.","authors":"Fuhai Li, Heming Zhang, Di Huang, Hao Li, Wenyu Li, Tianqi Xu, Yixin Chen, Michael Province, Philip R O Payne","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In recent years, the rapid advancement of high-throughput technologies has led to the generation of vast and complex multi-omics datasets that are valuable for characterizing and understanding complex cell signaling network systems. On the other hand, large language models (LLMs), domain-specific foundation models (FMs) and AI agents, have achieved significant breakthroughs and have been revolutionizing scientific research. The convergence of these two trends is catalyzing a new era for biomedical research to augment and speed up scientific discovery and the development of precision medicine. In this study, we examine the large-scale omics datasets, emerging applications, and challenges at the intersection of massive omic datasets and related AI models and agents, highlighting how their integration is reshaping the landscape of biomedical research and precision medicine.</p>","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"123 1","pages":"55-66"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147313284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Report of the American Medical Association Interim Meeting. 美国医学协会临时会议报告。
Missouri medicine Pub Date : 2025-11-01
Charles W Van Way
{"title":"Report of the American Medical Association Interim Meeting.","authors":"Charles W Van Way","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"122 6","pages":"463-465"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12721848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Autism Spectrum Disorder: Nature vs. Nurture. 自闭症谱系障碍：先天与后天。
Missouri medicine Pub Date : 2025-11-01
Joel C Eissenberg
{"title":"Autism Spectrum Disorder: Nature vs. Nurture.","authors":"Joel C Eissenberg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Autism Spectrum Disorder (ASD) is associated with a variety of inherited disorders, but most diagnoses have no identifiable genetic etiology. There has been a significant increase in the incidence of ASD diagnoses in the past three decades. The now-discredited vaccine theory of ASD causation has driven concerns over environmental exposures that may or may not lead to ASD. Here, I discuss the evidence for an underlying genetic basis for ASD, the evidence that environmental inputs could play a significant role ASD and potential treatments for associated symptoms.</p>","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"122 6","pages":"501-507"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12721837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Navigating Liability in Virtual Care: Risk Management Strategies for Physicians in a Rapidly Evolving Landscape. 导航责任在虚拟护理：风险管理策略的医生在一个快速发展的景观。
Missouri medicine Pub Date : 2025-11-01
Kimberly Chew, Colleen Pert, Kathleen Snyder
{"title":"Navigating Liability in Virtual Care: Risk Management Strategies for Physicians in a Rapidly Evolving Landscape.","authors":"Kimberly Chew, Colleen Pert, Kathleen Snyder","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"122 6","pages":"466-472"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12721841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Missouri Medicine Moments The 2025 Chronicle. 密苏里医学时刻2025纪事。
Missouri medicine Pub Date : 2025-11-01
John C Hagan
{"title":"Missouri Medicine Moments The 2025 Chronicle.","authors":"John C Hagan","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"122 6","pages":"444-445"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12721844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Embracing Opportunities, Making Choices, and Focusing on the Mission. 拥抱机遇，做出选择，专注于使命。
Missouri medicine Pub Date : 2025-11-01
Karen Edison
{"title":"Embracing Opportunities, Making Choices, and Focusing on the Mission.","authors":"Karen Edison","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":74203,"journal":{"name":"Missouri medicine","volume":"122 6","pages":"473-476"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12721835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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