Faculty Bibliography

OBJECTIVE/UNASSIGNED:To evaluate the safety of alopecia treatments during pregnancy, in-vitro fertilization (IVF), and polycystic ovary syndrome (PCOS) workup, with a focus on potential maternal and fetal risks. DATA SOURCES/UNASSIGNED:A comprehensive literature search was conducted across PubMed, Web of Science, and Scopus from November 2024 to December 2024. Search terms included medication names in combination with "pregnancy," "IVF," "in-vitro fertilization," and "PCOS." STUDY SELECTION/UNASSIGNED:Peer-reviewed studies addressing the use of therapies for androgenetic alopecia, alopecia areata, and scarring alopecias in the contexts of pregnancy, IVF, and PCOS were included. Articles evaluating maternal safety, fetal risks, and treatment timing were prioritized. Only English-language publications were reviewed. RESULTS/UNASSIGNED:Despite increasing therapeutic options for alopecia, significant knowledge gaps remain regarding their safety during pregnancy. Pregnant women are often excluded from clinical trials, leading to a reliance on older treatments with limited data on dosing or pharmacokinetics in the pregnant population. Unfortunately, there are few alopecia medications with robust safety data in pregnancy, and many medications are contraindicated during this period. Some medications may be used with caution, while others require additional investigation. During IVF, there are alopecia medications with potential benefit in women experiencing implantation failure or PCOS. For patients undergoing PCOS workup, some alopecia medications may impact hormonal labs or mask PCOS symptoms. CONCLUSION/UNASSIGNED:There is a critical need for more targeted research on alopecia treatments in pregnancy, IVF, and PCOS contexts. This review provides current evidence to guide clinicians and support informed, individualized treatment decisions during this vulnerable period.

BACKGROUND/UNASSIGNED:Predominantly Dorsal Thoracic Spinal Arachnoid Webs (DAW/SAW: 90%-100%), attributed to arachnoidal scarring obstructing cerebrospinal fluid (CSF) dynamics, typically cause dorsal cord compression. Their multiple etiologies include; trauma, idiopathic/post-surgical, inflammatory/infection, subarachnoid hemorrhage, and/or congenital defects. METHODS/UNASSIGNED:Patients with DAW/SAW are typically in their early/mid-fifties, and present with; back pain (i.e., 41.2%-88.9%), motor deficits (i.e. 59%-77.8%), sensory loss (i.e., numbness 65%-66.7%), and/or sphincter dysfunction (i.e., 33.3%). RESULTS/UNASSIGNED:MR and Myelo-CT studies for DAW/SAW classically demonstrate the positive scalpel sign (i.e., single or multilevel dorsally compressive "fluid" collections often containing multiple loculations/fenestrations usually accompanied by Syrinxes (i.e., 44 - 83%), and/or Spinal Arachnoid Cyst (SAC) formation. Conservative treatment is rarely effective. Alternatively, surgery consisting of laminectomy/decompression, resection/ lysis, marsupialization and/or fenestration of loculated collections including attendant SAC resections, and decompression/shunting of Syrinxes, results in postoperative improvement in up to 91% of patients. CONCLUSION/UNASSIGNED:Patients with DAW/SAW typically present with MR/Myelo-CT studies that demonstrate the dorsal thoracic positive scalpel sign in conjunction with Syrinxes, and/or SAC. Surgery typically includes laminectomy/ decompression, lysis/resection of arachnoidal adhesions with marsupialization/fenestration, and/or shunting, to achieve up to a 91% incidence of postoperative neurological improvement.

BACKGROUND/UNASSIGNED:Aspirin-exacerbated respiratory disease (AERD) is a distinct asthma endotype marked by asthma, nasal polyposis, and respiratory reactions to COX-1 inhibitors. Early and accurate identification of AERD remains clinically challenging. OBJECTIVE/UNASSIGNED:We sought to develop and externally validate an artificial intelligence (AI)-based diagnostic model that uses nasal epithelial mRNA expression profiles to accurately identify AERD. METHODS/UNASSIGNED:cohort. RESULTS/UNASSIGNED:(Charcot-Leyden crystal protein), which are known to be important to AERD pathogenesis. CONCLUSIONS/UNASSIGNED:Nasal transcriptomics can predict AERD diagnosis accurately and may improve disease understanding, enabling earlier and more precise endotype-based diagnosis and management.

BACKGROUND:Studies on patients have shown that normal anatomic motion is often not achieved with current total knee arthroplasty (TKA) designs. The purpose of this study was to determine whether anatomic motion could be restored using a design where intercondylar guiding surfaces were positioned between the medial and lateral femoral condyles. METHODS:A crouching machine was constructed, which included simulations of the collateral ligaments, the quadriceps mechanism, the hamstrings, and the gastrocnemius. Medial pivot, medially congruent, ultracongruent, and replica intercondylar TKAs were designed and 3-dimensionally printed. The femoral-tibial kinematics were measured by determining lateral and medial contacts, as the knee underwent flexion and extension from 12 to 130°. RESULTS:The replica intercondylar design showed an almost constant position of the medial contact, with a progressive posterior displacement laterally during flexion. In contrast, the other designs showed nearly parallel motion with minimal variation in contact location. CONCLUSIONS:It was concluded that intercondylar guiding surfaces could produce anatomical motion in a TKA where the cruciate ligaments were resected.

Patients admitted to contemporary cardiac intensive care units (ICUs) increasingly present with complex low-flow states and multisystem organ dysfunction, particularly in the perioperative cardiac surgery setting. This article outlines a systematic, organ-based approach to optimizing extracardiac organ function in patients with shock, emphasizing respiratory, renal, vascular, neurologic, hematologic, gastrointestinal, and endocrine management. Key principles include understanding cardiopulmonary interactions, minimizing secondary organ injury, tailoring supportive therapies to physiologic profiles, and applying ICU best practices. Coordinated, multidisciplinary optimization of noncardiac organ systems is essential to improve surgical candidacy, reduce complications, and enhance outcomes in this high-risk population.

BACKGROUND AND AIMS/UNASSIGNED:Pancreatic cystic lesions (PCLs) are increasingly detected because of the widespread use of imaging techniques. Among them, mucinous PCLs carry a higher malignancy risk, with intraductal papillary mucinous neoplasms (IPMNs) being the most frequent subtype. Accurate stratification based on the degree of dysplasia-low-grade dysplasia (LGD) versus high-grade dysplasia or carcinoma (HGD/C)-is essential to guide clinical management and avoid unnecessary surgical interventions. This study aimed to develop and evaluate a deep learning model for stratifying IPMNs into HGD/C and LGD using endoscopic ultrasound (EUS) images. METHODS/UNASSIGNED:This multicenter study included EUS images collected from 5 centers across Spain, Brazil, and the United States. Ground truth classification of IPMNs was established through cytologic and biochemical analysis of cyst fluid, EUS-guided through-the-needle biopsy, or surgical specimens. A deep learning model was trained to distinguish LGD from HGD/C. Model performance was assessed on the basis of sensitivity, specificity, accuracy, and area under the precision-recall curve. RESULTS/UNASSIGNED:A total of 51,046 EUS images were extracted from 30 examinations performed at 5 centers in Portugal, Spain, Brazil, and the United States. The model distinguished IPMNs with HGD/C from those with LGD with a sensitivity of 95.7%, a specificity of 88.7%, and an overall accuracy of 87.2%. The area under the receiver operating characteristic curve was 0.951. CONCLUSIONS/UNASSIGNED:To our knowledge, this is one of the first studies to evaluate the potential of an artificial intelligence model for dysplasia grading of IPMNs. Prospective validation of our model is necessary to ensure clinical benefit.

Learners who are neurodivergent, including individuals with autism, attention-deficit/hyperactivity disorder, learning disabilities, and related cognitive variations, remain underrecognized and insufficiently supported within medical education. Despite increasing representation, training environments continue to privilege rigid cognitive norms rooted in ableist assumptions and the ideal-physician archetype, reinforcing conformity, endurance, and neurotypical professionalism. This article synthesizes emerging literature on neurodivergence in medical education, highlighting persistent structural gaps in policy implementation, learning environments, and faculty evaluation practices. It examines the consequences of structural ableism, including masking, burnout, mental health strain, and attrition among trainees who are neurodivergent. It further reviews growing physician-led advocacy, mentorship networks, and institutional shifts toward neuroinclusive practices. Pediatrics is uniquely positioned to lead transformation, given its grounding in developmental variability, family-centered care, and communication across cognitive differences. Embracing neurodiversity in pediatric training offers a pathway to more inclusive educational cultures, improved patient care, and a physician workforce that reflects the populations it serves.

BACKGROUND/UNASSIGNED:Coronary CT angiography (CCTA) enables early noninvasive detection of coronary atherosclerosis, but its use in younger adults is limited by low pretest probability. Coronary artery disease polygenic risk score (CAD-PRS) may help identify individuals with increased likelihood of coronary plaque. METHODS/UNASSIGNED:= 1991), with follow-up through 2024. CAD-PRS was analyzed continuously and by risk categories (high [top decile], intermediate, low [bottom decile]). Plaque was classified as absent (CAD-RADS 0), non-obstructive (CAD-RADS 1-2), or obstructive (CAD-RADS 3-5). Extensive plaque was defined as ≥3-vessel involvement. Relative risk regression evaluated associations with plaque stratified by age. Kaplan-Meier and Cox proportional hazards models evaluated associations with adverse cardiovascular outcomes. RESULTS/UNASSIGNED:< .001). CONCLUSIONS/UNASSIGNED:High CAD-PRS was independently associated with greater presence, extent, and severity of CAD on CCTA. The impact of genetic risk was strongest in younger adults-a group for whom identifying early atherosclerotic plaque may have the greatest impact.