Faculty Bibliography

BACKGROUND:Patients with femoroacetabular impingement syndrome (FAIS) experiencing >2 years of pain before hip arthroscopy have been linked with worse short-term and midterm outcomes. PURPOSE/OBJECTIVE:To examine the effect of preoperative pain duration on patient-reported outcomes (PROs), clinically significant outcomes, and reoperation rates in patients undergoing primary hip arthroscopy for FAIS. STUDY DESIGN/METHODS:Cohort study; Level of evidence, 3. METHODS:A prospectively maintained surgical repository was reviewed to select patients who underwent primary hip arthroscopy for FAIS between January 2012 and October 2014 with 10-year follow-up. Patients who reported pain ≥2 years before surgery were propensity score matched 1:1 to patients reporting preoperative pain <2 years by age, sex, and body mass index (BMI). PRO scores collected included those for the Hip Outcome Score-Activities of Daily Living (HOS-ADL), Hip Outcome Score-Sports Subscale (HOS-SS), modified Harris Hip Score (mHHS), and visual analog scale (VAS) for pain and satisfaction. Achievement rates of the minimal clinically important difference and patient acceptable symptom state were compared. Reoperation-free survivorship was compared with Kaplan-Meier analysis. RESULTS:= .11). CONCLUSION/CONCLUSIONS:Patients with pain ≥2 years before undergoing primary hip arthroscopy for FAIS significantly improved at 10 years but experienced worse function, pain, satisfaction, and achievement of clinically significant outcomes, with similar survivorship, compared to a matched group of patients with preoperative pain <2 years.

BACKGROUND:Preterm infants encounter DEHP through medical devices and equipment. While hyperoxia is known to promote cardiac remodeling and dysfunction, the impact of early phthalate exposure is understudied. We hypothesized that independent and combined DEHP and hyperoxia exposure would impair neonatal cardiovascular development. METHODS:Newborn rats were exposed from birth to day 14 to one of four conditions: control (21% oxygen), hyperoxia (60% oxygen), DEHP (25 mg/m3), and DEHP + hyperoxia (25 mg/m3 DEHP and 60% oxygen). Cardiac tissue and serum were analyzed by histology, RT-qPCR and ELISA for markers of contractility, angiogenesis, and inflammation: myosin heavy chain 6 (Myh6), vascular endothelial growth factor (VEGF), interleukin-4 (IL-4), interleukin-10 (IL-10), and fractalkine (CX3CL1). RESULTS:Histology found increased cell size, cytoplasm per nucleus, and nuclear area in all exposures. DEHP exposure and hyperoxia exposure reduced Myh6 and VEGF gene expression. Serum VEGF was higher in the DEHP + hyperoxia group compared to hyperoxia alone. IL-10 was decreased in all exposed groups. IL-4 was reduced in the DEHP + hyperoxia group. CXC3L1 was increased in the DEHP + hyperoxia group compared to hyperoxia alone. CONCLUSION(S)/CONCLUSIONS:Independent and concurrent DEHP and hyperoxia exposure during early neonatal development significantly disrupted markers of cardiac morphology, contractility, angiogenesis, and inflammation. IMPACT/CONCLUSIONS:Key Message: Postnatal exposure to DEHP adversely impacts neonatal rat cardiovascular development. Adds to Existing Literature: This is the first study to examine concurrent long-term hyperoxia and DEHP exposure on cardiovascular development in an animal model relevant to preterm infants. Identifies a modifiable contributor, DEHP, to adverse cardiovascular development. Identifies various cardiovascular components affected by DEHP and hyperoxia, including structural, angiogenic, contractile, and inflammatory aspects. Leads to a new approach to investigate the impact of environmental toxins and the origin of cardiovascular disease in the newborn period.

STUDY DESIGN/METHODS:Retrospective multicenter registry. OBJECTIVE:To establish a multidimensional definition of surgical success in ASD surgery and evaluate achievement rates across diverse patient subgroups. SUMMARY OF BACKGROUND DATA/BACKGROUND:Adult spinal deformity (ASD) encompasses diverse deformity types, disability levels, and treatment options. Optimal surgery aims in part to improve function, reduce radicular pain, and minimize revisions. Despite some studies considering combined outcomes, comprehensive multifactorial evaluation remains limited. METHODS:Success was assessed across disability (2-year ODI ≤20 or ∆ODI >14), radicular pain (NRS Leg ≤3 or ∆NRS Leg >3), and reoperation (no mechanical/neurologic revision). Patients were categorized by preoperative high disability (ODI >40) and/or high pain (NRS Leg >5). Individual and composite success rates were compared across preoperative deficits and deformity types. Satisfaction and treatment repetition willingness were analyzed by success achievement. RESULTS:Of 1,504 patients, 1,084 (71.9%) completed 2-year follow-up (median age 64 years, 75.4% female, 50.7% prior surgery). Median preoperative scores: ODI 44, NRS Back 8, NRS Leg 5. Preoperatively, 40.7% had combined high disability and pain, 21.6% high disability only, 13.5% high pain only, and 20.2% neither. At 2 years, success rates were 60.9% for disability, 64.8% for leg pain, 81.2% for revision avoidance, and 40.5% composite. Composite success was highest without preoperative deficits (59.4%), intermediate with isolated deficits (38.0% high disability, 43.8% high pain), and lowest with combined deficits (32.2%). Severe coronal deformities achieved highest composite success (51.7%) versus 32.0%-41.3% for other types. Composite success strongly correlated with satisfaction (87.2%) and willingness to repeat treatment (94.4%). CONCLUSIONS:Success in ASD surgery should reflect both improvement and final outcomes. Composite success measures provide more comprehensive surgical assessment than single metrics. By identifying patient characteristics associated with higher success rates, this framework informs evidence-based patient selection, enables realistic preoperative counseling, and guides outcome-driven surgical planning.

BACKGROUND:The widespread use of next-generation sequencing has allowed refinement of the classification and diagnosis of salivary gland neoplasms, leading to identification of recurrent gene fusions in a majority of salivary gland carcinoma types, and characterization of several novel entities. A small proportion of salivary gland carcinomas do not meet the diagnostic criteria for any known tumor type and are therefore classified as "salivary gland carcinoma, not otherwise specified". Given the ever-growing arsenal of tools to classify these lesions, the number of cases diagnosed as such is expected to continue decreasing. CASE PRESENTATION/METHODS:In this article we describe a novel DLG1::BRAF fusion in a high grade salivary gland carcinoma arising in the tongue of a 78 year-old woman. This tumor had solid and cribriform architectural features and was composed of a dual population of abluminal and mucinous cells. Immunohistochemically, it had variable SOX10 expression, variable and strong MUC4 reactivity and expression of p63 and p40 (delta Np63) in the abluminal cell population. The gene fusion retained the kinase domain of BRAF, without the self-inhibitory CR1 domain, which is expected to lead to upregulation of BRAF protein. The patient had a complete resection of her tumor, without evidence of local recurrence or metastasis 10 months after diagnosis. CONCLUSION/CONCLUSIONS:These findings may represent a previously undescribed type of salivary gland tumor. However, additional reports of similar lesions are necessary for definitive characterization.

OBJECTIVES/OBJECTIVE:This study aimed to develop and validate the Knowledge Related to Oral Health Literacy Spanish (KROHL- S) instrument to assess oral health knowledge among Spanish-speaking adults in the United States, a population facing significant oral health disparities. DESIGN/METHODS:A cross-sectional study was conducted at NYU College of Dentistry. A convenience sample of 175 self-identified Spanish-speaking adults (70% female, mean age 49. 79 years) completed the orally administered KROHL- S questionnaire. Participants, mainly born outside the US (91. 9%), also completed the Comprehensive Measure of Oral Health Knowledge (CMOHK) and a single-item literacy screening tool in Spanish (SILS). Psychometric properties of the KROHL- S, including internal consistency (Cronbach's alpha), discriminant validity (correlation with CMOHK), and known-group validity (comparison across education levels), were evaluated. Confirmatory factor analysis was used to test the original factor structure. RESULTS:The mean KROHL- S score was 8.34 (SD = 5.82), indicating a low level of oral health knowledge in the sample. Internal consistency for the overall KROHL- S was good (Cronbach's alpha = 0.75), and interrater agreement was high. A moderate positive correlation was found between KROHL- S and CMOHK scores (r = 0.49, p < .0001). Participants with higher education levels showed significantly greater oral health knowledge on the KROHL- S. Confirmatory factor analysis suggested an average fit to the data (RMSEA = 0.064, CFI = 0.86, TLI = 0.83). CONCLUSION/CONCLUSIONS:The KROHL- S could be used to assess oral health knowledge among Spanish-speaking adults and incorporates cultural and linguistic aspects, making it suitable for a wider range of individuals. KROHL-S offers a valuable tool for healthcare providers by not only helping identify individuals' knowledge gaps to guide customized educational interventions but also helping enhance patient-provider communications.

CONTEXT/UNASSIGNED:A subset of metabolic diseases is caused by rare monogenic variants. Next-generation sequencing offers a promising approach for identifying such variants, but its application in clinical diagnostics for metabolic disease is limited and the diagnostic yield is unknown. OBJECTIVE/UNASSIGNED:To determine the diagnostic yield of clinical genome sequencing (GS) in adults presenting with common metabolic diseases. METHODS/UNASSIGNED:We performed clinical GS on 560 adults seen in New York clinical practices between August 2020 and December 2023. Participants presented with hyperlipidemia/hypertriglyceridemia (HLD/HTG), pre-diabetes, Type 2 diabetes mellitus (T2DM), and/or metabolic dysfunction-associated fatty liver disease/steatohepatitis (MAFLD/MASH). Variants in a curated set of 90 genes associated with monogenic forms of these conditions were classified as Pathogenic (P), Likely Pathogenic (LP), or Variant of Uncertain Significance (VUS) using ACMG/ClinGen guidelines. P/LP variants in ACMG secondary findings (v3.1) genes were also reported with participant consent. RESULTS/UNASSIGNED:The cohort had a female-to-male ratio of 1.7, with 18.6% African American and 22.6% Latino participants. The most common enrollment diagnoses were HLD/HTG (25%), T2DM (9%), pre-diabetes (7%), and MAFLD/MASH (4%). Many participants had multiple conditions (42% with two, 12% with three). Approximately one-third had reportable variants, with 6% classified as P/LP. The most common P/LP variants were in APOB and LDLR. CONCLUSION/UNASSIGNED:The prevalence of clinically significant (P/LP) variants related to primary metabolic disease in this cohort was 6%. An additional 5.5% of participants had P/LP variants in ACMG secondary findings genes. Future studies should refine participant selection for genome sequencing to optimize its diagnostic and clinical value.

INTRODUCTION/BACKGROUND:The relationship between plasma phosphorylated tau 217 (p-Tau217) and domain-specific cognitive performance across race and ethnic groups remains unclear. METHODS: = 1032). RESULTS:-0.05 to -0.11). Associations were strongest in Non-Hispanic White (NHW), limited in NHB, and domain-specific in Hispanic groups. Matched analyses attenuated effects. DISCUSSION/CONCLUSIONS:Plasma p-Tau217 is associated with domain-specific cognitive performance in clinically unimpaired individuals, but these associations vary across racial and ethnic groups.

The mammalian interstitium is a body-wide network of fluid-filled, prelymphatic spaces. Recent studies demonstrate that it exists at three scales in continuity both within and between organs, comprising intercellular, pericapillary, and large (or fascial) interstitial spaces, the latter including fascia, dermis, organ submucosae and capsules, vascular adventitia, and perineurium. Hyaluronic acid fills all interstitial spaces, but large interstitial spaces also contain additional structurally complex and varied extracellular matrices that support soluble factor, mechanical, and potentially electrical signaling. Here we review areas where the new anatomic concept of the interstitium has led to the re-examination of previous findings, including data on interstitial matrix composition and cell trafficking. We also identify new questions arising specifically from the finding that the interstitium is multiscale and body-wide, including questions about the characteristics and drivers of interstitial fluid flow and the role of the interstitium as a rich and active basolateral signaling compartment.

OBJECTIVE:ratio (TPR) imaging approach and evaluates its ability to characterize MS lesions alongside other quantitative MRI (qMRI) metrics. METHODS:and PD values were used to illustrate TPR contrast. Statistical analyses included Wilcoxon rank-sum tests and Spearman correlations (p < 0.05). RESULTS:* (92 ms) values but lower MTR (37.3%) and MTsat (1.57%) compared to hypointense lesions (1085 ms; 0.88 a.u.; 64 ms; 46%; 2.48%, respectively). QSM values varied across lesion types. INTERPRETATION/CONCLUSIONS:, PD, and MT metrics, consistent with demyelination. In contrast, hypointense lesions may reflect tissue changes associated with repair processes such as remyelination.