Faculty Bibliography

INTRODUCTION/BACKGROUND:Puberty is a key transition point in adolescents' lives that plays a foundational role in shaping health behaviors and outcomes across one's life course. This period holds significant potential to empower adolescents and support autonomy in health and well-being, but limited puberty education curricula exist for early adolescents (age 8-14), and those that do exist vary in content. There is a paucity of evaluations of puberty competencies and limited consensus on what competencies should be measured to assess effectiveness or even how to measure these competencies. OBJECTIVE:The objective of this scoping review is to systematically map and characterize the outcomes, domains, and instruments used to evaluate puberty education curricula for early adolescents aged 8-14 years. In accordance with PRISMA-ScR and JBI scoping review guidance, this review does not synthesize effect sizes or assess intervention efficacy, but maps the breadth of evidence to identify conceptual gaps and inform future framework development. METHODS:The review protocol is registered with the Open Science Framework (OSF). We will search PubMed, CINAHL, PsycInfo, ERIC, Education Source, Scopus, Web of Science Core Collection, ProQuest Dissertations and Theses Global, and OpenAlex for relevant sources. Two reviewers will independently screen and extract studies that meet inclusion criteria using our data extraction tool. EXPECTED OUTPUTS/UNASSIGNED:Findings from the scoping review will be synthesized to create an overarching framework that can guide approaches to the development and evaluation of puberty curricula targeted to early adolescents. Focus group discussions with adolescents, parents, and school representatives will be conducted to assess the applicability and appropriateness of identified competencies and evaluation measures prior to broader dissemination. Insights from this scoping review will ultimately be used to inform the implementation and evaluation of puberty education.

BACKGROUND:Population-based studies have linked progestin exposure to increased meningioma risk. However, the molecular basis of meningiomas associated with depot medroxyprogesterone acetate (DMPA) - a common injectable contraceptive-remains undefined. METHODS:We performed an integrated clinicopathologic and genomic analysis of meningiomas from 10 women with long-term DMPA exposure. Tumors underwent histopathological analysis, targeted sequencing, and DNA methylation profiling. Data were integrated with reference cohorts (Baylor and Heidelberg) and analyzed through classifier assignment, consensus clustering, copy number analysis, differential methylation testing, and dimensionality reduction. RESULTS:DMPA-associated meningiomas were all newly diagnosed, WHO grade 1 tumors with a predilection for the anterior and central skull base (n = 6). Nine patients harbored multiple meningiomas. Four experienced regression of untreated meningiomas following DMPA cessation, while five demonstrated stabilization. Histopathology demonstrated relative overrepresentation of metaplastic morphology, an uncommon meningioma subtype. All DMPA-associated meningiomas mapped to benign molecular groups, and most exhibited low copy number alteration burden. Targeted sequencing revealed enrichment for TRAF7 mutations (n = 5), with no NF2 mutations detected. Eight tumors shared consensus cluster identity, with cohesive grouping on principal component analysis and t-distributed stochastic neighbor embedding. No differential methylation was identified at the progesterone receptor locus. CONCLUSIONS:DMPA-associated meningiomas represent a recognizable phenotype within the broader NF2-wildtype/TRAF7-enriched spectrum of benign meningiomas, characterized by chromosomal stability, a shared methylation profile, tumor multiplicity, and regression or stabilization following DMPA cessation. While derived from a small single-institution cohort, these findings provide a molecular framework for understanding progestin-associated meningioma biology, re-interpreting epidemiologic literature, and informing population-level risk stratification.

Alexander von Humboldt's early nineteenth-century explorations of the Andes established foundational methods in biogeography and environmental science, emphasizing measurement, spatial integration, and the interdependence of natural systems. Nearly two centuries later, southern Ecuador became the site of a landmark discovery in endocrine genetics: a population with growth hormone receptor deficiency (Laron syndrome) characterized by severe insulin-like growth factor-1 (IGF-1) deficiency. This article examines the historical and scientific continuity of observation in the Ecuadorian Andes, linking Humboldt's integrative natural philosophy with modern approaches to human molecular physiology. While no direct historical connection exists between Humboldt's writings and the later identification of this endocrine condition, the shared geographic setting underscores the enduring scientific value of place-based investigation.

Hypomethylating agents (HMA) and allogeneic hematopoietic stem cell transplantation (alloHSCT) have both demonstrated remissions in VEXAS; however, comparative data is lacking. We conducted a multicenter, retrospective analysis of 66 patients diagnosed with VEXAS syndrome treated with HMA (n = 35) or alloHSCT (n = 31). Baseline characteristics such as genetics, co-morbidities, and performance status were balanced between the groups, except older age in the HMA group. Median follow-up from therapy initiation was 18 months (95% CI: 11-26), and 14 (21%) deaths were reported (alloHSCT n = 3; HMA n = 11). Among all evaluable patients within the alloHSCT cohort, all patients achieved molecular remission, and a substantial proportion of patients discontinued glucocorticoids (58%). In contrast, HMA therapy was associated with lower but meaningful rates of molecular remission (22%) and glucocorticoid discontinuation (6%). In a real-world setting, HMA therapy was associated with a high discontinuation rate related to toxicity or lack of response. On multivariable analysis adjusted for age and Charlson Comorbidity Index, alloHSCT was associated with improved overall survival (HR = 0.20, 95% CI: 0.05-0.81; p = 0.024). This association remained consistent across multiple ancillary sensitivity analyses, including restriction to transplant-eligible patients, patients aged ≤ 75 years, 1:1 matching, and propensity score-based weighted analyses. Although limited by retrospective design, these findings suggest that alloHSCT remains an attractive and potentially curative strategy in selected patients with VEXAS. Prospective validation of these findings is warranted.

This clinicopathologic challenge describes the case of a 60-year-old man with HLA-B27+ psoriatic arthritis who presented with acute-onset skin lesions and joint pains of his hands and feet. Clinicopathologic correlation established the diagnosis.

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.

BackgroundPostoperative care following endoscopic sinus surgery (ESS) aims to optimize mucosal healing, reduce inflammation, and minimize infectious complications. Although saline irrigation is considered standard of care, the potential benefit of adding topical antibiotics, such as mupirocin, during the early postoperative period remains uncertain.ObjectiveTo evaluate whether short-term postoperative mupirocin nasal irrigation improves clinical, endoscopic, and microbiological outcomes compared with saline irrigation alone following ESS.MethodsThis prospective, randomized, double-blinded, placebo-controlled trial included adults with chronic rhinosinusitis undergoing ESS. Patients were randomized to receive either mupirocin (0.05%) nasal irrigation or placebo saline irrigation twice daily for 21 days postoperatively. Outcomes assessed within the first 3 months included patient-reported symptoms using the sinonasal outcomes test (SNOT-22) and visual analog scale (VAS), endoscopic findings (mucosal edema, polyp formation, crusting, granulation tissue, and purulence), postoperative sinus culture results, and need for systemic antibiotics.ResultsSixty-eight patients were enrolled, and 56 completed follow-up. Both groups demonstrated significant postoperative improvement in SNOT-22 and VAS scores compared with preoperative baseline, without significant between-group differences. However, the mupirocin group showed significantly lower rates of endoscopic mucosal edema and polyp formation at 1 month postoperatively. Negative postoperative cultures were also more frequent in the mupirocin group, with reduced need for systemic oral antibiotics. No significant differences were observed in crusting, granulation tissue, purulence, steroid use, or pain medication requirements.ConclusionShort-term prophylactic postoperative mupirocin nasal irrigation after ESS does not confer additional improvement in patient-reported quality-of-life outcomes compared with saline alone but appears to reduce early inflammatory endoscopic changes, bacterial culture positivity, and need for systemic antibiotics. Larger studies with longer follow-up are needed to confirm these findings.

Cocaine produces widely recognized rewarding effects, but also produces aversive effects that occur several minutes after rewarding effects dissipate. Prior work shows these aversive effects are particularly strong in some animals, in whom they produce conditioned avoidance effects that reduce overall cocaine-seeking. The sources of these individual variations are largely unknown, but we found evidence for contributions from heritable influences. Using outbred male and female Sprague-Dawley (SD) and Heterogeneous Stock (HS) rats, we found that offspring of individuals expressing higher versus lower levels of conditioned avoidance to cocaine on a runway operant task are themselves higher or lower in this trait. These results did not differ between sexes, and are consistent with a heritable influence driving conditioned avoidance of cocaine, which could either be genetic or non-genetic. Runway latency to obtain cocaine also differed markedly between seven inbred rat strains (tested in males only), again consistent with a heritable influence. Several control tasks showed that variations in cocaine avoidance were not explained by differences in exploratory locomotion, overall motivation, or resistance of food-seeking to footshock punishment. Notably, the latter punishment resistance task has been linked to addiction-like behaviors in its own right, and performance on this task also varied considerably between inbred strains, but did so independently of cocaine avoidance. Hence, punishment resistance and cocaine avoidance may be influenced by independent heritable factors.Significance statement Cocaine's strong rewarding effects critically drive drug intake, but this intake can be reduced by cocaine's aversive effects, which occur a few minutes after rewarding effects dissipate, and whose intensity varies considerably between animals. Using inbred rat strains and selective breeding we show that conditioned avoidance to cocaine may have a substantial heritable component, which could be either genetic or non-genetic. We also show that aversive effects of cocaine vary independently of other aversive tasks, including resistance to punishment.