Faculty Bibliography

BACKGROUND:Women have historically been underrepresented in surgical subspecialties like facial plastic surgery. Authorship is a key metric in career progression; hence, it is important to assay progress in this domain. STUDY OBJECTIVES/OBJECTIVE:To identify trends in female authorship within facial plastic surgery over time. METHODS:Publications from three facial plastic surgery journals were reviewed for the gender of authors from 2007 to 2022. Female authorship across time was compared using chi-squared and Cochrane-Armitage trend tests. RESULTS:= 0.02). CONCLUSION/CONCLUSIONS:Female authorship in facial plastic surgery is increasing over time. First/single authorship is advancing more rapidly, possibly reflecting more female trainees advancing their careers. Further work is needed to support female representation in the facial plastic surgery literature.

Lupus nephritis (LN), a severe manifestation of systemic lupus erythematosus (SLE), is a heterogeneous disease driven by diverse immune and tissue cell types. We obtained 538,194 single-cell and 142,881 single-nuclear profiles from kidney biopsies of 155 patients with LN and 30 preimplantation transplant biopsy controls, along with 327,326 single-cell blood profiles. We characterized key stromal and immune cell types and cell states; moreover, we distinguished cell states that were tissue specific from those that were also present in the blood. We observed that LN pathological features were associated with particular cell states. For example, after controlling for the effects of chronic tissue damage, we observed that expansion of glomerular and scar-associated macrophage populations correlated with increasing inflammatory disease activity. Scar-associated macrophages appear to drive LN fibrosis and, in active disease, infiltrate the glomeruli more than other myeloid cells. These observations support that therapeutic targeting of myeloid populations may offer a strategy to prevent renal inflammation and ongoing kidney damage in LN.

Signal-to-noise ratio (SNR) is a key performance metric in magnetic resonance imaging (MRI) to evaluate pulse sequences, receive coils, and image reconstruction algorithms. A variety of methods have been proposed to estimate SNR. However, the lack of consistent and broadly available open-source implementations has been a challenge for reliable SNR comparisons in clinical and research settings. To address this gap, this work introduces MR Optimum, a cloud-native, open-source platform for standardized SNR analysis. MR Optimum integrates established SNR estimation techniques within a flexible, modular software architecture. A web-based user interface supports data upload, task configuration, cloud computations, and real-time results visualization. MR Optimum leverages serverless computing technologies (AWS Lambda and Fargate) to perform scalable, event-driven processing of MRI rawdata and allow users to calculate SNR using established methods: multiple replicas, pseudo multiple replicas, generalized pseudo multiple replicas, and analytic methods. Results include SNR maps, noise covariance and noise coefficient matrices, coil sensitivity profiles, and g factor maps. The web interface enables interactive visualization and histogram analysis based on regions of interest. Results can be exported in MATLAB, NIfTI, and JSON formats. By providing a unified computational environment, MR Optimum ensures reproducibility, and democratizes access to state-of-the-art SNR estimation, promoting multi-center harmonization and quality assurance.

PURPOSE/OBJECTIVE:Opioid overdose survivors are vulnerable to fatal overdose, particularly in the weeks following overdose, a period when health service use is often low. This study explores post-overdose health/medical services engagement among a diverse sample of survivors. METHODS:We conducted semi-structured interviews with 23 recent opioid overdose survivors across seven states. We asked about service utilization and drug use history, contextual factors related to the overdose, service use immediately after and in the months following, and the impact on wellbeing. RESULTS:Over half of participants described calls to 911 (n = 13), and one-third went to the hospital (n = 8). Six key themes guided by Levesque's patient-centered access to care framework emerged. Several themes explored why participants did not seek medical services following an overdose, including 1) the belief they could manage at home, 2) a lack of trust in responders, often based on prior negative experiences, 3) concern about unintended consequences such as legal issues, and 4) the financial, social, and opportunity costs associated with calling 911 or going to the hospital. Of those who did receive emergency services, some declined transport to the hospital for similar reasons, including potential repercussions from their treatment program if they were notified. A fifth theme focused on interactions with providers in the hospital, where individuals were rarely offered medications for opioid use disorder or connected to treatment. Interactions with providers were largely negative, though participants reported more positive experiences with social workers and peer support specialists. A few had early discharges, often due to feelings of vulnerability, unmanaged withdrawal symptoms, or poor interactions with providers. Last, the sixth theme focused on substance use treatment engagement. Treatment engagement was often delayed but was facilitated by factors like a social worker following up, longer hospital stays, or the participant seeking treatment on their own. CONCLUSIONS:Most of the sample did not engage with hospital or substance use treatment services after a nonfatal overdose. Negative prior experiences and fear of negative consequences were major barriers in this sample.

BACKGROUND:Cannabis consumption modalities such as smoking, vaping, and consumption of edibles differ in pharmacokinetics and potency, and vary by demographic characteristics. Data linking real-world consumption modality patterns to use frequency and cannabis use disorder (CUD) remain limited. METHODS:Latent class analysis (LCA) was applied to identify modality-based classes using data from 17,732 adults reporting past 30-day cannabis use on the 2022-2023 National Survey on Drug Use and Health. Multinomial logistic regression delineated associations of class membership with demographic characteristics, cannabis use frequency, and the presence/severity of CUD. RESULTS:LCA yielded four classes based on each modality likelihood: primary smoking (48.2 %), smoking and vaping (20.5 %), mainly edibles (16.9 %), and polymodal use (14.4 %). Compared to adults aged ≥ 50, those aged 18-25 years were more likely to belong to the smoking and vaping (aRRR = 2.52, 95 % CI: 1.77-3.61) or polymodal classes (aRRR = 3.58, 95 % CI: 2.48-5.18). Females were more likely to be in the mainly edibles class (aRRR = 1.78, 95 % CI: 1.48-2.13). Daily cannabis use was more likely among polymodal (aRRR = 2.67, 95 % CI: 2.25-3.17) and less likely among mainly edibles (aRRR = 0.49, 95 % CI: 0.35-0.68) classes, relative to the primary smoking class. Compared to the primary smoking class, risk of having CUD was higher among people in the smoking and vaping class, and in the polymodal class, but lower in the mainly edibles class. CONCLUSIONS:Cannabis use modalities were associated with differences regarding demographic characteristics and severity of use. Future interventions could account for route-specific use to improve prevention and harm reduction efforts.

With the rapid development in cell therapy and biopharmaceutical production in recent years, safe cryopreservation technologies are required to ensure product quality and safety. Dimethyl sulfoxide (DMSO), which is widely used as a conventional cryoprotectant, raises concerns owing to its cell permeability and consequent cytotoxicity. In this study, we focused on non-cell-permeable zwitterions that exhibit low cytotoxicity. We synthesised 21 zwitterions and systematically evaluated the relation between their molecular structures and cryoprotective effects. Elongation of the cationic side chain or spacer decreases the cryoprotective effects, which are associated with cytotoxicity and freezing of the unfrozen fraction. In contrast, ammonium/sulfonate-type zwitterions exhibited strong cryoprotective effects. This suggests their involvement in the modulation of membrane properties and the suppression of ice crystal formation. Notably, one of the synthesized ammonium/sulfonate-type zwitterions achieved cell recovery comparable with that of a commercial DMSO-containing cryoprotectant for human mesenchymal stem cells. This study deepens understanding of cryoprotective mechanisms based on the molecular design of zwitterions and provides guidelines for safe cellular cryoprotectants.

BACKGROUND AND STUDY AIMS/UNASSIGNED:Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is emerging as a minimally invasive alternative for benign gastric outlet obstruction (GOO). This study evaluated its safety, efficacy, and long-term outcomes. PATIENTS AND METHODS/UNASSIGNED:This international, multicenter retrospective study included 72 patients who underwent EUS-GE for benign GOO across 13 centers. Clinical success was defined as ability to tolerate solid food based on the GOO scoring system. Secondary outcomes included technical success and adverse events (AEs). RESULTS/UNASSIGNED:< 0.00001). Mean time to oral intake was 20.1 hours. AEs were mild,occurring in 6% intra-procedurally and 10% post-procedurally. Mean follow-up duration was 426.3 days. CONCLUSIONS/UNASSIGNED:EUS-GE demonstrates high technical and clinical success rates with a favorable safety profile for benign GOO, offering a promising alternative to traditional surgical approaches.

Developing dry antimicrobial delivery systems that combine bioactive protection with biofilm-matrix disruption remains a major challenge. Building on a previously established protease-modulated pea protein isolate (PPI)-carvacrol nanoemulsion system, this study developed protease-assisted microcapsules designed to preserve carvacrol and promote the removal of preformed biofilms. Carvacrol-loaded nanoemulsions were prepared at pH 3.5, 7.0, and 10.0 and supplemented with pepsin or trypsin before spray-drying or freeze-drying with maltodextrin. Protease-specific interfacial modification markedly affected emulsion stability, powder structure, and encapsulation performance. At pH 7.0 and 10.0, trypsin reduced droplet size from 284.60 to 232.52 nm and from 149.13 to 140.38 nm, respectively. The resulting spray-dried microcapsules exhibited high encapsulation efficiency (>96%) and low surface carvacrol contents (0.95-1.24 mg/g). In contrast, pepsin caused pronounced destabilization under acidic conditions, particularly after freeze-drying, yielding porous powders with an encapsulation efficiency of 48.18% and a surface carvacrol content of 69.51 mg/g. Trypsin-assisted microcapsules achieved 90-99% removal of preformed Listeria innocua biofilm biomass within 1 h, whereas enzyme-free and pepsin-containing formulations generally remained below 40%. Microscopic observations confirmed extensive disruption and detachment of the biofilm structure. After one year at 4 °C, trypsin-loaded formulations retained high biofilm biomass removal activity (85-99% after 2 h). These findings demonstrate that protease-assisted microencapsulation can couple interfacial regulation during particle formation with enzyme-mediated biofilm-matrix disruption after rehydration, providing a sustainable carvacrol delivery platform with durable antibiofilm functionality.