Faculty Bibliography

INTRODUCTION/BACKGROUND:The rapid integration of generative artificial intelligence (GenAI) into academic research has prompted ethical and regulatory concerns, particularly regarding its responsible use in scholarly publishing. Despite emerging recommendations from international organizations such as the Committee on Publication Ethics (COPE) and the International Committee of Medical Journal Editors (ICMJE), journal-specific guidance remains inconsistent. METHODS:This study evaluated the presence and characteristics of GenAI-related policies across 92 dermatology journals indexed in the 2024 Journal Citation Reports. Four reviewers independently assessed author instructions and publisher policies, collecting journal metrics, and applying logistic regression to explore associations with guideline adoption. RESULTS:GenAI-specific guidance was found in 82.6% of journals, with 60.5% linking to publisher-level policies. Most journals (90.8%) prohibited GenAI authorship and required author accountability, yet only 2.6% referenced ICMJE guidance. Disclosure of GenAI use was mandated by 98.7%, although only a minority required specification of tool version (28.0%) or manufacturer (17.3%). GenAI image generation was addressed in 55.3% of policies, with ChatGPT mentioned by 46.1% of journals. COPE membership and use of COPE AI guidance were significantly associated with the presence of journal-level GenAI policies. While journals with GenAI guidance exhibited higher impact and citation metrics in univariable analysis, no predictors remained significant in multivariable models. CONCLUSION/CONCLUSIONS:These findings highlight broad yet uneven adoption of GenAI policies in dermatology publishing. Gaps in specificity, transparency, and alignment with international standards may pose risks to research integrity, emphasizing the need for clearer, standardized, and field-specific editorial guidance on GenAI use.

OBJECTIVES/OBJECTIVE:Fentanyl test strips (FTS) have the potential to moderate drug use behavior amidst an unregulated drug supply, yet are underutilized in medical settings. We aimed to describe emergency department (ED) FTS distribution across a large NYC health system and examine characteristics associated with clinicians' ordering FTS compared with the current standard-of-care, take-home naloxone (THN), to identify opportunities to optimize FTS distribution. METHODS:We conducted a retrospective review of THN and FTS provision across a large urban health system in its first year of FTS distribution. We evaluated the demographic and clinical characteristics of visits in which clinicians ordered FTS, compared with THN only. RESULTS:From July 20, 2022 to July 20, 2023, 237 (of 423) clinicians ordered THN for 1279 unique individuals in 1376 eligible visits (436 with FTS, 940 without). In pairwise analysis, FTS receipt was associated with being male, younger, non-White, lacking commercial insurance; substance-related or overdose-related visit chief complaint or diagnosis, attending physician, and patient-directed discharge ( P <0.05 for each). In multivariable regression, higher odds of FTS receipt were associated with male gender (OR=2.4; 95% CI=1.8-3.5), a substance-related chief complaint (OR=2.0; 95% CI=1.2-3.2) or visit diagnosis (OR=5.5; 95% CI=3.8-8.0), and overdose visit diagnosis (OR=1.7; 95% CI=1.1-2.8). Lower odds of FTS receipt were associated with older age (OR=0.98; 95% CI=0.97-0.99), noncommunity hospital sites (OR=0.71; 95% CI=0.60-0.83), and non-attending clinicians (OR=0.83; 95% CI=0.69-0.98). CONCLUSIONS:Integrating FTS into an existing ED THN program was feasible without disrupting clinical workflow. ED encounters where FTS were dispensed differed significantly from THN-only, revealing opportunities to optimize FTS ordering.

BACKGROUND:School-based caries prevention programs are clinically and cost-effective public health approaches to increase access to essential oral healthcare for high-risk children. However, approximately 1 in 4 children participating in school caries prevention fail to respond to care, remaining at risk for dental caries and related sequela. METHODS:The Building Adaptive School-based Interventions for Caries study (BASICS) will develop and test adaptive preventive interventions using a Sequential, Multiple Assignment, Randomized Trial (SMART) design, reducing treatment nonresponse by incorporating personalized medicine into school caries prevention. Children will receive a first-stage treatment of either silver diamine fluoride or glass ionomer dental sealants and atraumatic restorations. At subsequent observations, the primary outcome of reoccurrence or new presentation of dental caries will be used as a tailoring variable for treatment nonresponse. Nonresponsive participants in either first-stage pathway will subsequently receive either (1) reapplication of initial treatment plus fluoride varnish and receipt of an electronic toothbrush or (2) an intensified Silver Modified Atraumatic Restorative Technique. The targeted enrollment is 1200 children from primarily low-income rural families enrolled in kindergarten through third grades in public primary schools. DISCUSSION/CONCLUSIONS:Primary study objectives of BASICS include determining the most effective initial treatment for caries prevention and sequence of treatments to reduce nonresponse, identifying the optimal dynamic treatment regime given patient attributes, and estimating the most cost-efficient allocation of resources for adaptive school-based caries prevention. If successful, BASICS will result in a resource-efficient approach to school dental care that optimizes resources matched to patient needs. TRIAL REGISTRATION/BACKGROUND:ClinicalTrials.gov #NCT07265830, Registered on 12/4/25. https://www. CLINICALTRIALS/RESULTS:gov/study/NCT07265830.

OBJECTIVES/OBJECTIVE:To update evidence-based management recommendations for clinicians caring for children (including infants, school-aged children, and adolescents) with sepsis or septic shock. DESIGN/METHODS:A panel of 68 international experts, representing 13 international organizations, as well as six methodologists, was convened. A formal conflict-of-interest policy was developed at the onset of the process and applied throughout. Teleconferences and electronic-based discussion among the chairs, co-chairs, methodologists, and subgroup leads as well as within subgroups, served as an integral part of the guideline development process. METHODS:New priority topics and recommendations from the prior guideline iteration were used to identify Population, Intervention, Control, and Outcomes (PICO) questions likely to have new or updated evidence. We conducted a systematic review to identify the best available evidence, summarized the evidence, and then assessed the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation approach. We used the evidence-to-decision framework to formulate recommendations as strong or conditional, or as a good practice statement. "In our practice," statements were included when evidence was inconclusive to issue a recommendation but the panel felt that some guidance based on practice patterns may be appropriate. RESULTS:The panel provided 61 statements on the management of children with sepsis or septic shock. Overall, five were strong recommendations, 24 were conditional recommendations, and ten were good practice statements. For 22 PICO questions, no recommendations could be made, but, for seven of these, "in our practice" statements were provided. Compared with the 2020 guidelines, 20 recommendations were new, 13 were updated for clarity and/or new evidence, six were reviewed but not changed, and 22 were carried forward based on consensus of the panel that new evidence was not available. Only three recommendations were based on high or moderate certainty of evidence. CONCLUSIONS:Updated management guidelines were issued by a panel of international experts for the best care of children with sepsis or septic shock, acknowledging that most aspects of care continue to have relatively low quality of evidence.

The lines defining Hepatocellular Adenoma (HCA) and Focal Nodular Hyperplasia (FNH) can be blurred when they occur outside their prototypical clinico-pathological contexts. A terminology going beyond HCA and FNH with comments on possible malignant potential, the status of the background liver and/or underlying unusual clinical scenario is thereby justified. Indeed, both more sophisticated contrast-enhanced characterization and the identification of specific immunohistochemical and molecular markers for well-differentiated hepatocellular lesions have enabled a greater understanding of their presentation and biology. The traditional concepts of HCA and FNH occurring in livers that are "otherwise histologically normal or near normal" has given way to understanding that these lesions can also occur in livers affected by chronic liver conditions. When this is the case, morpho-molecular overlap exists between the two entities. Hence, it is now necessary to set a new approach for HCA and FNH, considering not only their intrinsic morphologic and molecular features, but also the background liver in which they are arising, and the clinical context in which they are occurring. The dichotomous paradigm of benign vs. malignant also becomes more nuanced. To raise the diagnostic uncertainty in unusual clinico-pathological scenarios, the International Liver Pathology Study Group suggests designating these lesions as well-differentiated hepatocellular lesions, HCA-like (and subtype when applicable) or FNH-like. This nuanced terminology enables pathologists to highlight these outliers to the hepatobiliary multidisciplinary team that will adapt the clinical management accordingly. It also provides a framework for further collaborative studies. In conclusion, we propose a more nuanced terminology, beyond conventional HCA and FNH, to consider, alongside histological and molecular features, abnormalities in the background liver and unusual clinical scenarios.

INTRODUCTION/BACKGROUND:Medicaid is the largest source of health coverage in the United States and provides dental benefits to eligible low-income families. Federal policies establish minimum dental service requirements for children, while states have flexibility regarding the coverage of dental services for adults in any capacity. The objective of this study was to evaluate endodontic procedure coverage, reimbursement, and dentist participation for Medicaid beneficiaries. METHODS:This retrospective, cross-sectional study evaluated child and adult dental Medicaid benefits in 2021. For children, 18 endodontic procedure codes were evaluated; 16 were evaluated for adults. Mapping was used to depict state-level coverage of procedures. Logistic regression analyses were conducted to evaluate the odds of procedural coverage. RESULTS:For children and adults, initial root canal therapy was the most routinely covered endodontic procedure category; and molar teeth were the least likely tooth type to be covered. States were more likely to have established payment policies for vital pulp therapy procedures for children than for adults. For children and adults, geographic region was significantly associated with Medicaid coverage of endodontic procedures. Endodontic procedure reimbursement rates ranged from $7.00 to $1113.87 (median, $251.00). Overall, adult procedures tended to have lower reimbursement rates than child procedures at the category level but had a higher overall median reimbursement rate. Median endodontist participation for child dental services was 24%. CONCLUSIONS:Gaps in endodontic coverage exist for Medicaid beneficiaries. Endodontic treatments for molar teeth, vital pulp therapy, and regenerative endodontic procedures are the least consistently covered.

Neuronal axons have traditionally been considered to be the primary mediators of functional connectivity among brain regions. However, the role of astrocyte-mediated communication has been largely underappreciated. Astrocytes communicate with one another through gap junctions, but the extent and specificity of this communication remain poorly understood. Astrocyte gap junctions are necessary for memory formation^1,2, synaptic plasticity^3-5, coordination of neuronal signalling⁶, and closing the visual and motor critical periods^7,8. These findings indicate that this form of communication is essential for proper central nervous system development and function. Despite the importance of astrocyte gap junctional networks, studying them has been challenging. Current methods such as slice electrophysiology disrupt network connectivity and introduce artefacts due to tissue damage. Here, we developed a vector-based approach that labels molecules as they are fluxed by astrocyte gap junctions in awake, behaving animals to overcome these limitations. We then used whole-brain tissue clearing^9,10 to image these intact, three-dimensional astrocyte networks. We show that multiple astrocyte networks traverse the mouse brain. These networks selectively connect specific regions, rather than diffusing indiscriminately, and vary in size and organization. We observe local networks that are confined to single brain regions and long-range networks that robustly interconnect multiple regions across hemispheres, often exhibiting patterns distinct from known neuronal networks. We also demonstrate that astrocyte networks undergo structural reorganization in the adult brain after sensory deprivation. These findings reveal a mode of communication between distant brain regions that is mediated by plastic networks of gap junction-coupled astrocytes.

The CD30 antibody-drug conjugate, brentuximab vedotin, and PD-1 inhibitors, nivolumab and pembrolizumab have transformed the care of patients with Hodgkin lymphoma and have been incorporated into earlier lines of therapy. However, there are limited treatment options for patients with relapsed/refractory disease whose disease has progressed after brentuximab vedotin and checkpoint inhibitors. Novel immunotherapies for patients with relapsed/refractory Hodgkin lymphoma include CAR-T products, EBV-specific T cells, bispecific antibodies, and checkpoint inhibitor combinations. We review the rationale for each and summarize safety, efficacy, and progress in clinical development.