Faculty Bibliography

BACKGROUND:There is limited research on lung transplantation in patients with opioid use disorder (OUD), despite the significant burden of the overdose crisis. We sought to examine outcomes in lung transplant recipients with opioid use disorder, including those treated with medication for opioid use disorder (MOUD). METHODS:We performed a multicenter retrospective study of patients who received a lung transplant with OUD and/or documented history of prescribed MOUD. Patients were categorized based on engagement with medication for opioid use disorder at the time of admission for their index hospitalization. The primary outcome was 12-month survival. RESULTS:Among 28 included patients, 85.7% were male and 82% were white. Overall 12-month survival was 88%. Nine patients were prescribed MOUD at the time of admission to index transplant hospitalization, while 19 patients were not prescribed MOUD. Patients who received MOUD at the time of their admission were more likely to discharge home on MOUD (62.5% methadone, 25% buprenorphine vs 0% methadone, 10.5% buprenorphine). Patients who died within 12 months of transplant were more likely to have substance-related legal involvement prior to their initial listing (100% vs 35%) and discharge to home over another health care setting (66.7% vs 40.9%). CONCLUSIONS:In this multicenter study, one-year overall survival of patients on MOUD disorder who underwent lung transplantation was comparable to that of age-matched general patients. Study findings suggest that MOUD do not adversely affect lung transplant survival and may support policies promoting access for patients with OUD.

Soft tissue reconstruction often requires biomaterials that provide temporary mechanical support while permitting vascular integration and tissue remodeling. In reconstructive breast surgery, these demands converge within a uniquely challenging environment characterized by large surface areas, variable perfusion, frequent exposure to radiation, and reliance on prosthetic implants. Consequently, breast reconstruction serves as a clinically relevant model for evaluating the performance and limitations of soft tissue scaffolds. Acellular dermal matrices (ADMs) were introduced to provide biologically derived reinforcement capable of host integration and neovascularization. Although ADM has transformed implant-based reconstruction, clinical experience has revealed important limitations, including variability in mechanical properties, inconsistent vascularization, susceptibility to fibrosis, and suboptimal performance in compromised tissue beds. These challenges have driven increasing interest in synthetic polymer scaffolds engineered for reproducible mechanics, controlled degradation, and scalable manufacturing. This narrative review examines the evolution from ADM to synthetic and hybrid scaffold systems in breast reconstruction. We discuss how scaffold architecture, thickness, porosity, and degradation kinetics influence angiogenesis, immune response, and mechanical load transfer during healing. Hybrid strategies that incorporate selective bioactivity within synthetic frameworks are also explored, highlighting their translational promise and current limitations. These principles are particularly relevant in implant-based breast reconstruction, where scaffold performance directly influences complication rates, implant stability, and long-term outcomes. Collectively, breast reconstruction serves as a rigorous translational model demonstrating that optimal soft tissue scaffolds must balance vascular permissiveness, mechanical reliability, and predictable resorption to optimize reconstructive success and guide future biomaterial innovation.

In the face of a growing mismatch between candidates awaiting transplantation and the supply of conventional donor organs, attention has shifted toward novel methods to increase the donor pool, including the use of donation after circulatory death (DCD) and the refinement of procurement techniques that safeguard graft quality. Thoracoabdominal normothermic regional perfusion (TA-NRP) has emerged as a new strategy, leveraging extracorporeal support to curtail warm-ischemic injury while permitting in situ functional assessment. This review covers the rationale behind the use of TA-NRP, while outlining its use during procurement and the current body of evidence gathered on it implementation in lung transplantation specifically.

Microplastics (MPs), conventionally defined as plastic particles 1 μm-5 mm in size, are ubiquitous contaminants, infiltrating both our environment and our bodies. These particles, either manufactured at this scale or formed from the breakdown of larger plastics, possess diverse characteristics that allow them to absorb and release toxic substances, form biofilms, and abrade and inflame tissues. In humans, MPs have been detected in testes, semen, ovarian follicular fluid, placental tissue, and other locations in the reproductive system. Recent studies suggest that MPs may disrupt male and female reproduction through mechanisms involving oxidative stress, inflammation, DNA damage, and endocrine disruption. Over the past 5 years, there has been increasing excitement about MPs research and a burgeoning literature in this area. Despite this growing body of evidence, the full spectrum of MP-associated reproductive toxicity in humans remains poorly understood, with limited research on effects at environmentally relevant exposure levels and in the general population, and a poor understanding of the specific toxicity of different polymer types, sizes, and shapes. As the literature rapidly expands, it is important to take note of current constraints and how research in this field may be optimized for quality. This review summarizes current knowledge about MPs and their reproductive toxicity, highlights emerging research areas, and identifies key challenges and needs for future research on this class of contaminant.

Water diffusion gives rise to micron-scale sensitivity of diffusion MRI (dMRI) to cellular-level tissue structure. Precision medicine and quantitative imaging depend on uncovering the information content of dMRI and establishing its parsimonious hardware-independent fingerprint. Based on the rotational SO(3) symmetry, we study the geometry of the dMRI signal and the topology of its acquisition, identify irreducible components and a full set of invariants for the cumulant tensors, and relate them to tissue properties. Including all kurtosis invariants improves multiple sclerosis classification in a cohort of 1189 subjects. We design the shortest acquisitions based on icosahedral vertices to determine the most used invariants in only 1-2 minutes for whole brain. Representing dMRI via scalar invariant maps with definite symmetries will underpin machine learning classifiers of pathology, development, and aging, while fast protocols will enable translation of advanced dMRI into clinic.

BACKGROUND:Advances in understanding the molecular landscape of gastroesophageal junction (GEJ) adenocarcinoma underscore the need for biomarker-driven treatment approaches. MATERIALS AND METHODS/METHODS:The Society of Surgical Oncology (SSO) Gastrointestinal (GI) Disease Site Working Group has developed practice guidelines for the biomarker-based management of nonmetastatic GEJ adenocarcinoma, with specific integration of microsatellite instability (MSI) status. RESULTS:Although multimodal therapy has improved outcomes, treatment strategies for GEJ adenocarcinoma remain largely stage-based rather than biomarker-directed. With emerging evidence supporting the prognostic and predictive roles of MSI-high (MSI-H), human epidermal growth factor receptor 2 (HER2), and other novel targets, there is an urgent need for clear guidance on how to incorporate biomarkers into the management of resectable disease. CONCLUSIONS:These guidelines provide evidence-based recommendations to support precision oncology in GEJ cancer care.

INTRODUCTION/BACKGROUND:Colorectal cancer(CRC) is the third most commonly diagnosed malignancy with a rising global incidence. CRC shares many risk factors with other malignancies and may occur as a part of hereditary cancer syndromes. This retrospective cohort study aims to evaluate outcomes in patients with CRC and a history of prior malignancy to identify potential implications for personalized management. METHODS:The National Cancer Database was queried from 2004 to 2022 for patients diagnosed with CRC, who were stratified into two cohorts: those with and without malignancies prior to CRC diagnosis. Propensity score matching was performed to balance sociodemographic characteristics, and logistic regression was used to estimate odds ratios(ORs) for tumor and treatment characteristics. Subsequently, a Cox proportional hazards model was fit to assess the association of having prior malignancies and mortality. RESULTS:A total of 576,076 patients were included, with 288,038 in each cohort. Patients with prior malignancies had significantly lower odds of KRAS mutation(OR = 0.86, 95% CI:0.83-0.89, p < 0.001), abnormal CEA levels(OR = 0.95, 95% CI:0.94-0.96, p < 0.001), perineural invasion(OR = 0.86, 95% CI:0.84-0.88, p < 0.001), early-onset CRC(OR = 0.73, 95% CI:0.71-0.74, p < 0.001), advanced-stage CRC(OR = 0.77, 95% CI:0.76-0.77, p < 0.001), and tumor deposits(OR = 0.82, 95% CI:0.80-0.84, p < 0.001). These patients also had higher odds of receiving treatment(OR = 1.05, 95% CI:1.02-1.08, p < 0.001). However, they had higher odds of microsatellite instability(OR = 1.20, 95% CI:1.17-1.23, p < 0.001), treatment delays(OR = 1.42, 95% CI:1.40-1.43, p < 0.001), and postoperative readmissions(OR = 1.14, 95% CI:1.11-1.17, p < 0.001). Patients with a history of prior malignancies were associated with higher overall mortality(aHR = 1.19, 95% CI:1.10-1.27, p < 0.001) as well as stage-specific mortality, except for stage 1 CRC. CONCLUSION/CONCLUSIONS:These findings indicate that patients with prior malignancies may require greater preoperative optimization, closer post-discharge monitoring, and proactive efforts to avoid treatment delays.

Addressing endemic stunting remains a primary United Nations development goal. One potential contributor to global linear growth failure is environmental enteric dysfunction (EED). However, it has proven challenging to address with interventions focused on water, sanitation and hygiene. Initial theories of EED placed primacy on recurrent enteric exposures; however, it appears that these exposures are inadequate to explain the phenotype and sequelae. Children in EED endemic regions are at high risk of having inadequate nutrition, and strong associations can be found between malnutrition and stunting. In this review, we summarize the clinical, translational and mechanistic evidence linking intake of animal source foods as a source of protein and micro-nutrients and, in their absence, essential amino acid (EAA) deficiency with stunted growth and features of EED such as altered immune behaviour. EAA deficiency has been linked to growth failure through several mechanistic pathways including intestinal inflammation, barrier disruption and chondral plate closure, and amino acid supplementation has shown clinical efficacy. By better understanding this linkage, we will be able to better study not only EED but also pathways in which dietary sources mechanistically alter systemic signalling in metabolism and immune function. This article is part of the theme issue 'Biological, biomedical and environmental drivers of stunting'.

ABSTRACT/UNASSIGNED:Musculoskeletal magnetic resonance imaging has evolved substantially, driven by advances in hardware, image acquisition, and reconstruction techniques. Improvements in gradient performance and dedicated radiofrequency coils have enhanced spatial resolution and scan efficiency across field strengths. Image acceleration strategies, including parallel imaging, simultaneous multislice acquisition, and compressed sensing, now enable high-quality two-dimensional and three-dimensional magnetic resonance imaging with markedly reduced examination times and facilitate the time-neutral incorporation of advanced metal artifact reduction techniques into clinical magnetic resonance imaging protocols. ABSTRACT/UNASSIGNED:Deep learning-based reconstruction and super-resolution augmentation methods have further expanded achievable acceleration and image quality. Emerging techniques such as synthetic magnetic resonance imaging, magnetic resonance neurography, kinematic magnetic resonance imaging, and zero echo time magnetic resonance imaging expand the capabilities of musculoskeletal magnetic resonance imaging. At the same time, renewed interest in low-field magnetic resonance imaging provides intriguing opportunities to improve accessibility and sustainability. Ultra-high field magnetic resonance imaging provides unprecedented spatial resolution and quantitative insights in selected applications. These developments are redefining musculoskeletal magnetic resonance imaging practice and broadening its clinical value.

Background MR enterography (MRE) is increasingly used to guide treatment and improve outcomes in Crohn disease (CD). An abbreviated MRE (A-MRE) protocol-omitting contrast and antiperistaltic agents-may reduce scanning time and cost and improve compliance. Purpose To compare intrareader concordance and interreader agreement in detecting disease activity and disease-related complications using contrast-enhanced MRE (CE-MRE) versus an A-MRE protocol in participants with CD. Materials and Methods In this secondary analysis of a prospective study, 10 abdominal radiologists independently reviewed MRE examinations from a prospective study of participants with CD before and after treatment with biologics, using both A-MRE and CE-MRE protocols, at least 1 month apart. Interreader agreement and intrareader concordance were assessed using Gwet first agreement coefficient (AC1) at both the segment and participant levels for the presence of active inflammation, associated indicative features, and complications. Diagnostic accuracy of the simplified MR index of activity (sMaRIA) was evaluated against ileocolonoscopy when available. Results This study included 60 participants (median age, 36 years [IQR, 28-44 years]; 40 female; 80 examinations). Interreader agreement for detecting intestinal active disease was high and comparable between A-MRE and CE-MRE at the participant level (AC1, 0.87 [95% CI: 0.79, 0.95] vs 0.91 [95% CI: 0.85, 0.97]). For strictures, similar interreader agreement was observed between protocols (AC1: A-MRE, 0.61 [95% CI: 0.47, 0.74] vs CE-MRE, 0.50 [95% CI: 0.35, 0.65]). For penetrating complications, the interreader agreement was also similar between protocols (A-MRE, 0.71 [95% CI: 0.56, 0.86] vs CE-MRE, 0.76 [95% CI: 0.63, 0.90]). The intrareader concordance between protocols for detecting active inflammation and CD complications was almost perfect for all readers (AC1 range, 0.86-1.00). In the terminal ileum, sMaRIA showed high sensitivity (A-MRE, 96.4%; CE-MRE, 98.4%) and specificity (A-MRE, 68.1%; CE-MRE, 71.4%) for detecting inflammation. Conclusion An A-MRE protocol demonstrated comparable interreader agreement to conventional CE-MRE and high intrareader concordance for detecting active CD and related complications in participants with CD. © The Author(s) 2026. Published by the Radiological Society of North America under a CC BY 4.0 license. Supplemental material is available for this article. See also the editorial by Ohliger in this issue.