Faculty Bibliography

BACKGROUND/UNASSIGNED:Qualitative anatomical studies have reported ligament-specific differences in vascular organization in the anterior and posterior cruciate ligaments (ACL and PCL). PURPOSE/UNASSIGNED:(1) To quantitatively map the regional arterial vascular supply of the ACL and PCL across standardized anatomical regions using 7-Tesla quantitative magnetic resonance imaging (7T-qMRI), histology, and high-resolution computed tomography (micro-CT) in a fresh-frozen human cadaveric model; and (2) to directly compare vascular distribution patterns between cruciate ligaments. STUDY DESIGN/UNASSIGNED:Descriptive laboratory study. METHODS/UNASSIGNED:Seven fresh-frozen human cadaveric knee specimens (mean ± SD age, 41.9 ± 15.5 years) underwent pre- and postcontrast 7T-qMRI to quantify ligamentous vascularity by measuring contrast enhancement. Ligament zones were categorized based on relative distance from distal insertion as follows: 1 (≥90%), 2 (>75% to 90%), 3 (>25% to 75%), 4 (>10% to 25%), and 5 (≤10%). Subsequent quantitative algorithm-based histologic analysis with hematoxylin and eosin staining followed, and an additional specimen underwent micro-CT (98 μm) for qualitative assessment. RESULTS/UNASSIGNED:= .87). A 3-zone 7T-qMRI and histologic sensitivity analysis confirmed the distribution pattern. CONCLUSION/UNASSIGNED:This study demonstrates a distinct, region-specific arterial distribution in the ACL and PCL. The ACL exhibited predominantly proximal vascular supply, whereas the PCL showed greater distal and overall arterial contribution. These quantitative differences in vascular organization provide a biological basis that may help explain ligament-specific healing behavior. CLINICAL RELEVANCE/UNASSIGNED:This study establishes 7T-qMRI as a methodology for quantitative comparison of vascularity between the ACL and PCL to support future translational studies investigating the relationship between vascular supply, ligament-specific healing patterns, and injury-specific treatment strategies.

BACKGROUND:Tissue-based gene expression assays provide prognostic information in prostate cancer, but their influence on decisions regarding immediate treatment versus conservative management, including active surveillance (AS) and watchful waiting (WW), remains uncertain. METHODS:Using a linkage with the Surveillance, Epidemiology, and End Results program, we evaluated the association between a 22-gene genomic classifier (GC) and initial management among patients with low or intermediate clinical-risk prostate cancer diagnosed from 2015 through 2018. Initial management was classified as immediate therapy or AS/WW, and GC scores were grouped as low (<0.45), intermediate (0.45-0.60), or high (>0.60). Multivariable logistic regression assessed associations between GC category and immediate treatment, stratified by clinical-risk group and adjusted for demographic and clinical covariates. RESULTS:Among 2,547 patients, 286 of 1,030 (27.8%) with low- and 1,113 of 1,517 (73.4%) with intermediate clinical-risk prostate cancer received initial treatment. Use of initial treatment increased with higher GC category. Among patients with low and intermediate clinical-risk prostate cancer, respectively, 20.5% and 57.5% with low GC, 28.3% and 75.8% with intermediate GC, and 46.2% and 88.3% with high GC scores received initial treatment. Higher GC category was independently associated with greater odds of immediate treatment versus AS/WW (versus low GC: intermediate GC, odds ratio [OR] 1.98, 95% confidence interval [CI] 1.57-2.49, p < 0.001; high GC, OR 4.42, 95% CI 3.41-5.71, p < 0.001). CONCLUSIONS:Higher GC scores were associated with greater use of immediate treatment and less use of AS/WW, underscoring the need to determine whether GC testing also predicts long-term outcomes among patients managed with AS.

High-resolution quantitative susceptibility mapping (QSM) combined with susceptibility source decomposition provides a powerful approach for investigating the magnetic susceptibility alterations in Alzheimer's disease (AD). In this study, ex vivo three-dimensional multi-echo gradient-echo (mGRE) images of 5xFAD and

INTRODUCTION/BACKGROUND:Repetitive head impacts (RHIs) have been linked to later life neurodegeneration, yet the in vivo structural correlates of cumulative biomechanical loading remain unclear. We examined whether regional ventricular morphology in former American football players reflects exposure burden and traumatic encephalopathy syndrome (TES) classification. METHODS:Participants included 170 male former football players and 54 age-matched asymptomatic male controls from the Diagnostics, Imaging, and Genetics Network for the Objective Study and Evaluation of Chronic Traumatic Encephalopathy Research Project. Subject-specific manual segmentation quantified lateral ventricle, inferior horn, third ventricle, and fourth ventricle volumes. Group and exposure associations were tested using generalized least squares models. RESULTS:Former players showed larger left inferior lateral ventricle volume than controls, with the largest effects among professional players. Greater cumulative linear and rotational acceleration exposure was associated with enlargement across lateral ventricular and inferior horn regions. DISCUSSION/CONCLUSIONS:Regional ventricular enlargement may represent an in vivo marker of cumulative biomechanical loading after RHI exposure.

BACKGROUND/PURPOSE/UNASSIGNED:The effectiveness of intraoral scanners in accurately recording partially edentulous mandibles is still under scrutiny. This study aimed to assess the accuracy of digital impressions obtained using an intraoral scanner in a partially edentulous mandibular arch. MATERIALS AND METHODS/UNASSIGNED:A partially edentulous typodont model with missing five teeth was digitally scanned using a calibrated desktop scanner to create a reference model. The scan was saved as a standard tessellation language (STL) file and used as the control dataset. The same typodont model was then scanned 20 times using an intraoral scanner (IOS), with each digital impression exported in STL format. All datasets were analyzed using a best-fit registration algorithm in specialized software to compare the IOS scans against the reference model. RESULTS/UNASSIGNED:0.05). CONCLUSION/UNASSIGNED:The findings of this study indicate that the intraoral scanner evaluated is capable of generating digital impressions with clinically acceptable accuracy in partially edentulous mandibular arches.

This practice guideline provides updated evidence-based recommendations regarding the use of pharmacologic migraine prevention in adults. A multidisciplinary panel conducted a systematic review and developed practice recommendations following the process outlined in the 2017 edition of the American Academy of Neurology Clinical Practice Guideline Process Manual. The systematic review includes studies published through June 6, 2024, and is available in a companion publication. Recommendations are supported by structured rationales that integrate evidence from the systematic review, related evidence, principles of care, and inferences from evidence. Recommendations are provided on how to decide when it is appropriate to start a pharmacologic migraine preventive medication and how to decide which migraine preventive medication to start. Recommendations address decision making on appropriate choices of migraine preventive medications in specific situations and populations, including patients with fibromyalgia, obesity, or hypertension; considerations for older adults; treatment during pregnancy and lactation; sex-related factors in choosing medications; and treatment for patients with medication overuse. Recommendations on assessment of treatment efficacy, adverse effects, and discontinuing migraine preventive medications are provided.

Gluteal tendon tears are typically degenerative and often only partial. For patients who fail nonoperative management, endoscopic repair is a reasonable option. Traditionally, a knotted side-to-side suture repair technique has been used, though this can be technically demanding and leave knot stacks adjacent to the trochanteric bursa. Using a suture staple technique may increase the tendon-footprint contact area and avoids the knot stacks. Although the biomechanics seem theoretically in favor of the staple technique, this has yet to be proven. Clinically, the techniques are likely comparable, though more research is needed on several fronts before a determination can be made.