Faculty Bibliography

BACKGROUND/UNASSIGNED:Liver cancer poses a significant global health burden, characterized by substantial regional disparities. We analyzed liver cancer incidence and mortality across 204 countries and territories from 1990 to 2021 and projected trends from 2021 to 2041. MATERIALS AND METHODS/UNASSIGNED:Data from the Global Burden of Disease (GBD) Study 2021 were used to calculate age-standardized rate (ASR), average annual percentage change (AAPC), and estimated annual percentage change (EAPC). Risk factors, human development index (HDI), and sociodemographic index (SDI) were evaluated. The Nordpred and Bayesian Age-Period-Cohort (BAPC) models projected future trends. RESULTS/UNASSIGNED:Globally, according to the analysis of AAPC, the ASR of liver cancer incidence rose by 0.115% (95% CI: 0.07-0.159) annually, while the mortality ASR trend remains stable (-0.113%, 95% CI: -0.35-0.124). Viral hepatitis B and C remained primary causes, but non-alcoholic steatohepatitis (NASH) contributions increased. The summary exposure value (SEV) for drug use increased by 12% globally, with a dramatic increase of 308% in North America. High-HDI/SDI countries exhibited higher ASR than expected, which may be attributed to aging populations and the rising incidence of metabolic diseases. Projections indicated a rising number of cases but declining ASR for both males and females by 2041. CONCLUSIONS/UNASSIGNED:Tailored prevention strategies are needed to address region-specific risk factors and mitigate the growing burden of liver cancer.

IMPORTANCE:There are 3.5 million prostate cancer survivors in the US, with a need for evidence-based lifestyle recommendations that improve survivorship. OBJECTIVE:To assess whether consumption of specific dietary fats after diagnosis is associated with long-term survival among patients with nonmetastatic prostate cancer. DESIGN, SETTING, AND PARTICIPANTS:This study, nested in the Health Professionals Follow-Up Study, a cohort of male health professionals from across 50 US states ongoing since 1986, included participants with confirmed nonmetastatic prostate cancer between 1986 and January 2019, followed up through December 2022. Statistical analysis was conducted from July 2024 to May 2026. EXPOSURES:Dietary data were collected every 4 years from validated food frequency questionnaires and used to estimate intake of saturated, polyunsaturated, monounsaturated, trans, plant, and animal fat after cancer diagnosis. MAIN OUTCOMES AND MEASURES:Main outcomes were all-cause mortality and death from prostate cancer, other cancers, cardiovascular disease, and other causes during a median 12.8 years (IQR, 8.1-16.8 years) of follow-up through 2022. Hazard ratios (HRs) and 95% CIs from multivariable Cox proportional hazards regression and multivariate nutrient-density models examined associations with mortality, adjusting for demographic, epidemiologic, and clinical factors. RESULTS:Among 4884 patients with nonmetastatic prostate cancer, the mean (SD) age at diagnosis was 69.5 (6.9) years. During follow-up, 3040 deaths from any cause were confirmed. When comparing patients in the highest quintile of saturated fat consumption with those in the lowest quintile, higher postdiagnostic saturated fat intake was associated with greater all-cause (HR, 1.24 [95% CI, 1.05-1.47), cardiovascular (HR, 1.42 [95% CI, 1.02-1.98]), and other cancer mortality (HR, 1.42 [95% CI, 0.93-2.17]). Animal fat, a major source of saturated fats, was also positively associated with all-cause mortality (HR, 1.14 [95% CI, 0.97-1.33]), as well as deaths from other cancers (HR, 1.49 [95% CI, 1.00-2.21]). Replacing 10% of calories from animal fats with plant-based fats (HR, 0.84 [95% CI, 0.76-0.93]) and replacing 5% of calories from saturated fats with monounsaturated fats (HR, 0.80 [95% CI, 0.70-0.91]) was associated with a decrease in all-cause mortality. There were no associations between dietary fats and prostate cancer mortality. CONCLUSIONS AND RELEVANCE:In this cohort study of patients with nonmetastatic prostate cancer, saturated fats, including animal fats, were associated with greater all-cause mortality owing to deaths from cardiovascular disease and other cancers. Diets rich in monounsaturated and polyunsaturated fats and plant-based fats after prostate cancer diagnosis were associated with improved survival outcomes for patients. These findings support evidence-based recommendations for patients and clinicians around dietary fat consumption to improve survivorship outcomes in the clinical setting of nonmetastatic prostate cancer.

Clinical histories are essential for accurate radiologic interpretation but are often lengthy and time-consuming to review amid increasing radiologist workloads. Large language models (LLMs) offer a potential solution by generating concise, clinically focused summaries from existing documentation; however, the optimal presentation format for radiologists remains unclear. This retrospective reader study evaluated the readability, efficiency, and radiologist preference for a two-stage LLM-based summarization pipeline designed to identify the optimal summary format for radiologic use. Ninety imaging studies across multiple modalities and care settings were processed to generate structured timeline summaries (stage 1) and brief narrative summaries (stage 2). Text length was reduced by approximately 86.8% and 95.2% for stage 1 and stage 2, respectively. Four radiologists independently rated representative subsets of cases for clarity, relevance, usefulness, and comprehensiveness and indicated their order of preference. Stage 2 summaries were preferred in 89% of ratings and were rated significantly higher than stage 1 for perceived clarity, relevance, and usefulness (p < 0.0001), with equivalent comprehensiveness. Longer source documents and longer stage 1 summaries were associated with lower ratings for the detailed timeline format, whereas no such associations were observed for the brief narrative summaries. Manual review identified 25 total hallucinations across 90 cases, of which one was considered capable of altering image interpretation in a case with borderline radiographic features. These findings demonstrate that summary format, and particularly brevity, is critical for optimizing readability and radiologist preference. Automated summarization holds promise to reduce cognitive load and improve information accessibility in radiology practice.

OBJECTIVES/UNASSIGNED:To develop and evaluate the Community Research Consulting Initiative (CRCI), a no-cost, student-led model designed to build bidirectional capacity between academic institutions and community-based organizations (CBOs) through research consulting and project-based assistance. STUDY DESIGN/UNASSIGNED:This formative program evaluation examined the feasibility, acceptability, and preliminary outcomes of CRCI, which includes virtual Office Hours for short-term research consultation and Project-Based Assistance (PBA) for longer-term collaborations. The goal was to support CBOs with technical research needs while providing academic trainees with real-world experience. METHODS/UNASSIGNED:Academic consultants (students, staff, faculty) were recruited through institutional listservs and outreach and completed an intake form outlining their expertise and learning goals. CBOs were engaged through Community Advisory Boards, faculty referrals, and existing networks. Consultants provided support via Zoom-based Office Hours and were matched with CBOs for PBA through a memorandum of understanding. Data collection included Zoom registration logs, post-session surveys, and follow-up communications. Quantitative data were analyzed descriptively, and qualitative feedback was reviewed thematically to inform implementation improvements. RESULTS/UNASSIGNED:Thirty-three consultants expressed interest; 21 participated in Office Hours or PBA projects, representing a range of NYU departments. Consultants sought practical experience applying academic skills in community settings. Fifty-one unique CBOs registered for 90 Office Hours slots, primarily serving racial/ethnic minority and at-risk populations in New York City. Grant writing and data analysis were the most frequently requested topics. Among 20 completed surveys, 95% of CBO respondents found sessions useful and relevant, citing take-home resources as especially beneficial. Six CBOs engaged in PBA projects involving survey design, data analysis, and program evaluation. Consultants appreciated the learning opportunity but highlighted challenges related to attendance, preparation time, and expectation setting. CONCLUSION/UNASSIGNED:CRCI demonstrates a feasible and replicable model for advancing equitable academic-community partnerships aligned with NIH priorities. The initiative supports community capacity building while fostering practical training for future leaders in community-engaged research. Broader implementation of CRCI-like models may enhance the sustainability and impact of academic-community collaborations.

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.

INTRODUCTION/UNASSIGNED:The optimal timing of systemic therapy in pleural mesothelioma remains debated, particularly for asymptomatic patients with a limited disease burden. Prior studies suggest that deferred treatment may not compromise overall survival (OS) in selected patients. Reliable prognostic markers to guide treatment timing are lacking. We investigated whether baseline tumor volume and pretreatment tumor growth rate, quantified using an artificial intelligence (AI)-based model, predict OS in patients deferring systemic therapy. METHODS/UNASSIGNED:We conducted a single-center retrospective study including patients with pleural mesothelioma diagnosed between 2010 and 2025 who deferred systemic therapy for more than or equal to 3 months and had at least two pretreatment computed tomography scans. Total tumor volume and tumor growth rate (mL/mo) were automatically measured using the AI-based ARTIMES model. Optimal cutoffs were determined using receiver operating characteristic analysis. OS was analyzed using Kaplan-Meier estimates and Cox proportional hazards models. RESULTS/UNASSIGNED:= 0.007). CONCLUSIONS/UNASSIGNED:AI-derived baseline tumor volume and tumor growth rate are strong prognostic factors for OS in patients with pleural mesothelioma deferring systemic therapy. Patients with low baseline tumor volume and those with low tumor growth rate were significantly associated with a longer OS.

BACKGROUND:Consensus guidelines advocate multidisciplinary care to optimise recovery following laryngectomy. However, limited evidence exists regarding the nature of the patient recovery journey or their experience accessing rehabilitation services. AIMS/OBJECTIVE:This study examined the services accessed by, and experiences of, individuals with a laryngectomy (IWL) in the first 12 months post-surgery. METHODS AND PROCEDURES/METHODS:Patient journey mapping methodology was used to explore the healthcare journey and patient experience of 12 IWL across the first 12 months of rehabilitation. Demographics and detailed service data were collated from medical records and later reviewed for accuracy with each participant. Individual interviews were used to explore issues that influenced care experiences, and participants also provided experiential ratings relating to the emotional impact of each appointment (positive/negative/neutral) and the reason for the rating. Journeys were explored collectively as a group, then 3 detailed patient journeys are presented highlighting similarities and differences in participant experiences. OUTCOMES AND RESULTS/RESULTS:Participants attended a median (Mdn) of 7 medical visits (range = 4-14), 12 allied health visits (range = 4-45), saw 13 different professionals (range = 6-22), and travelled to 6 locations (range = 2-6) for healthcare. Factors adding to the complexity of the health care journeys included preparation for surgery, nature of surgery (primary versus salvage), access to trained specialists throughout phases of care, coordinating between services, travel and funding for consumables. Despite issues, participants largely rated experiences as positive (Mdn = 77; range = 37%-100% positive). Participant perspectives on issues impacting their healthcare journey formed 6 themes: (1) Preparation for laryngectomy surgery, (2) Recovery post-surgery (3) Access to skilled and coordinated services, (4) Approach of healthcare staff, (5) Communication difficulties impacting healthcare, and (6) Accessing laryngectomy resources and costs. CONCLUSIONS AND IMPLICATIONS/CONCLUSIONS:Following laryngectomy, a wide range of multidisciplinary services are accessed to support recovery and rehabilitation. Examining patient experiences through journey mapping has highlighted challenges that can influence the care pathway. Addressing issues that impact service access and patient experience will assist in enhancing laryngectomy care pathways and improve the patient experience. WHAT THIS PAPER ADDS/CONCLUSIONS:What is already known on the subject Current care pathways advocate specialist, multidisciplinary care for optimal recovery for individuals with a laryngectomy (IWL). Although existing laryngectomy guidelines specify that a range of specialist services are required, and detail what those services should entail, what this actually looks like and means for IWL as they live this path of recovery, remains largely unexplored. What this study adds to the existing knowledge This work expands the body of evidence in laryngectomy care by exploring the healthcare journeys of a cohort of IWL to better understand the extent of medical and allied health services required in the first 12-months post-surgery and the patients' experiences of that care. This work is the first to use journey mapping, a methodology that provides detailed insights gained from both quantitative and qualitative data to elucidate the patients' care experience. Understanding the patients lived experience, and any challenges faced, is essential information needed to continue to inform future care optimisation. What are the clinical implications of this study? The collective findings from this study highlight the potential challenges IWL can face accessing care in the post-acute phase. Participants attended a high number of medical and allied health visits, from a variety of professions and services, and faced several challenges including being prepared for their recovery, accessing skilled professionals, communication with healthcare staff, and costs of necessary consumables/equipment. Healthcare providers, including speech-language pathologists, must recognise and address these issues where possible, to optimise care and reduce patient burden.