Faculty Bibliography

Rhinoplasty is a technically demanding procedure in which the precision of osteotomy creation directly influences cosmetic and functional outcomes. Traditional osteotomes often produce uncontrolled fracture lines and soft tissue trauma. Piezoelectric devices have been introduced as an alternative. They offer selective cutting of mineralized tissue while sparing surrounding soft tissue structures. Although the clinical benefits of this approach have been well documented, the biological processes defining this technique remain unsettled. The current study aimed to compare the histological changes in bone regeneration and long-term healing outcomes within piezotome-induced and osteotome-induced nasal bone defects in a translational, preclinical ovine model. Bilateral osteotomies were created on the nasal bone of n=12 skeletally mature sheep using a piezoelectric bone-cutting system (Piezotome CUBE, Acteon) or a traditional osteotome. Euthanasia was performed at either 3 or 12 weeks postoperatively (6 defects per group per time point). Histological analysis at 3 weeks postoperatively revealed limited bone ingrowth, followed by substantial bone regeneration in both groups by 12 weeks. Osteotome-treated sites displayed irregular margins and bone debris, while piezotome-treated defects demonstrated cleaner margins and less bony fragmentation. Despite qualitative differences, semi-quantitative scoring of new bone formation showed no statistically significant differences in healing between devices at 3 weeks (p=0.500) or 12 weeks (p=0.125). These findings suggest that although piezoelectric osteotomies may offer advantages in intraoperative precision and early postoperative morbidity, long-term bone regeneration appears comparable to that achieved with conventional osteotomes.

BACKGROUND:Health care workers (HCWs) face sustained psychological demands that place them at heightened risk for burnout and posttraumatic stress disorder (PTSD). However, assessing psychological distress in this population remains challenging because of stigma, underreporting, and the limitations of self-report tools. Although nonverbal behaviors such as facial expressions and gaze hold diagnostic promise, most approaches overlook the fine-grained, temporal fluctuations in these signals. In this study, we focused on microbehavior intervals-brief, involuntary changes in multimodal nonverbal signals-that emerge during emotion-eliciting interviews. OBJECTIVE:This study aimed to determine whether microbehavior intervals improve the discrimination of psychological distress profiles among HCWs with symptoms of burnout and PTSD. METHODS:HCWs participated in a semistructured interview that included 5 work-related, emotionally charged questions and that was recorded via Webex (online video platform). Participants also completed validated questionnaires for burnout (Maslach Burnout Inventory General Survey 9-item) and PTSD (PTSD checklist for Diagnostic and Statistical Manual, 5th edition). Recordings were analyzed with computer vision models to generate time-series data of facial expressions, head movement, gaze, body posture, and hand gestures. An unsupervised anomaly detection model (MOMENT [a Family of Open Time-Series Foundation Models]) isolated microbehavior intervals without requiring manual labels. Features derived from these intervals were used to train a deep learning classifier that predicted 4 symptom classes of psychological distress: "moderate-severe burnout," "subthreshold-provisional PTSD," "burnout+PTSD," and "resilient." We conducted an ablation study by systematically removing one behavioral data stream at a time. Finally, we conducted an explainability analysis to characterize the features driving model predictions. RESULTS:-score. The explainability analysis revealed distinct temporal patterns across symptom classes, with irregularity and variability in microbehaviors emerging as key predictors. CONCLUSIONS:Focusing on microbehavior intervals yields a scalable, interpretable, and annotation-free framework for detecting psychological distress from nonverbal signals. By moving from whole-video features to fine-grained multimodal temporal modeling, we successfully captured subtle, involuntary fluctuations in nonverbal responses to emotion-eliciting questions. This multimodal approach enables an objective, robust, and explainable assessment of psychological distress and offers a promising complement to conventional psychometric assessments.

Alston's singing mouse has emerged as an intriguing model for the comparative study of vocal control. New work on the species sets the stage to understand the proximate mechanisms and evolutionary roots of novel acoustic communication traits.

Conventional imaging techniques lack the resolution and sensitivity to adequately characterize cerebral small-vessel abnormalities (CSVA) in vivo. This study aimed to overcome these limitations and evaluate the feasibility of a novel MRI technique called Microvascular In-vivo Contrast Revealed Origins (MICRO), which uses an ultrasmall superparamagnetic iron oxide (USPIO) contrast agent (Ferumoxytol) to resolve the cerebral microvascular architecture with a level of anatomical and physiological detail not previously achievable in vivo. Fifty-nine Parkinson's disease (PD) patients underwent MICRO MRI based on susceptibility-weighted imaging (SWI). Three independent raters identified and categorized CSVAs as large developmental venous anomalies (DVAs), micro DVAs, engorged vessels, and diminished vessels. The location of each CSVAs was documented, and its association with white matter hyperintensities (WMHs) was assessed. The MICRO imaging protocol demonstrated excellent inter-rater agreement for identifying these CSVAs. Our findings show a high prevalence of CSVAs in PD patients, with engorged vessels being the most common type (49.06% of subjects). Both engorged vessels (72.41%) and micro DVAs (81.82%) were highly associated with WMHs. CSVAs were most frequently observed in the periventricular white matter (n=28), deep white matter (n=32), and putamen (n=14), suggesting regional distribution pattern of detectable CSVAs. This work establishes MICRO as a feasible, reliable platform for in vivo microvascular mapping with potential applications in neurovascular research.

INTRODUCTION/BACKGROUND:Vascularized Composite Allotransplantation (VCA) is a reconstructive technique that restores form and function in patients with severe tissue loss from trauma, burns, tumors, or congenital anomalies. Despite improving clinical outcomes, public understanding and acceptance remain barriers to widespread public acceptance. This systematic review examines global public perceptions of VCA, focusing on demographic, cultural, religious, and educational influences on donation. METHODS:A PRISMA-guided systematic review was conducted in June 2025 across PubMed, Embase, MEDLINE, Scopus, and Web of Science. Eligible studies included original surveys or mixed-methods research involving nonexpert participants who reported willingness to donate to VCA. Excluded were studies limited to experts, discussion articles, reviews, abstracts, or commentaries. RESULTS:Twenty studies met the inclusion criteria, representing 19,023 respondents from 8 countries. Overall, there was a lower pooled willingness to donate facial VCA than hand VCA, with pooled willingness estimates of 47.9% and 54.8%, respectively. In contrast, willingness to receive VCA was higher overall, with pooled willingness estimates of 65.6% for facial transplantation and 72.4% for hand transplantation. Religious differences were evident: Christian and agnostic respondents were generally more willing to donate, whereas Muslim respondents were less willing. Racial differences were also noted, with White respondents more likely to donate. In contrast, Black and Asian respondents were less likely to indicate willingness to donate. CONCLUSIONS:This systematic review provides the first comprehensive synthesis of global survey data on public perceptions of VCA. Nearly half of the respondents reported willingness to donate, with higher acceptance of hand donation than of face donation. Racial, ethnic, and religious factors shape attitudes, underscoring the need for culturally tailored educational strategies to improve donation acceptance.

OBJETIVO/OBJECTIVE:Analizar la asociación entre experiencia migratoria en Estados Unidos y consumo de alcohol y drogas en población mexicana residente en México. Material y métodos. Estudio transversal con datos de la Encuesta Nacional de Consumo de Drogas, Alcohol y Tabaco 2025. El análisis incluyó descripción de características sociodemográficas y prevalencias de consumo según experiencia migratoria (Sí/No); comparación bivariada con pruebas χ² de Rao-Scott y t ajustadas por diseño; estimación de razones de prevalencia (RP) ajustadas mediante modelos de regresión de Poisson con varianza robusta y exploración de interacción entre experiencia migratoria y sexo. RESULTADOS/RESULTS:La población con experiencia migratoria presentó mayores prevalencias de consumo de alcohol y consumo excesivo en el último año (57.7 vs 45.5%) y (40.6 vs 28.6%), respectivamente, consumo de drogas ilícitas alguna vez en la vida (24.8 vs 12.5%). En los modelos ajustados la asociación entre experiencia migratoria y consumo de alcohol ([RP= 1.18; IC95%: 1.08,1.27], y consumo excesivo [RP= 1.22; IC95%: 1.09,1.37]) se mantuvo. La interacción con sexo fue significativa para consumo de drogas ilícitas. CONCLUSIONES/CONCLUSIONS:Los resultados sugieren que la experiencia migratoria puede influir en los patrones de consumo de alcohol. Las trayectorias migratorias deben considerarse como un determinante social relevante en el análisis y prevención del consumo de sustancias.

PurposeTo estimate the effect of the culturally-adapted Greenlight intervention on parent activation and locus of control (LOC) among Chinese-American immigrant parents.DesignProspective, quasi-experimental study.SettingA New York City-based federally-qualified health center with a large patient population of low-income, ethnically Chinese immigrant individuals and families.Sample444 Immigrant Chinese-American parents of infants (267 cross-sectionally enrolled historical controls and 177 Greenlight recipients followed prospectively).InterventionA culturally-adapted version of Greenlight, a health literacy- and communication-informed early childhood obesity prevention intervention in primary care which promotes certain healthy infant feeding practices at 12 months in the present sample.MeasuresParent activation and LOC were measured at 6, 12, 24, and 36 month well child visits.AnalysisGeneralized estimating equations were used to examine the effects of the Greenlight intervention on the outcome measures.ResultsCompared to historical controls, parents receiving Greenlight were more likely to strongly agree with the activation statements: "I know how to prevent my child from becoming overweight" (adjusted odds ratio (aOR): 9.62 [4.70, 19.73]); "I have been able to help my child maintain recommended changes like eating right or exercising" (aOR: 6.42 [4.14, 9.97]); and "I am confident I can keep my child eating and exercising right, even when I am busy or stressed" (aOR: 8.44 [5.35, 13.31]). Greenlight recipients also demonstrated increased internal LOC (aOR: 2.02 [1.35, 3.03]) and decreased powerful others external LOC (aOR: 1.76 [1.23, 2.51]).ConclusionTo reduce disparities in child obesity, especially among immigrant families, interventions must also prioritize parent factors like parent activation and LOC to build upon their inherent assets and promote long-term change.

IMPORTANCE/UNASSIGNED:Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer for which current guidelines recommend adjuvant chemotherapy. Data about the benefit of adjuvant chemotherapy in older women with TNBC are scarce. OBJECTIVE/UNASSIGNED:To assess the survival benefit of adjuvant chemotherapy in older women with nonmetastatic TNBC. DESIGN, SETTING, AND PARTICIPANTS/UNASSIGNED:This retrospective population-based cohort study used the Surveillance, Epidemiology, and End Results database from January 1, 2010, to December 31, 2021. Participants included women 70 years or older with nonmetastatic TNBC who underwent surgical removal of breast tumor and were candidates for adjuvant chemotherapy. The median follow-up was 46 (IQR, 21-83) months. Statistical analysis was conducted on August 4, 2025. EXPOSURE/UNASSIGNED:Receipt or nonreceipt of adjuvant chemotherapy. MAIN OUTCOMES AND MEASURES/UNASSIGNED:The primary outcome was breast cancer-specific survival between patients who received chemotherapy and those who did not. Logistic regression models assessed variables associated with chemotherapy use. Machine learning with a generalized boosted model was used to estimate propensity scores. Inverse probability of treatment weighting and Cox proportional hazards regression methods were used to compare breast cancer-specific and overall survival. RESULTS/UNASSIGNED:A total of 5730 women (median age, 76 [IQR, 73-81] years) were included in the analysis; 2509 received chemotherapy and 3221 did not. Patients who received chemotherapy were younger (median age, 74 [IQR, 71-77] vs 79 [IQR, 74-84] years) and had more advanced disease (stage II-III, 1388 [54%.5] vs 1664 [51.7%]) than those who did not. Adjuvant chemotherapy was associated with improved breast cancer-specific survival (hazard ratio [HR], 0.69; 95% CI, 0.58-0.82) and overall survival (HR, 0.55; 95% CI, 0.49-0.62). Similar results were observed across subgroups. Increasing age (odds ratio [OR] for 80-89 years, 0.15 [95% CI, 0.13-0.17]; OR for ≥90 years, 0.02 [95% CI, 0.01-0.04]) was associated with lower odds of receiving adjuvant chemotherapy. CONCLUSIONS AND RELEVANCE/UNASSIGNED:In this cohort study of older women with TNBC, adjuvant chemotherapy was associated with improved survival outcomes. Underutilization of adjuvant chemotherapy in older women may contribute to worse outcomes. Geriatric assessment tools may help guide individualized treatment decisions and promote equitable care.