Faculty Bibliography

Female sex workers (FSWs) encounter increased risk of negative health consequences, including common mental health conditions (CMCs) in Tanzania. The prevalence and association of the CMCs with social, structural, and violence-related factors remains to be fully understood. We assessed the prevalence of CMCs and associations with socio-structural risk factors among FSW. We used Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Harvard Trauma Questionnaire-17 (HTQ-17), World Health Organization violence against women Instrument, Alcohol Use Disorder Identification Test (AUDIT), and a two-item questionnaire to measure depression, anxiety, post-traumatic stress disorder (PTSD), violence, alcohol use risks, and suicidal behavior, respectively. Descriptive statistics and logistic regression were used in data analyses, with a significance level set at 0.05. The prevalence of depression, anxiety, and PTSD was 49.2%, 40.4% and 20.2%, respectively. Thirty-five percent had ever had suicidal thoughts, and 7.7% had ever attempted suicide. Being raped by a gang of men was significantly associated with depression, anxiety, and PTSD. Non-intimate partner violence (non-IPV) was significantly associated with depression, anxiety, and suicidal behavior, while both non-consensual sex at sexual debut and duration since last vaginal sex were significantly associated with PTSD and suicidal behavior. Some factors were condition-specific: religion and client volume in the past seven days were associated with anxiety; living with three or more children and sex work mobility were associated with increased PTSD; while place of residence, extra source of income, and engagement in anal sex in the past six months were significantly associated with suicidal behaviors. Alcohol use partially and fully mediated the relationship between non-IPV and anxiety and PTSD, respectively, whereas sex work mobility showed no moderation effect on the relationship between non-IPV and any CMC. Innovative and integrative mental health care targeting critical risk factors among FSWs is essential to mitigate the increasing prevalence of CMCs.

The identification of molecular subgroups of pediatric B-cell acute lymphocytic leukemia (B-ALL) has proven to be a powerful tool in understanding disease pathogenesis and treatment stratification. Studies have suggested aberrant transcription factor function and epigenetic regulation can explain differences between B-ALL subtypes, however, the impact of 3D genome re-organization remains unclear. Here we used in situ Hi-C and RNA-seq to profile the chromatin architectural landscape in healthy B-cell progenitors and B-ALL patient samples harboring prognostically relevant structural variations, including ETV6::RUNX1, KMT2A::AFF1, and BCR::ABL. We showed that B-ALLs undergo subtype-specific changes that, in part, reflect the differentiation stage of the disease, and that they acquire aberrant chromatin configurations that allow expression of oncogenic drivers. One such driver, ERG, displayed increased interactivity and expression in ETV6::RUNX1 B-ALL, and evidence suggests it plays a role in regulating survival and differentiation. Overall, these results underscore the essential role of 3D nuclear organization in acute leukemia.

Bessel beams are commonly used in two-photon microscopy to extend the depth of field and thereby achieve functional volumetric imaging of the living brain. In practice, this approach suffers from background signals and limited lateral resolution due to the Bessel beam's strong side lobes. We introduce and demonstrate a new approach to side lobe suppression based on non-degenerate two-photon excitation, in which dual wavelength illumination produces an imaging point-spread function that is the product of the two coaxial Bessel beams. This technique can reduce the main side lobe intensity of a Bessel beam by 50% or more. We illustrate the approach conceptually with an analytical paraxial model and use detailed physical simulation to show that the approach is effective in the presence of the symmetry-breaking aberrations that amplify side lobes in high NA systems. We experimentally demonstrated the technique using a refractive axicon and the pump and tunable beams of a femtosecond laser. This work establishes non-degenerate two-photon excitation as a practical and broadly applicable strategy for improving point spread-function quality in high-resolution volumetric microscopy.

PURPOSE/OBJECTIVE:Secondary brain injury is a common cause of poor outcome after trauma, subarachnoid hemorrhage, and intracerebral hemorrhage, and optimizing treatment requires real-time insight into cerebral metabolism. Cerebral microdialysis (CMD) uniquely provides key related information, yet consensus on its use has not been updated since publication of the consensus statement from the 2014 International Microdialysis Forum. We aimed to assess expert consensus on the use of CMD in critical care and provide contemporary guidance to standardize practice and advance clinical implementation. METHODS:We conducted a 3-round modified Delphi study with international experts in CMD and neurocritical care. Consensus was defined as ≥ 75% agreement among non-abstaining respondents, with a minimum of 30 non-abstaining respondents required per statement. Statements not reaching consensus were iteratively revised based on panelist feedback. RESULTS:Forty of 67 invited experts (60%) from 9 countries participated. Sixty of 62 individual items achieved consensus (97%) across 9 domains: indications and patient selection, technical and procedural considerations, detecting deterioration and secondary injury, metabolic interpretation, treatment algorithms, glucose management, sampling frequency, core reporting items, and barriers to clinical implementation. CONCLUSION/CONCLUSIONS:This consensus statement provides updated, evidence-informed recommendations for the use of CMD in critical care. The panel reaffirmed many core recommendations from the 2014 consensus while making targeted advances: cautious extension of guidance to intracerebral hemorrhage, comprehensive reporting guidance addressing frequently omitted elements (19 items vs. 6 in 2014), and identification of 10 key barriers to routine clinical adoption.

IMPORTANCE/UNASSIGNED:Transcatheter tricuspid valve replacement (TTVR) demonstrated superior outcomes over medical therapy in patients with severe tricuspid regurgitation (TR) in the Edwards EVOQUE Transcatheter Tricuspid Valve Replacement: Pivotal Clinical Investigation of Safety and Clinical Efficacy Using a Novel Device II (TRISCEND II) randomized clinical trial, and received regulatory approval in the US in 2024. Contemporary real-world data on its effectiveness and safety remain limited. OBJECTIVE/UNASSIGNED:To evaluate 30-day clinical, echocardiographic, and health status outcomes of TTVR in real-world use. DESIGN, SETTING, AND POPULATION/UNASSIGNED:Retrospective cohort study of all consecutive patients who underwent TTVR in the US from February 2024 through March 2025 in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry. Patients had symptomatic, severe TR despite optimal medical therapy and TTVR was deemed appropriate by a heart team. Statistical analysis was conducted from September 2025 to February 2026. EXPOSURE/UNASSIGNED:Device-enabled TTVR. MAIN OUTCOMES AND MEASURES/UNASSIGNED:Thirty-day event rates (all-cause death, stroke, bleeding, new cardiac implantable electronic device [CIED] implantation, heart failure hospitalizations), TR reduction, and changes in health status (New York Heart Association [NYHA] functional class and Kansas City Cardiomyopathy Questionnaire Overall Summary [KCCQ-OS] score) are reported. Subgroup analyses examined the impact of baseline CIED status on outcomes. RESULTS/UNASSIGNED:Among 1034 attempted procedures at 82 centers (mean [SD] age, 77.1 [10.6] years; 69.1% female; 73.2% NYHA functional class III/IV), a valve was successfully implanted in 1017 patients (98.4%). Mild or less TR was achieved in 98.4% of patients post procedure and in 97.7% at 30 days. At 30 days, all-cause mortality was 3.1%; stroke, 0.2%; bleeding, 7.9%; new CIED, 15.9% in CIED-naive patients; and heart failure hospitalization, 3.1%. There were significant improvements in NYHA functional class (class I/II, 82.7%; P < .001) and mean KCCQ-OS score (22.4 points; P < .001) from baseline to 30 days. There were no significant differences in 30-day mortality (P = .47), heart failure hospitalization (P > .99), and functional outcomes (P = .55) when patients were stratified by baseline CIED status. CONCLUSIONS AND RELEVANCE/UNASSIGNED:Early US real-world experience with TTVR confirms safety and effectiveness in patients with severe TR. Thirty-day outcomes are consistent with the TRISCEND II pivotal trial, demonstrating acceptable safety, near-complete TR elimination, and significant health status improvements in an older, comorbid population. Rates of new CIED implantation and bleeding were lower than randomized clinical trial experience.

BACKGROUND:The role of maternal and fetal characteristics in determining kidney size in early childhood remains largely unexplored. This study aims to evaluate the association between birth weight and kidney size in children aged one to six years and explore other children and maternal determinants in a United States cohort. METHODS:We analyzed data from 892 mother-child pairs enrolled in the New York University Children's Health and Environment Study (CHES). Renal sonographic measurements were taken from one to six years of age. Kidney size outcomes included average kidney length, width, depth, total kidney volume (TKV), adjusted kidney length (kidney length/body length), and adjusted TKV (TKV/body surface area). Maternal determinants include age, demographic characteristics, pre-pregnancy BMI, lifestyle, pregnancy complications, and diet during pregnancy. Fetal determinants included sex, birth weight for gestational age z-score, and gestational age at delivery. Anthropometric z change and breastfeeding duration were also considered. Associations were examined using crude and covariate-adjusted linear mixed models. RESULTS:Birth weight z-score and anthropometric z change were observed positively associated with all measures except adjusted kidney length. Female children had smaller average kidney length and TKV, and breastfeeding duration was negatively associated with average kidney depth and TKV. Children of non-Hispanic Black mothers and parous mothers had smaller kidney measures. CONCLUSION/CONCLUSIONS:In NYU CHES, we found that early childhood kidney size measures were consistently influenced by birth weight z-scores and changes in postnatal weight gain z-scores. Additionally, we observed racial differences and the influence of breastfeeding duration on kidney size. TRIAL REGISTRATION/BACKGROUND:Not applicable.

OBJECTIVE:Famotidine is a commonly used agent in pediatric intensive care units. There is no data regarding the safety of undiluted intravenous push (IVP) administration in pediatrics; however, there are historical concerns for hemodynamic instability in the adult population. This study assesses the safety of famotidine administered undiluted IVP for doses ≥ 5 mg in pediatric patients. METHODS:We performed a retrospective, observational, medication use evaluation in pediatric patients (≤ 18 years) who received famotidine undiluted IVP from February to July 2022. Patients with arterial lines and continuous cardiac telemetry were included. Patients requiring extracorporeal membrane oxygenation, receiving famotidine doses < 5 mg, or who had a change in vasoactive medication doses within 1 hour prior to famotidine IVP administration were excluded. The primary outcome was the incidence of hypotension and bradycardia within 45 minutes of undiluted famotidine IVP administration. RESULTS:A total of 59 patients were included. There were 8 patients (13.6%) with hypotension and 1 patient (1.7%) with bradycardia after famotidine administration in the full cohort. Of these 9 patients, 7 had hypotension and bradycardia at baseline. Two patients (3.4%) required adjustment of their vasoactive medication within 45 minutes after receiving famotidine, although these patients were also postoperative day zero from cardiac surgery. None of the patients required a fluid bolus for hypotension following famotidine administration. The percent change in hemodynamics from baseline were minimal across the various time intervals. CONCLUSION/CONCLUSIONS:Famotidine administered undiluted IVP produced no clinically significant hemodynamic -adverse effects in critically ill pediatric patients.