Faculty Bibliography

The rapid evolution of generative artificial intelligence (AI) is poised to transform medicine and medical education. Large language models (LLMs) have begun to demonstrate capabilities in reasoning, diagnosis, documentation, and patient communication that can rival or exceed those of clinicians. In medical education, AI is reshaping how students learn and how faculty teach-offering individualized, context-sensitive guidance at scale. This article outlines the current state of AI integration in health care, examines how systems can responsibly implement it to enhance patient care and education, and raises critical questions about ethics and safety as we harness its transformative potential.

Electronic health records (EHRs) present opportunities to study uterine fibroids uterine fibroids and endometriosis within diverse populations. When using EHR data, it is important to validate outcome classification via diagnosis codes. We performed a validation study of three approaches (1: ICD-10 code alone, 2: ICD-10 code + diagnostic procedure, and 3: ICD-10 code + all diagnostic information) to identify incident uterine fibroids and endometriosis patients among n=750 NYU Langone Health 2016-2023. Chart review was used to determine the true diagnosis status. When using a binary classification system (incident vs. non-incident patient), Approaches 2 and 3 had higher positive predictive values (PPVs) for uterine fibroids (0.86 and 0.87 vs. 0.78) and for endometriosis (0.70 and 0.73 vs. 0.66), but Approach 1 outperformed the other two in negative predictive values (NPVs) for both outcomes. When using a three-level classification system (incident vs. prevalent vs. disease free patients), PPV for prevalent patients was low for all approaches, while PPV/NPV of disease-free patients was generally above 0.8. Using ICD-10 codes alone yielded higher NPVs but resulted in lower PPVs compared with the other approaches. Continued validation of uterine fibroids/endometriosis EHR studies is warranted to increase research into these understudied gynecologic conditions.

Endometrial cancer is the most common gynecologic malignancy in the United States, with rising incidence and high recurrence rates. Immune checkpoint inhibitors (ICIs) benefit patients with mismatch repair-deficient (dMMR) tumors, but options remain limited for those with mismatch repair-proficient (pMMR) disease. Homologous recombination deficiency (HRD), a genomic instability phenotype, has emerged as a therapeutic target. Poly(adenosine diphosphate-ribose) polymerase inhibitors (PARPis) are being investigated in endometrial cancer, with studies exploring whether HRD predicts response, particularly in combination with ICIs or chemotherapy. This review examines HRD in endometrial cancer, focusing on its molecular basis, clinical implications, and emerging therapeutic strategies. HRD occurs in a sub-set of endometrial cancers, particularly non-endometrioid sub-types, and is linked to genomic instability and platinum sensitivity. The Cancer Genome Atlas (TCGA) molecular classification has improved understanding of HRD prevalence across sub-types. HRD testing remains challenging due to a lack of standardization, with current methods including genomic-scar assays, next-generation sequencing, and functional assays. Clinical trials, such as DUO-E and RUBY-2, suggest that PARPi combined with ICIs or chemotherapy may improve outcomes in pMMR tumors, whereas PARPi monotherapy offers limited benefits. Resistance to PARPi is common, driven by the restoration of homologous recombination repair, replication fork stabilization, and drug efflux. HRD is a promising biomarker and therapeutic target in endometrial cancer. Evidence supports the integration of PARPi for select populations, although further research is needed to refine testing, optimize patient selection, and overcome resistance. Future trials should prioritize predictive biomarkers and novel combinations to maximize the benefits of PARPi in HRD endometrial cancer.

OBJECTIVE:To propose a model of international meetings of minimally invasive gynecologic surgery to decrease the carbon footprint while preserving personal interactions and the financial stability of meetings and of medical societies. WHAT WE KNOW/UNASSIGNED:International medical society meetings create a substantial carbon footprint, with 95% generated by air travel. Meetings may be organized virtually or in-person with distinct benefits and drawbacks of each format. In-person meetings encourage personal interactions, sensitive discussions, and social exchanges which are important for learning and mental well-being. WHAT WE PROPOSE/UNASSIGNED:A collaborative effort of international societies to organize annual scientific meetings at one main venue per continent and regional hubs where participants, can come together in person. Presentations and session moderations will be possible from main venues and distant hubs. Carbon footprint from air travel would decrease, while the scientific contents would be improved by the collaboration between the societies. We theorize that local hubs, easier and less expensive to reach, will increase the number of participants who face economic, geopolitical, ecological and familial barriers to travel. Regional and time differences would allow each society to preserve the specific characteristics and sessions of its conference. The preservation of one main venue on each continent, will enable a gradual transition, allowing medical societies and corporate sponsors to take advantage of the enlarged audience, while measuring the desired outcomes and being able to adjust their management. Hubs participants will be actively involved reducing the burden of travel, transitioning to a preference of joining the main venue only every second or third year. CONCLUSION/CONCLUSIONS:An economically sustainable approach towards low carbon footprint, scientifically improved and more accessible meetings needs to be considered.

OBJECTIVE:The aim of this study was to evaluate the incidence of congenital anomalies in dichorionic-diamniotic twins conceived with in-vitro fertilization (IVF) versus unassisted conception pregnancies in a large geographically diverse population. DESIGN/METHODS:This is a secondary analysis of data from a retrospective cohort study of twin pregnancies seen at 17 centers between 12/2011-2/2020. SUBJECTS/METHODS:This study included dichorionic-diamniotic twins conceived unassisted, or by in-vitro fertilization. EXPOSURE/METHODS:The exposure group is dichorionic-diamniotic twins conceived with IVF. MAIN OUTCOME MEASURE/METHODS:The primary outcome was presence of a congenital anomaly. Neonates with an abnormal newborn exam were evaluated for having a major or minor congenital anomaly and the major anomalies were further classified by organ system (cardiac, renal/genitourinary, gastrointestinal, and musculoskeletal). RESULTS:Of the 968 dichorionic-diamniotic twin pregnancies included, 521 (53.8%) were conceived with IVF and 447 (46.2%) were conceived unassisted. Congenital anomalies were found in 70 pregnancies (7.23%). Of those, 37 were found in pregnancies conceived by IVF (52.9%) versus 33 unassisted conception pregnancies (47.1) (p=0.87). There were no significant differences between IVF and unassisted conception pregnancies for major anomalies (p=0.65) or minor anomalies (p=0.94). CONCLUSION/CONCLUSIONS:In this large cohort of twin pregnancies, there is no significant difference in the incidence of anomalies for dichorionic-diamniotic twin pregnancies conceived by IVF versus unassisted conception pregnancies.

IMPORTANCE/OBJECTIVE:Advanced airway management is a critical component of cardiopulmonary resuscitation. The use of video laryngoscopy has become increasingly common, but their effect on intubation success and patient outcomes during cardiac arrest remains uncertain. METHODS:We conducted a systematic review commissioned by the International Liaison Committee on Resuscitation (ILCOR) Advanced Life Support Task Force. Following PRISMA and ILCOR methodology, we searched PubMed, Embase, and Web of Science through October 2025 for randomized controlled trials (RCTs) and non-randomized studies comparing tracheal intubation with video laryngoscopy versus direct laryngoscopy during cardiac arrest. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 and Risk Of Bias In Non-randomized Studies of Interventions tools, and certainty of evidence was rated using Grading of Recommendations Assessment, Development and Evaluation methodology. Critical outcomes included first pass tracheal intubation success, overall tracheal intubation success, return of spontaneous circulation, survival, and survival with good neurologic outcome. RESULTS:From 13,031 screened records, 16 studies (3 RCTs, 13 observational) were included. Across three RCTs enrolling 331 patients, very low-certainty evidence showed no difference between video and direct laryngoscopy for first-pass tracheal intubation success (RR 0.88, 95% CI 0.63-1.22) or overall intubation success (RR 1.00, 95% CI 0.90-1.12). Observational studies (n = 29,595) generally favored video laryngoscopy for both outcomes. Very low-certainty data from observational studies showed no consistent difference in return of spontaneous circulation (ROSC) or survival. Rates of esophageal intubation were lower with video laryngoscopy in all studies reporting this outcome (RCT: 4.3% vs 0%; observational data: 5.6% vs 1.4%). CONCLUSIONS:Among adults undergoing tracheal intubation during cardiac arrest, use of video laryngoscopes may improve process outcomes such as first-pass success and reduced esophageal intubation, but there is no evidence of improved ROSC or patient survival. The overall certainty of evidence is very low.

IMPORTANCE/OBJECTIVE:A cost analysis model of supracervical (SCH) versus total hysterectomy (TH) at the time of minimally invasive sacrocolpopexy (SCP) has not been established. OBJECTIVES/OBJECTIVE:Minimally invasive sacrocolpopexy (SCP), a mesh-augmented pelvic organ prolapse (POP) repair, is frequently performed with concomitant hysterectomy, either a supracervical hysterectomy (SCH) or total hysterectomy (TH), with comparable POP outcomes with either approach. However, for SCH versus TH, there are important implications on cervical cancer screening and reported complication rates. Clinical outcomes data have not identified a clear preferred hysterectomy type at the time of SCP. This study aimed to perform a cost analysis to compare SCH versus TH at the time of SCP for POP. STUDY DESIGN/METHODS:A health care sector-perspective analysis was performed using a 10-year time horizon. Our model assumes that there is similar efficacy and patient satisfaction for SCH and TH, and that the age of patients undergoing SCP is 55 years (median age in the literature). The average cost of procedures and complications were estimated from publicly available data sources. Base-case probabilities for various complications were estimated through a PubMed literature search. RESULTS:TH-SCP is $654 less costly per treatment case compared with SCH-SCP ($26,101 vs. $26,754). Three model variables have the potential to reverse this cost advantage when varied across their ranges: SCH-SCP surgery, TH-SCP surgery, and the cost of cervical screening. Based on our model assumptions, SCH-SCP was 2.5% more costly than TH-SCP in relative terms. CONCLUSION/CONCLUSIONS:SCH-SCP was found to be more costly over a 10-year time horizon than TH-SCP in our study population.

The objective of this systematic review was to identify the evidence of testicular cancer risk for people with intersex conditions. This assessment is hoped to help refine risk stratification tools for assessing gonadal malignancy risk and guide the development of more robust evidence-based management strategies. The literature was searched in Ovid MEDLINE, Embase, and Cumulative Index of Nursing and Allied Health using a search string developed by a multidisciplinary team. The protocol was registered at Prospective Register of Systematic Reviews as CRD42021231313. A total of 3608 articles were found. After selection, 301 publications were included (1215 individuals). The results identified significant evidence that pre-pubertal gonadectomy may be linked to lower rates of malignant gonadal changes for patients with partial gonadal dysgenesis, Turner's syndrome with Y-chromosome material, complete androgen insensitivity, partial androgen insensitivity, and patients with ovotestis/es. The evidence was not significant for patients with complete gonadal dysgenesis, Klinefelter syndrome, nor WT1-related syndromes. Specific cancer outcomes were unable to be assessed due to small sample sizes and thus it is unknown if clinically significant cancer outcomes are meaningfully altered by pre-pubertal gonadectomy. Importantly, the quality of data on the topic of gonadal malignancy in intersex patients with testicular tissue was determined to be poor overall. The quality was relatively more robust regarding the conditions of Complete Androgen Insensitivity, Klinefelter syndrome, and patients with ovotestis/es. More high-quality research is needed to draw specific conclusions on the risks and benefits of performing pre-pubertal gonadectomy for intersex patients. When counseling these patients, clinicians should be transparent regarding the paucity of data supporting pre-pubertal gonadectomy.

BACKGROUND:Midkine is a heparin-binding growth factor that is overexpressed in most human malignancies, including breast cancer. While elevated midkine levels have been associated with tumor progression and aging, its role as a predictive biomarker for breast cancer risk in healthy individuals remains unclear. We previously showed that higher midkine expression in estrogen receptor-positive (ER +) breast cancer in younger (< 55) women is associated with shorter disease-free survival. We investigated whether serum midkine levels in premenopausal women are associated with subsequent risk of ER + breast cancer. METHODS:We conducted a prospective, nested case-control study within the New York University Women's Health Study (NYUWHS). Serum midkine levels were measured in baseline blood samples from 249 premenopausal women who developed ER + breast cancer more than 10 years after blood collection and 249 matched controls. Conditional logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) across quartiles and continuous midkine levels, adjusting for key breast cancer risk factors. RESULTS:Higher circulating midkine levels were associated with a marginally statistically significant lower risk of ER + breast cancer. Compared to the lowest quartile, women in the highest quartile had an OR of 0.55 (95% CI: 0.30-0.99; P for trend = 0.10). A doubling in midkine was associated with a 34% reduction in risk (OR = 0.66; 95% CI: 0.42-1.02). The inverse association was generally consistent across subgroups. CONCLUSION/CONCLUSIONS:These findings suggest that higher baseline serum midkine levels in premenopausal women are associated with a reduced long-term risk of ER + breast cancer. This challenges prior assumptions about midkine's uniformly pro-tumorigenic role and suggests it may be a context-dependent biomarker in breast cancer development.