Faculty Bibliography

BACKGROUND:Pregnancy is a critical window for tobacco cessation; socio-demographic correlates and prenatal care (PNC) utilization behaviors associated with quitting e-cigarette and dual use with conventional cigarettes remain understudied. OBJECTIVE:To examine the influence of socio-demographic characteristics and PNC utilization in the cessation of cigarette, e-cigarette, and dual-use during pregnancy, using Pregnancy Risk Assessment Monitoring System (2016-2022) data. METHODS:We analyzed data from 223,793 respondents (weighted count = 11,475,844) with singleton births who reported cigarette and/or e-cigarette use during the three months before and the last three months of pregnancy. Socio-demographic and PNC cessation correlates for cigarette, e-cigarette, and dual-use were examined versus continuation using logistic regression analysis. The Adequacy of Prenatal Care Utilization (APNCU) Index assessed PNC. Associations were expressed as adjusted odds ratios with 95% confidence intervals [AOR (95%CIs)]. RESULTS:Tobacco product use declined from 16.9% pre-pregnancy to 7.5% by late pregnancy. Pregnancy-associated cessation rates were 53.7% for cigarettes, 81.0% for e-cigarettes, and 48.1% for dual-use. Primiparity was associated with higher odds of quitting across all groups: cigarettes [1.8 (1.6‒2.0)], e-cigarettes [1.6 (1.2‒2.1)], and dual-use [2.3 (95% CI: 1.7‒3.1)]. Black race and Hispanic ethnicity were positively associated with cessation of cigarettes and dual-use, while Black race was also associated with higher odds of EC cessation. A higher smoking frequency was associated with reduced cessation odds of cigarette [0.2 (0.2‒0.3)] and dual-use [0.3 (0.2‒0.4)], while a higher vaping frequency was associated with reduced e-cigarette cessation [0.3 (0.2‒0.5)]. Inadequate APNCU Index was associated with lower odds of quitting cigarettes [0.6 (0.5‒0.7)] and dual-use [0.6 (0.4‒0.9)], but showed no significant association with e-cigarette cessation [0.9 (0.6‒1.5)]. CONCLUSIONS:Distinct socio-demographic and PNC factors influence cessation patterns by product type. Findings underscore potential opportunities to integrate PNC with targeted cessation support, particularly for high-risk groups amid rising e-cigarette and dual use during pregnancy.

BACKGROUND/UNASSIGNED:Pituitary hyperemia and gland enlargement can be cardinal features of intracranial hypotension secondary to cavernous sinus and epidural venous plexus distention. This phenomenon can therefore complicate radiographic interpretation of sellar lesions when both diagnoses co-exist. We report a unique case of a rapidly enlarging pituitary macroadenoma in the setting of a thoracic cerebrospinal fluid (CSF)-venous fistula causing symptomatic intracranial hypotension. CASE DESCRIPTION/UNASSIGNED:A 53-year-old female with no prior neurosurgical history presented with recurrent orthostatic headache. Magnetic resolution imaging revealed a pituitary lesion along with pathopneumonic signs of intracranial hypotension. The tumor grew rapidly on surveillance imaging, prompting consideration of surgery. Further work-up, however, revealed a thoracic CSF-venous fistula. Endovascular embolization of the fistula led to near-complete resolution of her symptoms and durable radiographic tumor regression. CONCLUSION/UNASSIGNED:Pituitary macroadenomas are susceptible to local hemodynamic changes occurring as a sequelae of occult CSF leak. Identification and treatment of the underlying etiology were sufficient to induce tumor regression.

VEXAS syndrome is a severe adult-onset autoinflammatory disease caused by somatic mutations in the UBA1 gene, disrupting cytoplasmic ubiquitin-activating enzyme E1 function in hematopoietic progenitors. Its pathogenesis remains poorly understood, particularly the mechanisms by which UBA1 mutations disrupt myeloid cell function in the context of inflammatory stimuli. Here, we combine a genetically engineered THP-1 monocytic model with ex vivo analyses of blood and tissue samples from VEXAS patients to investigate the consequences of the canonical UBA1M41V mutation. We show that UBA1-mutated monocytes exhibit TNF-α-induced cell death, characterized by RIPK1 phosphorylation, and MLKL- and caspase-8-mediated cell death. Importantly, we extend these findings to patient-derived CD14⁺ sorted cells, confirming that these cells undergo aberrant apoptotic and necroptotic cell death. Mechanistically, activation of these cell death pathways appears to be promoted by defective NF-κB-dependent transcriptional responses and reduced cFLIP(L) expression following TNF-α stimulation. UBA1-mutated monocytes also display blunted cytokine responses to Toll-like receptor (TLR) agonists despite preserved TLR expression, linked to an impaired NF-κB response. UBA1M41V-derived macrophages exhibit a pro-inflammatory transcriptional profile with increased chemokine secretion that promotes monocyte recruitment. In addition, these UBA1-mutated macrophages display impaired efferocytosis due to lysosomal dysfunction. Together, these findings reveal a pathogenic axis in VEXAS syndrome linking UBA1 loss of function and defective ubiquitination to RIPK1-mediated inflammatory cell death, impaired antimicrobial signaling, and defective resolution mechanisms. Our study provides novel mechanistic insights into the myeloid dysfunction underlying inflammation and cytopenia in VEXAS and supports the therapeutic targeting of inflammatory cell death pathways.

PURPOSE OF REVIEW/OBJECTIVE:This review discusses the current state of the evidence related to the relationship between the cerebellum and epilepsy, highlighting evidence on neurostimulation of the cerebellum for treatment of epilepsy, and placing current knowledge into historical context. RECENT FINDINGS/RESULTS:The cerebellum plays an important role in certain epilepsy types, both as a key part of epileptic networks and an area that can give rise to seizures. Cerebellar stimulation as a potential treatment for drug-resistant epilepsy is a recurring, albeit niche, topic of interest. Over decades of intermittent, often highly limited investigations into this area of research, there are still more questions than answers. However, more recent preclinical insights point the way towards leveraging modern surgical techniques and technology in investigating cerebellar stimulation as a potential viable treatment approach to select types of epilepsy. SUMMARY/CONCLUSIONS:Cerebellar stimulation holds promise for improving seizure control in people with specific types of drug-resistant epilepsy. Future studies should leverage new preclinical data, along with modern technology, neurosurgical techniques, and clinical trial design, to help determine the optimal stimulation parameters, optimal stimulation targets, and optimal patient-selection for this promising area of investigation.

The convergence of artificial intelligence (AI) and neuroscience represents one of medicine's most profound intellectual partnerships. Neuronal architecture has inspired computational methods, while computational models, evolving from theoretical constructs to transformative clinical tools, are reshaping neurological practice. As AI systems attempt to augment diagnostic accuracy, treatment planning, and patient care, neurologists must develop fluency in these technologies to harness their potential while navigating their limitations and dangers. AI-related publications have exponentially increased in recent years, yet many neurologists lack the foundational computer science background needed to critically evaluate and most safely and effectively implement these tools in clinical practice. This article serves to outline the historical foundations linking neuroscience to computing, examine core concepts of the past and current AI landscape in neurology, and describe methodologies that aim to revolutionize neurological care.

Respiratory viruses-including SARS-CoV-2 (COVID-19), Respiratory Syncytial Virus (RSV), and Influenza-pose significant risks to immunocompromised patients, who experience attenuated vaccine responses and higher morbidity. To address evolving vaccine recommendations for the 2025-2026 season, the Infectious Diseases Society of America (IDSA), in collaboration with the Vaccine Integrity Project (VIP) and partner organizations, developed rapid guidelines for U.S.-licensed vaccines targeting these viruses. The guideline applies to adults and children with compromised immunity due to hematologic malignancy, solid organ or hematopoietic cell transplantation, autoimmune disease on immunosuppressants, HIV with severe immunosuppression, and similar conditions. Strong recommendations, supported by moderate-certainty evidence, endorse timely administration of age-appropriate COVID-19, RSV, and Influenza vaccines, with guidance on optimal timing relative to immunosuppressive therapy and transplantation. Co-administration of these vaccines is considered appropriate. Research gaps remain in immunogenicity, durability, and clinical effectiveness, particularly for patients receiving B-cell-depleting therapies or early post-transplant. Priority areas include defining correlates of protection, optimizing vaccine schedules, evaluating high-dose or adjuvanted formulations, and improving real-world effectiveness and safety data. Equity and access strategies are essential to ensure uptake among vulnerable populations. These guidelines aim to support evidence-based decision-making and highlight the need for harmonized, multi-virus research to inform tailored vaccination strategies for immunocompromised individuals.

Exosomes, nanoscale extracellular vesicles released by nearly all cell types, have attracted substantial interest as potential diagnostic and therapeutic tools in dermatology due to their ability to selectively transport proteins, nucleic acids and lipids between cells. Experimental studies have demonstrated exosome involvement in immune signalling, inflammation, pigmentation, wound repair, hair biology and tumour behaviour, supporting their broad but still largely experimental relevance across dermatologic disease processes. However, despite rapid scientific progress, clinical translation remains at an early stage. Most evidence supporting dermatologic applications is derived from in vitro or animal studies, and few well-designed, adequately powered human trials exist. As of September 2025, only a small number of exosome-based clinical studies in dermatology have been completed, and no exosome therapeutic has received FDA approval. Major challenges-including the lack of standardized isolation and manufacturing methods, batch-to-batch variability, limited mechanistic understanding, inconsistent regulatory frameworks and unresolved safety considerations-continue to impede clinical adoption. Current clinical trials, although promising, are heterogeneous and often underpowered, with insufficient long-term safety and efficacy data to support routine use. Collectively, exosomes represent a compelling but still developmental platform for precision dermatology. Their successful integration into clinical practice will require rigorous mechanistic studies, harmonized quality control standards and large, high-quality randomized controlled trials to confirm therapeutic benefit, ensure safety and enable regulatory approval.

Follicular lymphoma (FL) is the most common indolent non-Hodgkin lymphoma. Although patients with FL have high response rates to therapy, most develop increasingly resistant disease. In addition, transformation into an aggressive lymphoma is associated with unfavorable outcomes. Many novel agents are under investigation, and early clinical data are encouraging. Aligning treatment with the underlying tumor biology and sequencing of therapies remain key clinical challenges. At the Lymphoma Research Foundation's biannual 2024 Follicular Lymphoma Scientific Workshop, experts convened to discuss the role of chemotherapy in the context of new therapies, the impact of early progression on treatment sequencing, novel end points in clinical trials, disease biology and the tumor microenvironment, and new treatments on the horizon. This report focuses on updates in FL biology, first-line treatment, the role of progression of disease in 24 months, clinical trial design, and redefining cure in FL.

This study draws on repeated-measures data on a diverse (51% female; 54% Latine, 20% Black, and 11% White), low--income cohort of children (N = 618) whose academic skills were assessed before and after COVID-19-induced school closures. Longitudinal models predicted changes in children's literacy and math trajectories from before school closures (ages 4-6; 2017-2019) to after school reopening (ages 8-11; 2021-2023) and tested whether remote learning participation moderated these changes. Results suggest that academic growth stagnated during school closures, with "losses" ranging from 3 months of literacy growth to 14 months of math growth. Sufficient participation in remote learning was only slightly protective. After schools reopened, children's growth rates were slower than before school closures, but this may reflect normal developmental deceleration.