Faculty Bibliography

High-riding vertebral artery (HRVA) is an important anatomical variant of the vertebral artery that poses significant challenges during cervical spine surgery, particularly at the C1-C2 level, where it reduces the safe corridor for pedicle screw placement and increases the risk of arterial injury. This narrative review summarizes current evidence regarding the definition, prevalence, imaging identification, and surgical implications of HRVA, along with risk mitigation strategies. Radiographically, HRVA is most commonly defined by reduced C2 isthmus height (C2IsH) (≤5 mm) and/or internal height (C2InH) (≤2 mm) on computed tomography (CT) scans. Reported prevalence varies widely across populations, typically ranging from 10% to 25%, with higher rates observed in selected patient cohorts. The presence of HRVA necessitates careful perioperative planning, including comprehensive imaging and modification of surgical techniques, such as the use of alternative fixation strategies, including pars screws, laminar screws, navigation-assisted instrumentation, and artery mobilization. Advances in CT angiography (CTA), alternative fixation strategies, surgical navigation, and emerging predictive models may further improve risk stratification and operative safety. Recognition of HRVA and tailored surgical planning are essential to minimize the risk of vertebral artery injury (VAI) and to optimize patient outcomes in cervical spine surgery and instrumentation.

Onychopapilloma (OP) is a benign nail unit tumor of the distal nail matrix and nail bed that typically presents as solitary longitudinal erythronychia with distal subungual hyperkeratosis and focal onycholysis. Atypical OP is a newly recognized and evolving concept in dermatopathology. Herein, we present a histopathologically-proven atypical OP with a classic clinical appearance that developed during pregnancy. A 37-year-old Gravida two Para one woman presented with a red longitudinal band on the left thumbnail that appeared during the first trimester of an uncomplicated pregnancy. The lesion was asymptomatic; however, it was gradually increasing in size, prompting a longitudinal excisional biopsy of the lesion post-partum. Histopathologic evaluation of the nail unit revealed common features of an OP, including acanthosis and papillomatosis of the nail bed with focal matrix metaplasia. There were focal areas of cytologic atypia and mitotic figures with corresponding increased suprabasilar Ki-67 expression. The tumor was excised with Mohs micrographic surgery in one stage, and the resulting defect healed with secondary intention. No recurrence was observed at 6-month follow-up. This case expands the current literature on histopathologically-proven atypical OP and describes the novel occurrence during pregnancy.

Articular cartilage lesions of the knee pose a significant clinical challenge due to the limited regenerative capacity of hyaline cartilage and the wide variability in patient presentation and lesion characteristics. Surface-based cartilage restoration techniques have evolved substantially, shifting from isolated marrow stimulation toward biologically enhanced strategies designed to improve repair tissue quality, durability, and clinical outcomes while preserving native joint anatomy. These techniques are primarily indicated for contained chondral defects without substantial subchondral bone compromise and include scaffold-augmented microfracture, particulated cartilage techniques using juvenile or adult allograft tissue, and matrix-associated autologous chondrocyte implantation (ACI). Selection among these options is driven by patient age, activity level, and expectations, as well as lesion-specific factors such as size, anatomic location, containment, and subchondral bone integrity. Single-stage approaches, including micronized cartilage extracellular matrix augmentation and particulated cartilage allografts, offer reduced procedural burden and avoidance of cell expansion, with favorable short- to mid-term outcomes for small to moderate lesions. In contrast, matrix-induced autologous chondrocyte implantation (MACI) is supported by randomized controlled trials and long-term cohort studies demonstrating sustained improvements in patient-reported outcomes (PROs) beyond 10 years, particularly in younger, active patients with larger isolated defects. Despite these advances, variability in imaging findings, complication profiles, and performance in the patellofemoral joint underscores the importance of appropriate patient selection, meticulous surgical technique, and structured postoperative rehabilitation. This review synthesizes current evidence regarding indications, surgical techniques, outcomes, and limitations of contemporary surface-based cartilage restoration options for the knee, providing a practical framework to guide clinical decision-making in joint preservation surgery.

Asian American populations are underrepresented within dietary programs and nutrition-specific funding. Existing understanding amongst Asian American communities focuses on those with pre-existing health conditions. There is a gap in published literature providing an overview of the food groups Asian American populations without noncommunicable diseases consume. This scoping review aims to provide a comprehensive mapping of the Asian American diet with a focus on food groups in the United States within existing literature. A scoping review was conducted from December 2023 to December 2024. Research databases (PubMed/Medline, CABI Digital Library, CINAHL, Scopus, Web of Science, EBSCO, and ProQuest Dissertations) were searched to identify articles published since 2000 that described food group consumption of Asian American populations. A total of 1486 articles were independently screened by 3 reviewers, leaving 165 articles for inclusion in this review. An additional 15 gray literature sources were separately reviewed for complementary information. Key findings (population and geographical focus, dataset, food group outcome, study limitations, and recommendations) were extracted and summarized in narrative form. Within the literature, Asian American adults and children generally consume more refined grains and less dairy than the standard United States population, though specific patterns vary: South Asians report higher saturated fat and dairy intake, while Chinese, Filipino, and Southeast Asian groups often fall short of recommended fruit and vegetable consumption. Dietary staples also differ by ethnicity, ranging from white rice and noodles in East/Southeast Asian diets to breads and buns among South Asian and Filipino communities. Recommendations for improving diets in Asian American communities emphasize culturally tailored nutrition education that incorporates traditional diets, promotes whole-grain substitutions, and adopts family-focused approaches. Future research efforts in Asian American diet and nutrition should better understand meal-sharing practices and cooking methods. Identifying broad insights in Asian American dietary consumption lays an essential framework for developing recommendations and interventions to address dietary behaviors contributing to diet-related disease burden among the Asian American population. This scoping review is registered on Open Science Framework (https://doi.org/10.17605/OSF.IO/K3X8S).

BACKGROUND/UNASSIGNED:Social determinants of health disparities (SDHD), encompassing environmental, health care, social, educational, and economic factors, are known to increase the risk of complications after various orthopaedic procedures. However, their impact on tibial tubercle osteotomy (TTO) outcomes remains undefined. HYPOTHESIS/PURPOSE/UNASSIGNED:This study aimed to compare complication risks and health care utilization within 90 days and 1 year of primary TTO in patients with versus without SDHD. It was hypothesized that SDHD patients would show higher odds of health care utilization and complications. STUDY DESIGN/UNASSIGNED:Cohort study; Level of evidence, 3. METHODS/UNASSIGNED:Adult (>17 years) patients who underwent primary TTO from January 2010 to April 2023 were identified using the PearlDiver M170 database. The exclusion criteria included inactivity within 90 days after TTO or a history of neoplasm or infection within 90 days before the procedure. The overall cohort was divided into SDHD and non-SDHD groups. Patient characteristics-including age, sex, Elixhauser Comorbidity Index, obesity, type 2 diabetes mellitus, tobacco or nicotine use, and substance use disorder-were abstracted. Patients without versus with SDHD were matched (2:1) based on all demographic variables. Moreover, 90-day and 1-year complications were identified and compared using the Pearson chi-square test and multivariable logistic regression, adjusted for demographic variables. RESULTS/UNASSIGNED:< 0.05). CONCLUSION/UNASSIGNED:The present study found that SDHD patients were associated with increased odds of ED visits, readmissions, VTE, and UTI after primary TTO. Additionally, SDHD patients demonstrated higher odds of revision TTO and nonunion. Further research is needed to identify the root causes of these differences, enabling targeted strategies to reduce future outcome inequities associated with SDHD.

BACKGROUND AND OBJECTIVE/UNASSIGNED:Non-small cell lung cancer (NSCLC) accounts for approximately 85% of lung carcinoma cases and is often diagnosed at an advanced stage, leading to poor prognosis. Local tumor ablation is an emerging treatment option; however, thermal ablation techniques, such as radiofrequency ablation (RFA) or microwave ablation (MWA), can have many adverse events, such as a negative impact on the extracellular matrix (ECM) architecture, promoting tumor progression. Pulsed electric field (PEF) therapy is a non-thermal modality that induces electrostimulatory pulses, which can preserve the ECM architecture while stimulating anti-tumor immune responses. This narrative review evaluates the safety, efficacy, and immunomodulatory potential of PEF therapy in NSCLC. METHODS/UNASSIGNED:A comprehensive literature search was conducted in Google Scholar, MEDLINE, Embase, Scopus, PubMed, Web of Science, UpToDate, and the Cochrane Library through October 1, 2025. Eligible studies included adult patients (≥18 years) with histologically confirmed NSCLC treated with PEF. Two independent reviewers screened studies and extracted data on patient demographics, tumor characteristics, treatment modalities, adverse events, and outcomes. KEY CONTENT AND FINDINGS/UNASSIGNED:33%) compared with standard systemic therapy. CONCLUSIONS/UNASSIGNED:PEF may play a role in stimulating an anti-tumor response and represents a promising, safe, non-thermal ablation modality for NSCLC treatment. It preserves ECM integrity while inducing local and systemic immunomodulatory effects. Early clinical evidence suggests potential efficacy. Nevertheless, randomized controlled trials are required to confirm clinical benefit and identify the patient populations most likely to benefit from PEF therapy.

Display technologies are a class of experimental methods that enable a direct association between protein function and nucleic acid sequence. Since the introduction of phage display in 1985, antibody display technologies have evolved along multiple branches and enabled new capabilities for drug discovery. Recent advances build on these foundations to accommodate new antibody modalities, improve library size, accelerate functional discovery, and leverage experimental data through computational analysis and structural predictions. Here, we discuss how recent advances in protein display are being applied to solve a broad range of problems in antibody drug discovery, immunology, and biotechnology.

Leucine-rich repeat kinase 2 (LRRK2) plays a central role in the pathogenesis of Parkinson's disease (PD), with pathogenic mutations leading to increased kinase activity. Consequently, LRRK2 has become a key therapeutic target in PD research. Although several candidate PET radioligands have been investigated for imaging brain LRRK2, only a few have shown good brain permeability and even these have exhibited limited specific binding to the target. In our search for an improved radioligand candidate, we identified GNE-0877 (28) as a highly potent and selective inhibitor for LRRK2 (K _i = 0.7 nM) with physicochemical properties favorable for brain penetration. We, therefore, synthesized an N-Boc-protected precursor (22) for labeling 28 with carbon-11 (t _1/2 = 20.4 min) at the N-methyl position, which yielded [¹¹C]28 in a two-step radiosynthesis with high isolated yields (∼12-15%), excellent radiochemical purity (≥97%), and high molar activity (260-330 GBq/μmol). We evaluated [¹¹C]28 as a potential PET radioligand for imaging brain LRRK2 in rodent and monkey. The radioligand showed excellent stability in vitro and desirably moderate lipophilicity (measured logD _7.4, 2.92). Following intravenous administration in rodents or monkey, [¹¹C]28 entered the brain rapidly reaching high peak uptake (∼4.0 SUV). In monkey, however, [¹¹C]28 showed slightly higher brain uptake and higher total volume of distribution (V _T) under preblocking of LRRK2 with 28 than at baseline, indicating an absence of measurable specific binding to LRRK2, possibly due to low LRRK2 density in vivo or to insufficient radioligand affinity.