Faculty Bibliography

PURPOSE/UNASSIGNED:The purpose was to identify the 100 most-cited scientific publications in ankle cartilage and provide an analysis of their main characteristics. METHODS/UNASSIGNED:The Web of Science (Clarivate) database was searched in April 2025 to obtain data and metrics on ankle cartilage research. The search list was sorted by the number of citations, and articles were included or excluded based on their relevance to ankle cartilage research. The information extracted for each article included the publication year, citation count, author's name, country of origin, journal name, article type, citation density and the level of evidence. RESULTS/UNASSIGNED:The 100 studies generated a total of 17,208 citations, with an average of 172 citations per article. The most-cited article was cited 489 times. The 100 studies included in this analysis were published between 1979 and 2018. In total, these articles represented 13 different countries of origin. The United States represented 38 of the 100 articles. The Netherlands, Italy and Germany followed with nine articles, and South Korea with seven articles. The most prevalent study designs were case series, and the most prevalent level of evidence was Level IV (69 studies). CONCLUSIONS/UNASSIGNED:The present research concludes that the 100 most-cited publications in cartilage lesions of the ankle research were cited a total of 17,208 times. Case series and cohort studies were among the most frequently used study designs with an overall relatively low-level of evidence. The present work may function as a reference standard to help direct orthopaedic providers to the 100 most-cited studies in cartilage lesions of the ankle. LEVEL OF EVIDENCE/UNASSIGNED:N/A.

OBJECTIVE:To evaluate the feasibility of same-day (postoperative day 0; POD0) physical therapy (PT) following lumbar fusion and to identify factors associated with failure to participate. METHODS:This retrospective study analyzed prospectively collected data from patients undergoing single-level posterior spinal fusion (PSF), with or without anterior (ALIF) or lateral (LLIF) interbody fusion, between January and December 2024 at a single institution. A standardized POD0 PT protocol was implemented for eligible patients. Patients were categorized into two groups: successful POD0 PT (ambulatory on POD0) and unable to participate. Demographic and surgical variables were compared between groups. Reasons for inability to participate were recorded and categorized. RESULTS:Among 129 patients in whom POD0 PT was attempted, 84 (65%) successfully participated, while 45 (35%) were unable. There were no significant differences in age, sex, BMI, ASA class, operative time, estimated blood loss, or surgical approach between groups. Patients who successfully completed POD0 PT had a significantly shorter hospital length of stay compared to those who did not (3.4 ± 1.6 vs 5.8 ± 2.9 days, P < 0.001), with no differences in complication rates, discharge disposition, emergency department visits, or reoperation rates. The most common barriers to POD0 PT were postoperative pain, medical issues (e.g., orthostatic hypotension, nausea, dizziness), and anesthesia-related somnolence. Less common factors included postoperative restrictions and logistical issues such as brace availability. CONCLUSIONS:POD0 PT following lumbar fusion is feasible in the majority of patients and is associated with a shorter hospital stay without increased complications. Failure to participate was not associated with the baseline patient or surgical characteristics evaluated in this study. Instead, the most common barriers were postoperative pain, transient medical issues, and anesthesia-related somnolence, suggesting that optimization of modifiable perioperative factors may improve the implementation of POD0 PT.

Platelets, classically defined by their hemostatic function, are increasingly recognized as immune effectors that shape chronic inflammation and vascular pathology in immune-mediated inflammatory diseases. In conditions such as systemic lupus erythematosus, rheumatoid arthritis, and psoriasis, immune activation skews platelet adhesion, secretion, and procoagulant activity, while persistent interferon signaling and immune complex engagement (via receptors such as FcγRIIA) amplify thromboinflammation. Platelets orchestrate leukocyte recruitment and endothelial activation through P-selectin/PSGL-1 (P-selectin glycoprotein ligand-1) interactions, CD40 ligand, interleukin-1β, and the release of extracellular vesicles carrying cytokines and RNAs. Platelet involvement manifests differently across immune-mediated inflammatory diseases. In systemic lupus erythematosus, they promote type I interferon priming, neutrophil extracellular trap formation, and endothelial dysfunction. In rheumatoid arthritis, they generate abundant synovial microparticles and systemic vascular changes. In psoriasis, they accumulate within skin lesions, enhance platelet-leukocyte aggregation and activate proatherogenic endothelial responses. These pathways promote, independent of traditional cardiovascular risk factors, atherothrombosis including myocardial infarction, stroke, and venous thromboembolism. Limited translational data suggest that hydroxychloroquine may attenuate platelet activation and improve endothelial function. P2Y₁₂ inhibition may blunt interferon-linked platelet RNA signatures and leukocyte-platelet interactions. However, some therapies targeting inflammation, such as Janus kinase inhibitors, may promote thrombosis, the mechanisms of which are not fully known. Advances in multiomics, single-cell and spatial profiling, and in vivo models are delineating targets for intervention and enabling biomarker-driven risk stratification. Collectively, platelets function as central translators between autoimmunity and atherothrombosis. Defining and modulating platelet-immune crosstalk holds the potential to reduce cardiovascular risk in rheumatologic populations.

INTRODUCTION/BACKGROUND:Patients with a suspected high-consequence infectious disease (HCID), such as Ebola virus disease, may require routine laboratory testing to guide management. We assessed the capabilities of frontline hospitals and the barriers they face performing laboratory testing for patients with a suspected HCID. METHODS:A one-time confidential REDCap survey querying capabilities to safely perform laboratory tests that the Centers for Disease Control and Prevention considers critical for patients with a suspected HCID was sent to 95 institutions in Baltimore, MD, Boston, MA, New York City, NY, and Washington, DC, from January to May 2025. RESULTS:Fifty (53%) institutions responded, mostly teaching hospitals (96%), with 24% reporting prior experience evaluating a patient with suspected Ebola virus disease. While many hospitals could perform on-site blood gas (70%), hemoglobin/hematocrit (68%), and lactate (68%) tests on a suspected HCID patient, fewer could safely perform a chemistry panel (64%), a urinalysis (60%), a complete blood count with differential (56%), and a malaria rapid diagnostic test (RDT) (48%) on a suspected HCID patient. The five tests respondents most often considered extremely or very important were hemoglobin/hematocrit (91%), chemistry panel (90%), CBC with differential and platelet count (89%), malaria RDT (88%), and blood gas (88%). Reported barriers to performing routine laboratory testing included issues related to patient and staff safety, infection control, lack of appropriate space, and funding. CONCLUSIONS:Our survey identified several barriers to implementing safe laboratory testing. The inability to conduct these laboratory tests may result in delays in care when an HCID is suspected.

Newly practicing early career radiologists face significant challenges as they onboard into their first attending role. One of the most difficult challenges is often aligning their expectations of their roles and responsibilities in the workplace with those of the institution or practice to which they now belong. This perspective will discuss some of these challenges and suggest potential approaches to assist new faculty in overcoming this alignment barrier to seamlessly integrate into their new work environment.

PURPOSE/UNASSIGNED:To determine whether exposure to antibiotics is associated with new-onset International Classification of Diseases (ICD) coding of geographic atrophy (GA). METHODS/UNASSIGNED:This case-control study of patients ages sixty and older used health insurance claims data from the Merative MarketScan Research Databases. A total of 3254 cases with new-onset ICD coding of GA between 2019 and 2021 were matched by year to 3249 controls without GA using propensity scores estimated by age, hypertension, U.S. Census Bureau region, and Charlson Comorbidity Index. For cases, we analyzed prescription drug claims of antibiotics in the two years before GA diagnosis. For controls, we analyzed claims in the two years before a randomly selected eye examination. We calculated the odds of new-onset ICD coding of GA controlling for age-related macular degeneration risk factors. RESULTS/UNASSIGNED:Exposure to any antibiotics (OR = 1.25; 95% confidence interval [CI], 1.11-1.41; P < 0.001), tetracyclines (OR = 1.18; 95% CI, 1.03-1.36; P = 0.021), quinolones (OR = 1.16; 95% CI, 1.03-1.31; P = 0.017), or broad-spectrum antibiotics (OR = 1.20; 95% CI, 1.07-1.34; P = 0.003) was associated with increased odds of new-onset ICD coding of GA. Greater cumulative day supply was associated with increasing odds, suggesting a dose-dependent relationship. CONCLUSIONS/UNASSIGNED:Exposure to antibiotics is associated with increased odds of new-onset ICD coding of GA. This association may be dose dependent. These findings suggest that antibiotic exposure could be a novel modifiable risk factor for GA, although this conclusion is tempered by potential confounding by health status or misclassification of GA and by multiple comparisons. Further investigation will be needed to validate these findings.

BACKGROUND:Magnetic resonance (MR) imaging-linear accelerator-based real-time adaptive planning for delivering ultra-hypofractionated stereotactic body radiotherapy (SBRT) has advanced clinical accuracy yet added complexity to the radiotherapy workflow. We retrospectively evaluated whether the addition of a Parallel Automated Contouring module with Enhancement of AI (PACE-AI) reduced contouring time and overall SBRT duration, and its impact on intra-fractional target motion. METHODS:This study included 250 fractions from 90 prostate cancer patients from which fraction time were tracked. All patients received definitive SBRT to the prostate on the 1.5-Tesla Unity (Elekta©) system, through the Adapt-To-Shape (ATS) workflow, which required real-time re-contouring of the normal tissues by the dosimetrists and target contouring by the physician for each of the fractions. We compared the fraction durations for 125 consecutive fractions treated with the incorporation of PACE-AI with 125 fractions previously treated without PACE-AI to determine whether PACE-AI improved efficiency and reduced treatment session duration. RESULTS:For the cohort treated without PACE-AI, the overall median duration was 67.6 min, including 23.9 min contouring time. With the incorporation of PACE-AI, the overall median duration was 51.2 min, representing a 24.3% reduction. The average contouring time was reduced by 55% to 10.8 min. In addition, the extent of positional shifts prior to beam delivery was significantly reduced from an average of 1.8 mm to 1.3 mm (p < 0.001) in both superior/inferior (range reduced from 0 to 6.3 mm to 0-4.2 mm) and anterior/posterior directions (range reduced from 0 to 6.6 mm to 0-5.0 mm). CONCLUSIONS:The incorporation of PACE-AI improved workflow efficiency during SBRT. The reduction in treatment duration also helped reduce organ motion during real-time adaptive planning.

PURPOSE/OBJECTIVE:Optical coherence tomography angiography (OCTA) has enabled detailed in vivo imaging of macular neovascularization (MNV) in neovascular age-related macular degeneration (nAMD), leading to a proliferation of morphological descriptive terms. This scoping review aimed to systematically map the existing literature on OCTA-based MNV morphology and evaluate its correlation with disease activity. METHODS:A systematic literature search covering publications through 2025 was performed. After screening 2,445 titles and obtaining 60 full texts, 43 studies were included. Data on morphological terminology, study design, and correlation with disease activity were extracted and synthesized. RESULTS:The included studies, encompassing a total of 2,712 eyes, identified a vast and heterogeneous lexicon of qualitative descriptors, including terms such as "medusa," "sea-fan," and "glomerulus", characterized by significant terminological overlap and inconsistent definitions across studies. Inconsistent, low-certainty associations between specific OCTA morphologies and MNV activity were identified across studies, with findings limited by significant methodological heterogeneity. The evidence for these patterns as reliable biomarkers of disease activity is weak and often contradictory, and several studies were found to use OCTA features to define activity, creating circular arguments that undermine their conclusions. CONCLUSION/CONCLUSIONS:The current terminology for OCTA morphology in nAMD is fragmented and inconsistently applied. The link between these patterns and disease activity is poorly established, severely limiting their clinical utility. These findings highlight a need for a standardized, consensus-based framework for describing and interpreting OCTA findings in nAMD.

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.

OBJECTIVE:To estimate the cumulative probability of achieving at least one live birth (LB) after up to six sequential single euploid embryo transfers (euploid SET) and characterize per-transfer outcomes to inform evidence-based counseling for patients undergoing in vitro fertilization (IVF) with preimplantation genetic testing for aneuploidy (PGT-A). DESIGN/METHODS:Retrospective cohort study. SETTING/METHODS:University-affiliated fertility center. SUBJECTS/METHODS:Patients who underwent IVF with PGT-A followed by euploid SET between January 2014 and December 2024. EXPOSURE/METHODS:Up to six sequential euploid SETs until a live birth was achieved, or the patient discontinued additional transfers. MAIN OUTCOME MEASURES/METHODS:Estimated cumulative probability of achieving ≥1 LB and per-transfer rates of live birth, spontaneous abortion, biochemical pregnancy, and non-pregnant. RESULTS:Among 5811 patients undergoing 7763 euploid SETs attempts, the estimated cumulative probability of a LB increased from 63.1% after one SET to 92.0% after three, 98.3% after five, and 98.8% after six SETs. Per-transfer live birth rate declined from 63.1% at the first euploid SET to 54.0% at the second, then remained stable across subsequent attempts. Rates of spontaneous abortion, biochemical pregnancy, and non-pregnant followed a similar trend. Fewer than 5% of patients met criteria for recurrent implantation failure after three euploid SETs, and fewer than 2% remained without live birth after five SETs. CONCLUSION/CONCLUSIONS:Continued sequential transfer of euploid embryos is supported as the primary management strategy after early transfer failure. For patients able to generate an adequate euploid embryo inventory aligned with their individual risk tolerance, persistence with treatment is associated with a high likelihood of achieving a live birth.