Faculty Bibliography

BACKGROUND:Feeding problems affect many children, yet their connection with diet quality in later childhood is unknown, despite the important role of diet quality on health outcomes, such as obesity. OBJECTIVE:To examine feeding problem behaviors and diet quality in later childhood. DESIGN/METHODS:The frequency of problematic feeding behaviors (i.e., items related to food refusal, feeding difficulties, and distress) were parent-reported at 18 and 24 months in a birth cohort (2008-2010) from New York state (n = 4,989). In this previously validated feeding behaviors scale, parents responded to how often their child engaged in behaviors such as crying/screaming during meals and food refusal, to create an average feeding problems score. Typical daily servings of food items that a child consumed were parent-reported at 30 months, 36 months, 7 years, and 9 years and diet quality using the Youth Healthy Eating Index (YHEI) was calculated, with a higher score indicating better diet quality. Mixed effects analyses calculated mean differences in YHEI per unit increase in feeding problem scores, adjusting for sociodemographic and health-related factors, such as parental education, gestational age, and any breastfeeding duration. RESULTS:Feeding problem scores at 18 and 24 months were prospectively associated with lower YHEI scores at 30/36 months (18 months: B = -1.10, 95% CI: -1.93, -0.27; 24 months: B = -1.56, 95% CI: -2.33, -0.79). Similar associations were observed at 7/9 years (18 months: B = -1.30, 95% CI: -2.61, 0.00; 24 months: B = -1.65, 95% CI: -2.96, -0.34). CONCLUSIONS:Higher feeding problems in infancy (18 and 24 months) were associated with lower quality diets in childhood, even after children started school. These findings highlight the importance of feeding behaviors to long-term diet quality even with observations as early as 18 months. TRIAL REGISTRATION/BACKGROUND:NCT03106493 in clinicaltrials.gov (Dates: 07/2008-11/2019, Study Registration Date: 2017-04-10).

IMPORTANCE/UNASSIGNED:Screening by low-dose computed tomography can reduce lung cancer mortality among high-risk individuals, but many lung cancers occur among individuals with a smoking history who are not eligible for screening. OBJECTIVE/UNASSIGNED:To develop and validate the protein-based Integrative Analysis of Lung Cancer Risk and Etiology (INTEGRAL)-Risk model in individuals with a smoking history from the general population. DESIGN, SETTING, AND PARTICIPANTS/UNASSIGNED:Cohorts in the Lung Cancer Cohort Consortium recruited research participants in the US, Europe, Asia, and Australia between 1985 and 2009, who were followed up for lung cancer and other health outcomes until 2021. Fourteen case cohorts of 3695 participants with a smoking history within the Lung Cancer Cohort Consortium, including 2305 randomly sampled participants and 1390 patients diagnosed with lung cancer within 3 years after blood sample collection, were designed. Plasma or serum samples from each participant were assayed using the INTEGRAL protein panel in 2022. The INTEGRAL-Risk model was trained using 7 predefined case cohorts (training set; n = 1951) to estimate absolute risk of being diagnosed with lung cancer based on age, smoking history, and 13 proteins. The validity of the INTEGRAL-Risk model was assessed in 7 independent case cohorts (testing set; n = 1744) at 1, 2, and 3 years after blood collection. EXPOSURE/UNASSIGNED:Absolute risk estimates from the protein-based INTEGRAL-Risk model. MAIN OUTCOMES AND MEASURES/UNASSIGNED:The primary outcome was the validity of the INTEGRAL-Risk model in the testing set with respect to discrimination (area under the curve [AUC]) and calibration (ratio of expected-to-observed cases [E/O]). RESULTS/UNASSIGNED:A total of 3695 participants were included, with 1951 participants (including 807 with lung cancer) in the training set and 1744 participants (including 583 with lung cancer) in the testing set. In the combined 14 training and testing sets, after application of statistical weights, 323 570 participants were represented (185 016 [57%] female; median [IQR] age, 60 [51-67] years). In the independent testing set, discrimination of the INTEGRAL-Risk model was highest at 1 year of follow-up and exceeded that of the questionnaire-based PLCOm2012 (Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial) model (INTEGRAL-Risk AUC of 0.88 [95% CI, 0.85-0.91] vs PLCOm2012 AUC of 0.79 [95% CI, 0.75-0.83]; P value for difference <.001). Using a risk threshold to achieve the same specificity as US Preventive Services Task Force (USPSTF) 2021 criteria, the INTEGRAL-Risk model captured 85% of lung cancer cases compared with 63% by USPSTF 2021 and 70% by PLCOm2012. Discrimination of the INTEGRAL-Risk model decreased with longer prediction horizons, with a 2-year AUC of 0.84 (95% CI, 0.81-0.86) and 3-year AUC of 0.81 (95% CI, 0.79-0.83). The model was well calibrated (E/O over 3 years, 0.87 [95% CI, 0.69-1.14]). CONCLUSIONS AND RELEVANCE/UNASSIGNED:Compared with questionnaire-based approaches, the protein-based INTEGRAL-Risk model improved short-term prediction of lung cancer in people with a smoking history. This model has potential to improve selection of high-risk individuals who are most likely to benefit from lung cancer screening.

BACKGROUND/UNASSIGNED:Heart failure is an increasingly common comorbidity among people with HIV infection, complicating care and heightening the vulnerability of this population to social adversity (SA). However, the impact of different SA domains on outcomes in this population remains poorly understood. METHODS/UNASSIGNED:We analyzed data on people with HIV infection and heart failure from the NYC 4H (NYC Health + Hospitals HIV-Heart Failure) cohort. Baseline multidimensional SA was assessed by licensed clinical social workers using standardized evaluations and grouped into 5 domains: economic hardship, health care access barriers, neighborhood or built environment instability, social support challenge, and psychobehavioral instability. We used multivariable adjusted Cox models to estimate hazard ratios (HRs) of all-cause, cardiovascular, and infection-related mortality and logistic regression to estimate odds ratios of 6-month rehospitalization risk. RESULTS/UNASSIGNED:Among 1044 participants (62.9% male; mean age, 61.6 years), 601 (58%) reported at least 1 SA: economic hardship (n=130), limited health care access (n=155), unstable housing (n=129), social support challenge (n=179), or psychobehavioral instability (n=438). Over a mean follow-up of 3.8 years, exposure to any SA was associated with higher all-cause mortality (HR, 4.32 [95% CI, 3.03-6.14]), cardiovascular mortality (HR, 4.05 [95% CI, 2.17-6.83]), and infection-related mortality (HR, 2.37 [95% CI, 1.23-4.56]). Social support challenge (HR, 2.19 [95% CI, 1.35-3.55]) and psychobehavioral instability (HR, 1.96 [95% CI, 1.24-3.11]) were associated with higher cardiovascular mortality. Economic hardship (HR, 2.40 [95% CI, 1.22-4.70]) and social support challenge (HR, 3.09 [95% CI, 1.75-5.48]) were associated with higher infection-related mortality. Compared with patients without SA, those with environmental instability, psychobehavioral instability, or social support challenges had a 73% (adjusted odds ratio, 1.73 [95% CI, 1.15-2.06]), 75% (adjusted odds ratio, 1.75 [95% CI, 1.31-2.35]), and 44% (adjusted odds ratio, 1.44 [95% CI, 1.00-2.06]) higher risk of rehospitalization within 6 months, respectively. CONCLUSIONS/UNASSIGNED:SA was significantly associated with mortality and rehospitalization among people with HIV infection and heart failure, with domain-specific pathways influencing specific outcomes. Multidimensional assessment of SA may offer a framework for domain-specific risk stratification in people with HIV infection and heart failure.

PURPOSE/OBJECTIVE:To develop a novel single-shot radial echo planar imaging (ss-rEPI) technique for rapid, distortion-free brain imaging in functional MRI experiments. METHODS:* mapping and QSM. Visual BOLD fMRI experiments were conducted and evaluated against Cartesian EPI measurements. RESULTS:* measurements. CONCLUSION/CONCLUSIONS:modeling is critical for ss-rEPI performance. Advanced reconstruction techniques and self-calibration methods could further enhance its speed, performance, and applicability across diverse MRI techniques.

Bioconjugation reactions are indispensable for probing biomolecules in their native environments. Photoactivatable bioconjugation offers spatiotemporal control; however, current methods face significant limitations, including the requirement for noncanonical functional groups, cytotoxic heavy-metal catalysts, and high-energy UV or visible light (λ < 800 nm), which restrict tissue penetration and increase phototoxicity risks. In response, we introduce TagC-RED, a Retro-Ene type sigmatropic rearrangement of Diazonium compounds for Cysteine-specific bioconjugation activated by infrared light (λ > 1000 nm). TagC-RED is quantitative, rapid, and catalyst-free, with deep tissue penetration, enabling robust labeling intracellularly and in vivo. Mechanistic studies and DFT calculations show that TagC-RED activates through the formation of an electron donor-acceptor (EDA) complex that enables IR irradiation and undergoes a stepwise retro-ene reaction. TagC-RED holds significant potential as a platform for in vivo chemical biology and diagnostic innovation.

Rotator cuff disease (RCD) is the leading cause of shoulder disability, characterized by progressive degeneration of tendon structure and function. Despite advances in surgical techniques that optimize repair biomechanics, biological healing remains a major challenge, leading to high rates of repair failure. Augmentation strategies, including biologic adjuvants, grafts, and bioinductive implants, aim to improve the healing environment and reduce re-tear rates. Although augmentation reliably reduces structural failure, its clinical benefits remain under investigation. Continued advancements in biologic therapies, graft technologies, and long-term clinical studies are needed to optimize outcomes and define best practices for augmentation in rotator cuff repair. This review summarizes the current understanding of RCD pathophysiology, natural history, treatment strategies, surgical repair techniques, healing mechanisms, and the role of augmentation.

PURPOSE/OBJECTIVE:This study evaluated the extent of prostate displacement during SBRT on an MRI Linac using comprehensive motion management (CMM) and identified variables associated with intrafraction motion (IFM). METHODS:212 patients with clinically localized prostate cancer were treated with 5-fraction SBRT on a 1.5 T MR-Linac where IFM was continuously tracked and gated by CMM. Pre-beam positional shifts were identified from MRI registration prior to beam delivery. Intrafraction positional variability during beam delivery was evaluated, and multivariable analysis identified variables associated with IFM. RESULTS:In 614 fractions (62.7%), a > 1.5 mm pre-beam positional shift led to an adapt-to-position (ATP) plan correction. Mean anterior-posterior and superior-inferior pre-beam shifts were 2.2 mm and 2.1 mm, respectively. For 962 evaluable fractions, the median beam-on-time was 13.7 min with a mean duty cycle of 95.8%. Sustained > 3 mm displacement was observed in 520 fractions (54.1%) with a median cumulative duration of 24 s; >5 mm displacement was observed in 209 fractions (21.7%) with a median duration of 12.4 s. The ATS + ATP workflow was associated with reduced odds of sustained > 3 mm motion (p = 0.035), while older age was associated with increased odds (p = 0.011). CONCLUSIONS:Significant prostate shifts can occur immediately prior to and during radiation beam delivery, frequently exceeding applied margins and potentially leading to tumor underdosage. Continuous motion tracking and gating during prostate SBRT is an important tool in reducing IFM and enhance treatment delivery accuracy.

Young adults with hip pathology present a therapeutic challenge requiring careful consideration of treatment options that will affect decades of future function. Historically, the orthopedic community has maintained a strong preservation bias, often pursuing multiple preservation attempts before considering arthroplasty because of concerns about implant longevity. This narrative review critically examines current evidence regarding hip preservation surgery and total hip arthroplasty in young adults to inform evidence-based decision making. The literature reveals that successful hip preservation requires a narrow therapeutic window defined by preserved articular cartilage, accurate structural diagnosis, and appropriate patient selection. Clinical and imaging predictors, including joint space narrowing below 2 mm, Tönnis grade 2 or higher osteoarthritis, bipolar chondral damage, and mechanical symptoms, reliably identify patients unlikely to benefit from preservation. Concurrently, advances in bearing surfaces-particularly highly cross-linked polyethylene and ceramics-have dramatically improved arthroplasty outcomes, with contemporary data demonstrating 10-year survivorship exceeding 90% in patients younger than 55 years. Modern total hip arthroplasty delivers consistent pain relief and functional improvement that often exceeds preservation outcomes in appropriately indicated patients. This review proposes a decision-making framework emphasizing that treatment selection should be guided by objective disease characteristics rather than age-based algorithms, optimizing long-term outcomes while minimizing unnecessary morbidity.

PURPOSE OF THE REPORT/OBJECTIVE:To determine the prevalence, etiology, and clinical significance of incidental focal small bowel FDG uptake in patients undergoing PET/CT for staging of non-small bowel cancers. MATERIAL AND METHODS/METHODS:Retrospective review of consecutive FDG PET/CT examinations obtained for cancer staging with incidental focal small bowel radiotracer uptake was performed. Exclusion criteria included known small bowel pathology or insufficient reference standard. Imaging findings assessed included lesion location, number, CT correlate, SUVmax, and presence of metastases outside the bowel. Clinical data included age, sex, cancer clinical setting, origin, and stage. Focal small bowel FDG uptake etiology (benign vs. metastatic) was determined by composite reference standard (histopathology, clinical, and imaging follow-up). Statistical analyses included Wilcoxon rank-sum test, Pearson's χ2 test, Fisher exact test, and ROC curve analyses. RESULTS:In a review of 147,516 PET/CT examinations, incidental focal small bowel FDG uptake was rare, with a prevalence of 0.1% (88/147,516). Most cases were metastatic, 60.2% (53/88), most commonly spread from lymphoma [32.1% (17/53)] and melanoma [30.2% (16/53)]. Metastatic lesions were evenly distributed throughout the ileum [47.2% (25/53)] and jejunum [39.6% (21/53)]. Metastatic focal small bowel FDG uptake was associated with presence of other sites of distant metastases, higher SUVmax, and presence of a CT correlate (P <0.01). CONCLUSIONS:Incidental focal small bowel FDG uptake is rare. Most small bowel hypermetabolic foci are metastatic and are predominantly encountered with melanoma and lymphoma. Multiple imaging and clinical factors helped differentiate between benign and metastatic focal small bowel FDG uptake.