Faculty Bibliography

We report a 71-year-old woman who developed disabling orthostatic tremor and severe orthostatic hypertension following cosmetic neck lift surgery. Autonomic testing demonstrated exaggerated pressor responses and excessive orthostatic catecholamine release, consistent with sympathoadrenal overactivation due to impaired carotid baroreflex function. This case highlights a potential autonomic complication of aesthetic neck surgery.

Intercompartmental water exchange in brain and other biological tissue can be probed in vivo with diffusion MRI (dMRI). We assess the accuracy of a recently proposed method for estimating a mean exchange rate by performing Monte Carlo simulations of random walkers through a packing of permeable, randomly placed, parallel cylinders to model water exchange within axonal fiber bundles. The diffusivity and kurtosis of the full system are calculated for a broad range of diffusion times and model parameters. The mean exchange rate is estimated from the logarithmic derivative of the kurtosis with respect to the diffusion time and compared with the exchange rate predicted by the Kärger model (KM), which is exact in certain limits. The mean exchange rate is also compared with the reciprocal exchange time obtained by conventional fitting of the kurtosis time dependence to a two-compartment KM, with a high correlation being found between the two quantities. The estimates from the logarithmic derivative are in good agreement with the KM predictions when the exchange time is long in comparison to the compartment traversal times, which corresponds to barrier-limited exchange. Compared to the standard procedure of fitting the kurtosis to the KM over a broad range of diffusion times, using the logarithmic derivative reduces the data acquisition burden by only requiring a narrow range of times and increases generality in that number of compartments need not be specified. This method may be useful for estimating the mean exchange rate from the kurtosis time dependence measured with dMRI.

UNLABELLED:= 123), we found that people’s willingness to exert effort is positively associated with outcome expected value under both risk and ambiguity. Additionally, people exert more effort when outcome distribution uncertainty increases in risky situations, but are insensitive to ambiguity, except when facing extreme ambiguity. Our results demonstrate an unexpected dissociation. Humans will engage in effort-based information-seeking, even for non-instrumental information, when facing risk. In contrast, they show a much lower willingness to expend effort to resolve non-instrumental ambiguity. SUPPLEMENTARY INFORMATION:The online version contains supplementary material available at 10.1038/s41598-026-43803-2.

Individuals with Down syndrome (DS) are at risk for early-onset Alzheimer's disease (AD), marked by neurodegeneration in hippocampal and basal forebrain circuits. Early-life interventions offer therapeutic potential, including maternal choline supplementation (MCS). MCS improves cognitive outcomes and neuroplasticity in rodent models of neurodevelopmental and neurodegenerative disorders, yet cell-type specific molecular effects remain unknown. We investigated the effect of MCS upon the onset of septohippocampal degeneration at 6 months of age in the Ts65Dn mouse model of DS/AD. Using laser capture microdissection and single population RNA-sequencing, transcriptomic changes were profiled within hippocampal CA1 and CA3 pyramidal neurons and dentate gyrus granule cells comparing trisomic and disomic offspring. Bioinformatic analysis revealed MCS-mediated downregulation of apoptotic pathways and upregulation of cognition-related functions across all populations, alongside cell-specific responses. These findings highlight MCS as a promising strategy for modulating disease-relevant pathways in a hippocampal cell-type-specific manner during early neurodegeneration in DS/AD.

INTRODUCTION/BACKGROUND:Accurate preoperative evaluation of pancreatic cysts is essential. However, cytology and biochemical analysis are often limited by low cellularity, and risk stratification is critical for management. PancreaSeq Genomic Classifier (GC) analyzes cyst fluid for molecular alterations to aid diagnosis and risk assessment. MATERIALS AND METHODS/METHODS:We retrospectively analyzed 219 pancreatic cysts from 206 patients using PancreaSeq GC, integrating molecular findings with cytology, biochemical, imaging, surgical pathology, and follow-up. RESULTS:PancreaSeq GC successfully analyzed 216/219 cysts (99%) and detected alterations in 182 (83%). Among cases with both cytology and molecular data (n = 201), concordance was high in cytologically mucinous neoplasms (94%) and atypical cases (95%). Notably, among cases reported as negative for malignancy or nondiagnostic on cytology (n = 128), PancreaSeq GC identified mucinous neoplasms in 82 cases (64%), demonstrating added value in limited samples. Surgical pathology correlation (n = 24) showed excellent performance for distinguishing mucinous from nonmucinous cysts (area under the curve [AUC] = 0.94, P < 0.001). Risk stratification for detection of any dysplasia yielded an AUC of 0.78 (P = 0.006), and for high-grade dysplasia an AUC of 0.74 (P = 0.046). PancreaSeq GC reliably predicted neuroendocrine tumors, but the sensitivity for focal high-grade dysplasia in mucinous neoplasms and serous cystadenoma was limited. Compared with carcinoembryonic antigen (CEA), cyst fluid glucose showed higher sensitivity but lower specificity for mucinous cyst detection. CONCLUSIONS:PancreaSeq GC provides significant diagnostic and risk-stratification value that complements cytological evaluation, particularly in indeterminate or nondiagnostic cytology specimens and when biochemical data are unavailable. Integration of molecular findings improves cyst classification and dysplasia risk assessment. Multidisciplinary assessment remains essential, given the assay's limited sensitivity for focal high-grade dysplasia and serous cystadenomas.

In mice and many other species, aggression levels are low in virgin females but increase dramatically during lactation to protect vulnerable offspring. This aggression, aimed at protecting the young, is known as maternal aggression. It emerges abruptly after parturition, peaks during early lactation, and declines after weaning. Given its stereotyped temporal profile, hormones associated with pregnancy and lactation are believed to play critical roles in its rise and fall. In addition, maternal aggression diminishes within hours of pup separation and rapidly recovers upon pup reunion, indicating a secondary, pup-dependent regulation of its expression. Here, we review current knowledge of the female aggression circuit and the hormonal and neural mechanisms that reshape it during pregnancy and lactation. We propose a two-step model in which pregnancy-associated sex hormone surges refine the aggression circuit, while lactation-associated neuropeptide signals gate circuit output in response to the need to protect offspring.

Ion channels are the second most common clinical drug target besides G protein-coupled receptors. Aneurysmal diseases pose a significant threat to human life. Novel drug targets for its treatment remain to be explored. We investigated the role of an ion channel, calcium homeostasis modulators 5 (CALHM5), on the development of aortic aneurysms. We characterized CALHM5 as a plasma membrane ion channel abundant in smooth muscle cells of both humans and mice, playing a pivotal role in regulating calcium homeostasis. Notably, CALHM5 deficiency suppressed the transcription of the L-type calcium channel (LTCC) pore-forming subunit by downregulating cAMP-response element binding proteins. This in turn diminished blood vessel contractility and decreased blood flow. Intriguingly, CALHM5 expression is downregulated in smooth muscle tissues of aortic aneurysm patients. Furthermore, CALHM5 deficiency was observed to ameliorate the development of abdominal aortic aneurysms in mice, partly by stimulating smooth muscle cell proliferation. CALHM5 emerges as an ion channel prominently expressed in arterial smooth muscles, serving as a physiological regulator of smooth muscle contraction and presenting itself as a promising therapeutic target for aortic aneurysms.

Three-dimensional (3D) ex vivo imaging of cleared tissue from intact brains from animal models, human brain surgical specimens, and large postmortem human and non-human primate brain specimens is essential for understanding physiological neural connectivity and pathological alterations underlying neurological and neuropsychiatric disorders. Contemporary light-sheet microscopy enables rapid, high-resolution imaging of large, cleared samples but is limited by the orthogonal arrangement of illumination and detection optics, which constrains specimen size. Light-sheet theta microscopy (LSTM) overcomes this limitation by employing two oblique illumination paths while maintaining a perpendicular detection geometry. Here, we report the development of a next-generation, fully integrated and user-friendly LSTM system that enables uniform subcellular-resolution imaging (with subcellular resolution determined by the lateral performance of the system) throughout large specimens without constraining lateral (XY) dimensions. The system provides a seamless workflow encompassing image acquisition, data storage, pre- and post-processing, enhancement and quantitative analysis. Performance is demonstrated by high-resolution 3D imaging of intact mouse brains and human brain samples, including complete downstream analyses such as digital neuron tracing, vascular reconstruction and design-based stereological analysis. This enhanced and accessible LSTM implementation enables rapid quantitative mapping of molecular and cellular features in very large biological specimens.

Ultrasound is the imaging study of choice for the initial diagnosis of autosomal dominant polycystic kidney disease (ADPKD) due to its high diagnostic accuracy and ability to detect kidney cysts as small as 2 to 3 mm. MRI of the kidneys is also highly sensitive at detecting small cysts and is an alternative to US. MRI is the preferred modality for determining total kidney volume (TKV). TKV can be used as an imaging biomarker to predict kidney function decline, track disease progression, and evaluate the effectiveness of treatment. CT abdomen and pelvis with contrast is the test of choice for detecting suspected complications such as renal cyst hemorrhage, rupture, or infection. MRI of the abdomen without and with contrast can also be used for diagnosing complications of ADPKD and is usually appropriate regardless of kidney function. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.