Faculty Bibliography

The Cattell-Imanaga reconstruction (CIR) is considered a more physiologic reconstruction after pancreaticoduodenectomy, as it promotes a more physiological mixing of alimentary and biliopancreatic secretions and facilitates endoscopic access to the anastomoses compared with traditional techniques. However, its application after total pancreatectomy (TP) has not previously been reported. This study describes the surgical technique and institutional experience with CIR, named modified CIR (mCIR), in patients undergoing open TP at a high-volume pancreatic surgery center. The mCIR positions the gastro-/duodeno-jejunostomy (G/DJ) proximally and the hepatico-jejunostomy (HJ) distally on a single transmesocolic limb. 89 patients underwent open TP with mCIR. Both en bloc and stepwise TP were performed; stepwise was mainly used for positive frozen margins (51.7%), high POPF risk (34.8%), or need for vascular resection to reduce POPF-related vascular complications (12.4%). Grade B-C biliary fistula occurred in 6.7% of patients, cholangitis secondary to hepatico-jejunostomy (HJ) stricture in 2.2%, delayed gastric emptying (DGE) in 11%, and duodeno-jejunostomy (DJ) leakage in 1.1%. An endoscopic interventional approach was generally preferred for the management of HJ complications. Major morbidity and 90-day mortality were 23.6% and 3.4%, respectively. The readmission rate was 9.7%, mainly due to infected or symptomatic collections. This is the first study to describe mCIR following TP and to report postoperative outcomes in line with previously reported results for traditional reconstruction techniques.

Apheresis medicine is a continually evolving field with numerous studies published each year. To help apheresis practitioners stay up to date with the current literature, members of the American Society for Apheresis (ASFA) Attending Physician Subcommittee identified and summarized 10 seminal articles published in 2025, from the field of apheresis medicine. PubMed was used to identify articles published in four topics including donor apheresis, therapeutic apheresis, apheresis education, and apheresis collection for cellular therapy. These articles met at least one of the following criteria: novel findings, practice-altering outcomes, international in scope, randomized-controlled trial, relevant to current clinical practice, and/or provide evidence for category III or IV indications based on the ASFA 9th Special Issue of the Guidelines on the Use of Therapeutic Apheresis in Clinical Practice-Evidence-Based Approach. Full length, peer-reviewed manuscripts in English with data from human subjects were included while case reports, review articles, and meta-analyses were excluded.

BACKGROUND:Identifying oral potentially malignant disorders and oral cavity cancer early can lead to better patient outcomes. The guideline panel evaluated the usefulness of light-based adjuncts for screening adults without mucosal abnormalities and for determining the need for biopsy among adults with mucosal abnormalities in the oral cavity or on the lip. TYPES OF STUDIES REVIEWED/METHODS:The authors conducted a living systematic review to evaluate evidence on the benefits and harms of light-based adjuncts and a scoping review to assess people and clinician values and preferences regarding the use of light-based adjuncts and biopsy of mucosal abnormalities. The guideline panel used this evidence to formulate recommendations according to the Grading of Recommendations Assessment, Development and Evaluation Evidence to Decision framework. The framework also guided the panel's consideration of required resources, equity, acceptability, and feasibility in shaping the final recommendations. RESULTS:The guideline panel formulated 2 recommendations and 2 good practice statements. For adults with and without mucosal abnormalities, they formulated conditional recommendations against the use of light-based adjuncts on the basis of very low certainty evidence. The good practice statements urge clinicians to perform a clinical oral examination in all adult patients. CONCLUSIONS AND PRACTICAL IMPLICATIONS/CONCLUSIONS:Biopsy remains the reference standard for establishing a definitive diagnosis of an oral potentially malignant disorder and oral squamous cell carcinoma. All adults should undergo a clinical oral examination in primary care settings. When implementing or adapting these recommendations, local contexts should be considered to promote equitable access to early detection.

INTRODUCTION/UNASSIGNED:To ensure Alzheimer's disease-modifying treatments can be initiated in diverse populations, efficient pathways to obtain timely diagnoses are required. METHODS/UNASSIGNED:This interim sub-analysis of a multicenter US study included cross-sectional surveys and interviews with neurologists at 12 diverse sites to assess real-world lecanemab use. RESULTS/UNASSIGNED:testing to inform risk/benefit decisions. Infusions usually started within 6 months of diagnosis. Delayed/incomplete referrals were identified as the most significant barrier in the current patient pathway. DISCUSSION/UNASSIGNED:These findings demonstrate the feasibility of lecanemab integration in diverse clinical settings and highlight the importance of primary care physician engagement, optimization of referral pathways, and expanding BBM use in improving timely diagnosis, equitable access, and early treatment initiation.

Cocaine produces widely recognized rewarding effects, but also produces aversive effects that occur several minutes after rewarding effects dissipate. Prior work shows these aversive effects are particularly strong in some animals, in whom they produce conditioned avoidance effects that reduce overall cocaine-seeking. The sources of these individual variations are largely unknown, but we found evidence for contributions from heritable influences. Using outbred male and female Sprague-Dawley (SD) and Heterogeneous Stock (HS) rats, we found that offspring of individuals expressing higher versus lower levels of conditioned avoidance to cocaine on a runway operant task are themselves higher or lower in this trait. These results did not differ between sexes, and are consistent with a heritable influence driving conditioned avoidance of cocaine, which could either be genetic or non-genetic. Runway latency to obtain cocaine also differed markedly between seven inbred rat strains (tested in males only), again consistent with a heritable influence. Several control tasks showed that variations in cocaine avoidance were not explained by differences in exploratory locomotion, overall motivation, or resistance of food-seeking to footshock punishment. Notably, the latter punishment resistance task has been linked to addiction-like behaviors in its own right, and performance on this task also varied considerably between inbred strains, but did so independently of cocaine avoidance. Hence, punishment resistance and cocaine avoidance may be influenced by independent heritable factors.Significance statement Cocaine's strong rewarding effects critically drive drug intake, but this intake can be reduced by cocaine's aversive effects, which occur a few minutes after rewarding effects dissipate, and whose intensity varies considerably between animals. Using inbred rat strains and selective breeding we show that conditioned avoidance to cocaine may have a substantial heritable component, which could be either genetic or non-genetic. We also show that aversive effects of cocaine vary independently of other aversive tasks, including resistance to punishment.

Psychedelic drugs are poised to become mainstream treatments, yet we lack a circuit-level account of how they reshape brain activity. Emerging evidence suggests that multiple psychedelic compounds modulate activity in the brain's default mode network (DMN), often interpreted as either increased or decreased bottom-up hierarchical processing. Most imaging studies, however, quantify activity as if it were stationary, remaining agnostic to the ascending or descending movements of activity that defines hierarchical processing. Here, we adapt optical flow analyses to track frame-to-frame trajectories of DMN activity across four independent datasets (humans and mice; methylenedioxymethamphetamine, psilocybin, and lysergic acid diethylamide; nine drug-vs.-control contrasts). In functional magnetic resonance and calcium imaging, all psychedelics attenuate signal flow magnitude and bottom-up directionality within the DMN. Propagation attenuation is not attributable to data quality or previously documented effects of psychedelics and is uniquely associated with self-reported outcomes. This replicable and generalizable attenuation of bottom-up cortical propagations provides fundamental clarification of the effects of psychedelics on macroscale hierarchical processing.

PURPOSE/OBJECTIVE:This narrative review summarizes an artificial intelligence (AI)-integrated digital workflow that enables a seamless, multidisciplinary approach to dental diagnosis and treatment planning, aiming to improve diagnostic coordination, efficiency, and interdisciplinary communication. STUDY SELECTION/METHODS:All studies selected for this narrative review were extracted from the PubMed database. Forty studies were selected, of which 24 were used for general information and 16 were used for the statistical analysis of accuracy of AI software within data acquisition, treatment planning, and clinical implementation. RESULTS:The digital workflow was divided into three phases: data acquisition, treatment planning, and AI data analysis for decision support. Six articles reported the accuracy outcomes for AI-integrated data acquisition tools, such as intraoral scanners (IOS), cone-beam computed tomography (CBCT), facial scanners (FS), and jaw motion trackers (JMT); seven reported AI performance in assisting treatment planning; and three assessed the clinician acceptance rate of AI-supported decisions. IOS, CBCT, FS, and JMT achieved 88-97% overall accuracies. The integrated convolutional neural network and recurrent neural network models obtained 87-98% overall accuracy for treatment planning. Finally, the AI-generated treatment plan obtained 75-95% clinician acceptance rate. CONCLUSIONS:By integrating the IOS, CBCT, FS, and JMT, a comprehensive virtual patient can be created to facilitate seamless communication and effective treatment planning. This AI-integrated workflow may enhance interdisciplinary coordination and treatment planning. However, prospective clinical studies are required to validate their effects on patient outcomes and satisfaction.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic caused significant global harm. Seroprevalence studies detected antibody increases from SARS-CoV-2 infection, assessing transmission and risk from infection. These studies and epidemiological modeling informed public health policy and behavior. Biases in early seroprevalence analyses caused underestimation of fatality risk, including the risk posed to pediatric populations and to those in lower-income nations. The scope of the pandemic was clarified by seroprevalence studies that better assessed at-risk groups and by adjustment of seroprevalence data for known data biases. Reassessment of seroprevalence data confirms the accuracy of early modeling. Public health authorities should inform the public of this modeling success and of the limitations of early seroprevalence analyses. This will prepare the public to better assess global health risk during future pandemics.