Faculty Bibliography

BACKGROUND:Preadmission functional status has important predictive values for outcomes among hospitalized patients, and may facilitate healthcare resource allocation including early palliative care referral. OBJECTIVES/OBJECTIVE:To compare acute healthcare and palliative care utilization among hospitalized patients with different levels of baseline functional impairment. METHODS:We conducted a retrospective cohort study of adult patients ≥ 18 years discharged from a quaternary academic hospital between July 1, 2022, and December 31, 2024, with baseline functional status assessed on admission via Karnofsky Performance Status (KPS) scale. Using electronic health records and billing data, we collected patients' socio-demographic information, clinical characteristics, and utilization of acute healthcare and palliative care. RESULTS:Among 18,049 patients, baseline functional impairment was classified as mild (KPS 70%-100%): 13,411 (74.3%), moderate (KPS 50%-60%): 2953 (16.4%), severe (KPS30%-40%): 974 (5.4%) and very severe (KPS 10%-20%): 711 (3.9%). Overall, 2089 (11.6%) patients had a intensive care unit (ICU) admission, 1574 (8.7%) received palliative care consultation, and 1021 (5.6%) died in the hospital. In generalized linear models stratified by functional status category, increasing severity of functional impairment was significantly associated with increasing ICU admission, ICU and hospital length of stay, in-hospital mortality, and receipt of palliative care intervention. Mean number of days between admission and palliative care consultation was significantly decreased among patients with very severe impairment when compared with those with mild impairment (5.3 vs. 6.7 days, p < .001). CONCLUSIONS:Baseline functional status assessment may offer an easy-to-measure guide for timely inpatient palliative care intervention among patients at elevated risk for in-hospital morbidity and mortality.

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.

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.

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.

BACKGROUND:Middle meningeal artery embolization (MMAE) has emerged as a treatment for chronic subdural hematoma (cSDH), but comprehensive real-world safety data remain limited. METHODS:We performed a multicenter retrospective analysis of 1781 consecutive patients undergoing MMAE for cSDH (2019-2025). The primary outcome was any procedure-related complication within 30 days. Inverse probability of treatment weighting (IPTW) assessed the association between technical success and complications, adjusting for demographic, clinical, and procedural confounders. RESULTS:Mean age was 72.8 ± 12.4 years; 68.1% were male. The 30-day complication rate was 5.1% (91/1781; 95% CI, 4.1-6.2). In-hospital mortality was 2.9% (47/1625). Technical success was achieved in 97.5% (1505/1543). Among documented complications, thromboembolic events were most common (37.2%; 32/86), followed by hemorrhagic complications (23.8%; 20/84) and access-site hematoma (10.4%; 8/77). Among patients with classifiable symptom status, 80.6% of complications were symptomatic, yielding an overall symptomatic complication rate of 3.0%. Neurological deterioration occurred in 27.1% (248/915). Among 1552 patients with documented surgical approach, complication rates were similar between surgery plus embolization (4.9%; 34/690) and embolization alone (5.2%; 45/860; OR, 0.94; 95% CI, 0.59-1.48; p = 0.79). After IPTW adjustment, technical success was associated with an 86% reduction in complication odds (OR, 0.14; 95% CI, 0.05-0.40; p < 0.001). CONCLUSIONS:In this large multicenter cohort, MMAE was associated with a 5.1% complication rate. Technical success was the strongest protective factor. Embolization with or without surgery showed equivalent safety profiles.

Once considered a surgical frontier fraught with risk, aortic arch aneurysms now represent a domain of evolving innovation. Despite their rarity, they pose severe risks of dissection, rupture, and mortality if not adequately managed. Primarily caused by prior aortic dissections, atherosclerosis, or connective tissue disorders, these aneurysms are often found incidentally on CTA or MRA imaging. Medical management focuses on reducing aortic wall stress through blood pressure control, risk factor modification, and regular imaging to monitor growth. Surgical intervention is typically indicated when the aneurysm diameter exceeds 5.5 cm, exhibits rapid growth, or causes symptoms such as compression or dissection. Open repair remains the gold standard for treatment due to its superior long-term outcomes, though hybrid and endovascular approaches are favored for high-risk patients due to reduced perioperative morbidity. Innovations in hybrid techniques and endovascular devices, alongside advancements in cerebral perfusion strategies, are shaping the future of personalized and minimally invasive approaches to aortic arch repair. This comprehensive review delves into the current management strategies for these aneurysms.

The complex pathophysiology of leukemia and other bone marrow-related hematological malignancies underscores the critical need for immunocompetent bone marrow models that can accurately recapitulate key disease microenvironment and patient therapeutic responses. Existing bone marrow models often lack the fidelity required to recapitulate patient-specific pathophysiology or to emulate the intricate dynamics of in vivo immune responses. This limitation ultimately constrains their utility in critical areas such as leukemia immunotherapy development. Here, to overcome this challenge, we present a detailed protocol for building a 3D microfluidic human bone marrow-on-a-chip microphysiological system that recapitulates the anatomical organization and function of the native tissue. Its concentric three-compartment design replicates the marrow's spatial architecture, co-culturing stromal and hematopoietic cells within a vascularized niche to establish a physiologically relevant, immunocompetent microenvironment. To model patient-specific biology, the platform incorporates patient-derived samples, enabling the personalized evaluation of therapeutic interventions such as chimeric antigen receptor T cell therapy and chemotherapy. The platform supports multiplexed readouts through live imaging, immunofluorescence, cytokine profiling, flow cytometry and single-cell sequencing, enabling a comprehensive analysis of treatment response. The protocol requires ~7 d to establish the functional bone marrow chip, comprising microfluidic device fabrication (1 d), cell seeding (1 d) and progressive development of the bone marrow model (5 d). Therapeutic testing is conducted over a variable timeframe, typically ranging from 2 d to 14 d. The protocol is designed for researchers with basic experience in cell culture and fluorescence imaging,who have basic microfluidics fabrication and tissue culture experience.

BACKGROUND:Patients with frequent emergency department (ED) use often have poor connection to primary care, limiting access to preventive screening. Screening patients at risk for diabetes is essential to ensure early treatment via medication and lifestyle changes. While ED screening programs have shown success in diagnosing diabetes, it is unknown the impact on follow-up with subsequent care, and thus downstream patient outcomes. This study aimed to evaluate the efficacy of an emergency department (ED)-based diabetes screening program, assessing follow-up for subsequent management, if patients changed health behaviors or initiated medications, and barriers reported to follow-up if patients did not establish care. METHODS:Screening results and patient data from four ED sites of a health system were retrospectively collected; we then performed a phone-based survey of all patients diagnosed with diabetes via ED screening over one year. Patients were queried about diagnosis awareness, connection to follow-up or barriers to establishing care, and health behavior changes (diet, exercise, medications). RESULTS:Of 9,897 screened ED patients, 615 (6.2%) had diabetes. We surveyed 307 patients (50% response rate). Among newly diagnosed patients; 79% reported obtaining outpatient care, but only 46% recalled ED diagnosis. Health behavior changes included 65% reporting diet improvement, 35% increasing exercise, and 52% starting diabetes medication. Patients who failed to follow-up reported barriers including awareness of screening result, time/scheduling issues, and financial considerations. CONCLUSION/CONCLUSIONS:This study assesses the reported rate of outpatient care following diabetes diagnosis via an ED screening program and identifies barriers experienced by patients who did not obtain follow-up. Improved connections between screening programs and subsequent care are needed to improve outcomes.