Hackensack Meridian School of Medicine (HMSOM) is a private medical school in Nutley, New Jersey. When it opened in 2015, it was the first private medical school in New Jersey to open in decades. Originally affiliated with Seton Hall University, the Hackensack Meridian School of Medicine became independent in 2020.HMSOM is affiliated with Hackensack Meridian Health (HMH), a network of 16 hospitals and the largest hospital network in the state after 2018 when a merger of Hackensack University Health Network (HUHN) and Meridian Health was completed with JFK Health. The merger comprises three regions across the state of NJ and the larger hospitals in each are: Hackensack University Medical Center (HUMC) in the North, JFK Medical Center in Central NJ, and the Jersey Shore University Medical Center (JSUMC) in the South. All three regional hubs serve as educational centers for HMSOM students during their clinical years of rotations.
Cranioplasty (CP) research has shown that the material used for its bone flap formation is not standardized, with several viable options. The aim of this study was to explore the development of research in cranioplasty from a bibliometric perspective, with a focus on material choice, to elucidate trends in CP literature over time. Original studies and review articles on cranioplasty material related research were obtained from the Scopus database from 2014 to 2024. R package “bibliometrix” was used to summarize main findings, examine the occurrence of top keywords, and visualize collaboration networks between countries. VOSviewer software was applied to conduct both co-authorship and co-occurrence analyses, with CiteSpace used to identify the references and keywords with the strongest citation bursts. A total of 933 publications on cranioplasty material were included. An analysis of publication titles demonstrated an increase in CP for traumatic brain injury (TBI) post-2010 along with the growth of custom implants (i.e., “patient-specific”). Early citation bursts focused on the application of various materials, while later keywords concerned surgical complications and clinical outcomes. Several authors had significant bursts of contribution, and the United States was the largest contributor to the existing body of literature. This bibliometric study elucidated keyword trends as they relate to CP and material selection. It mapped a fundamental knowledge structure consisting of countries, institutions, authors, journals, and articles in the research field of cranioplasty material over the past ten years. The results provide a comprehensive perspective about the wider landscape of this research area.
BACKGROUND/OBJECTIVES:Traumatic brain injury (TBI) is a significant public health concern resulting in physical, cognitive, and behavioral impairments. Emerging evidence highlights a bidirectional relationship between brain injury and gut health, known as the brain-gut axis. This paper provides a comprehensive review of current literature exploring the relationship between TBI and various gastrointestinal (GI) pathologies, examining how brain injuries contribute to GI dysfunction and how gut health influences neurorecovery. METHODS:A comprehensive search of peer-reviewed articles was conducted between March and June 2025 using databases including PubMed, Scopus, and Cochrane. Studies from 2010 onwards involving human subjects were screened. Search terms included combinations of "traumatic brain injury," "TBI," and "[gastrointestinal pathology]." Data regarding study design, population, GI outcomes, and proposed mechanisms were analyzed. RESULTS:TBI triggers secondary injury cascades, including neuroinflammation, dysautonomia, and gut microbiome dysbiosis. The review identifies a wide spectrum of TBI-associated GI disorders, including dysphagia, esophageal disorders, gastric disorders, and intestinal disorders. Bowel dysfunction, manifesting as constipation or incontinence, is prevalent due to neurogenic factors and cognitive impairments. Additionally, metabolic dysregulation following TBI leads to malnutrition, hyperglycemia, and hypoglycemia, all of which impact morbidity. CONCLUSIONS:The GI system is integrally connected to TBI recovery through immune modulation and nutrient absorption. Dysfunction within the brain-gut axis, specifically altered motility, permeability, and inflammation, contributes to secondary brain injury and impedes neurological outcomes. Clinical assessment of GI dysfunction should be integrated into routine TBI care. Therapeutic strategies, including early enteral nutrition, are essential to optimize recovery and reduce systemic inflammation.
OBJECTIVE:To assess the 2022 American College of Rheumatology (ACR)/EULAR classification criteria for antineutrophil cytoplasmic antibody-associated vasculitis (AAV) in children with chronic small-to-medium vessel vasculitis. METHODS:A cohort of 574 patients, identified by physician's diagnosis (MD-diagnosis) in A Registry of Childhood Vasculitis, was classified by computation of registry data as having granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), or eosinophilic GPA after applying (1) ACR/EULAR AAV criteria and (2) pediatric-adapted European Medicines Agency (Ped-EMA) classification algorithm (incorporating Ankara GPA criteria). Venn diagrams compared the resulting GPA and MPA cohorts with MD-diagnosis. Sensitivity and specificity of criteria for GPA were evaluated against MD-diagnosis. Fisher exact test evaluated differences in the frequencies of individual clinical features in GPA versus MPA. RESULTS:Comparing ACR/EULAR criteria against the Ped-EMA algorithm for classifying AAV, more patients were classified as GPA or MPA (n = 396 vs 360, respectively), fewer had GPA (n = 261 vs 288, respectively), more had MPA (n = 135 vs 72, respectively), and fewer GPA cases coclassified as MPA (12% vs 28%, respectively); there were more differences between GPA and MPA in Pediatric Vasculitis Activity Score-defined clinical features (n = 14 vs 10, respectively). When classifying GPA by ACR/EULAR or Ankara criteria, sensitivity (74.5% vs 72.1%, respectively) was comparable, and specificity for ACR/EULAR criteria (93.9% vs 79.9%, respectively) was improved. CONCLUSION:The 2022 ACR/EULAR classification criteria for AAV perform at least as well as previous pediatric criteria and provide categorical MPA criteria where none existed previously; the criteria for GPA and MPA now specifically differentiate each other, with more differences between them in the frequencies of clinical features. Our findings support the preferential use of ACR/EULAR over Ankara criteria for GPA in pediatrics.
Background/Objectives: Successful cementless total knee arthroplasty (TKA) requires adequate bone quality. However, reliable tools for intraoperative assessment remain limited. This study aimed to introduce a novel visual grading system for evaluating femoral bone during surgery and to assess its correlation with actual bone mechanical properties and suitability for cementless fixation. Methods: We prospectively recruited 193 patients receiving posterior-stabilized TKA. Intraoperatively, femoral cutting surfaces were classified into four visual grades (Excellent, Good, Fair, Poor) considering pore appearance and contour integrity. Femoral bone specimens were harvested during box preparation, and bone mechanical properties were measured through indentation testing. Spearman correlation was used to evaluate the relationship between visual grades and bone mechanical properties. Fisher’s exact test was used to evaluate the distribution pattern of cementless suitable and cemented mandatory classifications across visual grading. Receiver operating characteristic (ROC) analysis was used to evaluate diagnostic accuracy for each visual grade cutoff. Results: Visual grade strongly correlated with bone mechanical properties (Spearman’s ρ = 0.881, p < 0.01). Cementless suitable cases were predominantly distributed in Good/Excellent visual grades, while cemented mandatory cases were mostly found in Fair/Poor grades. However, 8% of Good visual grade specimens exhibited strength warranting cemented fixation, and 18% of Fair visual grade specimens demonstrated adequate mechanical properties for cementless fixation. Using the Good visual grade as a cutoff threshold, ROC analysis showed excellent diagnostic accuracy (AUC = 0.941) with high sensitivity (89%) and specificity (94%). Conclusions: The authors’ novel intraoperative visual assessment system demonstrated significant correspondence to measured bone mechanical properties in the distal femur and showed high accuracy in determining suitability for cementless TKA in Asian individuals. Given the ethnic homogeneity of this cohort, further validation in diverse populations is required to generalize these findings.
Cranioplasty following decompressive craniectomy remains a complex procedure with significant risks of infection, resorption, and implant failure. Increasingly, multidisciplinary surgical teams (MST) composed of neurosurgeons and plastic/reconstructive surgeons have been employed to optimize outcomes. This systematic review and quantitative analysis evaluates MST outcomes, focusing on complication, mortality, and revision rates across materials, flap types, and surgical indications. A systematic review was conducted following guidelines suggested by Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Article selection was conducted in the Scopus database. Inclusion criteria were (1) a multidisciplinary approach between neurosurgery and plastic/reconstructive surgery, (2) cranial reconstruction, (3) a definitive flap type, and (4) reported outcomes. Exclusion criteria included any studies without relevant focus, multidisciplinary approach, or reported outcomes. Data extracted included demographics, indication, implant material, flap type, and postoperative outcomes. Complication, mortality, and revision rates were pooled. Subgroup analysis compared outcomes by indication, material, and flap type using chi-square and relative risk calculations. A Scopus search identified 88 studies, of which 54 met inclusion criteria. Among 2,692 patients, the overall complication rate was 18.69
