Andrew Hannoudi

Background: Matching into integrated plastic surgery residency is extremely competitive. Although previous studies have examined the research output of matched residents, a thorough investigation of their types of publications, authorship trends, and citation metrics has not been performed following the transition of Step 1 to a pass/fail system. Identifying trends among successful matriculants may guide medical students toward successful preparation for the current application process. Methods: Research profiles for 213 first-year US integrated plastic surgery residents from the 2024-2025 cohort were analyzed using Scopus. Variables included publication count, number of first-author publications, types of publications, and journal impact factor. Residents were tiered into quartiles based on the amount of National Institutes of Health (NIH) funding received by their programs' associated universities or hospitals. Univariate regression analysis was performed to determine the relationship between NIH tiers and various research output characteristics. Results: The 2024-2025 integrated plastic surgery residency cohort had a median of 5 publications. First authorship contribution was evident in 32.6% of all publications, and 59.2% of all publications discussed plastic surgery-related topics. Original research articles were 66.4% of the studies. Journals published in had a median impact factor of 2.1. No significant differences were observed between NIH funding tiers and any of the research output characteristic variables. Conclusions: This study may guide future US integrated plastic surgery applicants toward success in the match by offering a qualitative and quantitative overview of the current landscape of research output characteristics for successful matriculants.

Introduction Ultraviolet (UV) light is a known trigger of both cutaneous and systemic disease manifestations in lupus patients. Lupus skin has elevated expression of type I interferons (IFNs) that promote increased keratinocyte (KC) death after UV exposure. The mechanisms by which KC cell death is increased by type I IFNs are unknown. Methods Here, we examine the specific cell death pathways that are activated in KCs by type I IFN priming and UVB exposure using a variety of pharmacological and genetic approaches. Mice that overexpress Ifnk in the epidermis were exposed to UVB light and cell death was measured. RNA-sequencing from IFN-treated KCs was analyzed to identify candidate genes for further analysis that could drive enhanced cell death responses after UVB exposure. Results We identify enhanced activation of caspase-8 dependent apoptosis, but not other cell death pathways, in type I IFN and UVB-exposed KCs. In vivo , overexpression of epidermal Ifnk resulted in increased apoptosis in murine skin after UVB treatment. This increase in KC apoptosis was not dependent on known death ligands but rather dependent on type I IFN-upregulation of interferon regulatory factor 1 (IRF1). Discussion These data suggest that enhanced sensitivity to UV light exhibited by lupus patients results from type I IFN priming of KCs that drives IRF1 expression resulting in caspase-8 activation and increased apoptosis after minimal exposures to UVB.

BACKGROUND: There is currently no proven surgical approach that prevents breast cancer related arm lymphedema (BCRAL). We hypothesized that the lymphatic microsurgical preventive healing approach (LyMPHA) during axillary lymph node dissection (ALND) could reduce BCRAL development. STUDY DESIGN: We conducted a single-center retrospective cohort study of patients with breast cancer who underwent ALND with or without immediate LyMPHA between 2016 and 2022. Primary outcomes were development of BCRAL and quality of life measures within 4 years of surgery. Secondary outcomes were days to drain removal and postoperative complications. Kaplan-Meier analysis determined risk of BCRAL over time. Cox regression analysis was used to determine risk factors associated with development of BCRAL. RESULTS: Of 187 patients who underwent ALND, 121 (64.7 %) received LyMPHA and 66 (35.3 %) underwent ALND only. The mean age was 56.4 ± 13.6 years. Patients who underwent LyMPHA had lower risk of lymphedema over time (p = 0.003), lower median percent functional impairment (4.7 % vs 11.6 %, p = 0.045), and shorter median drain duration (13.0 vs 15.0 days; p = 0.042). Regression analysis showed that those who received LyMPHA were half as likely to develop BCRAL (hazard ratio 0.53; 95 % CI 0.28-0.98; p = 0.043). Groups did not differ in the rate of postoperative complications. No other factors were associated with BCRAL, including age, body mass index, smoking status, or history of other cancer therapies. CONCLUSION: Performing immediate lymphatic reconstruction with LyMPHA after ALND may prevent arm lymphedema and reduce morbidity in patients with breast cancer.