bluuebunny/crossref_metadata_2025 huggingface dataset:
773 Diffusion-Weighted MRI Tractography of Midline Thalamic Subnuclei Characterizes the Return of Consciousness Following Severe Traumatic Brain Injury
Authors: Saluja Sabir , Saadon Jordan , Cosgrove Megan , Zhang Jason , Huang Chuan , Mikell Charles B. , Mofakham Sima
Published: March 2023

INTRODUCTION:

The prefrontal projections of the mediodorsal (MD) and central lateral (CL) thalamus have been implicated in the recovery of consciousness following severe traumatic brain injury (sTBI), but their specific roles are unknown. The CL has been proposed to modulate levels of arousal, while the MD modulates attention.

METHODS:

We generated tractograms in 25 patients with sTBI using DSI-Studio. The CL and MD were seeds and the orbitofrontal (OFC), dorsolateral prefrontal (dlPFC), medial prefrontal (mPFC), and anterior cingulate (ACC) cortices were targets. Fractional anisotropy (FA), a measure of tract integrity, and apparent diffusion coefficient (ADC), a proxy for neuronal injury, were computed for each tract and compared between the early (within 30 days post-injury) and late/no command followers. Spearman correlations were calculated between tract FA and ADC and final Glasgow Coma Scale (GCS) scores.

RESULTS:

Tractography revealed significantly increased MD-OFC tract FA in early compared late/no command followers (P = 0.0125). There was a statistically significant decrease in ADC in early compared late/no command followers in CL-dlPFC (P = 0.0281) and MD-dlPFC (P = 0.0454) tracts. GCS scores were significantly correlated with CL-ACC (P = 0.018) and CL-dlPFC (P = 0.0061) FA, and were not found to be significant in all MD tracts.

CONCLUSIONS:

The FA and ADC differences between early and late/no responders implicate tract integrity of the MD-OFC and dlPFC as key mediators in the return of command-following after TBI, respectively. The CL-ACC and CL-dlPFC tract FA were found to be associated with an increased final GCS score, which grades verbal, eye opening and motor responses. Our results corroborate the MD’s involvement in the content of consciousness, distinct from the CL’s in mediating the ascending arousal network.
806 Excess Postoperative Opioid Prescribing in Pediatric Neurosurgery
Authors: Ackerman Laurie L. , Ash Denise , Burroughs Leah
Published: March 2023

INTRODUCTION:

Introduction: The opioid crisis is worsening in the United States with opioid overdose deaths reaching record highs in 2020. Opioid medications prescribed at hospital discharge provide an unwitting source of excess opioids posing unique risks to pediatric patients, with half of pediatric overdoses in patients <2 years of age. Although legislative efforts have significantly limited opioid prescribing, recent studies suggest these medications may still be overprescribed.

METHODS:

Methods: Pediatric patients undergoing neurosurgical procedures at Riley Hospital for Children were identified prospectively. Surgery type, length of stay, and inpatient use of opioid and nonsteroidal (NSAID) medications were collected. Patients were contacted 7 days after hospital discharge and asked to report the number of post-discharge prescribed opioid and NSAID doses used.

RESULTS:

Results: 119 patients participated. An average of 22.3 doses of opioid medication were prescribed at discharge, with a mean 3.9 doses used at 7 days. Seventeen patients (14.3%) were prescribed concomitant NSAIDs, and 40 patients (33.6%) used zero doses of prescribed opioid medication. Patients aged ≤13 years used less prescribed opioid doses (x̄ = 15.1%) than patients aged 13-17 (x̄=23.8%). Trends toward increased opioid use in patients undergoing spinal procedures were observed. Patients prescribed NSAIDs used 19.4% of opioid doses compared to 17.2% in those not prescribed NSAIDs.

CONCLUSIONS:

Conclusion: Pediatric neurosurgery patients used only 17.5% of prescribed opioids in 7 days after hospital discharge, creating excess unused opioid medication that may increase the risk of accidental ingestion and misuse. Opioid prescription amounts were subsequently limited, and follow-up data collection continues. The present study highlights the need for educational initiatives for providers to minimize excess opioids prescribed and for parents to safely dispose of leftover opioid medication.
831 Evaluation of Trends in Gait Function Following Ventriculoperitoneal Shunt Placement in Patients with Idiopathic Versus Secondary Versus Neurodegenerative NPH: A Long Term Follow-Up of 63 Patients
Authors: Cunningham Coby , Barpujari Awinita , Kujawski Brandon , Thompson Diane , Lonich Ian , Leonardo Jody
Published: March 2023

INTRODUCTION:

Normal Pressure Hydrocephalus (NPH) most commonly presents in the elderly with symptoms such as gait dysfunction, urinary incontinence, altered mentation. In the current literature three categories of NPH are commonly considered: idiopathic (iNPH), secondary (sNPH), and neurodegenerative (nNPH). Due to variability in the causative pathology, NPH patients in each category may respond differently to ventriculoperitoneal shunt (VPS) placement over the long term.

METHODS:

An IRB approved retrospective review was conducted on 63 patients with diagnosed iNPH, sNPH, or nNPH who underwent shunt placement (2016 - present). Each patient was closely followed by a single surgeon and specialized team at our adult hydrocephalus clinic from time of symptomatic presentation through diagnosis, shunt placement, and post-operative assessments. Assessment at all pre- and post-operative visits included gait assessment via timed 25’ walk test (TW) and timed up-and-go (TUG) test.

RESULTS:

Long-term outcomes for the TW test, measured from baseline to most recent follow-up show that iNPH patients averaged an improvement of 4.83s (seconds), while sNPH and nNPH patients averaged improvements of 4.25s and 2.98s, respectively. Following the TUG test, the average improvement for iNPH patients was 4.37, with the improvement averages for sNPH and nNPH being 15.33s and 3.09s, respectively.

CONCLUSIONS:

There is a noticeable difference in the objective gait measurements at post-shunting follow-up among patients diagnosed with the three major categories of NPH. We believe the root of this variability lies within the specific causative factors for the respective patients’ NPH and may be particularly affected by the progressive degenerative nature of the nNPH category. Careful categorization of patients into each group may aid surgeons as they council their patients and set expectations for realistic post-operative courses.
832 Multiple Computations of Reward-Based Learning are Differentially Encoded in the Human Limbic Network
Authors: Huang Yuhao (Danny) , Kakusa Bina , Shivacharan Rajat , Feng Austin Y. , Parker Jonathon J. , Halpern Casey H.
Published: March 2023

INTRODUCTION:

Adaptive decision making requires the capacity to anticipate and detect rewarding or aversive outcomes. Prior animal and neuroimaging studies have implicated the limbic network as an important contributor to this process. However, how different limbic regions differ in supporting distinct phases of reward-related computations are not well understood.

METHODS:

Fourteen human participants undergoing electrographic monitoring were included based on implantation with a depth electrode targeting at least one of the following limbic regions: anterior cingulate, hippocampus, amygdala, orbitofrontal cortex, or anterior insula. Participants completed a reinforcement learning task known as the monetary incentive delay (MID) paradigm, which is a widely used computer-based task utilized in neuroimaging research to assay anticipatory and outcome signals to monetary reward and loss. A reinforcement model was constructed based on task behavioral data. Computations of this model were regressed against electrophysiologic signals.

RESULTS:

We found that an expectant value signal was encoded during both reward anticipation and outcome while prediction error was solely encoded in the outcome phase. Broadband gamma activity (25-180 Hz) positively scaled with expectation value and prediction error, while low-frequency activity (1-12 Hz) negatively scaled with prediction error. Limbic regions including the anterior insula, hippocampus, orbitofrontal and anterior cingulate cortices exhibited differential encoding schemes for reward valence. Finally, there was a difference in the distribution of individual channels across limbic regions encoding expectation value, prediction error, or both.

CONCLUSIONS:

These findings indicate spatially distributed limbic regions with their own unique functions support complex computations of reinforcement learning.
835 Rapid Prototyping, Digital Sculpting, and Computer Aided Design for Point of Care 3D Printed Stereo EEG Models
Authors: Austerman Ryan , Faraji Amir H.
Published: March 2023

INTRODUCTION:

Part of the workup for surgical management of epilepsy is stereotactic placement of intracranial depth electrodes to better understand the origin and network pattern of spread of seizures. To facilitate surgical decision making, epilepsy team discussion, and patient/family communication, a workflow was developed to create 3D printed models of sEEG patient brains and electrode locations which could be invaluable in explaining EEG results and surgical options.

METHODS:

Pre-op MRI and post-implantation CT scans of a sEEG case were imported and merged using 3D Slicer, a free and open-source software package for advanced medical imaging research.The CT was segmented to include only the high-density metallic electrodes. These 3D models were exported into Autodesk Fusion 360, a computer-aided design (CAD) program, where electrode models were designed based on their location on the CT scan. These models were exported to Maxon Zbrush to be cleaned and re-meshed to make the model easier to sculpt and manipulate.The electrode objects were used as cutting tools to create holes in the brain model. Finally, the relevant portion of the brain (right temporal lobe and surrounding regions) and electrodes were exported for 3D printing. The final models were 3D printed on a FormLabs Form 3 stereolithography (SLA) printer using clear resin for the brain and flexible grey resin for the electrodes.

RESULTS:

CONCLUSIONS:

A workflow was devised to print anatomic models of brains implanted with electrodes for seizure monitoring in 2-3 days utilizing software from multiple disciplines including medical imaging, CAD/engineering, and 3D sculpting used in the film and video game industries. Future models will include further anatomical definition with more advanced 3D sculpting and printing techniques.
866 Preclinical Study of Pamiparib, a CNS Penetrant PARP Inhibitor, in IDH1/2 Mutated Gliomas
Authors: Hong Christopher Sungwoon , Sundaram Ranjini , Bindra Ranjit
Published: March 2023

INTRODUCTION:

Our group demonstrated IDH1/2-mutated gliomas harbor intrinsic homologous recombination (HR) defects mediated by 2-HG, conferring sensitivity to PARP-inhibitors. We studied pamiparib, a CNS-penetrant PARP-inhibitor with potent PARP-trapping ability, in combination with TMZ and radiation in IDH1/2-mutated gliomas and its pharmacokinetics to demonstrate CNS penetrance.

METHODS:

We performed DNA-repair functional studies with in-vitro short- and long-term viability assays, and in-vivo studies utilizing an intracranial rat glioma model with bioluminescence imaging. Pharmacokinetics was measured with LCMS/MS from harvested tumor, normal brain, and blood.

RESULTS:

In-vitro viability assays in paired isogenic IDH1-wildtype and mutant U87 cells showed the IDH1 mutation conferred several-fold enhanced sensitivity to TMZ, as expected. Differential TMZ sensitivity was less pronounced in HCT116 cells, as expected given higher MGMT expression. ELISA confirmed PARylation inhibition by pamiparib at the nanomolar range in a dose-dependent manner. Enhanced pamiparib sensitivity was seen in IDH-mutant U87 and HCT116 cells compared to wildtype. Pamiparib and TMZ demonstrated synergistic interactions in U87 cells, dependent upon IDH1 mutation status. In HCT116 cells, TMZ resistance was overcome with pamiparib in wildtype and mutant cells but notably at lower doses in mutant cells. Synergy was observed with pamiparib and radiation in U87-mutant, compared to wildtype cells. Pharmacokinetics demonstrated favorable CNS penetration with tumor:plasma ratios (>0.20) with 3 mg/kg and 6 mg/kg doses of pamiparib, orally administered BID to rats harboring RG2-cell intracranial tumors. These levels persisted between 2- and 8-hours after last dosing. Pamiparib selectively penetrated tumors over normal brain with normal brain:plasma ratios <0.20.

CONCLUSIONS:

Pamiparib may selectively target IDH1/2-mutated gliomas and act synergistically with TMZ and radiation to exploit intrinsic HR defects. Pharmacokinetics suggest favorable CNS penetration after BID oral administration.
870 Association of MGMT Methylation With Response to Chemotherapy in WHO Grade 2 Low Grade Glioma
Authors: Chalif Eric , Young Jacob , Aghi Manish Kumar
Published: March 2023

INTRODUCTION:

The role of adjuvant chemotherapy (AC) in the treatment of low-grade glioma (LGG) has been an area of controversy. While of O6-methylgaunine-DNA-methyltransferase (MGMT) promoter methylation is a predictor of response to AC in high grade glioma, its relevance in LGG is uncertain.

METHODS:

Overall survival was evaluated using Kaplan-Meier estimates and multivariable Cox proportional hazards regression. Subgroup analyses were conducted in cohorts defined by tumor size, tumor location, histology, extent of resection, and receipt of radiation.

RESULTS:

Between 2004 and 2018, 1,139 participants were diagnosed with WHO grade 2 LGG (median [IQR] age, 40 years [31-53]; 578 were male [51%]; 614 were MGMT methylated (54%)). In multivariate analysis, among the 512 patients (45%) receiving AC, there was improved overall survival in methylated compared to unmethylated cohorts (hazard ratio [HR], 0.48; 95% CI, 0.32-0.72; p < 0.001). This association was not demonstrated in patients without AC (HR, 1.01; 95% CI, 0.63-1.60; p=0.985). On subgroup analysis, MGMT methylation status was associated with an independent improved response to chemotherapy in subgroups of patients with no 1p/19q codeletion [astrocytoma], tumor diameter ≥50mml, tumor diameter <50mm, frontal lobe tumors, radiotherapy, no radiotherapy, and subtotal resection MGMT methylation was not associated with improved response to chemotherapy in patients with 1p/19q codeletion [oligodendroglioma] or gross total resection.

CONCLUSIONS:

MGMT methylation status was associated with response to AC in adult astrocytic LGG, irrespective of treatment with radiation. This relationship was not present for oligodendroglioma. If replicated in contemporary trials, these findings will substantially guide treatment decisions for many LGG patients.
872 Disruption of KIF3a Increases Sensitivity of Primary Glioblastoma Cells to Temozolomide and Radiotherapy
Authors: Kaculini Christian , Springer Megan , Jung Mi-Yeon , Brown Desmond A.
Published: March 2023

INTRODUCTION:

Glioblastoma (GBM) is the most common primary malignant brain tumor, comprising 14.3% of all intracranial neoplasms and 49.1% of all malignant brain tumors. The current standard of care for newly diagnosed glioblastoma is maximal safe resection, 60 Gy of radiotherapy over a 6-week period, plus concomitant daily temozolomide, followed by adjuvant temozolomide over 6 months. Nonetheless, median overall and 5-year survival are only 15 months and 5%, respectively. Primary cilia are microtubule-based organelles that protrude from the apical surface of nearly all mammalian cells. They are critical to many canonical signaling pathways and are closely related to the cell cycle. They have been implicated in the formation and progression of many malignancies and are associated with resistance to chemoradiotherapy.

METHODS:

Patient-derived GBM cell lines were transduced with lentiviral particles to produce stable cell lines deficient in proteins essential for primary cilia regulation. Cell proliferation assays were used to assess sensitivity of each knockdown to temozolomide and radiotherapy.

RESULTS:

Proliferation of KIF3A knockdown cells was significantly decreased compared to control lines after radiotherapy (P = 0.009). GBM cells with disrupted primary cilia were more frequently found in the G2/M phase potentially explaining the increase in sensitivity. KIF3A depleted cells also displayed improved response to temozolomide. MGMT protein expression was decreased in these cells, providing a potential mechanism for the decrease in proliferation. This finding reveals a new relationship between primary cilia and MGMT, an extremely important biomarker that is commonly used to predict the efficacy of alkylating chemotherapy.

CONCLUSIONS:

Collectively, our findings provide strong evidence that primary cilia play an important role in resistance to the current standard treatment of GBM and identify KIF3A as a potential sensitizer to chemoradiation in GBM.
883 Impact of Awake Craniotomy within Eloquent Glioblastoma Subgroups (GLIOMAP): A Propensity-Score Matched Analysis of an International, Multicenter, Cohort Study
Authors: Gerritsen Jasper , Zwarthoed Rosa , Kilgallon John , Nawabi Noah , Jessurun Charissa , Versyck Georges , Pruijn Koen , Fisher Fleur , Lien Solie Emma Larivière; , Mekary Rania , Satoer Djaina , Schouten Joost , Bos Eelke , Kloet Fred , Tewarie Rishi Nandoe , Smith Timothy R. , Dirven Clemens , De Vleeschouwer Steven , Broekman Marike , Vincent Arnaud
Published: March 2023

INTRODUCTION:

Awake mapping has been associated with decreased neurological deficits and increased extent of resection in eloquent glioma resections. However, its impact within clinically relevant glioblastoma subgroups remains poorly understood.

METHODS:

Propensity-score matching with a 1:3 ratio was used to match awake with asleep patients for the overall cohort and subgroups stratified by age, NIHSS score and KPS. Cox proportional-hazard regressions and multiple multivarible logistic regressions were performed to analyze the independent impact of awake mapping.

RESULTS:

1047 patients with resection for primary eloquent glioblastoma between 2010 and 2020 were included. Overall, awake craniotomy resulted in fewer neurological deficits at 3 months and 6 months postoperatively; a lower residual tumor volume, a higher extent of resection, longer overall survival and progression-free survival. Regression analyses independently associated awake craniotomy with gross-total resection and overall survival. Awake craniotomy led in all subgroups to a higher extent of resection and in the subgroups age <70, NIHSS 0-1, NIHSS ≥ 2 and KPS 90-100 to less postoperative neurological deficits at 3 months and 6 months. For patients in the ≥70 years subgroup and KPS ≤ 80 subgroup, awake craniotomy led to less postoperative neurological deficits at 3 months (≥70 years) or 6 months (KPS ≤ 80). Median overall survival and progression-free survival were longer for the awake group in the subgroups aged <70, NIHSS 0-1 and KPS 90-100.

CONCLUSIONS:

Awake craniotomy was especially suitable in patients aged <70, with NIHSS score 0-1 or KPS 90-100, leading to decreased neurological morbidity, increased amount of tumor resection and improved OS and PFS. In patients aged ≥ 70, with NIHSS score ≥2 or KPS ≤ 80, awake craniotomy could be useful to prevent late deficits or to help patients maintain their performance status to undergo adjuvant therapy.
890 Disparities in Supportive Care Utilization Among Neurosurgical Patients With Malignant Central Nervous System Tumors
Authors: Jin Michael Chuwei , Hsin Gary , Ratliff John K. , Thomas Reena , Zygourakis Corinna Clio , Li Gordon , Wu Adela
Published: March 2023

INTRODUCTION:

Patients with central nervous system (CNS) malignancies benefit from palliative care (PC) in addition to other supportive services, such as home health and social work. Guidelines also propose early PC for patients with advanced cancers. Racial disparities exist in healthcare access, and we introduce a novel construct, “provider patient racial diversity index” (provider pRDI), higher categories of which refer to higher proportions of non-white patients a provider sees as a measure of the provider’s exposure to racial diversity and cultural sensitivity.

METHODS:

Using Optum Clinformatics Datamart Database, all patients with at least one neurosurgery encounter, diagnosis of primary or secondary CNS malignancy, and no prior supportive services were included. Patient-level demographics were collated. Supportive services were defined based on provider categorization on individual claims.

RESULTS:

The cohort of 48,722 patients demonstrated significantly low rates of PC, home health, and social work services among racial minorities. However, patients who saw providers categorized into high provider pRDI categories were increasingly more likely to interface with supportive services and at an earlier point in their disease courses. Patient race did not impact supportive service spending, but higher provider pRDI was associated with monotonic increases in spending on PC.

CONCLUSIONS:

Neurosurgical patients with CNS malignancies from minority backgrounds are less likely to receive supportive services. Such effect is mitigated when they encounter at least one provider who scores highly in provider pRDI; patients receive supportive services earlier and demonstrate greater utilization. Our study highlights patient-level healthcare disparities and the need for provider-level intervention to address cultural sensitivity.
Exploring Children’s Self-Reported Activity Compensation: The REACT Study
Authors: SWELAM BRITTANY A. , ARUNDELL LAUREN , SALMON JO , ABBOTT GAVIN , TIMPERIO ANNA , CHASTIN SEBASTIEN F. M. , RIDGERS NICOLA D.
Published: March 2023

Purpose

Previous research has focused on device-based measures of activity compensation, with little understanding of how children perceive potential compensatory responses to activity or inactivity, or whether these change after periods of activity or inactivity. The aim of this study was (a) to explore the alignment between children’s self-reported usual compensation and compensation recall after experimental conditions and (b) to examine sex differences.

Methods

In total, 360 children (47% boys) participated in at least one of three experimental conditions over 6 wk: (a) restricted physical activity (PA; indoor play), (b) imposed moderate- to vigorous-intensity PA (MVPA; sports class), and (c) imposed light-intensity PA (LPA; standing lesson). Before the first condition, children reported their “usual compensation” behavior to examples of restricted/imposed PA, and 2–3 d after each experimental condition, they completed a recall measure of their compensation after the condition. Multilevel regression models were conducted to determine whether children’s perceptions of “usual compensation” score were associated with recalled compensation score after imposed or restricted PA. Additional models were fitted for sex-specific associations.

Results

Overall and among girls, the usual compensation score was positively associated with the compensatory recall score for the additional MVPA and LPA conditions (P < 0.0005; e.g., they thought they would usually compensate for additional MVPA and then perceived that they compensated after additional MVPA). A negative association was seen in the restricted activity condition among girls (P = 0.03). All associations in the boys’ analyses were statistically nonsignificant.

Conclusions

These findings suggest some alignment between children’s self-reported usual compensation and compensation recall after imposed changes to routine activity. Future research should consider device-measured comparisons and identify characteristics of children at risk of activity compensation in future interventions.
The Effect of Exercise on Quality of Life in Type 2 Diabetes: A Systematic Review and Meta-analysis
Authors: SABAG ANGELO , CHANG COURTNEY R. , FRANCOIS MONIQUE E. , KEATING SHELLEY E. , COOMBES JEFF S. , JOHNSON NATHAN A. , PASTOR-VALERO MARIA , REY LOPEZ JUAN PABLO
Published: March 2023

Background

Exercise is a proven therapy for managing cardiometabolic risk factors in type 2 diabetes (T2D). However, its effects on patient-reported outcome measures such as quality of life (QoL) in people with T2D remain unclear. Consequently, the primary aim of this study was to determine the effect of regular exercise on QoL in adults with T2D. A secondary aim was to determine the effect of different exercise modalities on QoL. The third aim was to determine whether improvements in QoL were associated with improvements in gly'cated hemoglobin (A1C).

Methods

Relevant databases were searched to May 2022. Eligible studies included randomized trials involving ≥2 wk of aerobic and/or resistance exercise and assessed QoL using a purpose-specific tool. Mean differences and 95% confidence intervals (CI) were calculated as standardized mean difference (SMD) or weighted mean difference. A regression analysis was undertaken to examine the interaction between change in QoL with change in A1C.

Results

Of the 12,642 studies retrieved, 29 were included involving 2354 participants. Exercise improved QoL when compared with control (SMD, 0.384; 95% CI, 0.257 to 0.512; P < 0.001). Aerobic exercise, alone (SMD, 0.475; 95% CI, 0.295 to 0.655; P < 0.001) or in combination with resistance training (SMD, 0.363; 95% CI, 0.179 to 0.548; P < 0.001) improved QoL, whereas resistance training alone did not. Physical components of health-related QoL (HRQoL) improved with all exercise modalities, but mental components of HRQoL remained unchanged. Exercise improved A1C (mean difference, −0.509%; 95% CI, −0.806% to −0.212%; P = 0.001), and this change was associated with improvements in HRQoL (β = −0.305, SE = 0.140, Z = −2.18, P = 0.030).

Conclusions

These results provide robust evidence that regular aerobic exercise alone or in combination with resistance training is effective for improving QoL in adults with T2D. Such improvements seem to be mediated by improvements in physical components of HRQoL and are associated with improved blood glucose control. Further studies should be undertaken to determine the relative importance of exercise duration, intensity, and frequency on patient-reported outcomes such as QoL.
MR evaluation of the posteromedial corner of the knee: association of posterior horn medial meniscus tear with posterior oblique ligament and distal semi-membranosus tendon tear
Authors: Lee Jaehyung , Ahn Joong Mo , Kim Bo Ram , Kang Yusuhn , Lee Eugene , Lee Joon Woo , Kang Heung Sik
Published: March 2023

Objective:

To assess if posterior oblique ligament and distal semi-membranosus tendon tears are associated with posterior horn medial meniscus tears on MRI.

Methods:

From January 1, 2018 to December 31, 2019, 56 patients who met the inclusion criteria were enrolled in this study. Of the 56 patients, 43 patients who had a posterior horn of medial meniscus tear were included in the study group. A control group of 13 individuals was formed for comparison. Two radiologists reviewed the MR images and recorded the presence and grades of posterior oblique ligament and distal semi-membranosus tendon tears. We used the independent t-test and one-way ANOVA to compare the tear grades. Interobserver agreement was analyzed using a Cohen’s κ coefficient (κ value) for categorical variables.

Results:

The mean grades for the posterior oblique ligament and distal semi-membranosus tendon tears were significantly higher in the study group (all, p < 0.001). Interobserver agreement between the two readers was substantial in assessing the grade of posterior oblique ligament tear (κ = 0.653±0.087) and almost perfect in assessing the grade of distal semi-membranosus tendon tear (κ = 0.876±0.060).

Conclusion:

Posterior oblique ligament and distal semi-membranosus tendon tears are significantly associated with posterior horn of medial meniscus tear and medial meniscus posterior root tears, and the peel-back mechanism could be related to this association.

Advances in knowledge:

Presenting this paper could adjust radiologist search patterns and potentially help orthopedists with management and pre-surgical planning for the posteromedial corner injury of the knee.
Pharmacists’ readiness and willingness to vaccinate the public in United Arab Emirates community pharmacies: A cross-sectional study
Authors: Thomas Dixon , Abdalla Amal , Hussein Saeed , Joury Jean , Elshamy Amin , Khalifa Sherief , Saleh Ziad
Published: March 2023

Background: Pharmacist-administered vaccination is currently implemented in many countries worldwide. It has contributed to increased vaccine access and vaccine uptake. This observational cross-sectional study assessed community pharmacists’ willingness, and readiness to administer vaccines to the public in the United Arab Emirates (UAE) and relate it to national and international policies on vaccination. 

Methods: This research was an online survey of 24-questions that was made available to community pharmacists via social media and WhatsApp. The survey was open for six weeks (from April to June 2022). Descriptive and inferential analysis was performed.  

Results: The questionnaire was completed by 374 of 575 (65%) respondents. More than half (64.2%) of the respondents agreed or strongly agreed that pharmacists should be able to vaccinate and 68.4% responded that they were willing to administer vaccines if local regulations allowed them to vaccinate. Most (81.8%) expressed willingness to complete training required to be able to administer vaccines in their pharmacies. Logistic regression showed that pharmacists defined as having high readiness were significantly more willing to undergo all essential training to start a vaccination service in their pharmacies than were pharmacists with poor readiness (OR 2.647; 95% CI: 1.518–4.615; p=0.001). High readiness was also significantly associated with agreement on safety of pharmacy-based vaccination (p=0.027). 

Conclusions: The majority of community pharmacists surveyed showed readiness to commence pharmacy-based vaccination services. Those with high readiness characteristics are amenable to receiving essential training and consider that vaccination in the community pharmacy setting would be safe.
Towards achieving transnational research partnership equity: lessons from implementing adaptive platform trials in low- and middle-income countries
Authors: Modlin Chelsea , Sugarman Jeremy , Chongwe Gershom , Kass Nancy , Nazziwa Winfred , Tegli Jemee , Shrestha Prakriti , Ali Joseph
Published: March 2023

Background: Use of adaptive clinical trials, particularly adaptive platform trials, has grown exponentially in response to the coronavirus disease (COVID-19) pandemic. Implementation of these trials in low- and middle-income countries (LMICs) has been fostered through the formation or modification of transnational research partnerships, typically between research groups from LMICs and high-income countries (HICs). While these partnerships are important to promote collaboration and overcome the structural and economic disadvantages faced by LMIC health researchers, it is critical to focus attention on the multiple dimensions of partnership equity.

Methods: Based on informal literature reviews and meetings with leaders of one of the multinational COVID-19 adaptive platform trials, we describe what can be learned about research partnership equity from these experiences.

Results: We organize these considerations into eight thematic categories: 1) epistemic structures, 2) funding, 3) ethics oversight, 4) regulatory oversight, 5) leadership, 6) post-trial access to interventions, data, and specimens, 7) knowledge translation, and 8) research capacity strengthening and maintenance. Within each category we review the normative claims that support its relevance to research partnership equity followed by discussion of how adaptive platform trials highlight new dimensions, considerations, or challenges.

Conclusion: These observations provide insight into procedural and substantive equity-building measures within transnational global health research partnerships more broadly.
Gender inequity and COVID-19 vaccination policies for pregnant women in the Americas
Authors: Ambrogi Ilana , Brito Luciana , Griner Arbel , Bull Susan
Published: March 2023

The region of the Americas has been the epicenter of the COVID-19 pandemic’s worst outcome in terms of number of deaths due to COVID-19. SARS-CoV-2 infection during pregnancy and the postpartum period has been found to be associated with increased risk of mortality and severe disease. Several Latin American and Caribbean countries have disproportionally high maternal mortality rates due to COVID-19. Although this region achieved relatively high vaccination rates among the general adult population, there were differing restrictions regarding the vaccination of those who were pregnant. In a pandemic, policies reflect political priorities in responses to the threats posed to populations and play an important role in promoting gender equity. This paper reports the results of an ethical analysis of 45 national COVID-19 vaccination public policies from seven countries – Argentina, Brazil, Canada, Colombia, Mexico, Peru, and United States. The analysis drew on reproductive justice and feminist bioethics frameworks, paying close attention to whether and how gender and social and economic inequities were addressed. It found that exclusionary approaches in immunization policies which restricted access to vaccination during pregnancy were often justified on the basis of a lack of evidence about the effects of immunization of pregnant persons, and on the grounds of medical expertise, to the detriment of women’s autonomy and agency. As such these policies reiterate patriarchal moral understandings of women, pregnancy and motherhood. In practice, they counter human rights gender equity and equality principles, and became lethal, particularly to racialized women in Latin America. During an emerging lethal disease, policies and policy development must consider the intersection of oppressive structures to protect and guarantee rights of women, girls, and pregnant persons.
Travelers’, migrants’ and refugees’ health – individual, population and systemic aspects
Authors: Cianciara Dorota , Pruszyński Jacek , Włodarczyk-Pruszyńska Inga , Padzińska-Pruszyńska Irena , Szmigiel Andrzej
Published: March 2023

Introduction
Mobility, the ability to move from the place of residence, is a sign of the times. It results from many grounds and conditions. Numerous groups of mobile people can be distinguished. Changing the place of residence poses a health risk for mobile persons and, in the case of infectious diseases, also for people who may be in contact with them. Two groups of mobile people are in focus of the public health: the travelers and migrants and refugees.
Purpose
A panoramic presentation of selected issues related to multifacets and complex problem of travelers and migrants, health. Health risks and health interventions related to travel and migration are discussed, as well as system solutions for the health of travellers, migrants and refugees.
State of knowledge
Departures of travelers are induced by intrapersonal factors. The health risk depends on the state of health, the travel/transport conditions and mode, the specificity of the destination and the behavior of the traveller. Risk factors are relatively well recognized, including those of a biological nature. Health interventions have a long tradition, there are rules for systemic actions, but improvement of existing solutions is expected.
Departures of migrants and refugees are caused by external factors. Health risk is multidimensional and related to the migration phase (pre-migration, movement, arrival). Risk factors for the health of migrants are insufficiently recognized and can be of a very diverse nature - physical, chemical, biological, psychophysical and social. Health interventions are poorly established and focused on improving access to healthcare. The necessity for a broader spectrum of activities, including political, interdisciplinary, multisectoral and global ones is pointed.
Summary
Travelers’, migrants’ and refugees’ health are becoming increasingly important nationally and internationally.
ONLINE ACADEMIC LEADERSHIP PROGRAMS IN THE UNITED STATES: AN OVERVIEW
Authors: Guthrie Kathy L. , Hu Pei
Published: March 2023

Technology has transformed education by providing access and opportunities for learning through online formats. Leadership education has not been left out in this transformation as many higher education institutions offer online leadership courses and programs to college students. This case study’s primary purpose was to develop a fundamental understanding of the program characteristics of leadership programs offered fully online in higher education. The content analysis on 51 online academic leadership programs within 33 universities shows that these programs share similar characteristics in their goals, targeted student populations, and methods of engaging and supporting students in online leadership learning.
UNDERSTANDING THE IMPACT OF CASE-IN-POINT COURSES IN GRADUATE LEADERSHIP PROGRAMS
Authors: Weng John , Hubbard Lea
Published: March 2023

There exists a variety of programs designed to prepare future leaders. In the arena of graduate programs in leadership, the International Leadership Association (2020) provides over 350 programs in their database. Guthrie and Jenkins (2018) have outlined dozens of strategies for leadership education that are utilized in degree programs. As such, there exists a need for informed choices when experiential learning pedagogies are incorporated in leadership education curriculum. One methodology, known as case-in-point, was designed at the Harvard Kennedy School to teach adaptive leadership (Heifetz & Linsky, 2017). There lacks empirical research in demonstrating the effectiveness and impact of case-in-point pedagogy. This qualitative study explored the perceived impact of 12 alumni who took a case-in-point course embedded in a leadership master’s program across a decade. Alumni’s retrospective experiences were collected to understand the impact the course had on them during the time they were in their leadership program and the impact of the learning for their professional lives. Key themes that emerged from the participants included increased levels of awareness in race and power dynamics, an increased use of self-as-instrument, awareness of relationships to authority, and shifts in views of leadership. All participants viewed the case-in point pedagogy as powerful or positive after having graduated from the program despite many recollections of mixed or negative experiences during their time in the course/s. Implications of the findings suggest important considerations relating to scaffolding and proper processing to enhance or improve outcomes for case-in-point pedagogy designed to enhance leadership ability.
LEADERSHIP EDUCATION AT HISPANIC SERVING INSTITUTIONS IN THE SOUTHWEST UNITED STATES: WHAT DOES IT LOOK LIKE?
Authors: Noopila Mari Ysela , Pichon Henrietta Williams
Published: March 2023

This scholarly paper explores leadership education across Hispanic Serving Institutions (HSIs) in the Southwest of the United States. We searched for inclusion of social justice, ethics, and community engagement aspects within leadershipprograms.LeadershipeducationprogramsinhighereducationandspecificallyatHSIsmustbeintentional about offering programs, curriculum, and experiences that adopt inclusion of those who are underrepresented within the leadership realm. While scholarship concerning HSIs as complex organizations has grown, consideration of how leadership education programs contribute to truly serving their unique students is still in its infancy. This inquiry found that there are a number of similarities among leadership programs at HSIs in the way of academic location, degree offerings, and class format, but it also details missing characteristics of social justice, ethics, and community engagement within these areas. We propose that through further examination and future research, a framework of leadership education with underpinnings of social justice, ethics, and community engagement can be beneficial in truly serving underserved and underrepresented student populations specifically at HSIs.
RELATIONSHIP BETWEEN VOLUNTEER STEWARDSHIP ACTION-TAKING EXPERIENCES AND THEIR LEADERSHIP COMPETENCIES DURING THE COVID-19 PANDEMIC
Authors: Windon Suzanna , Buchko Olga
Published: March 2023

The purpose of this quantitative study was to assess the relationship between volunteer leadership competencies and stewardship action-taking experiences among Master Gardener (MG) and Master Watershed (MW) volunteers during the COVID-19 pandemic. We collected data from 1196 Penn State Extension MG and MW respondents. The mean summative score for the volunteer stewardship action-taking experience was 2.32 (SD = .79), and volunteer leadership competencies was 3.45 (SD = .60). The results of this study showed a significant moderate association between volunteer stewardship action-taking experiences and volunteer leader competencies (r = .34, p ≤ .001). Volunteer leadership competencies can explain approximately 11 % of the variation in volunteer stewardship action-taking experiences during the COVID-19 pandemic. The new knowledge that our research brings can significantly contribute to the practice in leadership teaching and learning of Extension organizations’ volunteers. Future leadership trainings on the enhancement of the MG and MW volunteer leaders’ stewardship action-taking capacity can help contribute to the greater good in their communities in a more confident and efficient manner. Further research should focus on identifying other factors that can affect MG and MW stewardship action-taking experiences, including the impact of the demographics and motivation.
A LETTER WRITING ASSIGNMENT FOR LEADERSHIP DEVELOPMENT: Creating Stakeholder Connection For Policy Advocacy
Authors: Bloomquist Candace , Speranza Carly , Bergland Daneen , Fierke Kerry K.
Published: March 2023

The purpose of this article is to share with leadership educators a writing exercise designed to provide doctoral students enrolled in an Administrative and Policy Leadership course an opportunity to gain experience with building collective will for policy advocacy on a social justice issue. This article describes the use of a letter writing assignment including the background and justification for using letter writing rather than other forms of writing across the curriculum, instructions for students to complete the assignment, and examples and ideas for grading and providing constructive and instructive feedback to leadership students. The article concludes with recommendations and potential assignment modifications for leadership educators that choose to adopt this type of writing assignment within their leadership training curriculum.
WHO WANTS TO BE HERE? Empirically Investigating Motivation and Engagement During Leader Development
Authors: Wallace David M. , Zaccaro Stephen J.
Published: March 2023

We present a framework for understanding the relationship between individual differences in leaders’ motivations and their engagement in leader development, and we empirically test that framework across three different operationalizations of engagement, demonstrating that the motivation to develop as a leader (MTDL) is distinct from other motivational constructs (specifically, motivation to lead and motivation to learn) and that MTDL differentially predicts engagement in leader development. Finally, we provide evidence that motivation and engagement mutually reinforce each other in a virtuous spiral during leader development.
CONDUCTING LEADERSHIP PROGRAM REVIEWS IN U.S. HIGHER EDUCATION: A Comparative Case Study
Authors: Jenkins Daniel M. , Rocco Melissa L.
Published: March 2023

Program reviews are standard practice in higher education. Yet, due to the infancy of the leadership discipline, little is known about the process of conducting reviews of leadership programs. Through interviewing 13 experienced leadership program reviewers in both curricular and co-curricular contexts, the authors of this study aim to address this gap in the literature. A comparative case study was employed to learn more about what encompasses a leadership program review and elicit experience-based practices for facilitating leadership program reviews in higher education. A thematic analysis of the interview transcripts was conducted by the researchers and the four major themes of review logistics, reviewer experiences, review outcomes, and lessons learned are shared in this study. The researchers found contextual factors related to the institutions and leadership programs, reviewer facilitation skills, setting clear expectations of the review process and outcomes, identifying resources, and nuances related to power considerations and political dynamics to be primary factors in conducting leadership program reviews. The authors close by offering implications for research and practice based on these findings.
QUEER REPRESENTATION IN LEADERSHIP EDUCATION: An Integrative Literature Review
Authors: Holden Sarah E.M. , Bruce Jacklyn A.
Published: March 2023

Modern leadership educators have shown an increased interest in empowering queer student leaders and making campuses more equitable for queer people. These educators help shape the policies, programs, and curriculums that directly impact how queer people experience higher education. Yet there appears to be a dearth of abundant literature on queer people and their experiences as they relate to leadership education. This integrative literature review explores the existing literature on the relationship between leadership education and the queer community over a thirty-year period. The results suggest that queer people are being represented more equitably than they were thirty years ago, but that representation does not extend to all members of the queer community.
JOLE 20TH ANNIVERSARY EDITORIAL ADVISORY BOARD
Authors: Noble Donnette , Hastings Lindsay , Bruce Jackie , Fine Leigh , Buschlen Eric , Leupold Chris
Published: March 2023

The JOLE Editorial Advisory Board provides an introduction to the 20th anniversary issue of The Journal of Leadership Education.
Uniqueness of Clearing Payment Matrices in Financial Networks
Authors: Csóka Péter , Herings P. Jean-Jacques
Published: March 2023

We study bankruptcy problems in financial networks in the presence of general bankruptcy laws. The set of clearing payment matrices is shown to be a lattice, which guarantees the existence of a greatest clearing payment and a least clearing payment. Multiplicity of clearing payment matrices is both a theoretical and a practical concern. We present a new condition for uniqueness that generalizes all the existing conditions proposed in the literature. Our condition depends on the decomposition of the financial network into strongly connected components. A strongly connected component that contains more than one agent is called a cycle, and the involved agents are called cyclical agents. If there is a cycle without successors, then one of the agents in such a cycle should have a strictly positive endowment. The division rule used by a cyclical agent with a strictly positive endowment should be positive monotonic, and the rule used by a cyclical agent with a zero endowment should be strictly monotonic. Because division rules involving priorities are not positive monotonic, uniqueness of the clearing payment matrix is a much bigger concern for such division rules than for proportional ones. As a final contribution of the paper, we exhibit the relationship between the uniqueness of clearing payment matrices and the continuity of bankruptcy rules, a property that is very much desired for stability of financial systems.

Funding: This research was supported by the Higher Education Institutional Excellence Program 2020 of the Ministry of Innovation and Technology in the framework of the “Financial and Public Services” research project [Grant TKP2020-IKA-02] at Corvinus University of Budapest. P. Csóka received funding from the National Research, Development and Innovation Office [Grants K-120035 and K-138826].