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This article demonstrates how educators can create opportunities for students to learn about leadership in a variety of circumstances. Through the integrated model for contextualizing leadership learning, educators can center culturally relevant leadership while considering the environment where leadership learning is provided as well as the context in which the identity, capacity, and effectiveness of leadership educators are developed. The implications of this integrated approach emerged from 26 narratives and are explored through three themes centered on co-curricular program development and implementation, as well as personal and professional development. These themes include examining organizations' histories and structures, the developmental readiness of educators and students, and the significance of context.

Cognitive scientists attribute representations to complex systems in order to explain their behavior. The shocking facility with which Large Language Models (LLMs) perform difficult linguistic and non-linguistic tasks has generated an increasing amount of speculation concerning what sorts of internal representations might underlie this behavior (whether personal, sub-personal, and of which kinds) and what properties such representations might have (for instance, whether they are grounded). This paper aims to elaborate and defend a conservative explanatory methodology, based on analyses of particular LLM behaviors, according to which attribution of sub-personal representations is key to explaining model performance which is robust, systematic, and flexible, especially in zero-shot settings, and that behavioral benchmarking alone is insufficient to resolve questions about representation due to the mutual underdetermination of performance and competence. The resulting view should help frame future explanations of LLM behavior, and provide an empirically grounded alternative to mere a priori speculation.

Chyle leak is a relatively rare post-operative complication of breast and axilla surgery, and the majority of these cases can be managed conservatively. We present the case of a 42-year-old female with chyle leak within the external thoracic cavity following elective augmentation mammoplasty and mastopexy. This patient failed initial operative management consisting of implant removal, washout, suture plication, and intra-operative drain placement as well as subsequent conservative management including diet modification, total parenteral nutrition, and percutaneous aspiration. Ultimately, this patientʼs chyle leak was successfully managed with lymphangiography and thoracic duct embolization. To our knowledge, this is the first documented case of successful use of lymphangiography with embolization to manage chyle leak within the superficial chest, and this intervention should be considered when contemplating management of this post-operative complication within the breast cavity.

Hazing--a form of interpersonal and community violence often minimized and normalized as tradition--can negatively impact students, undercut university missions, and contribute to harmful campus environments. While student hazing is a problem, postsecondary leaders are also grappling with legacies of whiteness and white supremacy that have shaped campus culture, including taken-for-granted norms and traditions. Using Critical Whiteness Studies (CWS) as a framework (Cabrera et al., 2017), this qualitative study explored how perceptions of campus hazing may reflect and contribute to perpetuating white supremacy in a sample of U.S. universities. Across 12 institutions, 7 public and 5 private, 345 individuals--169 staff members, 167 students, and nine alumni--were interviewed, primarily in focus groups, sharing perceptions of campus culture and hazing climate. Tradition, with themes of alumni involvement and influence, pride, and space, is discussed, illuminating how whiteness and white supremacy is reinscribed via campus hazing.

Purpose: This qualitative study aims to provide insights and reflections of how the pandemic affected the identity and a sense of self of students, who completed undergraduate leadership learning academic program. Design/methodology/approach: Interviews. Findings: Findings of this study showed three major themes throughout the interviews. During the COVID-19 pandemic, participants identified experiences with self-reflection, building community and navigating issues of social justice. Originality/value: These findings highlight how leadership learning enabled certain participants to navigate and seek to resolve these problems and how their leadership learning aided their own self-discovery.

This study highlights opportunities for developing programs and initiatives to assist Black men in understanding leadership and seeing themselves as leaders, and for decreasing low college retention and persistence rates. The themes from this qualitative narrative inquiry highlight leader identity, capacity, and efficacy for undergraduate Black men. Narrative inquiry was appropriate for this study because the researchers sought to better understand how Black undergraduate male student leaders make meaning of their experience in higher education related to their comprehension of leadership and identity as leaders.

Abstract Background The recent global pandemic due to severe acute respiratory syndrome coronavirus-2 resulted in a high rate of multi-organ failure and mortality in a large patient population across the world. As such, a possible correlation between acute kidney injury (AKI) and increased mortality rate in these patients has been suggested in literature. Methods This is a two-year retrospective study of critically ill adult patients infected with COVID-19 that were admitted to the intensive care unit (ICU) on ventilatory support. Two groups of patients were identified in this study, those who were directly admitted to the ICU or those who were initially admitted to the Medical Floor and were later transferred to the ICU due to either worsening respiratory status or change in their hemodynamic conditions. Within each group, three subgroups were created based on the status of AKI, namely, those who did not develop AKI, those who developed AKI, and those who with previous history of dialysis dependent AKI. Results The AKI subgroup had the highest mortality rate in the ICU and Floor patients. Of note, those patients who were directly admitted to the Floor and were later transferred to the ICU for worsening conditions also experienced a higher mortality rate if they had developed AKI during their course of hospital stay. Conclusions This study identified a statistically significant higher mortality in patients who developed AKI than those who did not develop AKI among critically ill patients. Trial registration Clinicaltrials.gov registration number NCT05964088. Date of registration: July 24 2023.

We present a synthesis of glacial geomorphology comprising Newfoundland and the surrounding continental shelf. During the last glaciation, this region was encompassed by the Newfoundland Ice Cap that coalesced with the Laurentide Ice Sheet and extended to the continental shelf edge. The subglacial geomorphic signal of terrestrial and marine portions of this ice sheet has been mapped using aerial photography, satellite imagery, SRTM DEMs, multibeam bathymetric data and onshore field mapping over the last 50 years. Here, we build on this, digitizing ∼146,380 features identified in published literature. Using newly available digital elevation data and multibeam bathymetric data, we identify ∼38,550 new features, such as undocumented ice thrust, crevasse and esker ridges and meltwater channels. This updated geomorphological map provides a record of paleo landforms over Newfoundland, enabling future efforts to reconstruct the dynamics, timing and erosion history of ice advance and retreat during the last glacial period..

Development occurs over the lifespan, and student affairs educators are not exempt from that life-long process. This article examined the coming out experiences of gay men within student affairs master's preparation programs. The study was comprised of 11 participants representing seven different higher education/student affairs administration programs. The findings of this study offer the following: first, the study offers insight on the coming out experiences of gay men in graduate preparation programs. Second, the findings showcase the role that student affairs programs, curriculum, and instruction play in the identity exploration process for gay men. Finally, findings from this study offer implications for pedagogical approaches and frameworks within student affairs/higher education administration programs.

ObjectiveDespite advances in the treatment of psychiatric diseases, currently available therapies do not provide sufficient and durable relief for as many as 30-40% of patients. Neuromodulation, including deep brain stimulation (DBS), has emerged as a potential therapy for persistent disabling disease, however it has not yet gained widespread adoption. In 2016, the American Society for Stereotactic and Functional Neurosurgery (ASSFN) convened a meeting with leaders in the field to discuss a roadmap for the path forward. A follow-up meeting in 2022 aimed to review the current state of the field and to identify critical barriers and milestones for progress.DesignThe ASSFN convened a meeting on June 3, 2022 in Atlanta, Georgia and included leaders from the fields of neurology, neurosurgery, and psychiatry along with colleagues from industry, government, ethics, and law. The goal was to review the current state of the field, assess for advances or setbacks in the interim six years, and suggest a future path forward. The participants focused on five areas of interest: interdisciplinary engagement, regulatory pathways and trial design, disease biomarkers, ethics of psychiatric surgery, and resource allocation/prioritization. The proceedings are summarized here.ConclusionThe field of surgical psychiatry has made significant progress since our last expert meeting. Although weakness and threats to the development of novel surgical therapies exist, the identified strengths and opportunities promise to move the field through methodically rigorous and biologically-based approaches. The experts agree that ethics, law, patient engagement, and multidisciplinary teams will be critical to any potential growth in this area.

Abstract Introduction Skin involvement in patients with psoriatic arthritis (PsA) worsens the severity and burden of disease. Ixekizumab (IXE), a selective interleukin (IL)-17A antagonist, was compared to placebo (PBO) in the SPIRIT-P1 (NCT01695239) and SPIRIT-P2 (NCT02349295) studies in patients with PsA and evidence of plaque psoriasis. This post hoc analysis reports musculoskeletal, skin, and nail outcomes through week 24 in patients from SPIRIT-P1 and SPIRIT-P2, stratified by mild, moderate, or severe psoriasis at baseline. Methods This post hoc analysis pooled patients from SPIRIT-P1 and SPIRIT-P2 who were randomly assigned to PBO or IXE 80 mg every 4 weeks (Q4W) or every 2 weeks (Q2W). Efficacy outcomes were analyzed through week 24 by baseline psoriasis severity, defined by percent body surface area (BSA) affected; mild = BSA 10%. The primary outcomes assessed were the proportion of patients achieving American College of Rheumatology (ACR)20, ACR50, and ACR70 responses. Secondary outcomes included musculoskeletal, disease activity, skin and nail, and health-related quality-of-life measures. Results Similar proportions of patients achieved ACR20/ACR50/ACR70 over time across all severity subgroups and treatment arms. More than one-third of IXE-treated patients achieved ACR20 at week 4, or ACR50 at week 24, with no significant differences according to psoriasis severity at baseline. Disease activity outcomes were similar through week 24 with both IXEQ4W and IXEQ2W, regardless of psoriasis severity at baseline. There were no significant differences over 24 weeks in the proportions of IXE-treated patients with mild, moderate, or severe baseline psoriasis who achieved Minimal Disease Activity (MDA). Across all severity subgroups, IXE demonstrated Psoriasis Area Severity Index 100 response as early as week 4, and approximately one-third of IXE-treated patients achieved total skin clearance at week 24. Conclusion IXE demonstrated rapid and consistent efficacy in joint, skin, and nail for patients with PsA, regardless of baseline psoriasis severity. Trial Registration SPIRIT-P1 (NCT01695239), SPIRIT-P2 (NCT02349295).

Abstract The Integrative Cluster subtypes (IntClusts) provide a framework for the classification of breast cancer tumors into 10 distinct groups based on copy number and gene expression, each with unique biological drivers of disease and clinical prognoses. Gene expression data is often lacking, and accurate classification of samples into IntClusts with copy number data alone is essential. Current classification methods achieve low accuracy when gene expression data are absent, warranting the development of new approaches to IntClust classification. Copy number data from 1980 breast cancer samples from METABRIC was used to train multiclass XGBoost machine learning algorithms (CopyClust). A piecewise constant fit was applied to the average copy number profile of each IntClust and unique breakpoints across the 10 profiles were identified and converted into ~ 500 genomic regions used as features for CopyClust. These models consisted of two approaches: a 10-class model with the final IntClust label predicted by a single multiclass model and a 6-class model with binary reclassification in which four pairs of IntClusts were combined for initial multiclass classification. Performance was validated on the TCGA dataset, with copy number data generated from both SNP arrays and WES platforms. CopyClust achieved 81% and 79% overall accuracy with the TCGA SNP and WES datasets, respectively, a nine-percentage point or greater improvement in overall IntClust subtype classification accuracy. CopyClust achieves a significant improvement over current methods in classification accuracy of IntClust subtypes for samples without available gene expression data and is an easily implementable algorithm for IntClust classification of breast cancer samples with copy number data.

The movement ecology of Bull Trout (Salvelinus confluentus) in watersheds at the northern geographic range extent is not well understood. We implanted 54 Bull Trout with acoustic transmitters in the Prairie Creek watershed, Northwest Territories, Canada and tracked fish from July 2011 to October 2012 using 19 stationary hydrophones. Bull Trout movement patterns generally corresponded to two groups, as a result of individual variation within and across seasons. The first group exhibited seasonal variations in movement and habitat use, moving most (range 11.7–115.9 km) and occupying the largest home ranges in summer and autumn, while exhibiting little movement during winter and spring. The second group made negligible movements within seasons and resided in localized areas. Restricted movement in winter resulted in a severe range contraction. The average distance moved within a season was 11.5 km (range 0.3–64.9 km per fish). The unusually high prevalence of stationarity in this watershed suggest fish can complete all life processes (spawning, feeding, and rearing) in short reaches (

Abstract Vestibular schwannomas (VS) are benign tumors that lead to significant neurologic and otologic morbidity. How VS heterogeneity and the tumor microenvironment (TME) contribute to VS pathogenesis remains poorly understood. In this study, we perform scRNA-seq on 15 VS, with paired scATAC-seq (n = 6) and exome sequencing (n = 12). We identify diverse Schwann cell (SC), stromal, and immune populations in the VS TME and find that repair-like and MHC-II antigen-presenting SCs are associated with myeloid cell infiltrate, implicating a nerve injury-like process. Deconvolution analysis of RNA-expression data from 175 tumors reveals Injury-like tumors are associated with larger tumor size, and scATAC-seq identifies transcription factors associated with nerve repair SCs from Injury-like tumors. Ligand-receptor analysis and in vitro experiments suggest that Injury-like VS-SCs recruit myeloid cells via CSF1 signaling. Our study indicates that Injury-like SCs may cause tumor growth via myeloid cell recruitment and identifies molecular pathways that may be therapeutically targeted.

Background: Information transmission into the human nervous system is the basis for a variety of prosthetic applications. Spinal cord stimulation (SCS) systems are widely available, have a well documented safety record, can be implanted minimally invasively, and are known to stimulate afferent pathways. Nonetheless, SCS devices are not yet used for computer-brain-interfacing applications. Objective: Here we aimed to establish computer-to-brain communication via medical SCS implants in a group of 20 individuals who had been operated for the treatment of chronic neuropathic pain. Methods: In the initial phase, we conducted interface calibration with the aim of determining personalized stimulation settings that yielded distinct and reproducible sensations. These settings were subsequently utilized to generate inputs for a range of behavioral tasks. We evaluated the required calibration time, task training duration, and the subsequent performance in each task. Results: We could establish a stable spinal computer-brain interface in 18 of the 20 participants. Each of the 18 then performed one or more of the following tasks: A rhythm-discrimination task (n = 13), a Morse-decoding task (n = 3), and/or two different balance/body-posture tasks (n = 18; n = 5). The median calibration time was 79 min. The median training time for learning to use the interface in a subsequent task was 1:40 min. In each task, every participant demonstrated successful performance, surpassing chance levels. Conclusion: The results constitute the first proof-of-concept of a general purpose computer-brain interface paradigm that could be deployed on present-day medical SCS platforms.

This article explores how doctoral graduates in Aotearoa New Zealand are being impacted by the COVID-19 pandemic. A survey captured the employment and mobility situations of doctoral graduates from 2019 to early 2021 from six of the eight universities in NZ. The 406 survey responses were analysed using descriptive statistics, as well as drawing on Cognitive Information Processing (CIP) theory in an inductive analysis of freeform comments. Most respondents were aspiring to academic careers, but the pandemic led to the loss of job offers for 19.2% and altered career plans for 60.6%. Family circumstances impacted career decisions for 21.4% and these were complicated by mobility difficulties with border closures and visa issues. The impacts of the pandemic on careers were significantly greater for international graduates. The qualitative analysis revealed themes of uncertainty, complications, pragmatism and academia. Using CIP, it is apparent that the pandemic has created a more complex job environment and heightened stress and anxiety over career and mobility options. As shown in our conceptual model, NZ universities need to better prepare graduates for the landscape of career possibilities, making students aware of their attributes, supporting their wellbeing, and helping them navigate the complexity of the current job environment.

This article explores how leadership functions as a form of identity among other multiple and often intersecting social identities. This article reviews emerging scholarship addressing racial identity, gender identity, and LGBTQ+ identities in diverse postsecondary institutional contexts. Finally, the article concludes with examples and implications for centering social identities for leadership educators who study, practice, teach, and develop leadership in higher education.