A case report of spontaneous gastric perforation in a premature and low-birth weight neonate.

Introduction: Spontaneous gastric perforation of the neonate is a rare phenomenon with a high risk of mortality. Despite an uncertain etiology, an association with prematurity and low-birth weight has been demonstrated. Prompt surgical repair and intensive care remain imperative to survival.

What Works? Fostering Inclusivity in Physician Assistant/Associate Education: The Retention, Outreach, Alignment, and Diversity (ROAD) Framework.

Introduction: There are well-known strategies to increase diversity in health professions education, evidence is sparse on how such strategies are practically implemented and longitudinally sustained. This study investigated the most widely used strategies across physician assistant/associate (PA) educational programs that have consistently demonstrated the ability to graduate racial and ethnic underrepresented students.

Methods: Following a grounded theory, qualitative interviews were conducted with 41 nationally accredited PA programs identified as top performers in consistently graduating racial and ethnic underrepresented students.

Academic Rank Disparities in Minoritized and Racialized Physician Assistant Educators.

Purpose: The aim of this study was to investigate the disparities in career progression and the need for inclusive mentorship in the physician assistant (PA) profession, specifically focusing on racial/ethnic minority faculty.

Methods: Pooled data from the Physician Assistant Education Association Program Survey in 2015, 2017, and 2019 were analyzed to examine the effect of PA faculty race/ethnicity on academic rank promotion. Logistic regression models were used to assess the association between faculty race/ethnicity and the likelihood of being in a middle/late-career (associate/professor) or early-career status (instructor/assistant), adjusting for confounding factors.

The role of traditional social determinants of health in referral patterns, timing of surgery, and Chiari Health Index for Pediatrics-determined quality of life in children with symptomatic Chiari type I malformation.

Objective: Understanding the impact of the social determinants of health on the utilization of healthcare resources is an important step in eliminating inequalities. The goal of this study was to determine the role of social determinants of health in referral patterns, timing of consultation/intervention, and quality of life in children with Chiari malformation type I (CM-I).

Methods: A retrospective study was conducted of children aged 0 to 18 years who underwent surgical treatment for CM-I at a single pediatric facility from 2015 to 2019.

Association between preoperative hematologic markers and aggressive behavior in meningiomas.

Introduction: Meningiomas have varying degrees of aggressive behavior. Some systemic hematologic makers are associated with malignancy, but their value in predicting aggressive meningioma behavior is not fully understood.

Objective: To evaluate the association between preoperative markers such as neutrophil-lymphocyte ratio (NLR), neutrophil-monocyte ratio (NMR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), and prognostic nutritional index (PNI), and diagnostic and prognostic factors including WHO grade, proliferation index, presence of edema on preoperative MRI, and tumor recurrence.

Conditional Recurrence-Free Survival After Surgical Resection of Meningioma.

Background: Recurrence after meningioma resection warrants serial surveillance imaging, but little evidence guides the optimal time interval between imaging studies/surveillance duration.

Objective: To describe recurrence-free survival (RFS) after meningioma resection, conditioned to short-term RFS.

Methods: A retrospective cohort study for adults presenting for meningioma resection from 2000 to 2018 was conducted.

Matched case-control analysis of outcomes following surgical resection of incidental meningioma.

Purpose: The management of incidentally discovered meningioma remains controversial. We sought to compare outcomes following surgical resection of incidental meningioma to a matched cohort of symptomatic meningiomas.

Methods: A retrospective single-center case-control study was conducted for patients undergoing resection of incidental meningioma from 2000 to 2019.

Assessing and benchmarking equity, diversity, and inclusion in healthcare professions.

Healthcare professions are among the fastest growing careers in the United States, but the issues of equity, diversity, and inclusion remain a challenge. The percentage of underrepresented minority groups is disproportionately small despite many efforts to increase workforce diversity over the past several decades. As the demographics in our nation are rapidly changing, increasing racial, ethnic, and cognitive diversity is crucial to achieving a workforce with the capacity to provide accessible and equitable healthcare.

An assessment of physician assistant student diversity in the United States: a snapshot for the healthcare workforce.

Background: The Physician Assistant (PA) workforce falls short of mirroring national demographics mainly due to a lack of diversity in student enrollment. Few studies have systematically examined diversity across PA programs at the national level, and little is known about best practices for consistently graduating a diverse group of students. We descriptively characterized the extent to which PA programs are graduating a diverse group of students and identified top performing PA programs.

Assessing Harmful Bias and Celebrating Strength Through the Narratives of Black/African American Physician Assistant Students.

Introduction: Two national crises, the COVID-19 pandemic and systemic racism, have drawn nationwide attention to the disparities that exist in our society today. The American healthcare system, including physician assistant (PA) education, is not exempt from the impact of harmful bias and discrimination. The purpose of this study was to explore narratives recounting the experiences of Black/African Americans who have successfully completed their PA education in an attempt to understand how PA educators can better support students of color.

Outcomes following surgical resection of cystic intracranial meningiomas.

Introduction: Cystic meningiomas are rare, accounting for 2-7% of all intracranial meningiomas. Little is known regarding whether these meningiomas behave differently compared to solid meningiomas. We sought to study this relatively uncommon imaging appearance of meningioma and to evaluate its clinical significance.

Loss to Follow-up and Unplanned Readmission After Emergent Surgery for Acute Subdural Hematoma.

Background: Loss to follow-up (LTF) and unplanned readmission are barriers to recovery after acute subdural hematoma evacuation. The variables associated with these postdischarge events are not fully understood.

Objective: To determine factors associated with LTF and unplanned readmission, emphasizing socioeconomic status (SES).

Impact of Thrombocytopenia on Preoperative Hematoma Expansion for Acute Traumatic Subdural Hematoma.

Background: Acute subdural hematoma is a neurosurgical emergency. Thrombocytopenia poses a management challenge for these patients. We aimed to determine the impact of thrombocytopenia on preoperative hemorrhage expansion and postoperative outcomes.

Comparison of supratentorial meningioma resection outcomes by dural reconstruction technique.

Objective: Excision of intracranial meningiomas often requires resection or coagulation of the dura mater. The choice of dural closure technique is individualized and based on surgeon preference. The objective of this study was to determine outcomes following various dural closure techniques for supratentorial meningiomas.

Red blood cell distribution width in glioblastoma.

Introduction: Glioblastoma (GBM) is the most common and deadly adult brain tumor. Red blood cell distribution width (RDW) has been found in non-central nervous system neoplasms to be associated with survival. This study aims to assess the prognostic value of pre-operative RDW and trends in RDW over time during the disease course.

Statins as a Medical Adjunct in the Surgical Management of Chronic Subdural Hematomas.

Background: By stabilizing immature leaky vessel formation in neomembranes, statin drugs have been suggested as a nonsurgical treatment option for chronic subdural hematomas (cSDH). Statin therapy seems to reduce conservatively managed cSDH volume. However, the usefulness of these medications in supplementing surgical treatment is unknown.

Predicting for Lost to Follow-up in Surgical Management of Patients with Chronic Subdural Hematoma.

Background: Lost to follow-up (LTF) represents an understudied barrier to effective management of chronic subdural hematoma (cSDH). Understanding the factors associated with LTF after surgical treatment of cSDH could uncover pathways for quality improvement efforts and modify discharge planning. We sought to identify the demographic and clinical factors associated with patient LTF.

Effectiveness of the Chiari Health Index for Pediatrics instrument in measuring postoperative health-related quality of life in pediatric patients with Chiari malformation type I.

Objective: The authors' previously published work validated the Chiari Health Index for Pediatrics (CHIP), a new instrument for measuring health-related quality of life (HRQOL) for pediatric Chiari malformation type I (CM-I) patients. In this study, the authors further evaluated the CHIP to assess HRQOL changes over time and correlate changes in HRQOL to changes in symptomatology and radiological factors in CM-I patients who undergo surgical intervention. Strong HRQOL evaluation instruments are currently lacking for pediatric CM-I patients, creating the need for a standardized HRQOL instrument for this patient population.

Do neurosurgeons receive more patient complaints than other physicians? Describing who is most at risk and how we can improve.

Objective: The number of unsolicited patient complaints (UPCs) about surgeons correlates with surgical complications and malpractice claims. Using a large, national patient complaint database, the authors sought to do the following: 1) compare the rates of UPCs for neurosurgeons to those for other physicians, 2) analyze the risk of UPCs with individual neurosurgeon characteristics, and 3) describe the types of UPCs made about neurosurgeons.

Methods: Patient and family complaint reports among 36,265 physicians, including 423 neurosurgeons, 8292 other surgeons, and 27,550 nonsurgeons who practiced at 33 medical centers (22 academic and 11 regional) from January 1, 2014, to December 31, 2017, were coded with a previously validated Patient Advocacy Reporting System (PARS) algorithm.

Chiari type I malformation: role of the Chiari Severity Index and Chicago Chiari Outcome Scale.

Objective: The authors aimed to determine whether the Chiari Severity Index (CSI), and other clinical variables, can be used as a predictor of postoperative outcomes for Chiari type I malformation (CM-I) using the modified Chicago Chiari Outcome Scale (mCCOS) as the postoperative measure.

Methods: The cohort included patients 18 years of age and younger who were treated for CM-I between 2010 and 2015 who had at least 12 months of clinical and radiographic follow-up. CSI grades were assigned using preoperative clinical and neuroimaging data.

Complication rates for preexisting baclofen pumps and ventricular shunts following scoliosis correction: a preliminary study.

OBJECTIVE Many patients undergoing spinal fusion for neuromuscular scoliosis have preexisting neurosurgical implants, including ventricular shunts (VSs) for hydrocephalus and baclofen pumps (BPs) for spastic cerebral palsy. Recent studies have discussed a possible increase in implant complication rates following spinal fusion, but published data are inconclusive. The authors therefore, sought to investigate: 1) the rate of implant complications following fusion, 2) possible causes of these complications, and 3) factors that place patients at higher risk for implant-related complications.

Similarities and Differences Between Physician Assistant Program and Medical School Mission Statement Themes.

Purpose: The purpose of this study was to examine the concordance of US physician assistant (PA) program mission statements with those of US public- and private-sponsored medical schools. With the exception of a broader medical school focus on research, the authors hypothesized that little difference in mission statement congruence would be found in a comparison of medical schools and PA programs.

Methods: Mission statements of 209 of the 210 accredited US PA programs as of May 2016 were obtained and analyzed.