Digital Commons Network^™

Clinical Outcomes Of Decompression Versus Decompression With Instrumented Fusion For Lumbar Spinal Stenosis Secondary To Degenerative Spondylolisthesis: A Systematic Review And Meta-Analysis, Lama N. Alqahtani, Ahmed K. Alzahrani, Razan A. Almutairi, Abdulaziz M. Salah, Shahad F. Khan, Mohammad G. Sindi, Khalid E. Fassi, Abdulrahman M. Alshami, Ibrahim A. Hakami

Saudi Medical Journal

Objective: To compare decompression alone with decompression with fusion in patients with degenerative lumbar spondylolisthesis. Methods: PubMed, Google Scholar, Ovid, and Web of Science databases were searched up to March 2025 for randomized controlled trials (RCTs). The primary outcomes were the Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) scores. The secondary outcomes included operative time, length of hospital stay, intraoperative blood loss, reoperation, complications, and cost. Pooled analysis was performed using a random-effects model in Review Manager following Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020. The quality of included randomized trials was evaluated using the …

Dual-Pathway System For Low-Latency Pii Redaction In Generative Image Modification, Mira Leung

Defensive Publications Series

Some personally identifiable information (PII) redaction methods for generative image applications can have high latency and computational costs, which may limit their use in interactive contexts. A dual-pathway architecture may be used to process image modification requests. A synchronous, low-latency pathway can detect and obfuscate potential PII before a generative model concurrently inpaints the obfuscated areas and applies user modifications. Simultaneously, an asynchronous, offline pathway can generate a more thoroughly redacted version of the source image and store it for future use. This hybrid approach can provide a low-latency response suitable for on-demand image generation, while progressively creating higher-quality redacted …

Generating Synthetic User Populations Via World Simulation For Privacy-Safe Ai Evaluation, Amey Venkatanarayan, Yen-Ting Liu, Kamakshi Kodur, Paddy Flynn, Yue Hu, Jose Jimenez-Olivas, Zhewen Song

Defensive Publications Series

Evaluating personalized artificial intelligence (AI) systems may be challenging, as the use of detailed user context can conflict with user privacy considerations. A system is described for generating synthetic user populations via a world simulation. The system can create generative agents with demographic and behavioral characteristics based on aggregated, anonymized statistical data. These agents can interact over time within a simulated environment, producing a stream of longitudinal user behavior captured in isolated test accounts. The resulting dataset can be used for scalable, automated testing and debugging of AI models, offering a contextually rich, privacy-respecting alternative to using real user data. …

Agent-Aware Mesh Network For Hybrid Ai Policy Enforcement, Antonio Ojea

Defensive Publications Series

Organizations in regulated sectors may face challenges using large-scale, cloud-based artificial intelligence (AI) services because of data sovereignty and compliance mandates. A system may provide a decentralized, agent-aware mesh network that functions as an infrastructure layer to bridge on-premise environments and external AI services. This network can intercept and semantically understand complex agent communications, allowing an active enforcement layer to perform actions such as sanitizing data, pausing high-risk operations for human review, and maintaining a sovereign audit log. This approach can allow organizations to leverage advanced AI reasoning capabilities from external providers while assisting in the maintenance of local control …

Reverse Hook Tent Peg Longer Diagonal, John Riley Mr

Defensive Publications Series

A reverse hook tent peg which redirects forces (as opposed to a traditional tent peg) and increases its holding power in the ground. The horizontal section flexes in windy conditions and retains its shape better than a traditional peg thus maintaining guy line tension more effectively. This version has a longer diagonal in proportion to the horizontal than in previous submissions. No claim is made on colour.

Phosphosulindac And Other Compounds, Anonymous

Defensive Publications Series

Disclosed are compounds expected to share properties of phosphosulindac.

The Role Of The Nlrp3 Inflammasome In Preeclampsia And Implantation Failure: A Molecular Review, Ari Budi Suryawinata, Mariel Tania Darmayani, Listyani Suhargo

Chulalongkorn Medical Journal

The NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome is a critical multiprotein complex of the innate immune system that functions as a molecular sensor for a wide array of danger signals. While its activation is essential for host defense and tissue homeostasis, its dysregulation is increasingly implicated in the pathophysiology of numerous inflammatory disorders. This review article synthesizes the current molecular understanding of the NLRP3 inflammasome, focusing on its dual role in health and disease. We first provide a concise overview of the canonical two-step mechanism of NLRP3 activation and the intricate molecular checkpoints including genetic factors, post-translational …

Effects Of Maternal Vitamin D Supplementation During Pregnancy And Lactation On Immune Development In Offspring: A Systematic Review, Kurnia Maidarmi Handayani, Ghaniyyatul Khudri, Laura Zeffira, Widia Sari

Chulalongkorn Medical Journal

Background: Vitamin D, a fat-soluble prohormone, is essential for skeletal health and plays a key role in immune regulation. Deficiency is common among pregnant and lactating women, raising concerns as fetal and neonatal vitamin D status relies entirely on maternal stores. Insufficiency during these periods is linked to preterm birth, low birth weight, and immune-mediated disorders. This review examines the effects of maternal vitamin D supplementation on the immune development of offspring.

Methods: A systematic review was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD420251117397). Experimental rodent studies published between 2019 and 2022 that investigated maternal vitamin …

Skip Segment Hirschsprung's Disease: Report Of A Rare Case And Literature Review, Nimmita Srisan, Paisarn Vejchapipat, Natcha Wanpiyarat

Chulalongkorn Medical Journal

We present an unusual case of skip segment Hirschsprung’s disease which was initially diagnosed with total colonic aganglionosis. A term male newborn presented with distal intestinal obstruction underwent exploratory laparotomy at three days old after ultrasound-guided contrast enema. Intra-operative frozen section of the full-thickness biopsies of each part of the colon and terminal ileum reported no ganglion cells, so we performed double-end ileostomy. Although all the final pathology reports confirmed no ganglion cells similar to the frozen sections, we were curious about the problematic bowel because of preoperative imaging (at the age of 30 months) which showed dilated transverse colon. …

Pituitary Apoplexy In A 19-Year-Old Woman: An Uncommon Age And Gender Presentation, I Ketut Aryawan, Jovita Jutamulia

Chulalongkorn Medical Journal

Pituitary apoplexy is a rare clinical syndrome caused by acute hemorrhage or infarction of the pituitary gland. It is most frequently reported in men during the 5th and 6th decades of life and is rarely encountered in young women. We describe a 19-year-old woman who presented with acute visual disturbance accompanied by occasional mild headache. Ophthalmologic examination revealed bitemporal hemianopia, and head MRI demonstrated an intrasellar mass with suprasellar extension, intratumoral hemorrhage, and optic chiasm compression, consistent with pituitary macroadenoma with apoplexy. The patient also had a history of secondary amenorrhea, suggesting possible endocrine dysfunction. This case highlights the importance …

Association Between Underpants Fit And Semen Quality: A Hospital-Based Cross-Sectional Study, Harnam Kaur, Unnop Jaisamrarn, Paweena Thuwanut, Chanakarn Suebthawinkul, Jiayu Li

Chulalongkorn Medical Journal

Background: The effect of underpants type on semen parameters remains controversial. Conducting such a study in the Thai population will contribute valuable region-specific data.

Objectives: This cross-sectional research studied the influence of fit of underpants worn on various semen parameters including semen volume, sperm count, sperm motility, sperm morphology and sperm DNA fragmentation among Thai male partners in Bangkok, Thailand.

Methods: Thai male partners aged 20–55 years who sought infertility treatment from Reproductive Biology Unit, King Chulalongkorn Memorial Hospital, Bangkok were recruited from March to June 2024. All participants completed questionnaire covering socio-demographics, disease history, and type of underpants worn …

Effectiveness And Implementation Of The Shield Integrated Multi-Level Model To Reduce Adolescent Depression And Internet Addiction: A Cluster Randomized Waitlist-Controlled Trial In Wangchin District, Phrae Province, Seubtrakul Tantalanukul, Amornpan Samorn

Chulalongkorn Medical Journal

Background: Adolescent depression and internet addiction represent significant comorbid mental health challenges in rural Thailand, where access to evidence-based interventions remains limited. Traditional single-modality approaches often fail to address the complex interplay between individual, family, and systemic factors contributing to these conditions.

Objectives: To evaluate the effectiveness and implementation outcomes of the SHIELD (Screening & Surveillance, Health Literacy Enhancement, Internet Wellness Program, Empowering Families, Linkage to Care, Data-driven Monitoring) integrated multi-level intervention for reducing depression and internet addiction among at-risk adolescents in rural Thailand.

Methods: A cluster randomized waitlist-controlled trial was conducted across eight secondary schools in Wangchin District, Phrae …

Computed Tomography Findings Of Normal Appendix In Pediatric Population, Thanwarat Koonthong, Teerasak Phewplung*

Chulalongkorn Medical Journal

Background: Appendicitis remains the most common indication for emergency abdominal surgery in children. Computed tomography (CT) plays a vital role in the evaluation of pediatric patients with suspected appendicitis. Yet, there is limited of literature describing the normal appendiceal diameter in the pediatric Asian population.

Objectives: To characterize the normal pediatric appendix and to identify the variables that influence its diameter in pediatric patients aged one day to 18 years who underwent abdominal CT.

Materials and Methods: The study was approved by the IRB. We conducted a retrospective study of 358 children (≤18 years of age) who underwent abdominal CT …

Global Trends In School Disaster Preparedness Research: Bibliometric Analysis Impacts On Public Health And Safety, Muhammad Farid, Muhammad Agita Hutomo, Oktomi Wijaya, Dian Ika Puspitasari

Chulalongkorn Medical Journal

Background: Disasters disrupt daily human activities, arising from natural or artificial triggers, with varying impacts based on community vulnerability and resource capacity. Effective disaster management involves a cycle of mitigation, preparedness, response, and recovery. One of the mitigation measures is to establish school disaster preparedness that integrate education and capacity building.

Objective: The aim of this research is to conduct a bibliometric analysis based on Scopus publications regarding school disaster preparedness.

Methods: A bibliometric analysis was performed on publications indexed in Scopus from 1965 to 2024. Data were processed and visualized using VOSviewer to explore trends in annual outputs, contributing …

Analysis Of Quasi-Periodic Waves Of Cubic Nonlinear Schrödinger Equations, Perla Kfoury, Stefan Le Coz, Tai-Peng Tsai

University of Tennessee Mathematical Journal

We study the quasi-periodic standing wave solutions of the focusing and defocusing cubic nonlinear Schrödinger equations in dimension one. In the defocusing case, we establish  a diffeomorphic correspondence between the invariants of the ordinary differential equation of the wave profiles and the conserved quantities of the evolution equation. We introduce a numerical scheme to compute the minimizers of the energy at fixed mass and momentum for both focusing and defocusing cases. The scheme is based on a gradient flow approach with discrete renormalization at each time step.  The novelty of our scheme is that the renormalization step deals at the …

Empowering Tomorrow’S Eco-Leaders: The Role Of Student-Led Recycling And Energy Conservation Initiatives In Fostering Environmental Sustainability In Educational Institutions, Angel Christian S. Arisga, Constantino G. Medilo Jr.

Journal of Educational Research and Practice

Environmental sustainability is now a growing priority in educational institutions as global environmental challenges continue to intensify. This paper studies the role of student-led recycling and energy conservation initiatives in promoting eco-friendly practices and developing environmental accountability among learners. Drawing on existing literature, the study illustrates how active student participation in waste management programs, recycling campaigns, renewable energy implementation, and energy audits contributes to reduced waste generation, lower energy consumption, and decreased greenhouse gas emissions in school settings. Apart from environmental outcomes, these projects foster essential competencies such as leadership, collaboration, problem-solving, and environmental awareness, positioning students as agents of …

Bridging The Gap Between Research And Practice In Schools, Giorgio Ostinelli

Journal of Educational Research and Practice

This case study examined how a group of Swiss primary school teachers collaborated with a school improvement advisor/researcher (SIA); it is now part of a larger project that uses a design-based methodology. The SIA is a rising entity in the educational landscape and serves as a state-mandated coach who bridges the gap between universities and schools. The SIA embodies the characteristics of both an educational researcher and a school advisor/coach. The SIA experience was created and designed using a frame–object, a valuable tool for collaboratively building professional development experiences with teachers and coaches. Understanding by Design served as the frame–object …

Leading Through Difference: Core Values, Neuroscience, And The Habits Of Transformative Leaders, Jaime E. Welborn

The Journal of Values-Based Leadership

Educational leaders are increasingly called to meet the demands of K-12 schools by managing diversity, navigating conflict, and leading change. One's core values, neuroscience, and cultural proficiency of educational practices play a very important role in how they lead organizations and interact with others. This conceptual paper explores the intersection of neuroscience, core values, and associated habits that support effective cross-cultural interactions. Drawing upon frequency count data from documents collected during professional learning activities in school organizations in New York, Missouri, and California from 2018 to 2025, empathy, open-mindedness, and communication emerged as the most frequently reported important core values …

Francis Bacon As Philosopher Of Leadership: The Essays As Manual For Values-Based Leaders, Matthew Sharpe

The Journal of Values-Based Leadership

This essay presents the case for Francis Bacon as what we would today term a leadership theorist avant la letter, focusing on the development of the character of leaders, faced with all the pressures of their role.  We aim to show Bacon's leadership theory at once anticipates without directly embodying contemporary leadership theories (in part 1): not only presenting a robust moral vision for leadership, as serving the public good (part 2), but differentiating characteristic kinds of “followers,” with their strengths, weaknesses, and characteristic vices, and realistically addressing how to best lead them (Part 3); and providing ten "how …

Learning Values-Based Leadership Through Practice, Jenny Guan

The Journal of Values-Based Leadership

This essay explores how values-based leadership can be developed through leadership practice in real-world contexts. Drawing on a Servant Leadership book project involving global contributors, it adopts the Values Clarity Model™ as a reflective lens and uses a practice-based approach informed by observation, imitation, and reflection to examine how leadership values are enacted in authentic settings. By analyzing the project in relation to what I learned in the Principles of Business Leadership course at business school, this essay reflects on how leadership values are understood, practiced, and internalized in real-world settings.

This reflection suggests that values-based leadership is not formed …

Rebuilding With Values-Based Governance: Lessons From A Glass Cliff Leadership Role, Mel D. Rutherford

The Journal of Values-Based Leadership

A department in crisis rebuilt its culture through values‑based governance. My department was in crisis and the world was locked down due to COVID restrictions, when I stepped into a Glass Cliff leadership role. Our faculty, staff, postdocs, and students worked together to articulate our shared values. These values became the foundation for three transformative practices: a Gap Analysis to align procedures with principles, adopting Formal Consensus Decision Making to ensure inclusive and values‑rooted decisions, and cultivating Compassionate Accountability grounded in covenantal relationships rather than punishment. Together, these practices created transparency, trust, and shared ownership of departmental life. Explicit values …

Beyond The Romance Of Leadership: Shackleton, Self-Inflicted Crisis, And The Values Of Recovery, Carl Lee Tolbert

The Journal of Values-Based Leadership

Two men answered to the name Ernest Shackleton. One belonged to the ice, where he was pioneering, inspirational, and heroic. The other belonged to dry land, where he was restless, indebted, and unfulfilled (Smith, 2014). The 1914 to 1916 Endurance expedition has become the most celebrated leadership case study of the past century, a status the 2022 discovery of the ship's preserved wreck has only hardened. Public and scholarly sentiment runs overwhelmingly positive. This article reads that sentiment as a late expression of what Meindl and colleagues named the Romance of Leadership, the disposition to attribute outcomes to dramatic individual …

Left On The Cutting Room Floor, Ross K. Goldberg

The Journal of Values-Based Leadership

Nearly two decades ago, a Los Angeles-based client of ours was looking for a way to draw broadcast media attention to their annual 5K walk. In Los Angeles, as every weekend is overcrowded with many such events, it is hard to politely tell a client that “the media doesn’t care” and that another standard walk in LA has all the presence and pizzazz as day-old mashed potatoes. Clearly, some creativity was required to make them care. As it turns out, the client was one of the largest campuses for senior housing in the Western United States so we suggested that …

Sustaining Purpose In Organizations: Leadership Insights From The Psalms, Hershey H. Friedman, Xianfang Zeng

The Journal of Values-Based Leadership

This conceptual paper examines how the Book of Psalms offers an integrative moral framework that enriches contemporary purpose-driven leadership theory. Although modern management scholarship increasingly emphasizes purpose, stakeholder orientation, and meaningful work, it often focuses on strategic articulation rather than the ethical and relational practices that sustain purpose over time. Drawing on selected Psalms as a historically influential corpus of leadership reflection, this study identifies key leadership principles and situates them within established management literature. Purpose-driven leadership rooted in ancient values builds psychologically safe environments. In these spaces, employees view their work as a meaningful calling instead of a simple …

Irish-Americans Audie Murphy And William Donovan: A Celebrity And A Statesman, Ritch Eich

The Journal of Values-Based Leadership

In the long annals of Irish history, many leaders have distinguished themselves as warriors in battle or as civilian heroes, or both. Lieutenant Colonel Robert Blain “Paddy” Mayne, a founding member of the Special Air Service and a highly decorated World War II British Army officer from Northern Ireland, is one. Monsignor Hugh O’Flaherty, an Irish Catholic priest whose rescue network helped over 6,500, escaped Allied POWs, Jews, and other fugitives at risk of Nazi persecution evade capture by the Germans during World War II, is another.1 But, not all heroes of Irish descent are remembered equally. Take, for example, …

A Person For All Seasons: The Remarkable Leadership Of Mother Cabrini And Why It Matters Today, Emilio F. Iodice

The Journal of Values-Based Leadership

The history of organizational management is often written in the bold, sweeping strokes of industrial barons or the calculated maneuvers of political statesmen. Yet at the turn of the twentieth century, one of the most sophisticated examples of global institutional scaling was orchestrated by a woman who stood barely five feet tall, held no formal political title, and suffered from debilitating physical frailty. Frances Xavier Cabrini (1850–1917) did not merely practice charity; she engineered a global revolution of care. Over a twenty-eight-year executive career, she founded sixty-seven schools, orphanages, and hospitals across three continents, thereby transforming the social landscape of …

Student Perspectives On Professionalism In The Academic Classroom: Examining Instructor Traits And Student Preferences At A U.S. Service Academy, Jason Lackey, Justin White

The Journal of Values-Based Leadership

At the US Air Force Academy, student developmental paths occur under both military and academic components. The academic component includes the typical collegiate coursework taught by a combination of civilian and military instructors. In this study, we explored student values of instructor leadership traits and practices that influence the classroom culture. We found that overall, the instructor’s degree of academic knowledge (distinguished from military knowledge), their ability to clearly communicate class content, and ability to inspire student participation ranked highest. Conversely, the instructor clearly communicating military responsibilities, their professional etiquette, and providing constructive feedback pertaining to military bearing ranked least, …

The Ethical Shadow: A Jungian Inquiry Into The Paradoxes Of Authentic Leadership, S. Eissa Hashemi

The Journal of Values-Based Leadership

This paper examines the “authenticity paradox” in leadership through the lens of Jungian psychology, moving beyond traditional behavioral frameworks to explore the depth of the leader’s psyche. Drawing on Shaw’s (2023) pillars of authenticity — self, followers, and context — the study investigates how leaders navigate conflicting existential and relational demands. By utilizing the concept of individuation, the paper analyzes the tension between the “unified self” and the “fluid self,” particularly as it relates to Mostafa Malekian’s (2021) five dimensions of self-alignment. The research highlights a “central clash” within the cultural context, where collective archetypes and cultural complexes impose idealized …

The Philosophical Aspect Of Spirituality And Entrepreneurial Leadership In The Indian Knowledge System, Nidhi Kaushal

The Journal of Values-Based Leadership

Entrepreneurs have an obligation to conserve their literature, art, and culture in any format because it helps to fortify their cultural heritage and memories. In the context of entrepreneurship, a useful and insightful examination of the ancient Indian knowledge framework has proposed the growth of culture-based enterprises, which reflects the magnificent integration of human values with traditional wisdom-based work ethics. The nature of today's modern entrepreneurship is an adjusted specification based on innovative context, which is different from the ancient fundamental policies and practices. This study introduces cultural entrepreneurship and its originality through the traditional and indigenous art and skill …

Values-Based Leadership In Public Discourse: How University Leaders Frame Character And Commitment, Heather Carroll, Jeff Fritz, Sarah Williams, Cheryl A. Maurana

The Journal of Values-Based Leadership

Public leadership speech is a consequential site of ethical positioning where institutional values are named, contested, and interpreted under pressure, and where the choice of virtue language shapes where attention is directed. Analyzing published quotations from university leaders during the first 100 days of the second Trump administration, we examine how virtue language functioned as a public act of values-based leadership through a socio-ecological framework for flourishing that treats character as dynamic and relational. We find that leaders constructed ethical stances by anchoring commitment to moral virtues that named goods, intellectual virtues that narrated deliberative process, and occasionally pairing both …