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Summary: We identified large between-ethnicity calibration differences in the Canadian FRAX® tool which substantially overestimated the major osteoporotic fracture (MOF) risk in Asian women and Black women, and overestimated hip fracture risk in Asian women. Purpose: FRAX® is calibrated using population-specific fracture and mortality data. The need for FRAX to accommodate ethnic diversity within a country is uncertain. We addressed this question using the population-based Manitoba Bone Mineral Density (BMD) Program registry and self-reported ethnicity. Methods: The study population was women aged 40 years or older with baseline FRAX assessments (Canadian and other ethnic calculators), fracture outcomes, and self-reported ethnicity (White N = 68,907 [referent], Asian N = 1910, Black N = 356). Adjusted hazard ratios (HR) with 95% confidence intervals (CI) for time to MOF and hip fracture were estimated. We examined candidate variables from DXA that might contribute to ethnic differences including skeletal size, hip axis length (HAL), trabecular bone score (TBS), and estimated body composition. Results: Adjusted for baseline risk using the Canadian FRAX tool with BMD, Asian women compared with White women were at much lower risk for MOF (HR 0.46, 95% CI 0.35–0.59) and hip fracture (0.16, 95% CI 0.08–0.34). Black women were also at lower MOF risk (HR 0.58, 95% CI 0.32–1.00); there were no hip fractures. The US ethnic-specific FRAX calculators accounted for most of the between-ethnicity differences in MOF risk (86% for Asian, 92% for Black) but only partially accounted for lower hip fracture risk in Asian women (40%). The candidate variables explained only a minority of the effect of ethnicity. Gradient of risk in analyses was similar (p-interactions ethnicity*FRAX non-significant). Conclusions: We identified significant ethnic differences in performance of the Canadian FRAX tool with fracture probability overestimated among Asian and Black women. The US ethnic calculators helped to address this discrepancy for MOF risk assessment, but not for hip fracture risk among Asian women. [ABSTRACT FROM AUTHOR]

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Summary: The Canadian FRAX® tool used without bone mineral density (BMD) is highly sensitive for identifying individuals qualifying for pharmacotherapy based upon an intervention threshold of 20% for major osteoporotic fracture risk (MOF) computed with BMD. Introduction: This analysis was performed to inform initial BMD testing as part of Osteoporosis Canada's Guidelines Update for women and men at average risk, assuming a pharmacotherapy intervention threshold of 20% for FRAX® MOF computed with BMD. Methods: Women and men age 50 + without previous low-trauma fracture or high-risk medication use were identified in a BMD registry for the province of Manitoba, Canada. Fracture probability assessments with the Canadian FRAX® tool were computed without and with BMD (denoted MOF-clinical and MOF-BMD, respectively). Results: The study population consisted of 50,700 women (mean age 65.5 ± 9.4 years) and 4152 men (69.2 ± 10.0 years). FRAX MOF-clinical score was > 10% in 33.8% of women and 13.3% of men (P < 0.001). The median (interquartile range [IQR]) age for MOF-clinical to reach 10% in women was 70 (69–72) and 65 years (62–67) years in the absence and presence of additional FRAX clinical risk factors, respectively. In men, comparable ages were 83 years [82–86] and 76 [70–78] years. Using MOF-BMD of 20% as the intervention threshold, 4.3% of women and 0.7% of men qualified for treatment. MOF-clinical > 10% had high sensitivity to identify those qualifying for treatment (99.3% in women and 99.1% in men). An age-based rule ("BMD testing is indicated at age 70 if no additional FRAX clinical risk factors are present, or at age 65 if one or more clinical risk factors exists") gave similarly high sensitivity (women 99.9% and men > 99.9%). Conclusions: FRAX without BMD offers an effective strategy to identify individuals meeting the current Canadian treatment threshold based upon FRAX® with BMD (≥ 20%). Moreover, this can be operationalized using simple age cutoffs of 70 years in the absence of additional clinical risk factors and 65 years in the presence of additional clinical risk factors. [ABSTRACT FROM AUTHOR]

Summary: Little is known about the association between health-related quality of life (HRQOL) and osteoporosis in the absence of fracture, and how HRQOL may change over time. This study provides evidence of substantially reduced HRQOL in women and men with self-reported and/or BMD-confirmed osteoporosis, even in the absence of fragility fracture. Introduction: Fragility fractures have a detrimental effect on the health-related quality of life (HRQOL) of those with osteoporosis. Less is known about the association between HRQOL and osteoporosis in the absence of fracture. Methods: Canadian Multicentre Osteoporosis Study participants completed the SF-36, a detailed health questionnaire and measures of bone mineral density (BMD) at baseline and follow-up. We report the results of participants ≥ 50 years with 10-year follow-up. Self-reported osteoporosis at baseline and BMD-based osteoporosis at follow-up were ascertained. Multivariable linear regression models were developed for baseline SF-36 domains, component summaries, and change over time, adjusting for relevant baseline information. Results: Baseline data were available for 5266 women and 2112 men. Women in the osteoporosis group had substantially lower SF-36 baseline scores, particularly in the physically oriented domains, than those without osteoporosis. A similar but attenuated pattern was evident for the men. After 10-year follow-up (2797 women and 1023 men), most domain scores dropped for women and men regardless of osteoporosis status, with the exception of mentally-oriented ones. In general, a fragility fracture was associated with lower SF-36 scores and larger declines over time. Conclusions: This study provides evidence of substantially reduced HRQOL in women and men with self-reported and/or BMD-confirmed osteoporosis, even in the absence of fragility fracture. HRQOL should be thoroughly investigated even prior to fracture, to develop appropriate interventions for all stages of the disease. [ABSTRACT FROM AUTHOR]

Family caregivers' physical and emotional well-being may be negatively impacted while in the caregiver role. Interventions to support caregiver health have largely focused on psychological support, with only a few studies to date evaluating the role of exercise. Of the exercise studies conducted, there has been one qualitative study examining caregivers' perspectives on the value and impact of this type of intervention. This qualitative study was part of a larger mixed methods investigation including a randomised controlled trial investigating the effects of a 24-week exercise programme for cancer caregivers conducted in western Canada. We aimed to explore cancer family caregivers' experience of participating in a structured exercise programme. We conducted face-to-face interviews with 20 of the participants from the exercise intervention and analysed transcribed data using Thorne's interpretive description as a guiding framework. Two main patterns characterised the experiences of the caregivers. The metaphor of a downward spiral represented the experience of being in the caregiver role, while the metaphor of an upward spiral represented the experience of participating in the exercise programme. Our findings highlight that caregivers valued the exercise programme, experienced positivity through exercise and the group-based format, and noticed improvements to their physical and emotional well-being. [ABSTRACT FROM AUTHOR]

Estimates of greenhouse gas (GHG) emissions from Canada's four main livestock industries were integrated with the Canadian Economic and Emissions Model for Agriculture (CEEMA) which operates at the census district level. The livestock crop complex (LCC), which defines the crop area required to feed Canada's livestock, was disaggregated from provincial to district level. The LCC areas were subtracted from the crop areas stored in the CEEMA database to define the maximum area available for non-meat food, fiber, and biofuel feedstock production. The resulting non-livestock residual (NLR) area estimates were 18.7 Mha in the west (excluding rangeland, summerfallow, irrigated cropland and any crops not associated with livestock diets) and 1.0 Mha in the east. The GHG emissions from the NLR in the west were 13.7 Tg CO2e, or 30% of the total GHG emissions from those crops associated with livestock diets. The 1.6 Tg CO2e of GHG from the NLR in Eastern Canada represented 8% of the total GHG emissions from those livestock-related crops. The eastern NLR crop areas were more sensitive to changes in livestock populations than the Western Canada NLR areas because of the more dominant role of livestock production in eastern Canadian agriculture than in the west. The total agricultural GHG emissions budget showed direct but muted sensitivity to changes in Canadian livestock populations in both eastern and Western Canada. The methodology will link agricultural GHG emissions with district level land use decisions. [ABSTRACT FROM AUTHOR]

Loss of genetic diversity can be due to a variety of causes and might take place unnoticed even in widespread and frequent species. In situ reserves can be a very efficient method of protecting genetic diversity in tree species if they are sufficiently large to sustain adequate populations and spatially well distributed to protect populations adapted to a range of environmental conditions. We use a geographical information system (GIS) based approach to assess the level of in situ protection based on forest inventory data. Recently revised maps of seed planning units used for management of genetic resources for 11 major commercial conifer species reflect geographic variation as observed in genetic tests. On this basis we investigate how well populations are represented in protected areas. Due to a systematic expansion of protected areas in the 1990s, it appears that conifer genetic resources are now well represented in protected areas. In this study we identify the remaining gaps for in situ protection and discuss implications for genetic resource management. Further, we evaluate protected areas for their importance with respect to gene conservation, and determine whether ground truthing is necessary to confirm that populations in protected areas are sufficiently large. [Copyright &y& Elsevier]

Examines the geographic variation in resin canal defenses in seedlings from the Sitka spruce x white spruce introgression zone in British Columbia. Infliction of wound on the seedlings to simulate white pine weevil attack; Differences among the 18 provenances; Increase in constitutive resin canals.

Investigates whether the Saskatchewan Farm Input Price Survey would result in a reduction of price dispersion. Analysis of the provision of comparative price information in the Saskatchewan market for farm inputs; Decline of price dispersion during the survey.

Limited information is available concerning the relationships existing among demand, supply, and price within the Canadian beef cattle sector. Since the sector is very dependent on exports to the U.S.A., an open econometric model is developed to estimate the simultaneous relationships prevailing among the demand, supply and price, and export variables. The two-stage least squares procedure is adopted to obtain a solution. It was estimated that by 1975 both Canadian domestic demand for beef and farm prices of beef will increase, but exports of live cattle will decline. The model also revealed that the price and production levels of feed grains are important factors in accommodating the expansion of demand. [ABSTRACT FROM AUTHOR]

Abstract: Runoff from agricultural watersheds can carry a number of agricultural pollutants and pathogens; often associated with the sediment fraction. Deposition of this sediment can impact water quality and the ecology of the river, and the re-suspension of such sediment can become sources of contamination for reaches downstream. In this paper a modelling framework to predict sediment and associated microbial erosion, transport and deposition is proposed for the South Nation River, Ontario, Canada. The modelling framework is based on empirical relationships (deposition and re-suspension fluxes), derived from laboratory experiments in a rotating circular flume using sediment collected from the river bed. The bed shear stress governing the deposition and re-suspension processes in the stream was predicted using a one dimensional mobile boundary flow model called MOBED. Counts of live bacteria associated with the suspended and bed sediments were used in conjunction with measured suspended sediment concentration at an upstream section to allow for the estimation of sediment associated microbial erosion, transport and deposition within the modelled river reach. Results suggest that the South Nation River is dominated by deposition periods with erosion only occurring at flows above approximately 250 m3 s−1 (above this threshold, all sediment (suspended and eroded) with associated bacteria are transported through the modelled reach). As microbes are often associated with sediments, and can survive for extended periods of time, the river bed is shown to be a possible source of pathogenic organisms for erosion and transport downstream during large storm events. It is clear that, shear levels, bacteria concentrations and suspended sediment are interrelated requiring that these parameters be studied together in order to understand aquatic microbial dynamics. It is important that any management strategies and operational assessments for the protection of human and aquatic health incorporate the sediment compartments (suspended and bed sediment) and the energy dynamics within the system in order to better predict the concentration of indicator organism. [Copyright &y& Elsevier]

Background: The National Institutes of Health Stroke Scale is a widely accepted tool for structured graded neurological examination of stroke or suspected stroke in the hyperacute setting. Concerns have arisen about the use of its picture stimuli in a contemporary and global health context. Here, we present new stimuli prepared to serve the needs of stroke providers worldwide: the precarious painter image description and updated objects for naming., Methods: This was a validation study of 101 healthy fluent English speakers. Participants were reached by the Johns Hopkins Outpatient Center, the University of South Carolina, and Prisma Health from 2022 to 2023 and included residents of the United States, Germany, Canada, the United Kingdom, Australia, and Zambia. Participants were recorded in person or via video conferencing when asked to describe the new picture, while a subset named seven illustrations. Multivariate analyses of variance were used for primary analyses. In a complementary investigation, 299 attendees of the 2023 International Stroke Conference were asked about their preference for the existing or new stimuli and why., Results: Each of the 44 content units from the picture description was included by at least 5% of respondents in the demographically representative subsample. Performance was similar across healthy participants irrespective of age, sex, race, ethnicity, or education. Typical descriptions were characterized by an average of 23 content units (SD=5) conveyed with 167 syllables (SD=79). The new naming stimuli were recognized by 100% of participants from many countries as being familiar and identifiable, and names provided in response to the task were highly convergent. The majority of stroke health care providers preferred both the precarious painter and naming stimuli., Conclusions: The description of the new National Institutes of Health Stroke Scale picture, the precarious painter, results in rich samples among healthy speakers that will provide an appropriate basis for the detection of language deficits., Competing Interests: Disclosures Apex Innovations is an accredited provider of educational services for health care facilities, which provides free training videos developed by neurologists from the University of Cincinnati, the University of Iowa, and the National Institute of Neurological Disorders and Stroke (NINDS) in the reliable and valid administration of the National Institutes of Health (NIH) Stroke Scale. The content of the videos is based on medical science, accepted standards of care, and best practice guidelines. Neither they nor the authors receive any commercial support associated with these educational activities or the NIH Stroke Scale, which is made freely available by the NINDS. Dr Lyden is a paid consultant to Apex Innovations. Dr Hillis receives compensation from the American Heart Association as the editor-in-chief of Stroke and from Elsevier as an associate editor of PracticeUpdate Neurology. All authors receive salary support from NIH (National Institute on Deafness and Other Communication Disorders [NIDCD] and NINDS) through grants.

Background: Subclinical atrial fibrillation is short-lasting and asymptomatic and can usually be detected only by long-term continuous monitoring with pacemakers or defibrillators. Subclinical atrial fibrillation is associated with an increased risk of stroke by a factor of 2.5; however, treatment with oral anticoagulation is of uncertain benefit., Methods: We conducted a trial involving patients with subclinical atrial fibrillation lasting 6 minutes to 24 hours. Patients were randomly assigned in a double-blind, double-dummy design to receive apixaban at a dose of 5 mg twice daily (2.5 mg twice daily when indicated) or aspirin at a dose of 81 mg daily. The trial medication was discontinued and anticoagulation started if subclinical atrial fibrillation lasting more than 24 hours or clinical atrial fibrillation developed. The primary efficacy outcome, stroke or systemic embolism, was assessed in the intention-to-treat population (all the patients who had undergone randomization); the primary safety outcome, major bleeding, was assessed in the on-treatment population (all the patients who had undergone randomization and received at least one dose of the assigned trial drug, with follow-up censored 5 days after permanent discontinuation of trial medication for any reason)., Results: We included 4012 patients with a mean (±SD) age of 76.8±7.6 years and a mean CHA 2 DS 2 -VASc score of 3.9±1.1 (scores range from 0 to 9, with higher scores indicating a higher risk of stroke); 36.1% of the patients were women. After a mean follow-up of 3.5±1.8 years, stroke or systemic embolism occurred in 55 patients in the apixaban group (0.78% per patient-year) and in 86 patients in the aspirin group (1.24% per patient-year) (hazard ratio, 0.63; 95% confidence interval [CI], 0.45 to 0.88; P = 0.007). In the on-treatment population, the rate of major bleeding was 1.71% per patient-year in the apixaban group and 0.94% per patient-year in the aspirin group (hazard ratio, 1.80; 95% CI, 1.26 to 2.57; P = 0.001). Fatal bleeding occurred in 5 patients in the apixaban group and 8 patients in the aspirin group., Conclusions: Among patients with subclinical atrial fibrillation, apixaban resulted in a lower risk of stroke or systemic embolism than aspirin but a higher risk of major bleeding. (Funded by the Canadian Institutes of Health Research and others; ARTESIA ClinicalTrials.gov number, NCT01938248.)., (Copyright © 2023 Massachusetts Medical Society.)

Objectives: Personal support workers (PSWs) are an essential but vulnerable workforce supporting the home care sector in Canada. Given the impact COVID-19 has had on healthcare workers globally, understanding how PSWs have been impacted is vital., Methods: We conducted a qualitative descriptive study to understand the working experiences of PSWs over the COVID-19 pandemic. Nineteen semistructured interviews were conducted, and analysis was guided by the collaborative DEPICT framework., Results: Personal support workers are motivated by an intrinsic duty to work and their longstanding client relationships despite feeling vulnerable to transmission and infection. They experienced co-occurring occupational stressors and worsening work conditions, which impacted their overall well-being., Conclusions: Pandemic conditions have contributed to increased occupational stress among PSWs. Employers must implement proactive strategies that promote and protect the well-being of their workforce while advocating for sector improvements., Competing Interests: Conflicts of interest: S.N., N.A.M., E.C.K., K.A.N., and S.M.M. are researchers employed by the organization at which the research was conducted., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Occupational and Environmental Medicine.)

Background and Objectives: Pediatric-acquired demyelination of the CNS associated with antibodies directed against myelin oligodendrocyte glycoprotein (MOG; MOG antibody-associated disease [MOGAD]) occurs as a monophasic or relapsing disease and with variable but often extensive T2 lesions in the brain. The impact of MOGAD on brain growth during maturation is unknown. We quantified the effect of pediatric MOGAD on brain growth trajectories and compared this with the growth trajectories of age-matched and sex-matched healthy children and children with multiple sclerosis (MS, a chronic relapsing disease known to lead to failure of normal brain growth and to loss of brain volume) and monophasic seronegative demyelination., Methods: We included children enrolled at incident attack in the prospective longitudinal Canadian Pediatric Demyelinating Disease Study who were recruited at the 3 largest enrollment sites, underwent research brain MRI scans, and were tested for serum MOG-IgG. Children seropositive for MOG-IgG were diagnosed with MOGAD. MS was diagnosed per the 2017 McDonald criteria. Monophasic seronegative demyelination was confirmed in children with no clinical or MRI evidence of recurrent demyelination and negative results for MOG-IgG and aquaporin-4-IgG. Whole and regional brain volumes were computed through symmetric nonlinear registration to templates. We computed age-normalized and sex-normalized z scores for brain volume using a normative dataset of 813 brain MRI scans obtained from typically developing children and used mixed-effect models to assess potential deviation from brain growth trajectories., Results: We assessed brain volumes of 46 children with MOGAD, 26 with MS, and 51 with monophasic seronegative demyelinating syndrome. Children with MOGAD exhibited delayed ( p < 0.001) age-expected and sex-expected growth of thalamus, caudate, and globus pallidus, normalized for the whole brain volume. Divergence from expected growth was particularly pronounced in the first year postonset and was detected even in children with monophasic MOGAD. Thalamic volume abnormalities were less pronounced in children with MOGAD compared with those in children with MS., Discussion: The onset of MOGAD during childhood adversely affects the expected trajectory of growth of deep gray matter structures, with accelerated changes in the months after an acute attack. Further studies are required to better determine the relative impact of monophasic vs relapsing MOGAD and whether relapsing MOGAD with attacks isolated to the optic nerves or spinal cord affects brain volume over time., (© 2023 American Academy of Neurology.)

Background: The late-onset cerebellar ataxias (LOCAs) have largely resisted molecular diagnosis., Methods: We sequenced the genomes of six persons with autosomal dominant LOCA who were members of three French Canadian families and identified a candidate pathogenic repeat expansion. We then tested for association between the repeat expansion and disease in two independent case-control series - one French Canadian (66 patients and 209 controls) and the other German (228 patients and 199 controls). We also genotyped the repeat in 20 Australian and 31 Indian index patients. We assayed gene and protein expression in two postmortem cerebellum specimens and two induced pluripotent stem-cell (iPSC)-derived motor-neuron cell lines., Results: In the six French Canadian patients, we identified a GAA repeat expansion deep in the first intron of FGF14 , which encodes fibroblast growth factor 14. Cosegregation of the repeat expansion with disease in the families supported a pathogenic threshold of at least 250 GAA repeats ([GAA] ≥250 ). There was significant association between FGF14 (GAA) ≥250 expansions and LOCA in the French Canadian series (odds ratio, 105.60; 95% confidence interval [CI], 31.09 to 334.20; P<0.001) and in the German series (odds ratio, 8.76; 95% CI, 3.45 to 20.84; P<0.001). The repeat expansion was present in 61%, 18%, 15%, and 10% of French Canadian, German, Australian, and Indian index patients, respectively. In total, we identified 128 patients with LOCA who carried an FGF14 (GAA) ≥250 expansion. Postmortem cerebellum specimens and iPSC-derived motor neurons from patients showed reduced expression of FGF14 RNA and protein., Conclusions: A dominantly inherited deep intronic GAA repeat expansion in FGF14 was found to be associated with LOCA. (Funded by Fondation Groupe Monaco and others.)., (Copyright © 2022 Massachusetts Medical Society.)

Background: Atherosclerotic cardiovascular diseases (CVDs) are leading causes of death despite effective therapies and result in unnecessary morbidity and mortality throughout the world. We aimed to investigate the cost-effectiveness of polygenic risk scores (PRS) to guide statin therapy for Canadians with intermediate CVD risk and model its economic outlook., Methods: This cost-utility analysis was conducted using UK Biobank prospective cohort study participants, with recruitment from 2006 to 2010, and at least 10 years of follow-up. We included nonrelated white British-descent participants (n=96 116) at intermediate CVD risk with no prior lipid lowering medication or statin-indicated conditions. A coronary artery disease PRS was used to inform decision to use statins. The effects of statin therapy with and without PRS, as well as CVD events were modelled to determine the incremental cost-effectiveness ratio from a Canadian public health care perspective. We discounted future costs and quality-adjusted life-years by 1.5% annually., Results: The optimal economic strategy was when intermediate risk individuals with a PRS in the top 70% are eligible for statins while the lowest 1% are excluded. Base-case analysis at a genotyping cost of $70 produced an incremental cost-effectiveness ratio of $172 906 (143 685 USD) per quality-adjusted life-year. In the probabilistic sensitivity analysis, the intervention has approximately a 50% probability of being cost-effective at $179 100 (148 749 USD) per quality-adjusted life-year. At a $0 genotyping cost, representing individuals with existing genotyping information, PRS-guided strategies dominated standard care when 12% of the lowest PRS individuals were withheld from statins. With improved PRS predictive performance and lower genotyping costs, the incremental cost-effectiveness ratio demonstrates possible cost-effectiveness under thresholds of $150 000 and possibly $50 000 per quality-adjusted life-year., Conclusions: This study suggests that using PRS alongside existing guidelines might be cost-effective for CVD. Stronger predictiveness combined with decreased cost of PRS could further improve cost-effectiveness, providing an economic basis for its inclusion into clinical care.

Women with thoracic aortic aneurysms (TAAs) have higher risk of acute aortic syndromes and death than men. We have shown that TAA growth is accelerated in women, helping explain the sex differences in TAA outcomes. Since aortic stiffness reflects the health of the aorta, we sought to determine the sex-specific role of aortic stiffness on TAA growth. One hundred thirty unoperated people with TAA were recruited. Maximal aneurysm size at the oldest and latest imaging studies was measured to calculate TAA growth rate. Aortic stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV) using applanation tonometry. Multivariable linear regression adjusted for confounders assessed the association of cfPWV with TAA growth. Seventy-three percent of subjects were men. Mean±SD age, baseline aneurysm size, follow-up time, and cfPWV were 62.5±11.5 years, 45.3±4.0 mm, 3.3±3.0 years and 9.6±3.5 m/s, and not different based on sex. TAA growth rate was 0.96±1.00 mm/y in women and 0.45±0.58 mm/y in men ( P=0.006). In the whole group, cfPWV was independently associated with TAA growth (β±SE: 0.06±0.02, P=0.02). However, in sex-specific analyses cfPWV was independently associated with faster aneurysm growth in women (β±SE: 0.21±0.09, P=0.03), but not in men (β±SE: -0.002±0.02, P=0.94), with a significant sex×cfPWV interaction ( P<0.0001). In patients with TAA, aneurysm growth is more than twice as fast in women than men, and aortic stiffness is associated with greater TAA growth in women, but not in men. Our findings highlight greater aortic stiffness as an important correlate of TAA expansion in women.

Background and Purpose: There has been extensive interest in promoting gender equality within radiology, a predominately male field. In this study, our aim was to quantify gender representation in neuroradiology faculty rankings and determine any related factors that may contribute to any such disparity., Materials and Methods: We evaluated the academic and administrative faculty members of neuroradiology divisions for all on-line listed programs in the US and Canada. After excluding programs that did not fulfill our selection criteria, we generated a short list of 85 US and 8 Canadian programs. We found 465 faculty members who met the inclusion criteria for our study. We used Elsevier's SCOPUS for gathering the data pertaining to the publications, H-index, citations, and tenure of the productivity of each faculty member., Results: Gender disparity was insignificant when analyzing academic ranks. There are more men working in neuroimaging relative to women (χ 2 = 0.46; P = .79). However, gender disparity was highly significant for leadership positions in neuroradiology (χ 2 = 6.76; P = .009). The median H-index was higher among male faculty members (17.5) versus female faculty members (9). Female faculty members have odds of 0.84 compared with male faculty members of having a higher H-index, adjusting for publications, citations, academic ranks, leadership ranks, and interaction between gender and publications and gender and citations (9)., Conclusions: Neuroradiology faculty members follow the same male predominance seen in many other specialties of medicine. In this study, issues such as mentoring, role models, opportunities to engage in leadership/research activities, funding opportunities, and mindfulness regarding research productivity are explored., (© 2018 by American Journal of Neuroradiology.)