Middle-Level Leaders Perceptions of Accountability

The purpose of this study was to identify the perceptions of middle-level principals personal and school accountability, their perceptions of beliefs and competencies that influence improvement in student achievement and accomplishment of accountability, and their perceptions regarding the adequacy of professional development and preparation for middle-level principals that affect their ability to improve student achievement and perform their leadership role in an increased accountability environment. This study specifically examined differences in the perceptions of middle-level principals\u27 accountability based on the socioeconomics of the school, the number of years of administrative experience, and previous middle-school teaching experience

Characterization of Silicon Phosphorus Alloy for Device Applications

A new material of highly-phosphorus doped silicon for device applications was characterized and analyzed for new material properties. Devices such as NMOS transistors and other CMOS compatible devices may benefit from new materials that reduce external resistances and increase drive currents. Material characterization requires numerous techniques and technologies to determine electrical, optical, and physical characteristics. For this work, Hall measurement, X-ray Diffraction, Raman Spectroscopy, Photoluminescence Characterization, and Spectroscopic Ellipsometry were used to better understand this new material. The results may lead to new models for silicon phosphorus alloys

Educate and Advocate: Dental Providers Promote HPV Vaccination as Oropharyngeal Cancer Prevention in Interprofessional Collaboration

PURPOSE Human papillomavirus (HPV) is the most common sexually transmitted infection in the US and the oropharynx is the most common site of HPV-associated cancer. The FDA’s approval for the nonavalent HPV vaccine expanded in 2020 to include prevention of oral cancers. Oral health practitioners (OHPs) are uniquely situated to recommend HPV vaccination as a primary preventive measure for OPC. METHODS Following a synchronous training, OHPs at two community health clinics, one urban and one rural, in North Carolina educated patients about the HPV-OPC link and recommended HPV vaccination to patients ages 12-26-years during a 3-month quality improvement (QI) pilot intervention. An interprofessional dental-medical team enabled patients to attain HPV vaccination immediately after an OHP’s recommendation. Descriptive statistics were used to capture practice change. RESULTS Patients ages 12-26-years accounted for 15.6% (323/2,066) of the appointments scheduled at two dental clinics staffed by five dentists. Prior to the pilot, 66.7% (6/9) of dental providers never educated patients about the HPV-OPC link and 88.9% (8/9) never recommended HPV vaccination. At the rural clinic, 25.5% (52/204) of 12-26-year-olds were overdue for HPV vaccination, OHPs educated and recommended vaccination to 59.0% of the targeted group, and seven patients were vaccinated during the pilot. At the urban clinic 44.5% of patients (53/119) were overdue for vaccination, 97.0% of targeted patients received the intervention, and three patients actualized same-day vaccination. CONCLUSIONS The QI pilot equipped OHPs with the knowledge and confidence to educate patients about the HPV-OPC link and recommend HPV vaccination. These recommendations were associated with vaccine uptake. Success of the pilot was facilitated by strong interprofessional collaboration including pre-existing systems to deliver vaccines at little or no cost to adolescents. The prohibitive cost ($248/dose) prevented willing 19-26-year-old uninsured patients from actualizing vaccination. Successful implementation of the practice change at two pilot sites suggests that dental providers across the organization should promote HPV vaccination as a cancer-prevention intervention.Doctor of Nursing Practic

Histo-blood group gene polymorphisms as potential genetic modifiers of infection and cystic fibrosis lung disease severity

Background: The pulmonary phenotype in cystic fibrosis (CF) is variable; thus, environmental and genetic factors likely contribute to clinical heterogeneity. We hypothesized that genetically determined ABO histo-blood group antigen (ABH) differences in glycosylation may lead to differences in microbial binding by airway mucus, and thus predispose to early lung infection and more severe lung disease in a subset of patients with CF. Methods and Principal Findings: Clinical information and DNA was collected on >800 patients with the ΔF508/ΔF508 genotype. Patients in the most severe and mildest quartiles for lung phenotype were enrolled. Blood samples underwent lymphocyte transformation and DNA extraction using standard methods. PCR and sequencing were performed using standard techniques to identify the 9 SNPs required to determine ABO blood type, and to identify the four SNPs that account for 90-95% of Lewis status in Caucasians. Allele identification of the one nonsynonymous SNP in FUT2 that accounts for >95% of the incidence of nonsecretor phenotype in Caucasians was completed using an ABI Taqman assay. The overall prevalence of ABO types, and of FUT2 (secretor) and FUT 3 (Lewis) alleles was consistent with that found in the Caucasian population. There was no difference in distribution of ABH type in the severe versus mild patients, or the age of onset of Pseudomonas aeruginosa infection in the severe or mild groups. Multivariate analyses of other clinical phenotypes, including gender, asthma, and meconium ileus demonstrated no differences between groups based on ABH type. Conclusions and Significance: Polymorphisms in the genes encoding ABO blood type, secretor or Lewis genotypes were not shown to associate with severity of CF lung disease, or age of onset of P. aeruginosa infection, nor was there any association with other clinical phenotypes in a group of 808 patients homozygous for the ΔF508 mutation

Lymph node infarction – a rare complication associated with disseminated intra vascular coagulation in a case of dengue fever

BACKGROUND: Lymph node infarction is known to occur in association with many non-neoplastic and neoplastic conditions however its occurrence in association with DIC is not reported hitherto in the literature. CASE PRESENTATION: We describe an unusual case of lymph node infarction in a twenty seven year old male following disseminated intravascular coagulation (DIC) in a case of dengue fever. Multiple sections of the infarcted and the surrounding non-infarcted lymph nodes failed to reveal any predisposing condition. How ever the parahilar vessels showed thrombotic occlusion, which must have been responsible for the infarction. CONCLUSION: Global infarction of the lymph node may mask the underlying pathology. Any malignancy especially lymphoma may coexist or follow lymph node infarction, therefore the patient needs constant surveillance

Different CFTR modulator combinations downregulate inflammation differently in cystic fibrosis

Previously, we showed that serum and monocytes from patients with CF exhibit an enhanced NLRP3-inflammasome signature with increased IL-18, IL-1β, caspase-1 activity and ASC speck release (Scambler et al. eLife 2019). Here we show that CFTR modulators down regulate this exaggerated proinflammatory response following LPS/ATP stimulation. In vitro application of ivacaftor/lumacaftor or ivacaftor/tezacaftor to CF monocytes showed a significant reduction in IL-18, whereas IL-1β was only reduced with ivacaftor/tezacaftor. Thirteen adults starting ivacaftor/lumacaftor and eight starting ivacaftor/tezacaftor were assessed over three months. Serum IL-18 and TNF decreased significantly with treatments, but IL-1β only declined following ivacaftor/tezacaftor. In (LPS/ATP-stimulated) PBMCs, IL-18/TNF/caspase-1 were all significantly decreased and IL-10 was increased with both combinations. Ivacaftor/tezacaftor alone showed a significant reduction in IL-1β and pro-IL-1β mRNA. This study demonstrates that these CFTR modulator combinations have potent anti-inflammatory properties, in addition to their ability to stimulate CFTR function, which could contribute to improved clinical outcomes