Perceptions of Principal Leadership Skills in High-Achieving Elementary Schools

The problem addressed in this study was the inability of certain schools in a rural school district in Florida to achieve adequate yearly progress (AYP) in comparison to a neighboring school district where students consistently made AYP. Research has shown a positive relationship between student achievement and principal leadership skills. The purpose of this study was to identify patterns in elementary teachers\u27 perceptions of their principals\u27 leadership skills related to student achievement and elementary principals\u27 perceptions of their own leadership practices and compare those perceptions. The conceptual framework for this qualitative case study design was instructional leadership. Twelve teachers of Kindergarten to Grade 5 from 3 high-achieving elementary schools volunteered to participate and provided data through 2 focus groups with 6 primary grade teachers and 6 intermediate grade teachers respectively. Principals at the same 3 high-achieving elementary schools provided data through semistructured interviews. Open coding and thematic analysis yielded 4 themes from the principals\u27 responses, including instructional leadership, hands-on leadership, communication and collaboration, and management by visibility. The teachers\u27 responses resulted in the themes of high expectations for student achievement, a supportive learning environment, consistent collection and review of student achievement data, and an overall positive school climate to promote exemplary instructional practices and student success. A positive social change that can stem from this study is implementing principal leadership practices related to the findings in low-achieving schools. This may result in gains in student achievement, leading to increased academic and economic opportunities

Explicating the Conditions Under Which Multilevel Multiple Imputation Mitigates Bias Resulting from Random Coefficient-Dependent Missing Longitudinal Data

Random coefficient dependent (RCD) missingness is a non-ignorable mechanism through which missing data can arise in longitudinal designs. RCD, for which we cannot test, is a problematic form of missingness that occurs if subject-specific random effects correlate with propensity for missingness or dropout. Particularly when covariate missingness is a problem, investigators typically handle missing longitudinal data by using single-level multiple imputation procedures implemented with long-format data, which ignores within-person dependency entirely, or implemented with wide-format (i.e., multivariate) data, which ignores some aspects of within-person dependency. When either of these standard approaches to handling missing longitudinal data is used, RCD missingness leads to parameter bias and incorrect inference. We explain why multilevel multiple imputation (MMI) should alleviate bias induced by a RCD missing data mechanism under conditions that contribute to stronger determinacy of random coefficients. We evaluate our hypothesis with a simulation study. Three design factors are considered: intraclass correlation (ICC; ranging from .25 to .75), number of waves (ranging from 4 to 8), and percent of missing data (ranging from 20% to 50%). We find that MMI greatly outperforms the single-level wide-format (multivariate) method for imputation under a RCD mechanism. For the MMI analyses, bias was most alleviated when the ICC is high, there were more waves of data, and when there was less missing data. Practical recommendations for handling longitudinal missing data are suggested

Open urethroplasty versus endoscopic urethrotomy - clarifying the management of men with recurrent urethral stricture (the OPEN trial) : study protocol for a randomised controlled trial

Peer reviewedPublisher PD

Bone marrow lesions from osteoarthritis knees are characterized by sclerotic bone that is less well mineralized

INTRODUCTION. Although the presence of bone marrow lesions (BMLs) on magnetic resonance images is strongly associated with osteoarthritis progression and pain, the underlying pathology is not well established. The aim of the present study was to evaluate the architecture of subchondral bone in regions with and without BMLs from the same individual using bone histomorphometry. METHODS. Postmenopausal female subjects (n = 6, age 48 to 90 years) with predominantly medial compartment osteoarthritis and on a waiting list for total knee replacement were recruited. To identify the location of the BMLs, subjects had a magnetic resonance imaging scan performed on their study knee prior to total knee replacement using a GE 1.5 T scanner with a dedicated extremity coil. An axial map of the tibial plateau was made, delineating the precise location of the BML. After surgical removal of the tibial plateau, the BML was localized using the axial map from the magnetic resonance image and the lesion excised along with a comparably sized bone specimen adjacent to the BML and from the contralateral compartment without a BML. Cores were imaged via microcomputed tomography, and the bone volume fraction and tissue mineral density were calculated for each core. In addition, the thickness of the subchondral plate was measured, and the following quantitative metrics of trabecular structure were calculated for the subchondral trabecular bone in each core: trabecular number, thickness, and spacing, structure model index, connectivity density, and degree of anisotropy. We computed the mean and standard deviation for each parameter, and the unaffected bone from the medial tibial plateau and the bone from the lateral tibial plateau were compared with the affected BML region in the medial tibial plateau. RESULTS. Cores from the lesion area displayed increased bone volume fraction but reduced tissue mineral density. The samples from the subchondral trabecular lesion area exhibited increased trabecular thickness and were also markedly more plate-like than the bone in the other three locations, as evidenced by the lower value of the structural model index. Other differences in structure that were noted were increased trabecular spacing and a trend towards decreased trabecular number in the cores from the medial location as compared with the contralateral location. CONCLUSIONS. Our preliminary data localize specific changes in bone mineralization, remodeling and defects within BMLs features that are adjacent to the subchondral plate. These BMLs appear to be sclerotic compared with unaffected regions from the same individual based on the increased bone volume fraction and increased trabecular thickness. The mineral density in these lesions, however, is reduced and may render this area to be mechanically compromised, and thus susceptible to attrition.National Institutes of Health and National Institute of Arthritis and Musculoskeletal and Skin: Biomarkers in Osteoarthritis MRI Studies (U01 AR50900-02); AstraZenic

Assessing longitudinal housing status using Electronic Health Record data: a comparison of natural language processing, structured data, and patient-reported history

IntroductionMeasuring long-term housing outcomes is important for evaluating the impacts of services for individuals with homeless experience. However, assessing long-term housing status using traditional methods is challenging. The Veterans Affairs (VA) Electronic Health Record (EHR) provides detailed data for a large population of patients with homeless experiences and contains several indicators of housing instability, including structured data elements (e.g., diagnosis codes) and free-text clinical narratives. However, the validity of each of these data elements for measuring housing stability over time is not well-studied.MethodsWe compared VA EHR indicators of housing instability, including information extracted from clinical notes using natural language processing (NLP), with patient-reported housing outcomes in a cohort of homeless-experienced Veterans.ResultsNLP achieved higher sensitivity and specificity than standard diagnosis codes for detecting episodes of unstable housing. Other structured data elements in the VA EHR showed promising performance, particularly when combined with NLP.DiscussionEvaluation efforts and research studies assessing longitudinal housing outcomes should incorporate multiple data sources of documentation to achieve optimal performance

Improving oceanic overflow representation in climate models : the Gravity Current Entrainment Climate Process Team

Author Posting. © American Meteorological Society, 2009. This article is posted here by permission of American Meteorological Society for personal use, not for redistribution. The definitive version was published in Bulletin of the American Meteorological Society 90 (2009): 657-670, doi:10.1175/2008BAMS2667.1.Oceanic overflows are bottom-trapped density currents originating in semienclosed basins, such as the Nordic seas, or on continental shelves, such as the Antarctic shelf. Overflows are the source of most of the abyssal waters, and therefore play an important role in the large-scale ocean circulation, forming a component of the sinking branch of the thermohaline circulation. As they descend the continental slope, overflows mix vigorously with the surrounding oceanic waters, changing their density and transport significantly. These mixing processes occur on spatial scales well below the resolution of ocean climate models, with the result that deep waters and deep western boundary currents are simulated poorly. The Gravity Current Entrainment Climate Process Team was established by the U.S. Climate Variability and Prediction (CLIVAR) Program to accelerate the development and implementation of improved representations of overflows within large-scale climate models, bringing together climate model developers with those conducting observational, numerical, and laboratory process studies of overflows. Here, the organization of the Climate Process Team is described, and a few of the successes and lessons learned during this collaboration are highlighted, with some emphasis on the well-observed Mediterranean overflow. The Climate Process Team has developed several different overflow parameterizations, which are examined in a hierarchy of ocean models, from comparatively well-resolved regional models to the largest-scale global climate models.The Gravity Current Entrainment Climate Process Team was funded by NSF grants OCE-0336850 and OCE-0611572 and NOAA as a contribution to U.S.CLIVAR

Genetic variations in A20 DUB domain provide a genetic link to citrullination and neutrophil extracellular traps in systemic lupus erythematosus

Objectives: Genetic variations in TNFAIP3 (A20) de-ubiquitinase (DUB) domain increase the risk of systemic lupus erythematosus (SLE) and rheumatoid arthritis. A20 is a negative regulator of NF-κB but the role of its DUB domain and related genetic variants remain unclear. We aimed to study the functional effects of A20 DUB-domain alterations in immune cells and understand its link to SLE pathogenesis. Methods: CRISPR/Cas9 was used to generate human U937 monocytes with A20 DUB-inactivating C103A knock-in (KI) mutation. Whole genome RNA-sequencing was used to identify differentially expressed genes between WT and C103A KI cells. Functional studies were performed in A20 C103A U937 cells and in immune cells from A20 C103A mice and genotyped healthy individuals with A20 DUB polymorphism rs2230926. Neutrophil extracellular trap (NET) formation was addressed ex vivo in neutrophils from A20 C103A mice and SLE-patients with rs2230926. Results: Genetic disruption of A20 DUB domain in human and murine myeloid cells did not give rise to enhanced NF-κB signalling. Instead, cells with C103A mutation or rs2230926 polymorphism presented an upregulated expression of PADI4, an enzyme regulating protein citrullination and NET formation, two key mechanisms in autoimmune pathology. A20 C103A cells exhibited enhanced protein citrullination and extracellular trap formation, which could be suppressed by selective PAD4 inhibition. Moreover, SLE-patients with rs2230926 showed increased NETs and increased frequency of autoantibodies to citrullinated epitopes. Conclusions: We propose that genetic alterations disrupting the A20 DUB domain mediate increased susceptibility to SLE through the upregulation of PADI4 with resultant protein citrullination and extracellular trap formation

Network-based atrophy modelling in the common epilepsies: a worldwide ENIGMA study

SUMMARY Epilepsy is increasingly conceptualized as a network disorder. In this cross-sectional mega-analysis, we integrated neuroimaging and connectome analysis to identify network associations with atrophy patterns in 1,021 adults with epilepsy compared to 1,564 healthy controls from 19 international sites. In temporal lobe epilepsy, areas of atrophy co-localized with highly interconnected cortical hub regions, whereas idiopathic generalized epilepsy showed preferential subcortical hub involvement. These morphological abnormalities were anchored to the connectivity profiles of distinct disease epicenters, pointing to temporo-limbic cortices in temporal lobe epilepsy and fronto-central cortices in idiopathic generalized epilepsy. Indices of progressive atrophy further revealed a strong influence of connectome architecture on disease progression in temporal lobe, but not idiopathic generalized, epilepsy. Our findings were reproduced across individual sites and single patients, and were robust across different analytical methods. Through worldwide collaboration in ENIGMA-Epilepsy, we provided novel insights into the macroscale features that shape the pathophysiology of common epilepsies

Event-based modelling in temporal lobe epilepsy demonstrates progressive atrophy from cross-sectional data

OBJECTIVE: Recent work has shown that people with common epilepsies have characteristic patterns of cortical thinning, and that these changes may be progressive over time. Leveraging a large multi-centre cross-sectional cohort, we investigated whether regional morphometric changes occur in a sequential manner, and whether these changes in people with mesial temporal lobe epilepsy and hippocampal sclerosis (MTLE-HS) correlate with clinical features. METHODS: We extracted regional measures of cortical thickness, surface area and subcortical brain volumes from T1-weighted (T1W) MRI scans collected by the ENIGMA-Epilepsy consortium, comprising 804 people with MTLE-HS and 1,625 healthy controls from 25 centres. Features with a moderate case-control effect size (Cohen's d≥0.5) were used to train an Event-Based Model (EBM), which estimates a sequence of disease-specific biomarker changes from cross-sectional data and assigns a biomarker-based fine-grained disease stage to individual patients. We tested for associations between EBM disease stage and duration of epilepsy, age of onset and anti-seizure medicine (ASM) resistance. RESULTS: In MTLE-HS, decrease in ipsilateral hippocampal volume along with increased asymmetry in hippocampal volume was followed by reduced thickness in neocortical regions, reduction in ipsilateral thalamus volume and, finally, increase in ipsilateral lateral ventricle volume. EBM stage was correlated to duration of illness (Spearman's ρ=0.293, p=7.03x10-16 ), age of onset (ρ=-0.18, p=9.82x10-7 ) and ASM resistance (AUC=0.59, p=0.043, Mann-Whitney U test). However, associations were driven by cases assigned to EBM stage zero, which represents MTLE-HS with mild or non-detectable abnormality on T1W MRI. SIGNIFICANCE: From cross-sectional MRI, we reconstructed a disease progression model that highlights a sequence of MRI changes that aligns with previous longitudinal studies. This model could be used to stage MTLE-HS subjects in other cohorts and help establish connections between imaging-based progression staging and clinical features