WHAT ARE THE DIFFERENCES BETWEEN EFFECTIVE AND INEFFECTIVE CHARTER SCHOOLS IN NORTH CAROLINA?

This purpose of this study was to investigate the effectiveness of the North Carolina charter schools. The variables were chosen based on the researcher‘s inference from literature reviews discussing common factors from qualitative charter school studies. The indicators were used to determine if charter schools could be categorized as effective or ineffective were: (1) attendance rates, (2) short suspensions, (3) student teacher ratio, (4) teacher quality, (5) Reading NCE, and (6) Math NCE scores. Charter schools were determined to be effective, if they were ?1? standard deviation point above average for Reading NCE and Math NCE scores. Charter schools were determined to be ineffective, if they were ?1? standard deviation point below average for Reading NCE and Math NCE scores. The data collected for this study was ex-post facto data from the North Carolina Department of Public Instruction‘s (NCDPI) website using the academic school year 2008-09. The data was coded and entered into SPSS creating a quantitative output to be analyzed and interpreted. The quantitative output determined that there were a total of 12 ineffective charter schools and 10 effective charter schools The results indicated that no charter schools in North Carolina were affiliated with a traditional school district. Also, the dependent variables, attendance rate and teacher quality were determined to be statistically significant in determining the effectiveness of a charter school in North Carolina. The other variables were determined to be insignificant in determining the effectiveness of charter schools in North Carolina

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Factors affecting outcome in liver resection

Background. Studies demonstrate an inverse relationship between institution/surgeon procedural volumes and patient outcomes. Similar studies exist for liver resections, which recommend referral of patients for liver resections to ‘high-volume’ centers. These studies did not elucidate the factors that underlie such outcomes. We believe there exists a complex interaction of patient-related and perioperative factors that determine patient outcomes after liver resection. We sought to delineate these factors

Effect of dimethyl sulfoxide in the treatment of sheep experimentally infected with Ehrlichia ruminantium

OBJECTIVE To evaluate the clinical response of sheep experimentally infected with Ehrlichia ruminantium to treatment with dimethyl sulfoxide (DMSO). ANIMALS 32 Merino crossbred sheep. PROCEDURES 16 sheep were infected with E ruminantium; 8 of these were treated twice daily with a 10% solution of DMSO (1 g/kg, i.v.) in polyionic fluid for 3 consecutive days. Treatment was initiated 2 days after the onset of clinical disease. Eight uninfected control sheep were similarly treated with DMSO. Placebo treatments (polyionic fluid administrations) were given to 8 infected and 8 uninfected sheep. Arterial and venous blood samples for blood gas and total plasma protein concentration measurements were collected daily (data from 5 days before until 6 days after onset of clinical disease were analyzed); physiologic variables and food consumption were also monitored. Gross pathologic findings and cytologic confirmation of the disease were recorded for the 16 infected sheep. RESULTS Infected sheep treated with DMSO were able to maintain pulmonary gas exchange and had reduced pleural effusion and plasma protein loss, compared with infected untreated sheep that became hypoxic. Infected treated sheep developed an uncompensated metabolic acidosis. Uninfected treated sheep had reduced appetite, whereas uninfected untreated sheep maintained normal food intake. CONCLUSIONS AND CLINICAL RELEVANCE Results of DMSO treatment in sheep with experimentally induced heartwater disease indicated that administration of this agent, in combination with specific antimicrobial treatment, may be of some benefit in treatment of naturally occurring disease