Factors Accounting for Variability in Superintendent Ratings of Academic Preparation

This study utilized findings from the 2010 decennial study of the school superintendent to determine the extent to which four predictor variables (courses, professor credibility, size [enrollment of employing school district], and gender) accounted for variability in superintendent overall ratings of their academic preparation. The standardized regression coefficients indicate that most of the variance accounted for in the linear equation was due to ratings of professor credibility and ratings of the perceived value of courses. Neither the institutional variable, school district size, nor the personal variable, gender, accounted for meaningful variance in the overall ratings. Recommendations are made for extending this line of inquiry

Job Satisfaction of Female and Male Superintendents: The Influence of Job Facets and Contextual Variables as Potential Predictors

A descriptive multiple regression approach was used to assess the job satisfaction of female and male public school superintendents taking part in a decennial survey conducted by AASA. Self-reported job satisfaction of public school superintendents was regressed on their affective reactions to specific job facets (supervision, co-workers, and compensation) and to contextual variables (type of school district, legislative mandates, and funding sources) purported to influence their job satisfaction. Results indicate that female and male superintendents were found to be similarly satisfied with their current job assignment but for different reasons as revealed by interaction terms addressed in the regression analyses

Looking Back, Looking Forward: How the Economic Downturn Continues to Impact School Districts

This study is the fourth in a series of studies conducted by the American Association of School Administrators on the impact of the economic downturn on schools. Collectively, the findings of the AASA Economic Impact Study series demonstrate that school districts in every part of the country are subject to the realities of the economic downturn. While this benchmark data cannot predict a trend, it is difficult to deny that the financial crisis is increasingly threatening the progress schools have obtained and the stability they have enjoyed in the past. This latest study, “Looking Back, Looking Forward: How the Economic Downturn Continues to Impact School Districts,” is based on a study of school administrators conducted in February and March 2009. This survey asked many of the same questions as the “AASA Study of the Impact of the Economic Downturn on Schools,” conducted in October 2008. Therefore, it is possible to compare and contrast key findings from the two studies

Impact of the Economic Downturn on Schools

In Fall 2008, in response to the recent economic downturn, as evidenced in state budget shortfalls, federal buy‐outs and interventions, and a series of additional events characterizing a slowing, stagnant economy, AASA examined the impact on school districts across the nation. While there are regional differences, the findings of AASA’s Economic Impact Survey, presented here, demonstrate that superintendents in every part of the country are subject to the realities of the economic downturn. While this benchmark data cannot predict a trend, it is difficult to deny that superintendents, in increasing numbers, are confronted by the looming financial crisis that threatens the progress schools have obtained and the stability they have enjoyed in the past

Lower diagnostic accuracy of hs-cTnI in patients with prior coronary artery bypass grafting

High-sensitivity cardiac troponin T (hs-cTnT) and the ESC 0/1h-hs-cTnT-algorithm have worse performance in the early diagnosis of myocardial infarction (MI) in patients with prior coronary artery bypass grafting (CABG). It is unknown, whether this concern applies also to hs-cTnI, the most widely used analyte worldwide.; In an international multicenter diagnostic study, two cardiologists centrally adjudicated the final diagnosis in patients presenting to the emergency department with symptoms suggestive of MI according to the Third Universal Definition of MI. The objective was to compare the diagnostic accuracy of hs-cTnI assays and their performance within the ESC hs-cTnI 0/1h-algorithms in patients with versus without prior CABG. Findings were externally validated in an U.S. multicenter diagnostic study.; A total of 392/5'200 patients (8%) had prior coronary artery bypass grafting (CABG). Diagnostic accuracy of hs-cTnI as quantified by the area under the receiver-operating characteristics-curve (AUC) in these patients was high, but lower versus patients without prior CABG (e.g. hs-cTnI-Architect 0.91 versus 0.95; p = 0.016). Sensitivity/specificity of rule-out/in by the European Society of Cardiology (ESC) 0/1h-hs-cTnI-algorithms remained very high [e.g. hs-cTnI-Architect 100% and 93.5%], but efficacy was lower (52% versus 74%, p < 0.01). External validation (n = 2113) confirmed these findings in 192 patients with prior CABG using hs-cTnI-Atellica, with 52% versus 36% (p < 0.001) remaining in the observe zone.; Diagnostic accuracy of hs-cTnI and efficacy of the ESC 0/1h-hs-cTnI-algorithms are lower in patients with prior CABG, but sensitivity/specificity remain very high.; https://clinicaltrials.gov/ct2/show/NCT00470587, number NCT00470587

Familial ALS-Associated Mutations Decrease the Thermal Stability of Distinctly Metallated Species of Human Copper/Zinc Superoxide Dismutase

We report the thermal stability of wild type (WT) and 14 different variants of human copper/zinc superoxide dismutase (SOD1) associated with familial amyotrophic lateral sclerosis (FALS). Multiple endothermic unfolding transitions were observed by differential scanning calorimetry for partially metallated SOD1 enzymes isolated from a baculovirus system. We correlated the metal ion contents of SOD1 variants with the occurrence of distinct melting transitions. Altered thermal stability upon reduction of copper with dithionite identified transitions resulting from the unfolding of copper-containing SOD1 species. We demonstrated that copper or zinc binding to a subset of “WT-like” FALS mutants (A4V, L38V, G41S, G72S, D76Y, D90A, G93A, and E133Δ) conferred a similar degree of incremental stabilization as did metal ion binding to WT SOD1. However, these mutants were all destabilized by ∼1–6 °C compared with the corresponding WT SOD1 species. Most of the “metal binding region” FALS mutants (H46R, G85R, D124V, D125H, and S134N) exhibited transitions that probably resulted from unfolding of metal-free species at ∼4–12 °C below the observed melting of the least stable WT species. We conclude that decreased conformational stability shared by all of these mutant SOD1s may contribute to SOD1 toxicity in FALS

Biomarkers Enhance Discrimination and Prognosis of Type 2 Myocardial Infarction

Background: The observed incidence of type 2 myocardial infarction (T2MI) is expected to increase with the implementation of increasingly sensitive cardiac troponin (cTn) assays. However, it remains to be determined how to diagnose, risk stratify and treat patients with T2MI. We aimed to discriminate and risk-stratify T2MI using biomarkers. Methods: Patients presenting to the Emergency Department with chest pain, enrolled in the CHOPIN study, were retrospectively analyzed. Two cardiologists adjudicated type 1 MI (T1MI) and T2MI. The prognostic ability of several biomarkers alone or in combination to discriminate T2MI from T1MI was investigated using receiver operating characteristic (ROC) curve analysis. The biomarkers analyzed were cTnI, copeptin, mid-regional pro-atrial natriuretic peptide (MRproANP), C-terminal pro-endothelin-1 (CT-proET1), mid-regional pro-adrenomedullin (MRproADM) and procalcitonin. Prognostic utility of these biomarkers for all-cause mortality and major adverse cardiovascular event (MACE: a composite of acute MI, unstable angina pectoris, reinfarction, heart failure, and stroke) at 180-day follow-up was also investigated. Results: Among the 2071 patients, T1MI and T2MI were adjudicated in 94 and 176 patients, respectively. Patients with T1MI had higher levels of baseline cTnI, while those with T2MI had higher baseline levels of MR-proANP, CT-proET1, MR-proADM, and procalcitonin. The area under the ROC curve (AUC) for the diagnosis of T2MI was higher for CT-proET1, MRproADM and MR-proANP (0.765, 0.750, and 0.733, respectively) than for cTnI (0.631). Combining all biomarkers resulted in a similar accuracy to a model using clinical variables and cTnI (0.854 versus 0.884, p = 0.294). Addition of biomarkers to the clinical model yielded the highest AUC (0.917). Other biomarkers, but not cTnI, were associated with mortality and MACE at 180-day among all patients, with no interaction between the diagnosis of T1MI or T2MI. Conclusions: Assessment of biomarkers reflecting pathophysiologic processes occurring with T2MI might help differentiate it from T1MI. Additionally, all biomarkers measured, except cTnI, were significant predictors of prognosis, regardless of type of MI

Use of procalcitonin for the diagnosis of pneumonia in patients presenting with a chief complaint of dyspnoea: results from the BACH (Biomarkers in Acute Heart Failure) trial

Biomarkers have proven their ability in the evaluation of cardiopulmonary diseases.We investigated the utility of concentrations of the biomarker procalcitonin (PCT) alone and with clinical variables for the diagnosis of pneumonia in patients presenting to emergency departments (EDs) with a chief complaint of shortness of breath. The BACH trial was a prospective, international, study of 1641 patients presenting to EDs with dyspnoea. Blood samples were analysed for PCT and other biomarkers. Relevant clinical data were also captured. Patient outcomes were assessed at 90 days. The diagnosis of pneumonia was made using strictly validated guidelines. A model using PCT was more accurate [area under the curve (AUC) 72.3%] than any other individual clinical variable for the diagnosis of pneumonia in all patients, in those with obstructive lung disease, and in those with acute heart failure (AHF). Combining physician estimates of the probability of pneumonia with PCT values increased the accuracy to .86% for the diagnosis of pneumonia in all patients. Patients with a diagnosis of AHF and an elevated PCT concentration (.0.21 ng/mL) had a worse outcome if not treated with antibiotics (P ¼ 0.046), while patients with low PCT values (,0.05 ng/mL) had a better outcome if they did not receive antibiotic therapy (P ¼ 0.049). Procalcitonin may aid in the diagnosis of pneumonia, particularly in cases with high diagnostic uncertainty. Importantly, PCT may aid in the decision to administer antibiotic therapy to patients presenting with AHF in which clinical uncertainty exists regarding a superimposed bacterial infection