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Calls to diversify the professoriate have been ongoing for decades. However, despite increasing numbers of scholars from underrepresented racial minority groups earning doctorates, actual progress in transitioning to faculty has been slow, particularly across STEM disciplines. In recent years, new efforts have emerged to recruit faculty members from underrepresented racial minority groups (i.e., African American/Black, Hispanic/Latinx, and/or Native American/Native Hawaiian/Indigenous) through highly competitive postdoctoral programs that allow fellows the opportunity to transition (or “convert”) into tenure-track roles. These programs hybridize some conventional aspects of the faculty search process (e.g., structured interview processes that facilitate unit buy-in) along with novel evidence-based practices and structural supports (e.g., proactive recruitment, cohort communities, search waivers, professional development, enhanced mentorship, financial incentives). In this policy and practice review, we describe and synthesize key attributes of existing conversion programs at institutional, consortium, and system levels. We discuss commonalities and unique features across models (N= 38) and draw specific insights from postdoctoral conversion models developed within and across institutions in the University System of Maryland (USM). In particular, experience garnered from a 10-year-old postdoc conversion program at UMBC will be highlighted, as well as the development of an additional institutional model aimed at the life sciences, and a state-system model of faculty diversification with support from a NSF Alliances for Graduate Education and the Professoriate (AGEP) grant.

Objectives The aim of this study was to investigate, whether maternal serum levels of sFlt-1, PlGF and PAPP-A at third trimester of pregnancy are associated with late-onset PE and intrauterine growth retardation (IUGR) after 34 weeks of pregnancy. Methods This was a prospective study measuring the maternal serum levels of soluble tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF) and pregnancy-associated plasma protein-A (PAPP-A) at 32–37 weeks of pregnancy: 730 patients were enrolled and 676 had neither intrauterine growth restriction (IUGR) nor preeclampsia (PE) or pregnancy induced hypertension (PIH) throughout the pregnancy. 22 patients developed IUGR, 32 PE and 24 PIH. Results Linear regression analyses after adjusting for maternal age, gestational age at the blood sampling and maternal BMI showed associations between PE and serum sFlt-1 levels (Exp(s) = 3.29; 95% CI: 2.69–4.04), serum PlGF levels (Exp(s) = 0.18; 95% CI: 0.13–0.24), sFlt-1/PlGF ratio (Exp(s) = 15.59; 95% CI: 10.64–22.84) and serum PAPP-A (Exp(s) = 1.48; 95% CI 1.15–1.89). sFlt-1, PlGF and sFlt-1/PlGF-Ratio showed comparable area under the curve (AUC) estimates with a predictive ability to discriminate pregnancies developing PE and IUGR from controls. The predictive ability of PAPP-A for PE was only slightly better than chance. Conclusions This study supported the ability of a single measurement of sFlt-1/PlGF ratio at third trimester to predict PE and IUGR occurring after 34 weeks of pregnancy. However, larger multicentre studies are needed to replicate our results.

Objectives Midregional pro atrial natriuretic peptide (MR-proANP) is a cardiac biomarker and the maternal serum levels could be different in preeclampsia (PE) or intrauterine growth restriction (IUGR) at third trimester of pregnancy. Methods This prospective study measured serum levels of MR-proANP between 32 and 37 weeks of pregnancy: 32 patients suffered from PE and 22 developed IUGR. 676 patients exhibited no pregnancy complications. Results The median level of MR-proANP was significantly higher in PE (64.9 pmol/l (interquartile range (IQR) 36.3-105.2) and IUGR (59.7 pmol/l (IQR 39.7- 163.0) groups compared to controls (38.7 pmol/l (IQR 29.7-49.2). Linear regression analysis showed association between PE and MR-proANP levels (Exp(s)= 1.56; 95% CI: 1.34-1.81). Area under the curve (AUC) estimates showed a predictive value for PE (AUC: 0.72) and IUGR (AUC: 0.71). Conclusions Measuring MR-proANP in maternal serum at third trimester could predict PE and IUGR presenting after 34 weeks of pregnancy. Thus, we assume that MR-proANP may be an additional biomarker which mirrors the maternal cardiosvascular status next to sFlt-1/PLGF representing the angiogenic status.

Purpose: Oxidative stress is involved in the pathogenesis of hypertensive disorders such as preeclampsia (PE) and associated with the human vitamin E-binding protein afamin. The aim of this study was, therefore, to analyse afamin in the first trimester of patients developing PE later in pregnancy and in control subjects without pregnancy complications. Methods: In this retrospective study, 137 serum samples from the first trimester of pregnancy were analysed in a case–control study design. 39 patients developed PE (10 patients with early-onset and 29 patients with late onset disease) and 98 women had an uncomplicated pregnancy. Mann–Whitney U test, t test, logistic regression and ROC analyses were performed for statistical evaluation. Results: Pregnant women developing PE presented with higher afamin concentrations in the first trimester [median 101.81 mg/L; interquartile range (IQR) 88.94–113.26] compared to subjects with uncomplicated pregnancy (median 86.40; IQR 75.26–96.92; p < 0.001). After adjusting for confounders, the odds ratio per afamin standard deviation was 1.60 (95% CI: 1.04–2.58; p = 0.04). An afamin threshold concentration of 87.8 mg/L exhibited the best sensitivity (79.5%) and specificity (57.1%) in predicting PE. Subgroup analysis of early- and late-onset disease resulted in substantially higher afamin concentrations in women with developing late-onset PE compared to controls (p < 0.001) with an odds ratio per afamin standard deviation of 1.62 (95% CI: 0.98–2.70; p = 0.06). Conclusions: Serum afamin concentrations are elevated in the first trimester among patients developing PE compared to controls. Substantial differences were observed mainly among patients with late-onset PE.

Die Geburtseinleitung ist eine haufige geburtshilfliche Masnahme, die bei angemessener Indikationsstellung Vorteile fur Mutter und Kind erbringen kann. Zur Verfugung stehen sowohl medikamentose als auch mechanische Methoden: PGE1/PGE2 in unterschiedlicher Verabreichungsform und Oxytocin sowie mechanische Instrumente wie der Zervixreifungsballon (CRB Cook®) und Foley-Katheter (Off-label-Use). Ein kombiniertes Einleitungsschema, das mechanische Methoden wie den Zervixreifungsballon impliziert, erscheint effektiv, sicher und fur die Patientinnen sehr zufriedenstellend.

Anti-Mullerian-hormone (AMH) does not seem to fluctuate significantly during the menstrual cycle in healthy women. However, little is known about cycle fluctuations of AMH levels in patients with polycystic ovarian syndrome (PCOS). The purpose of this study was to examine AMH fluctuations during the follicular phase in PCOS patients receiving antiestrogens or recombinant follicle-stimulating hormone (FSH). About 40 PCOS patients diagnosed according to Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group 2003 and 19 controls were prospectively enrolled. PCOS patients received either antiestrogens or recombinant FSH for monoovulation induction and controls received antiestrogens. AMH levels were determined (1) between the 2nd and the 5th day of follicular phase and (2) when a single large dominant follicle ≥18 mm had appeared. Our study shows that AMH levels do not change during follicular development in controls as well as in PCOS patients with AMH levels 5 ng/ml, irrespective of antiestrogen or FSH therapy. However, in PCOS patients with AMH levels ≥5 ng/ml, AMH declines significantly during follicular development (p 0.01). We conclude that AMH levels should be determined in the early follicular phase in PCOS patients without the influence of antiestrogens or exogenous FSH, because these interventions may lower AMH values in patients with high levels.

Oxidative stress seems to be present in patients with polycystic ovary syndrome (PCOS). The aim of this study was to evaluate the correlation between characteristics of PCOS and serum concentrations of afamin, a novel binding protein for the antioxidant vitamin E. A total of 85 patients with PCOS and 76 control subjects were investigated in a pilot cross-sectional study design between 2009 and 2013 in the University Hospital of Essen, Germany. Patients with PCOS were diagnosed according to the Rotterdam ESHRE/ASRM-sponsored PCOS Consensus Workshop Group. Afamin and diagnostic parameters of PCOS were determined at early follicular phase. Afamin concentrations were significantly higher in patients with PCOS than in controls (odds ratio (OR) for a 10 mg/ml increase in afamin=1.3, 95% CI=1.08–1.58). This difference vanished in a model adjusting for age, BMI, free testosterone index (FTI), and sex hormone-binding globulin (SHBG) (OR=1.05, 95% CI=0.80–1.38). In patients with PCOS, afamin correlated significantly with homeostatic model assessment-insulin resistance (HOMA-IR), fasting glucose, BMI, FTI, and SHBG (PP=0.001). No correlation was observed between afamin and androgens, LH, FSH, LH/FSH ratio, antral follicle count, ovarian volume, or anti-Müllerian hormone. In conclusion, elevated afamin values may indicate a state of oxidative stress and inflammation, strongly associated with IR and offering an indicator of impaired glucose tolerance in patients with PCOS irrespective of obesity.

Features of polycystic ovarian syndrome (PCOS) including sonographic aspects, androgens, LH and LH/FSH ratio as well as Anti-Mullerian Hormone (AMH) were evaluated according to their diagnostic potency in detecting different degrees of PCOS severity. 80 women with PCOS diagnosed according to the Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group 2003 and 48 controls were enrolled between 2011 and 2013. PCOS patients fulfilling all Rotterdam criteria were defined as having severe PCOS (n = 59), while patients showing oligo-/amenorrhoea and polycystic ovaries but without hyperandrogenemia were defined as having mild PCOS (n = 21). All patients were treated at the University Hospital of Essen, Germany. The strongest group difference between controls and severe PCOS patients was observed for AMH showing an age-adjusted odds ratio of 2.56 [95 % confidence interval (CI) 2.00–3.27; p

A common phenomenon in the financial reports of Nigerian pharmaceutical companies is the volume of short-term and long-term liabilities that forms a considerable size of their capital structure. Explaining the role of financial leverage in companies' financial performance is one of the primary objectives of contemporary researches and this role remains a questionable subject which has continued to attract the attention of many researchers. The main objective of this study is to determine the effect of financial leverage on financial performance of the Nigeria pharmaceutical companies over a period of twelve (12) years (2001 - 2012) for the three (3) selected companies. This work employed three (3) financial leverage for the independent variables such as: debt ratio (DR); debt-equity ratio (DER) and interest coverage ratio (ICR) in determining their effect on financial performance for Return on Assets (ROA) as dependent variable. The ex-post facto research design was used for this study. The secondary data were obtained from the financial statement (Comprehensive income statement and Statement of financial position) of the selected pharmaceutical companies' quoted on the Nigerian Stock Exchange (NSE). Descriptive statistics, Pearson correlation and regressions were employed and used for this study. The results of the analysis showed that debt ratio (DR) and debt-equity ratio (DER) have negative relationship with Return on Assets (ROA) while interest coverage ratio (ICR) has a positive relationship with Return on Assets (ROA) in Nigeria pharmaceutical industry. The analysis also revealed that all the independent variables have no significant effect on financial performance of the sampled companies. The results further suggested that only 16.4% of the variations on the dependent variable are caused by the independent variables in our model suggesting that 83.6% of the variations in financial performance are caused by other factors outside our model. Based on the above findings, the researchers now recommend that companies' management should ensure that financial decisions made by them are in consonance with the shareholders' wealth maximization objectives which encompasses the profit maximization objective of the firm. The amount of debt finance in the financial mix of the firm should be at the optimal level so as to ensure adequate utilisation of the firms' assets. The management should also monitor the interest charged on debt financing to avoid liquidation of the company.

Objective Ovarian quiescence is a common condition during pregnancy. In vitro, follistatin, an antagonist of follicle-stimulating hormone, blocks follicular development at early stages, and its serum levels increase during pregnancy. A possible surrogate biomarker of ovarian arrest during pregnancy is a decrease in anti-mullerian hormone (AMH) levels followed by an increase in these levels on the second day after labor. The purpose of this study was to determine whether follistatin could act as an ovarian-suppressing agent during pregnancy. Follistatin levels and AMH levels were determined at various stages of pregnancy and postpartum. Study design The follistatin and AMH levels of 69 patients were retrospectively determined with the AMH Gen II ELISA and with the Human Follistatin Quantikine ELISA Kit. For 49 patients, samples were available from various trimesters for cross-sectional analysis; for the other 20, samples were available longitudinally from day one before labor and then daily on days 1 through 4 after labor. Statistical significance was determined with linear regression, the Friedman rank sum test and the Wilcoxon–Nemenyi–McDonald–Thompson post hoc test. Results The behavior of follistatin levels was exactly opposite that of AMH levels: Follistatin levels increased significantly during pregnancy and on the first day after parturition but declined afterwards, whereas AMH levels decreased significantly during pregnancy and increased after labor. Conclusion Follistatin can induce ovarian arrest during pregnancy.

The present study was conducted to determine whether the use of strategic management Accounting Techniques (SMAT) is capable of providing Managers with information for sustainability in corporate governance. A survey was carried out using a well-structured questionnaire with questions on five point Likert format. The questionnaire was administered on one hundred and five Management staff specialized in Accounting and management related disciplines across product sector organizations. Primary data was gathered from the one hundred and five respondents and multiple regression technique was used for analysis. Our findings revealed the need for managers to employ strategic management accounting techniques (SMATs) to enable them identify, accumulate and manage social and environment costs of their activities for good corporate governance in Nigeria.

Shoulder dystocia is the term used to describe failure to progress in labour after the head has been delivered due to insufficient rotation of the shoulders. It is unpredictable and cannot be prevented by the midwife or the obstetrician. We report here on a severe case of shoulder dystocia, where delivery of the shoulder was finally achieved through direct pressure on the anterior shoulder after laparotomy and uterotomy with concurrent vaginal Woods screw manoeuvre and was followed by vaginal delivery. The patient presented risk factors like maternal obesity and administration of labour-inducing drugs. After different manoeuvres like McRoberts manoeuvre and several manoeuvres for internal rotation were carried out unsuccessfully, an emergency laparotomy was performed. The newborn was in need for reanimation and artifical ventilation postpartum but recovered fast during the following days. An Erb's palsy of the posterior arm improved during the hospital stay. The German Guideline of the DGGG 8 recommends a risk management plan and regular training to all birth attendants for obstetric clinics. Beside the vaginal manoeuvres one should have at least theoretical expertise in operative manoeuvres to be able to perform them in emergency cases.Die Schulterdystokie beschreibt einen Geburtsstillstand nach Geburt des Kopfes aufgrund unzureichender Schulterdrehung. Das Ereignis trifft die geburtshilflich tätige Person in der Regel völlig unerwartet. Es wird hier über einen Fall einer schweren Schulterdystokie berichtet, bei dem die Schulterlösung durch direkten Druck auf die vordere Schulter nach Laparotomie und Uterotomie bei gleichzeitigem Woods-Screw-Manöver von vaginal mit anschließender vaginaler Entbindung gelang. Die Patientin wies eine Adipositas und die Gabe von wehenfördernden Mitteln als Risikofaktoren auf. Nach erfolgloser Ausführung des McRoberts-Manövers und diverser Manöver zur inneren Rotation wurde eine Notlaparotomie durchgeführt. Das Neugeborene musste direkt postpartal reanimiert und für einige Stunden beatmet werden, erholte sich im weiteren Verlauf jedoch rasch. Eine Erbʼsche Armplexuslähmung des hinteren Armes besserte sich während des stationären Aufenthalts. Die Leitlinie der DGGG 8 sieht einen Risikomanagement-Plan sowie regelmäßiges Training aller beteiligten Personen für alle geburtshilflich tätigen Kliniken vor. Hierbei sollten nicht nur die vaginalen Manöver geübt werden, sondern auch zumindest theoretische Kenntnisse der operativen Manöver vermittelt werden, um sie im Notfall anwenden zu können.

Cervical cancer is the third most common cancer occurring in women worldwide. The therapy for advanced stage cervical cancer is a particular challenge. There are no evidence-based recommendations for the therapy of advanced cervical cancer FIGO stage IV in the guidelines of the German Working Group on Gynecological Oncology nor in the international literature. Large randomised and prospective studies on treatment are missing. We present a patient with cervical cancer (FIGO stage IV B) with bulky metastatic lymph nodes in the obturator fossae and the paraaortic area. In accordance with existing studies, laparoscopic lymphadenectomy and tumour debulking with excision of the metastases was performed after clinical staging. Postoperatively, radiochemotherapy was initiated with boost in the area of the bulky lymph nodes. Laparoscopic lymphadenectomy improved the prognosis of this patient and is, according to existing studies, superior to laparotomy with regard to convalescence time, blood loss and hospital stay. But it is absolutely necessary that the procedure is performed by an experienced surgeon who is well acquainted with the technique.

We investigated the potential value of maternal serum copeptin, midregional proatrial natriuretic peptide (MR-proANP) and Procalcitonin (PCT) levels at 11–13 weeks’ gestation in the prediction of preeclampsia (PE) in a case–control study. Maternal serum concentration of copeptin, MR-proANP and PCT were measured at 11–13 weeks’ gestation in cases of PE (n = 35) and controls (n = 100). The PE group was divided into early-onset PE (EO-PE) and late-onset PE (LO-PE). From the regression model, the value in each case and control was expressed as a multiple of the expected median (MoM). The Mann–Whitney test was used to determine the significance of differences in the median MoM in each outcome group from that in the controls. In the PE group, compared to controls, maternal serum concentrations of copeptin, MR-proANP and PCT were not significantly different. The maternal serum copeptin, MR-proANP and PCT levels are higher in EO-PE and LO-PE patients, but the difference is not significant. Thus, their levels in first trimester are not proven to be effective markers to screen for PE.

Der Konsum legaler oder illegaler Substanzen kann zu Schaden der Mutter-Plazenta-Kind-Einheit fuhren. Am bekanntesten ist das fetale Alkoholsyndrom, es spiegelt die Teratogenitat von Alkohol wider. Auch fur andere Substanzen wie Nikotin, Amphetamine, Kokain und Cannabis wurden in Studien nicht nur unmittelbar postnatal Auffalligkeiten des Neugeborenen beschrieben. Vermutlich kommt es durch fetale Programmierung und Storung des neuroendokrinen Systems pranatal zu Auffalligkeiten, die bis ins Jugendalter nachweisbar sind. Fur die Betreuung der substanzabhangigen Schwangeren und deren Kindern ist eine interinstitutionelle Vernetzung zwischen medizinischen Fachgebieten und Amtern notig.

Financial ratio analysis is a vital one since the profitability of an enterprise is directly affected by such decision. The successful selection and use of appropriate financial ratio is one of the key elements of the firm’s financial strategy. Hence, proper care and attention need to be given while such decision is taken. The purpose of this study is to examine the relationship between the financial ratio analysis and profitability of the Nigerian Pharmaceutical industry over the past eleven (11) years period from 2001 – 2011. These financial ratio analyse have immense potentials to help organizations in improving their revenue generation ability as well as minimization of costs. The researcher used five (5) variables for the analyses such as: Inventory turnover ratio (ITR); Debtors’ turnover ratio (DTR); Creditors’ velocity (CRSV); Total assets turnover ratio (TATR) and Gross profit margin (GPM). Profitability as a dependent variable is represented by Gross profit margin (GPM) while financial ratio analysis stands as ITR, DTR, CRSV and TATR for independent variables. Secondary data were obtained from the financial statements (Balance sheet and Profit and Loss account) of the selected quoted pharmaceutical companies’ financial statement. The data have been analyzed using descriptive research method and multiple regressions to find out the relationship between the variables. The results of the analysis showed that there is a negative relationship between all independent variables with profitability in the Nigerian pharmaceutical industry. It also revealed that debtors’ turnover ratio, creditors’ velocity and total assets turnover ratio have no significant relationship on the profitability of the company while only inventory turnover ratio shows a significant relationship with profitability. The results further suggested that only 17.8% of the independent variables are determinant factors of profitability in the enterprises sampled while 82.2% of the major factors are determine from other factors outside the independent variables. Based on the above premises, the researcher recommended that the inventories of the company should be checked and monitored more frequently by management to prevent out of stock syndrome or over stocking of their products. It is also recommended that creditors’ velocity should be at a point where the creditors and purchases are equal in order to take the advantage of credit facility and any discount associated with prompt payment for goods to increase the profitability of the company. The management should utilize its assets efficient in generating more income for the company.