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1, 2 Chronic hypoxia in healthy sea-level natives who move to high altitude frequently causes PH. Pulmonary hypertension (PH) is a disease of the pulmonary vasculature, characterised by sustained elevation of pulmonary vascular resistance (PVR) and pulmonary arterial pressure, which can ultimately lead to the development of right ventricular (RV) hypertrophy, RV failure and death. Taken together, these results demonstrate that macrophage migration inhibitory factor plays a central role in the development of the pulmonary vascular responses to chronic alveolar hypoxia. The major mechanism underlying the greater increase in pulmonary vascular resistance in the hypoxic MIF –/– mice was reduction of the pulmonary vascular bed due to an impairment of the normal hypoxia-induced expansion of the alveolar capillary network. Following exposure to hypoxia for three weeks, isolated lungs from MIF –/– mice had significantly higher pulmonary vascular resistance than those from MIF +/+ mice. We report here that isolated lungs from adult macrophage migration inhibitory factor knockout ( MIF –/–) mice maintained in normoxic conditions showed greater acute hypoxic vasoconstriction than the lungs of wild type mice ( MIF +/+). However, because of the multiple pathways through which it acts, the integrated actions of macrophage migration inhibitory factor during the development of hypoxic pulmonary hypertension were unclear. Macrophage migration inhibitory factor expression is increased in animal models of hypoxic pulmonary hypertension and macrophage migration inhibitory factor tautomerase inhibitors, which block some of the functions of macrophage migration inhibitory factor, and have been shown to attenuate hypoxic pulmonary hypertension in mice and monocrotaline-induced pulmonary hypertension in rats. In several diseases, macrophage migration inhibitory factor has pro-inflammatory roles that are dependent upon signalling through the cell surface receptors CD74, CXCR2 and CXCR4. Macrophage migration inhibitory factor is a pleiotropic cytokine with endogenous tautomerase enzymatic activity as well as both intracellular and extracellular signalling functions. Age, experience, and type of school influence the results only in former normal situations but not in times of crisis.While it is well established that the haemodynamic cause of hypoxic pulmonary hypertension is increased pulmonary vascular resistance, the molecular pathogenesis of the increased resistance remains incompletely understood. The results indicate that principals do not lead in the same manner in times of crisis as in normal times.
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As a direct result, there was a high degree of adaptation to this situation from the principals. However, other resources scored lower during the same period.
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The principals scored their leadership resources remarkably high in the former normality and maintained proactivity at a similar level during the crisis. The data analysis results confirmed that the role of the principals was crucial in redirecting the situation and completing the academic course satisfactorily. The questionnaire analyzed personal leadership resources used by the principals during the confinement and post-confinement periods, compared to a former ¨normal situation¨. A questionnaire was designed, validated, and provided to the principals from Primary Education schools to carry out the study. This article analyzes the personal leadership resources utilized by a sample of school principals in Catalonia (Spain) during the confinement and post-confinement periods due to the COVID-19 crisis.