The Joint Program Dilemma: Analyzing the Pervasive Role That Social Dilemmas Play in Undermining Acquisition Success

Tenth Annual Acquisition Research Symposium Acquisition ManagementExcerpt from the Proceedings of the Tenth Annual Acquisition Research Symposium Acquisition ManagementNaval Postgraduate School Acquisition Research ProgramPrepared for the Naval Postgraduate School, Monterey, CANaval Postgraduate School Acquisition Research ProgramApproved for public release; distribution is unlimited

IL-2 Immunotherapy to Recently HIV-1 Infected Adults Maintains the Numbers of IL-17 Expressing CD4+ T (TH17) Cells in the Periphery

Little is known about the manipulation of IL-17 producing CD4+ T cells (TH17) on a per-cell basis in humans in vivo. Previous studies on the effects of IL-2 on IL-17 secretion in non-HIV models have shown divergent results. We hypothesized that IL-2 would mediate changes in IL-17 levels among recently HIV-1-infected adults receiving anti-retroviral therapy. We measured cytokine T cell responses to CD3/CD28, HIV-1 Gag, and CMV pp65 stimulation, and changes in multiple CD4+ T cell subsets. Those who received IL-2 showed a robust expansion of naive and total CD4+ T cell counts and T-reg counts. However, after IL-2 treatment, the frequency of TH17 cells declined, while counts of TH17 cells did not change due to an expansion of the CD4+ naïve T cell population (CD27+CD45RA+). Counts of HIV-1 Gag-specific T cells declined modestly, but CMV pp65 and CD3/CD28 stimulated populations did not change. Hence, in contrast with recent studies, our results suggest IL-2 is not a potent in vivo regulator of TH17 cell populations in HIV-1 disease. However, IL-2-mediated T-reg expansions may selectively reduce responses to certain antigen-specific populations, such as HIV-1 Gag

The Decline and Fall of Joint Acquisition Programs

Naval Postgraduate School Acquisition Research Progra

Gender-Based Disparity Exists in the Surgical Experience of Female and Male Urology Residents

To determine if a discrepancy exists in the number and type of cases logged between female and male urology residents. ACGME case log data from thirteen urology residency programs was collected from 2007 to 2020. The number and type of cases for each resident were recorded and correlated with resident gender and year of graduation. The median, and 25th and 75th percentiles number of cases were calculated by gender, and then compared between female and male residents using Wilcoxon rank sum test. A total of 473 residents were included in the study, 100 (21%) were female. Female residents completed significantly fewer cases, 2174, compared to male residents, 2273 (p = 0.038). Analysis by case type revealed male residents completed significantly more general urology (526 versus 571, p = 0.011) and oncology cases (261 versus 280, p = 0.026). Additionally, female residents had a 1.3 fold increased odds of logging a case in the assistant role than male residents (95% confidence interval: 1.27 - 1.34, p < 0.001). Gender-based disparity exists within the urology training of female and male residents. Male residents logged nearly 100 more cases than female residents over four years, with significant differences in certain case subtypes and resident roles. The ACGME works to provide an equal training environment for all residents. Addressing this finding within individual training programs is critical