Faculty bargaining in public higher education

A review of Faculty Bargaining in Public Higher Education, a Report and Two Essays, by the Carnegie Council on Policy Studies in Higher Education

The γδ T Lymphocytes of the Perinatal Murine Thymus

We have previously shown that the adult thymus contains three subsets of γδ T cells that can be defined by the expression of Thy-1 and heat-stable antigen (HSA). In this study, the number of cells in each of these thymic γδ populations was investigated at different stages throughout life. In adult mice, the populations stayed relatively constant, however, in contrast, there were major variations in them early in development. It was shown that only two of the γδ populations were present in the prenatal thymus, a major population of Thy-1+ HSA- cells, and a smaller population of Thy-1+ HSA- cells. However, after birth, most of the Thy-1+ HSA-cells appear to loose the Thy-1 antigen, forming the third population of HSA- Thy-1-cells. The adult configuration of populations appeared to be established within the first week after birth. Therefore, whereas the γδ populations stayed relatively constant from this time point onwards, there were major variations early in development. Throughout life, most γδ thymocytes are CD4- CD8-, however, in the neonatal thymus, there are some CD4+ and CD8+ γδ thymocytes, and these are contained in the Thy-1+ HSA- population

Reflections on the Limitations of Rational Discourse, Empirical Data, and Legal Mandates as Tools for the Achievement of Gender Equity in American Higher Education

Scholars and academicians implicitly accept and subscribe to the notion that reasoned discourse supported by empirical data is at the core of the academic enterprise. Theoretically, then, organizational change within the academy ought to be attainable through the use of rational processes based upon the systematic collection, analysis, and interpretation of data to define the scope of the problem and to identify logical solutions. However, the centuries-long attempt to achieve gender equity for women in institutions of higher education belies the truth of that belief in the power of reason as a catalyst for reforming American higher education. Beginning with the Seneca Falls Convention in 1848, moving through the mid-twentieth century’s flurry of legal initiatives, and including two waves of scholarly studies and investigations of sexism on campus, the dominant characteristic of all the efforts to achieve gender equity in American colleges and universities has been reliance on reasoned discourse and data-based argumentation. Yet, today, only sixteen percent of all college and university presidents are women and less than one in four private research university faculty are women while well over fifty percent of all students are women. This paper is a reflection on the limited successes achieved in the almost 150 years since the Seneca Falls Convention using traditionally accepted academic approaches to eradicate sexism in the academy. The origins of the thoughts, ideas, and opinions offered here are found in the work of the Senate Council Ad Hoc Committee on the Status of Women at the University of Kentucky (“UK”). That work represents one of several contemporary efforts to use reasoned discourse predicated on empirical data to stimulate progress toward gender equity on campus. As such, and placed in its historical context, the experience of this UK committee is a case study in the long tradition of effort to use logic and reason to attain equal opportunities for women in higher education. When combined with the recent efforts of eight other similar universities, the UK experience highlights the limitations of the traditional academic approach to brining about gender-related organizational change. Equally important, when viewed collectively, these nine institutional change efforts illuminate various elements of the deeply entrenched, nonrational sensibilities present on campuses that limit the effectiveness of reasoned discourse, empirical data, and even legal mandates as tools for the achievement of gender equity. This Article briefly traces the early history of women’s struggle to secure access to educational and employment opportunities in America’s colleges and universities. A synopsis of the findings of the “First Wave” of investigations in the late 1960s and early 1970s of gender in the academy provides a context for the various legal strategies undertaken to secure gender equity in academia during the same time period. In the late 1980s a “Second Wave” of studies on gender on campus emerged. The results and implications of both a single institutional case study and a nine institution comparative study are reported and analyzed

Elective laparoscopic cholecystectomy:recurrent biliary admissions predispose to difficult cholecystectomy

INTRODUCTION: Patients undergoing elective laparoscopic cholecystectomy (ELLC) represent a heterogeneous group making it challenging to stratify risk. The aim of this paper is to identify pre-operative factors associated with adverse peri- and post-operative outcomes in patients undergoing ELLC. This knowledge will help stratify risk, guide surgical decision making and better inform the consent process. METHODS: All patients who underwent ELLC between January 2015 and December 2019 were included in the study. Pre-operative data and both peri- and post-operative outcomes were collected retrospectively from multiple databases using a deterministic records-linkage methodology. Patients were divided into groups based on clinical indication (i.e. biliary colic versus cholecystitis) and adverse outcomes were compared. Multivariate regression models were generated for each adverse outcome using pre-operative independent variables. RESULTS: Two-thousand one hundred and sixty-six ELLC were identified. Rates of peri- and post-operative adverse outcomes were significantly higher in the cholecystitis versus biliary colic group and increased with number of admissions of cholecystitis (p < 0.05). Rates of subtotal (29.5%), intra-operative complication (9.8%), post-operative complications (19.6%), prolonged post-operative stay (45.9%) and re-admission (16.4%) were significant in the group of patients with ≥ 2 admissions with cholecystitis. CONCLUSION: Our data demonstrate that patients with repeated biliary admission (particularly cholecystitis) ultimately face an increased risk of a difficult ELLC with associated complications, prolonged post-operative stay and readmissions. These data provide robust evidence that individualised risk assessment and consent are necessary before ELLC. Strategies to minimise recurrent biliary admissions prior to LC should be implemented

Evaluation of Textbook Outcome as a Composite Quality Measure of Elective Laparoscopic Cholecystectomy

IMPORTANCE: A textbook outcome (TO) is a composite quality measure that incorporates multiple perioperative events to reflect the most desirable outcome. The use of TO increases the event rate, captures more outcomes to reflect patient experience, and can be used as a benchmark for quality improvement. OBJECTIVES: To introduce the concept of TO to elective laparoscopic cholecystectomy (LC), propose the TO criteria, and identify characteristics associated with TO failure. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study was performed at 3 surgical units in a single health board in the United Kingdom. Participants included all patients undergoing elective LC between January 1, 2015, and January 1, 2020. Data were analyzed from January 1, 2015, to January 1, 2020. MAIN OUTCOMES AND MEASURES: The TO criteria were defined based on review of existing TO metrics in the literature for other surgical procedures. A TO was defined as an unremarkable elective LC without conversion to open cholecystectomy, subtotal cholecystectomy, intraoperative complication, postoperative complications (Clavien-Dindo classification ≥2), postoperative imaging, postoperative intervention, prolonged length of stay (>2 days), readmission within 100 days, or mortality. The rate of TOs was reported. Reasons for TO failure were reported, and preoperative characteristics were compared between TO and TO failure groups using both univariate analysis and multivariable logistic regressions. RESULTS: A total of 2166 patients underwent elective LC (median age, 54 [range, 13-92] years; 1579 [72.9%] female). One thousand eight hundred fifty-one patients (85.5%) achieved a TO with an unremarkable perioperative course. Reasons for TO failure (315 patients [14.5%]) included conversion to open procedure (25 [7.9%]), subtotal cholecystectomy (59 [18.7%]), intraoperative complications (40 [12.7%]), postoperative complications (Clavien-Dindo classification ≥2; 92 [29.2%]), postoperative imaging (182 [57.8%]), postoperative intervention (57 [18.1%]), prolonged length of stay (>2 days; 142 [45.1%]), readmission (130 [41.3%]), and mortality (1 [0.3%]). Variables associated with TO failure included increasing American Society of Anesthesiologists score (odds ratio [OR], 2.55 [95 CI, 1.69-3.85]; P < .001), increasing number of prior biliary-related admissions (OR, 2.68 [95% CI, 1.36-5.27]; P = .004), acute cholecystitis (OR, 1.42 [95% CI, 1.08-1.85]; P = .01), preoperative endoscopic retrograde cholangiopancreatography (OR, 2.07 [95% CI, 1.46-2.92]; P < .001), and preoperative cholecystostomy (OR, 3.22 [95% CI, 1.54-6.76]; P = .002). CONCLUSIONS AND RELEVANCE: These findings suggest that applying the concept of TO to elective LC provides a benchmark to identify suboptimal patterns of care and enables institutions to identify strategies for quality improvement

Surface Positioning Sensor For Contact Between Unrestrained Objects

The device of this invention is a flexible, adaptable, accurate system for detecting surface positioning data during physical contact between multiple objects. For any pair of objects, the technology records where a fixed location on the surface of the first object (striker object or Striker) makes contact within the perimeter of a positioning sensor on the surface of the second object (target object or Target)

The Effect of Antigen Stimulation on the Migration of Mature T Cells from the Peripheral Lymphoid Tissues to the Thymus

Although the maturation and export of T cells from the thymus has been extensively studied, the movement of cells in the opposite direction has been less well documented. In particular, the question of whether T cells which have been activated by antigen in the periphery are more likely to return to the thymus had been raised but not clearly answered. We examined this issue by activating T cells present in the periphery with their cognate antigen, and assessing migration to the thymus. TCR-transgenic cells from OT-I mice (Thy1.2+), which recognise the ovalbumin peptide OVA257–264 in the context of H-2Kb, were transferred into otherwise unmanipulated Thy1.1+ C57BL/6 mice. Recipient mice were injected i.v. with 5 μg peptide (SIINFEKL) approximately 24 hours later. The numbers of donor-derived (Thy1.2+) cells in the thymus and peripheral lymphoid tissue were determined. The results clearly show increased numbers of transgenic cells in the thymus 3 days after antigenic stimulation. However, since numbers of transgenic cells increased in the spleen and LN in about the same proportion, the data do not support the notion that there is highly increased selective migration of activated T cells to the thymus. Rather, they suggest that a sample of peripheral cells enters the thymus each day, and that the mature immigrants detected in the thymus merely reflect the contents of the peripheral T cell pool

Morbidity following emergency and elective cholecystectomy:a retrospective comparative cohort study

INTRODUCTION: An emergency laparoscopic cholecystectomy (EMLC) is commonly performed for all biliary pathology, yet EMLC can be challenging due to acute inflammation. Understanding the risks of EMLC is necessary before patients can make an informed decision regarding operative management. The aim of the present study was to compare rates of operative and post-operative outcomes between EMLC and elective LC (ELLC) using a large contemporary cohort, to inform the consent process and influence surgical decision making. METHODS: All patients who underwent EMLC and ELLC in one UK health board between January 2015 and December 2019 were considered for inclusion. Data were collected retrospectively from multiple regional databases using a deterministic records-linkage methodology. Patients were followed up for 100 days post-operatively for adverse outcomes and outcomes were compared between groups using both univariate and multivariate analysis adjusting for pre-operative factors. RESULTS: A total of 2768 LCs were performed [age (range), 52(13–92); M:F, 1:2.7]. In both the univariate and multivariate analysis, EMLC was positively associated with subtotal cholecystectomy (RR 2.0; p < 0.001), post-operative complication (RR 2.8; p < 0.001), post-operative imaging (RR 2.0; p < 0.001), post-operative intervention (RR 2.3; p < 0.001), prolonged post-operative hospitalisation (RR 3.8; p < 0.001) and readmission (RR 2.2; p < 0.001). EMLC had higher rates of post-operative mortality in univariate analysis (RR 10.8; p = 0.01). DISCUSSION: EMLC is positively associated with adverse outcomes versus ELLC. Of course this study does not focus on a specific biliary pathology; nevertheless, it illustrates the additional risk associated with EMLC. This should be clearly outlined during the consent process but should be balanced with the risk of further biliary attacks. Further studies are required to identify particular patient groups who benefit from elective surgery

Simultaneous expression of CD4 and CD8 antigens by a substantial proportion of resting porcine T lymphocytes

The existence of four subpopulations in resting porcine T lymphocytes is documented. In addition to the two known subpopulations which are typified by a mutually exclusive expression of either the CD8 or the CD4 differentiation antigen, CD4-CD8+ and CD4+CD8- T lymphocytes, respectively, two unusual subpopulations were prominent not only in peripheral blood, but also in lymphoid tissues: CD4-CD8- T lymphocytes expressing neither of these antigens and CD4+CD8+ T lymphocytes coexpressing both antigens. While CD4+CD8+ lymphoblasts have been found also in other species, resting T lymphocytes with that phenotype are without precedent among all species analyzed to date. This unique composition of the porcine T lymphocyte population has to be taken into consideration when the swine is used as a large animal model in experimental medicine