Delta infection without increase in severity of hepatitis.

The findings of increased morbidity of HbsAG positive hepatitis with delta infection in a study by Dr. Smedile et al were contrary to those of studies performed by the authors. A group of 27 and a group of 41 drug abusers were examined serologically and had liver biopsies performed. There was no significant difference in histological findings between delta positive and delta negative patients in the 27 member group. None of the 41 member group showed any increase in severity of illness. Ethnic origin may be an important factor in the pathogenicity of the delta agent

University governance and academic work: the 'business model' and its impact on innovation and creativity

Working Paper 48 is a transcript of the 2019 Burton R Clark lecture on higher education that Professor Shattock gave at the fourth annual conference of the Centre for Global Higher Education at the UCL Institute of Education in London on 3 April 2019. Public policy towards higher education lays great stress on the importance of innovation and creativity to the nation’s economic and social future. This lecture examines how far this is reflected in changes in university governance and the governance of the system in contemporary UK higher education and in the relationship between governance, academic performance and the nature of academic work. It draws on a large scale study of the governance of higher education conducted under the auspices of the Centre for Global Higher Education

Universities and regions: the 'hinterland' issue in European higher education policymaking

The article addresses the issues surrounding the importance of regions in the construction of European higher education systems and, in particular, the impact of ‘hinterlands’ in the formation of policy. It draws on studies of Germany, Hungary, Ireland, Norway, Portugal and the United Kingdom to illustrate different policy approaches and shows how in some countries ‘hinterland’ issues have been the major factor in the reconstruction of national higher education systems. It draws a distinction between the past where policies were essentially based on the growth of student numbers to the present where the drivers are much more related to regional social and economic factors and, in some countries, to public good policies on equalising opportunities between deprived and affluent areas. It suggests that regional issues are now central to how systems are constructed and that as a result systems will become more complex to manage but that regional and institutional ‘bottom up’ determination may offer better prospects for innovation and flexibility in the face of societal change

Intersectoral relationships within higher education: the FE/HE interface in the UK

This study seeks to understand the interface between further education colleges and universities in the UK. Its findings, based on a response rate of 45% of FE colleges, shows that 89% of colleges have formal links with at least one university; 95 universities, more than 50% of the UK’s universities, had formal agreements in respect to individual joint activities. The study reports in total and by regions the joint activities and the fields of study which these links cover and the cumulative student numbers engaged in each type of joint activity. The findings raise significant issues as to the extent to which higher education policies in the UK should be tertiary based rather than conceived as the product of two separate sectors. Wales has already adopted a tertiary system of education and Scotland is moving in that direction but England retains a two sector approach. The paper suggests that the evidence provided points to there being strong arguments for policy integration rather than separation and that this should be best undertaken on a regional rather than a centralised basis

Autonomic conflict exacerbates long QT associated ventricular arrhythmia

This study tested the hypothesis that concomitant sympathetic and parasympathetic stimulation (“autonomic conflict”) may act as a trigger for arrhythmia in long QT syndrome (LQTS). Studies were performed in isolated innervated rabbit hearts treated with clofilium (100 nmol/L); a potassium channel blocker. The influence of vagus nerve stimulation (VNS) on spontaneous ventricular arrhythmia was assessed in the absence/presence of sustained noradrenaline perfusion (100 nmol/L) and with sudden adrenergic stress (injections of noradrenaline into the perfusion line). Hearts were instrumented for a pseudo-electrocardiogram and monophasic action potential recordings. VNS, which slows heart rate, was associated with a stimulation frequency-dependent incidence of spontaneous early after-depolarisations (EADs) and ventricular tachycardia (VT), best predicted by the duration of the electrocardiographic T-wave and by triangulation of the ventricular action potential. In the presence of sustained (steady-state) noradrenaline perfusion, the incidence of EADs and VT with VNS was decreased from 73/55% to 45/27%, respectively. However, sudden adrenergic stress, imposed during periods of sustained VNS, was associated with a transient increase in the incidence of severity of observed arrhythmia, as indicated by an increase in the average arrhythmia score (1.6 ± 0.4 vs. 2.1 ± 0.7, p = .01). Analysis of electrophysiological parameters suggests that sudden adrenergic stress is associated with a transient prolongation, and increased triangulation, of the ventricular action potential, which may predispose to triggered activity. This study demonstrates that autonomic conflict is a pro-arrhythmic stimulus in LQTS. However, combined adrenergic and parasympathetic stimulation has a complex relationship with arrhythmogenicity, with differences in the effects of steady-state adrenergic activation vs. sudden adrenergic stress

Geometrical considerations in cardiac electrophysiology and arrhythmogenesis

The rate of repolarization (RRepol) and so the duration of the cardiac action potential is determined by the balance of inward and outward currents across the cardiac membrane (net ionic current). Plotting action potential duration (APD) as a function of the RRepol reveals an inverse non-linear relationship, arising from the geometric association between these two factors. From the RRepol-APD relationship it can be observed that a longer action potential will exhibit a greater propensity to shorten, or prolong, for a given change in the RRepol (i.e. net ionic current), when compared to one that is initially shorter. This observation has recently been used to explain why so many interventions that prolong the action potential exert a greater effect at slow rates (reverse rate-dependence). In this article we will discuss the broader implications of this simple principle and examine how common experimental observations on the electrical behavior of the myocardium may be explained in terms of the RRepol-APD relationship. An argument is made, with supporting published evidence, that the non-linear relationship between the RRepol and APD is a fundamental, and largely overlooked, property of the myocardium. The RRepol-APD relationship appears to explain why interventions and disease with seemingly disparate mechanisms of action have similar electrophysiological consequences. Furthermore, the RRepol-APD relationship predicts that prolongation of the action potential, by slowing repolarization, will promote conditions of dynamic electrical instability, exacerbating several electrophysiological phenomena associated with arrhythmogenesis, namely, the rate-dependence of dispersion of repolarization, APD restitution and electrical alternans

Financial self help and institutional autonomy in British higher education

The UK university system is experiencing a severe financial crisis at a time when the whole of the public sector is itself facing financial difficulty. The paper argues that rather than relying on what they see as the priority of their case universities should give greater attention to financial self help, to not responding to the freeze in the level of home tuition fees by concentrating on cutting expenditure but to actively look to generating income from new sources and thereby maintain their academic shape until the national position improves. It shows how severe financial downturns have occurred before and how in the first of these, the Thatcher cuts of 1981, one university adopted a ‘save half, make half’ policy which resulted in an increase rather than a decrease in funding and an enhancement of its academic profile. Economic and other conditions have changed since the 1980s and new solutions need now to be found appropriate to an institutions circumstances but the principle of exercising an institution’s financial autonomy remains valid. One important difference between the circumstances of 1981-82 and 2024-25 is the extreme differentiation between the size and financial profile of institutions in the university sector and particularly their relative dependence on income from home tuition fees. The paper analyses the income streams of a sample of six universities, two Russell group, two post-1992 universities and two post-post-1992 universities where there are variances in dependence from 23% to 62% to show that some financial models are much less sustainable in current conditions than others. The missions of some of these vulnerable institutions in terms of academic profile and roles in their communities are directly in line with the new Government’s priorities. The financial vulnerability of these institutions, arising largely from history and location, make a special case for intervention. The most important factor, however, in facing the funding crisis is a change in the internal financial culture of universities and the impact this can have on academic morale