bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anastomotic‐vaginal fistula (AVF) after anterior resection of the rectum for cancer – occurrence and risk factors
Authors: Matthiessen P. , Hansson L. , Sjödahl R. , Rutegård J. 
Published: February 2009

AbstractObjective  The aim of the study was to assess recto‐vaginal fistula (RVF) after anterior resection of the rectum for cancer with regard to occurrence and risk factors.Method  All female patients [median age 69.5 years, Union Internationale centre le Cancer (UICC) cancer stage IV in 10%] who developed a symptomatic RVF (n = 20) after anterior resection of the rectum for cancer from three separate cohorts of patients were identified and compared with those who developed conventional symptomatic leakage (n = 32), and those who did not leak (n = 338). Patient demography and perioperative data were compared between these three groups. Fourteen patient‐related and surgery‐related variables thought to be possible risk factors for RVF (anastomotic‐vaginal fistula) were analysed.Results  Symptomatic anastomotic leakage occurred in 52 (13.3%) of 390 patients. Twenty (5.1%) had an anastomotic‐vaginal fistula (AVF) and 32 (8.2%) conventional leakage (CL). Patients with AVF required unscheduled re‐operation and defunctioning stoma as often as those with CL. AVF was diagnosed later and more often after discharge from hospital compared with CL. Patients with AVF had lower anastomoses and decreased BMI compared with those with CL. Risk factors for AVF in multivariate analysis were anastomosis < 5 cm above the anal verge (P = 0.001), preoperative radiotherapy (P = 0.004), and UICC cancer stage IV (P = 0.005). Previous hysterectomy was a risk factor neither for AVF nor for CL.Conclusion  Anastomotic‐vaginal fistula forms a significant part of all symptomatic leakages after low anterior resection for cancer in women. Although diagnosed later, the need for abdominal re‐operation and defunctioning stoma was not different from patients with CL. Risk factors for AVF included low anastomosis, preoperative radiotherapy and UICC cancer stage IV.
Fibrin glue for the treatment of fistulae in ano – a method worth sticking to?
Authors: Yeung J. M. C. , Simpson J. A. D. , Tang S.‐W. , Armitage N. C. , Maxwell‐Armstrong C. 
Published: February 2009

AbstractObjective  The current evidence for fibrin glue as a treatment for anal fistulae is mixed. This study reviews the experience of fibrin glue as a treatment for anal fistulae in a single tertiary referral centre and attempts to identify factors related to failure of therapy and the length of follow‐up required.Method  Patients with fistulae in ano that were treated with fibrin glue between February 2004 and August 2008 were analysed. All procedures were performed by two colorectal consultants based at the Queens Medical Centre, Nottingham. All patients were followed‐up to assess the outcome of this treatment.Results  Forty patients (21 male, 19 female) with a mean age of 46.5 years were studied. The mean duration of symptoms prior to presentation was 39 months (range 4–240 months). Presenting symptoms included perianal discharge (72.5%), perianal abscess (57.5%), pain (12.5%), PR bleeding (7.5%), itching (5%) and urgency (2.5%). Patients had a minimum of two follow‐up appointments and the median follow‐up period was 5.2 months (range 1–16 months). Following MRI and operative assessment, 28 (70%) of the 40 fistulae were considered complex (high trans‐sphincteric, extra‐sphincteric, pouch‐vaginal). Patients who had inflammatory bowel disease were classified as simple tracts but all failed to heal (three patients). Twenty of the complex fistulae failed to heal. Three patients who had repeat application of glue for their complex fistulae failed to heal on follow‐up. Of the remaining 12 patients who had simple fistulae in ano, five (41.7%) healed completely. There were no complications such as abscess, related to treatment. All patients who were asymptomatic at 3 months did not develop any further recurrence.Conclusion  Fibrin glue is a simple treatment strategy, preserves sphincter function with minimal adverse side effects. It should therefore be considered as possible first line treatment in simple fistulae but it is less likely to be successful in complex or those fistulae associated with inflammatory bowel disease. Repeat gluing is unlikely to be successful. Fistulae that have failed to heal by 3 months will need further treatment.
A retrospective review of chronic anal fistulae treated by anal fistulae plug
Authors: El‐Gazzaz G. , Zutshi M. , Hull T. 
Published: February 2009

AbstractObjective  The aim of this study was to analyse the efficacy of the anal fistulae plug (Cook Surgisis® AFP™) for the management of complex anal fistulae.Method  A review of patients with anal fistulae treated using Cook Surgisis® AFP™ between October 2005 and 2007 was undertaken. Patient’s demographics, fistulae aetiology and success rates were recorded.Results  Thirty‐three patients underwent 49 plug insertions. The median age was 44.4 years; 18 females. The fistulae aetiology was cryptoglandular in 61% and Crohn’s disease in 39%. The median follow up 221.5 days (range 44–684). Twenty‐one patients had previous failed surgery. Twenty‐eight patients had draining setons in situ at time of plug placement. The overall success rate was 8/32 patients (25%). Two of the 22 Crohn’s fistulae healed (9.1%) and 9/26(34.6%) cryptoglandular fistulae healed. The reasons for failure were sepsis in 87% and plug dislodgement in 13%. Significant predictor factors for improved outcome were African‐Americans patients (P = 0.009), and presence of seton (P = 0.05).Conclusions  Anal fistulae plug was associated with a lower success rate than previously reported. Septic complications were the main reason for failure.
Are screen detected colorectal cancers asymptomatic?
Authors: Harmston C. , Akwei S. , Barnes R. , Goodyear S. , Wong L. 
Published: February 2009

AbstractObjective  Colorectal cancer (CRC) screening aims to detect asymptomatic disease and thus provide the opportunity for early diagnosis and treatment. This study assesses the prevalence of significant symptoms in patients found to have CRC detected through the NHS National Bowel Cancer Screening Programme (NHS NBCSP) pilots.Method  All patients in the NHS NBCSP pilots with a positive faecal occult blood completed a standardized symptomatology questionnaire before colonoscopy. This data was entered into the NHS BCS pilot database, data from the English arm has been analysed retrospectively.Results  There were 200 patients diagnosed with colorectal cancer. Of these, 28.5% were Dukes A, 35% Dukes B, 31% Dukes C1 and 5.5% Dukes C2. Some 81.5% reported experiencing GI symptoms. Symptoms considered significant included rectal bleeding, change in bowel habit, tenesmus and peri‐anal discomfort, reported in 47.7%, 24%%, 36.5% and 15.5% of patients respectively. In addition to this, 27% reported urgency, 20.5% reported abdominal pain and 29% reported upper GI symptoms.Discussion  This data suggests a high prevalence of significant symptoms amongst patients with screening‐detected CRC. It is possible that these patients would have presented via routine colorectal services if the awareness of symptoms of colorectal cancer were increased.
Faecal incontinence after seton treatment for anal fistulae with and without surgical division of internal anal sphincter: a systematic review
Authors: Vial M. , Parés D. , Pera M. , Grande L. 
Published: February 2009

AbstractObjective  The challenge of surgery for anal fistula is to eradicate the fistula track while maintaining anal continence. Seton placement is recommended to reduce postoperative faecal incontinence but interestingly a great range of functional impairment after surgery has been published. The aim of this study was to analyse the influence of intra‐operative internal anal sphincter division during tight or cutting seton technique for cryptogenic anal fistula, on the results of recurrence and postoperative faecal incontinence.Method  A systematic literature review was performed to identify published series from 1966 to May 2007 of patients with anal fistula treated by a tight or cutting seton technique. The published series has been divided in to those where preservation of internal anal sphincter was performed (PIAS group) or where intra‐operative surgical division was undertaken in the time of seton placement (SIAS group) .The main endpoints of the review were to study anal fistula recurrence rate and postoperative faecal incontinence.Results  Eighteen studies including 19 series and 448 patients were analysed in detail. Recurrence rate was 5.0% and 3.0% in PIAS and SIAS group respectively. Overall faecal incontinence rate was 5.6% in PIAS group and 25.2% in SIAS group.Conclusion  Although based on low‐evidence studies, intra‐operative preservation of internal anal sphincter at the time of seton insertion for anal fistula seems to reduce the postoperative faecal incontinence without a substantial increase in recurrence rates.
Seton drainage and fibrin glue injection for complex anal fistulas
Authors: De Parades V. , Far H. Safa , Etienney I. , Zeitoun J.‐D. , Atienza P. , Bauer P. 
Published: February 2009

AbstractObjective  The study aimed to evaluate the efficacy of fibrin glue in the treatment of complex anal fistula.Method  Thirty consecutive patients with a complex anal fistula underwent glue instillation after an 8 week period of seton drainage. Cure was defined as complete closure of any secondary opening, absence of fistula seepage, and no abscess formation.Results  The mean age of the patients (15 males) was 40.5 (range, 22.8–69.1) years. The mean duration of follow‐up was 11.7 (range, 0.2–33.5) months. Complete closure of the fistula was achieved in 17 patients at 1 month but in two patients a delayed abscess occurred. At the end of follow‐up, 15 (50%) patients were considered to have been cured. The success rate was no different in cases of Crohn’s disease or when postoperative antibiotic therapy was given. There was, however, a significant difference in success following regional vs general anaesthesia (68.4 vs 18.2% success, P = 0.02).Conclusion  Fibrin glue cured 50% of our first 30 patients, and regional anaesthesia was predictive of success.
Maturity and Interculturality: Chinese students' experiences in UK higher education
Authors: GU QING 
Published: February 2009

Increasing global competition for students has witnessed an ever more rapid internationalisation of higher education. In the case of the UK, there has been a major influx of Chinese students to British universities since the launch of the British Government's long‐term worldwide educational campaign in 1999. Drawing upon evidence from an extensive review of the literature on the internationalisation of higher education, this article will explore variations in Chinese students' intercultural adaptation to the British higher education environment. Discussion of their experiences will be based upon a synthesis of findings of three studies, led by the author, investigating the pedagogical, sociocultural and psychological challenges that they have encountered when studying in British universities.Evidence from these studies suggests that despite various challenges and struggles, most students have managed to survive the demands of the learning and the living environment and to adapt and develop. Analysis of their learning experiences suggests that this learning process spans a developmental continuum involving the students in overcoming emotional tensions arising from changes in their cognition, their sense of identity and sociocultural values. A holistic and developmental perspective is thus required to understand changes in students' perceptions and values as part of their wider adaptation to the academic conventions of their host countries. The findings will make an original contribution to understandings of the impact of the internationalisation of higher education on individuals' learning, change and development.
European Languages and Culture in Hong Kong: trade or education?
Authors: CRIBBIN JOHN 
Published: February 2009

Hong Kong Government policy is to promote Hong Kong as an international education hub for the region. This may be more rhetoric than reality. The article surveys the historical background of Hong Kong in terms of its role as a trading centre, a gateway to China and a meeting place for East and West for which interchange with European languages and cultures has been important. The development of education policy within Hong Kong as far as the European dimension is involved is also reviewed. In addition, the development of global trade in educational services is touched upon which thus far has been heavily Anglo‐centric. In terms of Hong Kong itself, an analysis is presented of overseas educational programmes available in Hong Kong from Europe. The extent of European languages and studies provided in the school, university and lifelong learning sectors is surveyed. The work of European consulates in promoting languages and culture through such organisations as the Alliance Française, Goethe Instituta, etc. is another important part of provision. The article makes passing reference to the neighbouring territory of Macau and the importance there of Portuguese.The article concludes that for European studies and languages, the role of Hong Kong as a trading and financial hub has been a more significant stimulant than the Hong Kong government's policy for Hong Kong to be an international education hub.
Lessons from the past: investigating historical data from bluefin tuna fisheries
Authors: Fromentin Jean‐Marc 
Published: February 2009

AbstractIn 1963, the leading fisheries targeting Atlantic bluefin tuna (Thunnus thynnus) in the Norwegian Sea and North Sea suddenly collapsed without any warning. Little is known about this collapse and several hypotheses have been put forward, such as changes in migratory routes, recruitment failure or eradication of a sub‐population: all of these hypotheses could result from natural causes and/or from overfishing. To help explain this mysterious event, an original data set of the main bluefin tuna fisheries of the 20th century, including total catch and size composition of the catch, has been compiled and analysed. The results reveal a strong and unambiguous link between the Nordic purse seine and Spanish trap fisheries during the 1950s and 1960s. However, this link vanished during the 1970s. In addition, the North‐west Atlantic and Mediterranean trap fisheries appeared also to be partially connected to the Nordic fisheries. During the 1950s and 1960s, the main migration routes of bluefin tuna were probably from the Mediterranean spawning grounds and from the West Atlantic coasts to the Norwegian coast and North Sea, which were probably a key feeding ground at that time. The analyses also lead to the conclusion that interactions between environmental, trophic and fishing processes have probably affected bluefin tuna migration patterns which would have finally caused the Nordic fisheries collapse. This retrospective analysis finally leads to an original – albeit more speculative – hypothesis concerning Atlantic bluefin tuna population structure, therein conjectured as an assemblage of at least three sub‐populations.
Synaesthesia: learned or lost?
Authors: Kadosh Roi Cohen , Henik Avishai , Walsh Vincent 
Published: February 2009

AbstractThe question why synaesthesia, an atypical binding within or between modalities, occurs is both enduring and important. Two explanations have been provided: (1) a congenital explanation: we are all born as synaesthetes but most of us subsequently lose the experience due to brain development; (2) a learning explanation: synaesthesia is related to some learning process during childhood. Three recent studies provide conflicting support for these explanations. Two studies supported the idea that synaesthesia is learned by showing that the frequency of everyday language implicitly modulates the synaesthetic experience. Another study argued that synaesthesia reflects basic, innate magnitude representations. In this paper we reassess these points of view, and show that it is possible for both to be valid. These findings are integrated into an interactive specialization account of development in order to explain the neuronal mechanism underlying synaesthesia.
Increasing convergence between imagined and executed movement across development: evidence for the emergence of movement representations
Authors: Caeyenberghs Karen , Wilson Peter H. , Van Roon Dominique , Swinnen Stephan P. , Smits‐Engelsman Bouwien C.M. 
Published: February 2009

AbstractMotor imagery (MI) has become a principal focus of interest in studies on brain and behavior. However, changes in MI across development have received virtually no attention so far. In the present study, children (N= 112, 6 to 16 years old) performed a new, computerized Virtual Radial Fitts Task (VRFT) to determine their MI ability as well as the age‐related confluence between performance in executed and imagined movement conditions. Participants aimed at five targets, which were positioned along radial axes from a central target circle. The targets differed in width (2.5, 5, 10, 20 or 40 mm), resulting in an index of difficulty (ID) that varied from 6.9 to 2.9 bits. Performance was indexed by the linear relationship between ID and Movement Time (MT). The findings showed that executed task performance was slower than imagined performance. Moreover, conformance to Fitts’ Law during executed movement performance was obtained from a very young age. Most importantly, correlations between imagined and executed movements were low in the young participants but gradually increased across age. These age‐related changes in MI are hypothesized to reflect the children's emerging ability to represent internal models for prospective actions, consistent with the gradual unfolding of feedforward control processes.
Catalytic assessment: understanding how MCQs and EVS can foster deep learning
Authors: Draper Stephen W. 
Published: February 2009

AbstractOne technology for education whose adoption is currently expanding rapidly in UK higher education is that of electronic voting systems (EVS). As with all educational technology, whether learning benefits are achieved depends not on the technology but on whether an improved teaching method is introduced with it. EVS inherently relies on the multiple‐choice question (MCQ) format, which many feel is associated with the lowest kind of learning of disconnected facts. This paper, however, discusses several ways in which teaching with MCQs, and so with EVS, has transcended this apparent disadvantage, has based itself on deep learning in the sense of focusing on learning relationships between items rather than on recalling disconnected true–false items, and so has achieved substantial learning advantages. Six possible learning designs based on MCQs are discussed, and a new function for (e‐)assessment is identified, namely catalytic assessment, where the purpose of test questions is to trigger subsequent deep learning without direct teaching input.
Micro Foundations for Wage Flexibility: Wage Insurance at the Firm Level*
Authors: Rute Cardoso Ana , Portela Miguel 
Published: February 2009

AbstractTo what extent do firms insulate their workers' wages from fluctuations in product markets? Which firm and worker attributes are associated with wage flexibility at the micro level? We first rely on Guiso, Pistaferri and Schivardi (2005) to estimate dynamic models of sales and wages, finding that in Portugal, workers' wages respond to permanent shocks on firm performance, as opposed to transitory shocks. We then explore the factors associated with wage flexibility, finding that collective bargaining and minimum wages are associated with higher wage insurance by the firm, while the threat of firm bankruptcy reduces it. Managers receive less protection against permanent shocks than other workers.
Takeover Contests, Toeholds and Deterrence
Authors: Ettinger David 
Published: February 2009

AbstractWe consider a setting in which two potential buyers, one with a prior toehold and one without, compete in a takeover modeled as an ascending auction with participating costs. The toeholder is more aggressive during the takeover process because she is also a seller of her own shares. The non‐toeholder anticipates this extra‐aggressiveness of the toeholder. Thus, he is deterred from participating unless he has a high valuation for the target company. This leads to large inefficiency losses. For many configurations, expected target returns are first increasing then decreasing in the size of the toehold.
Wealth Concentration over the Path of Development: Sweden, 1873–2006*
Authors: Roine Jesper , Waldenström Daniel 
Published: February 2009

AbstractWe study wealth concentration in Sweden over 130 years, from the beginning of industrialization until the present day. Our series are based on new evidence from estate and wealth tax data, foreign and domestic family firm‐wealth, and pension wealth estimates. We find that Swedish wealth concentration was high in the agrarian state, and changed little during early industrialization. From World War I until about 1950, the richest percentile lost ground to high‐income earners in the rest of the top‐wealth decile. This equalization continued postwar; the entire top decile lost‐out relative to the rest of the population. Around 1980, wealth compression stopped and inequality increased. We approximate the effects of international flows and find that the recent increase in wealth inequality is probably larger than what official estimates suggest.
Inflow Uncertainty in Hydropower Markets
Authors: Vegard Hansen Petter 
Published: February 2009

AbstractWe analyse the effects of uncertainty on market performance in hydropower systems under alternative assumptions about market structure. Uncertainty creates distinct possibilities for exercising market power that cannot be captured in deterministic models. The qualitative and quantitative features of these possibilities depend on the characteristics of residual demand facing individual firms, which again depends on consumer preferences and generation and transmission technologies.