Strict Selection Alone of Patients Undergoing Liver Transplantation for Hilar Cholangiocarcinoma Is Associated with Improved Survival

Liver transplantation for hilar cholangiocarcinoma (hCCA) has regained attention since the Mayo Clinic reported their favorable results with the use of a neo-adjuvant chemoradiation protocol. However, debate remains whether the success of the protocol should be attributed to the neo-adjuvant therapy or to the strict selection criteria that are being applied. The aim of this study was to investigate the value of patient selection alone on the outcome of liver transplantation for hCCA. In this retrospective study, patients that were transplanted for hCCA between1990 and 2010 in Europe were identified using the European Liver Transplant Registry (ELTR). Twenty-one centers reported 173 patients (69%) of a total of 249 patients in the ELTR. Twenty-six patients were wrongly coded, resulting in a study group of 147 patients. We identified 28 patients (19%) who met the strict selection criteria of the Mayo Clinic protocol, but had not undergone neo-adjuvant chemoradiation therapy. Five–year survival in this subgroup was 59%, which is comparable to patients with pretreatment pathological confirmed hCCA that were transplanted after completion of the chemoradiation protocol at the Mayo Clinic. In conclusion, although the results should be cautiously interpreted, this study suggests that with strict selection alone, improved survival after transplantation can be achieved, approaching the Mayo Clinic experience

Strict Selection Alone of Patients Undergoing Liver Transplantation for Hilar Cholangiocarcinoma is Associated with Improved Survival

Liver transplantation for hilar cholangiocarcinoma (hCCA) has regained attention since the Mayo Clinic reported their favorable results with the use of a neo-adjuvant chemoradiation protocol. However, debate remains whether the success of the protocol should be attributed to the neo-adjuvant therapy or to the strict selection criteria that are being applied. The aim of this study was to investigate the value of patient selection alone on the outcome of liver transplantation for hCCA. In this retrospective study, patients that were transplanted for hCCA between 1990 and 2010 in Europe were identified using the European Liver Transplant Registry (ELTR). Twenty-one centers reported 173 patients (69%) of a total of 249 patients in the ELTR. Twenty-six patients were wrongly coded, resulting in a study group of 147 patients. We identified 28 patients (19%) who met the strict selection criteria of the Mayo Clinic protocol, but had not undergone neo-adjuvant chemoradiation therapy. Five-year survival in this subgroup was 59%, which is comparable to patients with pretreatment pathological confirmed hCCA that were transplanted after completion of the chemoradiation protocol at the Mayo Clinic. In conclusion, although the results should be cautiously interpreted, this study suggests that with strict selection alone, improved survival after transplantation can be achieved, approaching the Mayo Clinic experience

International Coercion, Emulation and Policy Diffusion: Market-Oriented Infrastructure Reforms, 1977-1999

Why do some countries adopt market-oriented reforms such as deregulation, privatization and liberalization of competition in their infrastructure industries while others do not? Why did the pace of adoption accelerate in the 1990s? Building on neo-institutional theory in sociology, we argue that the domestic adoption of market-oriented reforms is strongly influenced by international pressures of coercion and emulation. We find robust support for these arguments with an event-history analysis of the determinants of reform in the telecommunications and electricity sectors of as many as 205 countries and territories between 1977 and 1999. Our results also suggest that the coercive effect of multilateral lending from the IMF, the World Bank or Regional Development Banks is increasing over time, a finding that is consistent with anecdotal evidence that multilateral organizations have broadened the scope of the “conditionality” terms specifying market-oriented reforms imposed on borrowing countries. We discuss the possibility that, by pressuring countries into policy reform, cross-national coercion and emulation may not produce ideal outcomes.http://deepblue.lib.umich.edu/bitstream/2027.42/40099/3/wp713.pd

Reclaiming heritage: colourization, culture wars and the politics of nostalgia

This article considers the discursive continuities between a specifically liberal defence of cultural patrimony, evident in the debate over film colourization, and the culture war critique associated with neo-conservatism. It examines how a rhetoric of nostalgia, linked to particular ideas of authenticity,canonicity and tradition,has been mobilized by the right and the left in attempts to stabilize the confguration and perceived transmission of American cultural identity. While different in scale, colourization and multiculturalism were seen to create respective (postmodern) barbarisms against which defenders of culture, heritage and good taste could unite. I argue that in its defence of the ‘classic’ work of art, together with principles of aesthetic distinction and the value of cultural inheritance,the anti-colourization lobby helped enrich and legitimize a discourse of tradition that, at the end of the 1980s, was beginning to reverberate powerfully in the conservative challenge to a ‘crisis’ within higher education and the humanities. This article attempts to complicate the contemporary politics of nostalgia, showing how a defence of cultural patrimony has distinguished major and minor culture wars, engaging left and right quite differently but with similar presuppositions

NEWS AND NOTES 1988, VOL.19, NO.3

https://digitalcommons.rockefeller.edu/news_and_notes_1988/1001/thumbnail.jp

Once we walked alone down by the river [first line of chorus]

Performers: Bing Crosby, Joan BennetPiano, Voice and Chord

Taking active learning into the primary school : a matter of new practices?

This paper examines the extension of active learning pedagogical practices familiar in preschool settings to the first class of primary school. Policy and practice guidance in the UK is advocating the benefits of experiential learning as a way of engaging young children as they move into primary school but for teachers this means a move to new practices which can be in tension with other expectations. In this paper, the rationale for active learning is considered along with an account of the classroom activities of teachers and children in five primary schools that were implementing the policy shift to active learning. The children in these classes spent varying amounts of time in whole class activities led by the teacher or in small groups directed to engage with specific activities. They had opportunities to engage and respond verbally, through manipulating objects and with physical actions but the emphasis was on planned, teacher-directed learning activities. The characteristics of active learning as introduced in these innovative classes are compared with the expectations of practice guidance and theorising about early learning