The impact of stapling technique and surgeon specialism on anastomotic failure after right-sided colorectal resection. An international multi-centre, prospective audit

There is little evidence to support choice of technique and configuration for stapled anastomoses after right hemicolectomy and ileocaecal resection. This study aimed to determine the relationship between stapling technique and anastomotic failure

PERCUTANEOUS TIBIAL NERVE STIMULATION FOR TREATMENT OF ANAL INCONTINENCE

Faecal incontinence (FI) is a not common symptom in the general population (0.4–2.2% in population-based studies), which 342 Tech Coloproctol (2009) 13:341–368 123 affects predominantly the elderly people, with a female prevalence. FI has a notable public health impact. It is psychologically and physically debilitating and can lead the patient to isolation and progressive loss of all social activities. Patient selection is decisive to opt for an effective intervention. A conservative approach is required to treat mild to moderate FI; it is based on nutritional, medical and rehabilitative therapy, with a success rate of5%. In no-responsive cases, other several different semi-conservative procedures, such as bulking agents, injection or sacral neuromodulator implant can be proposed prior to resorting to surgery. One of the least invasive forms of neuromodulation is the tibial nerve percutaneous stimulation (PTNS), currently used for a wide variety of urologic conditions.PTNS seems to be a safe and effective therapeutic option and it could represent a valid approach to mild to moderate FI. Tolerableness, affordability and mininvasivity of this simple procedure compel to further studie

Evidence for an Association Between Hearing Impairment and Disrupted Sleep: Scoping Review

Purpose: Hearing impairment (HI) is the most common sensory impairment and may negatively impact sleep through reduced auditory input. Factors associated with HI, such as anxiety regarding communication in daily life, may also adversely impact an individual’s sleep. Here, research on the relationship between HI and sleep disruption was catalogued using scoping review methodology. Methods: A systematic strategy was employed to search various electronic databases. This review is reported according to Preferred Reporting Items for Systematic Review and Meta-analysis Scoping Review Extension (PRISMA-ScR). Results: Sixteen records met inclusion criteria. Studies have investigated sleep in HI as a primary aim in noise exposed workers or large surveys in older participants. Experimental and quasi-experimental studies report alterations to sleep architecture of potential neuroplastic origins. Studies reporting sleep as a secondary aim generally report poorer in sleep in HI participants. Conclusions: This scoping review has catalogued evidence that altered or negatively impacted sleep may be associated with HI. Potential confounding factors, mechanisms, and considerations for future research are discussed

Characterising the frequency response of impedance changes during evoked physiological activity in the rat brain

OBJECTIVE: Electrical impedance tomography (EIT) can image impedance changes associated with evoked physiological activity in the cerebral cortex using an array of epicortical electrodes. An impedance change is observed as the externally applied current, normally confined to the extracellular space is admitted into the conducting intracellular space during neuronal depolarisation. The response is largest at DC and decreases at higher frequencies due to capacitative transfer of current across the membrane. Biophysical modelling has shown that this effect becomes significant above 100 Hz. Recordings at DC, however, are contaminated by physiological endogenous evoked potentials. By moving to 1.7 kHz, images of somatosensory evoked responses have been produced down to 2 mm with a resolution of 2 ms and 200 μm. Hardware limitations have so far restricted impedance measurements to frequencies  2 kHz using improved hardware. APPROACH: Impedance changes were recorded during forepaw somatosensory stimulation in both cerebral cortex and the VPL nucleus of the thalamus in anaesthetised rats using applied currents of 1 kHz to 10 kHz. MAIN RESULTS: In the cortex, impedance changed by -0.04 ± 0.02 % at 1 kHz, reached a peak of -0.13 ± 0.05 % at 1475 Hz and decreased to -0.05 ± 0.02 % at 10 kHz. At these frequencies, changes in the thalamus were -0.26 ± 0.1%, -0.4 ± 0.15 % and -0.08 ± 0.03 % respectively. The signal-to-noise ratio was also highest at 1475 Hz with values of -29.5 ± 8 and -31.6 ±10 recorded from the cortex and thalamus respectively. Signficance: This indicates that the optimal frequency for imaging cortical and thalamic evoked activity using fast neural EIT is 1475 Hz

Tsallis Information Measure, Multiresolution Analysis, and Nonlinear Dynamics

Projet PROMATHWe undertake the study of signals originated in time-dependent nonlinear systems by recourse to a wavelet based multiresolution analysis, as adapted to a non-extensive (Tsallis) scenario. Diverse applications are discussed that illustrate the fact that a Tsallis environment seems to provide one with more detailed information than the conventional Shannon one

Auditory Cortex Basal Activity Modulates Cochlear Responses in Chinchillas

Background: The auditory efferent system has unique neuroanatomical pathways that connect the cerebral cortex with sensory receptor cells. Pyramidal neurons located in layers V and VI of the primary auditory cortex constitute descending projections to the thalamus, inferior colliculus, and even directly to the superior olivary complex and to the cochlear nucleus. Efferent pathways are connected to the cochlear receptor by the olivocochlear system, which innervates outer hair cells and auditory nerve fibers. The functional role of the cortico-olivocochlear efferent system remains debated. We hypothesized that auditory cortex basal activity modulates cochlear and auditory-nerve afferent responses through the efferent system. Methodology/Principal Findings: Cochlear microphonics (CM), auditory-nerve compound action potentials (CAP) and auditory cortex evoked potentials (ACEP) were recorded in twenty anesthetized chinchillas, before, during and after auditory cortex deactivation by two methods: lidocaine microinjections or cortical cooling with cryoloops. Auditory cortex deactivation induced a transient reduction in ACEP amplitudes in fifteen animals (deactivation experiments) and a permanent reduction in five chinchillas (lesion experiments). We found significant changes in the amplitude of CM in both types of experiments, being the most common effect a CM decrease found in fifteen animals. Concomitantly to CM amplitude changes, we found CAP increases in seven chinchillas and CAP reductions in thirteen animals. Although ACE

Europeanization without substance? EU-Turkey relations and gender equality in employment

This paper focuses on EU-Turkey relations through gender-related employment policy practices. We argue that Turkey is undergoing a process of ‘Europeanization without substance’, in which vague commitments and policy initiatives to enhance female labour force participation coexist uneasily with a contravening political discourse. This is not merely the result of a stalemate in accession negotiations, nor does it stem from the diversity of employment practices across the Union. It rather results from the deliberative discourses used by Turkey’s political leadership to selectively appropriate certain aspects of Europeanization to further a politically motivated agenda that, in essence, negates gender equality altogether. This, we argue in turn, is reflected in a set of practices, policy initiatives, and public statements that make substantive progress in EU-Turkey relations harder. This process is facilitated by the diminishing emphasis placed by the EU on gender equality in employment as manifested by the evolution of gender equality practices at EU level and reinforced by austerity-led policies during the economic crisis