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Peri-operative modulation in gastro-intestinal surgery:Effects of Omega-3 fatty acids and the Enhanced Recovery After Surgery program
No full textSUMMARY In the last century and a half, current gastro-intestinal surgery could be developed because of the arrival of general anesthesia, antiseptic measurements, sutures, staplers and laparoscopic surgery. This thesis focuses on two large areas of surgical involvement; colorectal cancer and metabolic surgery. Colorectal cancer is currently one of the most common malignancies and one of the leading causes of cancer related mortality. A radical and oncological complete resection is a crucial factor in prognosis.(1) In a response to the rising epidemic of morbid obesity, metabolic surgery has increased as an important treatment option. Despite numerous technical and perioperative improvements, complication rates in gastrointestinal surgery are still considerable, affecting quality of life, hospital stay, oncological outcome and costs. The postoperative immune response is considered necessary for wound and intestinal healing, but an exaggerated response is also a potential cause of complications. Postoperative infection rates are higher in colorectal resections than in gastric and small bowel surgery because of manipulation of the large intestine, where bacteria are most abundant. The studies described in this thesis aim to investigate potential methods to beneficially influence the postoperative immune response and clinical outcomes in gastro-intestinal surgery: the enhanced recovery after surgery (ERAS) protocol (part 1), the administration of intravenous omega-3 fatty acids in colon cancer surgery (part 2) and the administration of oral omega-3 fatty acids in gastric bypass surgery (part 3)
Delving into Digibron:A historical and computational investigation of religious language and group dynamics among Dutch orthodox Protestants
No full textIn April 2011, ‘Digibron’ was launched on the internet. This digital archive contains a wide range of publications, the majority of which were written for and by Dutch orthodox Protestants. Examples include the newspaper Reformatorisch Dagblad, various church magazines, and a large number of religious autobiographies. The digitization and digital accessibility of large quantities of written sources have made it possible to analyze them using digital research techniques. This offers possibilities beyond traditional historical research, such as the relatively straightforward identification of trends over longer historical periods. Delving into Digibron maps the development of religious language among Dutch orthodox Protestants by using various text collections (primarily from Digibron) and a range of computational techniques. The study covers a period of four centuries: from the language used by so-called fijnen in the eighteenth century to the language of the bevindelijk gereformeerden in the twentieth and twenty-first centuries. The computational methods employed include keyword analysis, n-gram and collocation analysis, the calculation of relative word and word-list frequencies, topic modeling, and the computation of association scores. In his dissertation De weg in woorden (The Way in Words), Cornelis van de Ketterij collected a large number of words and expressions related to conversion that were used by bevindelijk gereformeerden between 1900 and 1970. He referred to these words and expressions as ‘pietistic vocabulary’ or ‘language of Canaan’. The term bevindelijk gereformeerden refers to orthodox Protestants who can be situated within various denominations, including the Oud Gereformeerde Gemeenten, the Gereformeerde Gemeenten, the Gereformeerde Gemeenten in Nederland and the Christelijke Gereformeerde Kerken. Van de Ketterij argued that pietistic vocabulary does not change or develop. He also found few differences in language use among the various sources he examined. The assumption that the language of Canaan is static and homogeneous is abandoned in this dissertation. Within sociolinguistics, language is understood as dynamic and varied. Religious language should be approached the same way, and in this dissertation the language of Dutch orthodox Protestants is examined accordingly. When the various findings of the research are brought together, several conclusions can be drawn. First, the research has shown that the ‘language of Canaan’ cannot be defined as a static set of words and expressions. It can, however, be understood as a commonly used crystallization term for the phenomenon whereby Dutch orthodox Protestants employ a distinctive linguistic variety that differs from the common language in several respects. The language of Canaan plays an important role in group identity. It is best characterized as a sociolect, a linguistic variety used by a specific social group. This study underlines the added value of applying computational research techniques in (religious) historical research. These techniques make it possible to analyze large quantities of sources spanning long periods of time. They also allow for the identification of differences that would be difficult to detect using traditional research methods, for example because they are implicitly embedded in the text or because they are very subtle. A disadvantage of computational research methods is that they often focus on words with above-average frequencies. This makes it advisable to combine computational techniques with close reading, as well as to combine different computational approaches with one another. Digibron is ideally suited for computational research. However, the possibilities for conducting analyses within Digibron’s digital environment are limited. It is therefore crucial that the digital files be made available to researchers
Reliving Memory and Religious Experience Through Multimodal Synchrony and Adaptation:An Adaptive Network Model
No full textDuring a group worship session, through intersensory facilitation participents can experience interpersonal synchrony. In addition it may occur that seemingly forgotten memories are suddenly relived and religious experiences come up. This chapter addresses the question whether a higher-order adaptive network model can enhance our understanding of such an interplay of interpersonal synchrony and the mentioned phenomena. In the developed adaptive dynamical system model, feeling of togetherness and oneness was modelled making use of synchrony detection states. The felt presence of God was modelled through a mental God-model. The improvements in cognition perceived were modelled by introducing adaptivity of certain connections between cognitive states. The subsequent simulation provided a closer look into the inner workings of the interplay of the mechanisms involved. It was found that synchronization suddenly intensifies after some time of mutual adaptation resulting in improvements in cognition of the cognitive impaired participant.</p
Gst. 2026/4:De toepassing van de Wet Bibob ten aanzien van een escortservice. (Heerhugowaard)
No full textCryo-EM structure of photosystem II supercomplex from a green microalga with extreme phototolerance
No full textPhotosystem II (PSII) is essential for energy conversion during oxygenic photosynthesis in plants and algae. Chlorella ohadii, one of the fastest multiplying green algae, thrives under the harsh desert sun but lacks the standard PSII photoprotective mechanisms involving LhcSR/PsbS proteins or protein phosphorylation. Here, we present the cryo-EM structure of the PSII supercomplex from C. ohadii at 2.9 Å resolution, which is used to determine whether the exceptional resistance to desert conditions has a structural basis in PSII. The structure reveals a distinct PsbO isoform and additional subunits, PsbR and PsbY, which enhance core complex stability through extensive interactions. Furthermore, the trimeric light-harvesting complexes (LHCII) are bound to the PSII core by specific light-harvesting proteins whose down-regulation in response to high-light conditions implies a reduction in the number of bound LHCII trimers. These structural modifications, together with the high accumulation of specific polyamines in the thylakoid membrane, play a key role in maintaining PSII stability and photoprotection, allowing C. ohadii to survive in extreme conditions.</p
Association between clinical, psychosocial and sociodemographic factors and ICF-domains in adults with chronic non-specific low back pain:a cross-sectional study
No full textBACKGROUND: Chronic non-specific low back pain (CNLBP) is the leading cause of years lived with disability worldwide. CNLBP is a multifactorial condition influenced by complex interactions between biopsychosocial components. This study aimed to investigate the association between clinical factors (e.g. disability, pain and prognosis), sociodemographic factors (e.g. age, gender, educational level, physical activity habits and medication use), and psychosocial factors (e.g. self-efficacy, quality of life, and fears and beliefs) in individuals with CNLBP, based on the International Classification of Functioning, Disability and Health (ICF).DESIGN: Cross-sectional study.METHODS: A total of 112 adults with CNLBP and aged 18-59 years were included. All participants were assessed using the following measures: disability (RMDQ); pain intensity; quality of life (EQ-5D-3 L); self-efficacy (LoBACS); fear-avoidance beliefs (FABQ); and risk of poor prognosis (STarT Back). The RMDQ items were linked to ICF domains to generate subscores: (1) body functions, (2) activity and participation. Three separate multiple linear regression models were then conducted to examine the association between a set of variables and the total score (disability) and the subscores: activity and participation, and body functions.RESULTS: Disability was primarily associated with higher fear-avoidance beliefs, older age, and greater pain intensity. In contrast, utility and low-risk prognostic classification showed significant negative associations with RMDQ scores. Together, these variables explained 58% of the variance. Activity and participation limitations were associated with age, low-risk classification, fear-avoidance beliefs and self-efficacy, explaining 56% of the variance. Body-function limitations were associated with pain intensity, utility, and fear-avoidance beliefs, explaining 28% of the variance.CONCLUSIONS: Distinct patterns of association were demonstrated between clinical, psychosocial and sociodemographic factors and ICF domains. Psychosocial factors played a central role in activity and participation, whereas pain intensity was more strongly associated with impairments in body function. These findings emphasise the importance of domain-specific biopsychosocial assessment strategies for individuals with CNLBP.</p
"Broodles": Well-being, needs and support of young siblings of children with disabilities:Practical guide with the dissertation
Full text linkThe Performance of Automatic Speaking Valves and Fixation Devices Enabling Hands-Free Speech Following Total Laryngectomy—A Systematic Review
No full textBackground: The percentage of daily automatic speaking valve use (AU) in laryngectomized patients has remained at ~25% since their invention. To increase this percentage, understanding the performance of existent devices is essential. Therefore, we reviewed studies reporting AU, fixation device lifetime (FDL), compliance, and voice and speech assessment outcomes (VSAOs).Methods: Studies published until 23 April 2025 were included. Quality assessment was performed using RoB2, ROBINS-I, and JBI tools.Results: Twenty studies were included, which were of poor methodological quality. AU and FDL were 3–13.25 h/day and 0.17–24 h/day. Baseline daily ASV compliance rate was 25%, increasing short-term but decreasing long-term. Reasons for non-compliance were inadequate fixation, skin problems, and voicing being too tiresome. There were no significant differences across ASVs in VSAOs.Conclusion: No single ASV or fixation device outperformed others. Personalized approaches, tailored to ASV experience, tracheostoma anatomy, and patient needs, may increase AU, FDL, and long-term compliance.</p
Attitudes of maternity care providers toward regional centralisation of vaginal breech birth:a qualitative study
No full textObjectives To explore maternity care providers’ attitudes toward regional centralisation of vaginal breech birth (VBB) care and gather their recommendations for maintaining clinical proficiency.Design Exploratory qualitative study using semi-structured interviews and thematic analysis.Participants 10 hospital-based maternity care professionals (nine obstetricians and one clinical midwife), purposively sampled to represent experience and institutional diversity.Setting 10 hospital maternity units in a metropolitan region of the Netherlands. Key themes describing provider attitudes towards two proposed models of centralised care (mobile breech team, designated referral centre) and alternative strategies.Results Three core themes emerged: (1) proficiency—providers valued regular exposure, formal training and peer support, expressing concern that centralisation would reduce overall workforce readiness; (2) organisation—concerns included unequal access, staffing burden, legal risks and inefficiencies in mobile teams and (3) alternatives—participants preferred a regional breech network with shared training, joint video review and expert on-call support.Conclusions Maternity care providers opposed full centralisation of VBB, favouring a networked model that distributes expertise and preserves local access. These insights highlight the importance of involving frontline providers in service redesign.</p