1,354,867 research outputs found
The effects of various sources of dietary fibre on cholesterol metabolism and colonic function in healthy subjects
No full textThis thesis deals with the influence of several types of dietary fibre on cholesterol metabolism and colonic function in young healthy subjects. Dietary fibre has been defined as those plant polysaccharides (cellulose, hemicelluloses, pectic substances) and lignin which are resistant to hydrolysis by the digestive enzymes of man.After a general introduction in Chapter 1, a review of reported experiments with healthy subjects is presented in Chapter 2. The few available data on dietary fibre consumption in Western communities are also summarized, and possible mechanisms for the action of dietary fibre on cholesterol metabolism and colonic function are discussed.Chapter 3 describes an experiment with 46 young healthy volunteers. The effects of a mixed high-fibre diet were studied, in which half of the dietary fibre was provided by vegetables and fruits, and the rest cam from cereal products. In Chapter 4 the results are presented from a trial with 62 subjects. In this study the effects of isolated citrus pectin were compared with those of the same amount of pectic substances contained naturally in fruits and vegetables, and also with those of a comparable amount of dietary fibre from wheat bran.Subjects in both studies were under strict dietary control. All foodstuffs except for 200 or 100 kcal (0.8 or 0.4 MJ respectively) per day were individually supplied, taking into account each subject's energy needs. Measurements were made of body weight, food consumption, serum total and high-density lipoprotein (HDL)-cholesterol, faecal mass, the content of steroids, fat, and electrolytes in faeces, frequency of defaecation, intestinal transit-time, and blood pressure.From these two studies it is concluded that in short-term controlled experiments fibre-rich foodstuffs have only a small (vegetables and fruits) or no (bran) favourable effect on the concentration of serum cholesterol. However, in uncontrolled circumstances, a mixed high-fibre diet may through its low fat and cholesterol content indirectly reduce the level of serum cholesterol.After 5 weeks of high-fibre diets the amount and type of dietary fibre had no significant effect on the concentration of serum HDL-cholesterol. The effects on serum total cholesterol could be explained only to a small extent by changes in the excretion of faecal steroids.Although there was a wide interindividual variation in colonic response to increased dietary fibre intake (Chapter 3.2.), in general a high-fibre diet with vegetables and fruits as well as a diet with bran shortened the intestinal transit-time and enhanced faeces production. Thus, it appears that the effects of certain types of dietary fibre on serum cholesterol are unrelated to their effects on colonic function.Finally, the above results are discussed in Chapter 5. It is concluded that a diet rich in cereals, as well as fruits, vegetables, and legumes may be advisable. However, at the present state of knowledge, it would be premature to make precise recommendations for dietary fibre intake
TAMIS is a valuable alternative to TEM for resection of intraluminal rectal tumors
No full textBACKGROUND: The aim of this study was to compare the short-term outcome after Transanal Endoscopic Microsurgery (TEM) and Transanal Minimally Invasive Surgery (TAMIS) for intraluminal rectal lesions. METHODS: Retrospective analysis of a prospectively maintained database of all TEM and TAMIS procedures performed at a single institution by one surgeon between March 2009 and September 2017 was conducted. Primary outcome was operating time. Secondary outcomes were blood loss, pathological outcome, length of hospital stay, 30-day readmission and mortality. RESULTS: Fifty-three patients underwent TEM procedure and 68 patients underwent TAMIS. Operating time was significantly shorter for TAMIS compared with TEM (median 45 vs 65 min, p < 0.0001). Blood loss was negligible for both TEM and TAMIS. Resection margins, lesion grade and invasion depth were comparable for both approaches. A significantly higher postoperative readmission rate was observed in the TEM group (17% vs 4.4%, p = 0.031). Mortality was zero in both groups. CONCLUSIONS: TAMIS is a valuable alternative to TEM, leading to decreased operating times, because all resections can be done in lithotomy position.status: Publishe
Populism and Parliamentary Argumentation Games
No full textThe research in this contribution indicates that members of parliament test each other’s positions on political issues in the form of argumentation games. These games have not been noticed by political scientists so far. That is problematic because, as Wolthuis argues here, it is a crucial feature of populist politics to minimize participation in these games. This means that populist parliamentary behaviour cannot be fully understood without reference to parliamentary argumentation games
Lower technical education in the Netherlands 1798-1993 : the rise and fall of a subsystem
No full textIn the rise and change of technical education caused by economical forces, political decisions, or educational motives? To what extent could teachers and students influence the developmentof this type of education?
In Lower technical education in the Netherlands 1798-1993, Jan Wolthuis provides a interdisciplinary study after the origins, growth and decline of Dutch technical daytime education for boys. This type of education is viewed as a subsystem of the national educational system. Schools for lower technical education have risen as a rather independent system in the 19th century. They became a subsystem of the general educational system in the first half of the 20th century. They were incorporated within this system in the second half to such an extent that they lost their independent features.
The study leaves from the theory of Margaret Archer on educational systems. It combines structural and cultural changes with interaction from corporate groups and primary actors.
The history of lower technical education in the Netherlands is characterized by tense relations between private initiative and the state, between education aimed at professional activities and general education, between the interests of crafts and industries and those of teachers and students, and between financial and political motives compared to professional and educational ones.
Increasing experience of modified two‐stage transanal ileal pouch–anal anastomosis for therapy refractory ulcerative colitis. What have we learned? A retrospective analysis on 75 consecutive cases at a tertiary referral hospital
No full textAIM: Ileal pouch-anal anastomosis (IPAA) should be delayed to a second stage in patients with ulcerative colitis and prolonged exposure to medical therapy. However, there is still discussion about whether a modified two-stage approach is preferable to a three-stage approach. Recently, a transanal approach has been introduced to overcome the well-known difficulties of laparoscopic pelvic surgery. This paper presents short-term outcomes of transanal IPAA (Ta-IPAA) according to a modified two-stage approach. METHODS: Data from all patients who underwent a modified two-stage Ta-IPAA for ulcerative colitis refractory to medical therapy were retrieved retrospectively from a prospective database. A comprehensive complication index was used for 90-day postoperative complications. Conversion, duration of surgery, hospital stay and reoperation were considered. A logistic regression model was used to assess risk factors for peri-pouch sepsis. RESULTS: Seventy-five (68.8%) patients were identified from 109 consecutive IPAAs. Median operation time was 159 min. Conversion rate was 4%. Mean comprehensive complication index was 7. All anastomotic leaks (10.6%) were treated with diverting ileostomy. Additionally, active rescue with transanal drainage and early resuturing of the anastomotic gap was performed in six patients. Ileostomy closure occurred after a median period of 5.4 months. At univariable analysis, factors associated with peri-pouch sepsis were male gender and age at IPAA construction. CONCLUSIONS: A modified two-stage Ta-IPAA is safe and feasible. Standardization and reproducibility of the technique are reflected in few conversions and intra-operative complications. Finally, morbidity and anastomotic leak do not differ from those reported in previous Ta-IPAA series with a variable proportion of multistage procedures.status: Publishe
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Effect of anastomotic configuration on Crohn's Disease recurrence after primary ileocolic resection. A comparative monocentric study of end-to-end versus side-to-side anastomosis
No full textBackground: Lived experience is a depiction of a person's experiences and decisions, as well as the knowledge gained from these experiences and choices. Despite a wealth of clinical studies and real-world data o
Effect of anastomotic configuration on Crohn's Disease recurrence after primary ileocolic resection. A comparative monocentric study of end-to-end versus side-to-side anastomosis
No full textBackground: Lived experience is a depiction of a person's experiences and decisions, as well as the knowledge gained from these experiences and choices. Despite a wealth of clinical studies and real-world data o
Variations on the Author
No full text“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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