Over papyrusrollen, krabben en de Top 10: voorkomen, genezen en pallieren

Rede, In verkorte vorm uitgesproken ter gelegenheid van het aanvaarden van het ambt van bijzonder hoogleraar met als leeropdracht Gastrointestinale Oncologie aan het Erasmus MC, faculteit van de Erasmus Universiteit Rotterdam op 7 januari 201

Functional changes after pancreatoduodenectomy: Diagnosis and treatment

Relatively little is known about the gastrointestinal function after recovery of a pancreatoduodenectomy. This review focuses on the functional changes of the stomach, duodenum and pancreas that occur after pancreatoduodenectomy. Although the mortality in relation to pancreatoduodenectomy has decreased over the years, it remains associated with considerable morbidity, which occurs in 40-60% of patients. Physical complaints early after the operation are often caused by motility disorders, in particular delayed gastric emptying, which occurs in up to 40% of patients. During longer follow-up of these patients the occurrence of endocrine and exocrine pancreatic insufficiency becomes more predominant. Diabetes mellitus develops in 20-50% of patients after a pancreatic resection (pancreatogenic diabetes). The main presenting symptoms of exocrine insufficiency are weight loss and steatorrhea. Its presence is suspected on clinical ground and can be supported by fecal elastase-1 measurement. Exocrine insufficiency can be compensated with oral enteric-coated enzyme supplements. The quality of life issue will be addressed as an important outcome measurement after pancreaticoduodenectomy. Furthermore, the functional changes after pancreatoduodenectomy are described in detail with suggestions for diagnosis and treatment

Dominance of non-native species increases over time in a historically invaded strandline community

Aim: We lack a robust understanding of whether exotic species, in addition to causing changes immediately after establishing, might continue to increase in dominance long after invasion events occur. To address this, we resurveyed strandline plant communities, which are likely to have been invaded for over two centuries. Location: Northeastern USA. Methods: We resurveyed the richness and cover of native and exotic plants in 2008 and 2009 at 18 sites, which had originally been surveyed in 1998. We examined whether native and exotic dominance had changed, whether native-rich sites were less likely to be impacted by exotics over time, whether changes in dominance were driven by large changes in a small number of outlier species or by small, incremental changes among many species and whether disturbance mediated any of these relationships. Results: Exotic dominance increased across sites. Initial native diversity was unrelated to patterns of exotic dominance during resurveys. The identity of species that were outliers with respect to changes in distribution or cover varied between resurvey years. Significant changes in exotic-to-native richness ratios at sites were detectible with or without the inclusion of outlier species, but changes in abundance ratios were only significant when outlier species were included. Disturbance across sites was not correlated with species richness, cover, or changes in dominance. Main conclusions: In this historically invaded community, exotics have increased in dominance over the last decade. This change is not due solely to the success of a few hyper-dominant species, but also to the cumulative effect of small changes in distribution among many species. It remains unclear whether patterns observed are due to invasion processes that are playing out very slowly through time or to some other explanation. Our findings highlight the need for a more robust understanding of the long-term dynamics of species invasions

Time-evolving measures and macroscopic modeling of pedestrian flow

This paper deals with the early results of a new model of pedestrian flow, conceived within a measure-theoretical framework. The modeling approach consists in a discrete-time Eulerian macroscopic representation of the system via a family of measures which, pushed forward by some motion mappings, provide an estimate of the space occupancy by pedestrians at successive time steps. From the modeling point of view, this setting is particularly suitable to treat nonlocal interactions among pedestrians, obstacles, and wall boundary conditions. In addition, analysis and numerical approximation of the resulting mathematical structures, which is the main target of this work, follow more easily and straightforwardly than in case of standard hyperbolic conservation laws, also used in the specialized literature by some Authors to address analogous problems.Comment: 27 pages, 6 figures -- Accepted for publication in Arch. Ration. Mech. Anal., 201

Screening for head and neck second primary tumors in patients with esophageal squamous cell cancer: A systematic review and meta-analysis

Background: Esophageal squamous cell carcinomas (ESCCs) are often accompanied by head and neck second primary tumors (HNSPTs). The prognosis of patients with an additional HNSPT is worse compared with patients with only ESCC. Therefore, early detection of HNSPTs may improve the overall outcome of patients with ESCC. The purpose of this study was to investigate the yield of endoscopic screening for HNSPTs in patients with primary ESCC. Methods: We conducted a systematic literature search of all available databases. Studies were included if ESCC patients were endoscopically screened for HNSPT. The primary outcome was the pooled prevalence of HNSPTs. Results: Twelve studies, all performed in Japan, were included in this systematic review with a total of 6483 patients. The pooled prevalence of HNSPTs was 6.7% (95% confidence interval: 4.9–8.4). The overall heterogeneity was high across the studies (I 2 ¼ 89.0%, p < 0.001). Most HNSPTs were low stage (85.3%) and located in the hypopharynx (60.3%). The proportion of synchronous (48.2%) and metachronous (51.8%) HNSPTs was comparable. Conclusion: Based on our results, HNSPT screening could be considered in patients with primary ESCC. All studies were performed in Japan; it is therefore not clear whether this consideration applies to the Western world

Multiracial Representations of Self, Otherness, and ‘Disalienation’ on The Middle Passage: C1770-1810

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