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Systematic review and meta-analysis

Background: An effective and tolerable bowel preparation is important to secure quality of colonoscopies. It remains unclear if sodium picosulphate with magnesium citrate (SPMC), which is considered a tolerable bowel preparation agent, is also an effective alternative for polyethylene glycol (PEG) and sodium phosphate (NaP). Aim: The aim of this article is to compare effectiveness of SPMC to PEG and NaP through assessment of quality of bowel cleansing measured by validated tools. Methods: We searched electronic databases up to January 2015. Only randomised controlled trials (RCTs) were included. Two authors independently performed selection of studies, risk of bias assessment and data extraction. Results: Thirteen RCTs were included, with overall good quality, but large heterogeneity. SPMC had slightly better quality of bowel cleansing than PEG (pooled RR 1.06; 95% CI 1.02 to 1.11). In most trials SPMC was significantly better tolerated than PEG. There were no significant differences in effectiveness or tolerability between SPMC and NaP. Side effects were similar between agents, except for dizziness (pooled RR 1.71; 95% CI 1.32 to 2.21 in favour of PEG vs. SPMC) and vomiting (pooled RR 0.35; 95% CI 0.13 to 0.95 in favour of single-dose SPMC vs. split-dose). Conclusions: SPMC is equally effective to NaP and little superior to PEG in terms of bowel cleansing. SPMC preparations were better tolerated than PEG preparations. SPMC may be considered as standard bowel preparation for colonoscopy.

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Effect of training intensity on insulin sensitivity evaluated by insulin tolerance test

This research article shows that a high intensity exercise program compared to a low intensity exercise program of the same session duration and frequency, increases insulin sensitivity to a larger extend in healthy subjects. It also shows that the short insulin tolerance test can be used to detect differences in insulin sensitivity in intervention studies.

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Implications of cellular agriculture for hospitality and tourism management research: sustainable development goal perspective.

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Indole-3-carbinol, a plant nutrient and AhR-Ligand precursor, supports oral tolerance against OVA and improves peanut allergy symptoms in mice

From PLoS website: In general, dietary antigens are tolerated by the gut associated immune system. Impairment of this so-called oral tolerance is a serious health risk. We have previously shown that activation of the ligand-dependent transcription factor aryl hydrocarbon receptor (AhR) by the environmental pollutant 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) affects both oral tolerance and food allergy. In this study, we determine whether a common plant-derived, dietary AhR-ligand modulates oral tolerance as well. We therefore fed mice with indole-3-carbinole (I3C), an AhR ligand that is abundant in cruciferous plants. We show that several I3C metabolites were detectable in the serum after feeding, including the high-affinity ligand 3,3´-diindolylmethane (DIM). I3C feeding robustly induced the AhR-target gene CYP4501A1 in the intestine; I3C feeding also induced the aldh1 gene, whose product catalyzes the formation of retinoic acid (RA), an inducer of regulatory T cells. We then measured parameters indicating oral tolerance and severity of peanut-induced food allergy. In contrast to the tolerance-breaking effect of TCDD, feeding mice with chow containing 2 g/kg I3C lowered the serum anti-ovalbumin IgG1 response in an experimental oral tolerance protocol. Moreover, I3C feeding attenuated symptoms of peanut allergy. In conclusion, the dietary compound I3C can positively influence a vital immune function of the gut.

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Achieving protein targets without energy overfeeding in critically ill patients: A prospective feasibility study

Background & aims: High protein delivery during early critical illness is associated with lower mortality, while energy overfeeding is associated with higher mortality. Protein-to-energy ratios of traditional enteral formulae are sometimes too low to reach protein targets without energy overfeeding. This prospective feasibility study aimed to evaluate the ability of a new enteral formula with a high protein-to-energy ratio to achieve the desired protein target while avoiding energy overfeeding.Methods: Mechanically ventilated non-septic patients received the high protein-to-energy ratio nutrition during the first 4 days of ICU stay (n = 20). Nutritional prescription was 90% of measured energy expenditure. Primary endpoint was the percentage of patients reaching a protein target of ≥1.2 g/kg ideal body weight on day 4. Other endpoints included a comparison of nutritional intake to matched historic controls and the response of plasma amino acid concentrations. Safety endpoints were gastro-intestinal tolerance and plasma urea concentrations. Results: Nineteen (95%) patients reached the protein intake target of ≥1.2 g/kg ideal body weight on day 4, compared to 65% in historic controls (p = 0.024). Mean plasma concentrations of all essential amino acids increased significantly from baseline to day 4. Predefined gastro-intestinal tolerance was good, but unexplained foul smelling diarrhoea occurred in two patients. In one patient plasma urea increased unrelated to acute kidney injury. Conclusions: In selected non-septic patients tolerating enteral nutrition, recommended protein targets can be achieved without energy overfeeding using a new high protein-to-energy ratio enteral nutrition.

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Achieving protein targets without energy overfeeding in critically ill patients: A prospective feasibility study

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Joint Interference and Power Minimization for Fault-Tolerant Topology in Sensor Networks

Energy conservation is crucial in wireless ad hoc sensor network design to increase network lifetime. Since communication consumes a major part of the energy used by a sensor node, efficient communication is important. Topology control aims at achieving more efficient communication by dropping links and reducing interference among simultaneous transmissions by adjusting the nodes’ transmission power. Since dropping links make a network more susceptible to node failure, a fundamental problem in wireless sensor networks is to find a communication graph with minimum interference and minimum power assignment aiming at an induced topology that can satisfy fault-tolerant properties. In this paper, we examine and propose linear integer programming formulations and a hybrid meta-heuristic GRASP/VNS (Greedy Randomized Adaptive Search Procedure/Variable Neighborhood Search) to determine the transmission power of each node while maintaining a fault-tolerant network and simultaneously minimize the interference and the total power consumption. Optimal biconnected topologies for moderately sized networks with minimum interference and minimum power are obtained using a commercial solver. We report computational simulations comparing the integer programming formulations and the GRASP/VNS, and evaluate the effectiveness of three meta-heuristics in terms of the tradeoffs between computation time and solution quality. We show that the proposed meta-heuristics are able to find good solutions for sensor networks with up to 400 nodes and that the GRASP/VNS was able to systematically find the best lower bounds and optimal solutions.

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The efﬁcacy and safety of non-pharmacological therapies for the treatment of acne vulgaris

Background: Acne vulgaris is a multifaceted skin disorder, affecting more than 85% of young individuals worldwide. Pharmacological therapy is not always desirable because of the development of antibiotic resistance or the potential risk of adverse effects. Non‐pharmacological therapies can be viable alternatives for conventional therapies. However, sufficient evidence‐based support in the efficacy and safety of non‐pharmacological therapies is lacking. Objective: To assess the efficacy and safety of several non‐pharmacological therapies in the treatment of acne vulgaris. Methods: A systematic literature review, including a best‐evidence synthesis, was performed to identify literature. Three electronic databases were accessed and searched for studies published between January 2000 and May 2017. Results: Thirty‐three eligible studies were included in our systematic review. Three main types of non‐pharmacological therapies were identified laser‐ and light‐based therapies, chemical peels and fractional microneedling radiofrequency. The majority of the included studies demonstrated a significant reduction in acne lesions. However, only seven studies had a high methodologic quality. Based on these seven trials, a best‐evidence synthesis was conducted. Strong evidence was found for glycolic acid (10–40%). Moderate evidence was found for amino fruit acid (20–60%), intense pulsed light (400–700 and 870–1200 nm) and the diode laser (1450 nm). Initially, conflicting evidence was found for pulsed dye laser (585–595 nm). The most frequently reported side‐effects for non‐pharmacological therapies included erythema, tolerable pain, purpura, oedema and a few cases of hyperpigmentation, which were in most cases mild and transient. Conclusion: Circumstantial evidence was found for non‐pharmacological therapies in the treatment of acne vulgaris. However, the lack of high methodological quality among included studies prevented us to draw clear conclusions, regarding a stepwise approach. Nevertheless, our systematic review including a best‐evidence synthesis did create order and structure in resulting outcomes in which a first step towards future research is generated.

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The efﬁcacy and safety of non-pharmacological therapies for the treatment of acne vulgaris

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Tolerance of organ transplant recipients to physical activity during a high-altitude expedition

BACKGROUND: It is generally unknown to what extent organ transplant recipients can be physically challenged. During an expedition to Mount Kilimanjaro, the tolerance for strenuous physical activity and high-altitude of organ transplant recipients after various types of transplantation was compared to non-transplanted controls.METHODS: Twelve organ transplant recipients were selected to participate (2 heart-, 2 lung-, 2 kidney-, 4 liver-, 1 allogeneic stem cell- and 1 small bowel-transplantation). Controls comprised the members of the medical team and accompanying family members (n = 14). During the climb, cardiopulmonary parameters and symptoms of acute mountain sickness were recorded twice daily. Capillary blood analyses were performed three times during the climb and once following return.RESULTS: Eleven of the transplant participants and all controls began the final ascent from 4700 meters and reached over 5000 meters. Eight transplant participants (73%) and thirteen controls (93%) reached the summit (5895m). Cardiopulmonary parameters and altitude sickness scores demonstrated no differences between transplant participants and controls. Signs of hyperventilation were more pronounced in transplant participants and adaptation to high-altitude was less effective, which was related to a decreased renal function. This resulted in reduced metabolic compensation.CONCLUSION: Overall, tolerance to strenuous physical activity and feasibility of a high-altitude expedition in carefully selected organ transplant recipients is comparable to non-transplanted controls.

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Overcrowded Amsterdam: Striving for a Balance Between Trade, Tolerance and Tourism

Amsterdam is known worldwide for its historical beauty, liberal lifestyle and tolerant atmosphere. With 860,000 residents (fewer than 90,000 living in the inner city), Amsterdam received 8.3 million hotel guests in 2017 and is urgently searching for ways to better manage its immense popularity. Its reputation is not a coincidence, but the result of the evolution of Amsterdam from a small urban trading centre into a prominent tourism city and destination, and that evolution forms the basis of this chapter. Overcrowding is one of the core issues affecting the city, and is not only caused by tourists. The city itself is rapidly expanding in terms of receiving more (temporary) inhabitants, commuters and Dutch day visitors. In such a context, the (perceived) overcrowding is clearly linked to urban mobility issues and is partly caused by tourists and touring vehicles. The number of (e)bikes (electronic bikes), scooters and the ‘loose’ traffic habits of locals themselves are also compounding the problem. Urban leisure lifestyles have changed in recent decades and have exacerbated the pressure on public spaces and parks, leading to overcrowding of (semi-) public spaces, increased littering and noise. This chapter uses the term ‘overcrowding’ rather than ‘overtourism’, as I feel it better reflects the root cause in the Amsterdam context. Overcrowding is described here as the process and results of an intensified use of (semi-) public space, which are perceived as disruptive forces by multiple stakeholders.

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Systematic review and meta-analysis

Effect of training intensity on insulin sensitivity evaluated by insulin tolerance test

Implications of cellular agriculture for hospitality and tourism management research: sustainable development goal perspective.

Indole-3-carbinol, a plant nutrient and AhR-Ligand precursor, supports oral tolerance against OVA and improves peanut allergy symptoms in mice

Achieving protein targets without energy overfeeding in critically ill patients: A prospective feasibility study

Joint Interference and Power Minimization for Fault-Tolerant Topology in Sensor Networks

The efﬁcacy and safety of non-pharmacological therapies for the treatment of acne vulgaris

Tolerance of organ transplant recipients to physical activity during a high-altitude expedition

Overcrowded Amsterdam: Striving for a Balance Between Trade, Tolerance and Tourism

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Optimising physical fitness in patients receiving chemo-radiotherapy for head and neck cancer; a feasibility study

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Products 665

Systematic review and meta-analysis

Effect of training intensity on insulin sensitivity evaluated by insulin tolerance test

Implications of cellular agriculture for hospitality and tourism management research: sustainable development goal perspective.

Indole-3-carbinol, a plant nutrient and AhR-Ligand precursor, supports oral tolerance against OVA and improves peanut allergy symptoms in mice

Achieving protein targets without energy overfeeding in critically ill patients: A prospective feasibility study

Joint Interference and Power Minimization for Fault-Tolerant Topology in Sensor Networks

The efﬁcacy and safety of non-pharmacological therapies for the treatment of acne vulgaris

Tolerance of organ transplant recipients to physical activity during a high-altitude expedition

Overcrowded Amsterdam: Striving for a Balance Between Trade, Tolerance and Tourism

Projects 1

Optimising physical fitness in patients receiving chemo-radiotherapy for head and neck cancer; a feasibility study