Viewing a Person Through the Body: The Relevance of Philosophical Anthropology to Medical Education

Wim Dekkers 한국의학교육학회 2009 Korean journal of medical education Vol.21 No.4

Although the revival of medical humanities in the past three decades has emerged primarily in the US and the UK, continental Europe has a strong tradition in espousing the medical humanities, such as by advancing the anthropological movement in medicine and philosophy. In this paper, we argue that philosophical anthropology deserves a separate focus in medical education from medical ethics and philosophy of science. The focus of the paper is on the philosophical aspects of the human body to view a person ‘through the body.’ First, a short description of the anthropological movement in medicine is discussed, including its central motive ‘to introduce the subject into medicine.’ Next, the ontological and moral relationship between the person and his or her body is addressed. Drawing examples from anatomy, a so-called hemicorporectomy, organ donation, and aesthetic surgery, the concept of bodily integrity is expounded. These ideas can encourage medical students to discuss their own moral experiences during medical training and should be taught to enhance their philosophical understanding of medicine and health care.

Longitudinal Analysis of Body Weight and Feed Intake in Selection Lines for Residual Feed Intake in Pigs

Cai, W.,Wu, H.,Dekkers, J.C.M. Asian Australasian Association of Animal Productio 2011 Animal Bioscience Vol.24 No.1

A selection experiment for reduced residual feed intake (RFI) in Yorkshire pigs consisted of a line selected for lower RFI (LRFI) and a random control line (CTRL). Longitudinal measurements of daily feed intake (DFI) and body weight (BW) from generation 5 of this experiment were used. The objectives of this study were to evaluate the use of random regression (RR) and nonlinear mixed models to predict DFI and BW for individual pigs, accounting for the substantial missing information that characterizes these data, and to evaluate the effect of selection for RFI on BW and DFI curves. Forty RR models with different-order polynomials of age as fixed and random effects, and with homogeneous or heterogeneous residual variance by month of age, were fitted for both DFI and BW. Based on predicted residual sum of squares (PRESS) and residual diagnostics, the quadratic polynomial RR model was identified to be best, but with heterogeneous residual variance for DFI and homogeneous residual variance for BW. Compared to the simple quadratic and linear regression models for individual pigs, these RR models decreased PRESS by 1% and 2% for DFI and by 42% and 36% for BW on boars and gilts, respectively. Given the same number of random effects as the polynomial RR models, i.e., two for BW and one for DFI, the non-linear Gompertz model predicted better than the polynomial RR models but not as good as higher order polynomial RR models. After five generations of selection for reduced RFI, the LRFI line had a lower population curve for DFI and BW than the CTRL line, especially towards the end of the growth period.

A Least Squares Regression Model to Detect Quantitative Trait Loci with Polar Overdominance in a Cross of Outbred Breeds: Simulation

Kim, Jong-Joo,Dekkers, Jack C.M. Asian Australasian Association of Animal Productio 2013 Animal Bioscience Vol.26 No.11

A least squares regression interval mapping model was derived to detect quantitative trait loci (QTL) with a unique mode of genomic imprinting, polar overdominance (POD), under a breed cross design model in outbred mammals. Tests to differentiate POD QTL from Mendelian, paternal or maternal expression QTL were also developed. To evaluate the power of the POD models and to determine the ability to differentiate POD from non-POD QTL, phenotypic data, marker data and a biallelic QTL were simulated on 512 F2 offspring. When tests for Mendelian versus parent-of-origin expression were performed, most POD QTL were classified as partially imprinted QTL. The application of the series of POD tests showed that more than 90% and 80% of medium and small POD QTL were declared as POD type. However, when breed-origin alleles were segregating in the grand parental breeds, the proportion of declared POD QTL decreased, which was more pronounced in a mating design with a small number of parents ($F_0$ and $F_1$). Non-POD QTL, i.e. with Mendelian or parent-of-origin expression (complete imprinting) inheritance, were well classified (>90%) as non-POD QTL, except for QTL with small effects and paternal or maternal expression in the design with a small number of parents, for which spurious POD QTL were declared.

Comparison of alternative approaches to single-trait genomic prediction using genotyped and non-genotyped Hanwoo beef cattle

Lee, Joonho,Cheng, Hao,Garrick, Dorian,Golden, Bruce,Dekkers, Jack,Park, Kyungdo,Lee, Deukhwan,Fernando, Rohan BioMed Central 2017 Genetics, selection, evolution Vol.49 No.-

<P><B>Background</B></P><P>Genomic predictions from BayesA and BayesB use training data that include animals with both phenotypes and genotypes. Single-step methodologies allow additional information from non-genotyped relatives to be included in the analysis. The single-step genomic best linear unbiased prediction (SSGBLUP) method uses a relationship matrix computed from marker and pedigree information, in which missing genotypes are imputed implicitly. Single-step Bayesian regression (SSBR) extends SSGBLUP to BayesB-like models using explicitly imputed genotypes for non-genotyped individuals.</P><P><B>Methods</B></P><P>Carcass records included 988 genotyped Hanwoo steers with 35,882 SNPs and 1438 non-genotyped steers that were measured for back-fat thickness (BFT), carcass weight (CWT), eye-muscle area, and marbling score (MAR). Single-trait pedigree-based BLUP, Bayesian methods using only genotyped individuals, SSGBLUP and SSBR methods were compared using cross-validation.</P><P><B>Results</B></P><P>Methods using genomic information always outperformed pedigree-based BLUP when the same phenotypic data were modeled from either genotyped individuals only or both genotyped and non-genotyped individuals. For BFT and MAR, accuracies were higher with single-step methods than with BayesB, BayesC and BayesC<I>π</I>. Gains in accuracy with the single-step methods ranged from +0.06 to +0.09 for BFT and from +0.05 to +0.07 for MAR. For CWT, SSBR always outperformed the corresponding Bayesian methods that used only genotyped individuals. However, although SSGBLUP incorporated information from non-genotyped individuals, prediction accuracies were lower with SSGBLUP than with BayesC (<I>π</I> = 0.9999) and BayesB (<I>π</I> = 0.98) for CWT because, for this particular trait, there was a benefit from the mixture priors of the effects of the single nucleotide polymorphisms.</P><P><B>Conclusions</B></P><P>Single-step methods are the preferred approaches for prediction combining genotyped and non-genotyped animals. Alternative priors allow SSBR to outperform SSGBLUP in some cases.</P>

Hemorrhoidectomy versus rubber band ligation in grade III hemorrhoidal disease: a large retrospective cohort study with long-term follow-up

Lisette Dekker,Michiel T.J. Bak,Willem A. Bemelman,Richelle J.F. Felt-Bersma,Ingrid J.M. Han-Geurts 대한대장항문학회 2022 Annals of Coloproctolgy Vol.38 No.2

Purpose: Standard therapy for grade III hemorrhoids is rubber band ligation (RBL) and hemorrhoidectomy. The long-term clinical and patient-reported outcomes of these treatments in a tertiary referral center for proctology were evaluated. Methods: A retrospective analysis was performed in all patients with grade III hemorrhoids who were treated between January 2013 and August 2018. Medical history, symptoms, reinterventions, complications, and patient-reported outcome measurements (PROM) were retrieved from individual electronic patient files, which were prospectively entered as standard questionnaires in our clinic. Results: Overall, 327 patients (163 males) were treated by either RBL (n=182) or hemorrhoidectomy (n=145). The median follow-up was 44 months. The severity of symptoms and patient preference led to the treatment of choice. The most commonly experienced symptoms were prolapse (83.2%) and blood loss (69.7%). Hemorrhoidectomy was effective in 95.9% of the cases as a single procedure, while a single RBL procedure was only effective in 51.6%. In the RBL group, 34.6% received a second RBL session. Complications were not significantly different, 11 (7.6%) after hemorrhoidectomy versus 6 (3.3%) after RBL. However, 4 fistulas developed after hemorrhoidectomy and none after RBL (P<0.05). The pre-procedure PROM score was higher in the hemorrhoidectomy group whereas the post-procedure PROM score did not significantly differ between the groups. Conclusion: Treatment of grade III hemorrhoids usually requires more than one session RBL whereas 1-time hemorrhoidectomy suffices. Complications were more common after hemorrhoidectomy. The patient-related outcome did not differ between procedures.

The Sphere of Voluntary Associations and the Ideals of Civil Society: A West-European Perspective

Paul Dekker 한국학술연구원 2004 Korea Observer Vol.35 No.3

Increased detection of invasive enteropathogenic bacteria in pre-incubated blood culture materials by real-time PCR in comparison with automated incubation in Sub-Saharan Africa

Frickmann, Hagen,Dekker, Denise,Boahen, Kennedy,Acquah, Samuel,Sarpong, Nimako,Adu-Sarkodie, Yaw,Schwarz, Norbert G.,May, Jü,rgen,Marks, Florian,Poppert, Sven,Wiemer, Dorothea F.,Hagen, Ralf M. Informa Healthcare 2013 Scandinavian journal of infectious diseases Vol.45 No.8

<P><I>Background:</I> Invasive enteropathogenic bacteria can cause systemic infections. Data from studies with PCR detection suggest, at least for Salmonella enterica, that blood culture may lead to underestimation in the tropics. Corresponding data are lacking for other invasive enteropathogenic bacteria. We compared classical blood culture and molecular methods for the diagnosis of blood infections. <I>Methods:</I> A real-time multiplex PCR for Salmonella spp., Shigella spp./entero- invasive Escherichia coli (EIEC), Yersinia spp., and Campylobacter jejuni was applied to 2321 retained blood culture samples from Ghanaian patients, after enrichment by automated culture. <I>Results:</I> PCR detected Salmonella DNA in 56 out of 58 pre-incubated Ghanaian blood cultures with growth of S. enterica. In 2 samples molecular diagnosis was only possible after 1:10 dilution. Twenty-two samples negative by blood culture and 1 positive with Micrococcus spp. were PCR-positive for Salmonella spp. In addition, 3 Shigella spp./EIEC, 2 Yersinia spp., and 1 C. jejuni were detected by PCR but not by culture growth. <I>Conclusions:</I> Real-time PCR was more sensitive in identifying invasive enteropathogenic bacteria than automated blood culture, which is hampered by a lack of evidence-based standardization of pre-analytic conditions in the tropics. Primary agar culture and Gram-staining prior to automated blood culture is advisable in cases where transportation times are long.</P>

Experiences and outcomes in shoulder replacements in a district general hospital over 19 years

Andrew Peter Dekker,Jamie Hind,Neil Ashwood 대한견주관절학회 2024 대한견주관절의학회지 Vol.27 No.3

Background: This study aimed to evaluate the changing experiences of shoulder surgeons working in a district general hospital. Methods: A consecutive series of 395 shoulders (225 male, 170 female) over a 19-year period (2000–2019) with a minimum follow-up of 2 years were analyzed. Outcome measures were length of stay, operating time, satisfaction visual analog score (VAS), pain VAS, Oxford Shoulder Score (OSS), Constant-Murley score, range of movement, complications, and implant survival. Results: The incidence of a diagnosis of osteoarthritis as the surgical indication increased over time. The number of cases by surgeon per year increased from three cases in 2,000 to a peak of 33 in 2011. Up to seven implant manufacturers were used. The incidence of hemiarthroplasties decreased, and more numerous reverse polarity and anatomic arthroplasties were performed (P<0.001). More glenoid and humeral components were cemented and more short-stem implants were used in later years (P<0.001). Length of stay was a median of 1 day with a trend towards daytime surgery in recent years. Patients were satisfied (VAS 8/10) and OSS improved by 8 points on average throughout the observation period. Conclusions: Despite frequent introductions of new implants, patient outcome, satisfaction, and complication rates remained good. There appears to be a need for large-scale, generalizable studies to understand why technological advancements leading to changes in implants do not influence clinical outcomes. Level of evidence: III.

종교개혁과 스콜라주의의 관계에 대한 연구 현황에 대한 서론

이은선 안양대학교 신학연구소 2002 신학지평 Vol.15 No.-

Colon Capsule Endoscopy: An Alternative for Conventional Colonoscopy?

Britt B.S.L. Houwen,Evelien Dekker 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.1

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