In this paper I first set out the role of common notions in the structure of Alexander’s argument in Mixt. V–VI. Furthermore, I argue that a series of topics discussed in Mixt. V–VI, Mant. XIV and... Show moreIn this paper I first set out the role of common notions in the structure of Alexander’s argument in Mixt. V–VI. Furthermore, I argue that a series of topics discussed in Mixt. V–VI, Mant. XIV and Quaest. II.12 concern the initial stages of Stoic as well as Peripatetic blending rather than the resulting blend. The presence of certain types of (filled) pores and changes in density both facilitate mutual division; mutual divi- sion and coextension go hand in hand until a degree of juxtaposition of ingredients is reached which easily allows for the specific interaction that creates the final blend: interaction of qualities for the Peripatetics, tensional dynamics for the Stoics. In addition, I show that a list of stock examples used by Alexander also raises serious questions concerning changes in density and volume, which Aristotle, Alexander and the Stoics had to deal with. I suggest that the role of pores found in Meteorology IV may have been part of the solution for some of Alexander’s contemporaries. Throughout the arguments in the chapters V–VI, indeed throughout the De mixtione, Alexander consistently tries to replace a comprehensive materialist metaphysics of interacting bodies by his own equally comprehensive brand of hylomorphism—even if not every argument is equally convincing. Show less
Winkelman, J.A.; Woude, L. van der; Heineman, D.J.; Bahce, I.; Damhuis, R.A.; Mahtab, E.A.F.; ... ; Dickhoff, C. 2021
Objectives: Data on national patterns of care for patients with superior sulcus tumors (SST) is currently lacking. We investigated the distribution of surgical care and outcome for patients with... Show moreObjectives: Data on national patterns of care for patients with superior sulcus tumors (SST) is currently lacking. We investigated the distribution of surgical care and outcome for patients with SST in the Netherlands. Material and methods: Data was retrieved from the Dutch Lung Cancer Audit for Surgery (DLCA-S) for all patients undergoing resection for clinical stage IIB-IV SST from 2012 to 2019. Because DLCA-S is not linked to survival data, survival for a separate cohort (2015-2017) was obtained from the Netherlands Cancer Registry (NCR). Results: In the study period, 181 patients had SST surgery, representing 1.03% (181/17488) of all lung cancer pulmonary resections. For 2015-2017, the SST resection rate was 14.4% (79/549), and patients with stage IIB/III SST treated with trimodality had a 3-year overall survival of 67.4%. 63.5% of patients were male, and median age was 60 years. Almost 3/4 of tumors were right sided. Surgery was performed in 20 hospitals, with average number of annual resections ranging from < 1 (n = 17) to 9 (n = 1). 39.8% of resections were performed in 1 center and 63.5% in the 3 most active centers. 12.7% of resections were extended (e.g. vertebral resection). 85.1% of resections were complete (R0). Morbidity and 30-day mortality were 51.4% and 3.3% respectively. Despite treating patients with a higher ECOG performance score and more extended resections, the highest volume center had rates of morbidity/mortality, and length of hospital stay that were comparable to those of the medium volume (n = 2) and low-volume centers (n = 1). Conclusion: In the Netherlands, surgery for SST accounts for about 1% of all lung cancer pulmonary resections, the number of SST resections/hospital/year varies widely, with most centers performing an average of < 1/year. Morbidity and mortality are acceptable and survival compares favourably with the literature. Although further centralisation is possible, it is unknown whether this will improve outcomes. Show less
Quality of care- and of surgical oncology in particular- is gaining momentum. In this thesis the scientific bases of minimal volume standards and quality indicators are evaluated. Also the impact... Show moreQuality of care- and of surgical oncology in particular- is gaining momentum. In this thesis the scientific bases of minimal volume standards and quality indicators are evaluated. Also the impact of centralization of pancreatic surgery is investigated as is the influence of comorbidity on patient outcomes after colorectal surgery Show less
