Biopsy in breast cancer small pieces, big consequences

Breast cancer screening and improved imaging techniques resulted in an increase of detected non-palpable breast lesions and performed biopsies. Management of these lesions is based on characteristics determined on histologic biopsy. This thesis aimed to describe the role of breast biopsy in personalizing treatment based on data from daily clinical practice. In conclusion:• Vacuum-assisted stereotactic biopsy for breast calcifications has a very high accuracy. A benign histopathologic result does not need follow-up. • MRI-guided breast biopsy in the diagnostic setting is an accurate procedure and a valuable tool in clinical decision-making.• Pre-operative breast MRI cannot reliably predict the presence of invasive cancer in patients with biopsy proven DCIS. Therefore, it cannot be used in the selection of patients for a SLNB. • The prediction model of Meurs et al (2018) is a valid model and has the clinical utility in the selection for SLNB in patients with biopsy-proven DCIS.• When surgical margins are pursued in the management of DICS, there is a very low ipsilateral breast cancer recurrence rate(8%). With a recurrence rate this low, there is no additional value of biomarkers to estimate the risk of recurrence.• In the majority of patients, cALND did not lead to upstaging and consequently, it did not change adjuvant treatment.• Patients were well-informed in their decision making and had individual motives to opt for or reject breast reconstruction. Differences in the rating of values seem to affect the decision since the same arguments were used as well to op for as to reject breast reconstruction.<br/

Histopathological growth patterns of primary and secondary malignant liver tumors

HGPs are a prognostic and predictive biomarker in patients with malignant liver tumors. They can be classified into desmoplastic HGP (dHGP), replacement HGP (rHGP) and pushing HGP (pHGP). The objective of this thesis was to describe the histopathological growth patterns (HGPs) of primary and secondary malignant liver tumors and to evaluate their association with prognosis after resection. The manuscript is structured in two parts. Part one serves as a general introduction into liver metastases and HGPs. Part two features multiple studies evaluating HGPs in liver metastases from various origins, primary liver tumors and in lung metastases.This manuscript illustrates that the HGPs can be identified in liver tumors, irrespective of specific tumor type, and that they are specific to the liver. This suggests an important role of the liver microenvironment in the underlying biology of HGPs.<br/

Storming the castle:Usutu virus vs. West Nile virus: Insights into neuroinvasion

West Nile virus (WNV) and Usutu virus (USUV) are mosquito-borne viruses that can infect humans. However, WNV leads to thousands of cases severe neurological disease and hundreds of fatalities annually, whereas USUV rarely causes disease and is generally less severe. The research in this thesis aimed to uncover whether the apparent differences in pathogenicity between USUV and WNV stemmed from a difference in their ability to gain access to and infect the brain. Using 3D brain models and 2D neuronal cultures, we found that both viruses could infect and replicate in neurons, but USUV did so less than WNV, suggesting a possible reason for the lower disease severity induced by USUV.To examine invasion into the brain, we used a model of the blood-brain barrier (BBB) and saw that both viruses could invade across this barrier from the blood into the brain compartment. We studied another route of invasion along motor neurons and saw that WNV could replicate and spread, but USUV could not due to induction of a robust immune response. These findings suggest USUV cannot use an important route of invasion into the brain, which could explain the reduced incidence of disease compared with WNV.Additionally, the models developed and employed in this thesis could act as platform to assess the neurotropism and neuroinvasive potential of other emerging viruses, aiding in public health preparedness.<br/

The localization and function of UBE3A isoforms in neurodevelopment:Everything in its right place

UBE3A is a ubiquitin E3 ligase, holding a key role in brain development. Its importance is manifested in its absence; the lack of functional UBE3A results in Angelman syndrome, a severe neurodevelopmental disorder. UBE3A is expressed in different isoforms, varying between mice and humans. The research presented in this dissertation attempts to unravel the molecular mechanisms that influence the localization and function of UBE3A isoforms across species, aiming to delineate their contributions to the pathology of Angelman syndrome

CVFSNet:A Cross View Fusion Scoring Network for end-to-end mTICI scoring

The modified Thrombolysis In Cerebral Infarction (mTICI) score serves as one of the key clinical indicators to assess the success of the Mechanical Thrombectomy (MT), requiring physicians to inspect Digital Subtraction Angiography (DSA) images in both the coronal and sagittal views. However, assessing mTICI scores manually is time-consuming and has considerable observer variability. An automatic, objective, and end-to-end method for assigning mTICI scores may effectively avoid observer errors. Therefore, in this paper, we propose a novel Cross View Fusion Scoring Network (CVFSNet) for automatic, objective, and end-to-end mTICI scoring, which employs dual branches to simultaneously extract spatial–temporal features from coronal and sagittal views. Then, a novel Cross View Fusion Module (CVFM) is introduced to fuse the features from two views, which explores the positional characteristics of coronal and sagittal views to generate a pseudo-oblique sagittal feature and ultimately constructs more representative features to enhance the scoring performance. In addition, we provide AmTICIS, a newly collected and the first publicly available DSA image dataset with expert annotations for automatic mTICI scoring, which can effectively promote researchers to conduct studies of ischemic stroke based on DSA images and finally help patients get better medical treatment. Extensive experimentation results demonstrate the promising performance of our methods and the validity of the cross-view fusion module. Code and data will be available at https://github.com/xwjBupt/CVFSNet.</p

Getting critical about critical world citizenship. Bottom-up skills development and in-classroom operationalization within a Dutch liberal arts college

This article addresses the challenge of translating critical world citizenship (CWC) into educational practice within interdisciplinary higher education. While scholarly literature provides theoretical frameworks for CWC, implementation remains difficult. Through a participatory educational design, we mapped current understandings and teaching practices. The resulting online toolboxFootnote1 presents nine interconnected skills with teaching activities. Our findings reveal five insights for effectively teaching CWC: (1) critique should be personal rather than universal, focusing on tangible manifestations in immediate environments; (2) educators must help students navigate societal challenges to avoid paralysis and cynicism; (3) teaching should guide critical thinking without prescribing conclusions; (4) institutions must create safe yet brave spaces for dialogue across divisions; and (5) Potential and limitations should be recognized to prevent polarization. This pedagogical platform offers practical implementation for CWC education that acknowledges tensions between theory and practice, ultimately supporting students in developing skills to engage meaningfully with complex societal challenges

Decolonization and Transnational Memory:The Revolusi in Indonesian and Dutch History Education, 1950-2025

History textbooks wield significant influence in shaping collective memory and identity, which is why history education is often positioned as both culprit and cure for gaps in collective memory. Yet its own historical development often remains underexamined. This article addresses this gap by examining how perspectives on decolonization have evolved in Indonesian and Dutch history education from 1950 to 2025, underscoring the need to empirically ground and historicize these perspectives across diverse temporal and spatial contexts. Employing a diachronic and transnational framework that engages with geopolitics and processes of instrumental and cultural perpetuation, it discusses history education as both a contested site and a catalyst for critical reflection and reparative action