TUmor-volume to breast-volume RAtio for improving COSmetic results in breast cancer patients (TURACOS); a randomized controlled trial

Background: Cosmetic result following breast conserving surgery (BCS) for cancer influences quality of life and psychosocial functioning in breast cancer patients. A preoperative prediction of expected cosmetic result following BCS is not (yet) standard clinical practice and therefore the choice for either mastectomy or BCS is still subjective. Recently, we showed that tumour volume to breast volume ratio as well as tumour location in the breast are independent predictors of superior cosmetic result following BCS. Implementation of a prediction model including both factors, has not been studied in a prospective manner. This study aims to improve cosmetic outcome by implementation of a prediction model in the treatment decision making for breast cancer patients opting for BCS. Methods/design: Multicentre, single-blinded, randomized controlled trial comparing standard preoperative work-up to a preoperative work-up with addition of the prediction model. Tumour volume to bre

Hydrography and Jack mackerel stock in the South Pacific - Final report

This study aims (i) to identify the most likely population structure hypotheses of Jack mackerel, (ii) to identify management objectives for Jack mackerel, and (iii) to evaluate sustainable management strategies to achieve these objectives. These three elements were considered through literature review, statistical and population dynamics modelling. Two different conclusions were drawn: a conclusion towards most likely population structure and a conclusion towards most likely stock structure

Composition and Structure of a Large Online Social Network in the Netherlands

Limitations in data collection have long been an obstacle in research on friendship networks. Most earlier studies use either a sample of ego-networks, or complete network data on a relatively small group (e.g., a single organization). The rise of online social networking services such as Friendster and Facebook, however, provides researchers with opportunities to study friendship networks on a much larger scale. This study uses complete network data from Hyves, a popular online social networking service in the Netherlands, comprising over eight million members and over 400 million online friendship relations. In the first study of its kind for the Netherlands, I examine the structure of this network in terms of the degree distribution, characteristic path length, clustering, and degree assortativity. Results indicate that this network shares features of other large complex networks, but also deviates in other respects. In addition, a comparison with other online social networks shows that these networks show remarkable similarities

Sex differences in the morphological failure patterns following hip resurfacing arthroplasty

<p>Abstract</p> <p>Background</p> <p>Metal-on-metal hybrid hip resurfacing arthroplasty (with a cementless acetabular component and a cemented femoral component) is offered as an alternative to traditional total hip arthroplasty for the young and active adult with advanced osteoarthritis. Although it has been suggested that women are less appropriate candidates for metal-on-metal arthroplasty, the mechanisms of prosthesis failure has not been fully explained. While specific failure patterns, particularly osteonecrosis and delayed type hypersensitivity reactions have been suggested to be specifically linked to the sex of the patient, we wished to examine the potential influence of sex, clinical diagnosis, age of the patient and the size of the femoral component on morphological failure patterns in a large cohort of retrieved specimens following aseptic failure of hip resurfacing arthroplasty.</p> <p>Methods</p> <p>Femoral remnants retrieved from 173 hips with known patient's sex were morphologically analyzed for the cause of failure. The results were compared with the control group of the remaining 31 failures from patients of unknown sex. The odds ratios (OR) and 95% confidence intervals (CI) of the following morphologically defined variables were calculated using logistic regression analysis: periprosthetic fractures (n = 133), osteonecrosis (n = 151), the presence of excessive intraosseous lymphocyte infiltration (n = 11), and interface hyperosteoidosis (n = 30). Logistic regression analysis was performed both unadjusted and after adjustment for sex, age, the size of the femoral component, and preoperative clinical diagnosis.</p> <p>Results</p> <p>Femoral remnants from female patients had a smaller OR for fracture (adjusted OR: 0.29, 95% CI 0.11, 0.80, <it>P </it>for difference = 0.02) and for the presence of osteonecrosis (adjusted OR: 0.16, 95% CI 0.04, 0.63, <it>P </it>for difference = 0.01). However, women had a higher OR for both the presence of excessive intraosseous lymphocyte infiltration (adjusted OR: 10.22, 95% CI 0.79, 132.57, <it>P </it>for difference = 0.08) and interface hyperosteoidosis (adjusted OR: 4.19, 95% CI 1.14, 15.38, <it>P </it>for difference = 0.03).</p> <p>Conclusions</p> <p>Within the limitations of this study, we demonstrated substantial sex differences in distinct failure patterns of metal-on-metal hip resurfacing. Recognition of pathogenically distinct failure modes will enable further stratification of risk factors for certain failure mechanisms and thus affect future therapeutic options for selected patient groups.</p

Religious Tastes and Styles as Markers of Class Belonging: A Bourdieuian Perspective on Pentecostalism in South America

Studies on the relationship between social class and religion tend to highlight the demographic dimension of class, but neglect its symbolic dimension. By addressing the symbolic dimensions through a Bourdieuian approach, this article contends that religious tastes and styles can be employed as class markers within the sphere of religion. A case study on Argentinean Pentecostalism and in-depth analysis of a lower and middle class church illustrate how symbolic class differences are cultivated in the form of distinctive religious styles. While the lower class church displays a style marked by emotional expressiveness and the search for life improvement through spiritual practices, the middle class church performs a sober and calm style of Pentecostalism. The study highlights the role of styles in the reproduction of class boundaries, while shedding a critical light on the importance of tastes

La estrategia Educativa 2020 o las limitaciones del Banco Mundial para promover el "aprendizaje para todos"

La nueva Estrategia Educativa 2020 del Banco Mundial establece las prioridades de reforma educativa en paises en vias de desarrollo para la decada siguiente. El titulo explicito de la estrategia, Aprendizaje para Todos, es un claro reconocimiento de que, mas alla de politicas centradas en el acceso, se debe hacer algo mas para asegurar que la educacion derive en experiencias positivas de aprendizaje. Sin embargo, como este articulo sostiene, las opciones de politicas explicitas y latentes en la Estrategia 2020 no son las mas adecuadas para lograr el Aprendizaje para Todos. El articulo desarrolla tres tipos de argumentos al respecto. El primero se refiere al fuerte apego del Banco a un conocimiento disciplinario y un enfoque metodológico que es insufi ciente para entender lo que aprenden los niños en la escuela y por que. El segundo argumento se refiere al sesgo pro-mercado de la Estrategia por lo que respecta a la reforma del sector publico y a nuevas formas de oferta educativa. En tercer lugar, el articulo senala las principales ausencias de la Estrategia, con especial atencion a las omisiones relacionadas con la compleja relación entre educación y pobreza.The World Bank's 2020 Education Strategy establishes the new education priorities in developing countries for the next decade. Its title, Learning for All, clearly recognizes that, beyond policies focusing on access, something else must be done to ensure that schooling involves positive learning experiences. However, as this paper argues, the 2020 Strategy explicit and latent policy options might not be adequate to achieve Learning for All. This paper develops three arguments on that matter. The fi rst one refers to the Bank's strong attachment to a disciplinary knowledge and a methodological approach that do not suffi ce to understand what children learn at school and why. The second one addresses its pro-market bias when it approaches the public sector reforms and the new forms of providing education. The last argument points out the main omissions of this Strategy, especially in what regards the complex relation between education and poverty

Interfacial fracture energy and the toughness of composites

The premises upon which prevailing composite toughness theories are based are discussed in the light of observed strength variations in boron-epoxy composites with differing shear strengths of the interfacial bond. None of the extant toughness theories (pull-out, debonding, stress redistribution) successfully predicts the work of fracture of the boronepoxy system. However, incorporation of the work to create new surfaces into the total toughness analysis gives better agreement with experiment, and work of fracture predictions for other sytems, such as carbon-polyester, can also be modified. The approach is more generalized than the Outwater/Murphy debonding explanation for toughness, which in the way usually presented only applies when the filament fracture strain is greater than the matrix fracture strain. The present analysis suggests how to tailor the interfacial shear strength in order to obtain a reasonable toughness yet still maintain strengths of the order of the rule of mixtures.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44787/1/10853_2004_Article_BF00737846.pd