Melanoma:the Impact of Staging on Treatment, Prognosis & Follow-up

Melanoma is increasing in the Netherlands and diagnosis is made at an increasingly earlier stage, resulting in a more favorable prognosis. Currently, 5-year survival rate is 92%. Melanoma diagnostics, treatment and follow-up can further increase this percentage. PhD student Eric Deckers therefore conducted research, specifically into the sentinel-node procedure (SLNB), the use of tumor markers and nuclear imaging, the frequency of follow-up and the effect of obesity on disease progression and survival in melanoma. The SLNB can determine metastases in a minimally invasive manner, so that the correct melanoma treatment can be performed. The SLNB is currently only performed at 65% for eligible patients in the Netherlands. A further implementation up to 80 (breast cancer) seems necessary. Follow-up checks of high-risk melanoma patients without complaints, increased blood levels of the tumor markers S-100B and LDH may be an indication for performing a PET/CT scan to detect early metastases and initiate treatment. A RCT showed that a less frequent follow-up than recommended in the current guideline for SLNB-staged melanoma patients 3-years after diagnosis, is associated with fewer stress symptoms, comparable anxiety and quality of life. Less frequent follow-up is safe in the sense of detecting recurrences, survival and it reduces the follow-up costs with 39%. Obesity does is not associated with recurrence-free and overall-survival. A multi-center study is needed to confirm or invalidate this result. The improvements in melanoma diagnostics with SLNB, tumor markers, PET/CT and stage-based follow-up schedules contribute to better, cost-effective melanoma treatment and quality of life

Gender, social capital and empowerment in northern Ethiopia

This paper investigates the interactions between gender, social capital and empowerment in the rural areas of northern Ethiopia. We define empowerment narrowly as the power of households to make important decisions that change their course of life. Depending on the degree of control over decisions, the response of households is classified into passive, active and full control. A multinomial logit model is used to analyze empowerment levels of the rural households, first for the full sample of households and then for male headed and female headed households separately. Findings indicate that social capital, measured by the number of local associations a household is a member of, is an important factor in empowerment, but with significant gender differences. Social capital is significant for male headed households but not for female headed households; for the latter, education and access to credit are the strongest determinants of empowerment.Empowerment, Gender, Social capital, Ethiopia

Increase of sentinel lymph node melanoma staging in The Netherlands; still room and need for further improvement

Aim: To investigate implementation of the seventh American Joint Committee on Cancer melanoma staging with sentinel lymph node biopsy (SLNB) and associations with socioeconomic status (SES). Patients & methods: Data from The Netherlands Cancer Registry on patient and tumor characteristics were analyzed for all stage IB-II melanoma cases diagnosed 2010-2016, along with SES data from The Netherlands Institute for Social Research. Results: The proportion of SLNB-staged patients increased from 40% to 65% (p <0.001). Multivariate analysis showed that being female, elderly, or having head-and-neck disease reduced the likelihood of SLNB staging. Conclusion: SLNB staging increased by 25% during the study period but lagged among elderly patients and those with head-and-neck melanoma. In The Netherlands, SES no longer affects SLNB staging performance

Rural livestock asset portfolio in northern Ethiopia: a microeconomic analysis of choice and accumulation

Livestock fulfill different functions. Depending on their livelihood strategies, households differ in their choice of what type of animal to keep and on accumulation of the chosen animal overtime. Using a panel data of 385 rural households in a mixed farming system in northern Ethiopia, this paper investigates the dynamic behavior of rural households' livestock holding to identify determinants of choice and accumulation of livestock overtime. Choice is analyzed for a principal animal, the animal that constituted the largest value of livestock assets a household possessed, using a multinomial logit model. Results indicate that rural households differ in their choice of what type of animal to keep. Agro-climatic conditions, sex and age of household head, presence of an adult male member in a household, and liquidity are the major factors that influence the type of principal animal households keep. Conditional on the principal animal selected, we analyzed the factors that determine the accumulation of the chosen animals by correcting for selection bias. Area of land cultivated is the most significant factor that explains the number of animals households keep. Other factors include sex of household head, diversification into nonfarm self-employment, and shocks

Episkeletozoans and bioerosional ichnotaxa on isolated bones of Late Cretaceous mosasaurs and cheloniid turtles from the Maastricht area, the Netherlands

Isolated bones of three taxa of marine reptiles (Mosasaurus hoffmannii Mantell, Plioplatecarpus marshi Dollo and Allopleuron hofmanni (Gray)) from various levels within the Maastricht Formation (upper Maastrichtian) at the former ENCI-HeidelbergCement Group quarry (Maastricht, the Netherlands) exhibit bioerosional traces and encrustation. Episkeletozoans include dimyid, ostreid and monopleurid bivalves, at least three species of cheilostome and cyclostome bryozoans and two adnate calcareous foraminifera. The bones show biting traces (Gnathichnus pentax Bromley, Linichnus cf. serratus Jacobsen & Bromley and Machichnus isp.), as well as borings. The latter may be referred to Karethraichnus lakkos Zonneveld, Bartels, Gunnell & McHugh, which is here considered to be a junior synonym of Gastrochaenolites isp