Feasibility of Narrow-Band Imaging, Intraductal Biopsy, and Laser Ablation During Mammary Ductoscopy: Protocol for an Interventional Study

Introduction: Ductoscopy is a minimally invasive micro-endoscopic approach for direct visualization of intraductal lesions of the breast. Challenges of ductoscopy are low sensitivity for detecting malignancy, the lack of a proper intraductal biopsy device, and adequate treatment of intraductal lesions. This study will analyze three new approaches to enhance the effectiveness of interventional ductoscopy in patients with (premalignant) intraductal lesions: narrow-band imaging (NBI), new intraductal biopsy tools, and intraductal laser ablation. The main aims of the present study are to improve diagnostic accuracy and therapeutic efficacy of interventional ductoscopy in patients with pathological nipple discharge (PND) and to explore the feasibility of the new approaches in diagnosing and removing intraductal precursor lesions. Methods and analysis: This prospective, single-center, diagnostic feasibility study will include two patient groups. Group A: women with PND with no radiological suspicion for malignancy. Group B: women undergoing mastectomy (preventive or therapeutic). The primary endpoints for both groups are the technical feasibility of NBI ductoscopy, intraductal biopsy, and laser ablation, and as secondary endpoint the number of diagnosed and successfully treated intraductal lesions. Discussion: Enhanced ductoscopy with NBI, intraductal biopsy, and laser ablation could prevent unnecessary surgery in patients with PND. Ethics and dissemination: This study was approved by the Medical Research Ethics Committee UMC Utrecht in The Netherlands (METC protocol number 21-688/H-D). The results of this study will be published in peer-reviewed journals and presented at national and international conferences. Highlights: - Pathological nipple discharge (PND) is a common breast-related complaint in women.- Ductoscopy, a minimally invasive technique, is used in the treatment of PND.- This study will analyze three new approaches to enhance interventional ductoscopy of the breast: narrow-band imaging, new intraductal biopsy tools, and intraductal laser ablation in patients with (premalignant) intraductal lesions

Human and Machine Learning

In this paper, we consider learning by human beings and machines in the light of Herbert Simon’s pioneering contributions to the theory of Human Problem Solving. Using board games of perfect information as a paradigm, we explore differences in human and machine learning in complex strategic environments. In doing so, we contrast theories of learning in classical game theory with computational game theory proposed by Simon. Among theories that invoke computation, we make a further distinction between computable and computational or machine learning theories. We argue that the modern machine learning algorithms, although impressive in terms of their performance, do not necessarily shed enough light on human learning. Instead, they seem to take us further away from Simon’s lifelong quest to understand the mechanics of actual human behaviour

Bedrijfsvoering met de computer.

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Teaching Particle-Wave Duality with Double-Slit Single-Photon Interference in Dutch Secondary Schools

A lessons series on quantum physics was taught to grade 12 students in 5 different secondary schools. Amongst others the series contained a special demonstration experiment for particle-wave duality (double slit single photon interference) which was supplemented by the PhET applet quantum wave interference. Preconceptions on particles and waves were assessed in a pretest. Interviews were conducted with 24 students in 4 schools after the demonstration. A posttest was administered to 112 students in 3 schools. Some lessons were observed by an outside observer and/or videotaped, followed by interviews. Results indicate that learning objectives of quantum physics are well within reach of the 12th grade students. This shows especially in student discussions of the PhET applet. However, understanding of wave-particle duality is hindered by insufficient understanding of the prerequisite wave concept, that waves are spread out in space. Most students associated a wave with an oscillation and somehow forgot about the spatial aspects. As a consequence, the “strangeness” of wave-particle duality was underappreciated. Also, the link with the de Broglie wavelength discussed early in the lesson series was not made. As in the 5th school quantum physics started several weeks later, we were able to try an improved lesson design for the demonstration successfully. Interviews are very helpful in catching misinterpretations of demonstrations and generating suggestions for improvement. Students do appreciate the confusing wonders of quantum physics but in the post-interviews seem unaware of the many quantum-based devices around them and the many everyday phenomena (like color) which need quantum physics for explanation. Perhaps as teachers and curriculum developers we are too eager to overemphasize the exotic and strange aspects of quantum theory and underemphasize utility in everyday applications

CLIWAT: a transnational project about climate change and coastal groundwater in the North Sea Region

CLIWAT is a transnational project in the North Sea Region with the main objective to evaluate the physical and chemical impacts of climate change on groundwater and surface water systems, and to provide data for adaptive and sustainable water management and infrastructure. Seventeen institutes from Denmark, Germany, The Netherlands and Belgium work together in this project. For this SWIM, we focus on salt water intrusion and upconing of saline groundwater from old marine deposits. We will present tools and methods which are used to increase our knowledge of the present physical system and to assess future changes in coastal groundwater systems