Improving Cervical Cancer Prevention by HPV Self-sampling, Colposcopy and Biomarkers

__Abstract__ The worldwide incidence rate of cervical cancer is around 500 000 per year with a mortality rate of around 270 000 women per year. With these figures, it represents the third most common cancer among women worldwide, after breast and colorectal cancer. However, the incidence varies widely among countries; with an average incidence of 452 000 new cases per year in developing countries versus 76 000 new cases per year in developed countries (Figure 1). This lower incidence of cervical cancer in developed countries is at least partially the result of organized cervical cancer screening programs, which lead to earlier detection of cervical cancer and treatable premalignant stages. Since the introduction of the national orga

Synchrotron Spectra and Ages of Compact Steep Spectrum Radio Sources

The high-frequency integrated spectra of Compact Steep Spectrum (CSS) sources show breaks with a moderate spectral steepening well fitted by continuous injection synchrotron spectra. In lobe-dominated CSS sources the radiative ages deduced by the synchrotron theory are in the range of up to 0.1 Myears, if equipartition magnetic fields are assumed. These radiative ages are well correlated with the source size indicating that the CSS sources are young. In order to maintain the frustration scenario, in which the sources' lifetimes are about 10 Myears, their equipartition magnetic field would be systematically decreased by a factor of more than 20. To complete the sample used in this work, we conducted observations at 230 GHz with the IRAM 30-m telescope of those sources which did not have such high-frequency observations up to now.Comment: 10 pages, 6 figures, 2 tables, accepted for publication in Astron. & Astrophys.; typos corrected; gzipped postscript version also available at: http://multivac.jb.man.ac.uk:8000/ceres/papers/papers.html http://gladia.astro.rug.nl:8000/ceres/papers/papers.htm

The Evolution of NGC 7027 at Radio Frequencies: A New Determination of the Distance and Core Mass

We present the results of a 25-year program to monitor the radio flux evolution of the planetary nebula NGC7027. We find significant evolution of the spectral flux densities. The flux density at 1465 MHz, where the nebula is optically thick, is increasing at a rate of 0.251+-0.015 % per year, caused by the expansion of the ionized nebula. At frequencies where the emission is optically thin, the spectral flux density is changing at a rate of -0.145+-0.005 % per year, caused by a decrease in the number of ionizing photons coming from the central star. A distance of 980+-100 pc is derived. By fitting interpolated models of post-AGB evolution to the observed changes, we find that over the 25-yr monitoring period, the stellar temperature has increased by 3900+-900 K and the stellar bolometric luminosity has decreased by 1.75+-0.38 %. We derive a distance-independent stellar mass of 0.655+-0.01 solar masses adopting the Bloecker stellar evolution models, or about 0.04 solar masses higher when using models of Vassiliadis & Wood which may provide a better fit. A Cloudy photoionization model is used to fit all epochs at all frequencies simultaneously. The differences between the radio flux density predictions and the observed values show some time-independent residuals of typically 1 %. A possible explanation is inaccuracies in the radio flux scale of Baars et al. We propose an adjustment to the flux density scale of the primary radio flux calibrator 3C286, based on the Cloudy model of NGC7027. We also calculate precise flux densities for NGC7027 for all standard continuum bands used at the VLA, as well as for some new 30GHz experiments.Comment: submitted to the Astrophysical Journa

The 1.4 GHz light curve of GRB 970508

We report on Westerbork 1.4 GHz radio observations of the radio counterpart to $\gamma$-ray burst GRB~970508, between 0.80 and 138 days after this event. The 1.4 GHz light curve shows a transition from optically thick to thin emission between 39 and 54 days after the event. We derive the slope $p$ of the spectrum of injected electrons ($dN/d\gamma_{e}\propto\gamma_{e}^{-p}$) in two independent ways which yield values very close to $p=2.2$. This is in agreement with a relativistic dynamically near-adiabatic blast wave model whose emission is dominated by synchrotron radiation and in which a significant fraction of the electrons cool fast.Comment: Paper I. Accepted for publication in the Astrophysical Journal Letter

The discovery of diffuse steep spectrum sources in Abell 2256

Context: Hierarchical galaxy formation models indicate that during their lifetime galaxy clusters undergo several mergers. Here we report on the discovery of three diffuse radio sources in the periphery of Abell 2256, using the GMRT. Aims: The aim of the observations was to search for diffuse ultra-steep spectrum radio sources within the galaxy cluster Abell 2256. Methods: We have carried out GMRT 325 MHz radio continuum observations of Abell 2256. V, R and I band images of the cluster were taken with the 4.2m WHT. Results: We have discovered three diffuse elongated radio sources located about 1 Mpc from the cluster center. Two are located to the west of the cluster center, and one to the southeast. The sources have a measured physical extent of 170, 140 and 240 kpc, respectively. The two western sources are also visible in deep low-resolution 115-165 MHz WSRT images, although they are blended into a single source. For the combined emission of the blended source we find an extreme spectral index of -2.05\pm 0.14 between 140 and 351 MHz. The extremely steep spectral index suggests these two sources are most likely the result of adiabatic compression of fossil radio plasma due to merger shocks. Conclusions: The discovery of the steep spectrum sources implies the existence of a population of faint diffuse radio sources in (merging) clusters with such steep spectra that they have gone unnoticed in higher frequency (\gtrsim 1 GHz) observations. An exciting possibility therefore is that such sources will determine the general appearance of clusters in low-frequency high resolution radio maps as will be produced by for example LOFAR or LWA.Comment: 5 pages, 2 figures, accepted for publication in A&A on October 16, 200

Samen sterk: een groepsprogramma voor ouders van jongeren met een depressie

Health and Well-bein

XMM-Newton observations of the merging galaxy cluster CIZA J2242.8+5301

We studied the intracluster medium of the galaxy cluster CIZA J2242.8+5301 using deep XMM-Newton observations. The cluster hosts a remarkable 2-Mpc long, ~50-kpc wide radio relic that has been nicknamed the "Sausage". A smaller, more irregular counter-relic is also present, along with a faint giant radio halo. We analysed the distribution of the ICM physical properties, and searched for shocks by trying to identify density and temperature discontinuities. East of the southern relic, we find evidence of shock compression corresponding to a Mach number of 1.3, and speculate that the shock extends beyond the length of the radio structure. The ICM temperature increases at the northern relic. More puzzling, we find a "wall" of hot gas east of the cluster centre. A partial elliptical ring of hot plasma appears to be present around the merger. While radio observations and numerical simulations predict a simple merger geometry, the X-ray results point towards a more complex merger scenario.Comment: Extensively revised and expanded, with 18 pages and 17 figure

Campylobacter jejuni bacteremia and Helicobacter pylori in a patient with X-linked agammaglobulinemia

We describe a 15-year-old patient with X-linked agammaglobulinemia who developed malabsorption and bacteremia due to infection of Helicobacter pylori and Campylobacter jejuni. The Campylobacter bacteremia was only recognized after subculturing of blood culture bottles that failed to signal in the automated system. After 2 weeks of treatment with meropenem and erythromycin for 4 weeks, the patient developed a relapse of bacteremia 10 months later with a high level erythromycin resistant C. jejuni. Sequencing revealed an A2058C mutation in the 23 S rRNA gene associated with this resistance. Treatment with doxycycline for 4 weeks finally resulted in complete eradication. This case report illustrates the importance for physicians to use adapted culture methods and adequate prolonged therapy in patients with an immunodeficiency. A summary of published case reports and series of patients with hypogammaglobulinemia or agammaglobulinemia with Campylobacter or Helicobacter bacteremia is given

Patients with intellectual disabilities:10 tips

Bijna iedere arts ziet in zijn of haar praktijk patiënten met een verstandelijke beperking.De gezondheid van mensen met een verstandelijke beperking loopt nog steeds achter bij die van de algemene bevolking.Een consult met deze groep patiënten verloopt vaak moeizamer dan met andere patiënten, maar er zijn verschillende manieren om het consult beter te laten verlopen.Neem de tijd voor het contact met patiënten met een verstandelijke beperking, pas het taalgebruik aan en gebruik visuele ondersteuning.Mensen met een verstandelijke beperking en een complexe zorgvraag kunnen verwezen worden naar een arts voor verstandelijk gehandicapten (AVG) of een syndroomspecifieke polikliniek.Almost all physicians see patients with intellectual disabilities in their practices. There are still health disparities between people with intellectual disability and the general population. Consultations with this group of patients can be challenging, but there are ways to improve on them. Take your time when it comes to communicating with patients with intellectual disabilities, adapt language use and make use of visual aids. People with intellectual disabilities and complex care needs can be referred to intellectual disability physicians (AVG in Dutch) or syndrome-specific outpatient clinics.</p