132 research outputs found
The Effects of New Screening Tests in the Dutch Cervical Cancer Screening Programme
Cervical cancer is the fourth most common cancer in women all over the world, mainly affecting young women. As cervical cancer is easy to prevent by early detection and treatment of the disease, screening was introduced in the Netherlands in the 1970s. The number of cervical cancer cases and cervical cancer related deaths were thereby effectively reduced. Substantial improvements in the understanding of the natural history of cervical cancer as well as advancements in technologies have led to a rapid development and implementation of novel screening tests. The aim of this thesis is to give an overview of the effects of using new screening tests in the Dutch cervical cancer screening programme. More specific, we focus on the effects of using different cytology tests in the current programme, as well as on the possible effects of self-sampling tests in the future programme
Supporting sustainable chainsaw milling through multi-stakeholder dialogue in Guyana
The Chainsaw Milling Project is using multi-stakeholder dialogue (MSD) as its key strategy for achieving its objectives. In Guyana the dialogue process aims to achieve a shared understanding of chainsaw milling practices and associated opportunities for economic development at local level. It aims to build consensus among stakeholders to reduce the level of conflict and illegality related to chainsaw milling by local communities; and review regulatory frameworks in order to strengthen governance in the forestry sector. So far the MSD in Guyana has focused largely on addressing chainsaw milling opportunities and challenges at local and regional level. To maximize its effectiveness the dialogue is in the process of being upscaled to a national level. Narratives, personal experiences and lessons from the MSD at the local level were felt to be useful in support of this endeavour. To that effect project staff and other stakeholders have written âstoriesâ that show the different dimensions of their work but with a common message: this multi-stakeholder dialogue is of key importance for those who make a living out of the forest, for now and in the future. This book contains their stories
Cervical cancer screening in partly HPV vaccinated cohorts - A cost-effectiveness analysis
Background: Vaccination against the oncogenic human papillomavirus (HPV) types 16 and 18 will reduce the prevalence of these types, thereby also reducing cervical cancer risk in unvaccinated women. This (measurable) herd effect will be limited at first
Comparing SurePath, ThinPrep, and conventional cytology as primary test method: SurePath is associated with increased CIN II+ detection rates
Purpose: Within the last decade, SurePath and ThinPrep [both liquid-based cytology (LBC) tests] have replaced conventional cytology (CC) as primary test method in cervical cancer screening programs of multiple countries. The aim of our study was to examine the effect in the Dutch screening program. Methods: All primary smears taken within this program from 2000 to 2011 were analyzed using the nationwide registry of histo- and cytopathology (PALGA) with a follow-up until March 2013. The percentage of smears classified as borderline/mildly dyskaryotic (BMD) and >BMD as well as CIN and cervical cancer detection rates were compared between SurePath and ThinPrep versus CC by logistic regression analyses (adjusted for age, screen region, socioeconomic status, and calendar time). Results: We included 3,118,685 CC, 1,313,731 SurePath, and 1,584,587 ThinPrep smears. Using SurePath resulted in an increased rate of primary smears classified as >BMD [odds ratio (OR)Â =Â 1.12 (95% confidence interval (CI) 1.09â1.16)]. CIN I and II+ detection rates increased by 14 % [OR = 1.14 (95% CI 1.08â1.20)] and 8Â % [ORÂ =Â 1.08 (95% CI 1.05â1.12)]. Cervical cancer detection rates were unaffected. Implementing ThinPrep did not result in major alterations of the cytological classification of smears, and it did not affect CIN detection rates. While not significant, cervical cancer detection rates were lower [ORÂ =Â 0.87 (95% CI 0.75â1.01)]. Conclusions: The impact of replacing CC by LBC as primary test method depends on the type of LBC test used. Only the use of SurePath was associated with increased CIN II+ detection, although it simultaneously increased the detection of CIN I
Cervical cancer incidence after normal cytological sample in routine screening using SurePath, ThinPrep, and conventional cytology: population based study
#### Objective
To compare the cumulative incidence of cervical cancer
diagnosed within 72 months after a normal screening
sample between conventional cytology and liquid
based cytology tests SurePath and ThinPrep.
#### Design
Retrospective population based cohort study.
#### Setting
Nationwide network and registry of histo- and
cytopathology in the Netherlands (PALGA), January
2000 to March 2013.
#### Population
Women with 5924474 normal screening samples
(23833123 person years).
#### Exposure
Use of SurePath or ThinPrep versus conventional
cytology as screening test.
#### Main outcome measure
72 month cumulative incidence of invasive cervical
cancer after a normal screening sample for each
screening test. Cox regression analyses assessed the
hazard ratios, adjusted for calendar time, age,
screening history, and socioeconomic status and
including laboratories as random effects.
#### Results
The 72 month cumulative cancer incidence was 58.5
(95% confidence interval 54.6 to 62.7) per 100000
normal conventional cytology samples, compared with
66.8 (56.7 to 78.7) for ThinPrep and 44.6 (37.8 to 52.6)
for SurePath. Compared with conventional cytology,
the hazard of invasive cancer was 19% lower (hazard
ratio 0.81, 95% confidence interval 0.66 to 0.99) for
SurePath, mainly caused by a 27% lower hazard (0.73,
0.57 to 0.93) of a clinically detected cancer. For
ThinPrep, the hazard was on average 15% higher
(hazard ratio 1.15, 0.95 to 1.38), mainly caused by a
56% higher hazard of a screen detected cancer (1.56,
1.17 to 2.08).
#### Conclusions
These findings should provoke reconsideration of the
assumed similarity in sensitivity to detect progressive
cervical intraepithelial neoplasia between different
types of liquid based cy
Statistical Studies on the Growth of Japanese Breed of Cattle (II) : Special reference to the body growth from 10 to 15 months age
BACKGROUND: We compared the sensitivity and specificity of liquid-based cytology (LBC) and computer-assisted reading for SurePath/FocalPoint and ThinPrep with those of manually read conventional cytology in routine cervical screening in four Danish laboratories. METHODS: Using data from five nationwide registers, technological phases were identified by slide preparation, reading technique, and triage of borderline cytology. Trends in the detection of cervical intraepithelial neoplasia (CIN) were an indicator of the technology's relative sensitivity, and trends in false-positive tests an indicator of relative specificity. RESULTS: At 23â29 years, SurePath/FocalPoint statistically significantly increased the detection of â©ŸCIN3 by 85% compared with manually read conventional cytology. The 11% increase with ThinPrep was not significant. At 30â44 years, the increase with SurePath/FocalPoint was 58% the 16% increase with ThinPrep was not significant. At 45â59 years, both technologies led to nonsignificant decreases in the detection. SurePath/FocalPoint doubled the frequency of false-positive tests at any age. With ThinPrep, these proportions remained the same at 23â29 years, but decreased by two-thirds at 45â59 years. In a fourth laboratory with continuous use of manually read conventional cytology, no such trends were seen. CONCLUSIONS: The sensitivity and specificity of modern LBC and computer-assisted reading technologies may be brand- and age-dependent
State space modelling and data analysis exercises in LISA Pathfinder
LISA Pathfinder is a mission planned by the European Space Agency to test the
key technologies that will allow the detection of gravitational waves in space.
The instrument on-board, the LISA Technology package, will undergo an
exhaustive campaign of calibrations and noise characterisation campaigns in
order to fully describe the noise model. Data analysis plays an important role
in the mission and for that reason the data analysis team has been developing a
toolbox which contains all the functionalities required during operations. In
this contribution we give an overview of recent activities, focusing on the
improvements in the modelling of the instrument and in the data analysis
campaigns performed both with real and simulated data.Comment: Plenary talk presented at the 9th International LISA Symposium, 21-25
May 2012, Pari
A strategy to characterize the LISA-Pathfinder cold gas thruster system
The cold gas micro-propulsion system that will be used during the LISA-Pathfinder mission will be one of the most important component used to ensure the "free-fall" of the enclosed test masses. In this paper we present a possible strategy to characterize the effective direction and amplitude gain of each of the 6 thrusters of this system
In-flight thermal experiments for LISA pathfinder: simulating temperature noise at the inertial sensors
Thermal Diagnostics experiments to be carried out on board LISA Pathfinder (LPF) will yield a detailed characterisation of how temperature fluctuations affect the LTP (LISA Technology Package) instrument performance, a crucial information for future space based gravitational wave detectors as the proposed eLISA. Amongst them, the study of temperature gradient fluctuations around the test masses of the Inertial Sensors will provide as well information regarding the contribution of the Brownian noise, which is expected to limit the LTP sensitivity at frequencies close to 1 mHz during some LTP experiments. In this paper we report on how these kind of Thermal Diagnostics experiments were simulated in the last LPF Simulation Campaign (November, 2013) involving all the LPF Data Analysis team and using an end-to-end simulator of the whole spacecraft. Such simulation campaign was conducted under the framework of the preparation for LPF operations
The LISA pathfinder mission
ISA Pathfinder (LPF), the second of the European Space Agency's Small Missions for Advanced Research in Technology (SMART), is a dedicated technology validation mission for future spaceborne gravitational wave detectors, such as the proposed eLISA mission. LISA Pathfinder, and its scientific payload - the LISA Technology Package - will test, in flight, the critical technologies required for low frequency gravitational wave detection: it will put two test masses in a near-perfect gravitational free-fall and control and measure their motion with unprecedented accuracy. This is achieved through technology comprising inertial sensors, high precision laser metrology, drag-free control and an ultra-precise micro-Newton propulsion system. LISA Pathfinder is due to be launched in mid-2015, with first results on the performance of the system being available 6 months thereafter.
The paper introduces the LISA Pathfinder mission, followed by an explanation of the physical principles of measurement concept and associated hardware. We then provide a detailed discussion of the LISA Technology Package, including both the inertial sensor and interferometric readout. As we approach the launch of the LISA Pathfinder, the focus of the development is shifting towards the science operations and data analysis - this is described in the final section of the paper
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