Intra-cavitary uterine pathology in women with abnormal uterine bleeding: a prospective study of 1220 women.

OBJECTIVES: Our primary aim was to assess how patients characteristics, bleeding pattern, sonographic endometrial thickness (ET) and additional features at unenhanced ultrasound examination (UTVS) and at fluid instillation sonography (FIS) contribute to the diagnosis of intracavitary uterine pathology in women presenting with abnormal uterine bleeding (AUB). We further aimed to report the prevalence of pathology in women presenting with AUB. METHODS: 1220 consecutive women presenting with AUB underwent UTVS, colour Doppler imaging (CDI) and FIS. Most women (n = 1042) had histological diagnosis. RESULTS: Mean age was 50 years and 37% were postmenopausal. Of 1220 women 54% were normal, polyps were diagnosed in 26%, intracavitary fibroids in 11%, hyperplasia without atypia in 4% and cancer in 3%. All cancers were diagnosed in postmenopausal (7%) or perimenopausal (1%) women. ET had a low predictive value in premenopausal women (LR+ and LR- of 1.34 and 0.74, respectively), while FIS had a LR+ and LR- of 6.20 and 0.24, respectively. After menopause, ET outperformed all patient characteristics for the prediction of endometrial pathology (LR+ and LR- of 3.13 and 0.24). The corresponding LR+ and LR- were 10.85 and 0.71 for CDI and 8.23 and 0.26 for FIS. CONCLUSION: About half of the women presenting to a bleeding clinic will have pathology. In premenopausal women, benign lesions are often the cause of AUB. For the prediction of intracavitary pathology ET is of little value in premenopausal women. CDI and FIS substantially improve the diagnostic accuracy

Genetic Prognostic Factors and Follow-up in Uveal Melanoma

An important part of oncological research is to identify prognostic factors and predict which patients are at risk for (early) metastasis. This thesis aims to describe the known genetic alterations in uveal melanoma and define new chromosomal regions and markers involved with (micro-) metastasis and the response to local therapy. In chapter 1 the current knowledge of clinical and molecular genetic aspects of uveal melanoma is reviewed. The similarities and dissimilarities regarding the genetic background and genetic differences between uveal melanoma and cutaneous melanoma are discussed in chapter 2. The following chapters, chapter 3-8, describe the cytogenetic and molecular genetic research regarding prognostic factors and follow-up in primary uveal melanoma samples and cell lines. In the final chapter 9, a general discussion including an overview of our results and recent techniques and developments in the ocular oncology field is presented

The Social Stratification of Social Risks: Class and Responsibility in the 'New' Welfare State

Welfare states are said to have evolved over the course of the past twenty years towards a ‘social investment’ model of welfare, characterised by a focus on equality of opportunity and upward social mobility combined with greater emphasis on individual responsibility. More or less concurrently, under the mantra of ‘individualisation’, scepticism has grown with regard to the relevance of traditional stratification schemes. This paper sets out to ascertain whether social class, i.e. intergenerational background, (still) affects the occurrence of ‘social risks’. Using SILC 2005 data, it considers the impact of social class (of origin) on a relevant selection of social risks: unemployment, ill-health, living in a jobless household, single parenthood, temporary employment, and low-paid employment. The results provide clear evidence of a continuing influence of social class. On this basis, we argue that a one-sided focus on individual responsibility could open the door to new forms of marginalisation.Ireland, Austerity, Fiscal Policy, Monetary Policy

What makes or breaks a campaign to stop an invading plant pathogen?

Diseases in humans, animals and plants remain an important challenge in our society. Effective control of invasive pathogens often requires coordinated concerted action of a large group of stakeholders. Both epidemiological and human behavioural factors influence the outcome of a disease control campaign. In mathematical models that are frequently used to guide such campaigns, human behaviour is often ill-represented, if at all. Existing models of human, animal and plant disease that do incorporate participation or compliance are often driven by pay-offs or direct observations of the disease state. It is however very well known that opinion is an important driving factor of human decision making. Here we consider the case study of Citrus Huanglongbing disease (HLB), which is an acute bacterial disease that threatens the sustainability of citrus production across the world. We show how by coupling an epidemiological model of this invasive disease with an opinion dynamics model we are able to answer the question: What makes or breaks the effectiveness of a disease control campaign? Frequent contact between stakeholders and advisors is shown to increase the probability of successful control. More surprisingly, we show that informing stakeholders about the effectiveness of control methods is of much greater importance than prematurely increasing their perceptions of the risk of infection. We discuss the overarching consequences of this finding and the effect on human as well as plant disease epidemics

Broad expertise retrieval in sparse data environments

Expertise retrieval has been largely unexplored on data other than the W3C collection. At the same time, many intranets of universities and other knowledge-intensive organisations offer examples of relatively small but clean multilingual expertise data, covering broad ranges of expertise areas. We first present two main expertise retrieval tasks, along with a set of baseline approaches based on generative language modeling, aimed at finding expertise relations between topics and people. For our experimental evaluation, we introduce (and release) a new test set based on a crawl of a university site. Using this test set, we conduct two series of experiments. The first is aimed at determining the effectiveness of baseline expertise retrieval methods applied to the new test set. The second is aimed at assessing refined models that exploit characteristic features of the new test set, such as the organizational structure of the university, and the hierarchical structure of the topics in the test set. Expertise retrieval models are shown to be robust with respect to environments smaller than the W3C collection, and current techniques appear to be generalizable to other settings

The dynamical distance and intrinsic structure of the globular cluster omega Centauri

We determine the dynamical distance D, inclination i, mass-to-light ratio M/L and the intrinsic orbital structure of the globular cluster omega Cen, by fitting axisymmetric dynamical models to the ground-based proper motions of van Leeuwen et al. and line-of-sight velocities from four independent data-sets. We correct the observed velocities for perspective rotation caused by the space motion of the cluster, and show that the residual solid-body rotation component in the proper motions can be taken out without any modelling other than assuming axisymmetry. This also provides a tight constraint on D tan i. Application of our axisymmetric implementation of Schwarzschild's orbit superposition method to omega Cen reveals no dynamical evidence for a significant radial dependence of M/L. The best-fit dynamical model has a stellar V-band mass-to-light ratio M/L_V = 2.5 +/- 0.1 M_sun/L_sun and an inclination i = 50 +/- 4 degrees, which corresponds to an average intrinsic axial ratio of 0.78 +/- 0.03. The best-fit dynamical distance D = 4.8 +/- 0.3 kpc (distance modulus 13.75 +/- 0.13 mag) is significantly larger than obtained by means of simple spherical or constant-anisotropy axisymmetric dynamical models, and is consistent with the canonical value 5.0 +/- 0.2 kpc obtained by photometric methods. The total mass of the cluster is (2.5 +/- 0.3) x 10^6 M_sun. The best-fit model is close to isotropic inside a radius of about 10 arcmin and becomes increasingly tangentially anisotropic in the outer region, which displays significant mean rotation. This phase-space structure may well be caused by the effects of the tidal field of the Milky Way. The cluster contains a separate disk-like component in the radial range between 1 and 3 arcmin, contributing about 4% to the total mass.Comment: 37 pages (23 figures), accepted for publication in A&A, abstract abridged, for PS and PDF file with full resolution figures, see http://www.strw.leidenuniv.nl/~vdven/oc