Comparison of 2.3 & 5 mega pixel (MP) resolution monitors when detecting mammography image blurring

Background - Image blurring in Full Field Digital Mammography (FFDM) is reported to be a problem within many UK breast screening units resulting in significant proportion of technical repeats/recalls. Our study investigates monitors of differing pixel resolution, and whether there is a difference in blurring detection between a 2.3 MP technical review monitor and a 5MP standard reporting monitor. Methods - Simulation software was created to induce different magnitudes of blur on 20 artifact free FFDM screening images. 120 blurred and non-blurred images were randomized and displayed on the 2.3 and 5MP monitors; they were reviewed by 28 trained observers. Monitors were calibrated to the DICOM Grayscale Standard Display Function. T-test was used to determine whether significant differences exist in blurring detection between the monitors. Results - The blurring detection rate on the 2.3MP monitor for 0.2, 0.4, 0.6, 0.8 and 1 mm blur was 46, 59, 66, 77and 78% respectively; and on the 5MP monitor 44, 70, 83 , 96 and 98%. All the non-motion images were identified correctly. A statistical difference (p <0.01) in the blurring detection rate between the two monitors was demonstrated. Conclusions - Given the results of this study and knowing that monitors as low as 1 MP are used in clinical practice, we speculate that technical recall/repeat rates because of blurring could be reduced if higher resolution monitors are used for technical review at the time of imaging. Further work is needed to determine monitor minimum specification for visual blurring detection

A 6 year study of mammographic compression force : practitioner variability within and between screening sites

Background The application of compression force in mammography is more heavily influenced by the practitioner rather than the client. This can affect client experience, radiation dose and image quality. This research investigates practitioner compression force variation over a 6 year screening cycle in three different screening units. Methods: Recorded data included: practitioner code, applied compression force(N), breast thickness(mm), BI-RADS® density category. Exclusion criteria included: previous breast surgery, previous/ongoing assessment, breast implants. 975 clients (2925) client visits, 11,700 mammogram images) met inclusion criteria across three sites. Data analysis assessed practitioner variation of compression force and breast thickness. Results: Practitioners across three breast screening sites behave differently in the application of compression force. Two of the three sites demonstrate variability within themselves, though they demonstrated no significant difference in mean, first and third quartile compression force and breast thickness values CC(p&gt;0.5), MLO(p&gt;0.1) between themselves. However, the third site (where mandate dictates a minimum compression force is applied) greater consistency was demonstrated; a significant difference in mean, first and third quartile compression force and breast thickness values(p&lt;0.001) was demonstrated between this site and the other two sites. Conclusion: Stabilisation of variations in compression force may have a positive impact on image quality, radiation dose reduction, re-attendance levels and potentially cancer detection. The large variation in compression forces could negatively impact on client experience between the units and within a unit. Further research is required to establish best practice guidelines for compression force within mammography. Keywords: Compression force, Breast compression, Compression variabilit

Men, Mental Health and Elite Sport: a Narrative Review

Mental health in elite sport is receiving more publicity due to an increase in male athletes sharing their personal experiences. Sports injury is recognised as the major risk factor for psychological distress amongst male athletes, although anecdotally this may be that athletes are more likely to discuss their emotional wellbeing when related to the injury they are experiencing. Stress can be amplified within elite sport and the pressure they experience in relation to competition and performance can be exacerbated by adverse life events. This ongoing stress does not end when their sporting career does, it can follow them into retirement. The physical and psychological demands placed upon them by the sporting environment may predispose athletes to developing depression. As an athlete's symptoms of mental illness intensify, their performance can be negatively affected leaving them vulnerable and exposed to further symptoms of common mental disorders. The pressure of performance can also expose male athletes to overtraining syndrome which can be difficult to distinguish from depression. Male athletes are more vulnerable to eating disorders compared with males in the general population and they do have anxieties, particularly around their bodies, but find it difficult to disclose their concerns. In addition to this, male athletes are more likely to use substances, including opioids to improve both sport and non-sport performance.Despite the prevalence of common mental disorders in male athletes, stigma still exists, and although some athletes discuss their issues publicly after their career has ended, the majority of athletes prefer to remain silent. There remains a view that athletes who seek help for psychological problems may be seen as weak. Although there is an improvement in help-seeking attitudes within elite sport, further research and education is needed to encourage men to talk about their mental health, share their experiences and to enjoy a greater sense of emotional wellbeing

Eating disorders in sport : current status and future directions in the study of the psychological factors

Este trabalho procura atingir dois objetivos. Em primeiro lugar, apresenta-se a situação atual da investigação sobre desordens alimentares no desporto. Neste caso, salientam-se as linhas de investigação dedicadas ao estudo da prevalência destes problemas no desporto e analisam-se as diferenças entre atletas e modalidades desportivas. Dadas as dificuldades destas linhas de investigação na compreensão dos comportamentos alimentares de risco nos atletas, são avançadas outras possibilidades de desenvolvimento da investigação. Assim, e enquanto segundo objetivo deste artigo, salientamos a necessidade dos estudos se dirigirem para a compreensão dos fatores psicológicos associados aos comportamentos alimentares de risco e implicados no desenvolvimento das desordens alimentares. Esta abordagem tem como vantagem adicional ajudar a prevenir estes problemas através da promoção das competências mentais dos atletas no sentido de resistirem melhor aos possíveis efeitos nocivos da prática desportiva, onde se inserem os problemas com a alimentação.This paper focuses on two main goals. In first place, we present the current status on the research about eating disorders in sport contexts. In this case, we point out studies dedicated to the analysis of the incidence of eating disorders in sport and studies that observe the differences between athletes and different sports in the tendency for these problems. Second, we proposed new research directions on this subject, namely the need of analysing the psychological factors that are related with the development of eating disorders on athletes. This research approach has the advantage of helping the prevention of eating disorders on athletes through the promotion of psychological skills that protect athletes from the negative effects of sport practicing, where are included maladaptive eating behaviors.(undefined

Enrichment methods to detect bone marrow micrometastases in breast carcinoma patients: clinical relevance

INTRODUCTION: Improving technologies for the detection and purification of bone marrow (BM) micrometastatic cells in breast cancer patients should lead to earlier prognosis of the risk of relapse and should make it possible to design more appropriate therapies. The technique used has to overcome the challenges resulting from the small number of target cells (one per million hematopoietic cells) and the heterogeneous expression of micrometastatic cell markers. In the present study, we have assessed the clinical relevance of current methods aimed at detecting rare disseminated carcinoma cells. METHODS: BM aspirates from 32 carcinoma patients were screened for the presence of micrometastatic cells positive for epithelial cell adhesion molecule and positive for cytokeratins, using optimized immunodetection methods. A comparison with data obtained for 46 control BM aspirates and a correlation with the clinical status of patients were performed. RESULTS: We developed a sensitive and efficient immunomagnetic protocol for the enrichment of BM micrometastases. This method was used to divide 32 breast carcinoma patients into three categories according to their epithelial cell adhesion molecule status. These categories were highly correlated with the recently revised American Joint Committee on Cancer staging system for breast cancer, demonstrating the clinical relevance of this simple and reliable immunomagnetic technique. We also evaluated immunocytochemical detection of cytokeratin-positive cells and cytomorphological parameters. Immunocytochemistry-based methods for the detection of BM micrometastases did not provide any information about the clinical status of patients, but helped to refine the immunomagnetic data by confirming the presence of micrometastases in some cases. We also tested a new density gradient centrifugation system, able to enrich the tumor fraction of BM specimens by twofold to threefold as compared with standard Ficoll methods. CONCLUSION: These improved methods for the detection of micrometastatic cells in patient BM should help clinicians to predict the clinical status of breast cancer patients at the time of surgery or treatment

Diet matters, particularly in pregnancy – Results from MoBa studies of maternal diet and pregnancy outcomes

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.Awareness that maternal diet may influence the outcome of pregnancy as well as the long-term health of mother and child has increased in recent years. A new food frequency questionnaire (FFQ) was developed and validated specifically for the Norwegian Mother and Child Cohort Study (MoBa). The MoBa FFQ is a semi-quantitative tool which covers the average intake of food, beverages and dietary supplements during the first 4 to 5 months of pregnancy. It includes questions about intakes of 255 foods and dishes and was used from 2002 onwards. Data assessed by the MoBa FFQ is available for 87,700 pregnancies. Numerous sub-studies have examined associations between dietary factors and health outcomes in MoBa. The aim of this paper is to summarize the results from 19 studies of maternal diet and pregnancy outcomes, which is the complete collection of studies based on the MoBa FFQ and published before September 2014. The overall research question is whether maternal diet – from single substances to dietary patterns – matters for pregnancy outcome. The pregnancy outcomes studied till now include birth size measures, infants being small and large for gestational age, pregnancy duration, preterm delivery, preeclampsia, as well as maternal gestational weight gain and postpartum weight retention. As a whole, the results from these studies corroborate that the current dietary recommendations to pregnant women are sound and that maternal diet during pregnancy is likely to contribute to reduce the risk of pregnancy complications including preterm birth, preeclampsia, and reduced foetal growth. The results provide supporting evidence for recommending pregnant women to consume vegetables, fruit, whole grain, fish, dairy, and water regularly and lower the intake of sugar sweetened beverages, processed meat products and salty snacks. The results showing negative impact of even low levels of environmental contaminants support the precautionary advice on consumption of foods containing these. New findings are that particularly lean fish explained the positive association between seafood intake and foetal growth, and the indications of a protective effect of probiotic and antimicrobial foods on pregnancy outcomes. This points to the importance of diet composition for a healthy gut flora and the body’s immune response. Although these studies are observational and cannot infer causality, the results identify diet as an important modifiable lifestyle factor, suggesting that healthy eating, defined as following the official recommendations, is particularly important in pregnanc

Female athlete health domains:A supplement to the International Olympic Committee consensus statement on methods for recording and reporting epidemiological data on injury and illness in sport

The IOC made recommendations for recording and reporting epidemiological data on injuries and illness in sports in 2020, but with little, if any, focus on female athletes. Therefore, the aims of this supplement to the IOC consensus statement are to (i) propose a taxonomy for categorisation of female athlete health problems across the lifespan; (ii) make recommendations for data capture to inform consistent recording and reporting of symptoms, injuries, illnesses and other health outcomes in sports injury epidemiology and (iii) make recommendations for specifications when applying the Strengthening the Reporting of Observational Studies in Epidemiology-Sport Injury and Illness Surveillance (STROBE-SIIS) to female athlete health data. In May 2021, five researchers and clinicians with expertise in sports medicine, epidemiology and female athlete health convened to form a consensus working group, which identified key themes. Twenty additional experts were invited and an iterative process involving all authors was then used to extend the IOC consensus statement, to include issues which affect female athletes. Ten domains of female health for categorising health problems according to biological, life stage or environmental factors that affect females in sport were identified: menstrual and gynaecological health; preconception and assisted reproduction; pregnancy; postpartum; menopause; breast health; pelvic floor health; breast feeding, parenting and caregiving; mental health and sport environments. This paper extends the IOC consensus statement to include 10 domains of female health, which may affect female athletes across the lifespan, from adolescence through young adulthood, to mid-age and older age. Our recommendations for data capture relating to female athlete population characteristics, and injuries, illnesses and other health consequences, will improve the quality of epidemiological studies, to inform better injury and illness prevention strategies

The presence of disseminated tumour cells in the bone marrow is inversely related to circulating free DNA in plasma in breast cancer dormancy.

BACKGROUND: The aim of this study was to gain insight into breast cancer dormancy by examining different measures of minimal residual disease (MRD) over time in relation to known prognostic factors. METHODS: Sixty-four primary breast cancer patients on follow-up (a median of 8.3 years post surgery) who were disease free had sequential bone marrow aspirates and blood samples taken for the measurement of disseminated tumour cells (DTCs), circulating tumour cells (CTCs) by CellSearch and qPCR measurement of overlapping (96-bp and 291-bp) amplicons in circulating free DNA (cfDNA). RESULTS: The presence of CTCs was correlated with the presence of DTCs measured by immunocytochemistry (P=0.01) but both were infrequently detected. Increasing cfDNA concentration correlated with ER, HER2 and triple-negative tumours and high tumour grade, and the 291-bp amplicon was inversely correlated with DTCs measured by CK19 qRT-PCR (P=0.047). CONCLUSION: Our results show that breast cancer patients have evidence of MRD for many years after diagnosis despite there being no overt evidence of disease. The inverse relationship between bone marrow CK19 mRNA and the 291-bp amplicon in cfDNA suggests that an inverse relationship between a measure of cell viability in the bone marrow (DTCs) and cell death in the plasma occurs during the dormancy phase of breast cancer