Risk of radiation-induced cancer from screening mammography

Background and Objectives: When the benefits and risks of mammography are considered, the risk of radiation-induced cancer is calculated only for the breast using the mean glandular dose (MGD). Whilst MGD is a useful concept, it has many limitations. This thesis aims to establish a novel method to determine and convey radiation risk from full field digital mammography (FFDM) screening using lifetime effective risk. Method: For effective risk calculations, organ doses as well as examined breast MGD are required. Screening mammography was simulated by exposing a breast phantom for cranio-caudal and medio-lateral oblique for each breast using 16 FFDM machines. An anthropomorphic dosimetry phantom loaded with thermo-luminescent detectors (TLDs) was positioned in contact with the breast phantom to simulate the client’s body. Once the risk per individual was calculated, total effective lifetime risk across 48 worldwide screening programmes was calculated. The total effective risk data sets were analysed to establish a regression model to predict the effective risk of any screening programme. Graphs were generated to extrapolate the total effective risk of any screening programme of specific screening commencement age and frequency considering the MGD differences of different FFDM machines. Since the highest radiation dose after examined breast was received by contralateral breast, the effect of a contralateral breast lead shield on effective risk was also investigated. Results: Large differences in the effective lifetime risk exist between worldwide screening programmes. The effective lifetime risk varied from approximately 50 cases/106 to more than 1000 cases/106. These differences were mainly attributed to the commencement age and frequency of screening. Since tissue radio-sensitivity reduces with age, the cessation age of screening mammography does not result in a noteworthy effect on the total effective risk. The use of contralateral breast shield reduces the total effective risk by about 1.5% for most worldwide screening programmes.Conclusion: A novel method has been proposed to assess radiation-induced cancer risk from FFDM screening which considers the radiation dose received by all body tissues in addition to the examined breast. Using effective risk, the data is more likely to be understandable by screening clients and referring clinicians, unlike MGD which is not readily available or understandable by the general populace. This novel method and the data are compatible with the incoming European Commission legislation about giving the patient information on radiation risk

Fragmented realities: The ‘sectarianisation’of space among Iraqi Shias in London

How do the spaces we inhabit shape our lived experiences? And how do those lived experiences in turn come to shape and influence our political subjectivity? Such questions are rendered all the more important in studies of migrant or diaspora populations who, by definition, conduct their daily lives in spaces and places that were initially alien to them. The way in which migrants interact with the spaces around them can tell us much about the social, political, and religious engagements they invest in, as well as the very real way in which they experience their local milieu. Through a detailed study of Iraqi Shiis living in London, specifically in the north-western borough of Brent, this article will seek to trace the ways in which religious institutions have carved up the physical and social landscape of north-west London in ways that have enduring effect on the communities with which they engage. The increasing diversification of different religious establishments, I argue, has led to a fragmentation of the city-as-lived, in which the vast majority of practising Iraqi Shiis engage with only small isolated pockets of the urban environment on a daily basis. Moreover, the growing number of specifically Shia schools, charities, mosques, community centres and other such institutions has resulted in what I call a ‘sectarianisation’ of space in Brent, in which individuals hailing from different branches of Islam inhabit different spaces within the city despite often living within metres of each other. Drawing on a mixture of interviews, participant observation, and mapping techniques, I bring together theory and practice in order to sketch out the ways migrant lives can come to be localised in certain spaces, and what that can ultimately mean in terms of their political subjectivity and engagement

Radiation dose from digital breast tomosynthesis screening - A comparison with full field digital mammography

To compare Mean Glandular Dose (MGD) and effective dose from digital breast tomosynthesis (DBT) screening with that from full field digital mammography (FFDM) screening. To simulate compressed breasts, two Perspex-polyethylene breast phantoms were used, one phantom for compressed breast in craniocaudal and the other for compressed breast in mediolateral oblique. An adult ATOM dosimetry phantom was loaded with high sensitivity thermoluminescence dosimeters; the phantom was then positioned on Hologic Selenia Dimensions mammographic machine to imitate DBT and 4-view FFDM screening. Organ radiation doses were measured from 4-view DBT and 4-view FFDM (craniocaudal and mediolateral oblique views for each breast). Organ radiation doses were used to calculate effective dose from one screening session. MGD for DBT was 3.6 mGy; MGD for FFDM was 2.8 mGy. For DBT, other organs (e.g. thymus, lungs, salivary glands, thyroid, contralateral breast and bone marrow) radiation dose was also higher than for FFDM. The use of DBT for breast cancer screening increases the effective dose (E) of one screening session by 22%. E for DBT was 0.44 mSv; E for FFDM was 0.34 mSv. The use of DBT for breast cancer screening increases the radiation dose to screening clients. [Abstract copyright: Copyright © 2020. Published by Elsevier Inc.

Antimalarial agents from medicinal plant and fungal sources

Malaria is the fourth major parasitic infectious disease for humans, causing severe symptoms and life-threatening complications, which, if untreated within 24–48 h may evolve in the fatality. In the past five decades, major initiatives in the treatment and prevention of this devastating disease have been implemented in endemic areas, leading to significant progress and declining trends. The majority of the reports presented here are focused on the activity of the extracts and fractions of plant or fungal origin: this approach has its rationale in the observation that crude materials are often more active than isolated compounds, due to the manifestation of beneficial synergistic and additional effects and/or pharmacokinetic/pharmacodynamic interactions. Consideration has been given to the antiplasmodial activities in relation to the different herbal part and nature of extracting solvents and to safety studies; whenever available, phytochemical fingerprint has been reported, disclosing a variety of unique molecular scaffolds with a potential as new pharmacophores. Despite the general lack of mechanistic information for the curative effects of the reported plants and fungi, these studies may undoubtedly pave the way to a new generation of antimalarial agents