Using Speed of Sound Imaging to Characterize Breast Density

A population of 165 women with negative mammographic screens also received an ultrasound tomography (UST) examination at the Karmanos Cancer Institute in Detroit, MI. Standard statistical techniques were employed to measure the associations between the various mammographic- and UST-related density measures and various participant characteristics such as age, weight and height. The mammographic percent density (MPD) was found to have similar strength associations with UST mean sound speed (Spearman coefficient, r_s = 0.722, p < 0.001) and UST median sound speed (r_s = 0.737, p < 0.001). Both were stronger than the associations between MPD with two separate measures of UST percent density, a k-means (r_s = 0.568, p < 0.001) or a threshold (r_s = 0.715, p < 0.001) measure. Segmentation of the UST sound speed images into dense and non-dense volumes showed weak to moderate associations with the mammographically equivalent measures. Relationships were found to be inversely and weakly associated between age and the UST mean sound speed (r_s = ?0.239, p = 0.002), UST median sound speed (r_s = ?0.226, p = 0.004) and MPD (r_s = ?0.204, p = 0.008). Relationships were found to be inversely and moderately associated between body mass index (BMI) and the UST mean sound speed (r_s = ?0.429, p < 0.001), UST median sound speed (r_s = ?0.447, p < 0.001) and MPD (r_s = ?0.489, p < 0.001). The results confirm and strengthen findings presented in previous work indicating that UST sound speed imaging yields viable markers of breast density in a manner consistent with mammography, the current clinical standard. These results lay the groundwork for further studies to assess the role of sound speed imaging in risk prediction.     

Squamous Carcinoma of the Ovary

Squamous ovarian cancer (SOC) represents a (very) rare subtype of ovarian cancer. The lack of evidence on which to base management presents significant challenges. The small number of patients prohibits randomised studies to establish level 1 evidence, and no non-randomised studies or prospective series have been reported. Here, we present a review of the available literature on squamous ovarian cancer and explore some lessons learnt from squamous cancers originating from other primary sites to see if these can be applied to SOC.     

Preservation of alpha-tocopherol in sunflower oil by herbs and spices

The ability of some commercially available herb and spice extracts to preserve alpha-tocopherol in sunflower oil during heating at 85-105°C was assessed using sunflower oil as a model system. The Rancimat® was evaluated for the heating stage and was used throughout as it was shown to be viable: α-tocopherol did not evaporate under the test conditions. The delay in the onset of rancidity was found to be directly related to the initial α-tocopherol concentration (P < 0.01). Rosemary, thyme, turmeric, sage, oregano and cumin extracts (2000 mg.kg^?1) delayed rancidity (P < 0.01) and preserved α-tocopherol (P < 0.01). Some preservation was observed with clove extract but coriander and cardamom extracts were pro-oxidants. With thyme extract, the log of the induction time (as an indicator of the delay in rancidity) was directly proportional to the temperature (85-100°C). The ethyl acetate, hexane and methanol extracts of fresh sage were effective for preserving α-tocopherol (P < 0.01). With thyme, rosemary and sage extracts, the increase in the preservation of α-tocopherol was directly related to the concentration of the herb extract (P < 0.01) and was quite effective even at 100 mg.kg^?1. The increased delay in the onset of rancidity was due directly to the improved preservation of α-tocopherol (P < 0.01). In further experiments, the preservative effect of turmeric was shown not to be due to its reported major antioxidant, curcumin, even though it delayed rancidity. When herb/spice extracts were examined mixed with thyme, bay and turmeric showed synergism (P < 0.01) whereas bay alone was slightly inhibitory. The mode of action appeared to be due to free radical activity rather than through singlet oxygen generation.     

Capacities for theory of mind,metacognition, and neurocognitive function are independently related to emotional recognition in schizophrenia

While many with schizophrenia spectrum disorders experience difficulties understanding the feelings of others, little is known about the psychological antecedents of these deficits. To explore these issues we examined whether deficits in mental state decoding, mental state reasoning and metacognitive capacity predict performance on an emotion recognition task. Participants were 115 adults with a schizophrenia spectrum disorder and 58 adults with substance use disorders but no history of a diagnosis of psychosis who completed the Eyes and Hinting Test. Metacognitive capacity was assessed using the Metacognitive Assessment Scale Abbreviated and emotion recognition was assessed using the Bell Lysaker Emotion Recognition Test. Results revealed that the schizophrenia patients performed more poorly than controls on tests of emotion recognition, mental state decoding, mental state reasoning and metacognition. Lesser capacities for mental state decoding, mental state reasoning and metacognition were all uniquely related emotion recognition within the schizophrenia group even after controlling for neurocognition and symptoms in a stepwise multiple regression. Results suggest that deficits in emotion recognition in schizophrenia may partly result from a combination of impairments in the ability to judge the cognitive and affective states of others and difficulties forming complex representations of self and others.     

Whistle‐blowing and workplace culture in older peoples' care: qualitative insights from the healthcare and social care workforce

Inquiries in the UK into mistreatment of older people by healthcare employees over the last 30 years have focused on introducing or supporting employee whistle‐blowing. Although whistle‐blowers have made an important contribution to patient safety it remains a controversial activity. The fate of whistle‐blowers is bleak, often resulting in personal and professional sacrifices. Here we draw on the views of healthcare and social care employees working with older people to explore perceptions of whistle‐blowing as well as alternative strategies that may be used to raise concerns about the mistreatment of patients by co‐workers. Whistle‐blowing was perceived as a negative term. Managers said they promoted open cultures underpinned by regular team meetings and an open‐door ethos. Others described workplace norms that were somewhat at odds with these open culture ideals. Whistle‐blowing was considered risky, and this led to staff creating informal channels through which to raise concerns. Those who witnessed wrongdoing were aware that support was available from external agencies but preferred local solutions and drew upon personal ethics rather than regulatory edicts to shape their responses. We argue that the importance of workplace relationships and informal channels for raising concerns should be better understood to help prevent the mistreatment of vulnerable groups.     

Treatment Improves Symptoms Shared by PTSD and Disordered Eating

Eating disorders and posttraumatic stress disorder (PTSD) are debilitating conditions that frequently co‐occur. Although the two disorders have different clinical presentations, they share associated features, including cognitive disturbances, emotion dysregulation, dissociation, and impulsivity. We hypothesized that reductions in PTSD symptoms following cognitive processing therapy (CPT) and its treatment components (CPT without the written account or the written account only) would be associated with improvements in symptoms common to PTSD and eating disorders. Participants in the current investigation included women with PTSD (N = 65) who reported a history of rape or physical assault, were in a randomized dismantling study of CPT, and completed the Eating Disorder Inventory‐2 (EDI‐2) at pre‐ and posttreatment. Latent growth modeling results indicated that decreases in PTSD symptom scores were significantly associated with reductions in the Impulse Regulation, Interoceptive Awareness, Interpersonal Distrust, Ineffectiveness, and Maturity Fears subscales of the EDI‐2. Thus, PTSD treatment affected symptoms shared by PTSD and eating disorders. Currently, there are no clear guidelines for treatment of comorbid PTSD and eating disorders. Traditional CPT may impact symptoms common to both, but additional therapy may be needed for specific disordered eating attitudes and behaviors.