Cancer and changes in facial appearance : a meta-ethnography of qualitative studies

Introduction: Living with an altered facial appearance as a result of treatment for cancer requires considerable psychological adjustment. As such it is essential that health care professionals understand the lived experience of people affected. This systematic review provides a metaethnography of studies that have explored the experience of changed facial appearance as a result of cancer. Methods: A search of four databases (Web of Science, CINAHL, PsycInfo and Scopus) took place using terms relating to qualitative research, cancer, and changed facial appearance. Thirteen studies were identified, appraised and included in the synthesis. The findings and interpretations within the studies were subject to meta-ethnography procedures so as to elicit novel cross cutting themes. Findings: The experience of changed facial appearance after cancer was clustered into three contexts. In the context of the disease, subthemes were the primacy of survival, the changing relationship with the disease and the impact of the care team on the experience of changed appearance. In the context of the social world, subthemes were positive reactions, negative reactions and coping strategies. In the context of the self, subthemes were the self under attack, self-to-self relating, the self in the world and rebuilding the self. Conclusions: The findings indicate that healthcare professionals must conduct holistic assessments, so as to fully recognise and where necessary address the impact upon self. The meta-ethnography shows that the experience of facial appearance change following cancer is complex and requires awareness of a number of theoretical areas including identity construction, social support, stigmatisation, and the specific literature on visible difference

The malaria parasite cyclic GMP-dependent protein kinase plays a central role in blood-stage schizogony

A role for the Plasmodium falciparum cyclic GMP (cGMP)-dependent protein kinase (PfPKG) in gametogenesis in the malaria parasite was elucidated previously. In the present study we examined the role of PfPKG in the asexual blood-stage of the parasite life cycle, the stage that causes malaria pathology. A specific PKG inhibitor (compound 1, a trisubstituted pyrrole) prevented the progression of P. falciparum schizonts through to ring stages in erythrocyte invasion assays. Addition of compound 1 to ring-stage parasites allowed normal development up to 30 h postinvasion, and segmented schizonts were able to form. However, synchronized schizonts treated with compound 1 for ≥6 h became large and dysmorphic and were unable to rupture or liberate merozoites. To conclusively demonstrate that the effect of compound 1 on schizogony was due to its selective action on PfPKG, we utilized genetically manipulated P. falciparum parasites expressing a compound 1-insensitive PfPKG. The mutant parasites were able to complete schizogony in the presence of compound 1 but not in the presence of the broad-spectrum protein kinase inhibitor staurosporine. This shows that PfPKG is the primary target of compound 1 during schizogony and provides direct evidence of a role for PfPKG in this process. Discovery of essential roles for the P. falciparum PKG in both asexual and sexual development demonstrates that cGMP signaling is a key regulator of both of these crucial life cycle phases and defines this molecule as an exciting potential drug target for both therapeutic and transmission blocking action against malaria

Outflows at the Edges of an Active Region in a Coronal Hole: A Signature of Active Region Expansion?

Outflows of plasma at the edges of active regions surrounded by quiet Sun are now a common observation with the Hinode satellite. While there is observational evidence to suggest that the outflows are originating in the magnetic field surrounding the active regions, there is no conclusive evidence that reveals how they are driven. Motivated by observations of outflows at the periphery of a mature active region embedded in a coronal hole, we have used a three-dimensional simulation to emulate the active region's development in order to investigate the origin and driver of these outflows. We find outflows are accelerated from a site in the coronal hole magnetic field immediately surrounding the active region and are channelled along the coronal hole field as they rise through the atmosphere. The plasma is accelerated simply as a result of the active region expanding horizontally as it develops. Many of the characteristics of the outflows generated in the simulation are consistent with those of observed outflows: velocities up to 45 km per sec, properties akin to the coronal hole, proximity to the active region's draining loops, expansion with height, and projection over monopolar photospheric magnetic concentrations. Although the horizontal expansion occurs as a consequence of the active region's development in the simulation, expansion is also a general feature of established active regions. Hence, it is entirely possible and plausible that the expansion acceleration mechanism displayed in the simulation is occurring in active regions on the Sun and, in addition to reconnection, is driving the outflows observed at their edges.Comment: 19 pages, 9 figure

On the Dynamical Ferromagnetic, Quantum Hall, and Relativistic Effects on the Carbon Nanotubes Nucleation and Growth Mechanism

The mechanism of carbon nanotube (CNT) nucleation and growth has been a mystery for over 15 years. Prior models have attempted the extension of older classical transport mechanisms. In July 2000, a more detailed and accurate nonclassical, relativistic mechanism was formulated considering the detailed dynamics of the electronics of spin and orbital rehybridization between the carbon and catalyst via novel mesoscopic phenomena and quantum dynamics. Ferromagnetic carbon was demonstrated. Here, quantum (Hall) effects and relativistic effects of intense many body spin-orbital interactions for novel orbital rehybridization dynamics (Little Effect) are proposed in this new dynamical magnetic mechanism. This dynamic ferromagnetic mechanism is proven by imposing dynamic and static magnetic fields during CNT syntheses and observing the different influence of these external magnetic environments on the catalyzing spin currents and spin waves and the resulting CNT formation

Distributions of dissolved trace metals (Cd, Cu, Mn, Pb, Ag) in the southeastern Atlantic and the Southern Ocean

International audienceComprehensive synoptic datasets (surface water down to 4000 m) of dissolved cadmium (Cd), copper (Cu), manganese (Mn), lead (Pb) and silver (Ag) are presented along a section between 34° S and 57° S in the southeastern Atlantic Ocean and the Southern Ocean to the south off South Africa. The vertical distributions of Cu and Ag display nutrient-like profiles similar to silicic acid, and of Cd similar to phosphate. The distribution of Mn shows a subsurface maximum in the oxygen minimum zone, whereas Pb concentrations are rather invariable with depth. Dry deposition of aerosols is thought to be an important source of Pb to surface waters close to South Africa, and dry deposition and snowfall may have been significant sources of Cu and Mn at the higher latitudes. Furthermore, the advection of water masses enriched in trace metals following contact with continental margins appeared to be an important source of trace elements to the surface, intermediate and deep waters in the southeastern Atlantic Ocean and the Antarctic Circumpolar Current. Hydrothermal inputs may have formed a source of trace metals to the deep waters over the Bouvet Triple Junction ridge crest, as suggested by relatively enhanced dissolved Mn concentrations. The biological utilization of Cu and Ag was proportional to that of silicic acid across the section, suggesting that diatoms formed an important control over the removal of Cu and Ag from surface waters. However, uptake by dino- and nano-flagellates may have influenced the distribution of Cu and Ag in the surface waters of the subtropical Atlantic domain. Cadmium correlated strongly with phosphate (P), yielding lower Cd / P ratios in the subtropical surface waters where phosphate concentrations were below 0.95 μM. The greater depletion of Cd relative to P observed in the Weddell Gyre compared to the Antarctic Circumpolar Current could be due to increase Cd uptake induced by iron-limiting conditions in these high-nutrient-low-chlorophyll waters. Similarly, an increase of Mn uptake under Fe-depleted conditions may have caused the highest depletion of Mn relative to P in the surface waters of the Weddell Gyre. In addition, a cellular Mn-transport channel of Cd was possibly activated in the Weddell Gyre, which in turn may have yielded depletion of both Mn and Cd in these surface waters

Young adults’ experience of appearance-altering orthognathic surgery: a longitudinal interpretative phenomenologic analysis

Objective: To gain an experiential account of the processes of change associated specifically with orthognathic surgery. Design: A qualitative design was used. Semi-structured interviews were carried out with seven participants approximately one week before and six to eight weeks after surgery. The data was analysed using Interpretative Phenomenological Analysis (IPA). Setting: Participants were recruited from a NHS Dental Hospital. Participants: Patients aged 16-25 scheduled to undergo orthognathic surgery on both the upper and lower jaws, were purposively sought to participate. Seven participants aged between 18-25 years and who had undergone a bimaxillary osteotomy completed interviews (five females and two males). Results: Themes were identified in connection with the overall journey of treatment being a right of passage; the treatments role in raising awareness about anomalies in appearance; the initial shock at the changes that followed surgery; the uncertainty about treatment; the impact of actual negative reactions of others; and the role of significant others in the decision making process. Conclusions: Participants described undergoing a much more complex process of adjustment to change in appearance than has been identified elsewhere within the literature, and the study highlights the nuanced fashion in which both medical and parental communication influence patient expectation and experience of surgery. There is a need to improve communication between clinicians, families, and young adults seeking orthognathic surgery. Further studies are needed to investigate the processes associated with seeking to change facial appearance resulting from other forms of dentofacial condition

Thomae type formulae for singular Z_N curves

We give an elementary and rigorous proof of the Thomae type formula for singular $Z_N$ curves. To derive the Thomae formula we use the traditional variational method which goes back to Riemann, Thomae and Fuchs.Comment: 22 page

Nonperturbative Renormalization and the QCD Vacuum

We present a self consistent approach to Coulomb gauge Hamiltonian QCD which allows one to relate single gluon spectral properties to the long range behavior of the confining interaction. Nonperturbative renormalization is discussed. The numerical results are in good agreement with phenomenological and lattice forms of the static potential.Comment: 23 pages in RevTex, 4 postscript figure

The new kid on the block: immigrant males win big whereas females pay fitness cost after dispersal

Dispersal is nearly universal; yet, which sex tends to disperse more and their success thereafter depends on the fitness consequences of dispersal. We asked if lifetime fitness differed between residents and immigrants (successful between‐population dispersers) and their offspring using 29 years of monitoring from North American red squirrels (Tamiasciurus hudsonicus) in Canada. Compared to residents, immigrant females had 23% lower lifetime breeding success (LBS), while immigrant males had 29% higher LBS. Male immigration and female residency were favoured. Offspring born to immigrants had 15–43% lower LBS than offspring born to residents. We conclude that immigration benefitted males, but not females, which appeared to be making the best of a bad lot. Our results are in line with male‐biased dispersal being driven by local mate competition and local resource enhancement, while the intergenerational cost to immigration is a new complication in explaining the drivers of sex‐biased dispersal.Our results are in line with male‐biased dispersal being driven by local mate competition and local resource enhancement, while the intergenerational cost to immigration is a new complication in explaining the drivers of sex‐biased dispersal.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154289/1/ele13436-sup-0001-Supinfo.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154289/2/ele13436.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154289/3/ele13436_am.pd

Indirect Impact of PD-1/PD-L1 Blockade on a Murine Model of NK Cell Exhaustion

The induction of exhaustion on effector immune cells is an important limiting factor for cancer immunotherapy efficacy as these cells undergo a hierarchical loss of proliferation and cytolytic activity due to chronic stimulation. Targeting PD-1 has shown unprecedented clinical benefits for many cancers, which have been attributed to the prevention of immune suppression and exhaustion with enhanced anti-tumor responses. In this study, we sought to evaluate the role of the PD-1/PD-L1 pathway in murine natural killer (NK) cell activation, function, and exhaustion. In an in vivo IL-2-dependent exhaustion mouse model, neutralization of the PD-1/PD-L1 pathway improved NK cell activation after chronic stimulation when compared to control-treated mice. These cells displayed higher proliferative capabilities and enhanced granzyme B production. However, the blockade of these molecules during long-term in vitro IL-2 stimulation did not alter the progression of NK cell exhaustion (NCE), suggesting an indirect involvement of PD-1/PD-L1 on NCE. Given the expansion of CD8 T cells and regulatory T cells (Tregs) observed upon acute and chronic stimulation with IL-2, either of these two populations could influence NK cell homeostasis after PD-L1/PD-1 therapy. Importantly, CD8 T cell activation and functional phenotype were indeed enhanced by PD-1/PD-L1 therapy, particularly with anti-PD-1 treatment that resulted in the highest upregulation of CD25 during chronic stimulation and granted an advantage for IL-2 over NK cells. These results indicate a competition for resources between NK and CD8 T cells that arguably delays the onset of NCE rather than improving its activation during chronic stimulation. Supporting this notion, the depletion of CD8 T cells reversed the benefits of PD-1 therapy on chronically stimulated NK cells. These data suggest a bystander effect of anti-PD1 on NK cells, resulting from the global competition that exists between NK and CD8 T cells for IL-2 as a key regulator of these cells’ activation. Thus, achieving an equilibrium between these immune cells might be important to accomplish long-term efficacy during anti-PD-1/IL-2 therapy