Une Intervention Psycho-oncologique d'Inspiration Psychodynamique

Introduction. La détresse psychique touche entre 30 et 50% des patients atteints de cancer (1-5). Les troubles psychiatriques les plus fréquemment observés sont les états dépressifs et les troubles anxieux et d'adaptation (1). En ce qui concerne les approches psychodynamiques auprès de patients atteints de cancer, il manque des études évaluant l'effet de ces thérapies. L'objectif de ce travail de master est d'investiguer une intervention psychothérapeutique d'inspiration psychodynamique effectuée auprès de patients nouvellement diagnostiqués de cancer. Méthode. Basée sur la lecture de 20 rapports, une grille de lecture des thématiques abordées dans les interventions a été élaborée puis discutée en deux focus groups entre trois chercheurs. Pour l'analyse semi-quantitative, deux de ces chercheurs ont appliqué la grille d'analyse à tous les rapports (N=135) et ont ensuite confronté et discuté leurs classifications jusqu'à l'obtention d'un consensus. Résultats. Une liste de vingt thématiques classées dans deux catégories a été élaborée: 1) témoignage/demande de soutien et 2) introspection avec les sous-catégories 2.1) changement de fonctionnement psychologique et 2.2) modification du positionnement relationnel. La moitié (50,4%) des patients ont consulté pour témoigner ou demander un soutien, 27,4% pour un changement de fonctionnement psychologique et 9,6% pour une modification du positionnement relationnel; 12,6% des patients n'ont pas pu être classifiés. En général, les patients consultant pour témoigner ou demander un soutien sont légèrement plus âgés et présentent un stade de maladie plus avancé, et consultent en moyenne durant 4 à 5 séances. Les patients qui visent un changement de fonctionnement psychologique suivent une tendance inverse et consultent en moyenne durant 11 à 12 séances; ceux qui désirent une modification de leur positionnement relationel sont également légèrement plus jeunes, avec un stade de maladie moins avancé, mais leur nombre de séances effectuées est très variable. Lorsque les patients effectuent un travail sur soi ou sur leurs relations, les sujets abordés ne sont que rarement centrés sur le cancer. Par contre, chez des patients qui consultent pour témoigner ou être soutenus, les angoisses liées au cancer sont plus souvent au coeur de l'intervention thérapeutique. Discussion. Les rapports de psychothérapie de patients atteints de cancer rédigés dans le cadre d'une étude sont sujets à la subjectivité des thérapeutes et à leurs interprétations quant au processus thérapeutique. Et il en va de même pour l'analyse que les chercheurs en font. Néanmoins, les résultats montrent qu'une grande variété de thématiques sont abordées durant les thérapies et que "l'évènement cancer" n'est pas toujours au centre des entretiens; avec certains patients les thérapeutes entament un travail plus conséquent en ce qui concerne sa durée et son contenu; travail qui va au-delà de "l'évènementiel". Les patients des différentes catégories identifiées se distinguent clairement quant à leur désir d'approfondir un travail thérapeutique, quant aux objectifs qu'ils souhaitent atteindre et quant au type d'intervention psychothérapeutique dont ils ont besoin. Conclusion. Les approches psychothérapeutiques pour les patients atteints de cancer demandent du thérapeute une grande souplesse, afin de s'adapter à la demande et aux capacités d'élaboration des patients. Une clarification rapide de ces deux paramètres dans les premières séances devrait faire partie intégrante de la prise en charge

The structure of and origin of nodular chromite from the Troodos ophiolite, Cyprus, revealed using high-resolution X-ray computed tomography and electron backscatter diffraction

Nodular chromite is a characteristic feature of ophiolitic podiform chromitite and there has been much debate about how it forms. Nodular chromite from the Troodos ophiolite in Cyprus is unusual in that it contains skeletal crystals enclosed within the centres of the nodules and interstitial to them. 3D imaging and electron backscatter diffraction have shown that the skeletal crystals within the nodules are single crystals that are surrounded by a rim of polycrystalline chromite. 3D analysis reveals that the skeletal crystals are partially or completely formed cage or hopper structures elongated along the axis. The rim is composed of a patchwork of chromite grains that are truncated on the outer edge of the rim. The skeletal crystals formed first from a magma supersaturated in chromite and silicate minerals crystallised from melt trapped between the chromite skeletal crystal blades as they grew. The formation of skeletal crystals was followed by a crystallisation event which formed a silicate-poor rim of chromite grains around the skeletal crystals. These crystals show a weak preferred orientation related to the orientation of the core skeletal crystal implying that they formed by nucleation and growth on this core, and did not form by random mechanical aggregation. Patches of equilibrium adcumulate textures within the rim attest to in situ development of such textures. The nodules were subsequently exposed to chromite under-saturated magma resulting in dissolution, recorded by truncated grain boundaries in the rim and a smooth outer surface to the nodule. None of these stages of formation require a turbulent magma. Lastly the nodules impinged on each other causing local deformation at points of contact

Morphology and microstructure of chromite crystals in chromitites from the Merensky Reef (Bushveld Complex, South Africa)

The Merensky Reef of the Bushveld Complex consists of two chromitite layers separated by coarse-grained melanorite. Microstructural analysis of the chromitite layers using electron backscatter diffraction analysis (EBSD), high-resolution X-ray microtomography and crystal size distribution analyses distinguished two populations of chromite crystals: fine-grained idiomorphic and large silicate inclusion-bearing crystals. The lower chromitite layer contains both populations, whereas the upper contains only fine idiomorphic grains. Most of the inclusion-bearing chromites have characteristic amoeboidal shapes that have been previously explained as products of sintering of pre-existing smaller idiomorphic crystals. Two possible mechanisms have been proposed for sintering of chromite crystals: (1) amalgamation of a cluster of grains with the same original crystallographic orientation; and (2) sintering of randomly orientated crystals followed by annealing into a single grain. The EBSD data show no evidence for clusters of similarly oriented grains among the idiomorphic population, nor for earlier presence of idiomorphic subgrains spatially related to inclusions, and therefore are evidence against both of the proposed sintering mechanisms. Electron backscatter diffraction analysis maps show deformation-related misorientations and curved subgrain boundaries within the large, amoeboidal crystals, and absence of such features in the fine-grained population. Microstructures observed in the lower chromitite layer are interpreted as the result of deformation during compaction of the orthocumulate layers, and constitute evidence for the formation of the amoeboid morphologies at an early stage of consolidation.An alternative model is proposed whereby silicate inclusions are incorporated during maturation and recrystallisation of initially dendritic chromite crystals, formed as a result of supercooling during emplacement of the lower chromite layer against cooler anorthosite during the magma influx that formed the Merensky Reef. The upper chromite layer formed from a subsequent magma influx, and hence lacked a mechanism to form dendritic chromite. This accounts for the difference between the two layers

Small nucleolar RNAs determine resistance to doxorubicin in human osteosarcoma

Doxorubicin (Dox) is one of the most important first-line drugs used in osteosarcoma therapy. Multiple and not fully clarified mechanisms, however, determine resistance to Dox. With the aim of identifying new markers associated with Dox-resistance, we found a global up-regulation of small nucleolar RNAs (snoRNAs) in human Dox-resistant osteosarcoma cells. We investigated if and how snoRNAs are linked to resistance. After RT-PCR validation of snoRNAs up-regulated in osteosarcoma cells with different degrees of resistance to Dox, we overexpressed them in Dox-sensitive cells. We then evaluated Dox cytotoxicity and changes in genes relevant for osteosarcoma pathogenesis by PCR arrays. SNORD3A, SNORA13 and SNORA28 reduced Dox-cytotoxicity when over-expressed in Dox-sensitive cells. In these cells, GADD45A and MYC were up-regulated, TOP2A was down-regulated. The same profile was detected in cells with acquired resistance to Dox. GADD45A/MYC-silencing and TOP2A-over-expression counteracted the resistance to Dox induced by snoRNAs. We reported for the first time that snoRNAs induce resistance to Dox in human osteosarcoma, by modulating the expression of genes involved in DNA damaging sensing, DNA repair, ribosome biogenesis, and proliferation. Targeting snoRNAs or down-stream genes may open new treatment perspectives in chemoresistant osteosarcomas

A perpendicular graphene/ferromagnet electrode for spintronics

We report on the large-scale integration of graphene layers over a FePd perpendicular magnetic anisotropy (PMA) platform, targeting further downscaling of spin circuits. An L10 FePd ordered alloy showing both high magneto-crystalline anisotropy and a low magnetic damping constant, is deposited by magnetron sputtering. The graphene layer is then grown on top of it by large-scale chemical vapor deposition. A step-by-step study, including structural and magnetic analyses by x-ray diffraction and Kerr microscopy, shows that the measured FePd properties are preserved after the graphene deposition process. This scheme provides a graphene protected perpendicular spin electrode showing resistance to oxidation, atomic flatness, stable crystallinity, and perpendicular magnetic properties. This, in turn, opens the way to the generalization of hybrid 2D-materials on optimized PMA platforms, sustaining the development of spintronics circuits based on perpendicular spin-sources as required, for instance, for perpendicular-magnetic random-access memory schemes

WS2 2D Semiconductor Down to Monolayers by Pulsed-Laser Deposition for Large-Scale Integration in Electronics and Spintronics Circuits

We report on the achievement of a large-scale tungsten disulfide (WS2) 2D semiconducting platform derived by pulsed-laser deposition (PLD) on both insulating substrates (SrTiO3), as required for in-plane semiconductor circuit definition, and ferromagnetic spin sources (Ni), as required for spintronics applications. We show thickness and phase control, with highly homogeneous wafer-scale monolayers observed under certain conditions, as demonstrated by X-ray photoelectron spectroscopy and Raman spectroscopy mappings. Interestingly, growth appears to be dependent on the substrate selection, with a dramatically increased growth rate on Ni substrates. We show that this 2D-semiconductor integration protocol preserves the interface integrity. Illustratively, the WS2/Ni electrode is shown to be resistant to oxidation (even after extended exposure to ambient conditions) and to present tunneling characteristics once integrated into a complete vertical device. Overall, these experiments show that the presented PLD approach used here for WS2 growth is versatile and has a strong potential to accelerate the integration and evaluation of large-scale 2D-semiconductor platforms in electronics and spintronics circuits

Mineralogy and geochemistry of atypical reduction spheroids from the Tumblagooda Sandstone, Western Australia

Funding Information: This research was supported by a CSIRO Mineral Resources studentship, a Curtin University student scholarship and a Minerals Research Institute of Western Australia scholarship. The editors of Sedimentology and three anonymous reviewers are acknowledged for their assistance in improving the manuscript. We would also like to thank Mike Paxman and the Parks and Wildlife Service for permission to sample in Kalbarri National Park. Finally, the authors would like to pay tribute to the memory of Professor Nigel Trewin, whose work laid much of the foundation for this study and many others on the Tumblagooda Sandstone.Peer reviewedPostprin

Mitochondrial ROS drive resistance to chemotherapy and immune-killing in hypoxic non-small cell lung cancer

BACKGROUND: Solid tumors subjected to intermittent hypoxia are characterized by resistance to chemotherapy and immune-killing by effector T-lymphocytes, particularly tumor-infiltrating Vγ9Vδ2 T-lymphocytes. The molecular circuitries determining this double resistance are not known. METHODS: We analyzed a panel of 28 human non-small cell lung cancer (NSCLC) lines, using an in vitro system simulating continuous and intermittent hypoxia. Chemosensitivity to cisplatin and docetaxel was evaluated by chemiluminescence, ex vivo Vγ9Vδ2 T-lymphocyte expansion and immune-killing by flow cytometry. Targeted transcriptomics identified efflux transporters and nuclear factors involved in this chemo-immuno-resistance. The molecular mechanism linking Hypoxia-inducible factor-1α (HIF-1α), CCAAT/Enhancer Binding Protein-β (C/EBP-β) isoforms LAP and LIP, ABCB1, ABCC1 and ABCA1 transporters were evaluated by immunoblotting, RT-PCR, RNA-IP, ChIP. Oxidative phosphorylation, mitochondrial ATP, ROS, depolarization, O(2) consumption were monitored by spectrophotometer and electronic sensors. The role of ROS/HIF-1α/LAP axis was validated in knocked-out or overexpressing cells, and in humanized (Hu-CD34(+)NSG) mice bearing LAP-overexpressing tumors. The clinical meaning of LAP was assessed in 60 NSCLC patients prospectively enrolled, treated with chemotherapy. RESULTS: By up-regulating ABCB1 and ABCC1, and down-regulating ABCA1, intermittent hypoxia induced a stronger chemo-immuno-resistance than continuous hypoxia in NSCLC cells. Intermittent hypoxia impaired the electron transport chain and reduced O(2) consumption, increasing mitochondrial ROS that favor the stabilization of C/EBP-β mRNA mediated by HIF-1α. HIF-1α/C/EBP-β mRNA binding increases the splicing of C/EBP-β toward the production of LAP isoform that transcriptionally induces ABCB1 and ABCC1, promoting the efflux of cisplatin and docetaxel. LAP also decreases ABCA1, limiting the efflux of isopentenyl pyrophosphate, i.e. the endogenous activator of Vγ9Vδ2 T-cells, and reducing the immune-killing. In NSCLC patients subjected to cisplatin-based chemotherapy, C/EBP-β LAP was abundant in hypoxic tumors and was associated with lower response to treatment and survival. LAP-overexpressing tumors in Hu-CD34(+)NSG mice recapitulated the patients’ chemo-immuno-resistant phenotype. Interestingly, the ROS scavenger mitoquinol chemo-immuno-sensitized immuno-xenografts, by disrupting the ROS/HIF-1α/LAP cascade. CONCLUSIONS: The impairment of mitochondrial metabolism induced by intermittent hypoxia increases the ROS-dependent stabilization of HIF-1α/LAP complex in NSCLC, producing chemo-immuno-resistance. Clinically used mitochondrial ROS scavengers may counteract such double resistance. Moreover, we suggest C/EBP-β LAP as a new predictive and prognostic factor in NSCLC patients. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13046-022-02447-6

Killing spectroscopy of closed timelike curves

We analyse the existence of closed timelike curves in spacetimes which possess an isometry. In particular we check which discrete quotients of such spaces lead to closed timelike curves. As a by-product of our analysis, we prove that the notion of existence or non-existence of closed timelike curves is a T-duality invariant notion, whenever the direction along which we apply such transformations is everywhere spacelike. Our formalism is straightforwardly applied to supersymmetric theories. We provide some new examples in the context of D-branes and generalized pp-waves.Comment: 1+35 pages, no figures; v2, new references added. Final version to appear in JHE