Pathways to a Lung Cancer Diagnosis

Purpose The purpose of this qualitative descriptive study was to identify and describe pathways to a lung cancer diagnosis based on narratives of persons diagnosed with the disease. Data sources Eleven adults with lung cancer were recruited from an academic thoracic oncology clinic in a large city in the southeastern United States. Moderately structured interviews were conducted by an experienced nurse practitioner (NP) to obtain information regarding the participants’ experiences leading to their diagnosis. Qualitative content analysis was used to develop a typology of pathways. Conclusions Findings revealed four distinct pathways: missing opportunities, waiting and seeing, being alarmed, and being blindsided. Implications for practice The Pathways to a Lung Cancer Diagnosis Typology has important implications for clinical practice and can be used to inform NPs and other healthcare providers who provide care for patients at risk for or diagnosed with lung cancer

Lung cancer stigma predicts timing of medical help-seeking in individuals with lung cancer

Purpose/Objectives To examine relationships among demographic variables, healthcare system distrust, lung cancer stigma, smoking status, and timing of medical help–seeking behavior in individuals with symptoms suggestive of lung cancer after controlling for ethnicity, socioeconomic status, and social desirability. Design Descriptive, cross-sectional, correlational study. Setting Outpatient oncology clinics in Louisville, KY. Sample 94 patients diagnosed in the past three weeks to six years with all stages of lung cancer. Methods Self-report, written survey packets were administered in person followed by a semistructured interview to assess symptoms and timing characteristics of practice-identified patients with lung cancer. Main Research Variables Timing of medical help–seeking behavior, healthcare system distrust, lung cancer stigma, and smoking status. Findings Lung cancer stigma was independently associated with timing of medical help–seeking behavior in patients with lung cancer. Healthcare system distrust and smoking status were not independently associated with timing of medical help–seeking behavior. Conclusions Findings suggest that stigma influences medical help–seeking behavior for lung cancer symptoms, serving as a barrier to prompt medical help–seeking behavior. Implications for Nursing When designing interventions to promote early medical help–seeking behavior in individuals with symptoms suggestive of lung cancer, methods that consider lung cancer stigma as a barrier that can be addressed through public awareness and patient-targeted interventions should be included

The Grizzly, December 4, 1987

Get a Grip on Handel • Aggressive Couple to Move • Letter: USGA Concerned with Fund Allocation • Wismer Move Official • Christmas Festivities Planned for Campus • Musser Plans Dinner • Ursinus Campus: Not What it Used to Be • Matters Successful • New Attitude Turns Ladies\u27 Fortune • Ursinus Welcomes Chang Back to College Campus • New Club in Spring • Home Streak Making Hoopla • Take a Realistic Look at the Job Market • All-American Honors for Field Hockey\u27s Dicton and Johnson • V-Baller Honored • Gymnasts Open Season • Scholars Gain All-ECAC • Walk This Way, Says Davidson • Concert Last in Forum Series • Don we Now Our Football Apparel • Dee Shares Business Ventures • Springsteen Sings In New Style • Limited Firebreathing for Lionarons\u27 Dragons • Final Exam Schedulehttps://digitalcommons.ursinus.edu/grizzlynews/1201/thumbnail.jp

The Grizzly, November 9, 1987

proTheatre Perfects Production • Balloon Bombings Banned • Norman Pearlstine Addresses Problems Associated with the U.S. Free Press • Letters: Beautifying Campus?; In One Ear, Out the Other • Rolling Stone Celebrates 20th Year • Iran Source of Conflict in Dialogue Discussion • Calix Relates Salvadorian Horrors • Notes: Room Policy Changed; Apartheid Subject of Forum; Discussion Includes Pretzels!; Myths to be Explained • Ursinus Not Affected by Stock Market Crash: Others Not as Lucky • Pray TV Damages Churches • UC Robs Team of Championship • Error Prone Bears Drop Another • Early Bowl Picture Thickens • Bears Battle Tough Season • Ursinus \u27Mers Open Season • Bear Pack Finishes Strong • Tri Lambda: Organization for Life Long Learners • Musser: The Year After • Get in The Real World Get the Grizzly Network • Busie Bodys Display Fancy Bodies • Welcome to the Greek Life: Congratulations 1987 Pledges • Phonathons Prove Successful: $30,000 Raised • Student Applauds Washington Semester • Seniors: Where Are You? • November Red and Gold Days • Eshbach Awards Winners • CAB Learns New Ideas • New Equipment Upgrades Dept.https://digitalcommons.ursinus.edu/grizzlynews/1198/thumbnail.jp

The Grizzly, September 25, 1987

Wild Weekend: Tippler Topples, Vandals Varnish, Class Cutters Cavort • Sororities to Begin Formal Rushing Season • Freshmen Find Fun on Campus • Letters: Unholy Parent\u27s Day Irks Jews; Old Men\u27s Life Bad News; Students Have Bills to Pay, Too • Freshman AIDS Orientation • Domestic Violence an Issue • Cameron a Pro Habla-ing • House Bill 749 • Victorious Volleyballers • Soccer\u27s Hoover Earns Athlete of the Week • Football Falls to F&M • Scabs to Score for NFL? • Cross Country Running to the Top • Hockey Lashes LaSalle • Busie Bodys Rehearse • Lantern Announces Deadline • All Greeks Not Geeks • Nautical Natives Sailing with Club Revival • Fat Fear: Freshman Fifteen Thickens Frosh • Ills a Problem Already • E-burg Offers Basic Grub • It\u27s Your Future • CAB Gets Some Public Relations • As Members Drop, the Show Must Go On • Entertainment: Ursinus Stylehttps://digitalcommons.ursinus.edu/grizzlynews/1193/thumbnail.jp

Germinal center B cells recognize antigen through a specialized immune synapse architecture

B cell activation is regulated by B cell antigen receptor (BCR) signaling and antigen internalization in immune synapses. Using large-scale imaging across B cell subsets, we show that in contrast to naive and memory B cells, which gathered antigen towards the synapse center before internalization, germinal center (GC) B cells extracted antigen by a distinct pathway using small peripheral clusters. Both naive and GC B cell synapses required proximal BCR signaling, but GC cells signaled less through the protein kinase C-β (PKC-β)–NF-κB pathway and produced stronger tugging forces on the BCR, thereby more stringently regulating antigen binding. Consequently, GC B cells extracted antigen with better affinity discrimination than naive B cells, suggesting that specialized biomechanical patterns in B cell synapses regulate T-cell dependent selection of high-affinity B cells in GCs

SHIP-Deficient Dendritic Cells, Unlike Wild Type Dendritic Cells, Suppress T Cell Proliferation via a Nitric Oxide-Independent Mechanism

Dendritic cells (DCs) not only play a crucial role in activating immune cells but also suppressing them. We recently investigated SHIP's role in murine DCs in terms of immune cell activation and found that TLR agonist-stimulated SHIP-/- GM-CSF-derived DCs (GM-DCs) were far less capable than wild type (WT, SHIP+/+) GM-DCs at activating T cell proliferation. This was most likely because SHIP-/- GM-DCs could not up-regulate MHCII and/or co-stimulatory receptors following TLR stimulation. However, the role of SHIP in DC-induced T cell suppression was not investigated.In this study we examined SHIP's role in DC-induced T cell suppression by co-culturing WT and SHIP-/- murine DCs, derived under different conditions or isolated from spleens, with αCD3+ αCD28 activated WT T cells and determined the relative suppressive abilities of the different DC subsets. We found that, in contrast to SHIP+/+ and -/- splenic or Flt3L-derived DCs, which do not suppress T cell proliferation in vitro, both SHIP+/+ and -/- GM-DCs were capable of potently suppressing T cell proliferation. However, WT GM-DC suppression appeared to be mediated, at least in part, by nitric oxide (NO) production while SHIP-/- GM-DCs expressed high levels of arginase 1 and did not produce NO. Following exhaustive studies to ascertain the mechanism of SHIP-/- DC-mediated suppression, we could conclude that cell-cell contact was required and the mechanism may be related to their relative immaturity, compared to SHIP+/+ GM-DCs.These findings suggest that although both SHIP+/+ and -/- GM-DCs suppress T cell proliferation, the mechanism(s) employed are different. WT GM-DCs suppress, at least in part, via IFNγ-induced NO production while SHIP-/- GM-DCs do not produce NO and suppression can only be alleviated when contact is prevented

Measurement of the cosmic ray spectrum above 4×10184{\times}10^{18} eV using inclined events detected with the Pierre Auger Observatory

A measurement of the cosmic-ray spectrum for energies exceeding $4{\times}10^{18}$ eV is presented, which is based on the analysis of showers with zenith angles greater than $60^{\circ}$ detected with the Pierre Auger Observatory between 1 January 2004 and 31 December 2013. The measured spectrum confirms a flux suppression at the highest energies. Above $5.3{\times}10^{18}$ eV, the "ankle", the flux can be described by a power law $E^{-\gamma}$ with index $\gamma=2.70 \pm 0.02 \,\text{(stat)} \pm 0.1\,\text{(sys)}$ followed by a smooth suppression region. For the energy ($E_\text{s}$) at which the spectral flux has fallen to one-half of its extrapolated value in the absence of suppression, we find $E_\text{s}=(5.12\pm0.25\,\text{(stat)}^{+1.0}_{-1.2}\,\text{(sys)}){\times}10^{19}$ eV.Comment: Replaced with published version. Added journal reference and DO

Energy Estimation of Cosmic Rays with the Engineering Radio Array of the Pierre Auger Observatory

The Auger Engineering Radio Array (AERA) is part of the Pierre Auger Observatory and is used to detect the radio emission of cosmic-ray air showers. These observations are compared to the data of the surface detector stations of the Observatory, which provide well-calibrated information on the cosmic-ray energies and arrival directions. The response of the radio stations in the 30 to 80 MHz regime has been thoroughly calibrated to enable the reconstruction of the incoming electric field. For the latter, the energy deposit per area is determined from the radio pulses at each observer position and is interpolated using a two-dimensional function that takes into account signal asymmetries due to interference between the geomagnetic and charge-excess emission components. The spatial integral over the signal distribution gives a direct measurement of the energy transferred from the primary cosmic ray into radio emission in the AERA frequency range. We measure 15.8 MeV of radiation energy for a 1 EeV air shower arriving perpendicularly to the geomagnetic field. This radiation energy -- corrected for geometrical effects -- is used as a cosmic-ray energy estimator. Performing an absolute energy calibration against the surface-detector information, we observe that this radio-energy estimator scales quadratically with the cosmic-ray energy as expected for coherent emission. We find an energy resolution of the radio reconstruction of 22% for the data set and 17% for a high-quality subset containing only events with at least five radio stations with signal.Comment: Replaced with published version. Added journal reference and DO