Exploring the lived experience of Long Covid in black and minority ethnic groups in the UK: Protocol for qualitative interviews and art-based methods.

Some people experience prolonged symptoms following an acute COVID-19 infection including fatigue, chest pain and breathlessness, headache and cognitive impairment. When symptoms persist for over 12 weeks following the initial infection, and are not explained by an alternative diagnosis, the term post-COVID-19 syndrome is used, or the patient-defined term of Long Covid. Understanding the lived experiences of Long Covid is crucial to supporting its management. However, research on patient experiences of Long Covid is currently not ethnically diverse enough. The study aim is to explore the lived experience of Long Covid, using qualitative interviews and art-based methods, among people from ethnically diverse backgrounds (in the UK), to better understand wider systems of support and healthcare support needs. Co-created artwork will be used to build on the interview findings. A purposive sampling strategy will be used to gain diverse experiences of Long Covid, sampling by demographics, geographic locations and experiences of Long Covid. Individuals (aged >18 years) from Black and ethnic minority backgrounds, who self-report Long Covid symptoms, will be invited to take part in a semi-structured interview. Interviews will be analysed thematically. A sub-sample of participants will be invited to co-create visual artwork to further explore shared narratives of Long Covid, enhance storytelling and increase understanding about the condition. A patient advisory group, representing diversity in ethnicity and experiences of Long Covid, will inform all research stages. Stakeholder workshops with healthcare professionals and persons, systems or networks important to people's management of Long Covid, will advise on the integration of findings to inform management of Long Covid. The study will use patient narratives from people from diverse ethnic backgrounds, to raise awareness of Long Covid and help inform management of Long Covid and how wider social systems and networks may inform better healthcare service access and experiences

CT-guided iodine-125 seed permanent implantation for recurrent head and neck cancers

<p>Abstract</p> <p>Background</p> <p>To investigate the feasibility, and safety of ¹²⁵I seed permanent implantation for recurrent head and neck carcinoma under CT-guidance.</p> <p>Results</p> <p>A retrospective study on 14 patients with recurrent head and neck cancers undergone ¹²⁵I seed implantation with different seed activities. The post-plan showed that the actuarial D90 of ¹²⁵I seeds ranged from 90 to 218 Gy (median, 157.5 Gy). The follow-up was 3 to 60 months (median, 13 months). The median local control was 18 months (95% CI, 6.1-29.9 months), and the 1-, 2-, 3-, and 5- year local controls were 52%, 39%, 39%, and 39%, respectively. The 1-, 2-, 3-, and 5- survival rates were 65%, 39%, 39% and 39%, respectively, with a median survival time of 20 months (95% CI, 8.7-31.3 months). Of all patients, 28.6% (4/14) died of local recurrence, 7.1% (1/14) died of metastases, one patient died of hepatocirrhosis, and 8 patients are still alive to the date of data analysis.</p> <p>Conclusion</p> <p>CT-guided ¹²⁵I seed implantation is feasible and safe as a salvage or palliative treatment for patients with recurrent head and neck cancers.</p

CD4+ T Cell-Derived IL-2 Signals during Early Priming Advances Primary CD8+ T Cell Responses

Stimulating naïve CD8+ T cells with specific antigens and costimulatory signals is insufficient to induce optimal clonal expansion and effector functions. In this study, we show that the activation and differentiation of CD8+ T cells require IL-2 provided by activated CD4+ T cells at the initial priming stage within 0–2.5 hours after stimulation. This critical IL-2 signal from CD4+ cells is mediated through the IL-2Rβγ of CD8+ cells, which is independent of IL-2Rα. The activation of IL-2 signaling advances the restriction point of the cell cycle, and thereby expedites the entry of antigen-stimulated CD8+ T-cell into the S phase. Besides promoting cell proliferation, IL-2 stimulation increases the amount of IFNγ and granzyme B produced by CD8+ T cells. Furthermore, IL-2 at priming enhances the ability of P14 effector cells generated by antigen activation to eradicate B16.gp33 tumors in vivo. Therefore, our studies demonstrate that a full CD8+ T-cell response is elicited by a critical temporal function of IL-2 released from CD4+ T cells, providing mechanistic insights into the regulation of CD8+ T cell activation and differentiation

Signal 0 for guided priming of CTLs: NKT cells do it too

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A role for self-gravity at multiple length scales in the process of star formation

Self-gravity plays a decisive role in the final stages of star formation, where dense cores (size 0.1 parsecs) inside molecular clouds collapse to form star-plus-disk systems(1). But self-gravity’s role at earlier times (and on larger length scales, such as 1 parsec) is unclear; some molecular cloud simulations that do not include self-gravity suggest that ‘turbulent fragmentation’ alone is sufficient to create a mass distribution of dense cores that resembles, and sets, the stellar initial mass function(2). Here we report a ‘dendrogram’ (hierarchical tree-diagram) analysis that reveals that self-gravity plays a significant role over the full range of possible scales traced by (13)CO observations in the L1448 molecular cloud, but not everywhere in the observed region. In particular, more than 90 per cent of the compact ‘pre-stellar cores’ traced by peaks of dust emission(3) are projected on the sky within one of the dendrogram’s self-gravitating ‘leaves’. As these peaks mark the locations of already-forming stars, or of those probably about to form, a self-gravitating cocoon seems a critical condition for their existence. Turbulent fragmentation simulations without self-gravity—even of unmagnetized isothermal material—can yield mass and velocity power spectra very similar to what is observed in clouds like L1448. But a dendrogram of such a simulation(4) shows that nearly all the gas in it (much more than in the observations) appears to be self-gravitating. A potentially significant role for gravity in ‘non-self-gravitating’ simulations suggests inconsistency in simulation assumptions and output, and that it is necessary to include self-gravity in any realistic simulation of the star-formation process on subparsec scales