Monthly Archives: June 2014

The HPV Vaccine: Part 2

Within the human papilloma viruses as a group, there is a lot of variation based on their DNA sequence. DNA is the Master Plan for the cell, and it is also the Master Plan for the virus. DNA contains the plans for cell-specific proteins, which are what make things and do things within the cell, and all cells and viruses have their own DNA.

Remember: Different strains of HPV=different DNA=different proteins.

Because of these differences in DNA sequence, some strains produce specific proteins which in true, terrible-at-naming-things Scientist fashion, have been called E6 and E7.

E6 and E7 run around the host cell and interact with some very important host cellular proteins, which, in the same scientific naming tradition, have been dubbed p53 and Rb.

p53 and Rb play vital roles in making sure that a cell does not divide when it shouldn’t.  For instance, a cell could have damaged DNA.  Under normal circumstances, the p53 and Rb proteins are guardians that survey the cell and assess its readiness to divide.  They have the power to say, “Stop!  We are not ready to divide!  Halt at once, and repair our Master Plan!” and the cell will listen, repair DNA, and not divide until p53 and Rb are cool with it.  E6 and E7 find p53 and Rb and physically prevent them from sounding the alarm, so suddenly, a cell that probably shouldn’t be dividing at all is instead dividing like crazy.

So we have cells dividing like crazy, creating masses that aren’t useful to us where they shouldn’t be…Sounds like cancer, right?

That’s because it is cancer!  See?  I knew we could Science this together!

Luckily, not all HPV viruses have E6, E7, or similar proteins.  And most humans with an intact immune system will either completely fight off most HPV infections, or the immune system will beat the HPV into dormancy.

At the same time, though, it is very rare for cervical cancer cells to not be infected with HPV, which rather strongly suggests that most cases of cervical cancer can be attributed to HPV.  Why wasn’t the HPV infection defeated by the immune system?  That may be because the human picked up a particularly nasty strain, but there’s also the fact that some humans don’t have an intact immune system—they could have an inherited immune disorder, or diabetes, or be on systemic steroids to treat a whole bunch of things, or have AIDS…I could literally make a blog entry on reasons why folks may be immunosuppressed.

The particularly nasty, common, high-risk strains of HPV with proteins E6 and E7 are called types 16 and 18.

Due to producing proteins E6 and E7, these strains are much more likely to cause cancer.

There are also two very common HPV strains, strains 6 and 11, and they usually cause anogenital warts.  However, these strains can also potentially cause cancer, and since so many people are infected by them, types 6 and 11 statistically give at least some people cancer.  It’s sort of like how, even though it is extremely unlikely, people manage to get struck by lightning.  There’s just a lot of lightning and a lot of people.  Statistically, someone will get struck.

So that’s the HPV virus in a nutshell. We’ve Scienced the heck out of it!  With that information in mind, let’s discuss the diseases caused by these cellular shenanigans!

Tell Me Why I Care:  The Effects of HPV Infections

Most commonly, HPV can cause cervical cancer.  These same strains can also cause anal cancer, oropharyngeal cancer, and something called respiratory papillomatosis which is a disease that occurs rarely when an HPV infection is transmitted to an infant’s respiratory tract from their mother during vaginal birth.  This means that masses will grow in the infant’s airway that will suffocate them if  not removed by surgery or lasers.

All of these are terrible.  All of these could potentially be a blog entry all by themselves.

However, given that this is the Sheroes blog and Sheroes has a lot of cervix-having members, I’m going to give you a relatively brief, generalized overview of cervical cancer.

Luckily for women of North America and most industrialized countries, we have access to something called a pap smear.

For readers who haven’t experienced this not-especially-fun-but-also-generally-not-too-painful procedure, a pap smear is when a doctor takes a sterile, specialized brush on a stick and swabs it lightly over your cervix. The brush picks up a layer of epithelial cells, the very cells HPV infects.  The doc then sends the sample to a lab.

A technician can put infected cells on a slide, stick the slide under a microscope, take a peek, and say, “Huh, this is not how a cervical cell should look!”

And then they will send the report to your doctor, who will tell you there is something called a dysplastic change.

Dysplastic change is a fancy phrase for “your cells look weird”.  However, in a woman who has had proper screening at regular intervals throughout her adult life, this is probably not a cause to panic right away since the change has probably been caught early. Depending on the individual patient, doctors tend to opt for either “watchful waiting” or something called a colposcopy and biopsy, in which case they’ll coat your cervix with a very dilute acid that makes the HPV infected cells turn white.  They will then take a small sample of your cervical tissue called a biopsy, and send that to the lab for analysis.

If the biopsy does show evidence of cancer, then the doctors can treat it with the usual suspects: surgery, radiation, chemo.

While a treatment plans are highly individual, in general, cancers which are caught early and confined to the surface of the cervix can be treated with a simple outpatient surgical procedure with nearly 100% success, as long as all of the cancer is cut out.

However, cervical cancer has a tendency to spread locally. It can move to the uterus, fallopian tubes, or ovaries.  This development may also necessitate a hysterectomy.  That can be really hard for women to go through emotionally, but again, survival rates at this stage are around 85%.

Even worse, the cancer can also invade nearby structures, like the anal canal, or ureters. One cause of death in cases like these is kidney failure, because the cancer literally blocks urine from getting out, which damages the kidneys irreparably.

In cases this advanced, patients may be offered a procedure that goes by several names, one of them being “hemicorporectomy.”

Dust off your Latin and Greek; we’re going to break this word down:

Hemi=half

Corp=body

Ectomy=surgical removal

…Yeah.

It’s intense.

Let’s take a moment to think about that word and what it might mean for a patient.

The patient’s legs, colon, reproductive system, and lower urinary tract are removed, because the cancer has spread that far.  Doctors recreate what structures they can, but they’re surgeons, not magicians.  It is a radical surgery with radical consequences. It is not done lightly—it is done because the patient will die without it.  Once cervical cancer reaches a certain stage, there is no radiation or chemotherapy that has been shown to increase survival rates.

And some patients still die, either because the cancer has spread too far, or because it recurs.  It is a horrible disease, and while it can be screened for, screening does not help women who without access to regular screening.  Since cervical cancer generally does not become symptomatic until relatively late, cases in unscreened women can be quite advanced, and the consequences can be devastating.  It is estimated that over 4,000 women will die of cervical cancer in 2014.

That’s terrible. The vast majority of these cancers are due to HPV infections and, thus, can be prevented. Luckily, there are two HPV vaccines on the market: Gardasil and Cervarix. Gardasil protects against HPV strains 6, 11, 16, and 18.  Cervarix only protects against strains 16 and 18.

These two vaccines are made from viral proteins produced in bacterial, yeast, or insect cells.  They cannot cause HPV infections because there is no viral DNA in the vaccine. Instead, they stimulate the immune system to respond to the viral proteins, so if the recipient is ever exposed to that strain of HPV, the immune system will be ready to kill the virus and prevent an infection.

How awesome is that?  Get vaccinated!  Get your kids vaccinated!  Vaccines for everyone, less cancer and anogenital warts and respiratory papillomatosis for all!  Heck yes!

Still not convinced? In the next installment, I’ll answer common questions about the HPV vaccine.

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Fancci is a US osteopathic medical school student in her clinical years.  She hopes to one day open a rural family practice clinic, but first needs to survive the rest of med school and a residency.

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The Changing Social History of the Photograph

I’m sure we’ve all heard it all before. This generation will be the lost generation, because so many of its photographs are treated differently, shared instantly through avenues such as Instagram, Snapchat, Facebook, email, text message, Pinterest (and other avenues I can’t even name, let alone use) – and, if printed at all, are often printed on budget paper with cheap ink. A generation or two from now, who will be able to find grandma’s university graduation photos or aunty’s first birthday party pictures? Should we be thinking about these things?

Recently I’ve been finding myself thinking about the social history shown in collections of photographs. I’ve been trawling through the well-organised photo album collection of one of my aunts, ostensibly to locate photos of some of the family who celebrate ‘0’ birthdays this year, but finding myself thinking about everything in the background instead. With little money and plenty of ingenuity and inventiveness, the legends on the back of Christmas photos show how proud my grandfather was of his young family, and their joy and happiness is evident in their grins as they pose with their trinket shelves and books and tea sets on a sunny Christmas morning. 

Brothers and sisters pose alongside the birthday girl, with a homemade cake in pride of place on a small stool. The whole family lines up along the back of the house, dressed in school uniform, clutching suitcases and schoolbooks. An older sibling comes home from university, and the whole family gets together for a photo. A younger sibling marries, and there’s a photo of each older sibling’s family group with the bride or groom. The passport sized school photograph is distributed among the family, captured forever in the family album. Baby’s first photos are printed multiple times, mailed out to everyone in the family, preserved in albums with the appropriate age handwritten on the back.

When it came to my generation, there are photos of my brothers and me on the first day of school, or blowing out birthday candles, or dressed in cub or scout or guide uniforms. An anniversary means an endless parade of family group photos, each of them getting larger as the years go by. The weddings of my generation include the siblings (my aunts and uncles), or the mixture of cousins who attended.

And then, once we get to the age of the digital cameras, the collections I have access to both grow and shrink. In five years I think we have managed two photos with my siblings and I, one of them less than a month ago. In ten years – well, you might be able to add a couple more. 

Even the background of the photos tells you something. Fashions, in clothing, in food, in cars, in toys, even in advertisements, and road signs, and shop names and sign writing. The wedding or birthday cakes, the candles, the gifts, the buffet menu. The size of the photo, and the shape – whether square or oblong, or rounded corners. 3.5 by 5 inches, or 4 x 6. Even the fading of the colours and the albums they’re so proudly mounted in – all of it tells a story about a place and a time and a way of life.

Why did we stop posing as family groups, and move towards a parade of selfies and candid photos, and group shots with hidden faces and bunny ear fingers? Do we think we’re now invincible, or so completely documented that another photo isn’t necessary? I might remember the family weekend at the beach – but will my niece and nephew? Do we spend too much time in the here and now to look at and learn from our past, or provide a record for our future? Or do we simply not take the time to celebrate who we are and what we’re doing, moving on to the next big thing?

In fifty years, in a hundred years, what evidence will there be of our existence?

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Ratesjul is an avid reader (of almost anything) and keen amateur (emphasis on the amateur) photographer. She loves looking through collections of family photos and hearing family stories – and is in awe of her aunt’s collection of photo albums.

 

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The HPV Vaccine: Part 1

I’m here today to talk about the HPV vaccine.

I know that’s the blandest introductory sentence ever.  I’m sorry, Freshman Comp professor, but I do have a purpose behind it: most blog entries I’ve read about the HPV vaccine frame it as a controversial vaccine starting from the introductory sentence, and it really shouldn’t be controversial.  I’ve chosen to start out with an innocuous topic sentence to convey how boring and routine and non-controversial this vaccine should be.

Getting yourself or your kids the HPV vaccine should be a no-brainer, and I’m here to convince you of that fact.

First, a caveat:  There are folks who will want to turn any discussion about vaccinations into a “controversy”, because they believe Vaccines are Evil.  There are plenty of other articles debunking them and their thinking, so I’m just going to address Anti-Vaxers with this video:

https://www.youtube.com/watch?v=WrjwaqZfjIY

Now shoo, Anti-Vaxers!  We have nothing to discuss, here!

Understanding the Human Papilloma Virus (HPV)

The discussion of the virus is going to involve Science.  Trust me, even if you are Science-adverse, you are smart, and you can handle this!  Just hang with me and we’ll get through the Science together!

Okay, onward!  To the Science!

The human papilloma virus is, as the name implies, a virus.  It’s a pretty hardy little guy that can survive heat, drying, and some kinds of disinfectants, so if it gets on a surface,  it will probably stick around for a while and remain infective.  Most viruses are transmitted by skin-to-skin contact, but the fact that HPV is so resilient does make it difficult to prevent transmission.  For instance, scratching a wart and then touching a cut on a different part of your skin can transmit HPV from the wart to your fingernail to the cells at the cut.  Similarly, if someone gets HPV on their hands and it gets on the outside of a condom while the human is applying a condom during safe sex, the HPV can be transmitted to their sexual partner from the condom.  Fortunately transmission of the virus via an inanimate object (whether a condom, fingernail, or table)does not appear to be super common, but it is possible. So condoms (and other safe-sex barrier methods) have some use in reducing the spread of HPV, but they don’t completely eliminate the risk.

I mean, condoms are totally awesome in preventing all sorts of other STDs, like AIDS, or chlamydia, or gonorrhea, or pregnancy.  Absolutely practice safe sex and use condoms.  Just know that there are limits to safe sex, and unfortunately, this is one of them.

So moving on, how does the virus actually get into your body and infect you? Normal human skin is really resistant to viral entry, so HPV has to get in by a break in the skin—a scratch, a nick, or a microtear, which is a scratch so tiny you probably don’t even know you have it.  Also, mucous membranes – which cover the penis, vulva, vagina, cervix, GI tract, and anus, among other places –are particularly susceptible to microtears and don’t have as strong defenses as regular skin.  Unsurprisingly, this makes mucous membranes an easy target for HPV viruses.

Once the HPV gets past the top layer of cells in your skin or mucous membrane, the virus enters the basal cells.  Basal cells are constantly dividing and producing new cells that will become your skin cells or the cells of your mucous membrane,  so that you don’t run out of skin and walk around skinless (assuming you managed to not die of a massive infection long enough to walk around).

However, if you have HPV, then during the growth and maturation of these new cells the virus will hijack the cell’s growth process to reproduce itself – even as the cell continues to mature.  Once that virus-laden cell reaches the surface of the skin, the virus is shed off into the environment with its host cell, ready to infect more cells and repeat the cycle.

In fact, a lot of viruses reproduce and spread this way, and sometimes this can be pretty benign– including some HPV viruses.  For instance, warts are maybe kind of unsightly, but they are not going to kill you. Unfortunately, HPV can also cause cancer sometimes, which can kill you.

So, what’s the deal with HPV and cancer? Since when does a virus cause cancer, anyway? I’ll answer those questions in the next installment.

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Fancci is a US osteopathic medical school student in her clinical years.  She hopes to one day open a rural family practice clinic, but first needs to survive the rest of med school and a residency.

Please join us over on the forums to discuss this post!

Feminist Science Fiction and Fantasy Starter Kit

I have always loved reading Science Fiction and Fantasy (SFF); I loved exploring what it might be like to live in a completely different world.  At some point I began to realize that the genres I loved didn’t always love me back. The most respected stories were by men and about men, and women were often not portrayed at all, as in early Asimov, or portrayed in problematic ways, e.g. Heinlein’s women who are incredibly othered.  Newer books may be a bit less blatant, but their portrayal of women can still be really problematic. Female characters often seem like afterthoughts and women’s stories are rarely given center stage.  SFF offers a lot of ways to explore gender, yet a few months ago, when Alex Dally MacFarlane posted on Tor.com suggesting the gender binary should not be the default for SFF, she was attacked.

As a teen I read lots of books that I would now avoid. I read quite a few problematic books. I read what I could find in bookstores and libraries and on my parents’ shelves.  Some of what I read was lovely, but most of my teen reading was really sexist. Books by women and books with feminist themes were not always easy to find. Over time, I’ve figured out new ways of finding books to read so I can avoid these issues. I joined online communities (like Sheroes!) where people talked about feminist books, and I started reading SFF blogs with a feminist focus. But I know it can still be hard to find feminist books that aren’t pushed through the main channels, especially older books.

This post is for people who like the idea of feminist Science Fiction and Fantasy but aren’t quite sure where to start. I attempted to include a mix of older classics along with some newer favorites of mine. These books consider feminism and gender in a variety of ways. There are books that foreground female characters or explore gender and society.

200px-woman_on_the_edge_of_time_book_coverWoman on the Edge of Time by Marge Piercy: Simultaneously dystopic and utopic, this book is about a woman in a mental institution who visit a utopic future. The mental institution is as grim as any dystopia; however, the future she visits is very feminist with roles such as “mother” being detached from the gender of the person performing the role.  The book also explores how women are disempowered and how even people who feel powerless can shape the future.

A-door-into-oceanJPGA Door Into Ocean by Joan Slonczewski: This book uses and subverts the planet of women trope.  The planet is called Shora and the women are purple and have the most awesome eco-tech. The women have a managed ecosystem that provides for all their needs. As someone who studies ecology, I especially loved this aspect of the book. Slonczewski’s Quaker values are very much in evidence, as the main characters attempt to resolve their problems with nonviolence.

41A2XSAMWHLSlow River by Nicola Griffith: All of Griffith’s work is amazing and worth checking out, but this one happens to be my personal favorite. It’s about troubled families and finding one’s place in the world, and also using bio engineering microbes to treat sewage. I love it when the science in science fiction is biology! The main character is a queer woman, who was kidnapped and is now estranged from her family, and must work to find herself again. (Trigger warning: Child abuse)

4b98224128a0b3494b677010The Left Hand of Darkness by Ursula K. Le Guin: All of Le Guin’s work touches on feminist themes, but this one deals with gender most directly. The book features a planet were the people are physically sexless most of the time, except for a few days a month, when they become either male or female bodied in order to procreate. It is beautifully written.

 

spiritwalker

The Spiritwalker Trilogy by Kate Elliott: This series engages with feminism in a much more political sense than the works I’ve discussed so far, and features more direct discussion of the legal rights of women. This book offers a complex alternative earth, were the ice age didn’t end, the intelligent descendants of dinosaurs are still with us, Rome didn’t defeat Carthage, and, oh, there is magic. I loved Cat, the main character, who is fierce and unapologetic, and has an important relationship with her cousin, Bee.

12974372A Natural History of Dragons: A Memoir by Lady Trent by Marie Brennan: This book is secondary world fantasy about a young woman in a restricted society who wants to be a scientist. The book addresses the obstacles she faces in a very feminist manner. Brennan has a background in anthropology and folklore, which really shows in her world building.

 

cover_red_stationOn a Red Station, Drifting by Aliette de Bodard: This book is a study of two women in power. It’s also an awesome story about a complex family that lives on a space station that makes its own fish sauce.  I find the focus on domestic issues, such as running a household and planning dinner parties, traditionally women’s work, to be very feminist.

 

908311The Female Man by Joanna Russ: An under-rated classic, The Female Man mixes together the stories of women from different timelines, including the female-only society of Whileaway. Russ really focuses on feminist issues like presenting oneself as feminine and saying no to men. This book is postmodern and can be a bit hard to follow in places.

 

Bonus Nonfiction:

51aLzdI9XfL._SY344_BO1,204,203,200_The Battle of the Sexes in Science Fiction by Justine Larbalestier: A great history of feminism and SFF that looks at not only how stories have been used to discuss gender, but also the role of feminist debate within science fiction fandom. The history of women participating in SFF is often erased, so I found it very valuable to have this resource.  This book acknowledges that women have always been part of SFF, both reading and writing.

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Glory is graduate student who studies ecology, history, and community planing. She also spends too much time reading, and loves science fiction and fantasy.

 

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Keeping YouTube celebrity in perspective

TRIGGER WARNING: The following blog post includes discussion of rape, sexual assault, and underage sexual behavior. Please be careful and read at your own discretion.

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Say “YouTube” and what comes to mind for most people are cat videos, grainy home footage of dads getting hit in the crotch with tennis balls and rakes, and comment sections populated by anonymous trolls who are most likely actual Neo-Nazis. What the average Joe doesn’t know, or knows only in passing, is that for nearly two million viewers, many of whom are teenaged girls, the name of the website brings to mind almost subconsciously the word “community,” tacked onto it like a shadow.

The community is comprised, on the one hand, of a group of people who make YouTube videos for a living (“content creators”), and, on the other, of the fans who tune in on a regular basis to keep up with their favorite artists. For these people, YouTube can be a refuge from ordinary life, and a place to make likeminded friends. Most of the time, the community is warm and inviting, and whole videos may go by with nary a racial slur.

In March of 2014, however, the YouTube community was shaken to its core when sexual assault and rape allegations against at least nine high-profile male YouTubers emerged on the blog-hosting site Tumblr. Fans’ reactions to the news typically fell on one of two very different sides of the fence: visceral horror and outrage on behalf of the victims, or a reflexive defense of the beloved YouTubers.

My own response to those defending the rapists and sexual harassers was disgust, and I wrote them off as young, impassioned teenagers who had completely missed the point. Caught up in their own feelings, they were reclassifying the perpetrators as victims in need of protection, instead of empathizing with the young women who experienced sexual assault at the hands of content creators who had age, experience, and celebrity all pulling to their advantage. I didn’t understand how so many responses could be lacking any sense of measured, thoughtful distance from the shocking news.

But then, allegations appeared targeting a YouTuber I followed. Alex Day is a 24-year old white British male, an irreverently funny entrepreneur whose vlogs amplify the comedic element of day-to-day minutiae. He is also, it turns out, an expert emotional manipulator who admitted to coercing young female fans into sexual behavior they had explicitly refused.

Until this past March, I had watched Day’s videos regularly since 2011. When the accusations came to light, I had to actively restrain myself from responding with pity for Day, and redirect my emotions to where I logically knew they belonged: with the victims. Yet I felt a personal sense of betrayal, hurt, anger, and disappointment, including, but going far beyond, a natural empathy and sadness for the young women who were stepping forward.

Why?

Handily enough, YouTuber Anthony D’Angelo uploaded a video in response to the sexual harassment scandal called “The Science and Dangers of YouTube Celebrity” explaining this very phenomenon, which discusses “para-social interaction” as a reason for the knee-jerk desire to defend our favorite celebrities against negative claims. Para-social interaction is a sociology term that can be defined as “one-sided intimacy, at a distance.” Mass media is rife with opportunity for one-sided intimacy to manifest, as it offers viewers at home frequent chances to develop a feeling of community with content creators. The nature of YouTube engenders a seemingly personal connection, blurring the line between performance and reality. YouTubers often vlog from their bedrooms on a weekly basis, and many don’t use scripts. While the intimacy is fictitious, it can feel incredibly realistic.

Over the course of three years of watching his videos, my brain constructed a pattern of fondness for Alex Day, developing something that is, chemically at least, very akin to friendship. I was therefore deeply resistant to the criminal allegations that upset my expected patterns of his behavior. Instead of immediately setting aside my enjoyment of Day’s work and writing him off, I felt both the urge to defend him and a sense of betrayed friendship.

These are false feelings that must be set aside in order to fully support and honor the victims and survivors in the community. As D’Angelo says in his video, the phenomenon of para-social interaction is especially common on YouTube, “which, by its connective and egalitarian nature, puts celebrities closer to fans than ever before.” Such closeness, however, is a fabrication. While we are eagerly watching someone whom our brain has counseled us to recognize as a “friend,” we must always remember that the person on the other side is merely staring into the impassive eye of a camera.

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Marie is a writer and editor who lives with her feral cat, and, like most people, prefers dance parties to homework.

 

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