Re-engage: A novel nurse-led program for survivors of childhood cancer who are disengaged from cancer-related care

Background: Survivors of childhood cancer often experience treatmentrelated chronic health conditions. Survivorship care improves survivors' physical and mental health, yet many are disengaged from care. Innovative models of care are necessary to overcome patient-reported barriers to accessing survivorship care and to maximize survivors' health. Methods:We piloted a novel survivorship program, called "Reengage,"a distance-delivered, nurse-led intervention aiming to engage, educate, and empower survivors not receiving any cancerrelated care. Re-engage involves a nurse-led consultation delivered via telephone/online to establish survivors' medical history and needs. Participants completed questionnaires at baseline, 1 month postintervention, and 6-month follow-up. Results: A total of 27 survivors who had not accessed survivorship care in the last 2 years participated (median age, 31 years; interquartile range [IQR], 27-39 years); of which, 82% were at high-risk for treatment-related complications. Participation in Re-engage was high (75%) and there was no attrition once survivors enrolled. At 1 month postintervention, 92% of survivors reported that Re-engage was "beneficial,"which all survivors reported at 6-month follow-up. Survivors' overall satisfaction with their care increased from 52% before Re-engage to 84% at 1 month postintervention. Survivors' mean self-efficacy scores remained similar from baseline to 1 month postintervention (b520.33, 95% CI, 21.31 to 0.65), but increased significantly from baseline to 6-month follow-up (b 5 1.64, 95% CI, 0.28-3.00). At 6-month follow-up, 73% of survivors showed an increase in health-related self-efficacy compared with baseline. Conclusions: Re-engage is a highly acceptable and feasible intervention and promotes health-related self-efficacy, which is integral to survivors being advocates for their own health. Further empirical work is needed to evaluate the long-term efficacy of Re-engage. Trial registration: ACTRN12618000194268

Combined effect of regulatory polymorphisms on transcription of UGT1A1 as a cause of Gilbert syndrome

<p>Abstract</p> <p>Background</p> <p>Gilbert syndrome is caused by defects in bilirubin UDP-glucuronosyltransferase (UGT1A1). The most common variation believed to be involved is A(TA)7TAA. Although several polymorphisms have been found to link with A(TA)7TAA, the combined effect of regulatory polymorphisms in the development of Gilbert syndrome remains unclear.</p> <p>Methods</p> <p>In an analysis of 15 patients and 60 normal subjects, we detected 14 polymorphisms and nine haplotypes in the regulatory region. We classified the 4-kbp regulatory region of the patients into: the TATA box including A(TA)7TAA; a phenobarbital responsive enhancer module including c.-3275T>G; and a region including other ten linked polymorphisms. The effect on transcription of these polymorphisms was studied.</p> <p>Results</p> <p>All haplotypes with A(TA)7TAA had c.-3275T>G and additional polymorphisms. In an <it>in-vitro </it>expression study of the 4-kbp regulatory region, A(TA)7TAA alone did not significantly reduce transcription. In contrast, c.-3275T>G reduced transcription to 69% of that of wild type, and the linked polymorphisms reduced transcription to 88% of wild type. Transcription of the typical regulatory region of the patients was 56% of wild type. Co-expression of constitutive androstane receptor (CAR) increased the transcription of wild type by a factor of 4.3. Each polymorphism by itself did not reduce transcription to the level of the patients, however, even in the presence of CAR.</p> <p>Conclusions</p> <p>These results imply that co-operation of A(TA)7TAA, c.-3275T>G and the linked polymorphisms is necessary in causing Gilbert syndrome.</p

Global heat balance and heat uptake in potential temperature coordinates

The representation of ocean heat uptake in Simple Climate Models used for policy advice on climate change mitigation strategies is often based on variants of the one-dimensional Vertical Advection/Diffusion equation (VAD) for some averaged form of potential temperature. In such models, the effective advection and turbulent diffusion are usually tuned to emulate the behaviour of a given target climate model. However, because the statistical nature of such a ``behavioural" calibration usually obscures the exact dependence of the effective diffusion and advection on the actual physical processes responsible for ocean heat uptake, it is difficult to understand its limitations and how to go about improving VADs. This paper proposes a physical calibration of the VAD that aims to provide explicit traceability of effective diffusion and advection to the processes responsible for ocean heat uptake. This construction relies on the coarse-graining of the full three-dimensional advection diffusion for potential temperature using potential temperature coordinates. The main advantage of this formulation is that the temporal evolution of the reference temperature profile is entirely due to the competition between effective diffusivity that is always positive definite, and the water mass transformation taking place at the surface, as in classical water mass analyses literature. These quantities are evaluated in numerical simulations of present day climate and global warming experiments. In this framework, the heat uptake in the global warming experiment is attributed to the increase of surface heat flux at low latitudes, its decrease at high latitudes and to the redistribution of heat toward cold temperatures made by diffusive flux

Multifaceted Regulation of Translational Readthrough by RNA Replication Elements in a Tombusvirus

Translational readthrough of stop codons by ribosomes is a recoding event used by a variety of viruses, including plus-strand RNA tombusviruses. Translation of the viral RNA-dependent RNA polymerase (RdRp) in tombusviruses is mediated using this strategy and we have investigated this process using a variety of in vitro and in vivo approaches. Our results indicate that readthrough generating the RdRp requires a novel long-range RNA-RNA interaction, spanning a distance of ∼3.5 kb, which occurs between a large RNA stem-loop located 3'-proximal to the stop codon and an RNA replication structure termed RIV at the 3'-end of the viral genome. Interestingly, this long-distance RNA-RNA interaction is modulated by mutually-exclusive RNA structures in RIV that represent a type of RNA switch. Moreover, a different long-range RNA-RNA interaction that was previously shown to be necessary for viral RNA replicase assembly was also required for efficient readthrough production of the RdRp. Accordingly, multiple replication-associated RNA elements are involved in modulating the readthrough event in tombusviruses and we propose an integrated mechanistic model to describe how this regulatory network could be advantageous by (i) providing a quality control system for culling truncated viral genomes at an early stage in the replication process, (ii) mediating cis-preferential replication of viral genomes, and (iii) coordinating translational readthrough of the RdRp with viral genome replication. Based on comparative sequence analysis and experimental data, basic elements of this regulatory model extend to other members of Tombusviridae, as well as to viruses outside of this family

Tracking changes between preprint posting and journal publication during a pandemic.

Amid the Coronavirus Disease 2019 (COVID-19) pandemic, preprints in the biomedical sciences are being posted and accessed at unprecedented rates, drawing widespread attention from the general public, press, and policymakers for the first time. This phenomenon has sharpened long-standing questions about the reliability of information shared prior to journal peer review. Does the information shared in preprints typically withstand the scrutiny of peer review, or are conclusions likely to change in the version of record? We assessed preprints from bioRxiv and medRxiv that had been posted and subsequently published in a journal through April 30, 2020, representing the initial phase of the pandemic response. We utilised a combination of automatic and manual annotations to quantify how an article changed between the preprinted and published version. We found that the total number of figure panels and tables changed little between preprint and published articles. Moreover, the conclusions of 7.2% of non-COVID-19-related and 17.2% of COVID-19-related abstracts undergo a discrete change by the time of publication, but the majority of these changes do not qualitatively change the conclusions of the paper