Using experience from supporting medical students to develop effective near-peer mentoring in Higher Education

Near-peer mentoring has been used within Higher Education settings for several years to support students through their transition from secondary to tertiary education. The goals of mentorship centre around support, development, and retention of students who themselves feel satisfied, fully engaged in their learning environment and are socially responsible. Having a more experienced mentor (near-peer) with lived experience can help guide and engage mentees providing measurable benefits to both, with mentees gaining a greater degree of social support and insight into their future learning requirements to help navigate them through their academic journey, and mentors enhancing their interpersonal skills such as communication, listening, networking and leadership. With the growing evidence that near-peer mentoring benefits all involved, it is perhaps unsurprising it is becoming commonplace in Higher Education. However, for these benefits to be recognised it is essential that behind the scenes there are dedicated staff who develop and support the peer mentoring programme ensuring they are fit for purpose. The following tips draw on experience of near-peer mentoring within a medical education setting but are considered applicable and transferable to other Higher Education programmes. Fundamental to all successful near-peer mentoring schemes should be clearly defined processes for selection, training (Tips 1-4) and programme implementation (Tips 5-9). Continuous reflection, improvement, and the importance of near-peer mentor recognition (Tip 10) should also be at the forefront of any near-peer mentoring scheme

Virtual peer mentoring: A partnership between two UK Medical Schools

The first-year student experience in Higher Education (HE) is complex due to the multiple life changing events occurring within this period. It is therefore important that universities embed accessible welfare support for students transitioning into HE. With near-peer support receiving recent credit for its benefit to medical students, the University of Nottingham (UoN) Medical School established a peer mentoring scheme where second-year students act as mentors to their first-year peers. The establishment of the Lincoln Medical School (LMS) in 2018, formed from a partnership between UoN and University of Lincoln (UoL), led to the inception of the Virtual Peer Mentoring (VPM) scheme. With the acknowledgement that there was a lack of near-peer support for the LMS students, VPMs were recruited from a pool of students who had been peer mentors at the UoN Medical School, with the responsibility of offering support to this cohort of students virtually, given the separate locations of the two campuses. As a novel concept between two UK Medical Schools, an evaluation of the VPM scheme revealed a positive experience for the VPMs. However, challenges identified by the peer mentees included the lack of face-to-face interactions, limited insight into the geographical and local knowledge of Lincoln and the limited use of technology to aid the virtual relationship. In acknowledging these limitations, with adjustments, there is scope to refine and enhance the VPM scheme, especially within the current climate of the coronavirus pandemic and beyond

Sustained maternal inflammation during the early third trimester yields fetal adaptations that impair subsequent skeletal muscle growth and glucose metabolism in sheep

Intrauterine growth restriction (IUGR) is linked to metabolic dysfunction in offspring, but the mediating mechanisms are still under investigation (Barker et al., 1993). IUGR fetuses adapt to their poor intrauterine environment by repartitioning nutrients to organs critical for survival (i.e., brain, heart) at the expense of tissues such as muscle (Yates et al., 2012c). These developmental adaptations help the fetus to survive in utero but have lifelong consequences in offspring; persistent reduction of highly metabolic muscle mass is detrimental to glucose homeostasis (DeFronzo et al., 1981). Glucose metabolism is regulated primarily by insulin, and nutrient depravation is associated with impaired β-cell mass, insulin secretion, and insulin action in the IUGR fetus (Limesand et al., 2006). Moreover, inflammation disrupts insulin action and aids in the development of insulin resistance (Bach et al., 2013). We recently showed that inflammatory cytokines acutely stimulate glucose metabolism despite their antagonistic effects on insulin signaling (Cadaret et al., 2017b). However, we hypothesize that chronic exposure alters responsiveness to cytokines and results in basal cytokine concentrations having a greater inhibitory tone. Furthermore, chronic maternal inflammation may induce fetal inflammatory adaptations that impair muscle growth and metabolism. Therefore, our objective was to determine the effects of sustained maternal inflammation on fetal growth, islet function, and muscle glucose metabolism

Sustained maternal inflammation during the early third trimester yields fetal adaptations that impair subsequent skeletal muscle growth and glucose metabolism in sheep

Intrauterine growth restriction (IUGR) is linked to metabolic dysfunction in offspring, but the mediating mechanisms are still under investigation (Barker et al., 1993). IUGR fetuses adapt to their poor intrauterine environment by repartitioning nutrients to organs critical for survival (i.e., brain, heart) at the expense of tissues such as muscle (Yates et al., 2012c). These developmental adaptations help the fetus to survive in utero but have lifelong consequences in offspring; persistent reduction of highly metabolic muscle mass is detrimental to glucose homeostasis (DeFronzo et al., 1981). Glucose metabolism is regulated primarily by insulin, and nutrient depravation is associated with impaired β-cell mass, insulin secretion, and insulin action in the IUGR fetus (Limesand et al., 2006). Moreover, inflammation disrupts insulin action and aids in the development of insulin resistance (Bach et al., 2013). We recently showed that inflammatory cytokines acutely stimulate glucose metabolism despite their antagonistic effects on insulin signaling (Cadaret et al., 2017b). However, we hypothesize that chronic exposure alters responsiveness to cytokines and results in basal cytokine concentrations having a greater inhibitory tone. Furthermore, chronic maternal inflammation may induce fetal inflammatory adaptations that impair muscle growth and metabolism. Therefore, our objective was to determine the effects of sustained maternal inflammation on fetal growth, islet function, and muscle glucose metabolism

Herbal Dietary Supplements: Safety, Efficacy, and Use by Breast Cancer Survivors

Gemstone Team IMAC (Integrative Medicine and Cancer)Herbal dietary supplements (HDS) are widely used in complementary, alternative, and integrative medicine, but data on attitudes, behavior, safety, and efficacy are lacking. Using mixed methods, we administered an online survey to >1,000 breast cancer survivors to investigate HDS practices and perceptions and performed in vitro studies assessing the efficacy and toxicity of actein, a bioactive component of the HDS black cohosh (Actaea racemosa). Among cancer survivors, curcumin, flaxseed, and green tea were reported as the most frequently used HDS. Many subjects increased HDS intake after diagnosis and sought web-based information on HDS. In human breast cancer (MCF-7) and liver (HepG2/C3A) cell lines, actein had anti-proliferative and anti-estrogenic effects and did not exhibit hepatotoxicity or affect the action of tamoxifen and raloxifene

Case report: whole exome sequencing of primary cardiac angiosarcoma highlights potential for targeted therapies

Abstract Background Primary cardiac angiosarcomas are rare, but they are the most aggressive type of primary cardiac neoplasms. When patients do present, it is with advanced pulmonary and/or cardiac symptoms. Therefore, many times the correct diagnosis is not made at the time of initial presentation. These patients have metastatic disease and the vast majority of these patients die within a few months after diagnosis. Currently the treatment choices are limited and there are no targeted therapies available. Case presentation A 56-year-old male presented with shortness of breath, night sweats, and productive cough for a month. Workup revealed pericardial effusion and multiple bilateral pulmonary nodules suspicious for metastatic disease. Transthoracic echocardiogram showed a large pericardial effusion and a large mass in the base of the right atrium. Results of biopsy of bilateral lung nodules established a diagnosis of primary cardiac angiosarcoma. Aggressive pulmonary disease caused rapid deterioration; the patient went on hospice and subsequently died. Whole exome sequencing of the patient\u2019s postmortem tumor revealed a novel KDR (G681R) mutation, and focal high-level amplification at chromosome 1q encompassing MDM4 , a negative regulator of TP53. Conclusion Mutations in KDR have been reported previously in angiosarcomas. Previous studies also demonstrated that KDR mutants with constitutive KDR activation could be inhibited with specific KDR inhibitors in vitro. Thus, patients harboring activating KDR mutations could be candidates for treatment with KDR-specific inhibitors

A cross-sectional national investigation of COVID-19 outbreaks in nurseries during rapid spread of the Alpha (B.1.1.7) variant of SARS-CoV-2 in England

Background: In England, the emergence the more transmissible SARS-CoV-2 variant Alpha (B.1.1.7) led to a third national lockdown from December 2020, including restricted attendance at schools. Nurseries, however, remained fully open. COVID-19 outbreaks (≥ 2 laboratory-confirmed cases within 14 days) in nurseries were investigated to assess the risk of SARS-CoV-2 infection and cumulative incidence in staff and children over a three-month period when community SARS-CoV-2 infections rates were high and the Alpha variant was spreading rapidly across England. Methods: This was a cross-sectional national investigation of COVID-19 outbreaks in nurseries across England. Nurseries reporting a COVID-19 outbreak to PHE between November 2020 and January 2021 were requested to complete a questionnaire about their outbreak. Results: Three hundred and twenty-four nurseries, comprising 1% (324/32,852) of nurseries in England, reported a COVID-19 outbreak. Of the 315 (97%) nurseries contacted, 173 (55%) reported 1,657 SARS-CoV-2 cases, including 510 (31%) children and 1,147 (69%) staff. A child was the index case in 45 outbreaks (26%) and staff in 125 (72%) outbreaks. Overall, children had an incidence rate of 3.50% (95%CI, 3.21–3.81%) and was similar irrespective of whether the index case was a child (3.55%; 95%CI, 3.01–4.19%) or staff (3.44%; 95%CI, 3.10–3.82%). Among staff, cumulative incidence was lower if the index case was a child (26.28%; 95%CI, 23.54–29.21%%) compared to a staff member (32.98%; 95%CI, 31.19–34.82%), with the highest cumulative incidence when the index case was also a staff member (37.52%; 95%CI, 35.39–39.70%). Compared to November 2020, outbreak sizes and cumulative incidence was higher in January 2021, when the Alpha variant predominated. Nationally, SARS-CoV-2 infection rates in < 5 year-olds remained low and followed trends in older age-groups, increasing during December 2020 and declining thereafter. Conclusions: In this cross-sectional study of COVID-19 outbreaks in nurseries, one in three staff were affected compared to one in thirty children. There was some evidence of increased transmissibility and higher cumulative incidence associated with the Alpha variant, highlighting the importance of maintaining a low level of community infections

Evaluating the Effects of SARS-CoV-2 Spike Mutation D614G on Transmissibility and Pathogenicity.

Global dispersal and increasing frequency of the SARS-CoV-2 spike protein variant D614G are suggestive of a selective advantage but may also be due to a random founder effect. We investigate the hypothesis for positive selection of spike D614G in the United Kingdom using more than 25,000 whole genome SARS-CoV-2 sequences. Despite the availability of a large dataset, well represented by both spike 614 variants, not all approaches showed a conclusive signal of positive selection. Population genetic analysis indicates that 614G increases in frequency relative to 614D in a manner consistent with a selective advantage. We do not find any indication that patients infected with the spike 614G variant have higher COVID-19 mortality or clinical severity, but 614G is associated with higher viral load and younger age of patients. Significant differences in growth and size of 614G phylogenetic clusters indicate a need for continued study of this variant