Reasons for not reaching or using web-based self-management applications, and the use and evaluation of Oncokompas among cancer survivors, in the context of a randomised controlled trial

Introduction: The web-based self-management application Oncokompas was developed to support cancer survivors to monitor health-related quality of life and symptoms (Measure) and to provide tailored information (Learn) and supportive care options (Act). In a previously reported randomised controlled trial (RCT), 68% of 655 recruited survivors were eligible, and of those 45% participated in the RCT. Among participants of the RCT that were randomised to the intervention group, 52% used Oncokompas as intended. The aim of this study was to explore reasons for not participating in the RCT, and reasons for not using Oncokompas among non-users, and the use and evaluation of Oncokompas among users. Methods: Reasons for not participating were assessed with a study-specific questionnaire among 243 survivors who declined participation. Usage was investigated among 320 participants randomised to the intervention group of the RCT via system data and a study-specific questionnaire that was assessed during the 1 week follow-up (T1) assessment. Results: Main reasons for not participating were not interested in participation in scientific research (40%) and not interested in scientific research and Oncokompas (28%). Main reasons for not being interested in Oncokompas were wanting to leave the period of being ill behind (29%), no symptom burden (23%), or lacking internet skills (18%). Out of the 320 participants in the intervention group 167 (52%) used Oncokompas as intended. Among 72 non-users, main reasons for not using Oncokompas were no symptom burden (32%) or lack of time (26%). Among 248 survivors that activated their account, satisfaction and user-friendliness were rated with a 7 (scale 0–10). Within 3 (IQR 1–4) sessions, users selected 32 (IQR 6–37) topics. Main reasons for not using healthcare options in Act were that the information in Learn was already sufficient (44%) or no supportive care needs (32%). Discussion: Main reasons for not reaching or using Oncokompas were no symptom burden, no supportive care needs, or lack of time. Users selected many cancer-generic and tumour-specific topics to address, indicating added value of the wide range of available topics

Connective tissue growth factor(CCN2), a pathogenic factor in diabetic nephropathy. What does it do? How does it do it?

Connective tissue growth factor (CTGF/CCN2) is a member of the CCN family of matricellular proteins. Its expression is induced by a number of factors including TGF-β. It has been associated with fibrosis in various tissues including the kidney. Diabetic nephropathy (DN) develops in about 30% of patients with diabetes and is characterized by thickening of renal basement membranes, fibrosis in the glomerulus (glomerulosclerosis), tubular atrophy and interstitial fibrosis, all of which compromise kidney function. This review examines changes in CTGF expression in the kidney in DN, the effects they have on glomerular mesangial and podocyte cells and the tubulointerstitium, and how these contribute to driving fibrotic changes in the disease. CTGF can bind to several other growth factors modifying their function. CTGF is also able to interact with receptors on cells, including integrins, tyrosine receptor kinase A (TrkA), low density lipoprotein receptor-related protein (LRP) and heparan sulphate proteoglycans. These interactions, the intracellular signalling pathways they activate, and the cellular responses evoked are reviewed. CTGF also induces the expression of chemokines which themselves have pharmacological actions on cells. CTGF may prompt some responses by acting through several different mechanisms, possibly simultaneously. For example, CTGF is often described as an effector of TGF-β. It can promote TGF-β signalling by binding directly to the growth factor, promoting its interaction with the TGF-β receptor; by triggering intracellular signalling on binding the TrkA receptor, which leads to the transcriptional repression of Smad7, an inhibitor of the TGF-β signalling pathway; and by binding to BMP-7 whose own signalling pathway opposing TGF-β is inhibited, leading to enhanced TGF-β signalling

Reasons for not reaching or using web-based self-management applications, and the use and evaluation of Oncokompas among cancer survivors, in the context of a randomised controlled trial

Introduction:  The web-based self-management application Oncokompas was developed to support cancer survi-vors to monitor health-related quality of life and symptoms (Measure) and to provide tailored information (Learn) and supportive care options (Act). In a previously reported randomised controlled trial (RCT), 68% of 655 recruited survivors were eligible, and of those 45% participated in the RCT. Among participants of the RCT that were randomised to the intervention group, 52% used Oncokompas as intended. The aim of this study was to explore reasons for not participating in the RCT, and reasons for not using Oncokompas among non-users, and the use and evaluation of Oncokompas among users

Enteropatia proliferativa em eqüinos Proliferative enteropathy in horses

Enteropatia proliferativa (EP), causada pela Lawsonia intracellularis, tem sido descrita em eqüinos jovens. A maioria dos relatos de EP em eqüinos é proveniente da América do Norte. Não existe ainda relato desta enfermidade em eqüinos na América Latina, apesar de a distribuição mundial da enfermidade em suínos. Portanto, é bastante provável que a EP esteja sendo negligenciada no diagnóstico de diarréias em potros desmamados. Esta revisão enfoca aspectos gerais sobre a infecção, abrangendo desde a etiologia, a epidemiologia, a patogenia, os sinais clínicos, as lesões anátomo e histopatológicas, o diagnóstico e o tratamento, alertando sobre a potencial importância de L. intracellularis como possível agente causal de diarréia em potros desmamados.<br>Proliferative enteropathy (PE), which is caused by Lawsonia intracellularis, has been recently described in young horses. The majority of horse PE cases have been reported in North America. Despite the fact that PE in swine has a worldwide distribution, there has not been any report of this disease in horse in Latin America yet. Therefore, it is very likely that L. intracellularis has been neglected on diagnosis of diarrhea in weanling foals. This review highlights general aspects about the infection, including etiology, epidemiology, pathogenesis, clinical signs, gross and histological lesions, diagnosis and treatment, and warns about the potential importance of L. intracellularis as possible causative agent of diarrhea in weanling foals

Intraperoxisomal redox balance in mammalian cells: oxidative stress and interorganellar cross-talk

Peroxisomes are capable of reactive oxygen species (ROS) generation, but their contribution to cellular redox balance is not well understood. This study demonstrates that peroxisomes and mitochondria functionally interact via ROS signaling, suggesting a potential broader role for the peroxisome in cellular aging and the initiation and progression of age-related diseases