Factors associated with fear of cancer recurrence in breast and colorectal cancer survivors: A cross-sectional study of cancer survivors.

AIM: To define the prevalence and severity of fear of cancer recurrence and identify factors associated with fear of cancer recurrence in breast cancer and colorectal cancer survivors attending the Sydney Cancer Survivorship Clinic. METHODS: A cross-sectional study was performed using prospectively collected data. Survivors completed questionnaires assessing quality of life (Functional Assessment of Cancer Therapy-General and symptoms (Distress Thermometer, Patient's Disease and Treatment Assessment Form)). Survivors were assessed by a clinical psychologist for the presence of fear of cancer recurrence. Clinical and quality of life variables were evaluated for associations with fear of cancer recurrence. RESULTS: Overall, 315 survivors (181 breast cancer, 134 colorectal cancer) were included. In total, 201 survivors (64%) had fear of cancer recurrence according to psychology assessment, and of the 118 that had fear of cancer recurrence severity recorded, 64 (54%) were rated as moderate-severe. On univariate analysis, fear of cancer recurrence was associated with younger age (P < 0.001), higher distress thermometer score (P = 0.001) and poorer overall wellbeing (P < 0.001). On multivariate analysis, younger age (P = 0.043), being bothered by side effects of treatment (P = 0.023), feeling sad (P = 0.020) and greater worry that their condition will get worse (P = 0.017) were independently associated with fear of cancer recurrence. CONCLUSIONS: Fear of cancer recurrence is common in breast and colorectal cancer survivors, and moderate-severe in over half. Fear of cancer recurrence was independently associated with younger age, feeling sad, being more bothered by side effects.

The chromatin remodelling factor ATRX suppresses R-loops in transcribed telomeric repeats.

ATRX is a chromatin remodelling factor found at a wide range of tandemly repeated sequences including telomeres (TTAGGG)n ATRX mutations are found in nearly all tumours that maintain their telomeres via the alternative lengthening of telomere (ALT) pathway, and ATRX is known to suppress this pathway. Here, we show that recruitment of ATRX to telomeric repeats depends on repeat number, orientation and, critically, on repeat transcription. Importantly, the transcribed telomeric repeats form RNA-DNA hybrids (R-loops) whose abundance correlates with the recruitment of ATRX Here, we show loss of ATRX is also associated with increased R-loop formation. Our data suggest that the presence of ATRX at telomeres may have a central role in suppressing deleterious DNA secondary structures that form at transcribed telomeric repeats, and this may account for the increased DNA damage, stalling of replication and homology-directed repair previously observed upon loss of ATRX function.

Genetic dissection of the α-globin super-enhancer in vivo.

Many genes determining cell identity are regulated by clusters of Mediator-bound enhancer elements collectively referred to as super-enhancers. These super-enhancers have been proposed to manifest higher-order properties important in development and disease. Here we report a comprehensive functional dissection of one of the strongest putative super-enhancers in erythroid cells. By generating a series of mouse models, deleting each of the five regulatory elements of the α-globin super-enhancer individually and in informative combinations, we demonstrate that each constituent enhancer seems to act independently and in an additive fashion with respect to hematological phenotype, gene expression, chromatin structure and chromosome conformation, without clear evidence of synergistic or higher-order effects. Our study highlights the importance of functional genetic analyses for the identification of new concepts in transcriptional regulation.

Fast Response, vertically oriented graphene nanosheet electric double layer capacitors synthesized from C(2)H(2).

The growth and electrical characteristics of vertically oriented graphene nanosheets grown by radio frequency plasma-enhanced chemical vapor deposition from C2H2 feedstock on nickel substrates and used as electrodes in symmetric electric double layer capacitors (EDLC) are presented. The nanosheets exhibited 2.7 times faster growth rate and much greater specific capacitance for a given growth time than CH4 synthesized films. Raman spectra showed that the intensity ratio of the D band to G band versus temperature initially decreased to a minimum value of 0.45 at a growth temperature of 750 °C, but increased rapidly with further temperature increase (1.15 at 850 °C). The AC specific capacitance at 120 Hz of these EDLC devices increased in a linear fashion with growth temperature, up to 265 µF/cm(2) (2 µm high film, 850 °C with 10 min growth). These devices exhibited ultrafast frequency response: the frequency response at -45° phase angle reached over 20 kHz. Consistent with the increase in D band to G band ratio, the morphology of the films became less vertical, less crystalline, and disordered at substrate temperatures of 800 °C and above. This deterioration in morphology resulted in an increase in graphene surface area and defect density, which, in turn, contributed to the increased capacitance, as well as a slight decrease in frequency response. The low equivalent series resistance varied from 0.07 to 0.08 Ω and was attributed to the significant carbon incorporation into the Ni substrate.

Dental health of community-living older people attending secondary healthcare: a cross-sectional comparison between those with and without diagnosed mental illness.

BACKGROUND: Mental illness and cognitive impairment are risk factors for poor dental health. METHODS: We conducted a cross-sectional study to compare the dental health of older patients attending out-patient clinics and day hospitals of old age psychiatry services (the psychiatry group, n = 103) with those attending general/geriatric medical services (the medical group; n = 99). Those living in care homes, and those with diagnosed mental illness (in the medical group) were excluded. A registered mental health nurse assessed mental and general health using validated and previously published instruments. A registered dentist made an independent assessment of dental health (examination to assess oral pathology, status of remaining teeth, and dentures) and made an overall judgment about whether the patient needed any dental treatment (a "normative" need). RESULTS: The normative need for dental treatment was significantly higher among the psychiatry group compared to the medical group (85% vs 52%; p<0.001); even after taking account of the effect of age, gender, teeth status, physical comorbidity, cognition, depressive symptoms, and overall mental and social health [adjusted odds ratio, OR (95% confidence interval): 4.32 (2.09, 8.91)]. The presence of any natural remaining teeth [OR: 4.44 (2.10, 9.42)] and Barthel Index [OR: 0.96 (0.93, 0.99)] were the two other independent predictors of the need for treatment. CONCLUSION: Dental problems are common in community-living older people, especially those with some natural remaining teeth and those with mental illness. There is a need to develop integrated mental health and dental care services for older people with emphasis on prevention of dental problems.

The effects of improving hearing in dementia.

BACKGROUND: audiological function is impaired in people with dementia and poor hearing is known to exaggerate the effects of cognitive deficits. OBJECTIVE: the objective of this study was to assess the effects of increasing auditory acuity by providing hearing aids to subjects with dementia who have mild hearing loss. METHOD: subjects were screened for hearing impairment and fitted with a hearing aid according to standard clinical practice. Measures of cognition and psychiatric symptoms, activities of daily living, and burden on carers were made over 6 months. Hearing aid diaries were kept to record the acceptability of the hearing aids to the subjects. RESULTS: more than 10% of eligible subjects were excluded as removal of wax restored hearing. Subjects showed a decline in cognitive function, no change in behavioural or psychiatric symptoms over the study period. Forty-two percent of subjects showed an improvement on an independently rated measure of change. The hearing aids were well accepted. Both carers and subjects reported overall reduction in disability from hearing impairment. CONCLUSIONS: all patients with hearing impairment require thorough examination. The presence of dementia should not preclude assessment for a hearing aid as they are well tolerated and reduce disability caused by hearing impairment. Hearing aids do not improve cognitive function or reduce behavioural or psychiatric symptoms. There is evidence that patients improved on global measures of change.