Frailty in older people living with HIV: current status and clinical management

This paper will update care providers on the clinical and scientific aspects of frailty which affects an increasing proportion of older people living with HIV (PLWH). The successful use of combination antiretroviral therapy has improved long-term survival in PLWH. This has increased the proportion of PLWH older than 50 to more than 50% of the HIV population. Concurrently, there has been an increase in the premature development of age-related comorbidities as well as geriatric syndromes, especially frailty, which affects an important minority of older PLWH. As the number of frail older PLWH increases, this will have an important impact on their health care delivery. Frailty negatively affects a PLWH's clinical status, and increases their risk of adverse outcomes, impacting quality of life and health-span. The biologic constructs underlying the development of frailty integrate interrelated pathways which are affected by the process of aging and those factors which accelerate aging. The negative impact of sarcopenia in maintaining musculoskeletal integrity and thereby functional status may represent a bidirectional interaction with frailty in PLWH. Furthermore, there is a growing body of literature that frailty states may be transitional. The recognition and management of related risk factors will help to mitigate the development of frailty. The application of interdisciplinary geriatric management principles to the care of older PLWH allows reliable screening and care practices for frailty. Insight into frailty, increasingly recognized as an important marker of biologic age, will help to understand the diversity of clinical status occurring in PLWH, which therefore represents a fundamentally new and important aspect to be evaluated in their health care

Specific detection of OCT3/4 isoform A/B/B1 expression in solid (germ cell) tumours and cell lines: Confirmation of OCT3/4 specificity for germ cell tumours

Background: OCT3/4 (POU5F1) is an established diagnostic immunohistochemical marker for specific histological variants of human malignant germ cell tumours (GCTs), including the seminomatous types and the stem cell component of non-seminomas, known as embryonal carcinoma. OCT3/4 is crucial for the regulation of pluripotency and the self-renewal of normal embryonic stem-and germ cells. Detection of expression of this transcription factor is complicated by the existence of multiple pseudogenes and isoforms. Various claims have been made about OCT3/4 expression in non-GCTs, possibly related to using nonspecific detection methods. False-positive findings undermine the applicability of OCT3/4 as a specific diagnostic tool in a clinical setting. In addition, false-positive findings could result in misinterpretation of pluripotency regulation in solid somatic cancers and their stem cells. Of the three identified isoforms-OCT4A, OCT4B and OCT4B1-only OCT4A proved to regulate pluripotency. Up until now, no convincing nuclear OCT4A protein expression has been shown in somatic cancers or tissues. Methods: This study investigates expression of the various OCT3/4 isoforms in GCTs (both differentiated and undifferentiated) and somatic (non-germ cell) cancers, including representative cell lines and xenografts. Results: Using specific methods, OCT4A and OCT4B1 are shown to be preferentially expressed in undifferentiated GCTs. The OCT4B variant shows no difference in expression between GCTs (either differentiated or undifferentiated) and somatic cancers. In spite of the presence of OCT4A mRNA in somatic cancer-derived cell lines, no OCT3/4

The syntax of ‘-cā’ (*-kwe) in Ahunavaiti Gāthā

This paper seeks to provide a full description of the syntactic behaviour of the enclitic co-ordinate conjunction -cā in the earliest stage of the Avestan language. By studying the occurrences of the particle in Ahunavaiti Gāthā, a distributive analysis is provided together with an interpretative hypothesis of its distributive dynamics. Two syntactic levels, phrase and sentence, are taken into consideration. Finally, a syntactic domain-based variation is argued and two clitic functional variants are identified as synchronically operating conjunction strategies

Assessment of Kansas Beef Producers’ Perception and Knowledge Level of Business-to-Consumer Marketing

Objective: The objective of this study was to assess the perception and knowledge level of Kansas beef producers regarding business-to-consumer marketing. Study Description: A digital survey was created to assess the perception and knowledge level of business-to-consumer (B2C) marketing of Kansas beef producers. The survey was disseminated to Kansas beef producers utilizing the Shop Kansas Farms online social networking group. Results: Results from this study showed that 25.5% of beef producer respondents (n = 41) raise another species in addition to beef. It was found that 50.0% of survey respondents sold 20 or fewer head of finished beef cattle in 2020, with 43.9% selling 100% of their beef to individual consumers. Furthermore, 61.0% of respondents reported an increase in sales to individual consumers in 2020 compared to previous years, with 75.0% indicating sales to large beef processors were about the same. An increase in individual consumer sales was classified as “very desirable” by 73.0% of respondents, and 87.1% believe sales to individual consumers are the most profitable marketing channel. There were 72.2% of respondents selling beef in a B2C market for 1–10 years, with 47.2% reporting that repeat customers make up 75% of their sales. Word of mouth was the most common method of product marketing, as indicated by 91.6% of producers. Concerns or complaints from consumers were noted by 38.9%. It was believed by 47.1% of respondents that an improvement in consumer knowledge would be “very effective” to prevent future complaints or concerns. Moreover, an increase in producer knowledge was believed by 31.03% to be “extremely effective” in preventing future complaints or concerns. Finally, it was believed that an increase in state extension resources would be “moderately” or “very” effective in improving consumer and producer knowledge by 46.9% and 33.3% of respondents, respectively. The Bottom Line: Producers self-reported B2C marketing to be the most profitable marketing channel within their operation. However, many are not utilizing this channel to its full potential, and many have experienced consumer concerns or complaints. This study confirms the need for more state extension resources to support B2C marketing for beef producers in Kansas and sets the foundation for future research priorities

Contrastive prosody and the subsequent mention of alternatives during discourse processing

Linguistic research has long viewed prosody as an important indicator of information structure in intonationally rich languages like English. Correspondingly, numerous psycholinguistic studies have shown significant effects of prosody, particularly with respect to the immediate processing of a prosodically prominent phrase. Although co-reference resolution is known to be influenced by information structure, it has been less clear whether prosodic prominence can affect decisions about next mention in a discourse, and if so, how. We present results from an open-ended story continuation task, conducted as part of a series of experiments that examine how prosody influences the anticipation and resolution of co-reference. Overall results from the project suggest that prosodic prominence can increase or decrease reference to a saliently pitch-accented phrase, depending on additional circumstances of the referential decision. We argue that an adequate account of prosody’s role in co-reference requires consideration of how the processing system interfaces with multiple levels of linguistic representation

Safety and immunogenicity of a bivalent cytomegalovirus DNA vaccine in healthy adult subjects.

BACKGROUND: VCL-CB01, a candidate cytomegalovirus (CMV) DNA vaccine that contains plasmids encoding CMV phosphoprotein 65 (pp65) and glycoprotein B (gB) to induce cellular and humoral immune responses and that is formulated with poloxamer CRL1005 and benzalkonium chloride to enhance immune responses, was evaluated in a phase 1 clinical trial. METHODS: VCL-CB01 was evaluated in 44 healthy adult subjects (22 CMV seronegative and 22 CMV seropositive) 18-43 years old. Thirty-two subjects received 1- or 5-mg doses of vaccine on a 0-, 2-, and 8-week schedule, and 12 subjects received 5-mg doses of vaccine on a 0-, 3-, 7-, and 28-day schedule. RESULTS: Overall, the vaccine was well tolerated, with no serious adverse events. Local reactions included mild to moderate injection site pain and tenderness, induration, and erythema. Systemic reactions included mild to moderate malaise and myalgia. All reactions resolved without sequelae. Through week 16 of the study, immunogenicity, as measured by enzyme-linked immunosorbant assay and/or ex vivo interferon (IFN)-gamma enzyme-linked immunospot assay, was documented in 45.5% of CMV-seronegative subjects and in 25.0% of CMV-seropositive subjects who received the full vaccine series, and 68.1% of CMV-seronegative subjects had memory IFN-gamma T cell responses at week 32. CONCLUSION: The safety and immunogenicity data from this trial support further evaluation of VCL-CB01

Evaluation of Kansas Beef Consumers’ Awareness and Understanding of Business-to-Consumer Marketing

Objective: The objective of the study was to determine the understanding and knowledge level of consumers purchasing beef in a business-to-consumer (B2C) format within Kansas. Study Description: A digital survey was created to evaluate consumers’ familiarity and satisfaction of buying beef in a B2C format. The survey was made available for a two-week period to consumers utilizing the Shop Kansas Farms online social media group. Results: Results of the survey showed 93% of consumers (n = 174) reported having previously purchased beef products from a local producer or locker. Of these, 63.1% reported that their most recent purchase was their first time purchasing in a B2C format and the same percentage of consumers had been purchasing beef in a B2C format for less than five years. The most common methods of purchasing beef in a B2C format were “portion cuts” (24.5%), followed by “quarter beef” (17.0%) and “half beef” (15.1%), or a combination of at least two of these methods (20.7%). Only 5.7% of consumers experienced challenges while purchasing beef in a B2C format, yet 100% of those consumers still intended to continue purchasing beef in this format. When consumers were given options that would be useful to prevent future complaints, the most selected response was “improved consumer knowledge.” The consumers (n = 82) who rated this response as “very effective” or “extremely effective” indicated that “increased state extension resources” would be at least “moderately effective” (82.9%). This indicates that increased state extension resources would be an effective way to improve consumer knowledge. The Bottom Line: Consumers within the state of Kansas are interested in and have positive experiences with purchasing beef in the B2C format. Moreover, most consumers are new consumers to buying beef in the B2C format, indicating that there is increasing demand for beef available for purchase in this format. Results of this study support this but show room for growth within consumer understanding of purchasing beef in a B2C format. Results of this study shows the opportunity for improvement of extension and other resources for consumers

Transmembrane Protein TMEM230, Regulator of Glial Cell Vascular Mimicry and Endothelial Cell Angiogenesis in High-Grade Heterogeneous Infiltrating Gliomas and Glioblastoma

High-grade gliomas (HGGs) and glioblastoma multiforme (GBM) are characterized by a heterogeneous and aggressive population of tissue-infiltrating cells that promote both destructive tissue remodeling and aberrant vascularization of the brain. The formation of defective and permeable blood vessels and microchannels and destructive tissue remodeling prevent efficient vascular delivery of pharmacological agents to tumor cells and are the significant reason why therapeutic chemotherapy and immunotherapy intervention are primarily ineffective. Vessel-forming endothelial cells and microchannel-forming glial cells that recapitulate vascular mimicry have both infiltration and destructive remodeling tissue capacities. The transmembrane protein TMEM230 (C20orf30) is a master regulator of infiltration, sprouting of endothelial cells, and microchannel formation of glial and phagocytic cells. A high level of TMEM230 expression was identified in patients with HGG, GBM, and U87-MG cells. In this study, we identified candidate genes and molecular pathways that support that aberrantly elevated levels of TMEM230 play an important role in regulating genes associated with the initial stages of cell infiltration and blood vessel and microchannel (also referred to as tumor microtubule) formation in the progression from low-grade to high-grade gliomas. As TMEM230 regulates infiltration, vascularization, and tissue destruction capacities of diverse cell types in the brain, TMEM230 is a promising cancer target for heterogeneous HGG tumors

Transmembrane protein TMEM230, a target of glioblastoma therapy

Glioblastomas (GBM) are the most aggressive tumors originating in the brain. Histopathologic features include circuitous, disorganized, and highly permeable blood vessels with intermittent blood flow. These features contribute to the inability to direct therapeutic agents to tumor cells. Known targets for anti-angiogenic therapies provide minimal or no effect in overall survival of 12–15 months following diagnosis. Identification of novel targets therefore remains an important goal for effective treatment of highly vascularized tumors such as GBM. We previously demonstrated in zebrafish that a balanced level of expression of the transmembrane protein TMEM230/C20ORF30 was required to maintain normal blood vessel structural integrity and promote proper vessel network formation. To investigate whether TMEM230 has a role in the pathogenesis of GBM, we analyzed its prognostic value in patient tumor gene expression datasets and performed cell functional analysis. TMEM230 was found necessary for growth of U87-MG cells, a model of human GBM. Downregulation of TMEM230 resulted in loss of U87 migration, substratum adhesion, and re-passaging capacity. Conditioned media from U87 expressing endogenous TMEM230 induced sprouting and tubule-like structure formation of HUVECs. Moreover, TMEM230 promoted vascular mimicry-like behavior of U87 cells. Gene expression analysis of 702 patients identified that TMEM230 expression levels distinguished high from low grade gliomas. Transcriptomic analysis of patients with gliomas revealed molecular pathways consistent with properties observed in U87 cell assays. Within low grade gliomas, elevated TMEM230 expression levels correlated with reduced overall survival independent from tumor subtype. Highest level of TMEM230 correlated with glioblastoma and ATP-dependent microtubule kinesin motor activity, providing a direction for future therapeutic intervention. Our studies support that TMEM230 has both glial tumor and endothelial cell intracellular and extracellular functions. Elevated levels of TMEM230 promote glial tumor cell migration, extracellular scaffold remodeling, and hypervascularization and abnormal formation of blood vessels. Downregulation of TMEM230 expression may inhibit both low grade glioma and glioblastoma tumor progression and promote normalization of abnormally formed blood vessels. TMEM230 therefore is both a promising anticancer and antiangiogenic therapeutic target for inhibiting GBM tumor cells and tumor-driven angiogenesis