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

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

Young men’s body dissatisfaction: A qualitative analysis of anonymous online accounts

Associated with numerous adverse health outcomes, body dissatisfaction in young men requires close examination. This study explores online accounts relating to male body image, including young men’s personal disclosures within one online newspaper article, and posts responding to this topic. Discursively informed thematic analysis indicated that non-disclosure was considered a problematic social expectation by the young men featured in the article. Also, reader posts variously constructed body dissatisfaction as a symptom of adolescence, a lack of self-care and an incapacity to capitalise on compensatory qualities. Our analysis suggests young men may welcome safe opportunities to critically discuss prevailing body image ideals

Primordial Germ Cell Specification from Embryonic Stem Cells

Background: Primordial germ cell (PGC) specification is the first crucial step in germ line development. However, owing to significant challenges regarding the in vivo system, such as the complex cellular environment and potential problems with embryo manipulation, it is desirable to generate embryonic stem (ES) cells that are capable of overcoming these aforementioned limitations in order to provide a potential in vitro model to recapitulate the developmental processes in vivo. Methodology and Principal Findings: Here, we studied the detailed process of PGC specification from stella-GFP ES cells. We first observed the heterogeneous expression of stella in ES cells. However, neither Stella-positive ES cells nor Stellanegative ES cells shared a similar gene expression pattern with either PGCs or PGC precursors. Second, we derived PGCs from ES cells using two differentiation methods, namely the attachment culture technique and the embryoid body (EB) method. Compared with PGCs derived via the attachment culture technique, PGCs derived via the EB method that had undergone the sequential erasure of Peg3 followed by Igf2r resulted in a cell line in which the expression dynamics of T, Fgf8 and Sox17, in addition to the expression of the epiblast markers, were more similar to the in vivo expression, thus demonstrating that the process of PGC derivation was more faithfully recapitulated using the EB method. Furthermore, we developed an in vitro model of PGC specification in a completely chemically defined medium (CDM) that indicated that BMP4 and Wnt3a promoted PGC derivation, whereas BMP8b and activinA had no observable effect on PGC derivation

Ambivalence related to potential lifestyle changes following preventive cardiovascular consultations in general practice: A qualitative study

<p>Abstract</p> <p>Background</p> <p>Motivational interviewing approaches are currently recommended in primary prevention and treatment of cardiovascular disease (CVD) in general practice in Denmark, based on an empirical and multidisciplinary body of scientific knowledge about the importance of motivation for successful lifestyle change among patients at risk of lifestyle related diseases. This study aimed to explore and describe motivational aspects related to potential lifestyle changes among patients at increased risk of CVD following preventive consultations in general practice.</p> <p>Methods</p> <p>Individual interviews with 12 patients at increased risk of CVD within 2 weeks after the consultation. Grounded theory was used in the analysis.</p> <p>Results</p> <p>Ambivalence related to potential lifestyle changes was the core motivational aspect in the interviews, even though the patients rarely verbalised this experience during the consultations. The patients experienced ambivalence in the form of conflicting feelings about lifestyle change. Analysis showed that these feelings interacted with their reflections in a concurrent process. Analysis generated a typology of five different ambivalence sub-types: perception, demand, information, priority and treatment ambivalence.</p> <p>Conclusion</p> <p>Ambivalence was a common experience in relation to motivation among patients at increased risk of CVD. Five different ambivalence sub-types were found, which clinicians may use to explore and resolve ambivalence in trying to aid patients to adopt lifestyle changes. Future research is needed to explore whether motivational interviewing and other cognitive approaches can be enhanced by exploring ambivalence in more depth, to ensure that lifestyle changes are made and sustained. Further studies with a wider range of patient characteristics are required to investigate the generalisability of the results.</p