An operational definition of musculoskeletal decline in older people is needed to allow development of interventions for prevention or treatment, as was developed for the treatment of osteoporosis. ...Frailty and sarcopenia are linked, but distinct, correlates of musculoskeletal aging that have many causes, including age-related changes in body composition, inflammation, and hormonal imbalance. With the emergence of a number of exciting candidate therapies to retard the loss of muscle mass with aging, the derivation of a consensual definition of sarcopenia and physical frailty becomes an urgent priority. Although several consensual definitions have been proposed, these require clinical validation. An operational definition, which might provide a threshold for treatment/trial inclusion, should incorporate a loss of muscle mass as well as evidence of a decrease in muscle strength and/or physical activity. Evidence is required for a link between improvements in the measures of muscle strength and/or physical activity and clinical outcomes to allow development of interventions to improve clinical outcomes in frail older patients.
There is a growing body of evidence that links nutrition to muscle mass, strength and function in older adults, suggesting that it has an important role to play both in the prevention and management ...of sarcopenia. This review summarises the discussions of a working group ESCEO working group meeting 8th September 2016 that met to review current evidence and to consider its implications for preventive and treatment strategies. The review points to the importance of ‘healthier’ dietary patterns that are adequate in quality in older age, to ensure sufficient intakes of protein, vitamin D, antioxidant nutrients and long-chain polyunsaturated fatty acids. In particular, there is substantial evidence to support the roles of dietary protein and physical activity as key anabolic stimuli for muscle protein synthesis. However, much of the evidence is observational and from high-income countries. Further high-quality trials, particularly from more diverse populations, are needed to enable an understanding of dose and duration effects of individual nutrients on function, to elucidate mechanistic links, and to define optimal profiles and patterns of nutrient intake for older adults.
We present that the next-generation Enriched Xenon Observatory (nEXO) is a proposed experiment to search for neutrinoless double- β (0νββ) decay in 136Xe with a target half-life sensitivity of ...approximately 1028 yr using 5 × 103 kg of isotopically enriched liquid-xenon in a time projection chamber. This improvement of two orders of magnitude in sensitivity over current limits is obtained by a significant increase of the 136Xe mass, the monolithic and homogeneous configuration of the active medium, and the multiparameter measurements of the interactions enabled by the time projection chamber. Finally, the detector concept and anticipated performance are presented based upon demonstrated realizable background rates.
Results from a search for neutrinoless double-beta decay (0νββ) of ^{136}Xe are presented using the first year of data taken with the upgraded EXO-200 detector. Relative to previous searches by ...EXO-200, the energy resolution of the detector has been improved to σ/E=1.23%, the electric field in the drift region has been raised by 50%, and a system to suppress radon in the volume between the cryostat and lead shielding has been implemented. In addition, analysis techniques that improve topological discrimination between 0νββ and background events have been developed. Incorporating these hardware and analysis improvements, the median 90% confidence level 0νββ half-life sensitivity after combining with the full data set acquired before the upgrade has increased twofold to 3.7×10^{25} yr. No statistically significant evidence for 0νββ is observed, leading to a lower limit on the 0νββ half-life of 1.8×10^{25} yr at the 90% confidence level.
Venetoclax (ABT-199), a specific inhibitor of the anti-apoptotic protein Bcl-2, is currently in phase I clinical trials for multiple myeloma. The results suggest that venetoclax is only active in a ...small cohort of patients therefore we wanted to determine its efficacy when used in combination. Combining venetoclax with melphalan or carfilzomib produced additive or better cell death in four of the five cell lines tested. The most striking results were seen with dexamethasone (Dex). Co-treatment of human myeloma cell lines and primary patient samples, with Dex and venetoclax, significantly increased cell death over venetoclax alone in four of the five cell lines, and in all patient samples tested. The mechanism by which this occurs is an increase in the expression of both Bcl-2 and Bim upon addition of Dex. This results in alterations in Bim binding to anti-apoptotic proteins. Dex shifts Bim binding towards Bcl-2 resulting in increased sensitivity to venetoclax. These data suggest that knowledge of drug-induced alterations of Bim-binding patterns may help inform better combination drug regimens. Furthermore, the data indicate combining this novel therapeutic with Dex could be an effective therapy for a broader range of patients than would be predicted by single-agent activity.
The COHERENT experiment is well poised to test sub-GeV dark matter models using detectors sensitive to coherent elastic neutrino-nucleus scattering (CEvNS) in the π+ decay-at-rest (π-DAR) neutrino ...beam produced by the Spallation Neutron Source. We show a planned 750-kg single-phase liquid argon scintillation detector would place leading limits on scalar light dark matter models for dark matter particles produced through vector and leptophobic portals in the absence of other effects beyond the standard model. The characteristic timing profile of a π-DAR beam allows a unique opportunity for constraining systematic uncertainties on the standard model background using a time window where dark matter signal is not expected, enhancing expected sensitivity. Additionally, we discuss future prospects which show that an on-axis CEvNS detector would probe the thermal abundance for a scalar dark matter candidate for all couplings α′ ≤ 1 for 15 MeV dark matter with just 1.0 tonne-yr of exposure with increased exposure testing a wider range of dark matter masses and spins.
Many extensions of the standard model of particle physics suggest that neutrinos should be Majorana-type fermions-that is, that neutrinos are their own anti-particles-but this assumption is difficult ...to confirm. Observation of neutrinoless double-β decay (0νββ), a spontaneous transition that may occur in several candidate nuclei, would verify the Majorana nature of the neutrino and constrain the absolute scale of the neutrino mass spectrum. Recent searches carried out with (76)Ge (the GERDA experiment) and (136)Xe (the KamLAND-Zen and EXO (Enriched Xenon Observatory)-200 experiments) have established the lifetime of this decay to be longer than 10(25) years, corresponding to a limit on the neutrino mass of 0.2-0.4 electronvolts. Here we report new results from EXO-200 based on a large (136)Xe exposure that represents an almost fourfold increase from our earlier published data sets. We have improved the detector resolution and revised the data analysis. The half-life sensitivity we obtain is 1.9 × 10(25) years, an improvement by a factor of 2.7 on previous EXO-200 results. We find no statistically significant evidence for 0νββ decay and set a half-life limit of 1.1 × 10(25) years at the 90 per cent confidence level. The high sensitivity holds promise for further running of the EXO-200 detector and future 0νββ decay searches with an improved Xe-based experiment, nEXO.
Prior studies have shown that myeloma patients exhibiting either genetically defined high-risk disease or plasma cell leukemia have a poor outcome with a median overall survival (OS) of ≤3 years. ...Results of IFM 2005-01 and 02 suggest that relatively limited bortezomib-containing induction regimens did not produce a major survival benefit among these patients. However, results of recent studies suggest that combination therapy may benefit these patients when given early and again later in the treatment. We evaluated a combination maintenance/consolidation regimen (RVD) following autologous stem cell transplant (ASCT) for high-risk patients to evaluate the impact of this approach on outcome. Following initiation of RVD maintenance, 51% of patients achieved stringent complete response (sCR), with 96% achieving at least VGPR as best response. Median progression free survival (PFS) for all patients is 32 months with a 3-year OS of 93%. The regimen was well tolerated with no grade 3/4 neuropathy. Early ASCT followed by RVD maintenance is a promising strategy for high-risk myeloma patients and delivered excellent response rates, and promising PFS and OS.