Frailty-Related Factors among Women Living with and without HIV Aged 40 Years and Older. The Women's Interagency HIV Study.

BACKGROUND: Frailty is a clinical, geriatric syndrome linked to disability and mortality; and may be associated with a variety of factors among underrepresented and underserved women living with HIV (WLWH) and without HIV (WLWOH) transitioning through the adult life course. OBJECTIVES: Determine whether a published set of factors associated cross-sectionally with frailty in WLWH and similar WLWOH at average age 39 years in 2005/2006 were associated with frailty in 2018/2019 among women who initiated frailty assessments at age ≥40 years, or whether a new set of factors were associated with frailty. DESIGN: Cross-sectional analyses within a longitudinal cohort study. SETTING: The multi-center Women's Interagency HIV Study (WIHS). PARTICIPANTS: 1285 participants (951 WLWH, 334 WLWOH), median age 53 years (interquartile range 47-58 years). MEASUREMENTS: The Fried Frailty Phenotype (FFP) in association with 23 factors representing HIV serostatus, other infections, sociodemographic factors, health behaviors, and chronic diseases. RESULTS: Frailty prevalence was 11.1% in 2018/2019 (12.6% among WLWOH, 9.6% among WLWH, p=0.121). The published 2005/2006 final multivariable stepwise regression model contained 9 predictors of frailty. When refit to women in 2018/2019, only age ≥50 years and annual income ≤$12,000 were independently positively associated with frailty; other significant 2005/2006 factors, HIV serostatus, CD4+ count <500 cells/mL among WLWH, smoking, drinking, FIB-4 and eGFR, were not. A newly-derived stepwise model considering all 23 predictors measured in 2018/2019, showed independent positive associations between frailty and age ≥50 years, annual income ≤$12,000, obesity (body mass index (BMI) ≥30kg/m2), and history of tuberculosis and cancer. CONCLUSION: Different chronic and infectious disease factors were associated with frailty among WLWH and WLWOH over the adult life course. Understanding factors associated with frailty by adult life stage, allows identification and implementation of novel, temporal interventions to alleviate frailty-associated outcomes and enhance quality of life among WLWH and WLWOH.

Frailty and Constellations of Factors in Aging HIV-infected and Uninfected Women--The Women's Interagency HIV Study.

BACKGROUND: Biological similarities are noted between aging and HIV infection. Middle-aged adults with HIV infection may present as elderly due to accelerated aging or having more severe aging phenotypes occurring at younger ages. OBJECTIVES: We explored age-adjusted prevalence of frailty, a geriatric condition, among HIV+ and at risk HIV- women. DESIGN: Cross-sectional. SETTING: The Women's Interagency HIV Study (WIHS). PARTICIPANTS: 2028 middle-aged (average age 39 years) female participants (1449 HIV+; 579 HIV-). MEASUREMENTS: The Fried Frailty Index (FFI), HIV status variables, and constellations of variables representing Demographic/health behaviors and Aging-related chronic diseases. Associations between the FFI and other variables were estimated, followed by stepwise regression models. RESULTS: Overall frailty prevalence was 15.2% (HIV+, 17%; HIV-, 10%). A multivariable model suggested that HIV infection with CD4 count<200; age>40 years; current or former smoking; income ≤$12,000; moderate vs low fibrinogen-4 (FIB-4) levels; and moderate vs high estimated glomerular filtration rate (eGFR) were positively associated with frailty. Low or moderate drinking was protective. CONCLUSIONS: Frailty is a multidimensional aging phenotype observed in mid-life among women with HIV infection. Prevalence of frailty in this sample of HIV-infected women exceeds that for usual elderly populations. This highlights the need for geriatricians and gerontologists to interact with younger 'at risk' populations, and assists in the formulation of best recommendations for frailty interventions to prevent early aging, excess morbidities and early death.

Ovarian function in the giant tiger prawn (Penaeus monodon) as determined by in vitro bioassay.

Ovary tissue fragments of the giant tiger prawn Penaeus monodon were incubated in vitro with L-methionine[35S] plus L-cysteine[35S] as a metabolic labeling reagent. The labeled cytoplasmic and secreted proteins synthesized in vitro during incubations under various conditions were subjected to SDS polyacrylamide electrophoresis and visualized by autoradiography. Vitellogenin (Vg) was immunologically identified and shown to be actively synthesized and released into the incubation medium. The synthesis and release of Vg into the incubation medium was optimized and shown to be linear over a 16-h period. Comparisons between different ovarian regions and different stages of development revealed that the level of Vg synthesis and accumulation in the incubation media was variable depending on stage of development and region within the ovary. Coincubation of ovarian fragments with sinus gland extracts showed a dose-related inhibition of total protein and Vg synthesis. The in vitro ovarian bioassay is suitable for examining the effect of hormonal inputs of P. monodon.

Neutralization of tiger snake (Notechis scutatus) venom by serum from other Australian elapids.

Sera from four Australian elapids and one boidid (python) were tested for their ability to protect neonatal mice against the toxic action of tiger snake (Notechis scutatus) venom. Of the five serum samples tested, only serum from Pseudechis australis and Pseudechis porphyriacus were capable of neutralizing the tiger snake venom. In addition, neutralization was shown to be highly variable within serum taken from individual snakes of the same species (P. porphyriacus). Previously, only viperid and colubrid snakes have been shown to possess neutralizing factors against snake venoms.

Differentiation of asymptomatic patients from symptomatic patients by the slope of the forced vergence fixation disparity curve.

Eighty-nine optometry students were divided into an asymptomatic group and a symptomatic group on the basis of a case history. A forced vergence fixation disparity (FD) curve was generated for each subject using a Disparometer (Vision Analysis, Columbus, Ohio). Slopes were calculated for each curve. In addition, each curve was labeled steep or flat based on a previously determined cutoff point of -0.96 min/delta (Sheedy, 1980). Steep curves did not correlate well with symptomatic patients, whereas flat curves did not correlate well with asymptomatic patients. An independent t-test found no significant difference between the two groups.