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Presents a rationale for studying the visual language of film. Reports on three studies that suggest some tentative answers concerning the manipulation of film and some promising approaches to the study of the medium. (RL)

Background: Electronic frailty indices (eFIs) can expand measurement of frailty in research and practice and have demonstrated predictive validity in associations with clinical outcomes. However, their construct validity is less well studied. We aimed to assess the construct validity of the VA-FI, an eFI developed for use in the U.S. Veterans Affairs Healthcare System., Methods: Veterans who underwent comprehensive geriatric assessments between January 31, 2019 and June 6, 2022 at VA Boston and had sufficient data documented for a comprehensive geriatric assessment-frailty index (CGA-FI) were included. The VA-FI, based on diagnostic and procedural codes, and the CGA-FI, based on geriatrician-measured deficits, were calculated for each patient. Geriatricians also assessed the Clinical Frailty Scale (CFS), functional status (ADLs and IADLs), and 4-meter gait speed (4MGS)., Results: A total of 132 veterans were included, with median age 81.4 years (IQR 75.8-88.7). Across increasing levels of VA-FI (<0.2; 0.2-0.4; >0.4), mean CGA-FI increased (0.24; 0.30; 0.40). The VA-FI was moderately correlated with the CGA-FI (r 0.45, p < 0.001). Every 0.1-unit increase in the VA-FI was associated with an increase in the CGA-FI (linear regression beta 0.05; 95% confidence interval [CI] 0.03-0.06), higher CFS category (ordinal regression OR 1.69; 95% CI 1.24-2.30), higher odds of ADL dependency (logistic regression OR 1.59; 95% CI 1.20-2.11), IADL dependency (logistic regression OR 1.68; 95% CI 1.23-2.30), and a decrease in 4MGS (linear regression beta -0.07, 95% CI -0.12 to -0.02). All models were adjusted for age and race, and associations held after further adjustment for the Charlson Comorbidity Index., Conclusion: Our results demonstrate the construct validity of the VA-FI through its associations with clinical measures of frailty, including summary frailty measures, functional status, and objective physical performance. Our findings complement others' in showing that eFIs can capture functional and mobility domains of frailty beyond just comorbidity and may be useful to measure frailty among populations and individuals., (Published 2023. This article is a U.S. Government work and is in the public domain in the USA.)

While cancer immunotherapies have become central to treatment, challenges associated with the ability of tumors to evade the immune system remain significant obstacles. At the heart of this issue is the tumor immune microenvironment, the complex interplay of the tumor microenvironment and the immune response. Recent advances in mRNA cancer vaccines represent major progress towards overcoming some of the challenges posed by deleterious components of the tumor immune microenvironment. Indeed, major breakthroughs in mRNA vaccine technology, such as the use of replacement nucleotides and lipid nanoparticle delivery, led to the vital success of mRNA vaccine technology in fighting COVID-19. This has in turn generated massive additional interest and investment in the platform. In this review, we detail recent research in the nature of the tumor immune microenvironment and in mRNA cancer vaccines and discuss applications by which mRNA cancer vaccines, often in combination with various adjuvants, represent major areas of potential in overcoming tumor immune microenvironment-imposed obstacles. To this end, we also review current mRNA cancer vaccine clinical trials.

We describe the design, synthesis, and antitumor activity of an 18 carbon α,ω-dicarboxylic acid monoconjugated via an ester linkage to paclitaxel (PTX). This 1,18-octadecanedioic acid-PTX ( ODDA-PTX ) prodrug readily forms a noncovalent complex with human serum albumin (HSA). Preservation of the terminal carboxylic acid moiety on ODDA-PTX enables binding to HSA in the same manner as native long-chain fatty acids (LCFAs), within hydrophobic pockets, maintaining favorable electrostatic contacts between the ω-carboxylate of ODDA-PTX and positively charged amino acid residues of the protein. This carrier strategy for small molecule drugs is based on naturally evolved interactions between LCFAs and HSA, demonstrated here for PTX. ODDA-PTX shows differentiated pharmacokinetics, higher maximum tolerated doses and increased efficacy in vivo in multiple subcutaneous murine xenograft models of human cancer, as compared to two FDA-approved clinical formulations, Cremophor EL-formulated paclitaxel (crPTX) and Abraxane (nanoparticle albumin-bound (nab)-paclitaxel).