Sarcopenia and cachexia are two common and overlapping but distinct muscle wasting syndromes that predict adverse outcomes and undermine quality of life among older adults with cancer. Despite their prognostic value and negative effects on older patients’ well-being, sarcopenia and cachexia are not routinely or adequately assessed and managed in clinical oncology practice. However, efforts to recognize and manage sarcopenia and cachexia at diagnosis and during follow-up may have beneficial effects on muscle mass, physical function, and quality of life among older adults with cancer, although evidence on long-term clinical outcomes in response to targeted interventions has yet to be established. This comprehensive review attempts to (i) delineate the differences in the pathophysiology and clinical manifestations between sarcopenia and cachexia, (ii) clarify how sarcopenia and cachexia are defined in the geriatric oncology literature, (iii) describe methods for assessing sarcopenia and cachexia in clinical practice, (iv) review the prognostic value of sarcopenia and cachexia among older patients, particularly those undergoing systemic cancer treatment, and (v) discuss evidence-based strategies aimed at managing sarcopenia and cachexia for older adults with cancer.

Inverted base pavements involve a well-compacted granular aggregate base built between a thin asphalt concrete layer and a cement-treated base. Inverted base pavements can be constructed using conventional equipment and procedures but require proper quality control. This study reviews the extensive South African experience and case histories in the USA. Accumulating evidence suggests that inverted base pavements are a viable alternative and can outperform conventional pavements at a lower cost. Inverted base pavements rely on the complementary interaction between layers. The cement-treated base provides a stiff foundation for efficient compaction and constrains the deformation of the stress-sensitive granular aggregate base. The thin asphalt surface layer deforms as a membrane and develops low tensile stress. Additional large-scale field tests should be conducted to assess the performance of inverted base pavement designs in a wide range of conditions relevant to the USA.

Introduction: Sarcopenia is common in men with metastatic castrate-resistant prostate cancer (mCRPC) and has been largely assessed opportunistically through computed-tomography (CT) scans, excluding measures of muscle function. Therefore, the impact of a comprehensive assessment of sarcopenia on clinical outcomes in men with mCRPC is poorly understood. The objectives of this study were to comprehensively assess sarcopenia through CT scans and measures of muscle function and examine its impact on severe treatment toxicity, time to first emergency room (ER) visit, disease progression, and overall mortality in men initiating chemotherapy or androgen receptor-targeted axis (ARAT) therapy for mCRPC. Methods: This was a secondary analysis of a prospective observational study of men with mCRPC at the Princess Margaret Cancer Centre between July 2015-May 2021. Participants were classified as sarcopenic if they had CT-based low muscle mass or low muscle density, a grip strength and gait speed score of <35.5kg and <0.8m/s, respectively, prior to treatment initiation. The impact of sarcopenia on severe treatment toxicity was assessed using multivariable logistic regression. Multivariable Cox regression models were used to determine the impact of sarcopenia on risk of visiting the ER, prostate-specific antigen progression, radiographic progression, and overall mortality. Results: A total of 110 men (mean age: 74.6) were included in the analysis. At baseline, 30 (27.3%) were classified as sarcopenic. Sarcopenia was a significant predictor of severe toxicity (aOR = 6.26, 95%CI = 1.17–33.58, P = 0.032) and ER visits (aHR = 4.41, 95%CI = 1.26–15.43, p = 0.020) in men initiating ARAT but not in men initiating chemotherapy. Sarcopenia was also a predictor of radiographic progression (aHR = 2.39, 95%CI = 1.06–5.36, p = 0.035) and overall mortality (aHR = 2.44, 95%CI = 1.17–5.08, p = 0.018) regardless of treatment type. Conclusions: Baseline sarcopenia predicts radiographic progression and overall mortality in men with mCRPC regardless of the type of treatment and may also predict severe treatment toxicity and ER visits in men initiating ARAT.

In this study we examined changes in the salivary concentrations of immunoglobulin A (sIgA), cortisol (sC), testosterone (sT), and testosterone-to-cortisol ratio (T/C) in 21 competitive swimmers, 11–15 years old, during a week leading to competition as compared to a control (noncompetition) week. No day-to-day changes or significant differences between weeks were observed for sIgA (47.9±4.4versus54.9±5.2 μg/mL for control versus competition week, resp.), sC (2.7±0.2versus2.5±0.2 ng/mL for control versus competition week, resp.), and T/C ratio (83.4±7.0versus77.9±7.7for control versus competition week, resp.). In contrast, sT was significantly lower during the week of competition (154.5±11.3 pg/mL) as compared to the control week (181.3±11.5 pg/mL) suggesting that the swimmers were in a catabolic state, although this did not have a negative effect on their performance. In conclusion, salivary cortisol did not change between the two weeks, and thus competition stress was relatively low, and mucosal immunity was unaffected in these young athletes prior to competition.